Central Counterparts Research Articles

Habituation of Central and Electrodermal Responses to an Auditory Two-Stimulus Oddball Paradigm.

The orienting reaction (OR) towards a new stimulus is subject to habituation, i.e., progressively attenuates with stimulus repetition. The skin conductance responses (SCRs) are known to represent a reliable measure of OR at the peripheral level. Yet, it is still a matter of debate which of the P3 subcomponents is the most likely to represent the central counterpart of the OR. The aim of the present work was to study habituation, recovery, and dishabituation phenomena intrinsic to a two-stimulus auditory oddball paradigm, one of the most-used paradigms both in research and clinic, by simultaneously recording SCRs and P3 in twenty healthy volunteers. Our findings show that the target stimulus was capable of triggering a more marked OR, as indexed by both SCRs and P3, compared to the standard stimulus, that could be due to its affective saliency and relevance for task completion; the application of temporal principal components analysis (PCA) to the P3 complex allowed us to identify several subcomponents including both early and late P3a (eP3a; lP3a), P3b, novelty P3 (nP3), and both a positive and a negative Slow Wave (+SW; -SW). Particularly, lP3a and P3b subcomponents showed a similar behavior to that observed for SCRs , suggesting them as central counterparts of OR. Finally, the P3 evoked by the first standard stimulus after the target showed a significant dishabituation phenomenon which could represent a sign of the local stimulus change. However, it did not reach a sufficient level to trigger an SCR/OR since it did not represent a salient event in the context of the task.

Good Suggestion - But No! Innovation as the Struggle Between Different Roles and Perceptions in a Municipal Organisation

Collaboration has been increasingly recognised as a key for enhancing capacity, effectiveness, and spurring innovation in the public sector. The purpose of this paper is to study empirically how different perceptions and roles within an organisation handle a proposal from strategic management related to engaging a large municipality in collaboration with social entrepreneurs. The primary focus of attention is middle managers, as they stand out as a central counterpart to the administrative and political leadership. The data collection included in-depth interviews, observation and documents. An abductive analysis that combined empirical findings with theoretical insights showed that middle managers controlled positional and professional power bases, enabling them to block the formal lines of authority. The paper contributes to view innovation as a part of the struggle between different roles and perceptions within an organisation and to an explanation for the outcome resulting from different power bases.

Cannabidiol treatment improves metabolic profile and decreases hypothalamic inflammation caused by maternal obesity.

The implications of maternal overnutrition on offspring metabolic and neuroimmune development are well-known. Increasing evidence now suggests that maternal obesity and poor dietary habits during pregnancy and lactation can increase the risk of central and peripheral metabolic dysregulation in the offspring, but the mechanisms are not sufficiently established. Furthermore, despite many studies addressing preventive measures targeted at the mother, very few propose practical approaches to treat the damages when they are already installed. Here we investigated the potential of cannabidiol (CBD) treatment to attenuate the effects of maternal obesity induced by a cafeteria diet on hypothalamic inflammation and the peripheral metabolic profile of the offspring in Wistar rats. We have observed that maternal obesity induced a range of metabolic imbalances in the offspring in a sex-dependant manner, with higher deposition of visceral white adipose tissue, increased plasma fasting glucose and lipopolysaccharides (LPS) levels in both sexes, but the increase in serum cholesterol and triglycerides only occurred in females, while the increase in plasma insulin and the homeostatic model assessment index (HOMA-IR) was only observed in male offspring. We also found an overexpression of the pro-inflammatory cytokines tumor necrosis factor-alpha (TNFα), interleukin (IL) 6, and interleukin (IL) 1β in the hypothalamus, a trademark of neuroinflammation. Interestingly, the expression of GFAP, a marker for astrogliosis, was reduced in the offspring of obese mothers, indicating an adaptive mechanism to in utero neuroinflammation. Treatment with 50 mg/kg CBD oil by oral gavage was able to reduce white adipose tissue and revert insulin resistance in males, reduce plasma triglycerides in females, and attenuate plasma LPS levels and overexpression of TNFα and IL6 in the hypothalamus of both sexes. Together, these results indicate an intricate interplay between peripheral and central counterparts in both the pathogenicity of maternal obesity and the therapeutic effects of CBD. In this context, the impairment of internal hypothalamic circuitry caused by neuroinflammation runs in tandem with the disruptions of important metabolic processes, which can be attenuated by CBD treatment in both ends.

