Detection of Urinary Misfolded Proteins for Imminent Prediction of Preeclampsia in Pregnant Women With Suspected Cases: Protocol for a Prospective Noninterventional Study.

BACKGROUND: Preeclampsia (PE) is one of the most common hypertensive diseases, affecting 2%-8% of all pregnancies. The high maternal and fetal mortality rates of PE are due to a lack of early identification of affected pregnant women that would have led to closer monitoring and care. Recent data suggest that misfolded proteins might be a promising biomarker for PE prediction, which can be detected in urine samples of pregnant women according to their congophilia (aggregated) characteristic. OBJECTIVE: The main purpose of this trial is to evaluate the value of the urine congophilia-based detection of misfolded proteins for the imminent prediction of PE in women presenting with suspected PE. The secondary objectives are to demonstrate that the presence of urine misfolded proteins correlates with PE-related maternal or neonatal adverse outcomes, and to establish an accurate PE prediction model by combining misfolded proteins with multiple indicators. METHODS: At least 300 pregnant women with clinical suspicion of PE will be enrolled in this prospective cohort study. Participants should meet the following inclusion criteria in addition to a suspicion of PE: ≥18 years old, gestational week between 20+0 and 33+6, and single pregnancy. Consecutive urine samples will be collected, blinded, and tested for misfolded proteins and other PE-related biomarkers at enrollment and at 4 follow-up visits. Clinical assessments of PE status and related complications for all participants will be performed at regular intervals using strict diagnostic criteria. Investigators and participants will remain blinded to the results. Follow-up will be performed until 42 days postpartum. Data from medical records, including maternal and fetal outcomes, will be collected. The performance of urine misfolded proteins alone and combined with other biomarkers or clinical variables for the prediction of PE will be statistically analyzed. RESULTS: Enrollment started in July 2023 and was still open upon manuscript submission. As of March 2024, a total of 251 eligible women have been enrolled in the study and enrollment is expected to continue until August 2024. Results analysis is scheduled to start after all participants reach the follow-up endpoint and complete clinical data are collected. CONCLUSIONS: Upon completion of the study, we expect to derive an accurate PE prediction model, which will allow for proactive management of pregnant women with clinical suspicion of PE and possibly reduce the associated adverse pregnancy outcomes. The additional prognostic value of misfolded proteins is also expected to be confirmed. TRIAL REGISTRATION: Chinese Clinical Trials Registry ChiCTR2300074878; https://www.chictr.org.cn/showproj.html?proj=202096. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/54026.

Predictive value of maternal serum placental growth factor levels for discordant fetal growth in twins: a retrospective cohort study.

BACKGROUND: Accurate prenatal recognition of discordant fetal growth in twins is critical for deciding suitable management strategies. We explored the predictive value of the level of maternal second-trimester placental growth factor (PLGF) as a novel indicator of discordant fetal growth. METHODS: A total of 860 women pregnant with twins were enrolled, including 168 women with monochorionic twins (31 cases of discordant fetal growth and 137 without) and 692 with dichorionic twins (79 cases of discordant fetal growth and 613 without). Maternal second-trimester PLGF concentrations were measured via immunofluorescence. RESULTS: Maternal second-trimester PLGF levels were significantly lower in women pregnant with twins who subsequently developed discordant fetal growth than in those who did not (monochorionic twin pregnancy: P < 0.001; dichorionic twin pregnancy: P < 0.001). A 3-4 fold difference in median PLGF concentrations was detected between the two groups with both monochorionic and dichorionic twin pregnancies. Maternal second-trimester PLGF levels were significantly correlated with birth weight differences (monochorionic twin pregnancy: r = - 0.331, P < 0.001; dichorionic twin pregnancy: r = - 0.234, P < 0.001). A receiver operating characteristic curve was used to evaluate the predictive efficiency. In monochorionic twin pregnancies, the area under the curve (AUC) was 0.751 (95% confidence interval [CI]: 0.649-0.852), and the cutoff value was 187.5 pg/mL with a sensitivity of 77.4% and specificity of 71.0%. In dichorionic twin pregnancies, the AUC was 0.716 (95% CI; 0.655-0.777), and the cutoff value was 252.5 pg/mL with a sensitivity of 65.1% and specificity of 69.6%. Based on the above cutoff values, univariate and multivariate logistic regression analyses were performed to calculate the odds ratios (OR) for the PLGF levels. After adjustment for potential confounding factors, low PLGF concentrations still significantly increased the risk of discordant fetal growth (monochorionic twin pregnancy: adjusted OR: 7.039, 95% CI: 2.798-17.710, P < 0.001; dichorionic twin pregnancy: adjusted OR: 4.279, 95% CI: 2.572-7.120, P < 0.001). CONCLUSIONS: A low maternal second-trimester PLGF level is considered a remarkable risk factor and potential predictor of discordant fetal growth. This finding provides a complementary screening strategy for the prediction of discordant fetal growth and offers a unique perspective for the subsequent research in this field.

