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Abstract Detection of microRNA-196a (miRNA-196a) is crucial in cancer research, enabling early diagnosis and providing guidance for individualized treatment. In this work, we employed a naturally occurring negatively charged nano silk fibroin (NSF) with high mechanical properties, biocompatibility, and conductivity to be encapsulated with a positively charged gold nanoparticles (AuNPs) were used as film-forming materials for electrostatic layer-by-layer self-assembly to modify the working electrode of the screen-printed carbon electrode (SPCE). Under the optimized experimental conditions, the uniformly distributed AuNPs on the surface of the multilayer film modified SPCE (AuNPs/NSF)5.5/SPCE combined with the sulfhydryl-modified capture probe cp-DNA through gold-sulfur bonds. Furthermore, miRNA-196a is specifically captured through complementary base pairing to achieve highly sensitive and specific detection. (AuNPs/NSF)5.5/SPCE electrode can detect miRNA-196a in a concentration range of 1.0 × 10−13 to 1.0 × 10−6 M, and the calculated detection limit is 4.63 × 10−14 M when the signal-to-noise ratio is 3. The obtained results showed that the (AuNPs/NSF)5.5/SPCE has excellent selectivity and good stability over time.

Sustainable intensification (SI) of agriculture can produce more food to meet the demand of a growing population while considering ecosystem health. The current SI estimation framework ignores the complex coupling between input and output intensity of arable land. A method for coupled analysis of arable land input intensity and output intensity based on sliding windows is proposed. By calculating the correlation coefficient and partial correlation coefficient between input intensity and output intensity in different value ranges as the order parameter, the phase transition and the influence process of input intensity on output intensity can be explained. Meanwhile, a python-based framework is developed.An application of the method was made to reveal the interaction process between annual provincial input intensity and output intensity in mainland China. Researchers in many fields may benefit from the method by obtaining a fast way to analysis the coupling relationship between driving and dependent variables in complex systems. • New method for SI estimation is presented. • The order parameter of the coupling relationship between input and output intensity is calculated based on sliding windows. • Analysis of coupling relationships between driving and dependent variables in complex systems.

Improving nitrogen (N) management are crucial for food security and ecological protection in China and globally. Assessing the contribution and influence characteristics of N input components on crop growth is a key component. There are challenges in conducting such assessments at large regional scales, particularly in developing models that fit regional N inputs and crop N uptake. An improved scheme that fit regional N inputs and crop N uptake with consideration of spatial heterogeneity of cultivation conditions was proposed. Based on the division of homogeneous cultivation conditions zones, linear models and Random Forest models were developed to assess the contribution and influence characteristics of N input components on crop growth at the provincial scale in mainland China. And synthetic N contribution rate (SNCR) and soil fertility N contribution (SFNC) were innovatively proposed to represent the contribution of fertilizer and soil fertility to crop growth. The results showed that the overall N use efficiency ranged from 35 % to 55 % in 1985–2020, and higher NUE could be seen in major grain producing provinces. The SNCR generally declined, with a spatial pattern higher in the southwest, northwest, and northeast regions. The SFNC showed an increasing trend, with a spatial pattern higher in the northeast than southeast than west. For each N input component, Synthetic N input was critical in the northwest, southwest regions and north China, positively affecting crop N uptake. The improved scheme, which incorporated considerations for spatial heterogeneity, demonstrated superior accuracy compared to the model fitted by year, increasing from 0.27 (0.11) to 0.42 (0.47). Over the past 35 years, the crop N uptake and N surplus of mainland China had experienced a process of extensive-unsustainable-sustainable-conservative pattern changes. The response of crop N uptake and N use efficiency to the regulation of N inputs in typical regions was simulated, providing reference for provincial N inputs regulation in China. This study can provide support for the design of N management strategies in China to reduce N pollution, and the method can provide guidance for other regions to assess N use in different scales.

