Search

This study investigated the impact of 24-h urinary calcium excretion (UCaE) on renal function decline in hospitalized patients with and without chronic kidney disease (CKD). This study enrolled 3815 CKD patients in stages 1–4 and 1133 non-CKD patients admitted to the First Center of the Chinese PLA General Hospital between January 2014 and July 2022. The primary outcome for CKD patients was a composite of CKD progression, defined as a 40% decline in estimated glomerular filtration rate (eGFR) or end-stage kidney disease. Annual eGFR change was the secondary outcome. For non-CKD patients, the primary outcome was an eGFR decline of ≥20% or CKD incidence, while annual eGFR change was the secondary outcome. The association between UCaE and kidney function decline was assessed using Cox proportional hazards and generalized linear models. Primary outcomes were observed in 813 CKD patients and 109 non-CKD patients over a median follow-up of 3.0 and 4.1 years, respectively. For CKD patients, every 1-mmol/d increase in UCaE was associated with a 15% decreased risk of CKD progression. The hazard ratio (HR) was 0.85, with a 95% confidence interval (CI) of 0.77–0.93. For non-CKD patients, the risk of renal function decline decreased by 11%. The multivariate models indicated that there was an annual decrease in eGFR in both CKD and non-CKD patients, with a reduction of 0.122 mL/min/1.73 m2/year (p < 0.001) and 0.046 mL/min/1.73 m2/year (p = 0.004), respectively, for every 1-mmol/d increase in UCaE. CKD experiences a decrease in 24-h UCaE as early as stage 1, with a significant decline in stage 4. CKD and non-CKD patients with lower UCaE levels are at an increased risk of renal decline, regardless of other variables.

Abstract Objective: This study investigated the impact of 24-hour urinary calcium excretion (UCaE) on renal function decline in hospitalized patients with and without chronic kidney disease (CKD). Methods: This study enrolled 3,815 CKD patients with stages 1-4, and 1,133 Non-CKD patients admitted to the First Center of the Chinese PLA General Hospital between January 2014 and July 2022. The primary outcome for CKD was a composite of CKD progression defined as a 40% decline in estimated glomerular filtration rate (eGFR) and end-stage kidney disease and rapid kidney function decline [RKFD, defined as annual eGFR decline of ≥ 5 ml/min/1.73m 2/yr] as the secondary outcome. For Non-CKD patients, an eGFR decline of ≥ 20%, incidence of CKD, and a declining slope of ≥3 ml/min/1.73m 2/yr were the outcomes. The association between UCaE and kidney function decline was assessed using Cox proportional hazards and generalized linear models. Results: The primary outcome was observed in 813 CKD and 109 without CKD over a median follow-up of 3.0 and 4.1 years, respectively. For CKD patients, every 1-mmol/d increase in UCaE was associated with a 15% decreased risk of CKD progression. The hazard ratio (HR) was 0.85, with a 95% confidence interval (CI) of 0.77-0.93. And, for Non-CKD patients, the risk of renal function decline decreased by 11%. The multivariate models indicated that there was an annual decrease of eGFR in both CKD and Non-CKD, with a reduction of 0.122 ml/min/1.73m2/yr (P < 0.001) and 0.046 ml/min/1.73m2/yr (P = 0.004), respectively, for every 1-mmol/d increase of UCaE. Conclusions: CKD experiences a decrease in 24-hour UCaE as early as stage 1, with a significant decline in stage 4. CKD and Non-CKD patients with lower UCaE levels are at an increased risk of renal decline, regardless of other variables.

