ABSTRACT
Blue space is an important place for physical activity and provides physical and mental health benefits to residents. However, little is known about the mechanism of association between blue space and physical activity. Based on China National Knowledge Infrastructure and Web of Science Core Collection, the Chinese and English literature on the correlation between blue space and physical activity were selected and analyzed. The research field has the following characteristics so far: there are few studies on blue space in inland cities, developing countries, and vulnerable populations, and it is an emerging research field. Most included studies demonstrate positive effects of blue space exposure on physical activity, while studies conducted in different populations demonstrate population differences. The combination of multi-source data and multidisciplinary approaches should be an important foundation of this research field. Based on this, a research framework was proposed in this paper to analyze the complex association between them from a perspective of multi-dimensional characteristics, and blue physical activity was modeled as ecosystem services to explore the relationship between blue space and physical activity from a perspective of ecosystem service supply-demand and flow.
ABSTRACT
ObjectiveTo determine the predictive value of CT and clinical characteristics for short-term disease progression in patients with 2019 novel coronavirus pneumonia (NCP). Materials and Methods224 patients with confirmed 2019 novel coronavirus (COVID-19) infection outside Wuhan who had chest CT examinations were retrospectively screened. Clinical data were obtained from electronic medical records. CT images were reviewed and scored for lesion distribution, lobe and segment involvement, ground-glass opacities, consolidation, and interstitial thickening. All included patients with moderate NCP were observed for at least 14 days from admission to determine whether they exacerbated to severe NCP (progressive group) or not (stable group). CT and clinical characteristics between the two groups were compared, and multivariate logistic regression and sensitivity analyses were performed to identify the risk factors for developing severe NCP. ResultsA total of 141 patients with moderate NCP were included, of which 15 (10.6%) patients developed severe NCP during hospitalization and assigned to the progressive group. Multivariate logistic regression analysis showed that higher neutrophil-to-lymphocyte ratio (NLR) (odds ratio [OR] and 95% confidence interval [CI], 1.26 [1.04-1.53]; P = 0.018) and CT severity score (OR and 95% CI, 1.25 [1.08-1.46]; P = 0.004) on admission were independent predictors for progression to severe NCP, and sensitivity analysis confirmed the consistent results in nonimported patients but not in imported patients. However, no significant difference in lung involvement was found on CT between imported and nonimported patients (all P > 0.05). Patients who were admitted more than 4 days from symptom onset tended to have more severe lung involvement. Spearman correlation analysis showed the close association between CT severity score and inflammatory indexes (r = 0.17[~]0.47, all P < 0.05). ConclusionCT severity score was associated with inflammatory levels and higher NLR and CT severity score on admission were independent risk factors for short-term progression in patients with NCP outside Wuhan. Furthermore, early admission and surveillance by CT should be recommended to improve clinical outcomes.