Rheological Heterogeneities Control the Non‐Progressive Uplift of the Young Iranian Plateau

AbstractThe Iranian plateau is at the early stage of plateau development and intracontinental deformation in response to the Arabia‐Eurasia collision. Its compressive deformation is concentrated in the northern plateau but skips the central counterpart, challenging the common views envisaging the progressive uplift from the collisional front to the hinterland. Based on three‐dimensional, crustal‐scale numerical models, we present how the rheological heterogeneities common in continents control the deformation of the young Iranian plateau. The weak northern plateau ensures itself a preferential zone in accommodating continental collision. The N‐S strike‐slip faults within the non‐rigid central plateau, formed along the boundaries between the tectonic units with rheological contrast, suppress the shortening of the central plateau while further accentuating the compressive deformation of the northern plateau. Our results suggest a non‐progressive intracontinental deformation pattern where rheological boundaries and mechanically weak zones, not necessarily those close to collisional fronts, preferentially accommodate continental convergence.

Clinical characteristics, risk factors, and outcomes in Chilean triple negative breast cancer patients: a real-world study.

Latin American (LA) studies on triple-negative breast cancer (TNBC) and their characteristics are scarce. This forces physicians to make clinical decisions based on data obtained from studies that include non-Hispanic patients. Our study sought to obtain local epidemiological data, including risk factors and clinical outcomes from a Chilean BC registry. This was a retrospective population-cohort study that included patients treated at a community hospital (mid-low income) or an academic private center (high income), in the 2010-2021 period. Univariate and multivariate analyses were performed to identify prognostic factors associated with survival. 647 out of 5,806 BC patients (11.1%) were TNBC. These patients were younger (p = 0.0001) and displayed lower rates of screening-detected cases (p = 0.0001) compared to non-TNBC counterparts. Among TNBC patients, lower income (i. e., receiving treatment at a community hospital) was associated with poorer overall survival (HR: 1.53; p = 0.0001) and poorer BC specific survival (HR: 1.29; p = 0.004). Other risk factors showed no significant differences between TNBC and non-TNBC. As expected, 5-year OS was significantly shorter on TNBC versus non-TNBC patients (p = 0.00001). In our multivariate analyses TNBC subtype (HR: 2.30), locally advanced stage (HR: 7.04 for stage III), lower income (HR: 1.64), or non-screening detected BC (HR: 1.32) were associated with poorer OS. To the best of our knowledge, this is the largest LA cohort of TNBC patients. Interestingly, the proportion of TNBC among Chileans was smaller compared to similar studies within LA. As expected, TNBC patients had poorer survival and higher risk for early recurrence versus non-TNBC. Other relevant findings include a higher proportion of premenopausal patients among TNBC. Also, mid/low-income patients that received medical attention at a community hospital displayed lower survival versus private health center counterparts.

Defined positive charge patterns created on DNA nanostructures determine cellular uptake efficiency.

We provide an effective method to create DNA nanostructures below 100 nm with defined charge patterns and explore whether the density and location of charges affect the cellular uptake efficiency of nanoparticles (NPs). To avoid spontaneous charge neutralization, the negatively charged polymer nanopatterns were first created by in situ polymerization using photoresponsive monomers on DNA origami. Subsequent irradiation generated positive charges on the immobilized polymers, achieving precise positively charged patterns on the negatively charged DNA surface. Via this method, we have discovered that the positive charges located on the edges of nanostructures facilitate more efficient cellular uptake in comparison to the central counterparts. In addition, the high-density positive charge decoration could also enhance particle penetration into 3D multicellular spheroids. This strategy paves a new way to construct elaborate charge-separated substructures on NP surfaces and holds great promise for a deeper understanding of the influence between the surface charge distribution and nano-bio interactions.

