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Abstract Background Cardiovascular disease (CVD) is a major global health concern with increasing incident cases and deaths. Homocysteine (Hcy) has been investigated for its potential association with CVD, researchers have debated the extent to which Hcy should be considered a risk factor for cardiovascular diseases, as only 50% of CVD can be explained by classical risk factors. Methods We conducted a prospective cohort study using NHANES 1999–2006 data, analyzing 1,739 US patients aged at least 30 with CVD. Cox proportional hazards regression and restricted cubic splines were used to examine the relationship between Hcy levels and mortality, adjusting for covariates. Result A total of 1,739 participants with cardiovascular disease (CVD) were enrolled, with a median follow-up period of 126 months. Among them, 1,194 participants died, including 501 deaths due to cardiovascular causes. After adjusting for covariates, the hazard ratios (HR) and 95% confidence intervals (CI) for CVD mortality at different levels of homocysteine (Hcy) (T1 ( 12.5)) were 1.26 (0.92, 1.73) (T2), and 1.69 (1.14, 2.51) (T3) (P for trend = 0.0086). The HR and 95% CI for all-cause mortality at different levels of Hcy were 1.22 (1.05, 1.42) (T2) and 1.64 (1.29, 2.09) (T3) (P for trend

This study investigates the ground and structural response of adjacent raft foundations induced by large-scale surcharge by ore in soft soil areas through a 130g centrifuge modeling test with an innovative layered loading device. The prototype of the test is a coastal iron ore yard with a natural foundation of deep soft soil. Therefore, it is necessary to adopt some measures to reduce the influence of the large-scale surcharge on the adjacent raft foundation, such as installing stone columns for foundation treatment. Under an acceleration of 130 g, the model conducts similar simulations of iron ore, stone columns, and raft foundation structures. The tested soil mass has dimensions of 900 mm × 700 mm × 300 mm (length × width × depth), which is remodeled from the soil extracted from the drilling holes. The test conditions are consistent with the actual engineering conditions and the effects of four-level loading conditions on the composite foundation of stone columns, unreinforced zone, and raft foundations are studied. An automatic layer-by-layer loading device was innovatively developed to simulate the loading process of actual engineering more realistically. The composite foundation of stone columns had a large settlement after the loading, forming an obvious settlement trough and causing the surface of the unreinforced zone to rise. The 12 m surcharge loading causes a horizontal displacement of 13.19 cm and a vertical settlement of 1.37 m in the raft foundation. The stone columns located on both sides of the unreinforced zone suffered significant shear damage at the sand-mud interface. Due to the reinforcement effect of stone columns, the sand layer below the top of the stone columns moves less. Meanwhile, the horizontal earth pressure in the raft foundation zone increases slowly. The stone columns will form new drainage channels and accelerate the dissipation of excess pore pressure.

Abstract Background This study addresses the scarcity of research on nausea and vomiting in pregnancy (NVP) in China. It aims to explore the current NVP status in the country using validated questionnaires, analyze associated factors, and provide a useful reference for future research. The study also compares results from different assessment tools. Methods Online questionnaires were utilized to gather data from 535 pregnant women across 24 provinces. Demographic, pregnancy, and NVP-related information were collected. NVP severity was assessed using Pregnancy-Unique Quantification of Emesis and Nausea (PUQE) and the Rhodes Index of Nausea, Vomiting, and Retching (RINVR) scales. Ordinal logistic regression identified factors linked to NVP severity. Differences between PUQE and RINVR assessments were compared. Results NVP prevalence exceeded 90%, with 96.1% assessed by PUQE and 90.8% by RINVR. Incidence decreased from nausea to retching and vomiting. Severe NVP correlated with reduced gestational weight gain, younger age, fewer gestational weeks, and living in North (all P values

Abstract Background The triglyceride–glucose (TyG) index, a tool for assessing insulin resistance, is increasingly recognized for its ability to predict cardiovascular and metabolic risks. However, its relationship with trauma and surgical patient prognosis is understudied. This study investigated the correlation between the TyG index and mortality risk in surgical/trauma ICU patients to identify high-risk individuals and improve prognostic strategies. Methods This study identified patients requiring trauma/surgical ICU admission from the Medical Information Mart for Intensive Care (MIMIC-IV) database, and divided them into tertiles based on the TyG index. The outcomes included 28-day mortality and 180-day mortality for short-term and long-term prognosis. The associations between the TyG index and clinical outcomes in patients were elucidated using Cox proportional hazards regression analysis and RCS models. Results A total of 2103 patients were enrolled. The 28-day mortality and 180-day mortality rates reached 18% and 24%, respectively. Multivariate Cox proportional hazards analysis revealed that an elevated TyG index was significantly related to 28-day and 180-day mortality after covariates adjusting. An elevated TyG index was significantly associated with 28-day mortality (adjusted hazard ratio, 1.19; 95% confidence interval 1.04–1.37) and 180-day mortality (adjusted hazard ratio, 1.24; 95% confidence interval 1.11–1.39). RCS models revealed that a progressively increasing risk of mortality was related to an elevated TyG index. According to our subgroup analysis, an elevated TyG index is associated with increased risk of 28-day and 180-day mortality in critically ill patients younger than 60 years old, as well as those with concomitant stroke or cardiovascular diseases. Additionally, in nondiabetic patients, an elevated TyG index is associated with 180-day mortality. Conclusion An increasing risk of mortality was related to an elevated TyG index. In critically ill patients younger than 60 years old, as well as those with concomitant stroke or cardiovascular diseases, an elevated TyG index is associated with adverse short-term and long-term outcomes. Furthermore, in non-diabetic patients, an elevated TyG index is associated with adverse long-term prognosis.

