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Abstract Background Short-term exposure to ozone (O3) has been associated with higher stroke mortality, but it is unclear whether this association differs between urban and rural areas. The study aimed to compare the association between short-term exposure to O3 and ischaemic and haemorrhagic stroke mortality across rural and urban areas and further investigate the potential impacts of modifiers, such as greenness, on this association. Methods A multi-county time-series analysis was carried out in 19 counties of Shandong Province from 2013 to 2019. First, we employed generalized additive models (GAMs) to assess the effects of O3 on stroke mortality in each county. We performed random-effects meta-analyses to pool estimates to counties and compare differences in rural and urban areas. Furthermore, a meta-regression model was utilized to assess the moderating effects of county-level features. Results Short-term O3 exposure was found to be associated with increased mortality for both stroke subtypes. For each 10-µg/m3 (lag0-3) rise in O3, ischaemic stroke mortality rose by 1.472% in rural areas and 1.279% in urban areas. For each 0.1-unit increase in the Enhanced Vegetation Index (EVI) per county, the ischaemic stroke mortality caused by a 10-µg/m3 rise in O3 decreased by 0.60% overall and 1.50% in urban areas. Conclusions Our findings add to the evidence that short-term O3 exposure increases ischaemic and haemorrhagic stroke mortality and has adverse effects in urban and rural areas. However, improving greenness levels may contribute to mitigating the detrimental effects of O3 on ischaemic stroke mortality.

ObjectivesLung cancer is one of the most common cancers in Shandong Province, China. Projecting future cancer trend is crucial for planning cancer control. We aimed to examine the trend of lung cancer incidence and mortality from 2012 to 2023, and predict the lung cancer burden to 2030 in Shandong.MethodsData of lung cancer incidence and mortality from 2012 to 2023 were obtained from the Shandong Cancer Registries. The average annual percentage change (AAPC) was used to quantify the trend of the lung cancer age-standardised rate using Joinpoint software. Bayesian age-period-cohort model was used to predict lung cancer incidence and mortality from 2024 to 2030.ResultsThe age-standardised incidence rate (ASIR) remained stable from 2012 to 2023. The ASIR in males decreased with an AAPC of -1.350%, while the ASIR in females increased with an AAPC of 2.429%. The age-standardised mortality rate (ASMR) decreased with an AAPC of -2.911%. This trend was also observed in males (AAPC=-2.513%), females (AAPC=-3.632%), urban areas (AAPC=-3.267%) and rural areas (AAPC=-2.603%). For our predictions, the ASIR will increase to 49.21 per 100,000 until 2030, with an AAPC of 1.873%. This upward trend is expected for females and urban areas, with an AAPC of 4.496% and 4.176%, while it is not observed for males and rural areas. The ASMR is expected to remain stable up to 2030, and this trend will maintain both in males and females. The ASMR will exhibit an upward trend (AAPC=1.100%) in urban areas and a downward trend (AAPC=-0.915%) in rural areas.ConclusionThe ASIR of lung cancer will increase until 2030, while the ASMR of lung cancer is expected to remain stable in Shandong. It is necessary to take further preventive measures such as strengthening tobacco control, enhancing health education and expanding screening efforts.

Nitrogen (N) fertilization is critical for spike and floret development, which affects the number of fertile florets per spike (NFFs). However, the physiological regulation of the floret development process by N fertilization is largely unknown. A high temporal-resolution investigation of floret primordia number and morphology, dry matter, and N availability was conducted under three N fertilization levels: 0 (N0), 120 (N1) and 240 (N2) kg ha−1. Interestingly, fertile florets at anthesis stage were determined by those floret primordia with meiotic ability at booting stage: meiotic ability was a threshold that predicted whether a floret primordium became fertile or abortive florets. Because the developmental rate of the 4th floret primordium in the central spikelet was accelerated and then they acquired meiotic ability, the NFFs increased gradually as N application increased, but the increase range decreased under N2. There were no differences in spike N concentration among treatments, but leaf N concentration was increased in the N1 and N2 treatments. Correspondingly, dry matter accumulation and N content of the leaf and spike in the N1 and N2 treatments was increased as compared to N0. Clearly, optimal N fertilization increased leaf N availability and transport of assimilates to spikes, and allowed more floret primordia to acquire meiotic ability and become fertile florets, finally increasing NFFs. There was no difference in leaf N concentration between N1 and N2 treatment, whereas soil N concentration at 0–60 cm soil layers was higher in N2 than in N1 treatment, implying that there was still some N fertilization that remained unused. Therefore, improving the leaf’s ability to further use N fertilizer is vital for greater NFFs.

Abstract Lung cancer is a leading cause of cancer deaths and imposes an enormous economic burden on patients. It is important to develop an accurate risk assessment model to determine the appropriate treatment for patients after an initial lung cancer diagnosis. The Cox proportional hazards model is mainly employed in survival analysis. However, real-world medical data are usually incomplete, posing a great challenge to the application of this model. Commonly used imputation methods cannot achieve sufficient accuracy when data are missing, so we investigated novel methods for the development of clinical prediction models. In this article, we present a novel model for survival prediction in missing scenarios. We collected data from 5,240 patients diagnosed with lung cancer at the Weihai Municipal Hospital, China. Then, we applied a joint model that combined a BN and a Cox model to predict mortality risk in individual patients with lung cancer. The established prognostic model achieved good predictive performance in discrimination and calibration. We showed that combining the BN with the Cox proportional hazards model is highly beneficial and provides a more efficient tool for risk prediction.