Palmitoylethanolamide dampens neuroinflammation and anxiety-like behavior in obese mice

High-fat diet (HFD) consumption leads to obesity and a chronic state of low-grade inflammation, named metainflammation. Notably, metainflammation contributes to neuroinflammation due to the increased levels of circulating free fatty acids and cytokines. It indicates a strict interplay between peripheral and central counterparts in the pathogenic mechanisms of obesity-related mood disorders. In this context, the impairment of internal hypothalamic circuitry runs in tandem with the alteration of other brain areas associated with emotional processing (i.e., hippocampus and amygdala). Palmitoylethanolamide (PEA), an endogenous lipid mediator belonging to the N-acylethanolamines family, has been extensively studied for its pleiotropic effects both at central and peripheral level.Our study aimed to elucidate PEA capability in limiting obesity-induced anxiety-like behavior and neuroinflammation-related features in an experimental model of HFD-fed obese mice.PEA treatment promoted an improvement in anxiety-like behavior of obese mice and the systemic inflammation, reducing serum pro-inflammatory mediators (i.e., TNF-α, IL-1β, MCP-1, LPS). In the amygdala, PEA increased dopamine turnover, as well as GABA levels. PEA also counteracted the overactivation of HPA axis, reducing the expression of hypothalamic corticotropin-releasing hormone and its type 1 receptor. Moreover, PEA attenuated the immunoreactivity of Iba-1 and GFAP and reduced pro-inflammatory pathways and cytokine production in both the hypothalamus and hippocampus. This finding, together with the reduced transcription of mast cell markers (chymase 1 and tryptase β2) in the hippocampus, indicated the weakening of immune cell activation underlying the neuroprotective effect of PEA. Obesity-driven neuroinflammation was also associated with the disruption of blood–brain barrier (BBB) in the hippocampus. PEA limited the albumin extravasation and restored tight junction transcription modified by HFD. To gain mechanistic insight, we designed an in vitro model of metabolic injury using human neuroblastoma SH-SY5Y cells insulted by a mix of glucosamine and glucose. Here, PEA directly counteracted inflammation and mitochondrial dysfunction in a PPAR-α-dependent manner since the pharmacological blockade of the receptor reverted its effects.Our results strengthen the therapeutic potential of PEA in obesity-related neuropsychiatric comorbidities, controlling neuroinflammation, BBB disruption, and neurotransmitter imbalance involved in behavioral dysfunctions.

Are minority-owned businesses moving to suburbs? Intrametropolitan spatial shifts and their causes

It is well documented that the U.S. metropolitan areas have experienced significant spatial, economic and demographic changes with increasing minority and immigrant population living in the suburbs. At the same time, minority-owned businesses saw substantial growth over the years and play important roles in local economic development. Using data from the 2007 and 2012 Survey of Business Owner, we trace the intrametropolitan location shifts of minority-owned businesses (including black-, Asian-, and Hispanic-owned) for 60 metropolitan areas and their performances in cities and suburbs over time through descriptive analysis. We find that minority-owned businesses had a strong presence in the suburbs but have grown faster in the central counties. They hired about 20–23% of total central area workforce and about 15–17% of total suburban workforce during this time period. Black-owned businesses remain the least suburbanized of all groups Suburban firms in general outperform their central city counterparts. Using regression analysis, we test a series of demographic, economic, and policy factors as potential causes of business spatial change and find the strong impact of co-ethnic population’s presence in a community for the growth of their respective businesses.

