Patients' needs and experiences of telerehabilitation after total hip and knee arthroplasty: A qualitative systematic review and meta-synthesis.

Background: The number of patients undergoing joint replacement procedures is continuously increasing. Tele-equipment is progressively being employed for postrehabilitation of total hip and knee replacements. Gaining a comprehensive understanding of the experiences and requirements of patients undergoing total hip and knee arthroplasty who participate in telerehabilitation can contribute to the enhancement of telerehabilitation programs and the overall rehabilitation and care provided to this specific population. Objective: To explore the needs and experiences of total hip and knee arthroplasty patients with telerehabilitation. Design: Systematic review and qualitative synthesis. Methods: Electronic databases PubMed, Web of Science, The Cochrane Library, Embase, CINAHL, Scopus, ProQuest, CNKI, Wanfang Data, VIP, and SinoMed were systematically searched for information on the needs and experiences of telerehabilitation for patients with total hip arthroplasty and total knee arthroplasty in qualitative studies. The search period was from the creation of the database to March 2024. Literature quality was assessed using the 2016 edition of the Australian Joanna Briggs Institute Centre for Evidence-Based Health Care Quality Assessment Criteria for Qualitative Research. A pooled integration approach was used to integrate the findings inductively. Results: A total of 11 studies were included and 4 themes were identified: the desire to communicate and the need to acquire knowledge; accessible, high-quality rehabilitation services; positive psychological experiences; the dilemmas of participating in telerehabilitation. Conclusions: This study's findings emphasize that the practical needs and challenges of total hip and knee arthroplasty patients' participation in telerehabilitation should be continuously focused on, and the advantages of telerehabilitation should be continuously strengthened to guarantee the continuity of patients' postoperative rehabilitation and to promote their postoperative recovery.

Patient Self-Management Scale after Total Knee Arthroplasty (PSMS-TKA): Instrument Development and Cross-Sectional Validation Study.

BACKGROUND: Effective self-management after total knee arthroplasty not only improves patients' knee pain and physical function, but also improves quality of life. However, there is no assessment tool that can be targeted to evaluate the self-management level of patients after total knee arthroplasty. This study aimed to develop and validate a scale to specifically assess the level of self-management in patients after total knee arthroplasty. METHODS: The study was conducted in two steps: (1) instrument development; and (2) psychological tests (n = 428). For the instrument development portion, scale items were generated through a literature review and semi-structured interviews, then reviewed and revised by a panel of experts, and assessed for content validity and pilot testing. For the psychometric tests component, items were analyzed using corrected item-total scale correlations, the critical ratio method, and Cronbach's α. Construct validity was evaluated using exploratory factor analysis and validation factor analysis. Criterion correlation validity was checked by calculating Pearson's correlation coefficient using the Arthritis Self-Efficacy Scale-8 and the scale developed in this study. Internal consistency reliability was evaluated using Cronbach's α and fold-half reliability, and retest reliability was assessed using intragroup correlation coefficients. RESULTS: The Patient Self-Management Scale after Total Knee Arthroplasty (PSMS-TKA) comprises 4 factors and 23 items that assess daily behavior management, disease information management, psychosocial management, and exercise rehabilitation management. Exploratory factor analysis and validation factor analysis yielded a stable 4-factor model for the 23 items. The PSMS-TKA demonstrated good criterion-related validity when using the Arthritis Self-Efficacy-8 as a criterion. The Cronbach's α of the PSMS-TKA was 0.903, the split-half reliability was 0.934, and the test-retest reliability correlation coefficient was 0.887 (P < 0.01); thus, the reliability of the scale is good. CONCLUSION: The PSMS-TKA developed in this study has good validity and reliability and can be used to assess the level of self-management in patients after total knee arthroplasty. The scale helps healthcare professionals understand the level of self-management of patients undergoing total knee arthroplasty.

Coal mining environment causes adverse effects on workers.

