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Abstract Introduction Gestational diabetes mellitus (GDM) is associated with an increased risk of developing type 2 diabetes mellitus (T2DM). The inflammatory potential of diet is crucial in GDM development. This study compares dietary inflammatory indices (DII) in females with and without a history of GDM and constructs a predictive model for prediabetes risk. Methods Cross-sectional data from NHANES cycles (2011–2014) were analyzed using the DII. Independent t tests, chi-square test, and Mann-Whitney U test examined DII scores in relation to GDM history. Multivariate logistic regression assessed DII’s association with prediabetes in females with GDM history. Restricted cubic spline (RCS) and LASSO regression modeled non-linear relationships and predicted prediabetes risk. Results 971 female participants were included. Those with GDM history had lower DII scores (1.62 (0.58, 2.93) vs. 2.05 (0.91, 2.93)). Higher DII scores in females with GDM were linked to prediabetes, remaining significant after adjusting for confounders. RCS analysis found no non-linear correlation (non-linear p = 0.617). The prediabetes model for GDM history had strong predictive performance (AUC = 88.6%, 95% CI: 79.9-97.4%). Conclusion Females with GDM history show lower DII levels, potentially reflecting improved diet and health awareness. Higher DII scores correlate with increased prediabetes risk in this group, emphasizing diet’s role in diabetes risk. Further studies are needed to confirm these findings.

Abstract Cartilage damage caused by injuries or degenerative diseases remains a major challenge in the field of regenerative medicine. In this study, we developed a composite hydrogel system for the delivery of melatonin and menstrual blood stem cells (MenSCs) to treat a rat model of cartilage defect. The composite delivery system was produced by incorporation of melatonin into the gelatin fibers and dispersing these fibers into calcium alginate hydrogels. Various characterization methods including cell viability assay, microstructure studies, degradation rate measurement, drug release, anti-inflammatory assay, and radical scavenging assay were used to characterize the hydrogel system. MenSCs were encapsulated within the nanocomposite hydrogel and implanted into a rat model of full-thickness cartilage defect. A 1.3 mm diameter drilled in the femoral trochlea and used for the in vivo study. Results showed that the healing potential of nanocomposite hydrogels containing melatonin and MenSCs was significantly higher than polymer-only hydrogels. Our study introduces a novel composite hydrogel system, combining melatonin and MenSCs, demonstrating enhanced cartilage repair efficacy, offering a promising avenue for regenerative medicine. Graphical Abstract

Abstract China’s large-scale tree planting programs are critical for achieving its carbon neutrality by 2060, but determining where and how to plant trees for maximum carbon sequestration has not been rigorously assessed. Here, we developed a comprehensive machine learning framework that integrates diverse environmental variables to quantify tree growth suitability and its relationship with tree numbers. Then, their correlations with biomass carbon stocks were robustly established. Carbon sink potentials were mapped in distinct tree-planting scenarios. Under one of them aligned with China’s ecosystem management policy, 44.7 billion trees could be planted, increasing forest stock by 9.6 ± 0.8 billion m³ and sequestering 5.9 ± 0.5 PgC equivalent to double China’s 2020 industrial CO2 emissions. We found that tree densification within existing forests is an economically viable and effective strategy and so it should be a priority in future large-scale planting programs.

Abstract The association between obstructive sleep apnea (OSA) and proteinuria is undetermined, with few studies on hypertension, a high-risk group for renal impairment. Therefore, we aimed to explore whether OSA is an independent risk factor for proteinuria in patients with hypertension. We investigated the cross-sectional association between OSA and proteinuria. Participants were divided into groups by apnea hypopnea index (AHI) category. Multivariable Logistic regression analysis was used to evaluate the association between OSA severity, objectively measured sleep dimensions, and proteinuria which is mainly defined by 24-h urine protein quantification > 300 mg/24 h. Sensitivity analyses were performed by excluding those with comorbidities (primary aldosteronism and homocysteine ≥ 15 μmol/L). Of the 2106 participants, the mean age was 47.57 ± 10.50 years, 67.2% were men, and 75.9% were OSA patients. In total participants, compared with those without OSA, patients with mild OSA, moderate OSA, and severe OSA showed 1.09 (95% CI 0.80–1.40), 1.24 (95% CI 0.89–1.74) and 1.47 (95% CI 1.04–2.08) fold risk for proteinuria with a trend test P trend

Abstract Age, gender, body mass index (BMI), and mean heart rate during sleep were found to be risk factors for obstructive sleep apnea (OSA), and a variety of methods have been applied to predict the occurrence of OSA. This study aimed to develop and evaluate OSA prediction models using simple and accessible parameters, combined with multiple machine learning algorithms, and integrate them into a cloud-based mobile sleep medicine management platform for clinical use. The study data were obtained from the clinical records of 610 patients who underwent polysomnography (PSG) at the Sleep Medicine Center of the Second Affiliated Hospital of Fujian Medical University between January 2021 and December 2022. The participants were randomly divided into a training-test group (80%) and an independent validation group (20%). The logistic regression, artificial neural network, naïve Bayes, support vector machine, random forest, and decision tree algorithms were used with age, gender, BMI, and mean heart rate during sleep as predictors to build a risk prediction model for moderate-to-severe OSA. To evaluate the performance of the models, we calculated the area under the receiver operating curve (AUROC), accuracy, recall, specificity, precision, and F1-score for the independent validation set. In addition, the calibration curve, decision curve, and clinical impact curve were generated to determine clinical usefulness. Age, gender, BMI, and mean heart rate during sleep were significantly associated with OSA. The artificial neural network model had the best efficacy compared with the other prediction algorithms. The AUROC, accuracy, recall, specificity, precision, F1-score, and Brier score were 80.4% (95% CI 76.7–84.1%), 69.9% (95% CI 69.8–69.9%), 86.5% (95% CI 81.6–91.3%), 61.5% (95% CI 56.6–66.4%), 53.2% (95% CI 47.7–58.7%), 65.9% (95% CI 60.2–71.5%), and 0.165, respectively, for the artificial neural network model. The AUROCs for the LR, NB, SVM, RF, and DT models were 80.2%, 79.7%, 79.2%, 78.4%, and 70.4%, respectively. The six models based on four simple and easily accessible parameters effectively predicted moderate-to-severe OSA in patients with PSG screening, with the artificial neural network model having the best performance. These models can provide a reliable tool for early OSA diagnosis, and their integration into a cloud-based mobile sleep medicine management platform could improve clinical decision making.

Abstract Small cell lung cancer (SCLC) patients exhibit significant heterogeneity in tumor burden, physical condition, and responses to initial treatment. This diversity in treatment responses can result in varying treatment outcomes. The primary objective of this study was to explore the patient demographics associated with improved survival outcomes through radiotherapy. Based on the SEER database, we identified 42,824 SCLC patients enrolled between 2004 and 2015. These patients were stratified into radiotherapy (n = 20,360) and non-radiotherapy groups (n = 22,464). We controlled for confounding factors using propensity score matching (PSM) analysis. Subsequently, Kaplan–Meier (KM) analysis was employed to evaluate the impact of radiotherapy on patients’ overall survival (OS) and cancer-specific survival (CSS). Cancer-specific mortality was further analyzed using competitive risk models. Cox analysis was also conducted to examine additional variables potentially affecting the survival of SCLC patients. We identified a total of 42,824 eligible patients, and following PSM, 13,329 patients were successfully matched in both the radiotherapy and non-radiotherapy groups. The KM analysis showed that the median OS was 9 months in the radiotherapy group and 6 months in the non-radiotherapy group. The median CSS was 10 months in the radiotherapy group and 7 months in the non-radiotherapy group. The 5-year OS and 10-year OS rates were 6.2% versus 1.6% in the radiotherapy group and 2.6% versus 0.8% in the non-radiotherapy group (P

Background: The sleep quality of medical staff was severely affected during COVID-19, but the factors influencing the sleep quality of frontline staff involved in medical assistance remained unclear, and screening tools for their sleep quality were lacking. Methods: From June 25 to July 14, 2022, we conducted an Internet-based cross-sectional survey. The Pittsburgh Sleep Quality Index (PSQI), a self-designed general information questionnaire, and a questionnaire regarding the factors influencing sleep quality were combined to understand the sleep quality of frontline medical staff in Fujian Province supporting Shanghai in the past month. A chi-square test was used to compare participant characteristics, and multivariate unconditional logistic regression analysis was used to determine the predictors of sleep quality. Stratified sampling was used to divide the data into a training test set ( n = 1061, 80%) and an independent validation set ( n = 265, 20%). Six models were developed and validated using logistic regression, artificial neural network, gradient augmented tree, random forest, naive Bayes, and model decision tree. Results: A total of 1326 frontline medical staff were included in this survey, with a mean PSQI score of 11.354 ± 4.051. The prevalence of poor sleep quality was 80.8% ( n = 1072, PSQI >7). Six variables related to sleep quality were used as parameters in the prediction model, including type of work, professional job title, work shift, weight change, tea consumption during assistance, and basic diseases. The artificial neural network (ANN) model produced the best overall performance with area under the curve, accuracy, sensitivity, specificity, precision, F1 score, and kappa of 71.6%, 68.7%, 66.7%, 69.2%, 34.0%, 45.0%, and 26.2% respectively. Conclusions: In this study, the ANN model, which demonstrated excellent predictive efficiency, showed potential for application in monitoring the sleep quality of medical staff and provide some scientific guidance suggestions for early intervention.

