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In the present study, we carried out a comprehensive investigation of glycoside hydrolase (GH) 46 model-chitosanases based on cleavage specificity classification to understand their unknown bifunctional activity. We for the first time show that GH46 chitosanase CsnMHK1 from

With the advent of the Industry 4.0 era, information technology has been widely developed and applied in the construction engineering field. Text mining techniques can extract interesting and important data hidden in plain text, potentially allowing problems in the construction field to be addressed. Although text mining techniques have been used in the construction field for many years, there is a lack of recent reviews focused on their development and application from a literature analysis perspective; therefore, we conducted a review with the aim of filling this gap. We use a combination of bibliometric and manual literature analyses to systematically review the text mining-based literature related to the construction field from 1997 to 2022. Specifically, publication analysis, collaboration analysis, co-citation analysis, and keyword analysis were conducted on 185 articles collected from the SCOPUS database. Based on a read-through of the 185 papers, the current research topics in text mining were manually determined and sorted, including tasks and methods, application areas, and core methods and algorithms. The presented results provide a comprehensive understanding of the current state of TM techniques, thereby contributing to the further development of TM techniques in the construction industry.

BACKGROUND Prices for total joint arthroplasty vary widely. Insurers have experimented with reference-based benefit designs (reference pricing) to control costs by setting a contribution limit that covers lower-priced facilities but necessitates higher out-of-pocket payments at higher-priced facilities. The purpose of this study was to evaluate the impact of reference pricing on the cost and quality of care for total joint arthroplasty. METHODS The California Public Employees' Retirement System (CalPERS) implemented reference pricing for total joint arthroplasty in January 2011. We obtained data on 2,023 CalPERS patients who underwent total joint arthroplasty from January 2009 to December 2013 and comparison group data on 8,024 non-CalPERS patients from the same time period. Trends in 9 cost and quality-related metrics were compared between the CalPERS group and the comparison group: patient choice of a lower-priced hospital, insurer payment, consumer payment, 90-day complication rate, 90-day readmission rate, annual surgical volume of the chosen hospital, length of stay, travel distance, and rate of discharge to home. The impact of reference pricing was estimated with difference-in-differences multivariable regressions, adjusting for covariates. RESULTS An increase of 19 percentage points (95% confidence interval [CI], 13.0 to 25.6 percentage points; p < 0.01) in the selection of lower-priced hospitals was attributable to reference pricing, with a concurrent mean savings for the insurer of $5,067 (95% CI, $2,315 to $7,819; p < 0.01) and an increase in the mean patient out-of-pocket payment of $1,991 (95% CI, $1,053 to $2,929; p < 0.01). No significant change in any quality indicator was attributable to reference pricing, with the exception of an 8% reduction (95% CI, 3.3% to 12.7% reduction; p < 0.01) in the length of stay for hip replacement. CONCLUSIONS Reference pricing motivates patients to choose lower-priced hospitals for total joint arthroplasty, with no measurable adverse impact on quality. Reference pricing represents a viable strategy in the shift toward value-based care.

The immobilization of sedimentary phosphorus (P) by capping sediments with amended calcium peroxide material (ACPM) and CaO2 was investigated, the sediments and overlying water from a black-odor river. Under the capping with ACPM and CaO2, the pH and dissolved oxygen (DO) in the overlying water were higher than in the control. This contributed to the more loss of external P under the ACPM (the phosphate sorption was fitted well by the Langmuir equation, the maximum P sorption capacity up to 29.28 mg P g−1). Additionally, ACPM improves the decrease of the reduction materials (e.g., NH4+-N, Fe2+) in the pore water compared to that associated with CaO2, resulting in a less obvious dissolved inorganic P (DIP) in the pore water, but the accumulation of DIP in the pore water with CaO2 suggested an explosive release once the micro-environment conditions encounters adverse conditions. The sharp reduction of Fe/Al-P and Res-P contributes to the increase of DIP in the pore water, with a release of up to 390.60 mg P kg−1 DW (dry weight), whereas the value is only 62.55 mg P kg−1 DW when capped with ACPM. Correspondingly, the percentage of the bioavailable P to Tot-P decreases rapidly from 17.27% (control, 0–2 cm) to 7.21% (ACPM, 0–2 cm) and 10.57% (CaO2, 0–2 cm), indicating the obvious P immobilization. The implication is that the application of CaO2 is not suitable for direct use, while the combination with other materials (e.g., WPS) is a better choice.