BackgroundThere is limited knowledge regarding the association between heart rate (HR) during different exercise phases and coronary artery disease (CAD). This study aimed to evaluate the relationship between four exercise-related HR metrics detected by cardiopulmonary exercise testing (CPET) and CAD. These metrics include HR at the anaerobic threshold (HRAT), HR at respiratory compensatory point (HRRCP), maximal HR (HRmax), and HR 60 s post-exercise (HRRec60s).MethodsThe 705 participants included 383 with CAD and 322 without CAD in Beijing Hospital, who underwent CPET between January 2021 and December 2022. The Logistic regression analysis was applied to estimate the odds ratio and the 95% confidence interval. Additionally, the multivariable Logistic regression analyses with restricted cubic splines were conducted to characterize the dose-response association and explore whether the relationship was linear or nonlinear.ResultsOur primary finding indicates that for each one-beat increase in HRAT, there is a 2.8% reduction in the adjusted risk of CAD in the general population. Similarly, a one-beat increase in HRRCP corresponds to a 2.6% reduction in the adjusted risk of CAD. Subgroup analyses revealed significant interactions between HRAT and factors such as sex, hypertension, and lung cancer, as well as between HRRCP and sex and hypertension, in relation to CAD. The dose-response analysis further confirmed that higher HRAT and HRRCP are associated with a reduced risk of CAD.ConclusionThese results are suggestive of a good association between HRAT, HRRCP, and CAD. The lower HRAT, and HRRCP are signs of poor HR response to exercise in CAD. HRAT and HRRCP are potentially good indicators of poor HR response to exercise without considering maximal effort.

The COVID-19 pandemic has influenced many movements of rapid digitization in several sectors/areas used by the public. The three primary sectors/areas affected by such digitization process are identified as healthcare, transportation, and public domain registration. There are only a few studies investigating the impacts of the COVID-19 pandemic on the digital divide for the expatriate population. To fill this research gap, this study investigates these three primary sectors/areas while highlighting the growing digital divide in the expatriate population, using Chinese cities as case studies. The study finds that the emerging barrier is beyond language barriers related to digital access and utilization issues. The study finds that the ongoing digital inequality is related to the autonomy of use, suggesting the urgency for technological upgrades, inclusive digital platforms, and reversing digital design marginalization. This study is sample-based research, using limited samples of expatriate populations in nine major cities in three primary economic clusters in China. The user perspective is assessed against five digital inequalities, namely “technical means,” “autonomy of use,” “social support networks,” “experience,” and “skills.” The analysis is followed by further research on digital divide barriers, addressing how the newly installed digital devices/facilities/services affect the expatriate population beyond the traditional language barriers. The analysis evaluates challenges based on four DDB pillars (i.e., availability, access, renovation, and utilization) and language barrier. The findings show the high correlation between the autonomy of use and digital utilization has led to further disparities and disconnection of the expatriate population from the smart city movements, such as digitized healthcare, transportation, and public domain registration. This study contributes to digital divide research, enhancing awareness of such research related to technological/digital changes and the expatriate populations.

Background: Metabolic syndrome (MetS) could increase the risk of cardiovascular disease (CVD) by 2-fold. Ideal control of modifiable risk factors in Life's Simple 7 (LS7) could reduce the CVD risk among the general population. This study aimed to investigate the effects of controlling modifiable risk factors using LS7 in MetS to prevent CVD. Methods: 44463 participants in NHANES 1999–2018 were included. The primary endpoint was a composite of CVD, including angina pectoris, coronary artery disease, myocardial infarction, congestive heart failure, and stroke. Multivariable weighted logistic regression analyses estimated the associations. The diagnosis of MetS complied with Harmonized International Diabetes Federation Criteria. Measurement of modifiable risk factors used the 2010 American Heart Association LS7 guideline and was indicated by cardiovascular health (CVH). Results: 14034 individuals were diagnosed with MetS. 4835 participants had CVD. The weighted mean CVH was 8.06 ± 0.03. Intermediate and poor CVH were associated with increased risk for CVD in participants with similar metabolic states compared to ideal CVH. By taking participants with metabolic health and ideal CVH as health control, participants with MetS and poor CVH were demonstrated to have a 3-fold (adjusted odds ratio, 4.00; 95 % confidence interval, 3.21–4.98) greater risk for CVD. Notably, under the condition of ideal CVH, the risk of having CVD was comparable between metabolic health and MetS after fully adjusted. Conclusion: Ideal control of Life's Simple 7 in metabolic syndrome contributes to a comparable risk of cardiovascular disease with healthy subjects. LS7 could be recognized as a guideline for secondary prevention in MetS.

Abstract Background The World Health Organization (WHO) has established recommended daily intakes for sodium and potassium. However, there is currently some controversy regarding the association between sodium intake, potassium intake, the sodium-to-potassium ratio, and overall mortality. To assess the correlations between sodium intake, potassium intake, the sodium-to-potassium ratio, and overall mortality, as well as the potential differences in sodium and potassium intake thresholds among different population groups, we analyzed data from NHANES 2003–2018. Methods NHANES is an observational cohort study that estimates sodium and potassium intake through one or two 24-h dietary recalls. Hazard ratios (HR) for overall mortality were calculated using multivariable adjusted Cox models accounting for sampling design. A total of 13855 out of 26288 participants were included in the final analysis. Restricted cubic spline analyses were used to examine the relationship between sodium intake, potassium intake, and overall mortality. If non-linearity was detected, we employed a recursive algorithm to calculate inflection points. Results Based on one or two 24-h dietary recalls, the sample consisted of 13,855 participants, representing a non-institutionalized population aged 40–80 years, totaling 11,348,771 person-months of mean follow-up 99.395 months. Daily sodium intake and daily potassium intake were inversely associated with all-cause mortality. Restrictive cubic spline analysis showed non-linear relationships between daily sodium intake, potassium intake, sodium–potassium ratio, and total mortality. The inflection point for daily sodium intake was 3133 mg/d, and the inflection point for daily potassium intake was 3501 mg/d, and the inflection point for daily sodium–potassium ratio intake was 1.203 mg/mg/d. In subgroup analyses, a significant interaction was found between age and high sodium intake, which was further confirmed by the smooth curves that showed a U-shaped relationship between sodium intake and all-cause mortality in the elderly population, with a inflection point of 3634 mg/d. Conclusion Nonlinear associations of daily sodium intake, daily potassium intake and daily sodium–potassium ratio intake with all-cause mortality were observed in American individuals. The inflection point for daily sodium intake was 3133 mg/d. And the inflection point for daily sodium intake was 3634 mg/d in elderly population. The inflection point for daily potassium intake was 3501 mg/d. The inflection point for daily sodium–potassium ratio intake was 1.203 mg/mg/d, respectively, A healthy diet should be based on reasonable sodium intake and include an appropriate sodium-to-potassium ratio.