Computational and experimental investigations on the evaporation of single and multiple elongated droplets

Although droplet evaporation has been studied extensively, the focus is mostly limited to single spherical drops rather than elongated or multiple droplets, which is extensively encountered in a wide range of applications. The present study provides, for the first time, an experimental investigation on the evaporation of high aspect ratio elongated droplets. In addition, a fully coupled model is developed and validated against the experimental observations. The model is extended to provide a fully coupled analysis of adjacent droplets. The model considers all instabilities in both liquid and gas phases. The results indicate that the dynamics of droplet evaporation dramatically changes with droplet size, shape, and distance between adjacent droplets. Therefore, a non-dimensional pitch distance (L/D) is introduced to investigate the velocity fields in the droplets and gas domains as well as the temperature map at the interface of the droplets. While previous studies stated that the side droplets have higher evaporation rates compared to their central counterparts, and depending on the strength of natural convection their evaporation rate may exceed a single droplet, it is revealed in this study that besides the effect of natural convection, the evaporation rate of the high aspect ratio elongated side droplets becomes larger than that of a single one in the absence of Marangoni flow. Also in the presence of Marangoni flow, the side elongated droplets possess evaporation rates smaller than their central counterpart, and the evaporation rate of both central and side droplets becomes smaller than a single droplet.

A symmetric matrix-variate normal local approximation for the Wishart distribution and some applications

The noncentral Wishart distribution has become more mainstream in statistics as the prevalence of applications involving sample covariances with underlying multivariate Gaussian populations as dramatically increased since the advent of computers. Multiple sources in the literature deal with local approximations of the noncentral Wishart distribution with respect to its central counterpart. However, no source has yet developed explicit local approximations for the (central) Wishart distribution in terms of a normal analogue, which is important since Gaussian distributions are at the heart of the asymptotic theory for many statistical methods. In this paper, we prove a precise asymptotic expansion for the ratio of the Wishart density to the symmetric matrix-variate normal density with the same mean and covariances. The result is then used to derive an upper bound on the total variation between the corresponding probability measures and to find the pointwise variance of a new density estimator on the space of positive definite matrices with a Wishart asymmetric kernel. For the sake of completeness, we also find expressions for the pointwise bias of our new estimator, the pointwise variance as we move towards the boundary of its support, the mean squared error, the mean integrated squared error away from the boundary, and we prove its asymptotic normality.

Analyzing the efficiency of portfolio strategies based on the dividend yield concept: Evidence from the Russian stock market

Subject. The article focuses on the formation and management of the securities portfolio. In developed economies, various strategies are used to manage portfolios. The tendencies permeate the practice of portfolio managers and in the domestic market. Objectives. We analyze the efficiency of portfolio management strategies based on the dividend yield concept in order to find the most appropriate one for the Russian market for mid-term investment. Methods. The study is based on general methods of logic, comparative and statistical analysis, graphical and indicative comparative analysis. Results. Having tested strategies based on the dividend yield concept, we suggested using an improved mid-term strategy, which may suit many investors, including institutional ones. The article presents our suggestions on the improvement of a strategy for creating and managing a securities portfolio in the Russian stock market, which is based on the Dogs-of-the-Do principle. Conclusions and Relevance. Drawing upon the dividend yield concept, the proposed strategy ensures the average yield exceeding those of DOW 5 and DOW 10 strategies, bank deposit and investment in federal loan bonds. However, it is inferior to IMOEX and MOEXBS due to the lose of the portfolio balance once a year. Securities within the strategy make up ETF to lure more investors. The inclusion of FXUS increased the average annual yield by 2.45 percent. The addition of FXMM significantly reduces foreign currency risks. To optimize the strategy, there should be REPO with the central counterpart and CCP-cleared REPO, which raises its yield through arbitrage transactions.