Graph Neural Networks(GNNs) has dominated the semi-supervised node classification task by its neighborhood aggregation mechanism over traditional network embedding methods. However, GNNs still encounters with two vital problems when scales to large networks. It requires the whole graph as input and aggregates attribute only, which brings out-of-memory(OOM) problem on single machine scenery and attribute over-smoothing respectively. To tackle these issues, from the traditional view, we propose a Sequence correlation preserving method for Attributed Network E mbedding (SANE) which transforms the network properties into three types of sequences and preserves the correlations among them. Firstly, SANE extracts three types of sequences in attributed network, namely node sequence, attribute sequence, and label sequence, which provide distinct insight into networks. Secondly, the proposed method preserves attribute-node sequence correlation and attribute-label sequence correlation by (1) extracting dual-directional features from attribute sequence and (2) exploiting the extracted features to decode node sequence and label sequence. SANE can scale to large networks and relieve the over-smoothing causing by attribute only aggregation. Experimental results on five real-world datasets demonstrate that SANE outperforms the state-of-the-art methods.

Introducing dynamic covalent bonding into thermoset polymers has received considerable attention because they can repair or recover when damaged, thereby minimizing waste and extending the service life of thermoset polymers. However, most of the yielded dynamic covalent bonds require an extra catalyst, high temperature and high-pressure conditions to trigger their self-healing properties. Herein, we report on a catalyst-free bis-dynamic covalent polymer network containing vinylogous urethane and disulfide bonds. It is revealed that the introduction of disulfide bonds significantly reduces the activation energy (reduced from 94 kJ/mol to 51 kJ/mol) of the polymer system for exchanging and promotes the self-healing efficiency (with a high efficiency of 86.92% after being heated at 100 °C for 20 h) of the material. More importantly, the mechanical properties of the healed materials are comparable to those of the initial ones due to the special bis-dynamic covalent polymer network. These results suggest that the bis-dynamic covalent polymer network made of disulfide and inter-vinyl ester bonds opens a new strategy for developing high-performance vitrimer polymers.

Background: The aim of this study was to analyze rheumatic heart disease (RHD) mortality trends in China’s urban and rural areas and to determine the roles of age, period, and cohort effects. Methods: Based on mortality data extracted from the Chinese Health Statistics Yearbook, we calculated the crude mortality rate of RHD in China. Age-adjusted rates were computed by the direct method using the 2020 census as the standard population. The annual percentage change (APC) and average annual percentage change (AAPC) were determined by the JoinPoint regression model. The age-period-cohort model and the intrinsic estimator (IE) algorithm were used to estimate the effects of age, period, and cohort. Results: From 2006 to 2020, the general trend in RHD standardized mortality declined. The RHD mortality rate was higher in rural than in urban areas and among females than males. JoinPoint regression showed that the elderly (over 60 years old) were at high risk for RHD deaths in China. The age effect increased with age, and the cohort effect showed an overall declining trend as chronology grew, but the period effect was not significant. Conclusions: China has achieved great success in RHD, but RHD mortality may increase with age. We should focus on publicity and education about RHD among the elderly. Compared with the period effect, age and cohort effects dominated the risk of RHD deaths.

A new hybrid system mainly composed of a dye-sensitized solar cell (DSSC), a solar selective absorber (SSA) and an absorption heat transformer (AHT) is theoretically put forward to harness the long wavelength sunlight transmitted through the DSSC. The models of both DSSC and AHT are adopted from the current literature and the condition enables the AHT to involve in heat upgrading is obtained. The model validations of DSSC and AHT are conducted using experimental data. Mathematical expressions of power output and efficiency for the hybrid system are formulated by taking a variety of irreversible losses into account. The effectiveness of the hybrid system is justified and evaluated. Maximum power density (MPD) and maximum energy efficiency (MEE) of the integrated system are, respectively, 158.2 W m−2 and 16.3 %, having evidently improvement compared to that of a single DSSC. A variety of operating conditions and design parameters affecting the hybrid system performance are studied. Numerical calculation results show that the working temperature, photoelectron absorption coefficient of DSSC and total heat-transfer area of the AHT have positive effects on the hybrid system performance. There exists an optimum TiO2 thin film thickness to optimize the hybrid system performance. However, a greater Schottky barrier has negative influence on the hybrid system performance. The results obtained here may provide some guidance for designing such a practical hybrid system.

