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All-perovskite tandem solar cells provide high power conversion efficiency at a low cost1-4. Rapid efficiency improvement in small-area (<0.1 cm2) tandem solar cells has been primarily driven by advances in low-bandgap (approximately 1.25 eV) perovskite bottom subcells5-7. However, unsolved issues remain for wide-bandgap (> 1.75 eV) perovskite top subcells8, which at present have large voltage and fill factor losses, particularly for large-area (>1 cm2) tandem solar cells. Here we develop a self-assembled monolayer of (4-(7H-dibenzo[c,g]carbazol-7-yl)butyl)phosphonic acid as a hole-selective layer for wide-bandgap perovskite solar cells, which facilitates subsequent growth of high-quality wide-bandgap perovskite over a large area with suppressed interfacial non-radiative recombination, enabling efficient hole extraction. By integrating (4-(7H-dibenzo[c,g]carbazol-7-yl)butyl)phosphonic acid in devices, we demonstrate a high open-circuit voltage (VOC) of 1.31 V in a 1.77-eV perovskite solar cell, corresponding to a very low VOC deficit of 0.46 V (with respect to the bandgap). With these wide-bandgap perovskite subcells, we report 27.0% (26.4% certified stabilized) monolithic all-perovskite tandem solar cells with an aperture area of 1.044 cm2. The certified tandem cell shows an outstanding combination of a high VOC of 2.12 V and a fill factor of 82.6%. Our demonstration of the large-area tandem solar cells with high certified efficiency is a key step towards scaling up all-perovskite tandem photovoltaic technology.
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Organic materials have been widely used as the charge transport layers in perovskite solar cells due to their structural versatility and solution processability. However, their low surface energy usually causes unsatisfactory thin-film wettability in contact with the perovskite solution, which limits the interfacial performance of the photovoltaic devices. Although solvent post-treatment could occasionally regulate the wetting behavior of organic films, the mechanism of the solid-liquid interaction is still unclear. Here, we present evidence of a possible correlation between the solvent and the wettability of a conventional polymer, poly[bis(4-phenyl) (2,4,6-trimethylphenyl) amine] (PTAA), and reveal the critical roles of Hansen solubility parameters (HSPs) of solvents in wetting mechanisms. Our results suggest that the conventional solvent N,N-dimethylformamide (DMF) improves the wettability of PTAA by the morphological disruption mechanism but negatively impacts interfacial charge collection and stability. In contrast, 2-methoxyethanol (2-Me) with an appropriate HSP value induces the transformation of the PTAA configuration in an orderly manner, which simultaneously improves the wetting property and maintains the film topography. After careful optimization of the surface conformation of the PTAA film, both perovskite crystallization and interfacial compatibility have been enhanced. Benefiting from superior interfacial properties, the perovskite solar cells based on 2-Me deliver a champion efficiency of 24.15% compared to 21.4% for DMF-based ones. More encouragingly, the use of 2-Me minimizes the perovskite buried interfacial defects, enabling the unencapsulated devices to maintain about 95% of their initial efficiencies after light illumination for 1100 h. The present study demonstrates the high effectiveness of solvent-polymer interaction for adjusting interfacial properties and strengthening the robustness of perovskite solar cells.
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Drought and nitrogen enrichment could profoundly affect the productivity of semiarid ecosystems. However, how ecosystem productivity will respond to different drought scenarios, especially with a concurrent increase in nitrogen availability, is still poorly understood. Using data from a 4-year field experiment conducted in a semiarid temperate steppe, we explored the responses of aboveground net primary productivity (ANPP) to different drought scenarios and nitrogen addition, and the underlying mechanisms linking soil properties, plant species richness, functional diversity (community-weighted means of plant traits, functional dispersion) and phylogenetic diversity (net relatedness index) to ANPP. Our results showed that completely excluding precipitation in June (1-month intense drought) and reducing half the precipitation amount from June to August (season-long chronic drought) both significantly reduced ANPP, with the latter having a more negative impact on ANPP. However, reducing half of the precipitation frequency from June to August (precipitation redistribution) had no significant effect on ANPP. Nitrogen addition increased ANPP irrespective of drought scenarios. ANPP was primarily determined by soil moisture and nitrogen availability by regulating the community-weighted means of plant height, rather than other aspects of plant diversity. Our findings suggest that precipitation amount is more important than precipitation redistribution in influencing the productivity of temperate steppe, and nitrogen supply could alleviate the adverse impacts of drought on grassland productivity. Our study advances the mechanistic understanding of how the temperate grassland responds to drought stress, and implies that management strategies to protect tall species in the community would be beneficial for maintaining the productivity and carbon sequestration of grassland ecosystems under climate drought.