Background: The objective of this study is to study the adverse effects of coal mining environment on workers to discover early effective biomarkers. Methods: The molecular epidemiological study was conducted with 502 in-service workers, who were divided into miner and auxiliary. We measured the individual levels of dust exposure for participants. Clinical examinations were conducted by qualified doctors. Peripheral blood was collected to measure biochemistry, hemogram, and karyocyte apoptosis. Results: All workers were healthy who have not found with any diseases that can be diagnosed medically in the physical examination and showed no difference in dust exposure level, age, height, weight, and body mass index between groups. The working years of miners were lower than that of auxiliaries (p < 0.001). Compared with auxiliaries, the concentration and percentage of lymphocytes (p = 0.040, p = 0.012), basophils (p = 0.027, p = 0.034), and red blood cells (p < 0.001) and the concentration of hemoglobin of miners were lower (p < 0.001). The percentage of neutrophils (p = 0.003), the concentration of mean corpuscular hemoglobin concentration (p = 0.002), and the proportion of karyocyte apoptosis in miners were higher (p < 0.001). Miners presented higher blood urea nitrogen (p < 0.001), ratio of blood urea nitrogen to creatinine (p < 0.001), the high density lipoprotein cholesterol (p < 0.001), lower creatinine (p < 0.05), and cholesterol (p < 0.001). Conclusion: The coal mining environment impacted mining workers' immune function, renal function, and the hematopoietic system, including BUN/CRE, HGB, RBC, and LYMPH, which could be used as early biomarkers to screen the health of coal miners.

Gut microbiome-mediated monocytes promote liver metastasis.

The gut microbiome plays an important role in tumor growth by regulating immune cell function. However, the role of the gut microbiome-mediated monocytes in liver metastasis remains unclear. In this study, we found that fecal microbiome transplantation (FMT) from the stool of patients with liver metastasis (LM) significantly promoted liver metastasis compared with healthy donors (HD). Monocytes were upregulated in liver tissues by the CCL2/CCR2 axis in LM patients' stool transplanted mouse model. CCL2/CCR2 inhibition and monocyte depletion significantly suppress liver metastasis. FMT using LM patients' stool enhanced the plasma lipopolysaccharides (LPS) concentration. The LPS/TLR4 signaling pathway is crucial for gut microbiome-mediated liver metastasis. These results indicated that monocytes contribute to liver metastasis via the CCL2/CCR2 axis.

Genome-Wide Association Analysis of Effective Tillers in Rice under Different Nitrogen Gradients.

Nitrogen is a crucial element that impacts rice yields, and effective tillering is a significant agronomic characteristic that can influence rice yields. The way that reduced nitrogen affects effective tillering is a complex quantitative trait that is controlled by multiple genes, and its genetic basis requires further exploration. In this study, 469 germplasm varieties were used for a genome-wide association analysis aiming to detect quantitative trait loci (QTL) associated with effective tillering at low (60 kg/hm2) and high (180 kg/hm2) nitrogen levels. QTLs detected over multiple years or under different treatments were scrutinized in this study, and candidate genes were identified through haplotype analysis and spatio-temporal expression patterns. A total of seven genes (NAL1, OsCKX9, Os01g0690800, Os02g0550300, Os02g0550700, Os04g0615700, and Os04g06163000) were pinpointed in these QTL regions, and were considered the most likely candidate genes. These results provide favorable information for the use of auxiliary marker selection in controlling effective tillering in rice for improved yields.

The Needs and Experiences of Patients Returning to Work After Total Knee Arthroplasty and Total Hip Arthroplasty: A Systematic Review and Meta-Synthesis.