BackgroundExcessive sodium and low potassium intake are involved in the development of hypertension. Growing evidence showed that the sodium-to-potassium ratio (Na/K) was significantly associated with blood pressure (BP). However, studies on the dose-response relationship of spot urinary Na/K ratio with hypertension and BP in the general population are scarce, especially in the Chinese population.Materials and methodsData from the post-intervention survey of the Shandong Ministry of Health Action on Salt and Hypertension (SMASH) project was analyzed. Associations between Na/K molar ratio and hypertension prevalence and between Na/K molar ratio and BP indices were analyzed using multivariable logistic and linear regression, respectively, followed by subgroup analysis and interaction analysis. The restricted cubic spline model was used to explore the dose–response relationship. Informed by existing literature, we adjusted for potential confounding factors, including temperature and renal function, to assess the association and dose–response relationship.ResultsThere was a non-linear positive association between Na/K and hypertension (OR:1.09, 95%CI: 1.08–1.11) and a linear positive association between Na/K and systolic BP, diastolic BP, and mean arterial pressure (β 0.53, 95%CI: 0.45–0.60; β 0.36, 95%CI: 0.31–0.41; and β 0.42, 95%CI: 0.36–0.47, respectively). The association was stronger in individuals with hypertension, female patients, those in the 50–59-year age group, and those who were obese. Environmental temperatures had little impact on associations.ConclusionOur findings provide further evidence that the spot urinary Na/K ratio is a simple, useful, and convenient indicator for monitoring salt reduction and potassium increase, which could be used in clinical and public health practices.

Evidence on the association between long-term ozone exposure and greenness exposure and hemorrhagic stroke (HS) is limited, with mixed results. One potential source of this inconsistency is the difference in exposure time metrics. This study aimed to investigate the association between long-term exposure to ambient ozone, greenness, and mortality from HS using exposure metrics at different times. We also examined whether greenness exposure modified the relationship between ozone exposure and mortality due to HS. The study population consisted of 45771 participants aged ≥40 y residing in 20 counties in Shandong Province who were followed up from 2013 to 2019. Ozone exposure metrics (annual mean and warm season) and the normalized difference a measure of greenness exposure, were calculated. The relationship between environmental exposures (ozone and greenness exposures) and mortality from HS was assessed using time-dependent Cox proportional hazards models, and the modification of greenness exposure was examined using stratified analysis with interaction terms. The person-years at the end of follow-up were 90,663. With full adjustments, the risk of death from hemorrhagic stroke increased by 5% per interquartile range increase in warm season ozone [hazard ratio =1.05; 95 % confidence interval: 1.01–1.08]. No clear association was observed between annual ozone and mortality HS. Both the annual and summer NDVI were found to reduce the risk of HS mortality. The relationships were influenced by age, sex, and residence (urban or rural). Furthermore, greenness exposure was shown to have a modifying effect on the relationship between ozone exposure and the occurrence of HS mortality (P for interaction = 0.001). Long-term exposure to warm season O3 was positively associated with HS mortality, while greenness exposure was inversely associated with HS mortality. Greenness exposure may mitigate the negative effects of warm season ozone exposure on HS mortality.

Abstract Underwater adhesives with injectable, organic solvent‐free, strong, fast adhesion, and hemostatic properties have become an urgent need in biomedical field. Herein, a novel polyurethane underwater adhesive (PUWA) inspired by mussels is developed utilizing the rapid post‐cure reaction of isocyanate esterification without organic solvents. The PUWA is created through the injectable two component curing process of component A (biocompatible polyurethane prepolymer) and component B (dopamine modified lysine derivatives: chain extender‐LDA and crosslinker‐L3DA). The two‐component adhesive cures quickly and firmly underwater, with an impressive bonding strength of 40 kPa on pork skin and excellent burst pressure of 394 mmHg. Moreover, the PUWA exhibits robust adhesion strength in hostile environments with acid, alkali and saline solutions. Combined with excellent biocompatibility and hemostatic performance, the PUWA demonstrates effectively sealing wounds and promoting healing. With the ability to bond diverse substrates rapidly and strongly, the PUWA holds significant potential for application in both biomedical and industrial fields.

ObjectivesThe impact of climate change, especially extreme temperatures, on health outcomes has become a global public health concern. Most previous studies focused on the impact of disease incidence or mortality, whereas much less has been done on road traffic injuries (RTIs). This study aimed to explore the effects of ambient temperature, particularly extreme temperature, on road traffic deaths in Jinan city.MethodsDaily data on road traffic deaths and meteorological factors were collected among all residents in Jinan city during 2011–2020. We used a time-stratified case-crossover design with distributed lag nonlinear model to evaluate the association between daily mean temperature, especially extreme temperature and road traffic deaths, and its variation in different subgroups of transportation mode, adjusting for meteorological confounders.ResultsA total of 9,794 road traffic deaths were collected in our study. The results showed that extreme temperatures were associated with increased risks of deaths from road traffic injuries and four main subtypes of transportation mode, including walking, Bicycle, Motorcycle and Motor vehicle (except motorcycles), with obviously lag effects. Meanwhile, the negative effects of extreme high temperatures were significantly higher than those of extreme low temperatures. Under low-temperature exposure, the highest cumulative lag effect of 1.355 (95% CI, 1.054, 1.742) for pedal cyclists when cumulated over lag 0 to 6 day, and those for pedestrians, motorcycles and motor vehicle occupants all persisted until 14 days, with ORs of 1.227 (95% CI, 1.102, 1.367), 1.453 (95% CI, 1.214, 1.740) and 1.202 (95% CI, 1.005, 1.438), respectively. Under high-temperature exposure, the highest cumulative lag effect of 3.106 (95% CI, 1.646, 5.861) for motorcycle occupants when cumulated over lag 0 to 12 day, and those for pedestrian, pedal cyclists, and motor vehicle accidents all peaked when persisted until 14 days, with OR values of 1.638 (95% CI, 1.281, 2.094), 2.603 (95% CI, 1.695, 3.997) and 1.603 (95% CI, 1.066, 2.411), respectively.ConclusionThis study provides evidence that ambient temperature is significantly associated with the risk of road traffic injuries accompanied by obvious lag effect, and the associations differ by the mode of transportation. Our findings help to promote a more comprehensive understanding of the relationship between temperature and road traffic injuries, which can be used to establish appropriate public health policies and targeted interventions.