A Chinese longitudinal maternity cohort study (2013-2021) on intrahepatic cholestasis phenotypes: Risk associations from environmental exposure to adverse pregnancy outcomes.

Intrahepatic cholestasis of pregnancy (ICP) is an idiopathic disease that occurs during mid-to-late pregnancy and is associated with various adverse pregnancy outcomes, including intrauterine fetal demise. However, since the underlying cause of ICP remains unclear, there is an ongoing debate on the phenotyping criteria used in the diagnostic process. Here, we identified single- and multi-symptomatic ICP (ICP-S and ICP-M) in 104,221 Chinese females from the ZEBRA maternity cohort, with the objective of exploring the risk implications of the two phenotypes on pregnancy outcomes and from environmental exposures. We employed multivariate binary logistic regression to estimate confounder-adjusted odds ratios and found that ICP-M was more strongly associated with preterm birth and low birth weight compared to ICP-S. Throughout pregnancy, incremental exposure to PM2.5, O3, and greenness could alter ICP risks by 17.3%, 12.5%, and -2.3%, respectively, with more substantial associations observed with ICP-M than with ICP-S. The major scientific advancements lie in the elucidation of synergistic risk interactions between pollutants and the protective antagonistic effects of greenness, as well as highlighting the risk impact of preconceptional environmental exposures. Our study, conducted in the context of the "three-child policy" in China, provides epidemiological evidence for policy-making to safeguard maternal and neonatal health.

Sphere-rod-like Ag/AgCl@Fe2O3 Z-scheme heterojunction as photocatalysts for efficient degradation of tetracycline under visible light irradiation.

Integration of multi-functional components into one is urgent for creating a viable platform to improve photocatalytic efficiency for environmental treatment. Here, MIL-88B-NH2 (Fe) was firstly employed to capture Ag+ cation for the formation of AgCl@MIL-88B-NH2 (Fe), and then turned into the strongly coupled Ag/AgCl@Fe2O3 with sphere-rod-like structure. As prepared Z-scheme Ag/AgCl@Fe2O3 heterojunction exhibited outstanding photocatalytic performance of tetracycline (TC) with a removal efficiency of 94.9% and a reaction kinetics of 0.0272 min-1, superior to single Ag/AgCl or Fe2O3, which attributed to the broad light absorption range and accelerated electron-hole pair separation stemmed from the synergistic effect between surface plasmon resonance effect (SPR) of metal Ag and AgCl/Fe2O3 heterojunction. Meanwhile, Ag/AgCl@Fe2O3 was found to be highly catalytic in the degradation of TC even after consecutive runs. Moreover, active species trapping experiments combined with ESR techniques revealed that superoxide radical, hydroxyl radical, electron, and hole all were involved in photodegradation of TC process. Importantly, the degradation intermediate products of TC were revealed in depth by LC-MS, and a possible degradation pathway was further proposed. This work opens up new insights into the integration of functional composites for the construction of advanced photocatalysts applied in environmental purification.

Prenatal exposure to emerging and traditional organophosphate flame retardants: Regional comparison, transplacental transfer, and birth outcomes.