This study sought a new way to utilize sludge as a low cost and efficient adsorbent. Preparation of sludge adsorbent by hydrothermal carbonization was done at different temperatures (160–250 °C). Various characterization techniques were used in this study including elemental analysis, Fourier transform infrared spectroscopy (FT-IR), and X-ray photoelectron spectroscopy (XPS). The adsorption performance of the organic matter was analyzed by adsorption experiments with the endocrine disruptor bisphenol A (BPA). Results showed that as the hydrothermal temperature increased, the solid yield of hydrochar decreased from 84.73% to 55.19%, and the maximum specific surface area was 11.9 m2/g. Elemental analysis showed that the hydrochar contains more aromatic carbon than the raw sludge. It was found using the FT-IR and XPS that the hydrochar retains a large amount of oxygen-containing functional groups on the surface after hydrothermal treatment. Hydrochar can be used as an organic-pollutant adsorbent in water; it has a good adsorption effect on BPA and the removal rate can reach 96%. The adsorbed hydrochar can be hydrothermally retreated and returned to the sewage treatment plant for reuse.

OBJECTIVE: To compare medication adherence, cost, and utilization in Medicare beneficiaries attributed to nurse practitioners (NP) and primary care physicians (PCP). DATA: Medicare Part A, B, and D claims and beneficiary summary file data, years 2009‐2013. STUDY DESIGN: We used propensity score‐weighted analyses combined with logistic regression and generalized estimating equations to test differences in good medication adherence (proportion of days covered (PDC >0.8); office‐based and specialty care costs; and ER visits. DATA EXTRACTION: Beneficiaries with prescription claims for anti‐diabetics, renin‐angiotensin system antagonists (RASA), or statins. PRINCIPAL FINDINGS: There were no differences in good medication adherence (PDC >0.8) between NP and PCP attributed beneficiaries taking anti‐diabetics or RASA. Beneficiaries taking statins had a slightly higher probability of good adherence when attributed to PCPs (74.6% vs 75.5%; P

This study examines how reference-based benefits (RBB) affect patient out-of-pocket payments across outpatient procedures. The California Public Employees’ Retirement System (CalPERS) implemented RBB asymmetrically for outpatient procedures in 2012, only applying RBB to outpatient procedures performed in a hospital outpatient department (HOPD), and not applying RBB to outpatient procedures performed in a lower cost ambulatory surgery center. Using claims data (2009-2013) on arthroscopy and colonoscopy services, we found that for colonoscopy, CalPERS patients paid an average of 63.9% ( p < .01) more for HOPDs than ambulatory surgery centers in 2012. For arthroscopy, no statistically different cost sharing was found on average. However, high-priced HOPDs were 17.3% and 17.9% less likely to be chosen by CalPERS patients in 2012 for colonoscopy and arthroscopy, respectively. These magnitudes increased in 2013 to 25.2% and 24.2% less, respectively. Overall, responsiveness to RBB with regard to the most expensive HOPDs was similar despite varying cost sharing by procedure.

It is indispensable to scientifically predict the consumption of aero-material spare parts and to make scientific decisions on aviation equipment maintenance resources and make full use of existing resources to improve maintenance capability. In this paper, the mathematic model and calculation method of linear regression model are introduced. And the parameter estimation and model test method of linear regression model is discussed. A linearization method is proposed for nonlinear problems. The application of linear regression model in forecasting the consumption of aero-material spare parts is analyzed by examples. Finally, the regression equation is analyzed for significance analysis, variance analysis and residual analysis. According to the analysis results, the regression equation is modified as necessary to further improve the prediction accuracy. The results show that the linear regression model is feasible and effective for the prediction of aero-material spare parts consumption.