Evaluating the effectiveness of China’s energy transition policies and formulating scientific policy optimization paths are essential for advancing China’s energy transition and global carbon reduction. This paper quantitatively evaluates China’s 22 key energy transition policies during the 14th Five-Year Plan period via text excavation, the Multi-Level Perspective (MLP), and the PMC index model. The research results show that the overall design of China’s energy transition policy is reasonable. Only two policies are graded as acceptable, while the rest of the policies are graded as good or higher. In addition, landscape policy, regime policy, and niche policy have a decreasing influence on energy transition projects in China. This research summarizes three common shortcomings in China’s energy transition policy: (1) the lack of explicit policy incentives and constraints; (2) the inadequate authority of policy releasers; and (3) the limited coverage of the policy focus.

Abstract The ICT service industry has become a burgeoning industry at a high and stable speed. Their equitable distribution can improve national and global positive peace. This paper aimed to verify the characteristics of spatio-temporal evolution and its influencing factors in the ICT service industry. Based on the data from 31 Provinces in China from 2015 to 2019, this paper uses location quotient, spatial autocorrelation methods and spatial econometric analysis to explore the development characteristics, evolution and influencing factors of the ICT service industry, respectively. The main results are shown as follows: (1) China's ICT service industry is mainly concentrated in Beijing, Shanghai, Zhejiang, Tibet, and Guangdong, with a trend of specialisation development. They are not only distributed in cities with relatively superior overall development but also those with superior industrial and development carrier elements. Technological relevance, aggregation, and political difference might have an impact on promoting the emergence and development of these industries. (2) ICT service industry is characterised by stable and highly concentrated development. Numbers between three to five significant provinces and types with high-high (HH) and high-low (HL) clusters of local spatio-temporal association kept stable in the period. The HH was in eastern coastal areas, including Zhejiang, Shanghai, Jiangsu, and Shandong, and the HL was in Guangdong in 2015. There is a definite spatial correlation in spatial distribution with constant strengthening. (3) TUR, NDN, MIAT and the area were shown to have a significant role in promoting the ICT service industry, while NW, GDP and ICT Employment were shown to have a significant negative impact on this industry. Correspondingly, two strategies were put forward here: (1) accelerating the inter-provincial networking development of the ICT service industry, and (2) strengthening government policy guidance for the ICT service industry. These outcomes can not only provide a scientific basis and theoretical support for the distribution of strategies and resources for these industries at the theoretical level but also improve resource integration from the national perspective and the efficiency of resource use at the practical level.

During the construction of tissue-engineered meniscus, the low porosity of extracellular matrix restricts the flow of nutrient solution and the migration and proliferation of cells, thus affecting the tissue remodeling after transplantation. In this study, the canine allogeneic meniscus was drilled first and then decellularized. The drilled tissue-engineered menisci (Drilled Allogeneic Acellular Meniscus + Bone Marrow Mesenchymal Stem Cells, BMSCs) were transplanted into the knee joints of model dogs. On the basis of ensuring the mechanical properties, the number of the porosity and the cells implanted in allogeneic acellular meniscus was significantly increased. The expression levels of glycosaminoglycans and type II collagen in the drilled tissue-engineered meniscus were also improved. It was determined that the animals in the experimental group recovered well-compared with those in the control group. The graft surface was covered with new cartilage, the retraction degree was small, and the tissue remodeling was good. The surface wear of the femoral condyle and tibial plateau cartilage was light. The results of this study showed that increasing the porosity of allogeneic meniscus by drilling could not only maintain the mechanical properties of the meniscus and increase the number of implanted cells but also promote cell proliferation and differentiation. After transplantation, the drilled tissue-engineered meniscus provided a good remodeling effect in vivo and played a positive role in repairing meniscal injury, protecting articular cartilage and restoring knee joint function.

Objectives: Evidence on cardiovascular-related and all-cause mortality risks in a wide range of cancer survivors is scarce but needed to inform prevention and management.Methods: We performed a nationwide prospective cohort study using information from the Continuous National Health and Nutrition Examination Survey (NHANES) in the United States and the linked mortality follow-up files, available for public access. A propensity score-matched analysis with a 1:1 ratio was conducted to reduce the baseline differences between participants with and without cancer. The relationship between cancer status and the cardiovascular-related and all-cause mortality risk was examined using weighted Cox proportional hazards regression. Independent stratification analysis and cancer-specific analyses were also performed.Results: The study sample included 44,342 participants, aged 20–85, interviewed between 1999 and 2018. Of these, 4,149 participants had cancer. All-cause death occurred in 6,655 participants, of whom 2,053 died from cardiovascular causes. Propensity-score matching identified 4,149 matched pairs of patients. A fully adjusted Cox proportional hazards regression showed that cancer was linked to an elevated risk of cardiovascular-related and all-cause mortality both before and after propensity score matching. Stratification analysis and cancer-specific analyses confirmed robustness of results.Conclusion: Our study confirmed that cancer was strongly linked to cardiovascular-related and all-cause mortality, even after adjusting for other factors that could impact a risk, including the American Heart Association (AHA)’s Life’s Simple 7 cardiovascular health score, age, sex, ethnicity, marital status, income, and education level.

Enhancing the output power of stratospheric airship photovoltaic arrays during months with weak irradiance is crucial for extending the endurance of airships. Models for predicting the output power of photovoltaic arrays and the phenomenon of mismatch losses have been proposed. However, static reconstruction schemes to reduce or eliminate mismatch losses have not been studied. In this paper, an output power model for stratospheric airship arrays including the solar radiation and irradiance distribution is established. The characteristics of the irradiance distribution for the photovoltaic array (PV) are investigated through simulation. Furthermore, an innovative reverse combination configuration is developed and compared to the SP and TCT configurations in terms of performance, mismatch loss and fill factor. Finally, simulations are conducted for a full-day irradiance period of 4 days in a real wind field. The simulation results demonstrate that the proposed RC configuration significantly reduces mismatch losses and output power fluctuations, thereby enhancing the PV array’s output power. This research provides interesting insights for the design of PV array topologies for stratospheric airships.