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Secas , Pradaria , Nitrogênio , Nitrogênio/metabolismo , Plantas/classificação , Solo/química , ChinaRESUMO
Cotton is a major cash crop globally, playing a pivotal role in the textile sector. However, cotton growers in Xinjiang region are experiencing cotton yield penalty caused by limited heat environment. In this region, limited heat conditions strongly arrest cotton plant growth and development resulting in recued productivity. To counteract this problem, there is an urgent need to robustly identify efficient management strategies to improve plant performance and increase cotton yield under heat-limited situations. This will hold crucial implications for agricultural sustainability and global cotton supply. This review article identified challenges faced by cotton producers under heat limited environments with potential solutions to enhance cotton productivity. Specifically, we focused on the implementation of two life history strategies including planting early maturing and cold tolerant cultivars, and adjusting sowing date that can promote early maturity and increase cold stress tolerance. These strategies have shown promising results in protecting cotton plants from limited heat injury and consequently improved cotton productivity. By focusing on Xinjiang province unique climate and associated agronomic practices, valuable insights can be gained, which may have broader applications in other heat-limited cotton-growing regions globally. This comprehensive review endeavors to provide a foundation for future research and practical interventions aimed at boosting cotton yields under limited heat areas.
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Gossypium , Gossypium/crescimento & desenvolvimento , Temperatura Alta , Agricultura/métodos , ChinaRESUMO
BACKGROUND: Auxin response factors (ARFs) are a class of transcription factors that regulate the expression of auxin-responsive genes and play important functions in plant growth and development. To understand the biological functions of the auxin response factor GhARF2 gene in upland cotton, the coding sequence (CDS) of GhARF2 gene was cloned, and its protein sequence, evolutionary relationship, subcellular localization and expression pattern were analysed. METHODS: The CDS sequence of GhARF2 gene was cloned from upland cotton variety Baimian No.1, and its protein sequence was analyzed by bioinformatics method. The subcellular localization of GhARF2 protein was detected by tobacco epidermal transient transformation system, and the tissue expression and stress expression pattern of GhARF2 were analyzed by quantitative RealTime PCR (qRT-PCR). RESULTS: The full-length CDS of GhARF2 gene was 2583 bp, encoded 860 amino acids, and had a molecular weight and an isoelectric point of 95.46 KDa and 6.02, respectively. The GhARF2 protein had multiple phosphorylation sites, no transmembrane domain, and secondary structures dominated by random coils and alpha helix. The GhARF2 protein had 3 conserved typical domains of ARF gene family members, including the B3 DNA binding domain, the Auxin_resp domain, and the Aux/IAA domain. Phylogenetic analysis revealed that ARF2 proteins in different species were clustered in the Group A subgroup, in which GhARF2 was closely related to TcARF2 of Theobroma cacao L. (Malvaceae). The subcellular localization results showed that the GhARF2 protein was localized in the nucleus. Analysis of tissue expression pattern showed that the GhARF2 gene was expressed in all tested tissues, with the highest expression levels in sepal, followed by leaf, and the lowest expression levels in fiber. Further stress expression analysis showed that the GhARF2 gene was induced by drought, high-temperature, low-temperature and salt stress, and had different expression patterns under different stress conditions. CONCLUSION: These results established a foundation for understanding the functions of GhARF2 and breeding varieties with high-stress tolerance in cotton.