ObjectiveTo analyze the trend in liver cancer incidence and mortality in Shandong province during 2013 – 2018 for providing evidence to the prevention and control of liver cancer. MethodsThe data of 2013 – 2018 on liver cancer incidence and mortality among residents covered by 35 tumor registries across Shandong province were extracted from tumor registry system of the province. After data cleaning, annual crude and standardized (based on national population of China 2000 census) incidence and mortality rate of liver cancer among the residents were calculated. Joinpoint 4.8.0.1 software was used to estimate the annual percentage change (APC) in liver cancer incidence and mortality rate. ResultsFrom 2013 to 2018 among the residents, the annual crude incidence rate (1/100 000) of liver cancer were 29.86, 30.26, 27.99, 29.57, 26.80, and 26.31 and the annual standardized incidence rate (1/100 000) were 19.51, 18.94, 17.33, 17.39, 15.73, and 15.18, respectively; both the crude and standardized incidence rate of liver cancer showed an overall decreasing trend, with the APC of – 2.7% and – 5.0% (both P < 0.05) ; the annual crude mortality rate (1/100 000) and standardized mortality rate (1/100 000) of liver cancer also presented an overall decreasing trend during the 6-year period, with the annual crude rate of 26.13, 26.07, 24.08, 23.12, 23.69, and 23.12 for incidence and 16.87, 16.13, 14.70, 13.08, 13.69 and 13.08 for mortality rate (APC = – 2.6% and – 5.1%, both P < 0.01); the annual incidents of liver cancer accounted for 36.65%, 36.36%, 32.81%, 31.68%, 28.66%, and 28.13% of all newly diagnosed malignant tumors per year and the annual number of deaths due to liver cancer accounted for 29.58%, 28.95%, 26.76%, 24.59%, 23.47%, and 22.54% of all malignant tumor deaths yearly for years 2013 – 2018. Also for the years 2013 – 2018, the age-specific (five year age group) liver cancer incidence rate decreased significantly among the male and female residents aged elder than 34 years and younger than 85 years (P < 0.05 for all); the age-specific liver cancer mortality rate decreased during the same period among the male and urban residents aged elder than 39 years and younger than 85 years (P < 0.05 for all); the decreasing trends in annual standardized incidence and mortality rate of liver cancer were significant for subgroups of male, female, urban, and rural populations (P < 0.05 for all). ConclusionDuring 2013 to 2018, the overall incidence and mortality rate of liver cancer showed a decreasing trend among the residents in Shandong province, but the incidence and mortality rate were still at a high level.

In order to improve the decorative properties of Magnesium-Glass-Board (MGB), the surface morphology and decoration performance of MGB, are studied in detail by using profilometer, microscope and SEM, and the influence of its characterization, such as surface roughness, surface porosity and wettability, on decorative properties of MGB is analyzed by comparing with medium density fiberboard (MDF) and medium density particleboard (MDP). The results first showed that the surface of MGB has a porous structure, but MDF and MDP are not, resulting in a poor decorative performance of MGB. Second, it is found that the surface wettability of MGB is better than others. Third, the hot-pressing parameters including pressure, temperature and time have different influence on decorative performance of MGB during hot-pressing experiment. Finally, the surface bonding strength is positively correlated with pressure, but not with temperature and time. In general, a higher surface bonding strength led to a better decorative performance of MGB. The furthermore research can concentrate on the modification method of the MGB's surface according to this paper's conclusion to improve the lamination performance of melamine paper.

Abstract We aimed to analyse cancer survival and its spatial distribution in Shandong Province. A total of 609,861 cancer cases from 2014 to 2016 were included in the analysis. Survival analysis was performed using strs in Stata. Spatial analysis was performed with GeoDa to determine measures of global and local spatial autocorrelation. Hotspot analysis was used to identify spatial clusters of high values (hotspots) and low values (cold spots) through ArcGIS. The 5-year relative survival rates were 37.85% for all cancers combined, 29.29% for males and 48.88% for females. After age standardisation, the survival rates were 34.47% for all cancers, 28.43% for males and 41.56% for females. Cancers with higher survival rates included thyroid (78.80%), breast (69.52%), uterus (64.51%) and bladder (62.54%) cancers. However, cancers with lower survival rates included pancreatic (11.34%), liver (13.19%), lung (18.39%), bone (19.71%), gallbladder (19.78%), oesophagus (24.52%), and stomach (28.85%) cancers and leukaemia (26.30%). Cancer survival rates in urban areas (37.53%) were higher than those in rural areas (32.83%). From the geographic distribution of cancer survival, we observed that the survival rate displayed a downward trend from east to west and from north to south. The hotspot analysis revealed that some counties of Qingdao, Jinan, Zibo, Dongying and Yantai cities were hotspots, whereas almost all counties of Linyi city and some counties of Weifang, Heze, Rizhao, and Dezhou cities were cold spots. In conclusion, the cancer survival rate in Shandong is still lower than that in China overall. The early diagnosis and treatment of lung and digestive tract cancers need to be further strengthened. Nevertheless, our results reflect a critical first step in obtaining and reporting accurate and reliable estimates of survival in Shandong.