Abstract Background Aldosterone plays important parts in development of cardio-metabolic diseases as end product of renin-angiotensin-aldosterone system. However, factors elevating circulating aldosterone are not clear, and lifestyle-related factors are suggested to be involved, whereas less studied. Therefore, we aimed to explore the association of lifestyle factors with plasma aldosterone concentration (PAC) in community population. Methods In this cross-sectional study, we recruited participants using multistage random sampling from Emin China in 2019, and collected data and fasting blood samples. The considered lifestyle factors included obesity parameters (neck circumference, abdominal circumference), alcohol consumption, blood pressure (BP), physical activity, sleep duration, sleep quality, mental state (depression and anxiety), fasting blood glucose (FBG), and lipid profiles (total cholesterol and triglyceride). PAC was measured using radioimmunoassay. We performed sex-stratified linear and logistic regressions to explore associated factors of PAC. Component analysis was further performed to identify the main factors affecting PAC. Results Twenty-seven thousand four hundred thirty-six participants with 47.1% men were included. Obesity parameters (neck circumference, abdominal circumference), glucose metabolism (FBG), psychological status (anxiety status in men and women, depression status in men), BP, liver function (in men), lipid metabolism (TC and TG in men), sleep parameters (sleep quality in women), and renal function (in women) are the main factors associated with elevated PAC. Conclusion lower physical activity, alcohol consumption, higher BP, fat accumulation, dyslipidemia, higher fasting blood glucose, and presence of depression and anxiety were the main factors associated with eleveated PAC.

Background The quality of life of patients receiving long-term peritoneal dialysis (PD) is significantly impacted by the onset of peritoneal fibrosis (PF), and one of the pathological changes is mesothelial-mesenchymal transition (MMT). In this study, we investigated the potential roles of miR-454-3p and signal transducer and activator of transcription 3 (STAT3) in the progression of peritoneal MMT and the underlying mechanisms.Methods Peritoneums were collected to detect morphology via hematoxylin-eosin staining and differentially expressed miRNAs were detected via RT-qPCR. PD effluent-derived cell populations in the peritoneal cavity were isolated from the effluents of 20 PD patients to determine miR-454-3p, STAT3, and MMT markers via Western blotting and RT-qPCR. The relationship between miR-454-3p and STAT3 was examined via a dual-luciferase reporter assay. Western blotting and RT-qPCR were utilized to evaluate the expression of STAT3, MMT markers, and glycolytic enzymes. Immunofluorescence staining revealed the localization and expression of MMT markers and STAT3.Results MiR-454-3p was downregulated in the peritoneums and PD effluent-derived cell populations of long-term PD patients. High glucose (HG) treatment promoted HMrSV5 cell MMT and glycolysis. MiR-454-3p overexpression alleviated HG-induced MMT and suppressed the expression of STAT3 and glycolytic enzymes. In contrast, the miR-454-3p inhibitor exacerbated HG-induced MMT and promoted the expression of glycolytic enzymes and STAT3. Moreover, STAT3 was the target of miR-454-3p.Conclusions This study demonstrated the protective role of miR-454-3p in HG-induced MMT and glycolysis in HMrSv5 cells, suggesting that miR-454-3p may prevent MMT by suppressing glycolytic enzymes via the STAT3/PFKFB3 pathway in the HG environment.

Deep-learning-based object detection in UAS imagery is crucial for outfall surveys and basin environmental protection. Comprehensive UAS image datasets serve as a foundation for creating deep-learning-based outfall-detection models and evaluating outfall-detection algorithms. However, existing remote sensing deep learning datasets lack specific outfall data. This study introduces a benchmark UAS image dataset of outfalls, categorized into three main and seven subcategories. Over 10,000 labeled images were collected from UAS images with a 10 cm resolution for the Yangtze River, Yellow River, and other basins from 2019 to 2022, covering nearly all types of outfalls in China. Each sample was matched with digital surface model (DSM) data generated through photographometry or the DSM transfer method. Evaluation with seven widely used deep learning-based object detection algorithms demonstrated the dataset's viability, achieving an average precision ([Formula: see text]) of 64.6, surpassing performance on Microsoft Common Objects in Context. Further experiments indicated that DSMs attached to this dataset could benefit from geo-deep-learning-based object detection algorithms for outfalls, achieving an [Formula: see text] exceeding 70. This study presents a UAS benchmark image dataset for outfall surveys, potentially advancing the application of deep learning in environmental protection.

Abstract Photovoltaic (PV) installations are a leading technology for generating green electricity and reducing carbon emissions. Roofing highways with solar panels offers a new opportunity for PV development, but its potential of global deployment and associated socio‐economic impacts have not been investigated. Here, we combine solar PV output modeling with the global highway distribution and levelized cost of electricity to estimate the potential and economic feasibility of deploying highway PV systems worldwide. We also quantify its co‐benefits of reducing CO2 equivalent emissions and traffic losses (road traffic deaths and socio‐economic burdens). Our analysis reveals a potential for generating 17.58 PWh yr−1 of electricity, of which nearly 56% can be realized at a cost below US$100 MWh−1. Achieving the full highway PV potential could offset 28.78% (28.21%–29.1%) of the global total carbon emissions in 2018, prevent approximately 0.15 million road traffic deaths, and reduce US$0.43 ± 0.16 trillion socio‐economic burdens per year. Highway PV projects could bring a net return of about US$14.42 ± 4.04 trillion over a 25‐year lifetime. To exploit the full potential of highway PV, countries with various income levels must strengthen cooperation and balance the multiple socio‐economic co‐benefits.

Background: Bilateral first rib fractures are rare. This article presented the diagnosis and treatment of a case of bilateral first rib fractures with multi-organ complications and discussed the injury mechanism. Case presentation: A 15-year-old girl fell off a motorcycle. She complained of right neck root pain and right upper limb weakness. The myodynamia of the right upper limb was grade 0, and the sensation disappeared below the level of the elbow joint. The computed tomography (CT) showed bilateral first rib fractures and transverse process fracture of the 6th cervical vertebra. Chest CT revealed a massive hemothorax in the right thoracic cavity, and head magnetic resonance imaging showed bilateral cerebellar infarction. Cervical computed tomography angiography (CTA) revealed a lumen occlusion at the origin of the right subclavian artery. The patient underwent an emergency thoracoscopy, and a re-examination of chest CT indicated that no obvious pleural effusion was found after the hemothorax was cleared. The patient underwent right subclavian arteriography and interventional endovascular thrombolysis, and the right subclavicular artery was patency postoperative. Bilateral first rib fractures and cerebellar infarction were treated conservatively. The brachial plexus injury did not show any signs of recovery after conservative treatment, and she was recommended to be transferred to a superior hospital for surgical treatment. Conclusions: The injury mechanism of bilateral first rib fractures with multi-organ complications was closely related to the initial factor of the right neck root colliding with a bulge on the ground. We believe that the fractures occur as a result of a combination including a high energy trauma from direct impact and a low-energy mechanism from violent muscle contraction caused by neck hyperextension. This case report was helpful for clinicians to understand bilateral first rib fractures and their complications.

Abstract This study aims to investigate the differential expression of insulin‐like growth factor 2 mRNA‐binding protein 3 (IGF2BP3) in the peritoneal dialysate among patients with different durations of peritoneal dialysis and its association with the angiogenic marker vascular* endothelial growth factor (VEGF), the fibronectin (FN), and various clinical indicators. A cohort of 122 peritoneal dialysis patients was categorized into short‐term (≤1 year, n = 33), mid‐term (>1 and ≤5 years, n = 55), and long‐term (>5 years, n = 34) groups based on dialysis duration. We utilized enzyme‐linked immunosorbent assay (ELISA) and western blot assays to quantify the levels of IGF2BP3, VEGF, and FN in the dialysate. Our findings showed a progressive increase in IGF2BP3 levels with the duration of PD, with the long‐term group exhibiting significantly higher levels than both the short‐term and mid‐term groups (p