Abstract Background Three‐dimensional reconstruction of chest computerized tomography (CT) excels in intuitively demonstrating anatomical patterns for pulmonary segmentectomy. However, current methods are labor‐intensive and rely on contrast CT. We hereby present a novel fully automated reconstruction algorithm based on noncontrast CT and assess its performance both independently and in combination with surgeons. Methods A retrospective pilot study was performed. Patients between May 2020 to August 2020 who underwent segmentectomy in our single institution were enrolled. Noncontrast CTs were used for reconstruction. In the first part of the study, the accuracy of the demonstration of anatomical variants by either automated or manual reconstruction algorithm were compared to surgical observation, respectively. In the second part of the study, we tested the accuracy of the identification of anatomical variants by four independent attendees who reviewed 3‐D reconstruction in combination with CT scans. Results A total of 20 cases were enrolled in this study. All segments were represented in this study with two left S1‐3, two left S4 + 5, one left S6, five left basal segmentectomies, one right S1, three right S2, 1 right S2b + 3a, one right S3, two right S6 and two right basal segmentectomies. The median time consumption for the automated reconstruction was 280 (205–324) s. Accurate vessel and bronchial detection were achieved in 85% by the AI approach and 80% by Mimics, p = 1.00. The accuracy of vessel classification was 80 and 95% by AI and manual approaches, respectively, p = 0.34. In real‐world application, the accuracy of the identification of anatomical variant by thoracic surgeons was 85% by AI+CT, and the median time consumption was 2 (1–3) min. Conclusions The AI reconstruction algorithm overcame defects of traditional methods and is valuable in surgical planning for segmentectomy. With the AI reconstruction, surgeons may achieve high identification accuracy of anatomical patterns in a short time frame.

BackgroundPrior research on women who had hysterectomies has shown mixed results on whether or not hysterectomies increased the incidence of stroke and cause-specific or all-cause mortality.MethodsUsing information from the Continuous National Health and Nutrition Examination Survey (NHANES) in the United States, including linked mortality follow-up files available for public access, a multicycle cross-sectional design mortality linkage study was performed.ResultsConducted during the years 2005–2018, the study sample included 14,214 female participants ranging in age from 20 to 85 years. The relationship between the hysterectomy status and the risk of stroke and cause-specific and all-cause mortality was examined using a series of weighted logistic regressions and Cox proportional hazards regressions, respectively. The presence of a hysterectomy was consistently linked to an elevated risk of stroke using weighted logistic regression models. The hysterectomy status, however, consistently showed no effect on survival by adjusted weighted Cox regression analysis.ConclusionOur study found a significant association between hysterectomy and stroke, even after adjusting for other factors that could impact risk, such as the American Heart Association (AHA)'s Life's Simple 7 cardiovascular health score and variables of age, ethnicity, marital status, income, education, and depression severity.

The spread of COVID-19 at a large scale and at a rapid pace indicates the lack of social distancing measures at multiple levels. The individuals are not to be blamed, nor should we assume the early measures were ineffective or not implemented. It is all down to the multiplicity of transmission factors that made the situation more complicated than initially anticipated. Therefore, in facing the COVID-19 pandemic, this overview paper discusses the importance of space in social distancing measures. The methods used to investigate this study are literature review and case study. Many scholarly works have already provided us with evidence-based models that suggest the influential role of social distancing measures in preventing COVID-19 community spread. To further elaborate on this important topic, the aim here is to look at the role of space not only at the individual level but at larger scales of communities, cities, regions, etc. The analysis helps better management of cities during the pandemics such as COVID-19. By reflecting on some of the ongoing research on social distancing, the study concludes with the role of space at multiple scales and how it is central to the practice of social distancing. We need to be more reflective and responsive to achieve earlier control and containment of the disease and the outbreak at the macro level.

A prominent move amid the COVID-19 pandemic is related to the wide use of ICT applications for various reasons. Such services are context-specific and sector-specific, but we see transformative directions leading to digital data collection, monitory, and management platforms. For now, these have been beneficial to evaluate trends and issues related to the pandemic. Some aggregated data could also help decision-making processes, which are helpful to contain such disruptive events. However, the main concern is the use of the individual's data and information, which means we may shift to micro-management and eventual controlling tools that could harm data protection processes. Undoubtedly, the use of ICTs during the COVID-19 pandemic has been primarily positive at multiple scales, but we have to evaluate the pros and cons before accepting all data collection processes. Such ICT-mediated platforms and/or applications must remain beneficial to all and avoid breaching the individual's data protection. This short communication paper first introduces ICT applications during the COVID-19 before providing an overview and further analysis of the situation of the ICT applications. Afterward, it discusses issues of data privacy, data collection, and data use, which are the backbone of ICT applications. The discussions highlight that future research in this area could look into associated issues related to digital privacy, data-driven approaches, and data protection regulations.

ABSTRACT Coronary artery disease (CAD) is one of leading causes of mortality worldwide. Studies on roles that the gut microbiota plays in development of atherosclerosis or acute myocardial infarction (AMI) have been widely reported. However, the gut microbiota is affected by many factors, including age, body mass index (BMI), and hypertension, that lead to high CAD risk. However, the associations between gut microbiota and CAD development or other CAD risk factors remain unexplored. Here, we performed a 16S RNA gene sequencing analysis of 306 fecal samples collected from patients with mild coronary stenosis (MCS; n = 36), stable angina (SA; n = 91), unstable angina (UA; n = 48), and acute myocardial infarction (AMI; n = 66) and 65 non-CAD controls. Using a noise-corrected method based on principal-component analysis (PCA) and the random forest algorithm, we identified the interference with gut microbial profiling of multiple factors (including age, gender, BMI, and hypertension) that potentially contributed significantly to the development of CAD. After correction of noise interference from certain interfering factors, we found consistent indicator microbiota organisms (such as Vampirovibrio, Ruminococcus, and Eisenbergiella) associated with the presence of MCS, SA, and AMI. Establishment of a diagnostic model revealed better performance in early CAD than clinical indexes with indicator microbes. Furthermore, indicator microbes can improve the accuracy of clinical indexes for the diagnosis of AMI. Additionally, we found that the microbial indicators of AMI Sporobacter and Eisenbergiella showed consistent positive and negative correlations to the clinical indexes creatine kinase (CK) and hemoglobin (Hb), respectively. As a control indicator of AMI, Dorea was negatively correlated with CK but positively correlated with Hb. IMPORTANCE Our study discovered the effect of confounding factors on gut microbial variations and identified gut microbial indicators possibly associated with the CAD development after noise correction. Our discovered indicator microbes may have potential for diagnosis or therapy of cardiovascular disorders.