OBJECTIVE: The objective of this study was to conduct a systematic and comprehensive review of qualitative research to examine the physical and psychological needs, as well as work experiences, of patients undergoing total knee replacement and total hip replacement surgeries during their process of returning to work. METHODS: A systematic review and meta-synthesis of qualitative literature was conducted. A systematic search was conducted across 8 databases to identify qualitative or mixed-methods research on the needs and experiences of individuals with total knee replacement and total hip replacement who have returned to work. The search period extended from the inception of each database to March 2023. Two researchers independently utilized a predetermined search strategy to retrieve relevant English-language studies published in any year. The included studies were assessed for quality using the Critical Appraisal Skills Program appraisal tool. Findings from the studies were then summarized and integrated using the pooled integration method. RESULTS: There were 10 studies in total. Three key themes were identified from the original research: needs during the return to work process and rehabilitation training, faith and support to return to work, and constraints and challenges at work. CONCLUSION: Health care professionals and employers should conscientiously consider the physical and psychological requirements of patients who have undergone total knee replacement and total hip replacement when they are resuming work, taking into account the specific constraints and challenges that may arise in the workplace. To ensure a seamless transition back to work, it is essential to develop tailored occupational interventions, implement comprehensive return to work programs, and offer patients sufficient understanding and support. IMPACT: The findings of this study offer valuable insights into the physical and psychological needs, as well as the work experiences, of patients who have undergone total knee replacement and total hip replacement during their reintegration into the workforce. These findings have the potential to assist health care professionals and employers in providing enhanced support to facilitate successful return-to-work outcomes for patients.

Effects of biochar application methods on greenhouse gas emission and nitrogen use efficiency in paddy fields.

Biochar application in rice production reduces nitrogen loss and greenhouse gases. We conducted in situ experiments for 3 years, with N210B0 (210 kg N ha-1) as the control. Two biochar application methods (B1:15 t ha-1 biochar applied once and B2: biochar applied three times at 5 t ha-1 yr-1) combined with two nitrogen levels (N210: 210 kg N ha-1 and N168: 168 kg N ha-1) were used. Soil physicochemical properties, CH4 and N2O emissions, functional gene abundance, rice yield, and nitrogen use efficiency were analyzed. Both methods improved the physicochemical properties of the soil, however, B1 was less effective than B2 in increasing soil pH, bulk density, organic carbon, total nitrogen, and microbial biomass nitrogen in year 3. B1 had a higher CH4 emission mitigation effect than B2 in 3 consecutive years, mainly due to the higher pmoA gene abundance. B1 showed a higher reduction effect of N2O emissions compared to B2 in year 1, but the opposite was observed in years 2 and 3. B2 had a higher abundance of AOB, nirK, and nosZ genes compared to B1 in year 3. Compared with N210B0, rice yields were increased by 9.1 %, 9.6 %, and 3.6 % with N210B1, N210B2, and N168B2, respectively, over 3 years, while N168B1 improved yields in the previous 2 years. Biochar improved nitrogen use efficiency over 3 consecutive years directly due to increased use efficiency of panicle fertilizer; the effect of B1 was greater than that of B2 during years 1 and 2, while the opposite was observed in year 3. Both Biochar applied once and three times appeared to be promising practices to increase yield and mitigate GHGs. From the GHGI perspective, the biochar applied once combined with 168 kg N ha-1 can further improve nitrogen use efficiency, and reduce GHGs without hindering improvements in rice yield.

LncRNA RP11-10E18.7 cooperates with lncRNA RP11-481C4.2 to affect the overall survival of breast cancer patients: a TCGA-based retrospective study.