The rapid expansion of digital commerce, particularly same-day-delivery and next-day-delivery online shopping, is transforming daily life and community dynamics in urban settings. This study explores how these shopping behaviors impact the sense of community by mediating various social activities at both individual and community levels. Using an online survey design, this study analyzes the mediating roles of different types of social interactions, including informal social gatherings and organized community events, in shaping a sense of community. The findings reveal that while both unplanned, low-threshold interactions and more structured, organized activities contribute to a sense of community, their effects vary in strength. Stronger, more deliberate social interactions, such as resident-led events, show a full mediation effect, whereas casual, spontaneous encounters provide partial mediation. Similarly, organized community events demonstrate different levels of influence, with community-organized activities fully mediating certain sense of community dimensions and resident-engaged activities providing more comprehensive impacts. These findings highlight that same-day-delivery and next-day-delivery online shopping behaviors significantly shape the sense of community by facilitating both informal and organized social interactions.

Community streets play a crucial role in promoting healthy aging and encouraging active behaviors among older adults. This study focuses on two types of activities of older adults: walking and social interaction. We explored the relationship between physical environmental factors and different activity types using a multiple linear regression model. Eye-level green visibility (GSVN) was used to represent the diversity of facilities (DFN), while betweenness (ABN) accounted for the mixed degree of functions (PNi), enhancing model stability. The results indicate that community environmental factors, both individually (R2 = 0.390) and in combination (R2 = 0.409), have significant effects on active behaviors. Notably, the combined variable model demonstrated greater stability. Moreover, the model’s explanatory power for social interaction (R2 = 0.567) was much higher than for walking behavior (R2= 0.137), underscoring the stronger influence of combined variables on social engagement. The results suggest that creating age-friendly urban environments requires a holistic approach that improves infrastructure, green visibility, and functional diversity to promote both mobility and social interaction. These insights provide valuable guidance for designing inclusive urban spaces that support active aging.

Informal green spaces (IGSs) play an essential role in enhancing urban well-being by offering restorative environments, yet the impact of visitor behaviors on perceived restorativeness (PR) remains underexplored. This study investigates how different spatio-temporal behaviors influence PR in IGS, providing urban planners with actionable insights to optimize these spaces for better user experiences. Using a visitor-employed photography (VEP) survey and post-visit PR assessments, K-means clustering was applied to identify distinct visitor behavior patterns. Correlation analysis further explored the relationships between these patterns and PR; the results reveal three unique clusters of visitor behaviors—fast, extensive exploration; moderate, focused exploration; and slow, thorough exploration—each showing distinct impacts on PR. Visitors who engage in rapid, broad exploration perceive larger, navigable spaces as more restorative, while those focusing on specific or in-depth exploration emphasize psychological aspects like escape and fascination. These behavioral patterns demonstrate varying strengths in their association with restorative experiences; This study underscores the importance of integrating spatio-temporal behavior data with PR assessments, highlighting how the physical and psychological features of IGS influence visitor experiences. These findings offer critical insights for designing and managing IGS to accommodate diverse user needs and promote urban well-being.

BackgroundHospital apps are increasingly being adopted in many countries, especially since the start of the COVID-19 pandemic. Web-based hospitals can provide valuable medical services and enhanced accessibility. However, increasing concerns about personal information (PI) and strict legal compliance requirements necessitate privacy assessments for these platforms. Guided by the theory of contextual integrity, this study investigates the regulatory compliance of privacy policies for internet hospital apps in the mainland of China. ObjectiveIn this paper, we aim to evaluate the regulatory compliance of privacy policies of internet hospital apps in the mainland of China and offer recommendations for improvement. MethodsWe obtained 59 internet hospital apps on November 7, 2023, and reviewed 52 privacy policies available between November 8 and 23, 2023. We developed a 3-level indicator scale based on the information processing activities, as stipulated in relevant regulations. The scale comprised 7 level-1 indicators, 26 level-2 indicators, and 70 level-3 indicators. ResultsThe mean compliance score of the 52 assessed apps was 73/100 (SD 22.4%), revealing a varied spectrum of compliance. Sensitive PI protection compliance (mean 73.9%, SD 24.2%) lagged behind general PI protection (mean 90.4%, SD 14.7%), with only 12 apps requiring separate consent for processing sensitive PI (mean 73.9%, SD 24.2%). Although most apps (n=41, 79%) committed to supervising subcontractors, only a quarter (n=13, 25%) required users’ explicit consent for subcontracting activities. Concerning PI storage security (mean 71.2%, SD 29.3%) and incident management (mean 71.8%, SD 36.6%), half of the assessed apps (n=27, 52%) committed to bear corresponding legal responsibility, whereas fewer than half (n=24, 46%) specified the security level obtained. Most privacy policies stated the PI retention period (n=40, 77%) and instances of PI deletion or anonymization (n=41, 79%), but fewer (n=20, 38.5%) committed to prompt third-party PI deletion. Most apps delineated various individual rights, but only a fraction addressed the rights to obtain copies (n=22, 42%) or to refuse advertisement based on automated decision-making (n=13, 25%). Significant deficiencies remained in regular compliance audits (mean 11.5%, SD 37.8%), impact assessments (mean 13.5%, SD 15.2%), and PI officer disclosure (mean 48.1%, SD 49.3%). ConclusionsOur analysis revealed both strengths and significant shortcomings in the compliance of internet hospital apps’ privacy policies with relevant regulations. As China continues to implement internet hospital apps, it should ensure the informed consent of users for PI processing activities, enhance compliance levels of relevant privacy policies, and fortify PI protection enforcement across the information processing stages.