Wheel/rail dynamic interactions of heavy-haul locomotives are highly nonlinear and complicated due to large traction/braking loads, frequent anti-slip control and complex wheel/rail interface envir...

Our study aimed to explore the intercorrelations of brachial‐ankle pulse wave velocity (baPWV), ankle‐brachial index (ABI), ambulatory arterial stiffness index (AASI), 24‐hour mean pulse pressure (24‐h PP), and augmentation index (AIx, AIx@75, the AIx standardized to a heart rate of 75) and compare the effectiveness of these markers for predicting renal outcomes. A total of 117 patients with chronic kidney disease (CKD) who received noninvasive arterial stiffness examinations were enrolled. We used correlation analysis and linear regression to explore the correlations between these five arterial stiffness markers and the Cox proportional hazards model and receiver operator characteristic (ROC) curve to assess the associations of markers with kidney disease outcomes. The median (interquartile range) of age and eGFR were 61 (49‐65) years and 50.5 (35.5‐84.1) ml/min/1.73 m2, respectively. In Pearson correlation analysis, baPWV was significantly associated with 24‐h PP (r = .531, p

Introduction Ribosomal protein SA pseudogene 52 (RPSAP52) has been characterized as an oncogenic lncRNA in pituitary tumors. Analysis of TCGA dataset revealed the upregulation of RPSAP52 in glioblastoma (GBM). We, therefore, investigated the roles of RPSAP52 in GBM. Methods A total of 50 GBM patients (33 males and 20 females; 54-75 years; mean age: 61.8±5.8 years) were selected from the 89 cases of GBM patients. Under the guidance of MRI, brain biopsy was performed to collect GBM tissues from each patient for the diagnosis of GBM. U-373 MG cells were employed and had transient transfections. qRNA, Western blot, and a series of experiments were performed to characterize their associations. Results The results showed that RPSAP52 was upregulated in GBM patients, and its high expression levels predicted poor survival. In GBM tissues, expression levels of RPSAP52 were significantly and positively correlated with that of TGF-β1. In GBM tissues, RPSAP52 positively regulated the expression of TGF-β1. Cell stemness assay showed that, compared to C and NC groups, overexpression of RPSAP52 and TGF-β1 led to increased, while silencing of RPSAP52 led to decreased CD133+ cells. Overexpression of TGF-β1 attenuated the effects of RPSAP52 siRNA silencing. Conclusion Therefore, RPSAP52 upregulates TGF-β1 to increase cancer cell stemness and predict postoperative survival in GBM.

Integrating a two-stage thermoelectric generator (TTEG) with a molten carbonate fuel cell (MCFC), a new hybrid system is put forward to harvest the waste heat from the MCFC for performance improvem...

It has important meaning to improve green total factor performance in the construction industry for China’s green and high-quality development. In addition to the traditional desirable economic output and undesirable CO2 emission output, the indicators representing social welfare of China’s construction industry were incorporated into the total factor framework. On this basis, a Global non-radial DEA approach was employed to explore the sources and the key factors leading to changes in regional green total factor performance of China’s construction industry from both static and dynamic perspectives. Results showed that the lower energy efficiency and the lower CO2 emission efficiency were the main reasons for low level of green total factor efficiency. During the sample period, energy efficiency increased rapidly while capital efficiency remained almost unchanged. The green total factor productivity demonstrated an increasing trend, which was driven by technological progress rather than technical efficiency. An in-depth decomposition revealed that the deterioration of technical efficiency was mainly caused by the negative effect of CO2 emissions. Regional green total factor performance of China’s construction industry demonstrated obvious spatial heterogeneity. Each province should comprehensively consider its own characteristics of green development in the construction industry to formulate the corresponding optimization strategy. These findings can help decision makers design specific policies on regional-oriented green development of China’s construction industry.