Background: As either oncogenes or tumor suppressor genes, long non-coding RNAs (lncRNAs) have a major role in both tumorigenesis and progression of human cancers, including breast cancer (BC). However, the statistical correlation between the lncRNA-lncRNA interaction and prognosis of BC remains unclear. Methods: We analyzed the fragments per kilobase per million (FPKM) lncRNA expression data in tumor tissue samples from 890 female patients with BC in The Cancer Genome Atlas (TCGA) between May 2021 and October 2022. The Cox proportional hazards model adjusted for age, race, clinical stage, neoadjuvant therapy, estrogen receptor (ER), and progesterone receptor (PR) was adopted to evaluate the lncRNA-lncRNA interaction regarding overall survival (OS) of BC. The multiple comparison was corrected by Bonferroni method. Results: RP11-10E18.7×RP11-481C4.2 was significantly associated with OS of BC patients [hazard ratio (HR)interaction =1.04, 95% confidence interval (CI): 1.03-1.06, P=3.35×10-9]. Then, gene-gene interaction analysis was performed for genes co-expressed with lncRNAs. FOXA1×U2SURP (HRinteraction =1.49, 95% CI: 1.28-1.73, P=2.16×10-7) was found to have a similar interactive pattern to RP11-10E18.7×RP11-481C4.2. after classifying the patients by intersection (3.47), we observed that the effect of FOXA1 opposite in patients with different U2SURP expression level (HRhigh vs. low =0.58, 95% CI: 0.34-0.99, P=0.046 in low expression of U2SURP; HRhigh vs. low =1.56, 95% CI: 1.18-2.87, P=0.029 in high expression of U2SURP). Conclusions: Our comprehensive study identified RP11-10E18.7×RP11-481C4.2 as a potential biomarker of BC prognosis. The results play an essential role in the impact of lncRNA-lncRNA interaction on BC survival. Our findings elucidated potential molecular mechanisms of BC progression under complex association patterns and provided potential dynamic and reversible therapeutic targets for BC patients.

Ionic Liquid Crystal Thin Film as Switching Layer in Nonvolatile Resistive Memory.

In this study, we propose the use of an ionic liquid crystal (ILC) as a new resistive switching layer in nonvolatile resistive random-access memory (ReRAM) devices. The high-quality vacuum-deposited ILC films of 1-hexadecyl-3-methylimidazolium hexafluorophosphate ([C16mim][PF6]) enabled to demonstrate the first operation of ReRAM devices with a low set voltage of ∼1 V and stable switching behavior for up to ∼44 cycles. The key to the successful operation is that the ILC layer is in the liquid crystal phase (smectic A), where the electric double layers formed at the electrode-ILC interfaces play a significant role. The results of basic electrical properties and I-V curve fittings suggested the following operation principle: the formation and rupture of charge-composed filaments within the ILC film, where the current conduction is primarily governed by the trap charge limited current (TCLC) mechanism. These achievements will pave the way for advanced studies of ILC-based electronic devices.

Airway management in out-of-hospital cardiac arrest: A systematic review and network meta-analysis.

OBJECTIVES: Airway management during cardiopulmonary resuscitation is particularly important for patients with out-of-hospital cardiac arrest (OHCA). This study was performed to compare the efficacy of the most commonly used out-of-hospital airway management methods in increasing the survival to discharge in patients with OHCA. METHODS: We screened all relevant literature from database inception to 21st January 2019 in PubMed, Web of Science, Embase, and the Cochrane Library. We included all randomized controlled trials (RCTs) of airway management for OHCA in adults (≥16 years of age) with no limitations on publication status, publication date, or language. The primary outcome was survival to discharge. The secondary outcomes were the overall airway technique success rate, return of spontaneous circulation, and survival to hospital admission. RESULTS: Overall, from 1986 to 2018, 9 RCTs involving 13,949 patients were included in the network meta-analysis, and the efficacy of six airway management methods for patients with OHCA were compared. However, none of the results were statistically significant. CONCLUSIONS: As the gold standard of airway management for patients with out-of-hospital cardiac arrest in most countries, endotracheal intubation (ETI) has been widely used for many years. However, our systematic review and network meta-analysis showed that ETI is no better than other methods in increasing the survival to discharge. This is not directly proportional to the various preparations required before ETI. Additional randomized controlled trials are needed to identify more effective methods and improve patients' outcome.

Emergency medical service utilization and timely treatment among acute ischemic stroke patients in Beijing from 2018 to 2021.