The frequent occurrence of extreme heat events has notably affected human's living environment, and a considerable number of studies have reported that green space is an efficient measure by investigating the correlation between green space and land surface temperature (LST). However, spatiotemporal effects of green space on LST still remain unclear. In this study, green space patterns (e.g., core, islet, perforation, edge, loop, bridge, and branch) were identified through morphological spatial pattern analysis (MSPA). Moreover, the effects of green space pattern on LST in three periods were investigated through three kinds of models. As indicated by the results: (1) the geographically and temporally weighted regression model exhibited the optimal performance compared with other two models. (2) in general, the core, the edge, the bridge, and the branch significantly contributed to cooling, and the islet hindered cooling. However, the perforation and the loop exerted significant dual nature effects with the similar quantity of the negative and positive coefficients, showing relatively complex impact mechanism. (3) the intensity of the effect of the respective MSPA class varied across the study area. The core had the most substantial effect, which distributed in the south and middle corners. (4) the result suggested that a neighborhood scale in China, which was 960 m in this study, served as a basic unit in green space management. The spatiotemporal non-stationarity of the effects of green space morphological patterns on LST provided important insights into urban thermal environment improvement through urban green space planning and design.

In contemporary society, the improper use of antibiotics leads to their persistent presence in the ecological environment. Due to the diverse physical and chemical properties of antibiotics, their spatial and temporal distribution in the environment varies. Moreover, antibiotics can stimulate the emergence of antibiotic resistance genes (ARGs), which complicates the monitoring and regulation of antibiotics and poses a significant threat to both aquatic and terrestrial environments. This study investigated the distribution of 15 antibiotics and 11 typical ARGs across four categories at 19 sites of drinking water sources in Wuhan, China. The findings revealed that the concentration of antibiotics during the dry season (nd~61,883 ng/L) was significantly higher compared to both the normal water season (nd~49,883 ng/L) and the wet season (nd~28,686 ng/L). Sulfamethoxazole (SMX), sulfamethoxazole (SMD), sulfadiazine (SD), and roxithromycin (RTM) were the predominant antibiotics in the target water environments. The study indicated that most of the antibiotics analyzed posed little to no risk to aquatic organisms. The primary ARGs detected in the surface water of the study area were sul1, qnrD, and tetO. Furthermore, some ARGs showed a negative correlation with their respective antibiotics. Additional research is necessary to evaluate the impact of these emerging pollutants (antibiotics and ARGs) on the safety of high-quality drinking water for residents in Wuhan City.