BackgroundImproving the quality of life (QoL) of older adults is becoming an important global issue. However, very few studies have been focused on the relationship between socioeconomic status (SES) and QoL in older adults with hypertension. The purpose of this study is to investigate (a) the status of QoL and (b) the mediating effect of social capital in the relationship between SES and QoL, among rural older adults with hypertension in China.MethodsUsing multistage stratified random sampling, a face-to-face questionnaire survey was conducted among rural older adults with hypertension in Shandong province of China from June to July 2021. Three typical measures representing SES were used, namely, annual household income, educational level, and employment status. Individual social capital and QoL were assessed by the Resource Generator-China Scale (RG—China) and a 34-item simplified Patient Report Outcome (PRO)-specific scale for older adults with hypertension, respectively. A total of 950 rural older adults with hypertension were included in the analysis. The mediation model based on bootstrap analyses was employed to explore the relationship between SES and QoL and the mediating role of social capital in the SES-QoL nexus.ResultsThe sampled rural older adults with hypertension had an upper-middle level of QoL, and the average score was 132.57 ± 19.40. SES was positively correlated with both QoL and individual social capital; individual social capital was significantly positively correlated with QoL. Controlling for sociodemographic variables, SES was still significantly associated with individual social capital (β = 0.140, P < 0.001), and the higher the individual social capital, the better QoL (β = 0.153, P < 0.001). Individual social capital played a partially mediating role in the association between SES and QoL (indirect effect = 0.021, 95% CI: 0.010–0.038), which accounted for 9.38% of the total effect.ConclusionThis study provides evidence that the effect of SES on QoL was partially mediated by individual social capital among rural older adults with hypertension in China. The government should pay more attention to the rural older hypertensive population with lower SES and strive to reduce the negative impact of poor SES on their QoL, based on effective strategies including improving their individual social capital.

Hyaline cartilage plays a critical role in maintaining joint function and pain. However, the lack of blood supply, nerves, and lymphatic vessels greatly limited the self-repair and regeneration of damaged cartilage, giving rise to various tricky issues in medicine. In the past 30 years, numerous treatment techniques and commercial products have been developed and practiced in the clinic for promoting defected cartilage repair and regeneration. Here, the current therapies and their relevant advantages and disadvantages will be summarized, particularly the tissue engineering strategies. Furthermore, the fabrication of tissue-engineered cartilage under research or in the clinic was discussed based on the traid of tissue engineering, that is the materials, seed cells, and bioactive factors. Finally, the commercialized cartilage repair products were listed and the regulatory issues and challenges of tissue-engineered cartilage repair products and clinical application would be reviewed.

Background Peritoneal dialysis (PD) is one of the most important kidney replacement therapies for patients with end‐stage kidney disease (ESKD). PD technique failure can lead to an escalated cost and increased infectious and cardiovascular risk, up and including to death. The accumulation of uric acid (UA) was associated with adverse outcomes in ESKD patients. However, the relationship between serum UA and technique failure is little explored. Methods Here, a total of 266 continuous ambulatory peritoneal dialysis (CAPD) patients (age, 41.8 ± 12.6 years; 125 males) were enrolled and followed up for 31.7 months. Serum UA levels were examined at baseline and each visit. Subjects were divided into three groups according to their baseline serum UA concentrations. Multivariable Cox regression models were used to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) of PD technique failure. Results The level of serum UA increased gradually as time prolonged. During the follow-up period, 77 (28.9%) patients occurred PD technique failure, of which 56 (21.1%) transferred to hemodialysis (HD) and 21 (7.9%) died. Compared to the lowest UA tertile, after adjusting for potential confounders, HRs of technique failure in tertile 2 and tertile 3 were 1.82 (95% CI: 0.95–3.49) and 2.03 (95% CI: 1.05–3.92), respectively, and p for trend was 0.043. Adjusted HRs of all-cause technique failure, transferring to HD and mortality with each 1 mg/dL increase in serum UA were 1.20 (95% CI: 1.03–1.40, p = 0.019), 1.22 (95% CI: 1.01–1.48, p = 0.039), and 1.25 (95% CI: 0.94–1.67, p = 0.128), respectively. Conclusion Higher serum UA level predicted higher risk of technique failure in CAPD patients.

Abstract Background The relative contributions of genetic and environmental factors versus unavoidable stochastic risk factors to the variation in cancer risk among tissues have become a widely-discussed topic. Some claim that the stochastic effects of DNA replication are mainly responsible, others believe that cancer risk is heavily affected by environmental and hereditary factors. Some of these studies made evidence from the correlation analysis between the lifetime number of stem cell divisions within each tissue and tissue-specific lifetime cancer risk. However, they did not consider the measurement error in the estimated number of stem cell divisions, which is caused by the exposure to different levels of genetic and environmental factors. This will obscure the authentic contribution of environmental or inherited factors. Methods In this study, we proposed two distinct modeling strategies, which integrate the measurement error model with the prevailing model of carcinogenesis to quantitatively evaluate the contribution of hereditary and environmental factors to cancer development. Then, we applied the proposed strategies to cancer data from 423 registries in 68 different countries (global-wide), 125 registries across China (national-wide of China), and 139 counties in Shandong province (Shandong provincial, China), respectively. Results The results suggest that the contribution of genetic and environmental factors is at least 92% to the variation in cancer risk among 17 tissues. Moreover, mutations occurring in progenitor cells and differentiated cells are less likely to be accumulated enough for cancer to occur, and the carcinogenesis is more likely to originate from stem cells. Except for medulloblastoma, the contribution of genetic and environmental factors to the risk of other 16 organ-specific cancers are all more than 60%. Conclusions This work provides additional evidence that genetic and environmental factors play leading roles in cancer development. Therefore, the identification of modifiable environmental and hereditary risk factors for each cancer is highly recommended, and primary prevention in early life-course should be the major focus of cancer prevention.