This paper investigates whether children’s political success contributes to social stratification and health inequality among older adults. Using China Health and Retirement Longitudinal Study (CHARLS) data, we investigate whether having a cadre (i.e., politically employed) child substantially increases overall cognitive functioning among older adults. We find that the beneficial effect of having a cadre child on cognitive functioning is equivalent to a 1.5-year increase in education, even after controlling for other variables related to general intelligence. This positive effect is more salient among parents of higher-ranking cadre children, and more salient in less-marketized regions. The results of a Sobel test suggest that about one-fifth of the effect can be explained by the channel of increased social interaction.

Block chain technology can provide a new storage mode for sensitive data in the Internet of Things. However, due to the structural characteristics of block chains, block chains also have the risk of privacy leakage. This paper starts with the analysis of the background of block chain technology and the characteristics of block chain technology, further analyses the privacy problems faced by block chain technology at present, and elaborates the corresponding protection and solution strategies.

Primary care providers are at the center of the opioid epidemic. Whether nurse practitioners (NPs) have different opioid-prescribing outcomes from physicians is not known.To examine opioid-prescribing outcomes of Medicare beneficiaries receiving care from NPs and physicians in primary care.We used Medicare data from 2009 to 2013 and a propensity score-weighted analysis.Beneficiaries residing in states in which NPs are able to prescribe controlled substances without physician oversight and who did not have a cancer diagnosis, hospice care, or end-stage renal disease.First, we measured whether beneficiaries received any opioid prescription. Second, for beneficiaries who received opioids, we measured acute (90 d supply) and chronic (≥90 d supply) use at baseline (2009-2010) and follow-up (2012-2013). Third, we measured potential misuse of opioid prescribing using a daily morphine milligram equivalent dose of100 mg, overlapping prescriptions of opioids7 days, and overlapping prescriptions of opioids with benzodiazepines7 days.Beneficiaries managed by NPs were less likely to receive an opioid [odds ratio (OR), 0.87; P0.001], were less likely to be acute users at baseline (OR, 0.84; P0.001), and were more likely to receive a high daily opioid dose of morphine milligram equivalent100 mg compared with physician-managed beneficiaries (OR, 1.11; P=0.048).Findings suggest educational programs and clinical guidelines may require approaches tailored to different providers. Future research should examine the contributing factors of these patterns to ensure high-quality pain management and guide policy makers on NP-controlled substance-prescribing regulations.

Urban open spaces provide various benefits to large populations in cities. Since thermally comfortable urban open spaces improve the quality of urban living, an increasing number of studies have been conducted to extend the existing knowledge of outdoor thermal comfort. This paper comprehensively reviews current outdoor thermal comfort studies, including benchmarks, data collection methods, and models of outdoor thermal comfort. Because outdoor thermal comfort is a complex issue influenced by various factors, a conceptual framework is proposed which includes physical, physiological and psychological factors as direct influences; and behavioral, personal, social, cultural factors, as well as thermal history, site, and alliesthesia, as indirect influences. These direct and indirect factors are further decomposed and reviewed, and the interactions among various factors are discussed. This review provides researchers with a systematic and comprehensive understanding of outdoor thermal comfort, and can also guide designers and planners in creating thermally comfortable urban open spaces.