Abstract Objective To explore the mechanism of the p38MAPK signaling pathway in repairing articular cartilage defects with biological collagen membranes. Methods Thirty-two healthy adult male rabbits were randomly divided into a control group (n = 8), model group (n = 8), treatment group (n = 8) and positive drug group (n = 8). The control group was fed normally, and the models of bilateral knee joint femoral cartilage defects were established in the other three groups. The knee cartilage defects in the model group were not treated, the biological collagen membrane was implanted in the treatment group, and glucosamine hydrochloride was intragastrically administered in the positive drug group. Twelve weeks after the operation, the repair of cartilage defects was evaluated by histological observation (HE staining and Masson staining), the degree of cartilage repair was quantitatively evaluated by the Mankin scoring system, the mRNA expression levels of p38MAPK, MMP1 and MMP13 were detected by real-time fluorescence quantitative PCR (qRT-PCR), and the protein expression levels of p38MAPK, p-p38MAPK, MMP1 and MMP13 were detected by Western blotting. The results after the construction of cartilage defects, histological staining showed that the articular cartilage wound was covered by a large capillary network, the cartilage tissue defect was serious, and a small amount of collagen fibers were formed around the wound, indicating the formation of a small amount of new bone tissue. In the treatment group and the positive drug group, the staining of cartilage matrix was uneven, the cytoplasmic staining was lighter, the chondrocytes became hypertrophic as a whole, the chondrocytes cloned and proliferated, some areas were nest-shaped, the cells were arranged disorderly, the density was uneven, and the nucleus was stained deeply. The Mankin score of the model group was significantly higher than that of the control group, while the Mankin scores of the treatment group and positive drug group were significantly lower than that of the model group. The results of qRT-PCR detection showed that compared with the control group, the expression level of the p38MAPK gene in the model group did not increase significantly, but the gene expression levels of MMP1 and MMP13 in the model group increased significantly, while the gene expression levels of MMP1 and MMP13 decreased significantly in the treatment group and positive drug group compared with the model group. The results of Western blot detection showed that compared with the control group, the expression level of p38MAPK protein in the model group was not significantly increased, but the phosphorylation level of p38MAPK protein and the protein expression levels of MMP1 and MMP13 were significantly increased in the model group, while the phosphorylation level of p38MAPK protein and the protein expression levels of MMP1 and MMP13 in the treatment group and positive drug group were significantly lower than those in the model group. Conclusion The biological collagen membrane can regulate the expression of MMP1 and MMP13 and repair the activity of chondrocytes by reducing the phosphorylation level of p38MAPK and inhibiting the activation of the p38MAPK signaling pathway, thus improving the repair effect of articular cartilage defects in rabbits. The P38MAPK signaling pathway is expected to become an important molecular target for the clinical treatment of cartilage defects in the future.

Abstract Objective Ni-Ti memory alloys are unusual materials for hard-tissue replacement because of their unique superelasticity, good biocompatibility, high strength, low specific gravity, low magnetism, wear resistance, corrosion resistance and fatigue resistance. The current study aims to evaluate its mechanical properties and provide biomechanical basis for the clinical application of the prosthesis. Methods Ten adult metacarpophalangeal joint specimens were randomly divided into a prosthesis group (n = 5, underwent metacarpophalangeal joint prosthesis) and a control group (n = 5, underwent sham operation). Firstly, the axial compression strength was tested with BOSE material testing machine to evaluate its biomechanical strength. Secondly, these specimens were tested for strain changes using BOSE material testing machine and GOM non-contact optical strain measurement system to evaluate the stress changes. Thirdly, fatigue test was performed between groups. Lastly, the mechanical wear of the metacarpophalangeal joint prosthesis was tested with ETK5510 material testing machine to study its mechanical properties. Results Axial compression stiffness in the prosthesis group was greater than that in the control group in terms of 30 ° and 60 ° flexion positions (P 0.05). In the fatigue wear test, the mean mass loss in the prosthesis group’s prosthesis was 17.2 mg and 17.619 mm3, respectively. The mean volume wear rate was 0.12%. There was no statistically significant difference in the maximum pull-out force of the metacarpal, phalangeal, and polymer polyethylene pads between the prosthesis group and the control group specimens. Conclusions Ni-Ti memory alloy metacarpophalangeal joint prosthesis conforms to the biomechanical characteristics of metacarpophalangeal joints without implants, and the fatigue strength can fully meet the needs of metacarpophalangeal joint activities after joint replacement.

Abstract The detrimental influence of inhaled ozone on human respiratory system is ambiguous due to the complexity of dose response relationship between ozone and human respiratory system. This study collects inhaled ozone concentration and respiratory disease data from Shenzhen City to reveal the impact of ozone on respiratory diseases using the Generalized Additive Models (GAM) and Convergent Cross Mapping (CCM) method at the 95% confidence level. The result of GAM exhibits a partially significant lag effect on acute respiratory diseases in cumulative mode. Since the traditional correlation analysis is incapable of capturing causality, the CCM method is applied to examine whether the inhaled ozone affects human respiratory system. The results demonstrate that the inhaled ozone has a significant causative impact on hospitalization rates of both upper and lower respiratory diseases. Furthermore, the harmful causative effects of ozone to the human health are varied with gender and age. Females are more susceptible to inhaled ozone than males, probably because of the estrogen levels and the differential regulation of lung immune response. Adults are more sensitive to ozone exposure than children, potentially due to the fact that children need longer time to react to ozone stress than adults, and the elderly are more tolerant than adults and children, which may be related to pulmonary hypofunction of the elderly while has little correlation with ozone exposure.

Development of biocompatible and biodegradable 3D scaffold for biomedical application has been challenging. Herein, the application of a novel nanocomposite 3D scaffold based on poly vinyl alcohol and sodium alginate embedded with Ca2+ doped titanium dioxide nanoparticle (PVA + SA/Ca@TiO2) as bioactive material was investigated. The 3D scaffold was prepared using a solvent casting method and characterized using FTIR, SEM, XRD and TGA to study their physiochemical properties. The spectroscopy techniques were used to confirm the formation of the required poly vinyl alcohol and sodium alginate with Ca doped TiO2 nanoparticles fillers interaction by the identification of bands. The TiOH bonds and the bonds related to the interconnected network between the inorganic and the organic components from hybrids. The PVA + SA/Ca@TiO2 nanocomposite 3D scaffold was demonstrated good bioactivity to promote nucleation and growth of hydroxyapatite (HAp) in the simulated body fluid. The PVA + SA/Ca@TiO2 nanocomposite 3D scaffold supported the growth and proliferation of 3 T3 mouse fibroblast cells with strong proliferation and cell attachment. The biocompatibility and nontoxic character of the 3D scaffold was probed using fibroblast cell with over 90 % of cell viability. It offers a potential for cell attachment and captured for biomedical application.

European Centre for Medium-Range Weather Forecasts Reanalysis 5 (ERA5) is a state-of-the-art reanalysis dataset and has been widely used in climate change analysis and land surface process simulations. However, few assessments have been conducted across the entire ocean for this dataset till now. The motivation of this study is to utilize the in-situ observations and remotely sensed sea surface temperature (SST) products to propose a new approach to evaluate the precision of ERA5 air temperature over the whole ocean. First, a stacked multilayer perceptron regressor model was employed to map global marine air temperature (MAT) by incorporating in-situ records into moderate-resolution imaging spectroradiometer (MODIS) SST products. Second, a monthly MAT dataset with a spatial resolution of 0.05° × 0.05° was developed and validated for the assessment of ERA5 air temperature particularly in the regions where only satellite observations are available. It demonstrates that the quality of estimated MAT (RMSE = 1.62 °C, Bias = 0.03 °C) is evidently high in 80.3% of the observation stations, which is much better than that of averaged SST (RMSE = 2.29 °C, Bias = 1.14 °C). Thus, the estimated MAT is credible enough to be employed to assess ERA5 air temperature both at the grid and regional scale. Finally, the ERA5 air temperature was compared and validated with the estimated MAT temporally and spatially. The further study suggested that estimated MAT and ERA5 air temperature basically maintain consistency in expressing persistent warming, particularly in the western Pacific, western Atlantic, and northern Indian Ocean. In addition, the trend of ERA5 air temperature during 50°S–50°N reaches 0.016 ± 0.003°C/yr, which is similar to that of estimated MAT (0.017 ± 0.002 °C/yr) during 2003–2021.

