Chinese pediatrician beliefs about counseling and medications for parents who smoke: a survey in southern China

Background: Pediatricians play an important role in promoting smoking cessation among the parents of young children as more behavioral counseling and cessation treatment are made available in the Chinese healthcare system. However, beliefs about the effectiveness of these interventions can influence pediatricians’ recommendations to their patients. This study examined pediatricians’ beliefs regarding effectiveness of counseling and medications for smoking cessation. Methods: A cross-sectional survey of pediatricians was conducted in thirteen conveniently selected southern Chinese hospitals, during September to December 2013. A self-administered questionnaire was used for data collection. We used chi square tests and multinomial logistic regression analysis to identify factors associated with beliefs regarding effectiveness of counseling and medications for smoking cessation. Results: Beliefs of the respondents (504/550; 92% response rate) were divided regarding the effectiveness of counseling and medications for smoking cessation. Sixty percent believed that physician counseling is effective for smoking cessation; 53% believed pharmacological products (or medications) are effective. Factors that were associated with positive beliefs towards the effectiveness of counseling included: believing about the professional responsibility to discuss smoking cessation, being confident in discussing smoking cessation or SHS exposure reduction with patients’ parents, believing that health professionals should routinely ask about their patients smoking habits, believing that health professionals should routinely advise their smoking patients to quit smoking, possessing adequate knowledge in quitting smoking, and being able to assess smokers different stages of readiness to quit. Most of the above factors were also associated with the belief that medication is effective for smoking cessation. Conclusions: A substantial proportion of Chinese pediatricians believed that cessation counseling and medications are not effective, which is not supported by current evidence in the field. Several factors including individual, practice level and health system level characteristics were associated with their belief. Training efforts are needed to influence pediatricians’ beliefs regarding the effectiveness of cessation counseling and medications

Testosterone Is Associated with Erectile Dysfunction: A Cross-Sectional Study in Chinese Men

Testosterone is essential for the regulation of erectile physiology, but the relationship between low testosterone and erectile dysfunction (ED) has not been firmly established.To examine the association between serum total, free and bio-available testosterone and ED in a population-based sample.A consecutive series of 1776 men aged 20–77 participated in the routine physical examination from September 2009 to December 2009 in Guangxi, China. ED was assessed using the five-item International Index of Erectile Function (IIEF-5) questionnaire. Total testosterone (TT), sex hormone binding globulin (SHBG) and other biochemical profiles were measured. Free testosterone (FT) and bio-available testosterone (BT) were calculated based on Vermeulen’s formula. Data were collected with regard to smoking, alcoholic drinking, physical activity and metabolic syndrome.The prevalence of ED (IIEF-5<22) was 47.6%. Men with ED were significantly older, and more prone to smoke cigarettes (≥20 cigarettes/day) or drink alcohol (≥3 drinks/week), and more likely to have elevated blood pressure (P = 0.036) or hyperglycemia (P<0.001) compared with those without ED. The significant increase in SHBG with age was parallel to its increase with increasing severity of ED (P<0.001). The obscure increase in TT across the ED status was detected without significance (P = 0.418), but TT was positively associated with ED after adjustment for age [odds ratio (OR)  = 1.02, 95% CI (confidence internal): 1.00–1.04]. FT and BT were inversely associated with ED (OR = 0.14, 95%CI: 0.06–0.33; OR = 0.92 (95%CI: 0.89–0.96, respectively) in the univariate analysis, and this inverse association appeared to be independent of smoking status, alcoholic drinking, physical activity, hyper-triglyceridemia and hyperglycemia.FT and BT are inversely related to worsening ED, whereas the positive association between TT and ED is most likely due to the increase in SHBG

The Cytoplasmic Domain of MUC1 Induces Hyperplasia in the Mammary Gland and Correlates with Nuclear Accumulation of β-Catenin