BACKGROUND AND IMPORTANCE: Activation of emergency medical services (EMS) is recommended for timely reperfusion therapy for acute ischemic stroke (AIS). The association of EMS utilization and time intervals from hospital arrival to a series of necessary procedures before reperfusion therapy was rarely investigated. OBJECTIVE: The objective of this study is to investigate the association of EMS utilization with the time intervals from hospital arrival to therapy in patients with AIS. DESIGN: Observational study. SETTINGS AND PARTICIPANTS: Medical records for AIS in all emergency departments in Beijing were obtained from January 2018 to December 2021. INTERVENTION OR EXPOSURE: Patients transported by ambulance were defined as the EMS group, whereas others as the non-EMS group. OUTCOME MEASURES AND ANALYSIS: Door-to-imaging time (DIT), door-to-needle time (DTN) and door-to-puncture time (DTP) were compared between the two groups. MAIN RESULTS: There were 11 190 (46%) and 13 106 (54%) AIS patients in the EMS and non-EMS groups. Compared with the non-EMS group, patients in the EMS group were more likely to receive intravenous thrombolysis or endovascular therapy (OR, 1.81; 95% CI, 1.68-1.94). For intravenous thrombolysis therapy, the DIT, ITN (time in minutes from obtaining the first brain imaging to tPA delivery) and DTN times in the EMS group were significantly shorter with time differences between the two groups of -1.1 (95% CI, -1.1 to -1.1) min, -2.6 (-2.6 to -2.6) min, and -3.7 (-3.8, -3.7) min, respectively. The proportion of DIT ≤25 min, DTN ≤45 min or DTN ≤60 min was significantly higher in the EMS group (OR, 1.03, 95% CI, 1.02-1.05; 1.11, 1.07-1.14; 1.05, 1.03-1.07). For endovascular therapy, the differences in DIT, ITP (time in minutes from obtaining the first brain imaging to groin puncture) and DTP times between the EMS and non-EMS groups were +1.1 (1.0-1.2) min, -3.8 (-4.2 to -3.5) min, -2.7 (-3.1 to -2.4) min, respectively, but no significant association was observed between EMS usage and the proportion of DIT ≤25 min or DTP ≤90 min. CONCLUSION: In this observational study, the use of EMS for patient with AIS was associated with a shorter time from hospital arrival to intravenous thrombolysis and endovascular therapy.

Cold Stress Induced a Higher Level of Fat Oxidation in Women.

ABSTRACT: Niu, X, Han, P, Tang, Z, Huang, J, Li, L, He, H, Zhang, W, Zhao, L, and Zhao, L. Cold stress induced a higher level of fat oxidation in women. J Strength Cond Res 37(1): 114-122, 2023-To investigate women's fat oxidation under cold stress during incremental exercise testing and compare the effect of cold stress on fat oxidation between the sexes. Twenty-six healthy subjects performed 2 incremental exercise tests to determine maximal oxygen uptake (V̇ o2 max) on a treadmill in different ambient temperatures. Cardiopulmonary variables were continuously recorded during incremental exercise tests. Maximal fat oxidation (MFO) and the corresponding exercise intensity (Fat max ) were determined from the fat oxidation curve constructed by indirect calorimetry. Both men and women relied more on fat oxidation in cold environment ( p < 0.05). Compared with men, fat oxidation was significantly greater in women in the cold environment from 50 to 70% V̇ o2 max ( p < 0.05). There were no significant differences in the change of fat oxidation as exercise intensity increased between the sexes ( p > 0.05). Women had a greater MFO ( p < 0.05) and Fat max ( p < 0.05) than men in the cold environment. When MFO was the dependent variable, sex, fat-free mass, fat mass, V̇ o2 max, and temperature accounted for 48% of its variability. We conclude that cold stress enhances fat oxidation in women. Compared with men, women have significantly higher value and rely more on fat oxidation to supply energy in the cold environment, although the increasing level of fat oxidation was similar between the sexes. These factors may have important implications in the individualization of exercise prescription in cold conditions for both men and women.

Efficacy and safety profile of angiotensin receptor neprilysin inhibitors in the management of heart failure: a systematic review and meta-analysis of randomized controlled trials.