Abstract Background Substantial studies have demonstrated that oxidative stress placenta and endothelial injury are considered to inextricably critical events in the pathogenesis of preeclampsia (PE). Systemic inflammatory response and endothelial dysfunction are induced by the circulating factors released from oxidative stress placentae. As a novel biomarker of oxidative stress, advanced oxidation protein products (AOPPs) levels are strongly correlated with PE characteristics. Nevertheless, the molecular mechanism underlying the effect of factors is still largely unknown. Methods With the exponential knowledge on the importance of placenta-derived extracellular vesicles (pEVs), we carried out lncRNA transcriptome profiling on small EVs (sEVs) secreted from AOPPs-treated trophoblast cells and identified upregulated lncRNA TDRKH-AS1 as a potentially causative factor for PE. We isolated and characterized sEVs from plasma and trophoblast cells by transmission electron microscopy (TEM), nanoparticle tracking analysis (NTA) and western blotting. The expression and correlation of lncRNA TDRKH-AS1 were evaluated using qRT-PCR in plasmatic sEVs and placentae from patients. Pregnant mice injected with TDRKH-AS1-riched trophoblast sEVs was performed to detect the TDRKH-AS1 function in vivo. To investigate the potential effect of sEVs-derived TDRKH-AS1 on endothelial function in vitro, transcriptome sequencing, scanning electron Microscopy (SEM), immunofluorescence, ELISA and western blotting were conducted in HUVECs. RNA pulldown, mass spectrometry, RNA immunoprecipitation (RIP), chromatin isolation by RNA purification (ChIRP) and coimmunoprecipitation (Co-IP) were used to reveal the latent mechanism of TDRKH-AS1 on endothelial injury. Results The expression level of TDRKH-AS1 was significantly increased in plasmatic sEVs and placentae from patients, and elevated TDRKH-AS1 in plasmatic sEVs was positively correlated with clinical severity of the patients. Moreover, pregnant mice injected with TDRKH-AS1-riched trophoblast sEVs exhibited a hallmark feature of PE with increased blood pressure and systemic inflammatory responses. Pyroptosis, an inflammatory form of programmed cell death, is involved in the development of PE. Indeed, our in vitro study indicated that sEVs-derived TDRKH-AS1 secreted from AOPPs-induced trophoblast elevated DDIT4 expression levels to trigger inflammatory response of pyroptosis in endothelial cells through interacting with PDIA4. Conclusions Herein, results in the present study supported that TDRKH-AS1 in sEVs isolated from oxidative stress trophoblast may be implicated in the pathogenesis of PE via inducing pyroptosis and aggravating endothelial dysfunction.

Abstract BackgroundDigital technologies, especially contact tracing apps, have been crucial in monitoring and tracing the transmission of COVID-19 worldwide. China developed health code apps as an emergency response to the pandemic with plans to use them for broader public health services. However, potential problems within privacy policies may compromise personal information (PI) protection. ObjectiveWe aimed to evaluate the compliance of the privacy policies of 30 health code apps in the mainland of China with the Personal Information Protection Law (PIPL) and related specifications. MethodsWe reviewed and assessed the privacy policies of 30 health code apps between August 26 and September 6, 2023. We used a 3-level indicator scale based on the information life cycle as provided in the PIPL and related specifications. The scale comprised 7 level-1 indicators, 26 level-2 indicators, and 71 level-3 indicators. ResultsThe mean compliance score of the 30 health code apps was 59.9% (SD 22.6%). A total of 13 (43.3%) apps scored below this average, and 6 apps scored below 40%. Level-1 indicator scores included the following: general attributes (mean 85.6%, SD 23.3%); PI collection and use (mean 66.2%, SD 22.7%); PI storage and protection (mean 63.3%, SD 30.8%); PI sharing, transfer, disclosure, and transmission (mean 57.2%, SD 27.3%); PI deletion (mean 52.2%, SD 29.4%); individual rights (mean 59.3%, SD 25.7%); and PI processor duties (mean 43.7%, SD 23.8%). Sensitive PI protection compliance (mean 51.4%, SD 26.0%) lagged behind general PI protection (mean 83.3%, SD 24.3%), with only 1 app requiring separate consent for sensitive PI processing. Additionally, 46.7% (n=14) of the apps needed separate consent for subcontracting activities, while fewer disclosed PI recipient information (n=13, 43.3%), safety precautions (n=11, 36.7%), and rules of PI transfer during specific events (n=10, 33.3%). Most privacy policies specified the PI retention period (n=23, 76.7%) and postperiod deletion or anonymization (n=22, 73.3%), but only 6.7% (n=2) were committed to prompt third-party PI deletion. Most apps delineated various individual rights: the right to inquire (n=25, 83.3%), correct (n=24, 80%), and delete PI (n=24, 80%); cancel their account (n=21, 70%); withdraw consent (n=20, 60%); and request privacy policy explanations (n=24, 80%). Only a fraction addressed the rights to obtain copies (n=4, 13.3%) or refuse advertisement of automated decision-making (n=1, 3.3%). The mean compliance rate of PI processor duties was only 43.7% (SD 23.8%), with significant deficiencies in impact assessments (mean 5.0%, SD 19.8%), PI protection officer appointment (mean 6.7%, SD 24.9%), regular compliance audits (mean 6.7%, SD 24.9%), and complaint management (mean 37.8%, SD 39.2%). ConclusionsOur analysis revealed both strengths and significant shortcomings in the compliance of privacy policies of health code apps with the PIPL and related specifications considering the information life cycle. As China contemplates the future extended use of health code apps, it should articulate the legitimacy of the apps’ normalization and ensure that users provide informed consent. Meanwhile, China should raise the compliance level of relevant privacy policies and fortify its enforcement mechanisms.