With the 15 yr of Pass 8 data recorded by the Fermi Large Area Telescope, we report the detection of an extended gigaelectronvolt emission component with a 68% containment radius of 0.°85, which is spatially associated with the newly identified supernova remnant (SNR) G321.3–3.9. The γ -ray spectrum is best described by a log-parabola model in the energy range of 100 MeV–1 TeV, which shows a significant spectral curvature at ∼1 GeV. Either a leptonic or a hadronic model could explain the multiwavelength data of G321.3–3.9, while the leptonic model predicts a too-low strength of magnetic field. Also considering the flat radio spectrum of G321.3–3.9 and the γ -ray upper limit in the low energy band, the hadronic model is favored. The spatial coincidence between the γ -ray morphology and the diffuse thermal X-ray emission of G321.3–3.9 and the curved gigaelectronvolt γ -ray spectrum make G321.3–3.9 similar to the typical middle-aged SNRs interacting with molecular clouds (MCs). Such characteristics provide further evidence of the potential hadronic origin for its γ -ray emission. However, there is no MC detected around G321.3–3.9, which challenges the hadronic model.

HESS J1813-178 is one of the brightest and most compact TeV γ -ray sources, and whether its γ -ray emission is associated with supernova remnant (SNR), pulsar wind nebula (PWN), or young stellar cluster (YSC) is still under debate. By analyzing the GeV γ -ray data in the field of HESS J1813-178 using 14 yr of PASS 8 data recorded by the Fermi Large Area Telescope (Fermi-LAT), we report the discovery of three different sources with different spectra in this region. The hard source with a PL spectral index of 2.11 ± 0.08 has a small size extension, which is spatially and spectrally coincident with the TeV γ -ray emission from HESS J1813-178. CO observations display the dense molecular clouds surrounding HESS J1813-178 in the velocity range of 45–60 km s ^−1 . The possible origins of the γ -ray emission from HESS J1813-178 are discussed, including SNR G12.820.02, the PWN driven by the energetic X-ray pulsar PSR J1813-1749 and YSC Cl 1813-178. However, none of them can be ruled out clearly. Note that the maximum energy of protons in the hadronic model should exceed a few hundred TeV, which makes HESS J1813-178 a promising PeVatron. A detailed LHAASO data analysis about the morphology and spectrum would be helpful to investigate the origin of the γ -ray emission in this region and test its PeVatron nature.

We report the discovery of the energy-dependent morphology of the GeV gamma-ray emission from HESS J1857+026 with more than 13 yr of Fermi Large Area Telescope data. The GeV gamma-ray emission from this region is composed of two extended components. The hard component with an index of 1.74 ± 0.07 in the energy range of 0.5–500 GeV is spatially coincident with HESS J1857+026, and its 68% containment radius varies from ∼0.°44 below 40 GeV to ∼0.°30 above 140 GeV. The hard GeV gamma-ray spectrum and the energy-dependent morphology of HESS J1857+026 make it favor a pulsar wind nebula origin, which is associated with the energetic pulsar PSR J1856+0245. The soft component with an index of 2.70 ± 0.16 and another extended gamma-ray source detected in this region, 4FGL J1857.9+0313e, with an index of 2.55 ± 0.07, are spatially coincident with two molecular clumps in the northeast and southwest of HESS J1857+026, which favors the hadronic process, and the protons could be accelerated by the hypothetical supernova remnant associated with PSR J1856+0245.

Abstract Background The incidence of perioperative stroke following spinal surgery, including ischemic and hemorrhagic stroke, has not been fully investigated in the Chinese population. Whether specific spinal or emergency/elective procedures are associated with perioperative stroke remains controversial. This study aimed to investigate the incidence of perioperative stroke, health economic burden, clinical outcomes, and associated risk factors. Method A retrospective cohort study using an electronic hospital information system database was conducted from Jan 1, 2015, to Jan 1, 2021, in a tertiary hospital in China. Patients aged ≥18 years who had undergone spinal surgery were included in the study. We recorded patient demographics, comorbidities, and health economics data. Clinical outcomes included perioperative stroke during hospitalization and associated risk factors. The patients’ operative data, anesthetic data, and clinical manifestations were recorded. Result A total of 17,408 patients who had undergone spinal surgery were included in this study. Twelve patients had perioperative stroke, including seven ischemic stroke (58.3%) and five hemorrhagic stroke (41.7%). The incidence of perioperative stroke was 0.07% (12/17,408). In total, 12 stroke patients underwent spinal fusion. Patients with perioperative stroke were associated with longer hospital stay (38.33 days vs. 9.78 days, p