During gestation, organophosphate flame retardants (OPFRs) have the potential to pose health risks to fetuses due to their ability to cross the placental barrier. However, data are scarce regarding the transplacental transfer of these compounds, particularly concerning emerging OPFRs and regional variations. In this study, we analyzed 14 traditional OPFRs and 5 emerging OPFRs in maternal and cord serum samples from Mianyang and Hangzhou, two cities in eastern and western China, respectively. The results revealed marked disparities in the overall levels of OPFRs between the two cities (p < 0.05), with the average concentration in maternal serum being higher in Hangzhou (14.55 ng/mL) than in Mianyang (8.28 ng/mL). The most abundant compounds found in both cities were tris (2-chloroethyl) phosphate (TCEP), Triphenyl phosphate (TPHP), and Tri-n-butyl phosphate (TnBP). Additionally, this study marked the first detection of novel OPFRs, including resorcinol bis (diphenyl phosphate) (RDP), isodecyl diphenyl phosphate (IDDPP), cresyl diphenyl phosphate (CDP), and bisphenol A bis (diphenyl phosphate) (BPA-BDPP) in maternal and cord serum simultaneously with the detection frequencies higher than 45%. This study also found that transplacental transfer efficiencies for OPFRs varied by ester group, with Aryl-OPFRs exhibiting the highest transfer rates (0.90-1.11) and Alkyl-OPFRs exhibiting the lowest (0.66-0.83). Transfer efficiencies exhibited a positive correlation with log Kow values (p < 0.05), suggesting that hydrophobic OPFRs with higher log Kow values are more likely to permeate the placental barrier. Moreover, the exposure levels of Tris (1,3-dichloro-2-propyl) phosphate (TDCIPP), Tri (Chloropropyl) Phosphate (TCIPP), TPHP, and CDP in cord serum were negatively associated (p < 0.05) with birthweight of newborns. This research adds to our understanding of the transplacental transfer of OPFRs and the possible health risks associated with prenatal exposure.

DBALM: A novel method for identifying ornamental flowering plants based on DNA barcodes-leaf morphology.

Whereas the presence of flowers on ornamental flowering plants is essential for their identification via traditional methods, ornamental flowering plants cannot be reliably identified in non-flowering stages likewise. Here, DBALM (DNA Barcodes-Leaf Morphology), a new approach that combines DNA barcoding data with micromorphological features of the leaf epidermis and that is not limited by the flowering stage, was used to identify 16 evergreen rhododendron cultivars. First, the sequences of DNA barcodes, ITS, matK, psbA-trnH, and rbcL, were obtained from the DNA of leaves. Phylogenetic analysis was conducted to clarify the groupings among all the samples based on the four markers. Then, microscopic features of the leaf epidermis were used to further distinguish individuals from the same clade. DNA barcoding permitted the 16 cultivars to be divided into eight groups. The microscopic features of the leaf epidermis permitted cultivars within the same clade to be distinguished. The matK + psbA-trnH combination was the most effective barcode combination in this study. In addition, the new primer matK-Rh_R was designed, and it increased the amplification rate of evergreen rhododendron cultivars to 100%. In sum, DBALM was capable of accurately identifying the 16 evergreen rhododendron cultivars using data collected from a single leaf in the vegetative growth stage. This method can greatly facilitate the identification and breeding of ornamental flowering plants.

Emerging and Legacy Perfluoroalkyl Substances in Breastfed Chinese Infants: Renal Clearance, Body Burden, and Implications.

BACKGROUND: Human breast milk is a primary route of exposure to perfluoroalkyl substances (PFAS) in infants. To understand the associated risks, the occurrence of PFAS in human milk and the toxicokinetics of PFAS in infants need to be addressed. OBJECTIVES: We determined levels of emerging and legacy PFAS in human milk and urine samples from Chinese breastfed infants, estimated renal clearance, and predicted infant serum PFAS levels. METHODS: In total, human milk samples were collected from 1,151 lactating mothers in 21 cities in China. In addition, 80 paired infant cord blood and urine samples were obtained from two cities. Nine emerging PFAS and 13 legacy PFAS were analyzed in the samples using ultra high-performance liquid chromatography tandem mass spectrometry. Renal clearance rates (CLrenals) of PFAS were estimated in the paired samples. PFAS serum concentrations in infants (<1 year of age) were predicted using a first-order pharmacokinetic model. RESULTS: All nine emerging PFAS were detected in human milk, with the detection rates of 6:2 Cl-PFESA, PFMOAA, and PFO5DoDA all exceeding 70%. The level of 6:2 Cl-PFESA in human milk (median concentration=13.6 ng/L) ranked third after PFOA (336 ng/L) and PFOS (49.7 ng/L). The estimated daily intake (EDI) values of PFOA and PFOS exceeded the reference dose (RfD) of 20 ng/kg BW per day recommended by the U.S. Environmental Protection Agency in 78% and 17% of breastfed infant samples, respectively. 6:2 Cl-PFESA had the lowest infant CLrenal (0.009mL/kg BW per day), corresponding to the longest estimated half-life of 49 y. The average half-lives of PFMOAA, PFO2HxA, and PFO3OA were 0.221, 0.075, and 0.304 y, respectively. The CLrenals of PFOA, PFNA, and PFDA were slower in infants than in adults. CONCLUSIONS: Our results demonstrate the widespread occurrence of emerging PFAS in human milk in China. The relatively high EDIs and half-lives of emerging PFAS suggest potential health risks of postnatal exposure in newborns. https://doi.org/10.1289/EHP11403.

