Determinants of never-treated status in rural versus urban contexts for individuals with schizophrenia in a population-based study in China

Background A goal of China’s 2012 National Mental Health Law is to improve access to services and decrease urban versus rural disparities in services. However, pre-reform data is needed for objective evaluation of these reforms’ effectiveness. Accordingly, this study compares the pre-reform utilization of medical services for the treatment of schizophrenia in rural and urban communities in China. Methods In a large community-based study in four provinces representing 12% of China’s population conducted from 2001 to 2005, we identified 326 individuals with schizophrenia (78 never treated). Comparing those living in urban (n = 86) versus rural (n = 240) contexts, we used adjusted Poisson regression models to assess the relationship of ‘never treated’ status with family-level factors (marital status, family income, and number of co-resident family members) and illness severity factors (age of onset, symptom severity and functional impairment). Results Despite similar impairments due to symptoms, rural patients were less likely to have received intensive mental health services (i.e., use psychiatric inpatient services), and appeared more likely to be ‘never treated’ or to only have received outpatient care. Among rural patients, only having more than four co-resident family members was independently associated with ‘never-treated’ status (RR = 0.34; 95% CI, 0.12–0.94; p = 0.039). Among urban patients, only older age of onset was independently associated with ‘never-treated’ status (RR = 1.06; 95% CI 1.02–1.10, p = 0.003). Conclusions Identifying differential drivers of service utilization in urban and rural communities is needed before implementing policies to improve the utilization and equity of services and to define metrics of program success

Fetal Isolated Anomalous Origin of Right Pulmonary Artery from Aorta

Abstract The anomalous origin of a branch pulmonary artery from the aorta (AOPA) is characterized by the anomalous origin of one of the branch pulmonary arteries (PA) from the ascending aorta and a normal origin of the other PA from main PA. AOPA is an extremely rare cardiac malformation. Few studies have reported fetal anomalous origin of PA from aorta with other malformation. We report a case of isolated distal anomalous origin of the right PA from the aorta that was diagnosed by fetal echocardiography at 25 weeks' of gestation. Tracing the course of PA branches is important to make diagnosis

Pesticide exposure and suicidal ideation in rural communities in Zhejiang province, China

OBJECTIVE: To investigate the association between pesticide exposure and suicidal ideation in rural areas of China. METHODS: The analysis involved data from a survey of a representative sample of 9811 rural residents in Zhejiang province who had been asked about the storage of pesticides at home and about whether or not they had considered suicide within the 2 years before the interview. The Chinese version of the 12-item General Health Questionnaire (GHQ) was administered to screen for mental disorder. FINDINGS: The unadjusted odds ratio (OR) for the association between pesticide storage at home and suicidal ideation over the prior 2 years was 2.12 (95% confidence interval, CI: 1.54-2.93). After adjusting for gender, age, education, socioeconomic status, marital status, physical health, family history of suicidal behaviour, GHQ caseness and study design effects, the OR was 1.63 (95% CI: 1.13-2.35). CONCLUSION: A potential marker of chronic pesticide exposure was found to be associated with suicidal ideation, which supports findings from previous studies. Given the high level of pesticide exposure and the high suicide risk in rural China, clarification of the causal mechanisms underlying this association and the development of appropriate interventions are priorities for public health and health policy

Comparing levocardia and dextrocardia in fetuses with heterotaxy syndrome: prenatal features, clinical significance and outcomes

Abstract Background To investigate the differences in cardiovascular disease, extracardiac anomalies and outcomes between fetuses with levocardia and dextrocardia. Methods Clinical demographics, prenatal features, postnatal characteristics and the outcomes of fetuses with levocardia or dextrocardia were recorded and analyzed. Results Sixty-five fetuses with dextrocardia and thirty-eight fetuses with levocardia were enrolled. Right ventricle outlet obstruction, atrioventricular septal defect and intestinal malrotation were common in both groups. Univentricular physiology, transposition of the great arteries and esophageal atresia were more frequent in fetuses with levocardia, whereas abnormal pulmonary venous connection, double outlet of right ventricle, left ventricle outlet obstruction and brain abnormalities were more frequent in the dextrocardia group. The accuracy of evaluating cardiac malformations was high, but the sensitivity in assessing extracardiac abnormalities was low. Conclusions Although the disorders have certain overlapping features, there are several differences between fetuses with levocardia and dextrocardia. These findings might improve patient counseling and perinatal management