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Genoma de Planta , Gossypium , Gossypium/genética , Filogenia , Ácidos Indolacéticos , Família Multigênica , Melhoramento Vegetal , Regulação da Expressão Gênica de Plantas/genética , Proteínas de Plantas/genéticaRESUMO
Pain is a common annoying non-motor symptom in Parkinson's disease (PD) that causes distress to patients. Treatment for PD pain remains a big challenge, as its underlying mechanisms are elusive. Pituitary adenylate cyclase-activating polypeptide (PACAP) and its receptor PAC1-R play important roles in regulating a variety of pathophysiological processes. In this study, we investigated whether PACAP/PAC1-R signaling was involved in the mechanisms of PD pain. 6-hydroxydopamine (6-OHDA)-induced PD model was established in rats. Behavioral tests, electrophysiological and Western blotting analysis were conducted 3 weeks later. We found that 6-OHDA rats had significantly lower mechanical paw withdrawal 50% threshold in von Frey filament test and shorter tail flick latency, while mRNA levels of Pacap and Adcyap1r1 (gene encoding PAC1-R) in the spinal dorsal horn were significantly upregulated. Whole-cell recordings from coronal spinal cord slices at L4-L6 revealed that the frequency of spontaneous excitatory postsynaptic currents (sEPSCs) in dorsal horn neurons was significantly increased, which was reversed by application of a PAC1-R antagonist PACAP 6-38 (250 nM). Furthermore, we demonstrated that intrathecal microinjection of PACAP 6-38 (0.125, 0.5, 2 µg) dose-dependently ameliorated the mechanical and thermal hyperalgesia in 6-OHDA rats. Inhibition of PACAP/PAC1-R signaling significantly suppressed the activation of Ca2+/calmodulin-dependent protein kinase II and extracellular signal-regulated kinase (ERK) in spinal dorsal horn of 6-OHDA rats. Microinjection of pAAV-Adcyap1r1 into L4-L6 spinal dorsal horn alleviated hyperalgesia in 6-OHDA rats. Intrathecal microinjection of ERK antagonist PD98059 (10 µg) significantly alleviated hyperalgesia in 6-OHDA rats associated with the inhibition of sEPSCs in dorsal horn neurons. In addition, we found that serum PACAP-38 concentration was significantly increased in PD patients with pain, and positively correlated with numerical rating scale score. In conclusion, activation of PACAP/PAC1-R induces the development of PD pain and targeting PACAP/PAC1-R is an alternative strategy for treating PD pain.
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Doença de Parkinson , Polipeptídeo Hipofisário Ativador de Adenilato Ciclase , Ratos , Humanos , Animais , Polipeptídeo Hipofisário Ativador de Adenilato Ciclase/farmacologia , Polipeptídeo Hipofisário Ativador de Adenilato Ciclase/metabolismo , Hiperalgesia/tratamento farmacológico , Hiperalgesia/metabolismo , Oxidopamina , Doença de Parkinson/tratamento farmacológico , Transmissão Sináptica , Dor , MAP Quinases Reguladas por Sinal Extracelular/metabolismo , Células do Corno Posterior/metabolismo , Receptores de Polipeptídeo Hipofisário Ativador de Adenilato Ciclase/metabolismoRESUMO
OBJECTIVES: Cardiopulmonary bypass (CPB) induces inflammatory homeostasis dysregulation, closely related to many postoperative adverse effects. Minimizing the systemic inflammatory response to CPB is imperative to improving cardiac surgery safety. This study aimed to retrospectively evaluate the efficacy of the hemoperfusion cartridge, a device recently designed for extracorporeal blood purification to remove cytokines from the blood for patients undergoing cardiac valve replacement surgery using CPB. METHODS: The hemoperfusion (HP) group consisted of 138 patients, who underwent a hemoperfusion cartridge procedure during CPB. The control group included 149 patients, who received standard CPB management. The evaluated indices included inflammatory cytokines, blood biochemical indices, and postoperative outcome indices. RESULTS: Patients in the HP group had relatively lower interleukin (IL)-6 levels (days one and two post-CPB) and IL-8 (day one post-CPB) compared with the control group. Some relatively decreased biochemical blood indices also were observed in the HP group, including a significantly lower lactic acid level (days one, two, and three post-CPB), platelet counts (days one, two, and three post-CPB), and aspartate aminotransferase (days one and three post-CPB). Regarding the postoperative outcomes, no severe complications occurred in the patients; however, the HP group required less ventilation time than the control group. CONCLUSIONS: The hemoperfusion cartridge seems promising in limiting the inflammatory reactions during CPB, with noteworthy potential for application in cardiac surgery.