MUC1 is an oncoprotein that is overexpressed in up to 90% of breast carcinomas. A previous in vitro study by our group demonstrated that the cytoplasmic domain of MUC1 (MUC1-CD), the minimal functional unit of MUC1, contributes to the malignant phenotype in cells by binding directly to β-catenin and protecting β-catenin from GSK3β-induced degradation. To understand the in vivo role of MUC1-CD in breast development, we generated a MUC1-CD transgenic mouse model under the control of the MMTV promoter in a C57BL/6J background, which is more resistant to breast tumor. We show that the expression of MUC1-CD in luminal epithelial cells of the mammary gland induced a hyperplasia phenotype characterized by the development of hyper-branching and extensive lobuloalveoli in transgenic mice. In addition to this hyperplasia, there was a marked increase in cellular proliferation in the mouse mammary gland. We further show that MUC1-CD induces nuclear localization of β-catenin, which is associated with a significant increase of β-catenin activity, as shown by the elevated expression of cyclin D1 and c-Myc in MMTV-MUC1-CD mice. Consistent with this finding, we observed that overexpression of MUC1-C is associated with β-catenin nuclear localization in tumor tissues and increased expression of Cyclin D1 and c-Myc in breast carcinoma specimens. Collectively, our data indicate a critical role for MUC1-CD in the development of mammary gland preneoplasia and tumorigenesis, suggesting MUC1-CD as a potential target for the diagnosis and chemoprevention of human breast cancer

Effect of CO2 flooding in an oil reservoir with strong bottom-water drive in the Tahe Oilfield, Tarim Basin, Northwest China

The dissolution and diffusion of CO2 in oil and water and its displacement mechanism were investigated by laboratory experiment and numerical simulation for Block 9 in the Tahe oilfield, a sandstone oil reservoir with strong bottom-water drive in Tarim Basin, Northwest China. Such parameters were analyzed as solubility ratio of CO2 in oil, gas and water, interfacial tension, in-situ oil viscosity distribution, remaining oil saturation distribution, and oil compositions. The results show that CO2 flooding could control water coning and increase oil production. In the early stage of the injection process, CO2 expanded vertically due to gravity differentiation, and extended laterally under the action of strong bottom water in the intermediate and late stages. The CO2 got enriched and extended at the oil-water interface, forming a high interfacial tension zone, which inhibited the coning of bottom water to some extent. A miscible region with low interfacial tension formed at the gas injection front, which reduced the in-situ oil viscosity by about 50%. The numerical simulation results show that enhanced oil recovery (EOR) is estimated at 5.72% and the oil exchange ratio of CO2 is 0.17 t/t

Progress and prospects of EOR technology in deep, massive sandstone reservoirs with a strong bottom-water drive

The Triassic massive sandstone reservoir in the Tahe oilfield has a strong bottom-water drive and is characterized by great burial depth, high temperature and salinity, a thin pay zone, and strong heterogeneity. At present, the water-cut is high in each block within the reservoir; some wells are at an ultra-high water-cut stage. A lack of effective measures to control water-cut rise and stabilize oil production have necessitated the application of enhanced oil recovery (EOR) technology. This paper investigates the development and technological advances for oil reservoirs with strong edge/bottom-water drive globally, and compares their application to reservoirs with characteristics similar to the Tahe oilfield. Among the technological advances, gas injection from the top and along the direction of structural dip has been used to optimize the flow field in a typical bottom-water drive reservoir. Bottom-water coning is restrained by gas injection-assisted water control. In addition, increasing the lateral driving pressure differential improves the plane sweep efficiency which enhances oil recovery in turn. Gas injection technology in combination with technological measures like channeling prevention and blocking, and water plugging and profile control, can achieve better results in reservoir development. Gas flooding tests in the Tahe oilfield are of great significance to identifying which EOR technology is the most effective and has the potential of large-scale application for improving development of deep reservoirs with a strong bottom-water drive

Nonlinear association between proteinuria levels and the risk of cardiovascular disease events and all-cause mortality among chronic kidney disease patients