A preliminary report on the association between maternal serum organophosphate ester concentrations and gestational diabetes mellitus.

Organophosphate esters (OPEs) are extensively manufactured and used in China. Whether exposure to OPEs during pregnancy increases the risk of gestational diabetes mellitus (GDM) is unknown. Between 2011 and 2012, a case-control study including 130 and 67 women with and without GDM, respectively, was conducted in Hangzhou, China. The levels of 10 OPEs in maternal serum samples at delivery were quantified, and the relationships between the OPE concentrations and GDM risk were investigated. The results show that in all participants, tri-n-butyl phosphate (TNBP, median: 2.02 ng/mL) was the most common OPE present in the serum, followed by tri-phenyl phosphate (TPHP, median: 1.74 ng/mL) and tri-iso-butyl phosphate (median: 1.68 ng/mL). With one-unit elevation in the tris (2-chloroethyl) phosphate, TNBP, TPHP, and tris (2-butoxy ethyl) phosphate (TBOEP) concentrations in maternal serum, 1-h glucose levels increased by 0.19 (95% confidence interval (CI): -0.01, 0.29), 0.11 (95% CI: -0.18, 0.62), 0.29 (95% CI: 0.12, 0.58), and 0.20 units (95% CI: 0.01, 0.44), respectively. In addition, a unit increase in TBOEP levels in maternal serum was associated with an increase of 0.26 units (95% CI: 0.09, 0.61) in 2-h glucose levels. After adjusting for covariate factors, serum TNBP (odds ratio (OR) = 2.07; 95% CI: 1.27, 3.41), TBOEP (OR = 2.63; 95% CI: 1.68, 4.11), and TPHP (OR = 1.03; 95% CI: 1.05, 1.51) concentrations were associated with GDM incidence in pregnant women. Overall, TNBP, TBOEP, and TPHP exposure during pregnancy is associated with GDM risk and increased glucose levels.

Prenatal exposure to 209 PCBs in mother-infant pairs from two cities in China: Levels, congener profiles, and transplacental transfer.

Prenatal exposure to polychlorinated biphenyls (PCBs) has been well researched, but studies covering all 209 congeners are limited. Recent literature suggests a shift in the dominant congeners and increasing levels of unintentionally-produced PCBs (UP-PCBs) in environmental samples in China. To investigate the exposure levels and profiles of PCBs in pregnant women and newborns, as well as the characteristics of transplacental transfer, we measured 209 PCBs in 80 pairs of maternal serum (MS) and cord serum (CS) from Hangzhou and Mianyang, China. The levels of ∑PCBs of participants in this study were lower than those in developed countries and followed the order of (ng/g lw): Hangzhou-MS (148) > Hangzhou-CS (107) > Mianyang-MS (63.8) > Mianyang-CS (57.9). UP-PCBs (mainly PCB-11) contributed around 50% of ∑PCBs in serum, which is consistent with the environmental samples. Environmental burden and dietary intake may account for the differences in the exposure levels, while the historical production and release may have impacted the homologue profiles. Prenatal exposure to PCB-126 was associated with increased birth weight (n = 80, adjusted ß = 0.270, p = 0.030). The body burden of dioxin-like PCBs of newborns in Hangzhou was 82.4 pg TEQ/kg bw, suggesting certain health risks under WHO tolerable daily intake of 1-4 pg TEQ/kg bw. Log10 KOW was negatively correlated with log10-transformed transplacental transfer efficiency (R2 = 0.36, p < 0.001), serving its importance for PCBs' transplacental transfer. This study is the first to investigate maternal and fetal exposure to PCBs in China based on their levels, congener and homologue profiles, and potential adverse effects. Our findings help to provide insights into the processes and factors influencing the transplacental transfer of PCBs.

Self-healing waterborne polyurethane coatings with high transparence and haze via cellulose nanocrystal stabilized linseed oil Pickering emulsion.