Using the hourly precipitation data from 35 stations in the Three Gorges Reservoir Region （TGRR） from 1998 to 2020， the spatial and temporal variation characteristics of extreme precipitation occurrence were analyzed around the total amount， frequency and intensity of hourly heavy precipitation （≥20 mm·h-1） and hourly extreme heavy precipitation （≥50 mm·h-1） in the TGRR in the past 23 years.The characteristics of hourly extreme precipitation variation in the TGRR before and after 2010 are also compared and analyzed.The results indicate that the frequency and intensity of hourly heavy precipitation and extreme heavy precipitation in the TGRR were abnormally high in 1998.If this year is excluded， the total number of hourly heavy precipitation and extreme heavy precipitation has no significant trend from 1999 to 2020.In recent 23 years， hourly heavy precipitation occurs 3.8 times per station per year on average， and 3.0~5.0 times per year in most stations.The average annual occurrence of hourly extreme heavy precipitation is 5.5 times， and the average annual occurrence is less than 0.25 times in most stations.The average annual occurrence is more in the Jianshi-Xuanen area in the central mountainous area.The spatial distribution of annual mean heavy precipitation and hourly heavy precipitation in the TGRR is quite different.After 2010， the annual mean hourly heavy precipitation decreased by 10.4 mm， mainly in Chongqing area in the west of the TGRR， with an annual mean decrease of 15.5 mm.The annual mean hourly heavy precipitation and its occurrence frequency increased at 31.4% stations， and the increase was more obvious in the Jianshi-Laifeng area in central Hubei Province， and the annual heavy precipitation at five stations increased by 16.1 mm on average.And formed the distribution state with the beginning of construction as the center.The "increase and decrease" of the average number of extreme heavy precipitation for many years before and after 2010 presents an alternating southwest-northeast belt distribution.The average number of extreme precipitation in most regions remained at 0.0~0.5， with little change on the whole.The stations with increasing characteristics of heavy rainfall intensity accounted for 48.6%， and the increasing range of heavy precipitation rain intensity was further expanded.In the Wulong-Changyang area， the rainfall intensity of hourly heavy precipitation increased while the heavy precipitation decreased.On the whole， the increase of heavy precipitation in the TGRR is mainly concentrated in the eastern area closer to the reservoir area， and the influence of hourly extreme precipitation on incoming water in flood season needs to be paid attention to.