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Procedimentos Cirúrgicos Cardíacos , Hemoperfusão , Humanos , Ponte Cardiopulmonar , Estudos Retrospectivos , Citocinas , Interleucina-6 , Valvas CardíacasRESUMO
Sedoheptulose-1,7-bisphosphatase (SBPase, EC 3.1.3.37) is a key enzyme in the plant Calvin cycle and one of the main rate-limiting enzymes in the plant photosynthesis pathway. Many studies have demonstrated that the SBPase gene plays an important role in plant photosynthetic efficiency, yield, and stress responses; however, few studies have been conducted on the function and expression of the GhSBPase gene in upland cotton. In this study, our results showed that the coding sequence (CDS) of GhSBPase gene was 1182 bp, encoding a protein with 393 amino acids. The GhSBPase protein had adenosine monophosphate (AMP) binding site and a FIG (FBPase/IMPase/glpX) domain, and had six Cys residues and a CGGT(A/Q)C motif that were involved in redox regulation in plants. Evolutionarily, the GhSBPase protein clustered into the dicotyledon subgroup and was most closely related to the tomato SlSBPase protein. Western-blot analysis further indicated that the GhSBPase gene was indeed the gene encoding the SBPase protein in upland cotton. The GhSBPase protein was localized in chloroplast, which was consistent with its function as a key enzyme in photosynthesis. The GhSBPase gene was specifically highly expressed in leaves, and its expression level was significantly lower in a yellow-green leaf mutant than in the wild type. Moreover, the GhSBPase expression was in response to drought, salt, high- and low-temperature stress, and exhibits different expression patterns. The GhSBPase promoter had the cis-acting elements in response to abiotic stress, phytohormone, and light. In addition, the GhSBPase expression was positively correlated with the chlorophyll fluorescence parameters, suggesting that changes in the expression of the GhSBPase had potential applicability in breeding for enhanced cotton photosynthetic efficiency. These results will help to understand the function of the GhSBPase gene in photosynthesis and the adaptability of plants to external stress and provide important gene information for the high-yield breeding of crops in the future.
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Gossypium , Melhoramento Vegetal , Gossypium/genética , Gossypium/metabolismo , Fotossíntese/genética , Monoéster Fosfórico Hidrolases/genética , Monoéster Fosfórico Hidrolases/metabolismo , Regulação da Expressão Gênica de PlantasRESUMO
Consumer-directed care (CDC) programs for older people aim to optimize health outcomes by offering clients control and flexibility regarding service arrangements. However, policy design features may differ due to heterogenous sociostructural systems. By operationalizing a framework with three dimensions of CDC, i.e. control and direct services, variety of service options, and information and support, we analyzed how countries vary in their policy designs to achieve consumer direction. Using an expert survey (n = 20) and cross-national document analysis, we analyzed 12 CDC programs from seven selected countries: the United States, the United Kingdom, Germany, the Netherlands, China, Australia, and Spain. Among the three dimensions, CDC programs placed more emphasis on and displayed more homogenous performance of policy designs that achieve consumer direction in the dimension of control and direct services, while less emphasis was placed on and more heterogenous performance displayed in the dimensions of variety of service options and information and support. We offer a systematically operationalized framework to investigate CDC policy designs. Findings advance our understanding of CDC policy features from a cross-national perspective. Policymakers could incorporate these findings to empower older people in their respective societies.