Background: The effects of fine particulate matter (PM2.5) on acute myocardial infarction (AMI) have been widely recognized. However, no studies have comprehensively evaluated future PM2.5-attributed AMI burdens under different climate mitigation and population change scenarios. We aimed to quantify the PM2.5-AMI association and estimate the future change in PM2.5-attributed AMI incident cases under six integrated scenarios in 2030 and 2060 in Shandong Province, China. Methods: Daily AMI incident cases and air pollutant data were collected from 136 districts/counties in Shandong Province from 2017 − 2019. A two-stage analysis with a distributed lag nonlinear model was conducted to quantify the baseline PM2.5-AMI association. The future change in PM2.5-attributed AMI incident cases was estimated by combining the fitted PM2.5-AMI association with the projected daily PM2.5 concentrations under six integrated scenarios. We further analyzed the factors driving changes in PM2.5-related AMI incidence using a decomposition method. Results: Each 10 μg/m3 increase in PM2.5 exposure at lag05 was related to an excess risk of 1.3 % (95 % confidence intervals: 0.9 %, 1.7 %) for AMI incidence from 2017 − 2019 in Shandong Province. The estimated total PM2.5-attributed AMI incident cases would increase by 10.9−125.9 % and 6.4–244.6 % under Scenarios 1 − 3 in 2030 and 2060, whereas they would decrease by 0.9–5.2 % and 33.0–46.2 % under Scenarios 5 – 6 in 2030 and 2060, respectively. Furthermore, the percentage increases in PM2.5-attributed female cases (2030: −0.3 % to 135.1 %; 2060: −33.2 % to 321.5 %) and aging cases (2030: 15.2–171.8 %; 2060: −21.5 % to 394.2 %) would wholly exceed those in male cases (2030: −1.8 % to 133.2 %; 2060: −41.1 % to 264.3 %) and non-aging cases (2030: −41.0 % to 45.7 %; 2060: −89.5 % to −17.0 %) under six scenarios in 2030 and 2060. Population aging is the main driver of increased PM2.5-related AMI incidence under Scenarios 1 − 3 in 2030 and 2060, while improved air quality can offset these negative effects of population aging under the implementation of the carbon neutrality and 1.5 °C targets. Conclusion: The combination of ambitious climate policies (i.e., 1.5 °C warming limits and carbon neutrality targets) with stringent clean air policies is necessary to reduce the health impacts of air pollution in Shandong Province, China, regardless of population aging.

Abstract The interactive corrosion between stainless steel 316 (SS) and International Simple Glass (ISG) has been studied for 12 months. The samples were placed in intimate contact to create crevice corrosion conditions on SS in a 0.6 M NaCl solution with and without 142 ppm dissolved silica species enriched in 29Si. Corrosion on SS was observed with large pits located close to the crevice mouth at the end of 1 year in 0.6 M NaCl solution. The SS corrosion was also associated with the dissolution of nearby glass in a highly localized manner. When the leaching solution was saturated with silica species, the corrosion rate of SS was suppressed. However, the presence of SS enhances ISG dissolution in both conditions. The implications of the observed phenomena on the long-term storage of nuclear waste are discussed.

Background: The occurrence of compound hot extreme (CHE) events in China is increasingly frequent. This study aimed to investigate the association between CHEs and all-cause mortality in Shandong Province and to estimate the attributable excess deaths. Methods: We collected daily data on weather, air pollution, and all-cause mortality at the subdistrict level in Shandong Province from 2013 to 2018. A CHE was defined as both daily maximum and minimum temperatures being higher than their historical 90th percentiles during 2013–2018 hot seasons. A case time-series analysis with a distributed lagged non-linear model was applied to analyze the subdistrict-specific association between different hot extremes and mortality risk, which were then pooled at the province level using meta-analysis. Results: Hot nights (RR = 1.44, 95%CI: 1.35–1.53) and CHEs (RR = 1.77, 95%CI: 1.64–1.90) were significantly associated with an increased mortality risk. CHEs had a greater effect for females (RR = 1.99, 95%CI: 1.81–2.19) and the elderly (>74 years) (RR = 2.14, 95%CI: 1.93–2.38) than their counterparts, respectively. Cardiovascular and respiratory deaths were more susceptible to CHEs than other deaths. Each year, 4888 (95%CI: 4133–5811) excess deaths in Shandong Province were attributable to CHEs, accounting for 2.60% (95%CI: 2.20–3.10%) of all-cause deaths and equating to 50 (95%CI: 42–58) deaths per 1,000,000 residents. The CHE-related mortality burden varied across subdistricts, with the highest occurring in the southeastern area and the lowest occurring in the northeastern and southwestern regions. Conclusion: CHEs and hot nights were substantially associated with excess deaths in Shandong Province, especially for females, the elderly, and residents living in the southeastern area. Our findings may facilitate the development of a heat alert warning system and preventive measures for vulnerable populations.

With the interdisciplinary convergence of biology, medicine and materials science, both research and clinical translation of biomaterials are progressing at a rapid pace. However, there is still a huge gap between applied basic research on biomaterials and their translational products - medical devices, where two significantly different perspectives and mindsets often work independently and non-synergistically, which in turn significantly increases financial costs and research effort. Although this gap is well-known and often criticized in the biopharmaceutical industry, it is gradually widening. In this article, we critically examine the developmental pipeline of biodegradable biomaterials and biomaterial-based medical device products. Then based on clinical needs, market analysis, and relevant regulations, some ideas are proposed to integrate the two different mindsets to guide applied basic research and translation of biomaterial-based products, from the material and technical perspectives. Cartilage repair substitutes are discussed here as an example. Hopefully, this will lay a strong foundation for biomaterial research and clinical translation, while reducing the amount of extra research effort and funding required due to the dissonance between innovative basic research and commercialization pipeline.