Land use types other than specialized athletic fields provide a variety of jogging environments, addressing the shortage of urban fitness facilities and promoting urban health as well as sustainability. Currently, there is limited research comparing the differences in jogging support among various land use types, which can assist decision-makers in setting priorities and targeted strategies for urban renewal, especially in urban built-up areas with limited land resources. Initially, spatial information, statistical data, and recommendation reason text were extracted from recommended routes in mobile fitness apps and categorized into six land use types. Subsequently, spatial potential was measured through descriptive statistics, buffer area analysis, spatial autocorrelation analysis, and line density analysis. Environmental preferences were gauged by text analysis using jieba word segmentation and grouped word frequency calculation. Finally, the measurement results of different land uses were compared, including scale differences, spatial differentiation, environmental perception, and environmental elements. The research found that streets, residential areas, campuses, parks, and greenways possess significant potential to support jogging, particularly streets. These types of land use exhibit varying spatial potentials and attractions in environmental preferences. Targeted recommendations have been proposed to support the renewal of urban built-up areas and research in related fields.

ObjectiveTo investigate the diagnostic value of dermoscopy in defining the tumor margin of cutaneous squamous cell carcinoma (cSCC) for the appropriate surgical margin.MethodsA total of 90 cSCC patients were enrolled in the study. All patients were recruited into two groups: those who preserved intact macroscopic features of neoplasms without or after incisional biopsy and those with uncertain residual tumors after excisional biopsy. A dermoscopy-defined surgical margin of 8mm outward was used according to the tumor boundaries observed with the naked eye and dermoscopy. All excised tumor specimens were divided into serial sections according to the four “3, 6, 9, 12” directions at every 4-mm interval from the dermoscopy-detected tumor margin. Pathological examination was performed at 0 mm, 4 mm, and 8 mm margins to confirm tumor remnants.ResultsRetrospective analysis of dermatoscopic results showed inconsistent clinical and dermatoscopic borders in 43 of 90 cases (47.8%). The ability of dermoscopy to detect tumor borders showed no statistical difference between the two groups (p > 0.05). In the unbiopsy or incisional biopsy group, 66.6% of the tumors were resected with a 4-mm margin and 98.3% with an 8-mm margin, with significant differences (p = 0.047). For patients with inconspicuous clinical evidence of residual tumor after excisional biopsy, the tumor clearance rate was 53.3% at 0 mm, 93.3% at 4 mm, and 100.0% at 8 mm. Statistically significant differences were noted between 0 mm and 4 mm (p = 0.017), as well as between 0 mm and 8 mm (p = 0.043) but did not differ between 4 mm and 8 mm (p > 0.05).ConclusionsDermoscopy defined the tumor margin of cSCC better than visual inspection alone. Direct dermoscopic-guided surgery with at least 8-mm expansion was recommended for high-risk cSCC. Dermoscopy also assisted in identifying surgical margins at the healing biopsy site, making 8 mm still the recommended expansion range.

Abstract Continuous urban development leads to urban heat island effects. Research suggests that urban green spaces can help effectively reduce urban heat island effects in the summer. Previous studies have mainly focused on the influence of different underlying surfaces on air cooling and humidification. There is a lack of in-depth research on the relationship between park structure and microclimatic effects. Here, we examined the main landscape parameters of green spaces in 15 parks located in Suzhou Industrial Park (SIP) with a subtropical maritime monsoon climate zone during the summer to analyze their influence on the microclimate. We adopted a multiple regression method to perform a quantitative analysis of the correlation between the factors and the cooling and humidifying effects. We used one-way ANOVA (analysis of variance) and multiple linear regression statistical analysis methods to study the influence of woodland density and water bodies on the microclimatic effect of the green areas. The result shows that the average cooling and humidifying effect of medium-size green spaces was most significant during high-temperature hours in the daytime. Also, the result shows that the shape and size of water areas within a green space have a significant influence on local cooling and humidification.