Protection coatings with self-healing ability can significantly enhance their anti-corrosion properties and service life. In this study, self-healing waterborne polyurethane (WPU) coatings with high transparence and haze were facile fabricated via cellulose nanocrystal (CNC) stabilized linseed oil (LO) Pickering emulsion. Sustainable CNCs displayed outstanding emulsifying ability and stability to stabilize LO Pickering emulsion. The size of LO Pickering emulsion droplets decreases with the CNC concentration, while the emulsion fraction and surface coverage by CNCs increase with CNC concentration, leading to a more stable Pickering emulsion. The self-healing rates of WPU coatings at varied time, temperature, CNC and catalyst concentration were investigated. Higher temperature, larger emulsion droplets, and with driers employed as catalysts generally lead to faster self-healing rate. The WPU self-healing coatings displayed much better abrasion resistance and mechanical properties than pristine WPU due to the incorporation of CNCs. Moreover, the WPU self-healing coatings show a high transparence and haze due to light scattering, and their applications as coatings of lamp covers and glass to achieve uniform light distribution and privacy protection with high light transmission were further demonstrated.

A Review of the Role of the School Spatial Environment in Promoting the Visual Health of Minors.

Rising childhood myopia rate has detrimental health consequences that pose a considerable challenge to health systems. The school spatial environment, which is where students are for the longest period of time, has a high health value for myopia systematic intervention. While research has demonstrated associations between physical daylight environments, medical gene and visual health, the literature currently lacks a synthesis of evidence that will act as a spatially-organized resource for school designers. This study is based on literature from the period 2000-2022 and has been taken from the Web of Science, scopus, Medline and CNKI core collection database. Collaboration, literature co-citation and quantitative and qualitative analysis, in addition to keyword co-occurrence are adopted to conduct a visual health research review. The results indicate that intensive near work activity (as a risk factor) and longer time spent outdoors (as a protective factor), are involved in visual health factors. Two main research themes are obtained and relate to: (1) The environment of visual work behavior (especially the near work learning environment) and adaptable multimedia learning environment; and (2) the environment of outdoor exposure behavior. Furthermore, with the variation of educational demands, models and concepts, there are different demands for near work behavior, and this study makes an important contribution by pointing to two future research directions, including the accurate and controllable environment of near work behavior, which operate in accordance with various educational mode requirements and the active design of the environment of outdoor exposure behavior. In referring to differences between regions and countries, as well as the development of the educational environment, it provides insight into how these demands can be controlled.

Serum concentrations of phthalate metabolites in pregnant women and their association with gestational diabetes mellitus and blood glucose levels.

Phthalate metabolites are widely present in humans and can have many adverse effects on pregnant women. To date, many studies on the effects of phthalate metabolites on the risk of gestational diabetes mellitus (GDM) have been published, but the findings of these studies are controversial. We conducted a case-control study to quantify the concentrations of seven phthalate metabolites in the serum of pregnant women and to investigate their association with the risk of GDM and blood glucose levels in pregnant women. Therefore, 201 serum samples (139 pregnant women with GDM and 62 control serum samples) were collected from Hangzhou, China, between 2011 and 2012. The results showed that mono butyl phthalate (MBP; mean = 4.08 ng/mL) was the most abundant phthalate metabolites in human serum, followed by mono (2-ethylhexyl) phthalate (MEHP; mean = 1.28 ng/mL) and mono isobutyl phthalate (MiBP; mean = 1.20 ng/mL). The other results indicated significant associations between MBP (ß = 2.24, 95 % confidence interval (CI): 1.02, 5.07, P = 0.050) and MiBP (ß = 1.84, 95 % CI: 1.03, 3.31, P = 0.041) concentrations in human serum and the incidence of GDM. Moreover, serum MBP (ß = 0.40, 95 % CI: 0.10, 0.70, P = 0.010) and MiBP levels (ß = 0.18, 95 % CI: 0.010, 0.35, P = 0.047) in humans were positively associated with 2-hour blood glucose levels. Our study provides affirmative evidence on previously inconsistent findings that MBP and MiBP exposure may increase the risk of GDM in pregnant women.

Human serum poly- and perfluoroalkyl substance concentrations and their associations with gestational diabetes mellitus.