Abstract Background Uncertainty remains about the association of potassium (K) intake with depression and anxiety status. We explored their relationship using 24‐h urinary K, reflecting K intake, in general population. Methods We collected 24‐h urine and performed self‐rating depression and anxiety scales (SDS, SAS) cross‐sectionally in adults selected by random sampling in China. SDS and SAS standard score ≥50 defined depression and anxiety status. Participants were divided into three groups (T1, T2, and T3) by 24‐h urinary K tertile. Odds ratios (OR) and 95% confidence intervals were calculated. Sensitivity analysis was performed by excluding anti‐hypertensive agent takers. Results 546 participants comprised current analytical sample. First, T1 and T2 groups showed higher SDS scores (40.0 vs 40.0 vs 36.0, p = .001), prevalence (19.8 vs 15.9 vs 7.1%, p = .002), whereas increased adjusted odds for depression status only in T1 group (OR = 2.71, p = .017), compared with T3 group. Second, T1 and T2 groups showed higher SAS scores (38.0 vs 40 vs 35.0, p

BackgroundCOVID-19 has been reported to affect the sleep quality of Chinese residents; however, the epidemic’s effects on the sleep quality of college students during closed-loop management remain unclear, and a screening tool is lacking. ObjectiveThis study aimed to understand the sleep quality of college students in Fujian Province during the epidemic and determine sensitive variables, in order to develop an efficient prediction model for the early screening of sleep problems in college students. MethodsFrom April 5 to 16, 2022, a cross-sectional internet-based survey was conducted. The Pittsburgh Sleep Quality Index (PSQI) scale, a self-designed general data questionnaire, and the sleep quality influencing factor questionnaire were used to understand the sleep quality of respondents in the previous month. A chi-square test and a multivariate unconditioned logistic regression analysis were performed, and influencing factors obtained were applied to develop prediction models. The data were divided into a training-testing set (n=14,451, 70%) and an independent validation set (n=6194, 30%) by stratified sampling. Four models using logistic regression, an artificial neural network, random forest, and naïve Bayes were developed and validated. ResultsIn total, 20,645 subjects were included in this survey, with a mean global PSQI score of 6.02 (SD 3.112). The sleep disturbance rate was 28.9% (n=5972, defined as a global PSQI score >7 points). A total of 11 variables related to sleep quality were taken as parameters of the prediction models, including age, gender, residence, specialty, respiratory history, coffee consumption, stay up, long hours on the internet, sudden changes, fears of infection, and impatient closed-loop management. Among the generated models, the artificial neural network model proved to be the best, with an area under curve, accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of 0.713, 73.52%, 25.51%, 92.58%, 57.71%, and 75.79%, respectively. It is noteworthy that the logistic regression, random forest, and naive Bayes models achieved high specificities of 94.41%, 94.77%, and 86.40%, respectively. ConclusionsThe COVID-19 containment measures affected the sleep quality of college students on multiple levels, indicating that it is desiderate to provide targeted university management and social support. The artificial neural network model has presented excellent predictive efficiency and is favorable for implementing measures earlier in order to improve present conditions.

Syphilis, a chronic multisystemic disease caused by spirochete Treponema pallidum subspecies pallidum infection, continues to be a serious global health problem and congenital syphilis remains a major cause of adverse outcomes in pregnancy in developing countries. The development of an effective vaccine is the most cost-effective way to eliminate syphilis, but so far has been elusive. Here, we evaluated the immunogenicity and protective efficacy of Tp0954, a T. pallidum placental adhesin, as a potential vaccine candidate in a New Zealand White rabbit model of experimental syphilis. Animals immunized with recombinant Tp0954 (rTp0954) produced high titers of Tp0954-specific serum IgG, high levels of IFN-γ from splenocytes and specific splenocyte proliferation response when compared to control animals immunized with PBS and Freund’s adjuvant (FA). Furthermore, rTp0954 immunization significantly delayed the development of cutaneous lesions, promoted inflammatory cellular infiltration at the primary lesion sites, as well as inhibited T. pallidum dissemination to distal tissues or organs when compared with that of the control animals. In addition, the naïve rabbits receiving popliteal lymph nodes from Tp0954-immunized, T. pallidum-challenged animals were not infected by T. pallidum, confirming sterile immunity. These findings suggest that Tp0954 is a potential vaccine candidate against syphilis.

Summary: The expansion of dryland has caused a huge impact on the natural environment and human society. Aridity index (AI) can effectively reflect the degree of dryness, but spatiotemporally continuous estimation of AI is still challenging. In this study, we develop an ensemble learning algorithm to retrieve AIs from MODIS satellite data in China from 2003 to 2020. The validation proves the high match between these satellite AIs and their corresponding station estimates with a root-mean-square error of 0.21, bias of −0.01, and correlation coefficient of 0.87. The analysis results indicate China has been drying in recent two decades. Moreover, the North China Plain is undergoing an intense drying process, whereas the Southeastern China is becoming significantly more humid. On the national scale, China's dryland area shows a slight expansion, while the hyper arid area has a decreasing trend. These understandings have contributed to China's drought assessment and mitigation.

Abstract Different medical treatment choices may affect the health of patients with chronic diseases. This study aims to assess the relationship between treatment choices, including the use of traditional Chinese medicine (TCM), and the health levels of middle-aged and elderly patients with six chronic diseases. The sample data comes from China Health and Retirement Longitudinal Study (CHARLS 2018). Basic conditions, medical choices and health status of patients are incorporated. The ordered Logit and Logit regression models are used to analyze and compare the effects of six chronic disease patients’ medical options on their self-rated health (SRH) and depression. The overall average score of SRH is the highest in patients with heart disease (the worst in SRH), which is 3.433. Arthritis patients have the highest overall depression average score (depression) at 0.444. Under the premise of controlling a variety of socio-demographic factors, compared with the non-treatment group, taking TCM has a significant positive effect on SRH of patients with five diseases except hypertension. Both taking western medicine (WM) and taking integrated Chinese and Western medicine (IM) have a significant positive effect on SRH scores of patients with six chronic diseases in middle and old age. Taking TCM has effect on depression of patients with heart or stomach diseases, and taking WM and IM affects depression of middle-aged and elderly chronic patients except diabetes. Taking IM has a greater effect on SRH and depression of chronically ill patients, followed by taking WM, and the effect of taking TCM is relatively small, which is related to the development stage of the disease. Therefore, in the future, the control and treatment of chronic diseases in the middle and late stages can be discussed from the perspective of integrated traditional Chinese and western medicine, but attention should be paid to drug interactions. In order to improve the treatment rate and health level of patients with chronic diseases, their economic burden should be reduced, and they should be guided to choose more reasonable treatment methods.

Abstract Objective Falling is one of the main causes of death and morbidity in the elderly. This study aims to explore the association between elderly patients with chronic diseases and their health-related behaviors and falls in the elderly, and to provide clues for the prevention and intervention of injuries caused by falls in the elderly. Methods Based on the basic demographic characteristics data, number of chronic diseases, health-related behaviors, and physical and mental health data of 5867 elderly people aged 60 and above in the 2018 CHARLS data, this paper used ordered logit regression to analyze the correlation between chronic diseases and their health-related behaviors and falls of Chinese elderly. On this basis, it also distinguishes whether there is care or not, explores whether the related factors of falls of elderly people will be different, and tests the intermediary effect of health status to further explore its mechanism. Results The number of chronic diseases and health-related behaviors in the four dimensions of sleeptime, drinking, smoking, and activity are significantly correlated with falls in the elderly. Among them, health status plays a significant mediating role in the relationship of the number of chronic diseases and sleeptime and activity on the falls of the elderly. In addition, compared with the elderly without care, the risk of falls in the elderly in care is only related to the number of chronic diseases and sleeptime, while the elderly without care is related to the number of chronic diseases and multiple factors such as smoking, drinking and activity. Conclusion Falls are significantly associated with chronic disease and health-related behaviors, while risk or protective factors for falls vary according to whether older adults are cared for. Therefore, targeted interventions can be made for the factors that affect the fall of the elderly according to different situations.

Abstract Background Sleep disordered breathing (SDB) plays a significant role in both sleep quality and cognition and whether it has an impact on the relationship between above two factors remains to be clear. The study aimed to explore the association between sleep quality and cognitive performance in general population by considering influence of sleep disordered breathing (SDB). Methods In this cross-sectional study, we enrolled subjects aged ≥ 18 years using a multi-stage random sampling method. Cognitive status was assessed using Mini Mental State Examination (MMSE) questionnaire, sleep quality using Pittsburgh Sleep Quality Index (PSQI) and SDB was assessed using No-SAS scale, respectively. Multi-variable logistic regression was applied to examine the association of sleep quality and cognitive performance. Subgroup analyses were performed in different age groups, and in those with and without SDB. Results Finally, 30,872 participants aged 47.5 ± 13.8 years with 53.5% women were enrolled, of whom 32.4% had poor sleep quality and 18.6% had low cognitive performance. Compared with good sleepers, subjects with poor sleep quality exhibited significantly higher presence of low cognitive performance (23.7% vs 16.2%, P

Abstract Background There may be differences in gender and marital status in the impact of grandchild care on the depression of the Chinese older adults. This research explores the effect of grandchild care on the depression of Chinese older adults of different genders and marital status, and explores the mediating role of intergenerational support from children between grandchild care and depression. Methods This research uses the data of 3540 Chinese older adults from the China Health and Retirement Longitudinal Study (CHARLS) in 2018. The OLS model is used to analyze the effect of grandchild care on the depression of the older adults. and the older adults are classified according to gender and marital status, and the differences in the effect of grandchild care on the depression of the elderly of different genders and marital status is explored. Finally, the bootstrap method is used to test the mediating effect of intergenerational support from children. Results The research finds that grandchild care has a significant impact on the depression of the older adults in China, and providing grandchild care can significantly reduce the depression of the older adults. The effect of grandchild care on the depression of the older adults is different between different genders and marital status. After categorizing the older adults by gender, the grandchild care only has a significant impact on the depression of female older adults; after classified by marital status, grandchild care only has a significant impact on the depression of the older adults who don’t have a spouse. The mediating effect analysis shows that both children’s emotional support and children’s economic support have a mediating effect between grandchild care and depression of the older adults. Conclusion The depression of the Chinese older adults is affected by grandchild care, and this effect is more prominent in female older adults and the older adults who don’t have a spouse. The society should support and encourage capable older adults to participate in grandchild care, and children should also provide more intergenerational support to the older adults who provide grandchild care, so as to further play the role of grandchild care in relieving depression of the older adults.