Several guidelines have recommended the use of angiotensin receptor neprilysin inhibitors (ARNIs) as replacement for angiotensin-converting enzyme inhibitors in the management of heart failure. Till date, there are no reviews done that comprehensively cover different aspects of efficacy and safety parameters. Hence, we have performed a comprehensive systematic review and meta-analysis on role of ARNIs for the management of heart failure patients. Searches were done in Embase, Scopus, China National Knowledge Infrastructure, Chinese Biomedical Literature Database, PubMed Central, Cochrane Library, MEDLINE, Google Scholar, ScienceDirect and Clinicaltrials.gov until June 2022. Risk of bias assessment was done with Cochrane's risk of bias tool. Meta-analysis was carried out using random-effects model. Pooled standardized mean difference (SMD)/mean difference (MD) and/or risk ratio (RR) with 95% confidence intervals (CIs) was reported. In total, we analysed 34 studies, with almost all of them had a high risk of bias. Pooled RR was 0.88 (95% CI: 0.82-0.95) for all-cause mortality, 0.84 (95% CI: 0.77-0.92) for cardiovascular mortality and 0.78 (95% CI: 0.70-0.87) for hospitalization. Pooled MD was 3.74 (95% CI: 1.93-5.55) for left ventricular ejection fraction, -2.16 (95% CI: -3.58 to -0.74) for left atrial volume index, -3.80 (95% CI: -6.60 to -1.00) for left ventricular end-diastolic dimension and -1.16 (95% CI: -1.98 to -0.35) for E/E' ratio. Regarding adverse events, pooled RR was 1.55 (95% CI: 1.31-1.85) for symptomatic hypotension, 0.93 (95% CI: 0.78-1.11) for worsening renal function, 1.09 (95% CI: 0.94-1.26) for hyperkalaemia and 1.29 (95% CI: 0.67-2.50) for angioedema. ARNIs had beneficial efficacy and safety profile on the management of heart failure especially patients with reduced ejection fraction.

Ultrasonography in the assessment of primary myxofibrosarcoma in the left atrium: a case report.

BACKGROUND: Cardiac myxofibrosarcoma is a rare cardiac malignant tumor, whose diagnosis is challenging due to its rare and non-specific manifestations. Ultrasound is the most important tool for detecting cardiac tumors. Yet, its diagnostic value in cardiac myxoidfibrosarcoma is rarely reported. Herein, we summarized the ultrasonic manifestations of myxofibrosarcoma in a 72-year-old Han woman. CASE PRESENTATION: The patient presented with crushing chest pain without obvious inducement, lasting 3-5 min each time, which would be relieved after rest, accompanied by palpitation, chest tightness, shortness of breath, dizziness, and syncope. The electrocardiogram (ECG) suggested atrial fibrillation. Ultrasound found two moderate echogenic masses in the left atrium; one was about 48 × 31 mm in size, and the other was about 25 × 24 mm in size. The clinical diagnosis was atrial mass and atrial fibrillation. The patient underwent the operation of left atrial tumor resection + mitral valvuloplasty + atrial fibrillation radiofrequency ablation + left atrial appendectomy. The tumor was completely removed, and the patient did not receive radiotherapy or chemotherapy after surgery. The patient was reexamined by ultrasound at 6, 42, and 91 days after surgery, and no obvious abnormalities were found. On day 115, moderate echoic mass was detected on the posterior wall of the left atrium, nearing the mitral valve ring, with a size of about 28 × 23 mm. Currently, the patient is under follow-up care. CONCLUSION: As the most important examination method for cardiac tumors, cardiac ultrasound has good diagnostic and differential diagnosis value and can be used regularly due to its simplicity and safety. The diagnosis rate of cardiac myxofibrosarcoma can be greatly improved by summarizing the ultrasonographic manifestations of cardiac myxofibrosarcoma and differentiating them from other lesions.

The impact of mental disturbance on second language learning psychology among Chinese undergraduate students: a structural equation modelling analysis.