AbstractBackground The association between proteinuria levels and cardiovascular disease (CVD) development and all-cause mortality in chronic kidney disease (CKD) patients remains controversial.Methods In this investigation, we conducted a retrospective analysis involving 1138 patients who were registered in the CKD-Research of Outcomes in Treatment and Epidemiology (ROUTE) study. The primary outcome of this study was the composite of cardiovascular events or all-cause death. Cox proportional hazards regression, smooth curve fitting, piecewise linear regression, and subgroup analyses were used.Results The mean age of the included individuals was 67.3 ± 13.6 years old. Adjusted hazard ratios (HRs) for UPCR in middle and high groups, compared to the low group, were 1.93 (95% CI: 1.28–2.91) and 4.12 (95% CI: 2.87–5.92), respectively, after multivariable adjustment. Further adjustments maintained significant associations; HRs for middle and high groups were 1.71 (95% CI: 1.12–2.61) and 3.07 (95% CI: 2.08–4.54). A nonlinear UPCR-primary outcome relationship was observed, with an inflection point at 3.93 g/gCr.Conclusion Among non-dialyzed patients with stage G2-G5 CKD, a nonlinear association between UPCR and the primary outcome was observed. A higher UPCR (when UPCR < 3.93 g/gCr) was an independent predictor of the primary outcome. Importantly, our study predates SGLT2 inhibitor use, showcasing outcomes achievable without these medications. Future research considerations will involve factors like SGLT-2 inhibitor utilization

Estimating the Railway Network Capacity Utilization with Mixed Train Routes and Stopping Patterns: A Multiobjective Optimization Approach

Railway capacity estimation problem is typically defined as estimating the maximum number of trains that can be operated in a railway section within a given time interval. However, trains with different speeds, routes, and stopping patterns in a railway network will likely compete for the limited capacity of network nodes and sections. As these trains may provide different services, it is ambiguous to simply indicate the network capacity by a scalar number of trains. To comprehensively estimate and interpret the railway capacity considering the capacity competition between heterogeneous trains, we propose a multiobjective perspective for the capacity estimation problem to enrich the capacity theory while handling the competition among trains with different routes and stopping patterns. Based on a time-space network timetable saturation model, we extend the multiobjective capacity estimation approach to the detailed timetable level by optimizing the saturated timetable under capacity estimation objectives with respect to different routes and stopping patterns. With the ε-constraint method, we can obtain the Pareto front of saturated timetables, i.e., a set of nondominated optimized timetables that no more candidate train can be additionally scheduled. The result is a more comprehensive capacity representation than a single absolute scalar number. A case study is conducted on a combined high-speed and intercity network of Zhengzhou Railway group in China. An extensive set of Pareto-optimal saturated timetables describing the effects on the capacity of the railway network is obtained. The results can help infrastructure managers select saturated timetables as the capacity utilization reference by considering the trade-off between time indexes from passengers’ and operators’ perspectives

Railway capacity estimation considering vehicle circulation: Integrated timetable and vehicles scheduling on hybrid time-space networks

Railway capacity is a vague concept, related to the possibility to run a maximal transport performance given a set of available resources. While most approaches focus only on infrastructure resources (i.e. availability of train paths), we include both infrastructure and vehicle resources in a capacity estimation problem. We study the railway capacity estimation problem applying an associated timetable saturation method; in other words, the capacity is related to a timetable where no additional trains can be added. We use optimization methods to find such a timetable integrating explicitly variables and constraints from vehicle circulation. A hybrid time–space network describes the integrated timetabling and vehicles scheduling problem, based on which an integer programming model can be formulated, to maximize the overall transportation performance. A Lagrangian relaxation-based decomposition algorithm is proposed to solve the problem, and is shown able to scale to large instances efficiently. The integrated scheduling problem is decomposed into a timetabling sub-problem and a vehicle circulation sub-problem by dualizing the consistency constraints linking the two. A new heuristic, based on the concept of timetable intensity, is employed to improve the quality of the feasible (non-relaxed) solution found. The experimental result shows the benefit of the approach, which can evaluate transportation performance and relate it to various fleet sizes, vehicle depot locations, and minimum headways