Assessment Tools have become the de facto method to address sustainability issues within the built environment. They provide a measurable third-party approach to ensuring sustainability design and directives are met through the use of indictors, criteria’s and credit system. A key challenge is that the existing tools such as BREEAM Communities and LEED Neighbourhood Development address a wider community but cannot efficiently address the more nuanced and context specific sustainability requirements of campuses. However, the approach of utilizing credits, indicator and criteria systems is a tactic that campus planners have slowly began to imbibe. This is even more critical to sustainable development cities due to the huge amounts of land and human resources consumed on campuses; However, gaps exist within the currently existing Campus Sustainability Assessment Tools (CSAT) that have been developed. Generally. Though studies have identified trends and gaps in neighbourhood and building assessment tools, no comprehensive study has investigated the potential gaps from the newly emerging CSATs. Using bibliometric analysis, this study reviews over 1000 articles on campus sustainability and assessment tools with the aim of determining the gaps, trends and focus area of campus sustainability via CSAT. The result draw out 15 dimensions that govern the design of sustainable campuses, and the most predominant dimensions were environmental, educational and governance dimension. The results also highlight the importance of context in implementing and developing CSATs and showed numerous overlooked campus sustainability issues, which have considerable impact on the determining the claims that makes campuses sustainable. Finally, results demonstrated a need to enhance inclusivity in decision making on campus via different survey techniques in both education and implementation of campus sustainability initiatives. In sum this study enhances the development of new CSAT and campus sustainability initiative and the modification existing initiatives to effectively meet the required sustainability standards within the built environment.

Walking is a fundamental movement skill in humans. However, how the brain controls walking is not fully understood. In this functional magnetic resonance imaging study, the rhythmic, bilaterally alternating ankle movements were used as paradigm to simulate walking. In addition to the resting state, several motor tasks with different speeds were tested. Independent component analysis was performed to detect four components shared by all task conditions and the resting state. According to the distributed brain regions, these independent components were the cerebellum, primary auditory cortex–secondary somatosensory cortex–inferior parietal cortex–presupplementary motor area, medial primary sensorimotor cortex–supplementary area–premotor cortex–superior parietal lobule, and lateral primary somatosensory cortex–superior parietal lobule–dorsal premotor cortex networks, which coordinated limb movements, controlled the rhythm, differentiated speed, and performed a function as a basic actor network, respectively. These brain networks may be used as biomarkers of the neural control of normal human walking and as targets for neural modulation to improve different aspects of walking, such as rhythm and speed.

BackgroundMorbidity and mortality of arteriosclerotic cardiovascular disease (ASCVD) varied according to socioeconomic status (SES), and evidence on the association between SES and ASCVD risk, and cause-specific and all-cause mortality was nevertheless lacking in large-scale or population-based studies.MethodsA multicycle cross-sectional design and mortality linkage study was conducted using data from Continuous National Health and Nutrition Examination Survey (NHANES) in the United States, including public use linked mortality follow-up files through December 31, 2019. Poverty income ratio (PIR) served as a SES index. A series of weighted Logistic regressions and Cox proportional hazards regressions were used to investigate the association between the SES and the risk of ASCVD and mortality, respectively.ResultsThe study sample was comprised of 30,040 participants aged 20–85 years old during the 2005–2018 period. Weighted Logistic regression models consistently indicated significant relationship between people experiencing poverty and increased risk of ASCVD, and linear trend tests were all statistically significant (all P for trend < 0.001). Additionally, weighted Cox regression analysis consistently demonstrated that the hazards of cause-specific and all-cause mortality increased, with the decrease of each additional income level, and trend analyses indicated similar results (all P for trend < 0.001).ConclusionsOur study confirmed that the SES was strongly linked to living with ASCVD, and cause-specific and all-cause mortality, even after adjusting for other factors that could impact risk, such as the American Heart Association (AHA)'s Life's Simple 7 cardiovascular health score and variables of age, sex, marital status, education, and depression severity.

Research on the association between level of depression and coronary heart disease (CHD), stroke risk, and all-cause and cardiovascular mortality is lacking in large-scale or population-based studies incorporating cardiovascular disease (CVD) endpoints. We aim to assess the relationship between the level of a person's depression and their risk of CHD, stroke, and all-cause and cardiovascular mortality. Utilizing data from the United States National Health and Nutrition Examination Survey (NHANES), multicycle cross-sectional design and mortality linkage studies were conducted. The study sample included 30918 participants aged 20–85 years old during the 2005–2018 period. Depression was assessed using the nine-item Patient Health Questionnaire (PHQ-9), with scores of 5, 10, 15, and 20 being the cut-off points for mild, moderate, moderately severe, and severe depression, respectively. A series of weighted logistic regression analyses and Cox proportional hazards models were utilized to examine the relationship between the level of depression with the risk of CHD, stroke, all-cause, and cardiovascular mortality. Trend analyses were conducted by entering the level of depression as a continuous variable and rerunning the corresponding regression models. Weighted logistic regression models consistently indicated a statistically significant association between the level of depression and increased risk of CHD and stroke, and those linear trend tests were statistically significant (P for trend < 0.001). Furthermore, weighted Cox regression analyses consistently indicated that participants who had a more severe degree of depression were at a higher risk of all-cause death, and trend analyses suggested similar results (P for trend < 0.001). Another weighted Cox regression analysis also consistently indicated that except for severe depression, the hazard of cardiovascular death was increased with each additional level increase of depression. Our study confirmed that the level of depression was strongly associated with CHD, stroke, and all-cause and cardiovascular mortality, even after accounting for other factors that could impact risk, including variables of age, gender, ethnicity, income, education, body mass index (BMI), marital, and smoking status.