Background: Arterial stiffness influences the prognosis of patients with end-stage kidney disease; however, the factors that promote arterial stiffness in chronic kidney disease (CKD) patients remain unknown. We aimed to explore the clinical factors associated with arterial stiffness in CKD. Methods: Between September 2017 and September 2022, all CKD patients treated at the Department of Nephrology, General Hospital of the Chinese People’s Liberation Army, excluding dialysis patients, were screened and their medical records within the last month were collected. Arterial stiffness was measured by the augmentation index (AIx). The correlative clinical factors with arterial stiffness were explored in different linear regression models. Results: 559 patients were included in the study. AIx@75 increased as the deterioration of CKDG1–CKDG5, with values of 1 (−9, 11), 5.5 (−4, 13.25), 9 (0, 16), 12 (1.5, 23.5), and 22 (13, 28), respectively (Z = 63.03, p < 0.001). Multivariate linear regression analysis showed that AIx@75 was positively associated with female sex (β = 8.926, 95% confidence interval (CI) 6.291, 11.562, p < 0.001), age (β = 0. 485, 95% CI 0.39, 0.58, p < 0.001), mean arterial pressure (MAP) (β = 0.255, 95% CI 0.159, 0.35, p < 0.001), and was negatively associated with ACEI/ARB (β = −4.466, 95% CI −6.963, −1.969, p < 0.001) and glucocorticoid (β = −3.163, 95% CI −6.143, −0.183, p = 0.038). Smoking, eGFR, hemoglobin, and cause of disease were associated with AIx@75 in multivariate linear regression models when considering factors partly. Conclusions: Female, age, smoking, MAP, eGFR, cause of disease, ACEI/ARB, and glucocorticoid were found to be associated with atherosclerosis in CKD patients.

This paper studies the effects of planting plants and coupled microbial fuel cells (MFCs) on the decontamination capacity and purification mechanism of constructed wetlands (CWs). Four systems were set, namely CW-without plants (A1), CW-with plants (A2), CW-MFC-without plants (A3) and CW-MFC-with plants (A4). The daily reductions per unit area of chemical oxygen demand (COD) were 48.72 ± 5.42, 51.26 ± 4.10, 53.49 ± 5.44 and 58.54 ± 4.16 g·(d·m2)−1, respectively. The daily reductions per unit area of nitrogen (N) were 11.89 ± 0.73, 12.38 ± 0.76, 12.24 ± 0.79 and 13.61 ± 1.07 g·(d·m2)−1, respectively. After studying the pollutant removal efficiency, it was found that the unit area of A4 removes the highest number of pollutants, improving the area efficiency of the wetland system and fundamentally alleviating the disadvantage of the large land footprint of wetland processes. The average output voltages of A3 and A4 were 568.29 and 717.46 mV, respectively, and the maximum power densities were 4.59 and 15.87 mW/m3, respectively. In addition, after high-throughput analysis of microbial samples, anaerobic ammonia oxidising (anammox) bacteria were found to remove N from the system in the anaerobic anode region.

To harvest the relatively high wavelength sunlight, a novel hybrid system coupling a thermally regenerative electrochemical cycle to a dye-sensitized solar cell is proposed. Efficiencies and power outputs of dye-sensitized solar cell and thermally regenerative electrochemical cycle are calculated, and the mathematical relationship between the electric current of thermally regenerative electrochemical cycle and the working current density of dye-sensitized solar cell is deduced. The power output and efficiency of the hybrid system are also derived considering multiple irreversible losses. The feasibility and effectiveness of the proposed hybrid system will be assessed by comparing the performances between the hybrid system and the single dye-sensitized solar cell. Numerical calculations show that the maximum efficiency and power density of the hybrid system allow 32.04% and 32.18% greater than that of the single dye-sensitized solar cell, respectively. Comprehensive parametric studies are undertaken to examine the dependences of the hybrid system performance on some operating conditions and microstructure parameters, including electrode porosity, photoelectron absorption coefficient, Schottky barrier, film thickness and internal resistance of thermally regenerative electrochemical cycle. The derived results may offer new insights into design and optimization of such an actual hybrid system.