BackgroundThe migrant elderly following children (MEFC) are a vulnerable group that emerged during fast urbanization in China. The MEFC faced physical and psychological discomfort upon their arrival in the inflow city, particularly those who came from rural areas.ObjectiveThis study aimed to explore the relationship between oral health status, loneliness, and sleep quality among the MEFC in China and to clarify the disparities in the above mentioned relationship by migration type.MethodsIn 2021, a cross-sectional survey was conducted in Weifang, Shandong Province, using multistage cluster random sampling to collect data from the MEFC aged 60 years and over. In total, 613 respondents [525 rural-to-urban (RTU) and 88 urban-to-urban (UTU)] were included in the final database. The chi-square test, t-test, and structural equation modeling (SEM) were used to investigate the relationship between oral health status, loneliness, and sleep quality among the RTU and UTU MEFC.ResultsTotal scores [mean ± standard deviation (SD)] for oral health status, loneliness, and sleep quality were 54.95 ± 6.47, 8.58 ± 3.03, and 4.47 ± 3.60, respectively. SEM revealed that, among the RTU and UTU MEFC, oral health status was positively and significantly related to sleep quality; however, the correlation was slightly stronger in the UTU MEFC. In both groups, there was a significant negative correlation between oral health status and loneliness, which was stronger in the UTU MEFC. In the RTU MEFC, a significant negative correlation between loneliness and sleep quality was observed, and in the UTU MEFC, no significant association between loneliness and sleep quality was observed.ConclusionThe sleep quality among the MEFC in this study was higher compared to previous studies. Oral health status was negatively correlated with loneliness and positively associated with sleep quality, whereas loneliness was negatively correlated with sleep quality. These three associations differed significantly between the UTU and RTU MEFC. The government, society, and families should take measures to improve oral health and reduce loneliness among the MEFC to improve their sleep quality.

IntroductionNumerous studies have reported the modification of particulate matters (PMs) on the association between cold temperature and health. However, it remains uncertain whether the modification effect may vary by size of PMs, especially in Shandong Province, China where the disease burdens associated with cold temperature and PMs are both substantial. This study aimed to examine various interactive effects of cold exposure and ambient PMs with diameters ≤1/2.5 μm (PM1 and PM2.5) on premature deaths in Shandong Province, China.MethodsIn the 2013-2018 cold seasons, data on daily mortality, PM1 and PM2.5, and weather conditions were collected from the 1822 sub-districts of Shandong Province. A time-stratified case-crossover study design was performed to quantify the cumulative association between ambient cold and mortality over lag 0-12 days, with a linear interactive term between temperature and PM1 and PM2.5 additionally added into the model.ResultsThe mortality risk increased with temperature decline, with the cumulative OR of extreme cold (−16.9°C, the 1st percentile of temperature range) being 1.83 (95% CI: 1.66, 2.02), compared with the minimum mortality temperature. The cold-related mortality risk was 2.20 (95%CI: 1.83, 2.64) and 2.24 (95%CI: 1.78, 2.81) on high PM1 and PM2.5 days, which dropped to 1.60 (95%CI: 1.39, 1.84) and 1.60 (95%CI: 1.37, 1.88) on low PM1 and PM2.5 days. PM1 showed greater modification effect for per unit concentration increase than PM2.5. For example, for each 10?g/m3 increase in PM1 and PM2.5, the mortality risk associated with extreme cold temperature increased by 7.6% (95% CI: 1.3%, 14.2%) and 2.6% (95% CI: −0.7%, 5.9%), respectively.DiscussionThe increment of smaller PMs' modification effect varied by population subgroups, which was particularly strong in the elderly aged over 75 years and individuals with middle school education and below. Specific health promotion strategies should be developed towards the greater modification effect of smaller PMs on cold effect.

Abstract Smart coatings that provide corrosion protection on demand have received a lot of recent attention. In the present study, nanofibers containing a corrosion inhibitor were prepared by a coaxial electrospinning technique, which addresses the limitations of inhibitor-loaded microcapsules or nanocontainers. The as-prepared nanofibers have a core-shell structure with Ce(NO3)3 and the chitosan/polyacrylic acid polyelectrolyte coacervate as the core and shell materials, respectively. UV-vis spectroscopic analysis confirms that the nanofibers are pH-sensitive and able to release the enclosed Ce(NO3)3 at both low and high pH conditions, which are spontaneously generated during corrosion at local anodes and cathodes, respectively. A coating system consisting of such nanofibers within a polyvinyl butyral coating matrix exhibits improved corrosion protection of an AA2024-T3 substrate. Moreover, the embedded Ce(NO3)3-loaded nanofibers can persistently release Ce(NO3)3 to impede corrosion of AA2024-T3 when the artificially damaged coating sample is exposed to NaCl solution.

ObjectiveThe efficacy of concurrent chemoradiotherapy (CRT) after induction chemotherapy (IC) in the treatment of esophageal squamous cell carcinoma (ESCC) remains unclear. The purpose of this study was to explore the efficacy of IC in patients with ESCC.Methods124 patients with ESCC receiving CRT were included. Patients were divided into IC+CRT group and CRT group. Short-term and long-term efficacy as well as survival time of the two groups were compared, influencing factors of IC efficacy were investigated, and overall survival (OS) and progression-free survival (PFS) between the two groups were compared in different subgroups.ResultsThere was no significant difference in the objective response rate (ORR) between the two groups. After IC, the ORR was higher in patients with single-drug concurrent chemotherapy weekly and patients with effective IC. In the long-term efficacy, advanced clinical stage patients had a shorter PFS compared to early-stage patients, and chemoradiotherapy mode ameliorates patients’ PFS. OS and PFS of IC+CRT group were longer than that of CRT group in both tumor diameter