Party Adaptation Strategies for Provincial Standing Committees in Post-Mao China

The Chinese Communist Party has been surprisingly successful in carrying out its plans in the face of various challenges in the post-Mao era. Compared to their central counterparts, the operating patterns of local institutions in tackling such difficulties have been less examined. This paper aims to fill this gap by exploring the party’s management of provincial standing committees (PSCs). As the highest level of local collective leadership, the PSC essentially sets the agenda for the province. Using a new database of PSC members from 1980 to 2016, this study provides a systematic illustration of the historical composition of provincial collective leadership. Instead of making drastic changes, the party has subtly shifted the roles of provincial leaders: it has redefined the role of the vice party secretary, adjusted the number of posts in the provincial government, and raised the level of professionalism.

Characterizing hernia centers in the United States: what defines a hernia center?

A universal definition for what constitutes a hernia center does not exist. The purpose of this study was to characterize hernia centers in the United States by analyzing hernia centers and their non-hernia center counterparts. A web-based search was conducted to identify defining features of hernia centers including faculty demographics and composition, research output, research funding, clinical trials, and website content. Hernia centers and non-hernia centers were compared. Most hernia centers (n = 36) are in urban areas (89%) and distributed evenly across regions of the United States. Hernia centers are associated with University program types (p = 0.001) while non-hernia centers are associated with University-Affiliate (p = 0.001) and Community (p = 0.02) program types. Hernia centers are associated with Abdominal Core Health Quality Collaborative participation (p = 0.01) and Center of Excellence by the Surgical Review Corporation certification (p = 0.005). Hernia centers are associated with presence of active clinical trials (p < 0.001) and number of clinical trials (p < 0.001). Hernia centers are associated with industry-sponsored trials (p < 0.001) but are not associated with NIH-sponsored trials. Fifty percent of hernia centers have PRS faculty. The vast majority of hernia center websites describe hernias treated (92%) and repair techniques (89%). The majority of hernia center mission statements emphasize an individualized care plan (61%) and multidisciplinary care (57%). Only 39% of websites and 17% of mission statements mention research. In the United States, hernia centers are clinically oriented, multidisciplinary surgical teams at predominantly urban, University programs that may use this title to attract patient referrals and industry sponsorship of clinical trials.

A Novel Enzymatic Digestion Approach for Isolation and Culture of Rodent Bone Marrow Mesenchymal Progenitors.

Bone marrow mesenchymal stem cells (MSCs) are promising therapeutic tools for tissue repair and treatment of a number of human diseases. As a result, there is substantial interest in characterizing and expanding these cells to uncover their therapeutic potential. Bone marrow mesenchymal progenitors, containing both MSCs and their proliferative progeny, are commonly isolated from the central region of rodent long bones. However, challenges exist in expanding these central mesenchymal progenitors in culture. We have designed an enzymatic digestion protocol to isolate mesenchymal progenitors within rodent long bones that resides close to the bone surface, which we termed endosteal mesenchymal progenitors. These cells are more metabolically active and more responsive to external stimuli compared to central mesenchymal progenitors. Therefore, they represent a biologically important target for MSC research. This chapter describes the approach in detail how to isolate and culture endosteal mesenchymal progenitors as well as their central counterparts from rodent long bones.

Priorities for upgrading the Russian lending system in the current circumstances

Subject. The article focuses on the lending system in the banking sector of Russia. Objectives. We examine and set priorities for modernizing the Russian lending system in the current circumstances. Methods. The article represents the statistical analysis of macroeconomic developments, estimates of the banking sector performance. Results. We indicate what the financial system shall mainly address and how banking resources can increase their contribution to the socio-economic development of the territory. The financial position of customers shall be evaluated on the differential basis, considering the industrial specifics of their business, inter alia, for making loan and similar reserves, imposing less strict requirements to additional information on borrowers. Conclusions and Relevance. Macroprudential regulation is one of the most important and extensive objectives to improve the financial market in Russia. The mandatory centralized clearance seems promising with respect to OTC derivatives if viewed by assessing the economic motivation for using the clearance that involves the central counterpart, as compared with bilateral deals. The actions are supposed to positively influence the development of the national economy. The findings can be used to examine development trends in the Russian banking sector.