Recent developments in the field of second language acquisition have led to a growing interest in exploring the influential power of domain-general psychological properties in the L2 learning context. Several attempts have been made to elucidate the impact of properties such as boredom, resilience and enjoyment, etc. However, the association between psychopathology and second language learning psychology has received scant attention and has not been closely examined. Hence, the current study aims to explore the impact of mental disturbance on second language learning psychology and delineate the influential trajectory, by referring to the network approach as the theoretical foundation. Participants were 173 Chinese speakers of L2 English. By performing correlation analysis and structural equation modelling analysis, this research revealed that mental disturbance had a significant positive impact on L2 anxiety and a significant negative impact on L2 autonomy and L2 self-efficacy. L2 anxiety and L2 autonomy acted as mediating roles in the impact of mental disturbance on L2 self-efficacy, in which a chain mediation trajectory was detected. An expanded network approach was thus advanced. Pedagogical implication and future research were identified and discussed.

The impact of social phobia on willingness to communicate in a second language: The mediation effect of ideal L2 self.

In recent years, a greater focus has been placed on the influential power of domain-general psychological properties in second language acquisition and learning. The investigations of these properties, such as grit, academic procrastination and enjoyment etc. have been extensively conducted and are well-documented. Notwithstanding the surge of academic inquiry, the link between psychopathological notions and second language learning has not been adequately established and thoroughly scrutinized. The current study, therefore, aims to broaden the spectrum of second language research and explore the impact of social phobia on willingness to communicate in the second language context. Meanwhile, this research introduces the self-construct, particularly the ideal L2 self to further examine and elucidate the impact. 173 qualified Chinese speakers of L2 English participated in the study. By conducting correlation analysis, regression analysis and structural equation modelling analysis, it was revealed that social phobia had a significant negative impact on L2 willingness to communicate in social situations of meetings and public speaking. Ideal L2 self acted as a complete mediating role in the impact. Pedagogical implications and future directions were proposed and discussed.

Impact of urban green space on self-rated health: Evidence from Beijing.

As a crucial component of urban green space (UGS), urban parks have been found to be closely associated with the health of urban residents. Drawing on a large-scale survey, "International First-class Harmonious and Livable Capital", in Beijing conducted in 2018, this paper examines the impact of subjective and objective characteristics of UGS on residents' self-rated health (SRH) by using a binary logistic regression model. The results indicate that the overall SRH status of urban residents in Beijing is relatively good, with 73.8% of the respondents reporting good SRH. The perceived quality of UGS and objectively measured accessibility to UGS are positively associated with residents' SRH, but the subjective indicator of UGS has a greater impact on SRH than the objective indicator of UGS. In terms of influencing mechanisms, social interaction and air quality perception were the two major mediators of UGS that affected residents' SRH. The heterogeneity analysis suggests that objective accessibility to different types of urban parks has mixed effects on residents' SRH. Access to high-quality parks is positively associated with residents' SRH, whereas access to common parks has a negative impact on residents' SRH. Our findings provide important policy implications for optimizing urban park design and improving the quality of urban park provision according to human needs in the Beijing Metropolitan Area.

Identification of QTL under Brassinosteroid-Combined Cold Treatment at Seedling Stage in Rice Using Genotyping-by-Sequencing (GBS).

Cold stress is a major threat to the sustainability of rice yield. Brassinosteroids (BR) application can enhance cold tolerance in rice. However, the regulatory mechanism related to cold tolerance and the BR signaling pathway in rice has not been clarified. In the current study, the seedling shoot length (SSL), seedling root length (SRL), seedling dry weight (SDW), and seedling wet weight (SWW) were used as the indices for identifying cold tolerance under cold stress and BR-combined cold treatment in a backcross recombinant inbred lines (BRIL) population. According to the phenotypic characterization for cold tolerance and a high-resolution SNP genetic map obtained from the GBS technique, a total of 114 QTLs were identified, of which 27 QTLs were detected under cold stress and 87 QTLs under BR-combined cold treatment. Among them, the intervals of many QTLs were coincident under different treatments, as well as different traits. A total of 13 candidate genes associated with cold tolerance or BR pathway, such as BRASSINAZOLE RESISTANT1 (OsBZR1), OsWRKY77, AP2 domain-containing protein, zinc finger proteins, basic helix-loop-helix (bHLH) protein, and auxin-induced protein, were predicted. Among these, the expression levels of 10 candidate genes were identified under different treatments in the parents and representative BRIL individuals. These results were helpful in understanding the regulation relationship between cold tolerance and BR pathway in rice.