MYB transcription factors are major actors regulating plant development and adaptability. Brassica napus is a staple oil crop and is hampered by lodging and diseases. Here, four B. napus MYB69 (BnMYB69s) genes were cloned and functionally characterized. They were dominantly expressed in stems during lignification. BnMYB69 RNA interference (BnMYB69i) plants showed considerable changes in morphology, anatomy, metabolism and gene expression. Stem diameter, leaves, roots and total biomass were distinctly larger, but plant height was significantly reduced. Contents of lignin, cellulose and protopectin in stems were significantly reduced, accompanied with decrease in bending resistance and Sclerotinia sclerotiorum resistance. Anatomical detection observed perturbation in vascular and fiber differentiation in stems, but promotion in parenchyma growth, accompanied with changes in cell size and cell number. In shoots, contents of IAA, shikimates and proanthocyanidin were reduced, while contents of ABA, BL and leaf chlorophyll were increased. qRT-PCR revealed changes in multiple pathways of primary and secondary metabolisms. IAA treatment could recover many phenotypes and metabolisms of BnMYB69i plants. However, roots showed trends opposite to shoots in most cases, and BnMYB69i phenotypes were light-sensitive. Conclusively, BnMYB69s might be light-regulated positive regulators of shikimates-related metabolisms, and exert profound influences on various internal and external plant traits.

The surface effects on running biomechanics have been greatly investigated. However, the effects on rearfoot strike runners remain unknown. The purpose of this study was to investigate the effects of surfaces on the running kinematics, kinetics, and lower-limb stiffness of habitual rearfoot strikers. Thirty healthy male runners were recruited to run at 3.3 ± 0.2 m/s on a customized runway covered with three different surfaces (artificial grass, synthetic rubber, or concrete), and their running kinematics, kinetics, and lower-limb stiffness were compared. Differences among the three surfaces were examined using statistical parametric mapping and one-way repeated-measure analysis of variance. There were no statistical differences in the lower-limb joint motion, vertical ground reaction force (GRF), loading rates, and lower-limb stiffness when running on the three surfaces. The braking force (17%–36% of the stance phase) and mediolateral GRF were decreased when running on concrete surface compared with running on the other two surfaces. The moments of ankle joint in all three plane movement and frontal plane hip and knee joints were increased when running on concrete surface. Therefore, habitual rearfoot strikers may expose to a higher risk of running-related overuse injuries when running on a harder surface.

To date, most studies on building environments and walking behavior have utilized top-down approaches (e.g., big data or social media data) yet lack bottom-up approaches to verify their findings. Therefore, this study divided urban streets into three main settings (community streets, waterfront paths, and urban greenways) and collected data from a sample of 411 urban residents in Chengdu via an online questionnaire to examine the impact of street environmental factors on their choice of walking path. It was found that: (1) people with higher levels of education preferred streets with water bodies as walking paths; (2) the environmental quality of the physical and aesthetic aspects both had an impact on residents’ choices, and the aesthetic environmental quality had a stronger impact; (3) the impact of most infrastructures on community streets was stronger than on other streets; (4) residents were more concerned about the environmental quality of waterfront paths and urban greenways. Based on these findings, three design patterns for residents’ preferred street environments are proposed.

ABSTRACTThe Law for Licensing Medical Practitioners of the People’s Republic of China, enacted in 1999, was amended in 2021. This commentary reviews the key points of the amendment and raises doubts as to one of its points. Specifically, we argue that the minimum education level required to take the physicians’ licensing examination should be set to completion of a bachelor degree, instead of a vocational diploma or junior college graduation as in the 2021 amendment. China adopted a system of multi-tiered medical education more than 70 years ago. This policy has resulted in a threshold of entry-level medical education far below the global standards. The highly heterogeneous education background of physicians in China has led to low standards of practicing physicians, which in turn have significantly negative impacts on the health care market. We illustrate changes over time in the educational distribution and regional distribution of practicing physicians in China, and present reasons to improve entry-level educational standards, by setting the physician licensing threshold at an appropriate level. This will not only improve the overall quality of physicians but will also help address equity and efficiency issues in the health care market.

As the main power source of new energy electric vehicles, the accurate estimation of State of Charge (SOC) of Li-ion batteries is of great significance for accurately estimating the vehicle’s driving range, prolonging the battery life, and ensuring the maximum efficiency of the whole battery pack. In this paper, the ternary Li-ion battery is taken as the research object, and the Dual Polarization (DP) equivalent circuit model with temperature-varying parameters is established. The parameters of the Li-ion battery model at ambient temperature are identified by the forgetting factor least square method. Based on the state space equation of power battery SOC, an adaptive Sliding Mode Observer is used to study the estimation of the State of Charge of the power battery. The SOC estimation results are fully verified at low temperature (0 °C), normal temperature (25 °C), and high temperature (50 °C). The simulation results of the Urban Dynamometer Driving Schedule (UDDS) show that the SOC error estimated at low temperature and high temperature is within 2%, and the SOC error estimated at normal temperature is less than 1%, The algorithm has the advantages of accurate estimation, fast convergence, and strong robustness.