PurposeThis study constructs a structure of interaction between dimensions and criteria within the diagnosis-related groups (DRGs) system from a quantitative system and identifies key factors affecting the overall performance of medical services.MethodFrom September to December 2020, the influence relation structure diagram (IRSD) of the dimensions and corresponding criteria was developed from the practical experience of a group of domain experts, based on the DEMATEL method. Subsequently, all dimensions and criteria construct influential weights from a systems perspective. Finally, the main influential factors were identified based on the analysis results.ResultsThe IRSD results showed that, in the overall performance of medical services, “Medical service capacity (C1)” was the main influential dimension, influencing both “Medical service efficiency (C2)” and “Medical service safety (C3).” At the criteria level, “Case-mix index (CMI) (C12),” “Time efficiency index (C21),” and “Inpatient mortality of medium-to-low group (C32)” were the main influential criteria in the corresponding dimensions. The influential weight results showed that “Medical service capacity (C1)” was also a key dimension. “Case-mix index (CMI) (C12),” “Cost efficiency index (C22),” and “Inpatient mortality of medium-to-low group (C32)” were the key criteria in their respective dimensions.ConclusionPatients and managers should first focus on the capacity of medical service providers when making a choice or deciding using the results of the DRGs system. Furthermore, they should pay more attention to medical safety even if it is not as weighted as medical efficiency.

Abstract Background Bone marrow mesenchymal stem cells are a potential resource for the clinical therapy of certain diseases. Canine, as a companion animal, living in the same space with human, is an ideal new model for human diseases research. Because of the high prevalence of diabetes, alternative transplantation islets resource (i.e. insulin producing cells) for diabetes treatment will be in urgent need, which makes our research on the transdifferentiation of Bone marrow mesenchymal stem cells into insulin producing cells become more important. Result In this study, we completed the transdifferentiation process and achieved the transcriptome profiling of five samples with two biological duplicates, namely, “BMSCs”, “islets”, “stage 1”, “stage 2” and “stage 3”, and the latter three samples were achieved on the second, fifth and eighth day of induction. A total of 11,530 differentially expressed transcripts were revealed in the profiling data. The enrichment analysis of differentially expressed genes revealed several signaling pathways that are essential for regulating proliferation and transdifferentiation, including focal adhesion, ECM-receptor interaction, tight junction, protein digestion and absorption, and the Rap1 signaling pathway. Meanwhile, the obtained protein–protein interaction network and functional identification indicating involvement of three genes, SSTR2, RPS6KA6, and VIP could act as a foundation for further research. Conclusion In conclusion, to the best of our knowledge, this is the first survey of the transdifferentiation of canine BMSCs into insulin-producing cells according with the timeline using next-generation sequencing technology. The three key genes we pick out may regulate decisive genes during the development of transdifferentiation of insulin producing cells.

Abstract Background Cell-based tissue engineering represents a promising management for meniscus repair and regeneration. The present study aimed to investigate whether the injection of parathyroid hormone (PTH) (1-34) could promote the regeneration and chondroprotection of 3D printed scaffold seeded with bone marrow mesenchymal stem cells (BMSCs) in a canine total meniscal meniscectomy model. Methods 3D printed poly(e-caprolactone) scaffold seeded with BMSCs was cultured in vitro, and the effects of in vitro culture time on cell growth and matrix synthesis of the BMSCs–scaffold construct were evaluated by microscopic observation and cartilage matrix content detection at 7, 14, 21, and 28 days. After that, the tissue-engineered meniscus based on BMSCs–scaffold cultured for the appropriate culture time was selected for in vivo implantation. Sixteen dogs were randomly divided into four groups: PTH + BMSCs–scaffold, BMSCs–scaffold, total meniscectomy, and sham operation. The regeneration of the implanted tissue and the degeneration of articular cartilage were assessed by gross, histological, and immunohistochemical analysis at 12 weeks postoperatively. Results In vitro study showed that the glycosaminoglycan (GAG)/DNA ratio and the expression of collagen type II (Col2) were significantly higher on day 21 as compared to the other time points. In vivo study showed that, compared with the BMSCs–scaffold group, the PTH + BMSCs–scaffold group showed better regeneration of the implanted tissue and greater similarity to native meniscus concerning gross appearance, cell composition, and cartilage extracellular matrix deposition. This group also showed less expression of terminal differentiation markers of BMSC chondrogenesis as well as lower cartilage degeneration with less damage on the knee cartilage surface, higher expression of Col2, and lower expression of degeneration markers. Conclusions Our results demonstrated that PTH (1-34) promotes the regenerative and chondroprotective effects of the BMSCs–3D printed meniscal scaffold in a canine model, and thus, their combination could be a promising strategy for meniscus tissue engineering.

One of the leading health consequences of the pandemic is the prevalence of sleep-related issues, such as insomnia. Hence, this study highlights the relationship between COVID-19 and insomnia and how insomnia is increasing due to the pandemic. The study's findings summarise that the COVID-19 pandemic has produced ubiquitous mental challenges, including loneliness, anxiety, fear, stress, extreme tiredness, and health concerns. It is also associated with physical issues such as social isolation, juggling work or study, parenting challenges, and significant behavior changes stemming from mass home confinement. There are also economic hardships, financial insecurity, risk, and infection. These factors lead to undoing routines and broken circadian rhythms amid the pandemic, affecting three sleep regulatory processes of the homeostatic sleep drive, the circadian rhythm, and the arousal system.Furthermore, we suggest future research directions to explore (1) long-term health impacts of the pandemic, (2) therapeutic strategies and the implementation of social policies to support people with sleep difficulties, (3) prevention programs and clinical interventions, and (4) nationwide or cross-regional online and practical psychological and sleep management intervention systems and platforms to address the psychological strain of isolation and traumatic experiences of the pandemic.

Incidental affect has an important impact on intertemporal choice (IC). This research aimed to test how positive incidental affect influences IC and its underlying mechanisms. We assumed that positive incidental affect may have a disjunction effect on IC that includes or excludes immediate time. Moreover, we examined the role of time perception for the effect of affect on IC. In Study 1, after undergoing affect priming by video clips, participants completed the IC task using a multiple staircase paradigm. Using Hierarchical Bayesian Modeling, we estimated the discount rate parameter by distinguishing “immediate” and “non-immediate” conditions of IC. The participants’ time perception was also measured. In Study 2, apart from the choice preference of IC, we additionally investigated the differences in the participants’ attention to delay and reward attributes before decision making. The results of the two studies indicated that positive incidental affect leads to longer time perception (Study 1) and prior and more attention to the delay attribute of IC (Study 2), which leads individuals to prefer immediate options in the IC (Studies 1 and 2). Moreover, there is a disjunction effect of affect; in other words, the incidental affect did not influence IC excluding immediate time (Studies 1 and 2). This study improves our understanding of the disjunctive effect and its mechanism of inducing a positive incidental affect on IC and thus provides a new perspective on how related decision making can be improved.