Objective To investigate smoking prevalence and cessation services provided by male physicians in hospitals in three Chinese cities. Methods Data were collected from a survey of male physicians employed at 33 hospitals in Changsha, Qingdao and Wuxi City (n=720). Exploratory factor analysis was performed to identify latent variables, and confirmatory structural equation modelling analysis was performed to test the relationships between predictor variables and smoking in male physicians, and their provision of cessation services. Results Of the sampled male physicians, 25.7% were current smokers, and 54.0% provided cessation services by counselling (18.8%), distributing self-help materials (17.1%), and providing traditional remedies or medication (18.2%). Factors that predicted smoking included peer smoking (OR 1.14 95% CI 1.03 to 1.26) and uncommon knowledge (OR 0.94 95% CI 0.89 to 0.99), a variable measuring awareness of the association of smoking with stroke, heart attack, premature ageing and impotence in male adults as well as the role of passive smoking in heart attack. Factors that predicted whether physicians provided smoking cessation services included peer smoking (OR 0.82 95% CI 0.76 to 0.89), physicians’ own smoking (OR 0.87 95% CI 0.81 to 0.93), training in cessation (OR 1.36 95% CI 1.27 to 1.45) and access to smoking cessation resources (OR 1.69 95% CI 1.58 to 1.82). Conclusions The smoke-free policy is not strictly implemented at healthcare facilities, and smoking remains a public health problem among male physicians. A holistic approach, including a stricter implementation of the smoke-free policy, comprehensive education on the hazards of smoking, training in standard smoking-cessation techniques and provision of cessation resources, is needed to curb the smoking epidemic among male physicians and to promote smoking cessation services in China.

According to data released by World Health Organization WHO, chronic non-communicable diseases have become the highest mortality disease. This paper is from the perspective to secure the health of people with chronic diseases. The research achieves the health knowledge from Big Data of the chronic diseases and is applied to Smart Health Service methods. Through collecting data in social media and integrating vast amounts of electronic health records, medical research literature and wearable device in personal health data, our purpose is to build a healthy big data environment. On this basis, we achieve the related knowledge of chronic disease by extracting the symptoms, the diseases and treatment options, inferring adverse drug reactions relationship, collecting health-related emotional reactions, and digging patients' social communication information, etc., which is to provide decision support for the patients and to achieve personalized Medical Services and Community Service. This paper focuses on the contents concluding knowledge discovery technology, personalized decision support technology, community health care services and so on, which relates to the health Big Data in the social media, then proposes collecting, digging and management of chronic disease health Big Data and builds the theoretical framework of chronic disease knowledge, in order to promote the realization of the Smart Health Services.

Background: Animal models have suggested that undernutrition during gestation and the early postnatal period may adversely affect kidney development and compromise renal function. As a natural experiment, famines provide an opportunity to test such potential effects in humans. We assessed whether exposure to the Chinese famine of 1959–1961 during gestation and early postnatal life was associated with the levels of proteinuria among female adults three decades after exposure to the famine. Methods: We measured famine intensity using the cohort size shrinkage index and we constructed a difference-in-difference model to compare the levels of proteinuria, measured with a dipstick test of random urine specimens, among Chinese women (n = 70 543) whose exposure status to the famine varied across birth cohorts (born before, during or after the famine) and counties of residence with different degrees of famine intensity. Results: Famine exposure was associated with a greater risk [odds ratio (OR) = 1.54; 95% confidence interval (CI): 1.04, 2.28; P = 0.029) of having higher level of proteinuria among women born during the famine years (1959–61) compared with the unexposed post famine-born cohort (1964–65) in rural samples. No association was observed among urban samples. Results were robust to adjustment for covariates. Conclusions: Severe undernutrition during gestation and the early postnatal period may have long-term effects on levels of proteinuria in humans, but the effect sizes may be small.

The aim of this study was to investigate experimentation with smoking among primary school students in China. Data were acquired from a recent survey of 4,073 students in grades 4 to 6 (ages 9-12) in 11 primary schools of Ningbo City. The questions were adapted from the Global Youth Tobacco Survey (GYTS). Results suggest that although the Chinese Ministry of Education (MOE) encourages smoke-free schools, experimentation with cigarettes remains a serious problem among primary school students in China. Peers, family members, and the school environment play important roles in influencing smoking experimentation among students. Having a friend who smoked, seeing a family member smoke, and observing a teacher smoking on campus predicted a higher risk of experimentation with smoking; the exposure to anti-tobacco materials at school predicted a lower risk of experimentation with smoking. The evidence suggests that public health practitioners and policymakers should seek to ensure the implementation of smoke-free policies and that intervention should target young people, families, and communities to curb the commencement of smoking among children and adolescents in China.