A new combined system consisting of a high-temperature proton exchange membrane fuel cell (HT-PEMFC), a regenerator and a thermoelectric generator (TEG) is developed. The mathematical relationship between the HT-PEMFC operating current density and the TEG dimensionless current is derived, and the operating current density range of HT-PEMFC in which the TEG allowed to work is determined. Power output and efficiency of the combined system are formulated under different operating conditions. Compared with the stand-alone HT-PEMFC, the proposed combined system allows the equivalent power density to increase by 21%. The optimum criteria and general performance characteristics for the complete system are specified. Moreover, the effects of the operating current density, doping level, relative humidity, operating temperature, heat conductivity and figure of merit of the thermoelectric materials on the combined system performance characteristics are revealed. The obtained results may provide some theoretical insights into the design and integration of such an actual combined system.

A combined system model consisting of a high-temperature polymer electrolyte membrane fuel cell (HT-PEMFC), a regenerator and a thermoelectric generator (TEG) is proposed, where the TEG is applied to harness the generated waste heat in the HT-PEMFC for extra electricity production. The TEG considers not only the Seebeck effect and Peltier effect but also the Thomson effect. The mathematical expressions of power output, energy efficiency, exergy destruction rate and exergy efficiency for the proposed system are derived. The energetic and exergetic performance characteristics for the whole system are revealed. The optimum operating ranges for some key performance parameters of the combined system are determined using the maximum power density as the objective function. The combined system maximum power density and its corresponding energy efficiency and exergy efficiency allow 19.1%, 12.4% and 12.6% higher than that of a stand-alone HT-PEMFC, while the exergy destruction rate density is only increased by 8.6%. The system performances are compared between the TEG with and without the Thomson effect. Moreover, the impacts of comprehensive parameters on the system performance characteristics are discussed. The obtained results are helpful in developing and designing such an actual combined system for efficient and clean power production.

In addition to electricity generation, high-temperature proton exchange membrane fuel cells also produce numerous high-quality waste heat, which may be further used in combined cooling, heating and power systems. In this study, a new general model of an integrated system consisting of a high-temperature proton exchange membrane fuel cell, a regenerator and an absorption cycle is proposed for waste heat recovery, where the absorption cycle can be functioned as either an absorption heat pump for heating or an absorption refrigerator for cooling. Considering various irreversible losses within the system, mathematical expressions for the equivalent power output and efficiency of the proposed system are derived, from which the general performance characteristics are revealed and the optimum criteria are given. When the absorption cycle is operated in the heat pump mode or refrigerator mode, the maximum attainable power densities for the proposed system allow 33.41% and 19.34% greater than that of the sole high-temperature proton exchange membrane fuel cell system, respectively. Furthermore, the effects of the operating current density, operating temperature, doping level, relative humidity, heat leak and heat-transfer irreversibilities on the performance characteristics of the proposed system are discussed in detail. The results obtained in this paper may offer some theoretical help for the integration and design of such an actual system.

Ambulatory blood pressure monitoring (ABPM) can produce many variables, of which the lowest nocturnal systolic blood pressure (LNSBP) currently used in calculating morning surge is occasionally overlooked in recent kidney studies compared with other ABPM parameters. We explored the clinical effects of LNSBP in elderly patients with chronic kidney disease (CKD) in a multicenter, observational cohort study. A total of 356 elderly patients with CKD from 19 clinics were included in this analysis. We used multiple logistic regression and survival analyses to assess the associations between the lowest nocturnal systolic blood pressure and heavy proteinuria and kidney disease outcomes, respectively. The median age was 66 years, and 66.6% were men. The median eGFR was 49.2 ml/min/1.73 m2. Multivariate logistic regression analysis demonstrated that LNSBP (OR 1.24; 95% CI 1.10–1.39; P