Background Subclinical infection of cardiac implantable electronic devices (CIEDs) is a common condition and increases the risk of clinical infection. However, there are limited studies focused on risk stratifying and prognostic analysis of subclinical CIED infection. Methods and Results Data from 418 consecutive patients undergoing CIED replacement or upgrade between January 2011 and December 2019 were used in the analysis. Among the patients included, 50 (12.0%) were detected as positive by bacterial culture of pocket tissues. The most frequently isolated bacteria were coagulase‐negative staphylococci (76.9%). Compared with the noninfection group, more patients in the subclinical infection group were taking immunosuppressive agents, received electrode replacement, or received CIED upgrade and temporary pacing. Patients in the subclinical infection group had a higher PADIT (Prevention of Arrhythmia Device Infection Trial) score. Univariable and multivariable logistic regression analysis found that use of immunosuppressive agents (odds ratio [OR], 6.95 [95% CI, 1.44–33.51]; P=0.02) and electrode replacement or CIED upgrade (OR, 6.73 [95% CI, 2.23–20.38]; P=0.001) were significantly associated with subclinical CIED infection. Meanwhile, compared with the low‐risk group, patients in the intermediate/high‐risk group had a higher risk of subclinical CIED infection (OR, 3.43 [95% CI, 1.58–7.41]; P=0.002). After a median follow‐up time of 36.5 months, the end points between the subclinical infection group and noninfection group were as follows: composite events (58.0% versus 41.8%, P=0.03), rehospitalization (54.0% versus 32.1%, P=0.002), cardiovascular rehospitalization (32.0% versus 13.9%, P=0.001), CIED infection (2.0% versus 0.5%, P=0.32), all‐cause mortality (28.0% versus 21.5%, P=0.30), and cardiovascular mortality (10.0% versus 7.6%, P=0.57). Conclusions Subclinical CIED infection was a common phenomenon. The PADIT score had significant value for stratifying patients at high risk of subclinical CIED infection. Subclinical CIED infection was associated with increased risks of composite events, rehospitalization, and cardiovascular rehospitalization.

Atrial fibrillation (AF) increases the risk of ischemic stroke and systemic arterial embolism. However, the risk factors or predictors of stroke in AF patients have not been clarified. Therefore, it is necessary to find effective diagnostic and therapeutic targets. Two datasets were downloaded from the Gene Expression Omnibus (GEO) database. Differently expressed genes (DEGs) were identified between samples of atrial fibrillation without stroke and atrial fibrillation with stroke. Enrichment analysis of Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) by Gene Set Enrichment Analysis (GSEA), construction and analysis of protein-protein interaction (PPI) network and significant module, and the receiver operator characteristic (ROC) curve analysis were performed. A total of 524 DEGs were common to both datasets. Analysis of KEGG pathways indicated that the top canonical pathways associated with DEGs were ubiquitin-mediated proteolysis, endocytosis, spliceosome, and so on. Ten hub genes (SMURF2, CDC42, UBE3A, RBBP6, CDC5L, NEDD4L, UBE2D2, UBE2B, UBE2I, and MAPK1) were identified from the PPI network and were significantly associated with a diagnosis of atrial fibrillation and stroke (AFST). In summary, a total of 524 DEGs and 10 hub genes were identified between samples of atrial fibrillation without stroke and atrial fibrillation with stroke. These genes may serve as the target of early diagnosis or treatment of AF complicated by stroke.

The practice shows that deep strip mining induces rockburst disaster easily. Accurately evaluating rockburst risk of the strip coal pillar is of great significance for ensuring the safety of deep strip mining. In this paper, the catastrophe mechanics model was used to analyze the abrupt instability condition of strip coal pillar. And the three indicators that are the medium stiffness ratio (k) of the elastic and plastic zone in the coal pillar, the plastic zone width ratio (aY), and the elastic deformation index (Uq) of core zone were put forward with considering the geometry size of coal pillar. Based on the 3202 panel of Gucheng Coal Mine, the evolution characteristics of rockburst risk of coal pillar under different mining widths and coal pillar widths were studied by numerical simulation. The evaluation result shows that the strip coal pillar of the 3202 panel is in danger of strong rockburst, which is more in line with the actual situation than the results of the traditional rockburst tendency identification test and comprehensive index method. These three indicators can be regarded as important indicators to evaluate the rockburst risk in the strip mining engineering field. Based on that, the design principle of strip mining in Gucheng Coal Mine was put forward, which is considered an important reference for similar cases.

The cuneiform nucleus (CN) and the pedunculopontine nucleus (PPN) in the midbrain control coordinated locomotion in vertebrates, but whether similar mechanisms exist in humans remain to be elucidated. Using functional magnetic resonance imaging, we found that simulated gait evoked activations in the CN, PPN, and other brainstem regions in humans. Brain networks were constructed for each condition using functional connectivity. Bilateral CN–PPN and the four pons–medulla regions constituted two separate modules under all motor conditions, presenting two brainstem functional units for locomotion control. Outside- and inside-brainstem nodes were connected more densely although the links between the two groups were sparse. Functional connectivity and network analysis revealed the role of brainstem circuits in dual-task walking and walking automaticity. Together, our findings indicate that the CN, PPN, and other brainstem regions participate in locomotion control in humans.

The mobile satellite laser ranging system TROS1000, successfully developed in 2010, achieves a high repetition rate and enables daytime laser ranging. Its measurement range has reached up to 36000 km with an accuracy as precise as 1 cm. Using recent observations in Wuhan, Jiufeng, Xianning, and Rongcheng, Shandong, we introduce the progress made using this mobile observation system.