Objective This study examines the impact of a salt reduction campaign on knowledge, attitudes, intentions, behaviours and barriers to behaviour change relating to salt consumption in two provinces of China.Methods In 2019, the ‘Love with Less Salt’ campaign ran on China Central Television and on local television channels in Shandong and Anhui provinces. Data for this study come from two representative household surveys conducted among a sample of adults aged 25–65 years in Shandong and Anhui provinces: precampaign (n=2000) and postcampaign (n=2015). Logistic regression was performed to estimate the effects of the campaign on knowledge, attitudes, intentions, behaviours and barriers to behaviour change.Results Overall, 13% of postcampaign respondents recalled seeing the campaign, and reactions towards the campaign were positive. Postcampaign respondents were more likely to plan to reduce their purchase of foods high in salt than precampaign respondents (OR=1.45, p=

Wheat seedlings are becoming popular for its high nutritional value. Effects of White (W), White + Red (WR), and White + Blue (WB) light-emitting diodes (LEDs) treatments on growth, nutritional characteristics and antioxidant properties of wheat seedlings were studied in a plant factory. The results showed that height, leaf area, shoot fresh, and shoot dry weight per wheat seedling were the highest under WR at 13 and 22 days after planting. Soluble sugar content in leaves and stems were 22.3 and 65% respectively higher under WB than those under W. Soluble protein content in leaves and stems were 36.8 and 15.2% respectively lower under WR than those under W. Contents of total flavonoids, glutathione (GSH) and ascorbic acid (ASA) in leaves were the highest under WB, whereas malondialdehyde (MDA) content in leaves was the lowest under WB. The activities of antioxidant enzymes [superoxide dismutase (SOD), peroxidase (POD), and ascorbate peroxidase (APX)] in leaves and 2,2-diphenyl-1-picrylhydrazyl (DPPH) radical scavenging ability were also the highest under WB. In conclusion, WR promoted the growth of wheat seedlings, and WB promoted antioxidant level and nutritional accumulation. This study provides guidance for wheat seedlings to carry out preferential production (biomass or quality).

Pea sprouts have rich nutrition and are considered good for heart health. In this study, the kaspa peas and black-eyed peas were chosen to clarify the effect of different LED spectral combinations on the growth, yield, and nutritional quality of pea sprouts under long photoperiod (22 h light/2 h dark). The results showed that the two pea varieties responded differently to light spectral combinations. Black-eyed pea sprouts had higher plant height, fresh weight per plant, dry weight per plant, soluble sugar content, and lower malondialdehyde (MDA) content than kaspa peas under the same light treatment. Compared with white light, red-to-blue ratio of 2:1 significantly increased peroxidase (POD) and superoxide dismutase (SOD) activity, soluble sugar and soluble protein content of kaspa pea sprouts, and decreased MDA content of black-eyed pea sprouts. Blue light was negatively correlated with the plant height of pea sprouts and positively correlated with SOD activity, vitamin C, soluble sugar, and soluble protein content. Antioxidant capacity, yield, and nutritional quality of black-eyed pea sprouts were higher than those of kaspa pea sprouts under the same light treatment. Blue light improved the nutritional quality of pea sprouts. Compared with other light treatments, the red-to-blue ratio of 2:1 was more conducive to improving the antioxidant capacity and nutritional quality of pea sprouts under long photoperiod.

Background: Primary health care system is a critical component of diabetes care and management. This article aimed to analyze the availability of glucose-lowering drugs in primary health institutions (PHIs) in China, and to explore the relationship between availability of glucose-lowering drugs and medication adherence among type 2 diabetes mellitus (T2DM) patients. Methods: This cross-sectional study conducted in Shandong Province, eastern China (hereafter referred to as Shandong), between August and December 2017. In total, 2 520 community-managed T2DM patients were selected from 68 PHIs in Shandong, including 62 village-level and 6 township-level PHIs. The self-developed questionnaire was used to survey the availability of glucose-lowering drugs in PHIs. Patients’ medication adherence was assessed by four self-reported questions, and was classified as either adherent or non-adherent. Descriptive statistics was used to analyze the availability of glucose-lowering drugs in PHIs and the medication adherence among the T2DM patients. Multilevel logistic regression models were used to explore the relationship between the availability of glucose-lowering drugs in PHIs and patients’ medication adherence. Results: A total of 1 866 T2DM patients prescribed with at least one glucose-lowering drug were included in analysis. Among them, 58.5% patients followed their antidiabetic treatment well. In village-level PHIs, the patient's adherence rate was lower than in township-level PHIs (55.9% vs. 61.1%, P < 0.05). Among the 68 PHIs, average (2.53±0.97) glucose-lowering products (generic names) were available, which in village-level PHIs were less than in township-level PHIs (2.47 vs. 3.17, P < 0.05). And the number of available glucose-lowering products in PHIs was associated with the adherence of T2DM patients. Conclusion: Poor availability of glucose-lowering products was found in PHIs in Shandong. The availability of glucose-lowering products in PHIs was positively associated with patients’ medication adherence, and could be enhanced to improve the control of diabetes in primary care settings.

Measurement(s) pitting potential • repassivation potential • Crevice corrosion potential • pitting temperature • Crevice corrosion temperature • corrosion current density • passive current density • corrosion rate • corrosion potential Technology Type(s) digital curation Factor Type(s) alloy composition • temperature • pH • chloride ion concentration • alloy microstructure • alloy heat treatment Machine-accessible metadata file describing the reported data: https://doi.org/10.6084/m9.figshare.13611623