Emergency medical service utilization among acute ischemic stroke patients in Beijing: An observational study.

Objective: To investigate emergency medical service (EMS) utilization and its associated factors in patients with acute ischemic stroke (AIS), and further explore the urban-rural differences. Methods: Medical records for AIS in all emergency departments in Beijing were obtained from the Beijing Emergency Care Database from January 2018 to December 2021. EMS utilization was described and factors associated with EMS use were examined by multivariable logistic regression models with the generalized estimating equations. Results were compared between urban and rural districts. Results: A total of 24,296 AIS patients were included in the analysis, and 11,190 (46.1%) were transported to hospitals by EMS. The percentage of EMS usage in urban areas was significantly higher than that in rural areas (53.6 vs. 34.4%, P < 0.001). From 2018 to 2021, EMS utilization was on the increase (P-value for trend <0.001) with a higher average annual growth rate in rural areas (12.6%) than in urban (6.4%). Factors associated with EMS utilization were age (OR: 1.20 per 10-year increase, 95% CI: 1.17-1.23), NIHSS scores, off-hour arrival (OR: 1.32, 95% CI: 1.23-1.37), treatment in tertiary hospitals (OR: 1.75, 95% CI: 1.60-1.92), and possessing comorbidities such as coronary artery disease (OR: 1.15, 95% CI: 1.17-1.24), atrial fibrillation (OR: 1.56, 95% CI: 1.41-1.73), prior stroke (OR: 0.84, 95% CI: 0.78-0.90) or dyslipidemia (OR: 0.78, 95% CI: 0.71-0.85). Conclusion: This study demonstrated an inadequate use of EMS among AIS patients in Beijing, especially in rural areas, and revealed several associated factors. Enhanced education programs and EMS accessibility are necessary particularly for high-risk individuals and regions.

A multifunctional theranostics nanosystem featuring self-assembly of alcohol-abuse drug and photosensitizers for synergistic cancer therapy.

Conventional treatments for cancer, such as chemotherapy, surgical resection, and radiotherapy, have shown limited therapeutic efficacy, with severe side effects, lack of targeting and drug resistance for monotherapies, which limit their clinical application. Therefore, combinatorial strategies have been widely investigated in the battle against cancer. Herein, we fabricated a dual-targeted nanoscale drug delivery system based on EpCAM aptamer- and lactic acid-modified low-polyamidoamine dendrimers to co-deliver the FDA-approved agent disulfiram and photosensitizer indocyanine green, combining the imaging and therapeutic functions in a single platform. The multifunctional nanoparticles with uniform size had high drug-loading payload, sustained release, as well as excellent photothermal conversion. The integrated nanoplatform showed a superior synergistic effect in vitro and possessed precise spatial delivery to HepG2 cells with the dual-targeting nanocarrier. Intriguingly, a robust anticancer response of chemo-phototherapy was achieved; chemotherapy combined with the efficacy of phototherapy to cause cellular apoptosis of HepG2 cells (>35%) and inhibit the regrowth of damaged cells. Furthermore, the theranostic nanosystem displayed fluorescence imaging in vivo, attributed to its splendid accumulation in the tumor site, and it provided exceptional tumor inhibition rate against liver cancer cells (>76%). Overall, our research presents a promising multifunctional theranostic nanoplatform for the development of synergistic therapeutics for tumors in further applications.