Poly- and perfluoroalkyl substances (PFAS), which have been found in high concentrations in maternal serum, have the potential to impair glucose metabolism in pregnant women. However, the effects of PFAS exposure on the risk of gestational diabetes mellitus (GDM) remain inconsistent. In the current investigation, a case-control study involving 135 patients with GDM and 69 controls was conducted in Hangzhou, China. We determined the concentrations of 17 PFAS in maternal serum from each participant and elucidated the associations between those concentrations and the risk of GDM. Among the 17 PFAS, perfluorooctanesulfonate (median 7.53 and 7.44 ng/mL) was the predominant PFAS in both cases and controls, followed by perfluorooctanoic acid (PFOA; median 5.22 and 5.03 ng/mL) and 6:2 chlorinated perfluoroalkyl ether sulfonate (6:2 Cl-PFESA; median 2.58 and 2.42 ng/mL). Conditional logistic regression analysis showed that the maternal serum continuous levels of PFOA, perfluorononanoic acid (PFNA), perfluorohexanesulfonate (PFHxS), and 6:2 Cl-PFESA were significantly associated with the GDM risk, with adjusted odds ratios (ORs) of 1.84 (95% confidence interval (CI): 1.26, 3.51), 1.47 (1.17, 3.29), 1.33 (1.72, 3.48), and 1.34 (1.17, 2.53), respectively. In the adjusted model, the ORs of GDM for increasing tertiles of PFOA, PFNA, PFHxS, and 6:2 Cl-PFESA significantly increased. The adjusted ORs (95% CI) were 3.38 (2.16, 6.89), 2.61 (1.26, 5.40), 3.46 (1.64, 6.30), and 3.50 (1.62, 6.91) at the highest concentrations of PFOA, PFNA, PFHxS, and 6:2 Cl-PFESA, respectively. These results suggest that higher PFAS exposure, reflected in serum PFAS concentrations, was associated with GDM incidence in pregnant women.

Safety of vaginal delivery in women with placental chorioangiomas diagnosed by prenatal ultrasound: A retrospective cohort study.

This study aimed to examine the maternal and neonatal outcomes in different mode of delivery in pregnant women with placental chorioangiomas, in order to determine the safety of vaginal delivery. We conducted a retrospective study of 54 women with placental chorioangioma diagnosed by prenatal ultrasound and subsequently proven histologically, excluding those who underwent cesarean section for obstetric indications. The mode of delivery was divided into a vaginal delivery group (23 women) and a cesarean section group (31 women). The indication of cesarean section group was only for placental chorioangioma, no other obstetric indications. The maternal characteristics, pregnancy outcomes and the color doppler imaging characteristics of placental chorioangioma of the 2 groups were compared, and the clinical characteristics of women in the vaginal delivery group were described in detail. The incidence of placental chorioangioma was nearly 0.43‰ in our study. There was no significant difference in the maternal characteristics and pregnancy outcomes between the 2 groups. 82.6% (19/23) of the women successfully delivered vaginally and 4 failed who turned to cesarean section in the vaginal delivery group; among them, 17 women had giant chorioangiomas (>4 cm in diameter). The direct cause of vaginal delivery failure was fetal distress, persistent occiput posterior fetal position and cephalopelvic disproportion. Pregnant women with placental chorioangiomas and no other obstetric indications for cesarean section may attempt a vaginal delivery, even with giant chorioangiomas. If there are risk factors of vaginal delivery failure, the progress of labor needs to be closely monitored.

Fetal Ductus Arteriosus Premature Constriction.

This study aimed to investigate the connections between the echocardiography indices of fetal ductus arteriosus premature constriction and newborn prognosis by analyzing 22 cases of spontaneous fetal ductus arteriosus premature constriction.An ultrasonic instrument was used to observe prenatal fetal heart state, combine clinical examination data and echocardiographic results after delivery, summarize the ultrasound manifestations and imaging characteristics, and analyze the prognosis of the fetus.In all cases, fetal ductus arteriosus premature constriction occurred in the third trimester of pregnancy (34 + 1 to 41 weeks), and no abnormality in extracardiac organs were observed. Seven neonates required respiratory support due to the accompanying severe tricuspid regurgitation. The remaining 15 neonates did not receive respiratory support, including 4 with severe tricuspid regurgitation, 5 with moderate regurgitation, and 6 with mild regurgitation. Significant differences were observed in the fetal right atrium size and tricuspid regurgitation severity between the neonatal respiratory support group and non-respiratory support group. Furthermore, there were statistical differences in the ductus arteriosus inner diameter and pulsation index between the two groups.The severity of fetal ductus arteriosus premature contraction accompanied by tricuspid regurgitation and right atrium enlargement can predict the immediate prognosis of the newborn and provide guidance for the clinical judgment of the timing of pregnancy termination.