&lt;p&gt;&lt;strong&gt;An assessment of the local endemism of flowering plants in the northern Western Ghats and Konkan regions of India: checklist, habitat characteristics, distribution, and conservation&lt;/strong&gt;&lt;/p&gt;

The Western Ghats of India support a significant amount of biodiversity despite heavy habitat loss. The northern part of this biodiversity hot-spot, along with Konkan, is considerably different from its southern and central counterparts on account of lesser precipitation and extended dry season. Though this region has been floristically surveyed well, there was a long need for a synthesis on local endemism of the flowering plants. Therefore, the present work was undertaken to produce an updated list of the local endemic plant species of the region with an analysis of habitat characteristics and their survival strategies. An extensive review of literature, herbarium records, and field studies yielded a checklist of 181 taxa including four monospecific genera which were examined for their distribution across their latitudinal spread and habitat specificity. A majority of the endemics are therophytes with their predominance, especially on rock outcrops. Northern Western Ghats seems to be the center of rapid diversification of certain herbaceous endemic genera like Ceropegia, Glyphochloa, Dipcadi, Eriocaulon and a few others. Despite being declared as a biodiversity hot-spot and having a higher concentration of endemic taxa, the region is underrepresented in global IUCN threat status assessments. The implication of effective conservation measures is necessary and the data presented in the manuscript can be used as a proxy for conservation planning.

Endpoint Sobolev Continuity of the Fractional Maximal Function in Higher Dimensions

Abstract We establish continuity mapping properties of the noncentered fractional maximal operator $M_{\beta }$ in the endpoint input space $W^{1,1}({\mathbb R}^d)$ for $d \geq 2$ in the cases for which its boundedness is known. More precisely, we prove that for $q=d/(d-\beta )$ the map $f \mapsto |\nabla M_\beta f|$ is continuous from $W^{1,1}({\mathbb R}^d)$ to $L^{q}({\mathbb R}^d)$ for $ 0 &amp;lt; \beta &amp;lt; 1$ if $f$ is radial and for $1 \leq \beta &amp;lt; d$ for general $f$. The results for $1\leq \beta &amp;lt; d$ extend to the centered counterpart $M_\beta ^c$. Moreover, if $d=1$, we show that the conjectured boundedness of that map for $M_\beta ^c$ implies its continuity.

Impact Of Hepatitis C Treatment On Long-Term Outcomes For Patients With Hepatocellular Carcinoma: A United States Safety-Net Collaborative Study

Presenter: Michael Turgeon MD | Emory University Background: Hepatitis C Virus (HCV) is a common risk factor for the development of hepatocellular carcinoma (HCC). Although HCV treatment has dramatically changed the landscape for HCV management, its widespread use is limited by its high cost. Given this potential obstacle, our aim was to assess barriers to receiving HCV treatment and the impact of HCV treatment on survival in patients with concurrent HCC treated at safety-net hospitals compared to academic referral centers. Methods: Patients in the US Safety-Net Collaborative Database (2012-2014) with HCV and primary, non-metastatic HCC were included. The collaborative consists of five large safety-net hospitals and their academic referral center counterparts. Primary and secondary outcomes were overall survival (OS) and recurrence-free survival (RFS) based on HCV treatment status. Results: Of 941 patients who had HCV-induced cirrhosis, median age was 60 years (IQR 56-64), 78% were male (n=734), 57% received care at an academic referral center (n=533) and 43% at a safety-net hospital (n=408). 25% received HCV treatment (n=245), while 74% did not (n=696). Among those who received HCV treatment, 76% of patients received care at an academic referral center (n=186) while 24% received care at a safety-net hospital (n=59). 6% underwent resection (n=54), 17% liver transplant (n=163), 50% liver-directed therapy (radiofrequency ablation, transarterial chemoembolization, Y90, and/or radiation therapy; n=473), 7% received chemotherapy (n=60), and 20% received no HCC treatment (n=191). Median follow-up was 37 months. For all patients, HCV treatment was associated with improved median OS compared to no HCV treatment (70 vs 21 months, p<0.01; Figure1A). This association persisted across clinical stages I, II, III, and IVa (all p<0.01) and all HCC treatment modalities (all p<0.01). On multivariable Cox regression, accounting for age, insurance type, treatment facility type, MELD score, clinical stage, and HCC treatment type, HCV treatment was still associated with improved OS. In a subset analysis for patients who underwent complete tumor extirpation (surgical resection or liver transplant), patients who received HCV treatment had improved median RFS compared to those who did not (91 vs 80 months, p=0.03; Figure1B). On multivariable analysis, factors associated with not receiving HCV treatment included Black race, uninsured status, and treatment at a safety-net hospital (all p<0.03). When this patient demographic did receive HCV treatment, however, the degree of improvement in survival was similar regardless if treated at an academic referral center (5-yr OS: 56 vs 30%, p<0.01; Figure 1C) or a safety-net hospital (5-yr OS: 52 vs 23%, p<0.01; Figure 1D). Conclusion: HCV treatment for patients with HCC portends improved survival and oncologic outcomes, irrespective of clinical stage, HCC treatment modality, or type of treatment facility. Despite this, given its high cost and associated barriers, a minority of patients treated at safety-net hospitals receive HCV treatment. Efforts must be directed towards removing obstacles that prevent this vulnerable patient population from receiving the standard of care treatment for HCV with concurrent HCC.