ObjectiveImpairment of circadian blood pressure (BP) patterns has been associated with cardiovascular risks and events in individuals with hypertension and in general populations, which are more likely to be found in obstructive sleep apnea (OSA). The aim of this study was to investigate the association of non-dipping BP pattern with new-onset diabetes in hypertensive patients with OSA, based on Urumqi Research on Sleep Apnea and Hypertension (UROSAH) data.Materials and methodsThis retrospective cohort study included 1841 hypertensive patients at least 18 years of age, who were diagnosed with OSA without baseline diabetes and had adequate ambulatory blood pressure monitoring (ABPM) data at enrollment. The exposure of interest for the present study was the circadian BP patterns, including non-dipping and dipping BP pattern, and the study outcome was defined as the time from baseline to new-onset diabetes. The associations between circadian BP patterns and new-onset diabetes were assessed using Cox proportional hazard models.ResultsAmong 1841 participants (mean age: 48.8 ± 10.5 years, 69.1% male), during the total follow-up of 12172 person-years with a median follow-up of 6.9 (inter quartile range: 6.0-8.0) years, 217 participants developed new-onset diabetes with an incidence rate of 17.8 per 1000 person-years. The proportion of non-dippers and dippers at enrollment in this cohort was 58.8% and 41.2%, respectively. Non-dippers were associated with higher risk of new-onset diabetes compared with dippers (full adjusted hazard ratio [HR]=1.53, 95% confidence interval [CI]: 1.14-2.06, P=0.005). Multiple subgroup and sensitivity analyses yielded similar results. We further explored the association of systolic and diastolic BP patterns with new-onset diabetes separately, and found that diastolic BP non-dippers were associated with higher risk of new-onset diabetes (full adjusted HR=1.54, 95% CI: 1.12-2.10, P=0.008), whereas for systolic BP non-dippers, the association was nonsignificant after adjusted the confounding covariates (full adjusted HR=1.35, 95% CI: 0.98-1.86, P=0.070).ConclusionsNon-dipping BP pattern is associated with an approximately 1.5-fold higher risk of new-onset diabetes in hypertensive patients with OSA, suggesting that non-dipping BP pattern may be an important clinical implication for the early prevention of diabetes in hypertensive patients with OSA.

Scientific literature, as the major medium that carries knowledge between scientists, exhibits explosive growth in the last century. Despite the frequent use of many tangible measures, to quantify the influence of literature from different perspectives, it remains unclear how knowledge is embodied and measured among tremendous scientific productivity, as knowledge underlying scientific literature is abstract and difficult to concretize. In this regard, there has laid a vacancy in the theoretical embodiment of knowledge for their evaluation and excavation. Here, for the first time, we quantify the knowledge from the perspective of information structurization and define a new measure of knowledge quantification index (KQI) that leverages the extent of disorder difference caused by hierarchical structure in the citation network to represent knowledge production in the literature. Built upon 214 million articles, published from 1800 to 2021, KQI is demonstrated for mining influential classics and laureates that are omitted by traditional metrics, thanks to in-depth utilization of structure. Due to the additivity of entropy and the interconnectivity of the network, KQI assembles numerous scientific impact metrics into one and gains interpretability and resistance to manipulation. In addition, KQI explores a new perspective regarding knowledge measurement through entropy and structure, utilizing structure rather than semantics to avoid ambiguity and attain applicability.

Study objectivesObstructive sleep apnea (OSA) severity has been suggested in aldosterone elevation in resistant hypertension, whereas it is undetermined in the rest population. We explored the association of OSA parameters with plasma aldosterone concentration (PAC) in participants with and without hypertension.MethodsWe enrolled clinically hypertensive patients with polysomnography and PAC data under no interfering agents, compared (log) PAC, and assessed the linearity of log PAC by tertiles (T1/2/3) of sleep parameters and their association using linear regression by gender and age. We enrolled participants with and without hypertension who had No-SAS scale and PAC data from the community and duplicated the observations from clinical setting considering age, gender, and presence of hypertension.ResultsOf the 2,066 clinical patients with hypertension (1,546 with OSA), men participants (n=1,412), log apnea–hypopnea index (p=0.043), apnea index (AI, p=0.010), and lowest oxygen saturation (LSaO2, p=0.013) showed significant linearity with log PAC. Log AI (B=0.04, 95%CI: 0.01,0.07, p=0.022) and log LSaO2 (B=−0.39, 95%CI: −0.78,−0.01, p=0.044) showed significant positive and negative linear associations with log PAC in regression. In community dwellers, 6,417 participants with untreated hypertension (2,642 with OSA) and 18,951 normotensive participants (3,000 with OSA) were included. Of the men participants with and without hypertension, the OSA group showed significantly higher (log) PAC than did their counterparts, and log No-SAS score showed positive association with log PAC (hypertension: B=0.072, 95%CI: 0.002,0.142, p=0.043; normotension: B=0.103, 95%CI: 0.067,0.139, p

Anesthesia mumps have rarely been reported. This article presents the diagnosis and treatment of a case of anesthesia mumps with airway obstruction in the urology department and reviews previous cases of the disease. A 58-year-old man had a history of hypertension and diabetes, and his blood pressure and glucose levels were well controlled. He underwent laparoscopic radical nephrectomy for a right renal tumor. Postoperatively, a swelling of approximately 5 × 4 cm was observed in the left parotid region and left eyelid, no palpable crepitation was detected, and the skin overlying the left parotid gland was mildly hyperemic and tender. Enhanced computed tomography of the head and neck revealed obvious swelling of the laryngopharyngeal airway, and electronic laryngoscopy showed narrow airway. Laboratory test results including white blood cell count, C-reactive protein, serum amylase, and lipase levels were normal. Glycosylated hemoglobin level was 6.8%, and the salivary culture from Stensen's duct was negative. The patient was managed with endotracheal intubation and a ventilator to maintain breathing along with anti-infection, expectorant, and symptomatic treatment. The swelling in the left parotid gland gradually resolved without recurrence, and the patient was extubated on the 7th postoperative day. In this case, the pathophysiology of anesthesia mumps may have been related to the incorrect positioning of the thick short neck and the use of a head ring, which can result in the squeezing of vessels. In most cases, the salivary gland swelling resolves with observation and symptomatic treatment. In patients with anesthesia mumps, emergency airway management and careful observation are necessary if upper airway obstruction occurs. This case report should increase awareness of anesthesia mumps and its complications among anesthesiologists, surgeons, and postoperative caregivers.

Abstract Temperature extremes have been extensively observed on the Tibetan Plateau (TP), of which the dynamics were mostly monitored by traditional trend analysis based on linear regression. This method however, is often impacted by a quasi‐periodic heterogeneity disturbance in variance, leading to results susceptible to extreme outliers. In this study, we conducted the comprehensive detection of extreme temperature changes using quantile regression on the TP from 100 weather stations from 1979 to 2019. The use of quantile regression enabled us to characterize the entire density function of the extreme temperature time‐series (the daily minimum, mean and maximum temperature) at each location. Our results revealed that the daily minimum temperature was generally warming faster than the daily maximum and mean temperatures with the respective trend interval of [−0.45, 1.29], [−0.1, 0.98], [−0.01, 1.01] °C/decade among the conditional quantile levels. Furthermore, the warming rate of extremely cold (0.05 quantile level) and hot days (0.95 quantile level) was higher than that of the mean condition (0.5 quantile level) in each extreme temperature time‐series. We also found that there was a significant elevation‐dependent warming only in extremely cold days. In addition, results from the teleconnection analysis showed that the Arctic Oscillation had a strong influence on the extreme cold and hot extremes over the northern and southwestern TP region, while the El Niño‐Southern Oscillation mainly modulated temperatures over the southeastern TP area. This study can potentially offer improved understanding of the temperature extremes over TP in the face of global warming.