Introduction: A number of provinces have implemented a fiscal reform of flattening government since the first decade of this century in China. This study aims to quantitatively analyze the influences of this government fiscal reform on county-level health expenditure. We also bring forward policy suggestions for improving county-level fiscal system and healthcare delivery.Methods: We collected a novel longitudinal county-level data from 2003 to 2010, including counties' socioeconomic data, fiscal revenue, and health expenditure. Jilin Province, Hebei Province, and Anhui Province were selected as representative samples for this policy evaluation. The study employed a time-varying difference-in-difference model specification to investigate the impacts of flattening fiscal reform on health expenditure.Results: The analyses find that the fiscal system reforms of the three provinces have a significantly positive impact on the health expenditure of county-level governments. However, we find no policy effects on the proportion of health expenditure to fiscal expenditure of county-level governments. The estimation results are robust after controlling several background variables.Conclusion: The results yield important policy insights that public finance and its reform significantly impacts health expenditures in China. The government may still need to strengthen the transfer payment system to guarantee the social welfare provision in healthcare.

Objectives To investigate the demographics and motivations of whole-body donors in China, and help suggest a solution to the problem of low body donation numbers.Design A cross-sectional study on body donors in China. Demographic analysis of the donating information of deceased donors and in-depth interviews of potential body donors.Setting Eleven districts in Nanjing, China.Participants Deceased whole-body donors who had donated their bodies to the body donation receiving station of Nanjing Medical University between 1 July 2009 and 30 June 2019 (n=835), and living registered whole-body donors (n=68).Results Among the whole-body donor population, the numbers of males, people older than 65 years and those working as teachers, government officials, medical staff and farmers were significantly higher than those of the general Nanjing population. Donors with an education level of college or above accounted for nearly half of the deceased donors, and considered donating their bodies earlier in their lives than others. Cancer and heart disease were the major causes of death among donors. Interviews of the 68 living donors revealed the following major motivations for the decision to donate: to support medical education; to reduce their children’s funeral burden; no longer holding traditional Chinese views on life and death; influence by role models and annoyance at complex funeral ceremonies.Conclusions Older people, people with an education level of college or above, labourers, teachers, government officials and farmers are the major groups that donate their bodies. Although people’s motivations for donation are complex, their desire to support medical education is the most prevalent motivation. By helping focus on target groups for promotional messaging and identifying their prime motivations, this study’s findings can provide a reference for promoting body donation in China.

The objective of this study is to investigate plantar loads characteristics of habitual forefoot strike runners while running on different surfaces. Twenty-six runners (age: 28.2 ± 6.8 y, height: 172.9 ± 4.1 cm, weight: 67.7 ± 9.6 kg, BMI (body mass index): 22.6 ± 2.8 kg/m2, running age: 5.0 ± 4.2 y, running distance per week: 14.6 ± 11.7 km) with habitual forefoot strike participated in the study. Runners were instructed to run at 3.3 ± 0.2 m/s on three surfaces: grass, synthetic rubber and concrete. An in-shoe pressure measurement system was used to collect and analyze plantar loads data. Running on the synthetic rubber surface produced a lower plantar pressure in the lateral forefoot (256.73 kPa vs. 281.35 kPa, p = 0.006) than running on concrete. Compared with the concrete surface, lower pressure−time integrals were shown at the central forefoot (46.71 kPa⋅s vs. 50.73 kPa⋅s, p = 0.001) and lateral forefoot (36.13 kPa⋅s vs. 39.36 kPa⋅s, p = 0.004) when running on the synthetic rubber surface. The different surfaces influence plantar loads of habitual forefoot strikers and runners should choose appropriate overground surface to reduce the risk of lower extremity musculoskeletal injuries.