Guiding Hypertension Management Using Different Blood Pressure Monitoring Strategies (GYMNs study): comparison of three different blood pressure measurement methods: study protocol for a randomized controlled trial

BackgroundHome blood pressure (BP) and unattended automated BP (uAOBP) monitoring have been recommended by guidelines for the care of hypertensive subjects. However, BP measurements in the peripheral arteries cannot serve as direct substitutes for their central counterparts. Moreover, the comparative effectiveness and safety of BP-guided strategies using these BP measuring devices have never been evaluated.Methods/designPatients with uncontrolled or newly diagnosed hypertension aged 20–90 years will be recruited via outpatient clinics and allocated into three arms by stratified randomization (baseline systolic BP 130–155 mmHg and 155–180 mmHg): home BP, uAOBP, and central BP-guided treatment. At each scheduled visit to the clinic, a patient’s BP will be measured by each of the three methods of measuring BP. The blood pressure from three different methods will be confirmed available at each visit. Patients and physicians will be blinded to the allocated interventions because they will use measured BP values in the clinic through a standardized report format. A common BP target for systolic blood pressure (SBP) of 130 mmHg is adopted for these BP-guided strategies. The primary outcome is the change of 24-h mean ambulatory SBP at 3 months. A key secondary outcome is to determine the percentage achieving their target BPs at 3 months and the decrease of left ventricular mass at 12 months.DiscussionTo our knowledge, this is the first prospective double-blind randomized controlled trial to assess the optimal guiding strategy for hypertension. It will help to define which BP monitoring method is the most effective for guiding the clinical management of hypertension. It will provide good evidence to support future guideline recommendations for BP monitoring devices.Trial registrationClinicalTrials.gov, NCT03578848. Registered on 4 June 2018.

From Suppressive to Proactive?: Chinese Governments' Media Control Strategies in Popular Protests

Scholarship today asserts that the Chinese Party-state's media control strategy with regard to popular protests has changed from suppressive to proactive. Nevertheless, existing literature tends to regard the Chinese state as a monolithic and unitary actor, and neglects the heterogeneity in different levels of government in handling protests. This article attempts to make a modest contribution to the literature by viewing the Chinese state as heterogeneous and multilayered actors with respect to popular protests. The authors contend that due to the distinctive incentives as well as the context factor "hierarchical government trust", lower-level authorities, especially the local ones, have a lower tendency to adopt a proactive approach to controlling media coverage of protests than their central counterparts. The authors utilise the Wukan incident as a case study to corroborate their argument, and identify the specific strategies that various levels of the governments have adopted.