The fall armyworm (FAW), Spodoptera frugiperda, is a highly polyphagous lepidopteran pest, with its growth and adaptation affected by different host plants. However, little is known about the effects of host plants on ovarian development in this species. Thus, we evaluated the effects of feeding on corn (Zea mays L.) and goosegrass (Eleusine indica), on the ovarian development of S. frugiperda. Using various stages of S. frugiperda, we also evaluated the larval and pupal weights, number of eggs, and differentiation of ovarioles over time. Results showed that females fed on goosegrass had shorter ovarioles and laid less eggs than those fed on corn. Transcriptome analysis identified 3,213 genes involved in ovarian development in the fall armyworm. Of these, 881 genes were differentially expressed when fed on corn and goosegrass. The analysis also indicated that the hormone biosynthetic pathways may be involved in the reproductive system. In relation to the reproductive function, nine juvenile hormone (JH) biosynthetic genes, four 20-hydroxyecdysone (20E) biosynthetic genes, and four ovary-relevant functional genes were identified. The time course of the expression profiles of these hormone- and ovary development-related genes was measured by quantitative real-time PCR (qRT-PCR). In total, six of them showed a decreasing trend in the ovary of the FAW fed on goosegrass, while two genes showed an increasing trend. Our results showed that significant changes in the reproductive activity/ovary development in the FAW occurred in response to different diets. These results serve as bases for evaluating how optimal host plants and feeding preference affect ovarian development in the FAW.

Rooftop solar photovoltaics (PV) play increasing role in the global sustainable energy transition. This raises the challenge of accurate and high-resolution geospatial assessment of PV technical potential in policymaking and power system planning. To address the challenge, we propose a general framework that combines multi-resource satellite images and deep learning models to provide estimates of rooftop PV power generation. We apply deep learning based inversion model to estimate hourly solar radiation based on geostationary satellite images, and automatic segmentation model to extract building footprint from high-resolution satellite images. The framework enables precise survey of available rooftop resources and detailed simulation of power generation on an hourly basis with a spatial resolution of 100 m. The case study in Jiangsu Province demonstrates that the framework is applicable for large areas and scalable between precise locations and arbitrary regions across multiple temporal scales. Our estimates show that rooftop resources across the province have a potential installed capacity of 245.17 GW, corresponding to an annual power generation of 290.66 TWh. This highlights the huge space for carbon emissions reduction through developing rooftop PVs.

The site of Qujialing experienced a long, sustained process of the development of Neolithic culture in the Jianghan Plain, with a period of some1600 years. Our previous studies based on macrofossil remains and phytoliths revealed that rice (Oryza sativa) from Qujialing was already domesticated, and millet (Setaria italica and Panicum miliaceum) had also been spread into the site since the Youziling Culture period (5800-5100 BP). Nevertheless, no direct evidence has been provided regarding the daily consumed plant foods, especially plant foods obtained by gathering, throughout the site occupation. This paper thus examines pottery sherds (n=41) associated with culinary practices from Qujialing with starch grain analysis. Apart from starch grains from rice and millet, the results indicate that job’s tears (Coix lacryma-jobi), lotus roots (Nelumbo nucifera), tubers possibly from Chinese yam (Dioscorea panthainca), acorns (Quercus sp.), and beans (Vigna sp. or/and Vicia sp.) were consumed by the ancient Qujialing people, within job’s tears and lotus roots were not discovered before in the macrofossil remains and phytoliths. Combining the starch data and multiple lines of evidence from macrofossil remains and phytoliths, it is suggested that rice was among the most frequently consumed plant foods since the first occupation phase at Qujialing, while acorns could have been gradually replaced by other agricultural products (i.e., rice) and became less important food ingredients, especially when agriculture was more developed in the last occupation phase at Qujialing. These novel findings not only complement our previous research by providing the first line of evidence of paleodiet in the Jianghan Plain from the perspective of starch grain analysis but also delivers a better understanding of the characterized dietary trends and agricultural development in the research region.

Abstract Objectives To comprehend the relationship between various indicators of health service equity and patients’ health expenditure poverty in different regions of China, identify areas where equity in health service is lacking and provide ideas for improving patients’ health expenditure poverty. Method Data from China Family Panel Studies (CFPS) in 2018 and the HFGT index formula were used to calculate the health expenditure poverty index of each province. Moreover, Global Moran’s I and Local Moran’s I test are applied to measure whether there is spatial aggregation of health expenditure poverty. Finally, an elastic net regression model is established to analyze the impact of health service equity on health expenditure poverty, with the breadth of health expenditure poverty as the dependent variable and health service equity as the independent variable. Results In the developed eastern provinces of China, the breadth of health expenditure poverty is relatively low. There is a significant positive spatial agglomeration. “Primary medical and health institutions per 1,000 population”, “rural doctors and health workers per 1,000 population”, “beds in primary medical institutions per 1,000 population”, “proportion of government health expenditure” and “number of times to participate in medical insurance (be aided) per 1,000 population” have a positive impact on health expenditure poverty. “Number of health examinations per capita” and “total health expenditure per capita” have a negative impact on health expenditure poverty. Both effects passed the significance test. Conclusion To enhance the fairness of health resource allocation in China and to alleviate health expenditure poverty, China should rationally plan the allocation of health resources at the grassroots level, strengthen the implementation of hierarchical diagnosis and treatment and encourage the investment in business medical insurance industry. Meanwhile, it is necessary to increase the intensity of medical assistance and enrich financing methods. All medical expenses of the poorest should be covered by the government.

The use of rice and millet has been uncovered at a few archaeological sites associated with the Shuangdun Culture (ca. 7.3–6.8 ka BP) in the middle catchment of the Huai River, China. Nevertheless, the consumption of rice, millet, and other types of plant foods at other contemporaneous sites in the same region still needs supporting information from more case studies. This article examines pottery sherds (n = 21) excavated from another representative Shuangdun Culture site at Houjiazhai with starch grain analysis. Varied types of pottery vessels contain starch remains from rice (Oryza sativa), foxtail millet (Setaria italica), broomcorn millet (Panicum miliaceum), Job’s tears (Coix lacryma-jobi), Triticeae, roots of snake gourd (Trichosanthes kirilowii), lotus root (Nelumbo nucifera), Chinese yam (Dioscorea panthainca), lily bulbs (Lilium sp.), acorns (Quercus sp.), and beans (Vigna sp. or/and Vicia sp.). Further quantitative analysis of the starch data indicates that cereals, including rice and millet, were predominantly consumed in the pottery vessels. Changes and continuities of culinary practices are also present at Houjiazhai, which are reflected in the different pottery assemblages as well as the utilized plant species in different occupation phases at the site. Combining previous studies, this article also reveals the differences and similarities of the past population in choosing their plant food resources during the period of Shuangdun Culture in the middle catchment of the Huai River, China.

ObjectiveTo evaluate the association between Chinese visceral adiposity index (CVAI) and incident renal damage and compared its predictive power with that of other visceral obesity indices in patients with hypertension and abnormal glucose metabolism (AGM).MethodsThis retrospective cohort consecutively included patients with hypertension and AGM who did not have renal damage at baseline. Renal damage was defined using the estimated glomerular filtration rate (eGFR) and urine protein. Multivariable Cox regression analysis was used to evaluate the association between CVAI and incident renal damage. Restricted cubic splines were used to determine the shape of the association. The predictive power of the CVAI was examined and directly compared with other indices, including the VAI, body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WHtR), using the area under the receiver operating characteristic curve (AUC) and C-index.ResultsIn total, 2,033 patients with hypertension and AGM were included. During a median follow-up of 2.6 years, the incidence of renal damage was 31.5, 48.9, 56.8, and 67.5/1,000 person-years across the quartiles of CVAI. Compared with the first quartile, the risk of renal damage was higher in the second (hazard ratio (HR) = 1.36 [95% CI: 0.93−1.97]), third (HR = 1.57 [95% CI: 1.09−2.27]), and fourth (HR = 1.65 [95% CI: 1.11−2.44]) quartiles (p for trend = 0.011). A linear dose–response association was observed. Sensitivity and subgroup analyses confirmed the robustness and consistency of the results. In terms of predictive power, the CVAI had the highest AUC and C-index values.ConclusionsCVAI is positively associated with renal damage risk in a linear dose–response pattern and has the best performance in predicting incident renal damage in patients with hypertension and AGM. The CVAI may serve as a reliable indicator for identifying patients at a high risk of renal damage.

BackgroundPostoperative symptoms, bowel dysfunction and recurrence are common problems after resection of colorectal polyps. We aimed to evaluate the efficacy of Bifidobacterium in the postoperative patients.MethodsIn this single-center, randomized, double-blind, placebo-controlled trial, adults (≥ 18 years) undergoing endoscopic resection of colorectal polyps were treated with probiotics (Bifidobacterium animalis subsp. lactis MH-02, 2 × 109 colony-forming units per packet) or placebo once daily for 7 days. The primary clinical endpoint was a reduction in the mean total postoperative symptoms score within 7 days postoperatively. Secondary clinical endpoints were the single symptom scores, time to recovery of bowel function, and changes in the intestinal microbiota. This study is registered with the number ChiCTR2100046687.ResultsA total of 100 individuals were included (48 in probiotic group and 52 in placebo group). No difference was seen in the mean scores between the two groups (0.29 vs. 0.43, P = 0.246). Colorectal polyps size (P = 0.008) and preoperative symptoms (P = 0.032) were influential factors for the primary endpoint. Besides, MH-02 alleviated difficult defecation (P = 0.045), and reduced the time to recovery of bowel function (P = 0.032). High-throughput analysis showed that MH-02 can help restore the diversity of intestinal microbiota, and increased the relative abundance of Bifidobacterium, Roseburia, Gemmiger, Blautia and Ruminococcus, while reduced the relative abundance of Clostridium at genus level (P < 0.05).ConclusionIn this prospective trial, MH-02 showed efficacy in patients with resection of colorectal polyps, particularly in the recovery of bowel function, and the changes in the intestinal microbiota may provide evidence for further exploration of the therapeutic mechanisms.