Enhancing ignition and combustion characteristics of micron-sized aluminum powder in steam by adding sodium fluoride

Micron-sized aluminum powder exhibits difficulties in ignition and burnout in steam. To overcome these problems, we added various sodium fluoride contents to micron-sized aluminum powder in steam at 800, 900, and 1000 degrees C to assess their effects on ignition and combustion performances. The ignition delay times, ignition temperatures, and combustion characteristics of all samples were measured primarily using two high-temperature tube resistance electric furnace systems. The experiments showed that adding sodium fluoride to micron-sized aluminum powder decreases its ignition delay time and temperature. Moreover, the ignition delay time and temperature of aluminum powder with addition of sodium fluoride decreases considerably when the temperature increases. For this study, the components and morphology of solid combustion products were obtained using X-ray diffraction and scanning electron microscopy. The combustion efficiency was measured volumetrically using a specially designed apparatus. The obtained combustion efficiency was found to increase with the amount of sodium fluoride added and increase in the temperature. The relationship among the parameters related to combustion characteristics and product characterization was examined in detail to reveal the combustion mechanism. (C) 2019 Published by Elsevier Inc. on behalf of The Combustion Institute

Malnutrition in early life and adult mental health: Evidence from a natural experiment

As natural experiments, famines provide a unique opportunity to test the health consequences of nutritional deprivation during the critical period of early life. Using data on 4,972 Chinese born between 1956 and 1963 who participated in a large mental health epidemiology survey conducted between 2001 and 2005, we investigated the potential impact of famine exposure in utero and during the early postnatal life on adult mental illness. The risk of mental illness was assessed with the 12-item General Health Questionnaire (GHQ-12) and eight other risk factors, and the famine impact on adult mental illness was estimated by difference-in-difference models. Results show that compared with women born in 1963, women born during the famine years (1959–1961) had higher GHQ scores (increased by 0.95 points; CI: 0.26, 1.65) and increased risk of mental illness (OR= 2.80; CI: 1.23, 6.39); those born in 1959 were the most affected and had GHQ scores 1.52 points higher (CI: 0.42, 2.63) and an OR for mental illness of 4.99 (CI: 1.68, 14.84). Compared to men in the 1963 birth cohort, men born during the famine had lower GHQ scores (decreased by 0.89 points; CI: −1.59, −0.20) and a nonsignificant decrease in the risk of mental illness (OR = 0.60; CI: 0.26, 1.40). We speculate that the long-term consequences of early-life famine exposure include both the selection of the hardiest and the enduring deleterious effects of famine on those who survive. The greater biological vulnerability and stronger natural selection in utero of male versus female fetuses during severe famine may result in a stronger selection effect among men than women, obscuring the deleterious impact of famine exposure on the risk of mental illness in men later in life

A high performance contra-rotating energy harvester and its wireless sensing application toward green and maintain free vehicle monitoring

Intelligent transportation necessitates advanced perception and cognitive systems that can provide continuous feedback from the vehicle. However, sensors relying on batteries face challenges such as high maintenance costs and environmental issues due to the limited lifespan of the power source. To overcome these challenges, this paper reports an efficient battery-free solution for transportation monitoring. The solution utilizes a speed-amplified rotary energy harvester (SAREH) to power various wireless Bluetooth sensors, enabling continuous monitoring of the vehicle's motion state. The SAREH combines a contra-rotating mechanism with a friction pendulum, resulting in excellent power output in a compact design. Experimental results demonstrate the ability of SAREH to extract power from vehicles operating at speeds ranging from 180 to 1260 rpm. The maximum power output and corresponding power density are measured as 712 mW and 34 mW cm−3, respectively. The prototype successfully powers portable electronics and supports battery-free navigation, triaxial acceleration, and temperature multi-sensors during real road and railway simulation tests. Additionally, the SAREH operates as a highly sensitive speed sensor and an early-warning system for detecting the vehicle's motion state. These results represent a significant advancement in intelligent transportation systems by showcasing the practicality of self-powered wireless monitoring capabilities on vehicles