α-MoO3 has been used as a hydrogen sensing material due to its excellent properties and unique crystalline layer structure. However, the low repeatability of α-MoO3 based hydrogen sensor restricts its practical application. In this paper, the effect of intercalated ion species and the amount in α-MoO3 is experimentally investigated and discussed. It is concluded that the repeatability of the sensor depends on the radius of intercalated ions and amount of ionic bonds. The optimal ion species is Na+ and the optimal amount of precursor is 1 mmol.

A new high performance fluorescence assay for detection of Ag+ based on CdS quantum dots (QDs) using L-Aspartic acid (L-Asp) as a stabilizer was proposed in this work. The CdS quantum dots conjugation with L-Aspartic acid (L-Asp@CdS QDs) were successfully synthesized via a simple hydrothermal process. The QDs have a fluorescence emission band maximum at 595 nm with a quantum yield of 11%. The obtained CdS QDs exhibit a particle size of 1.63 ± 0.28 nm and look like quantum dot flowers. Basically, the fluorescence intensity of L-Asp@CdS QDs can be enhanced only upon addition of Ag+ and a redshift in the fluorescence spectrum was observed. Under optimum conditions, the fluorescence enhancement of L-Asp@CdS QDs appeared to exhibit a good linear relationship in between 100−7000 nM (R2 = 0.9945) with the Ag+ concentration, with a detection limit of 39 nM. The results indicated that the L-Asp@CdS QDs were well used in detection for Ag+ as fluorescence probe in aqueous solution with high sensitivity and selectivity. Moreover, the sensing system has been applied in detection Ag+ in real water samples. The recovery test results were 98.6%~113%, and relative standard deviation (n = 5) is less than 3.6%, which was satisfactory.

The fluorescence intensity of N, S co-doped graphene quantum dots (N, S-GQDs) can be quenched by Fe3+ and Hg2+. Density functional theory (DFT) simulation and experimental studies indicate that the fluorescence quenching mechanisms for Fe3+ and Hg2+ detection are mainly attributed to the inner filter effect (IFE) and dynamic quenching process, respectively. The electronegativity difference between C and doped atoms (N, S) in favor to introduce negative charge sites on the surface of N, S-GQDs leads to charge redistribution. Those negative charge sites facilitate the adsorption of cations on the N, S-GQDs’ surface. Atomic population analysis results show that some charge transfer from Fe3+ and Hg2+ to N, S-GQDs, which relate to the fluorescent quenching of N, S-GQDs. In addition, negative adsorption energy indicates the adsorption of Hg2+ and Fe2+ is energetically favorable, which also contributes to the adsorption of quencher ions. Blue fluorescent N, S-GQDs were synthesized by a facile one-pot hydrothermal treatment. Fluorescent lifetime and UV-vis measurements further validate the fluorescent quenching mechanism is related to the electron transfer dynamic quenching and IFE quenching. The as-synthesized N, S-GQDs were applied as a fluorescent probe for Fe3+ and Hg2+ detection. Results indicate that N, S-GQDs have good sensitivity and selectivity on Fe3+ and Hg2+ with a detection limit as low as 2.88 and 0.27 nM, respectively.

Pd-functionalized one-dimensional (1D) SnO2 nanostructures were synthesized via a facile hydrothermal method and shaddock peels were used as bio-templates to induce a 1D-fiber-like morphology into the gas sensing materials. The gas-sensing performances of sensors based on different ratios of Pd-functionalized SnO2 composites were measured. All results indicate that the sensor based on 5 mol % Pd-functionalized SnO2 composites exhibited significantly enhanced gas-sensing performances toward butane. With regard to pure SnO2, enhanced levels of gas response and selectivity were observed. With 5 mol % Pd-functionalized SnO2 composites, detection limits as low as 10 ppm with responses of 1.38 ± 0.26 were attained. Additionally, the sensor exhibited rapid response/recovery times (3.20/6.28 s) at 3000 ppm butane, good repeatability and long-term stability, demonstrating their potential in practical applications. The excellent gas-sensing performances are attributed to the unique one-dimensional morphology and the large internal surface area of sensing materials afforded using bio-templates, which provide more active sites for the reaction between butane molecules and adsorbed oxygen ions. The catalysis and “spillover effect” of Pd nanoparticles also play an important role in the sensing of butane gas as further discussed in the paper.

Citric acid capped CdS quantum dots (CA-CdS QDs), a new assembled fluorescent probe for copper ions (Cu2+), was synthesized successfully by a simple hydrothermal method. In this work, the fluorescence sensor for the detection of heavy and transition metal (HTM) ions has been extensively studied in aqueous solution. The results of the present study indicate that the obtained CA-CdS QDs could detect Cu2+ with high sensitivity and selectivity. It found that the existence of Cu2+ has a significant fluorescence quenching with a large red shifted (from greenish-yellow to yellowish-orange), but not in the presence of 17 other HTM ions. As a result, Cu2S, the energy level below the CdS conduction band, could be formed at the surface of the CA-CdS QDs and leads to the quenching of fluorescence of CA-CdS QDs. Under optimal conditions, the copper ions detection range using the synthesized fluorescence sensor was 1.0 × 10‒8 M to 5.0 × 10‒5 M and the limit of detection (LOD) is 9.2 × 10‒9 M. Besides, the as-synthesized CA-CdS QDs sensor exhibited good selectivity toward Cu2+ relative to other common metal ions. Thus, the CA-CdS QDs has potential applications for detecting Cu2+ in real water samples.

Hepatitis C virus (HCV) infection is a leading cause of liver-related mortality. Chronic hepatitis C (CHC) is frequently associated with disturbances in iron homeostasis, with serum iron and hepatic iron stores being elevated. Accumulating evidence indicates that chronic HCV infection suppresses expression of hepatic hepcidin, a key mediator of iron homeostasis, leading to iron overload conditions. Since hepcidin mediates degradation of ferroportin, a basolateral transporter involved in the release of iron from cells, diminished hepcidin expression probably leads to up-regulation of ferroportin-1 (Fpn1) in patients with CHC. In this study, we determined the protein levels of duodenal Fpn1, and found that its expression was significantly up-regulated in patients with CHC. The expression of duodenal Fpn1 is negatively correlated with mRNA levels of hepcidin, and positively correlated with serum iron parameters. Although iron is a critical factor for growth of a variety of pathogenic bacteria, our results suggest that iron overload in blood does not increase the infection rate of bacteria in patients with CHC.