Sea surface temperature (SST) is a key factor for both climate and weather. Most studies focus on evaluation of satellite SSTs in different oceanic regions, but the performance of ERA5 reanalysis SST datasets (ERA5 SSTs) has not been systematically evaluated. In this article, buoy measurements from 46 National Data Buoy Center (NDBC) sites around the Pacific and the Atlantic are used to make an analysis of the deviations of the ERA5 SSTs on an hourly basis and its variations on a daily basis. Overall, ERA5 SSTs have a global coverage with a -0.04 °C bias and 4.60 °C standard deviation in the study area. It is worthwhile to notice that ERA5 SSTs exhibit significant differences in the amplitude and the phasing of their spatial patterns. The products are found to meet the accuracy criterion, except in near coastal areas, which may result from the near-coastal mixture effect and the warm SST. The results reveal that ERA5 SSTs completely capture the diurnal variability of SST under all wind speed conditions, especially in the situation when wind speed is above 6 m/s. There is a slight cold bias when wind speed is below 6m/s, indicating that ERA5 SSTs are not affected by solar radiation heating. These findings contribute to the sensible use of ERA5 SSTs around the Pacific and the Atlantic.

Precipitation is a major driven factor in water cycle and hydrological process. Since satellite sensors have been the main sources for acquiring globally continuous precipitation data, inter-comparison between satellite precipitation products (SPPs) from different sensors becomes increasingly significant, especially at daily or sub-daily scale and in regions suffering from frequent heavy rainfall and floods. This paper assessed the performance of four daily SPPs, including data from the Tropical Rainfall Measuring Mission (TRMM), Climate Hazards group Infrared Precipitation with Stations (CHIRPS), Climate prediction center MORPHmorphing technique (CMORPH) and Advanced SCATterometer (ASCAT) based Soil Moisture to RAINfall algorithm (SM2RAIN-ASCAT), using the ground gauge measurements from 2010 to 2014 over the Pearl River Basin (PRB), China. Accuracy of precipitation estimates and the capability in detecting rainy/non-rainy days and different precipitation categories were evaluated at both basin and station scale. The findings show that: 1) Performance of the SPPs varies temporally and spatially, and better performance can be observed in wet season and south-eastern part of the PRB, when or where precipitation is abundant. 2) All SPPs have poor performance in estimating extreme precipitation in the PRB; 3) Among the four SPPs, TRMM 3B42 exhibits the best performance in the PRB, followed by CMORPH, while CHIRPS performs the worst and is inapt for precipitation estimates in the PRB; SM2RAIN-ASCAT has quite high estimate errors, but it shows advantages against other products in detecting heavy precipitation events. Findings in this study are compared with recent studies conducted in other regions, and some limitations are discussed. This study provides significant reference for understanding the performance of daily SPPs in the PRB as well as areas with similar climate and surface condition.

Recent studies have provided evidence of alcohol production and consumption in 16 sites in northern China during the Neolithic period, focusing on the Yangshao Culture (ca. 7,000–5,000 cal. BP). Yet, the comparison of similarities and differences in brewing technology and drinking patterns within the Yangshao Culture still needs more supporting information from case studies in different regions. In this paper, 17 pottery samples excavated from the Yangshao Culture site of Qingtai (ca. 5,500–4,750 cal. BP) in the central part of Henan Province were analyzed for microfossils (starch grains, phytoliths, fungi) and organic acids, on the basis of the theoretical model constructed from our simulation experiments. The results revealed a mixed filtered alcoholic beverage, likely to be fermented by fruit and/or honey. The ingredients were mainly foxtail millet, rice, Job’s tears, Triticeae, snake gourd roots, lotus roots, legumes, nuts, fruits, and/or honey. What’s more, we found that the jiandiping amphora from Qingtai was not likely used for brewing or drinking. In terms of prehistoric drinking habits, in the large-scale settlement of the late Yangshao Culture in China, it is possible that people drank filtered alcohol alone or that a few people drank filtered alcohol poured from the painted bottle, indicating a switch from communal drinking to individual drinking. This study sheds light on the similarities and differences in brewing techniques, fermentation ingredients, and drinking patterns among different regions of the late Neolithic Yangshao Culture, and deepens our understanding of alcoholic beverages in the early Chinese civilized societies.

ObjectivesThe elderly face multiple vulnerabilities such as health, economy and society, and are prone to catastrophic health expenditures. This study aims to analyze the impact of children's intergenerational economic support, emotional support, and illness on the catastrophic health expenditures of middle-aged and elderly families.MethodsUsing China Health and Retirement Longitudinal Study (CHARLS 2018) data to calculate the catastrophic health expenditure of Chinese households as the dependent variable. Taking children's intergenerational economic support, emotional support and multimorbidity as core independent variables, gender, age, marital status, medical insurance and other variables as control variables, and perform logistic regression analysis. According to the heterogeneity analysis of age and gender, the impact of intergenerational economic support, emotional support and multimorbidity on the catastrophic health expenditure of middle-aged and elderly families is explored.ResultsWhen catastrophic health expenditures occur in middle-aged and elderly families, the children's intergenerational economic support will increase significantly, especially in families with members aged 60–74. Children's emotional support can effectively reduce the risk of catastrophic health expenditures for middle-aged and elderly families. Compared with children's intergenerational economic support and emotional support, the impact of multimorbidity on the catastrophic health expenditures of middle-aged and elderly families is the most significant. Suffering from multimorbidity can increase the risk of catastrophic health expenditures for middle-aged and elderly families, especially families with male members suffering from multiple diseases.ConclusionsIt is recommended that we should do a good job in popularizing the knowledge of chronic diseases to minimize the occurrence of multimorbidity. The government should establish group medical insurance related to chronic disease diagnosis. According to the severity of the disease or the special circumstances of the patient, the level of medical insurance reimbursement is divided in detail, especially for chronic disease clinics and drug reimbursement. Children should be encouraged to strengthen the emotional connection and effective care of the elderly, focusing on the elderly 60–74 years old, in order to reduce their care pressure and maintain the physical and mental health of the elderly.

Determining the accuracy of lake water levels calculated based on Ice, Cloud, and land Elevation Satellite (ICESat) data mainly relies on identifying lake water footprints (LWFs), which are obtained using an overlay analysis of lake water masks (LWMs) and ICESat tracks. However, most previous studies that have conducted a buffer analysis based on LWMs have set the buffer size subjectively without providing a detailed explanation for this or conducting a system analysis. In this study, the effects of using inside and outside buffers to obtain LWMs for seven lakes are analyzed. The Modified Normalized Difference Water Index (MNDWI) was applied to extract LWMs from Thematic Mapper (TM) images. The boxplot was used to remove footprints with abnormal elevations, and then the average of the remaining footprints was calculated as the ICESat water level. To compare with the in situ measured data, the root mean square error (RMSE) was used for accuracy evaluation. Results show the following: (1) for Yamzhog Yumco, which is a narrow lake, the altimetry accuracy is higher when using the outside buffer than for the inside buffer or with no buffer, and the highest accuracy is obtained with an outside buffer of approximately 100 m. (2) For other relatively wide lakes, such as Lake Michigan, Lake Erie, Lake Huron, Lake Ontario and Lake Superior, the inside buffer method does not always improve altimetry accuracy, and this result differs from those presented previously. (3) For different lakes, the range of change in altimetry accuracy is affected by the number of LWFs. This study is of value for use in studies that apply ICESat altimetry data to obtain changes in lake water levels, especially for relatively narrow lakes, and the results imply that the altimetry accuracy can be improved by using the outside buffer.

There exists a time lag between short-term exposure to fine particulate matter (PM2.5) and incidence of respiratory diseases. The quantification of length of the time lag is significant for preparation and allocation of relevant medical resources. Several classic lag analysis methods have been applied to determine this length. However, different models often lead to distinct results and which one is better is subtle. The prerequisite of obtaining the reliable length is that the model can truly reveal the underlying pattern hidden in the above relationship. Long short-term memory (LSTM) is an artificial recurrent neural network (RNN) architecture used in the field of deep learning, whose strong capability makes it widely applied in many fields. In this study, we manage to exploit it to acquire the time-lag length in the exposure-response relationship. The relationship between exposure and response is assumed as linear and non-linear, and models with and without confounding factors are performed under these two assumptions. Results of DLNM model show that the best hospital emergency visit prediction appears in 3 lag days, with the maximum RR value of 1.004357 (95% CI: 1.000938-1.009563). Then, a vary of LSTM models with different time steps are performed, which are evaluated by mean absolute error (MAE), the mean absolute percentage error (MAPE), the root of mean square error (RMSE) and R square (R2). The results show that LSTM of time step 3 achieves the lowest MAE (33), MAPE (9.86), RMSE (42) and the highest R2 (0.78), consistent with the result of DLNM model. Also, the proposed model is compared with ARIMA model, one of the commonly used forecasting models, showing better accuracy. This demonstrates that LSTM can be used as a new method to detect the lag effect of PM2.5 on respiratory diseases.