The Perceived Restorativeness of Outdoor Spatial Characteristics for High School Adolescents: A Case Study from China.

Heavy schoolwork and overpopulated classrooms have made high schools overstressed environments. Previous investigations have identified a wide body of naturally restorative elements. However, evidence regarding the relationship between spatial typology and its perceived restorativeness (PR) for adolescents is limited. This paper explores the connection between spatial characteristics and PR by linking their restorative quality to how they are actually used. A high school with multiple types of outdoor spaces is used as a case study and typical spatial characteristics (area, distance, and openness) are quantified. A revised perceived restorativeness scale (RPRS) is exploited to assess the restorative quality of different spaces, and a self-reported questionnaire is used to map the actual usage. The obtained results reveal that: (1) the restorativeness of the selected spaces varied considerably, with a natural garden being more restorative than a built environment; (2) the area and openness were positively correlated to the PR, but the distance was negatively correlated; (3) the theoretical dimensions of "getting away" at high school are primarily psychological, not physical; (4) the actual use of outdoor spaces during breaks does not match the students' favorite places or their PR. These findings expand our understanding of the role of spatial characteristics in PR in high schools and indicate direct links between campus design and restorative quality.

Effects of Micro Architectural Environmental Interventions on Handwashing Compliance of Adolescents: A School-Based Intervention Trial.

PURPOSE: Aimed to explore more practical interventions for handwashing compliance (HWC) and protect the minor' health with the pandemic background, this study tested whether micro architectural interventions would promote HWC of adolescents through active experience. BACKGROUND: Despite the well-documented benefits of handwashing (HW), low compliance is common among adolescents. HW space in schools has always been treated as attached spaces of little matter, which is unfavorable to public health. According to environment behavior perspective, personal motivation of HWC may be motivated by active environment. METHOD: A school-based investigation and a 30-week environmental behavior experiment were conducted when students returned to school after the COVID-19 pandemic closure in 2020 in China to evaluate the effects of active environment interventions selected by previous survey on promoting adolescents' HW rate. Digital infrared counters were used to unobtrusively document their behavior. RESULTS: Results in summer revealed a positive effect on all intervention groups. The effects of combined interventions were higher than the effect of any single intervention. However, HW rates of all groups declined sharply in the coldest month and the between-group differences decreased. Significant correlations were found between HW rates and satisfaction with the intervention schemes. CONCLUSIONS: Findings suggest that architectural environmental intervention may potentially be a positive, friendly, and one-time investment mean to expand the HWC intervention scope from passive policies to positive experience, and HW space design for adolescents should be treated as a public health strategy.

Regulating autogenic vegetation in the riparian zone reduces carbon emissions: Evidence from a microcosm study.

Riparian zones have been found to be hot spots of greenhouse gas (GHG) production and have attracted increasing attention in recent decades. The occurrence of autogenic vegetation in riparian zones is prevalent, but little information is available concerning the influence of the occurrence and decomposition of this vegetation on carbon mitigation. We conducted a 220-day (110 days for the dry season and 110 days for the flooded season) microcosm experiment to study the mitigation and transformation of carbon regulated by the vegetation. The results revealed that there was a carbon dioxide (CO2) flux in the treatment with vegetation, and that without vegetation harvesting (835.58 mg/m2/h) was close to that with vegetation harvesting (796.22 mg/m2/h) under the simulated dry season conditions, but it was significantly higher than that without vegetation seedlings (411.55 mg/m2/h). After being flooded, the decomposition of the vegetation residues increased the total organic carbon (TOC) content of the sediment, the dissolved organic carbon (DOC) concentration of the water, and the dissolved CO2 and methane (CH4) contents of the sediment. This effect was reversed by harvesting the vegetation biomass. During the flooded season, the CO2 flux reached 222.95 mg/m2/h in the vegetation seeded treatment, but it decreased to -53.71 mg/m2/h when the vegetation biomass was harvested before being submerged. This was due to the decrease in the substrate available for CO2 production, the altered microorganism communities, and the decrease in the abundance of carbon metabolizing related enzymes. As a result, vegetation harvesting reduced the net carbon emissions by 48 % compared to that without vegetation regulation during the 220-day incubation period. The results of this study are significant to implementing measures to reduce GHG emissions from the riparian zone.