ObjectiveTo develop and validate a radiomics nomogram based on pre-treatment, early treatment ultrasound (US) radiomics features combined with clinical characteristics for early prediction of response to neoadjuvant chemotherapy (NAC) in breast cancer.MethodA total of 217 patients with histological results of breast cancer receiving four to eight cycles of NAC before surgery from January 2018 to December 2020 were enrolled. Patients from the study population were randomly separated into a training set (n = 152) and a validation set (n = 65) at a ratio of 7:3. A total of 788 radiomics features were extracted from each region of interest in the US image at pre-treatment baseline (radiomic signature, RS1), early treatment (after completion of two cycles of NAC, RS2) and delta radiomics (calculated between the pre-treatment and post-treatment features, Delta RS). The Max-Relevance and Min-Redundancy (mRMR) and the least absolute shrinkage and selection operator (LASSO) regression were applied for feature selection. The predictive nomogram was built based on the radiomics signature combined with clinicopathological risk factors. Discrimination, calibration, and prediction performance were further evaluated in the validation set.ResultsOf the 217 breast masses, 127 (58.5%) were responsive to NAC and 90 (41.5%) were non-responsive. Following feature selection, nine features in RS1, 11 features in RS2, and eight features in Delta RS remained. With multivariate analysis, the RS1, RS2, Delta RS, and Ki-67 expression were independently associated with breast NAC response. However, the performance of the Delta RS (AUCDelta RS = 0.743) was not higher than RS1 (AUCRS1 = 0.722, PDelta vs RS1 = 0.086) and RS2 (AUCRS2 = 0.811, PDelta vs RS2 =0.173) with the Delong test. The nomogram incorporating RS1, RS2, and Ki-67 expression showed better predictive ability for NAC response with an area under the curve (AUC) of 0.866 in validation cohorts than either the single RS1 (AUC 0.725) or RS2 (AUC 0.793) or Ki-67 (AUC 0.643).ConclusionThe nomogram incorporating pre-treatment and early-treatment US radiomics features and Ki-67 expression showed good performance in terms of NAC response in breast cancer, thereby providing valuable information for individual treatment and timely adjustment of chemotherapy regimens.

The rapid development of modern science nowadays makes it rather challenging to pick out valuable ideas from massive scientific literature. Existing widely-adopted citation-based metrics are not adequate for measuring how well the idea presented by a single publication is developed and whether it is worth following. Here, inspired by traditional X-ray imaging, which returns internal structure imaging of real objects along with corresponding structure analysis, we propose Scientific X-ray, a framework that quantifies the development degree and development potential for any scientific idea through an assembly of 'X-ray' scanning, visualization and parsing operated on the citation network associated with a target publication. We pick all 71,431 scientific articles of citation counts over 1,000 as high-impact target publications among totally 204,664,199 publications that cover 16 disciplines spanning from 1800 to 2021. Our proposed Scientific X-ray reproduces how an idea evolves from the very original target publication all the way to the up to date status via an extracted 'idea tree' that attempts to preserve the most representative idea flow structure underneath each citation network. Interestingly, we observe that while the citation counts of publications may increase unlimitedly, the maximum valid idea inheritance of those target publications, i.e., the valid depth of the idea tree, cannot exceed a limit of six hops, and the idea evolution structure of any arbitrary publication unexceptionally falls into six fixed patterns. Combined with a development potential index that we further design based on the extracted idea tree, Scientific X-ray can vividly tell how further a given idea presented by a given publication can still go from any well-established starting point. Scientific X-ray successfully identifies 40 out of 49 topics of Nobel prize as high-potential topics by their prize-winning papers in an average of nine years before the prizes are released. Various trials on articles of diverse topics also confirm the power of Scientific X-ray in digging out influential/promising ideas. Scientific X-ray is user-friendly to researchers with any level of expertise, thus providing important basis for grasping research trends, helping scientific policy-making and even promoting social development.

Forest inventory at single-tree level is of great importance to modern forest management. The inventory contains two critical parameters about trees, including their numbers and spatial locations. Traditional methods to catalogue single trees are laborious, while deep neural networks enable to discover the multi-scale features hidden in images and thus make it possible to count trees with remote sensing imagery. In this study, four different tree counting networks, which were constructed by remodeling four different classical deep convolutional neural networks, were evaluated to determine their abilities to grasp the relationship between remote sensing images and tree locations for automatic tree counting end-to-end. To this end, a tree counting dataset was constructed with remote sensing images of 0.8-m spatial resolution in distinct regions. This dataset consisted of 24 GF-II images and the corresponding manually annotated locations of trees based on these images. Thereafter, a large number of experiments were conducted to examine the performance of these networks in regards to tree counting. The results demonstrated that all networks could achieve the competitive performance (above 0.91) in terms of the determination coefficient (R2) between the ground truth and the estimated values. The average accuracy of the Encoder-Decoder Network (one of the four networks) was greater than 91.58% and its R2 was equal to 0.97, achieving the best performance. It has been found that the deep learning is an efficient and effective means for tree counting task.

Abstract. Background:. The pathogenesis of obstructive sleep apnea (OSA) remains not fully understood. This study aimed to explore the mechanism of OSA by assessing the association between the human tandem of P domains in a weak inwardly rectifying K+ channel (TWIK)-related acid-sensitive K+ channel-1 (TASK-1) gene and OSA. Methods:. A total of 164 patients with severe OSA and 171 patients without OSA were recruited from the Center for Hypertension of People's Hospital of Xinjiang Uygur Autonomous Region (China) from April to December in 2016. Two single nucleotide polymorphisms (rs1275988 and rs2586886) in the TASK-1 gene were selected and genotyped using a kompetitive allele specific polymerase chain reaction genotyping system. Clinical-pathological characteristics and genotype data were compared between the severe and non-OSA groups to explore the association between TASK-1 gene polymorphism and severe OSA. Results:. There were no significant differences in genotype distribution, allele frequency, and the recessive and dominant model of the two selected single nucleotide polymorphisms (rs1275988 and rs2586886) between the severe and non-OSA groups in the total population (P > 0.05). However, for patients with a body mass index (BMI) ≥28 kg/m2, the distribution of genotypes and alleles, and the recessive model (GG + GA vs. AA) exhibited significant differences between the severe and non-OSA group (for genotypes: P = 0.014 and P = 0.026; for alleles: P = 0.006 and P = 0.011; for the recessive model: P = 0.005 and P = 0.009, respectively). The simple logistic regression analysis revealed that the GG genotype was a risk factor for OSA. The odds ratio (OR) and 95% confidence intervals (CI) were 4.902 (1.582–15.186, P = 0.006) for rs1275988 and 4.420 (1.422–13.734, P = 0.010) for rs2586886, respectively. In multivariate logistic regression analysis, the combination of GG genotypes of rs1275988 with BMI ≥28 kg/m2 increased the risk of severe OSA (OR = 8.916, 95% CI 4.506–17.645, P

Abstract Background Enhanced glycolysis in tumors, known as the Warburg effect, provides the metabolic basis of enhanced cancer cell proliferation and metastasis. The Warburg pathway enzyme 6-phosphofructo-2-kinase/fructose-2,6-bisphosphatase 4 (PFKFB4) is a newly identified key kinase that regulates transcriptional reprogramming and cell proliferation. Here we show the prognostic value of PFKFB4 expression in patients with operable breast cancer. Methods PFKFB4 expression was evaluated by immunohistochemistry in surgical specimens retrospectively collected from 200 patients with histologically proven invasive ductal breast cancer. Kaplan–Meier survival analysis and Cox regression analysis were performed to assess the prognostic significance of PFKFB4 expression. Results Kaplan–Meier survival analysis revealed that breast cancer patients with high PFKFB4 expression demonstrated unfavorable disease-free survival (p = 0.008) and overall survival (p = 0.002). PFKFB4 had an hazard ratio (HR) of 7.38 (95% CI 1.69–32.3; p = 0.008) in univariate Cox analysis and retained prognostic power (HR 7.44, 95% CI 1.67–33.2; p = 0.009) when adjusted by tumor size, lymph node status, grade, estrogen receptor status, human epidermal growth factor receptor 2 status and subtype, which indicated PFKFB4 was an independent prognostic factor in breast cancer. Conclusions Together, our findings establish the prognostic value of metabolic enzyme PFKFB4 in patients with operable breast cancer.