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Transparent glass with metal mesh is considered a promising strategy for high performance transparent glass heaters (TGHs). However, the realization of simple, low-cost manufacture of high performance TGHs still faces great challenges. Here, a technique for the fabrication of high performance TGHs is proposed using liquid sacrificial substrate electric-field-driven (LS-EFD) microscale 3D printing of thick film silver paste. The liquid sacrificial substrate not only significantly improves the aspect ratio (AR) of silver mesh, but also plays a positive role in printing stability. The fabricated TGHs with a line width of 35 µm, thickness of 12.3 µm, and pitch of 1000 µm exhibit a desirable optoelectronic performance with sheet resistance (Rs ) of 0.195 Ω sq-1 and transmittance (T) of 88.97%. A successful deicing test showcases the feasibility and practicality of the manufactured TGHs. Moreover, an interface evaporator is developed for the coordination of photothermal and electrothermal systems based on the high performance TGHs. The vapor generation rate of the device reaches 10.69 kg m-2 h-1 with a voltage of 2 V. The proposed technique is a promising strategy for the cost-effective and simple fabrication of high performance TGHs.
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China is one of the countries with high biodiversity on the globe, but suffers extreme biodiversity loss due to the increasingly interconnected economy. Understanding the nation-level public awareness of biodiversity under economic trades is crucial for implementing sustainable production and consumption of Sustainable Development Goals (SDGs). This study is the first to assess the public awareness of biodiversity loss associated with China's interprovincial trades by utilizing social media data and the multiregion input-output (MRIO) table. Results show that China's interprovincial trades cause heavy threats not only to local species but to distant species. Approximately 60% of provinces displace over half of their consumption-based biodiversity threats to other provinces. Nevertheless, individuals do not clearly realize their responsibility for the distant biodiversity they consumed, with a large mismatch both in popularity (Gini index = 0.51, Robin index = 39.57) and donation (Gini index = 0.69, Robin index = 54.58). To alleviate this phenomenon, our analysis suggests that the expansion of national-level nature reserves may be effectively beneficial to public biodiversity awareness, showing significantly positive partial correlation coefficients with individuals' popularity and donations. These insights provided by this study offer targeted information for conservation and call for synergistic collaboration between the civil society, especially consumers, and governments to turn the tide of biodiversity loss.
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Biodiversidade , Comércio , China , Humanos , Opinião Pública , Desenvolvimento SustentávelRESUMO
OBJECTIVE: Tranexamic acid (TXA) plays a significant role in the treatment of traumatic diseases. However, its effectiveness in patients with traumatic brain injury (TBI) seems to be contradictory, according to the recent publication of several meta-analyses. We aimed to determine the efficacy of TXA treatment at different times and doses for TBI treatment. METHODS: PubMed, MEDLINE, EMBASE, Cochrane Library, and Google Scholar were searched for randomized controlled trials that compared TXA and a placebo in adults and adolescents (≥ 15 years of age) with TBI up to January 31, 2022. Two authors independently abstracted the data and assessed the quality of evidence. RESULTS: Of the identified 673 studies, 13 involving 18,675 patients met our inclusion criteria. TXA had no effect on mortality (risk ratio (RR) 0.99; 95% confidence interval (CI) 0.92-1.06), adverse events (RR 0.93, 95% Cl 0.76-1.14), severe TBI (Glasgow Coma Scale score from 3 to 8) (RR 0.99, 95% Cl 0.94-1.05), unfavorable Glasgow Outcome Scale (GOS < 4) (RR 0.96, 95% Cl 0.82-1.11), neurosurgical intervention (RR 1.11, 95% Cl 0.89-1.38), or rebleeding (RR 0.97, 95% Cl 0.82-1.16). TXA might reduce the mean hemorrhage volume on subsequent imaging (standardized mean difference, -0.35; 95% CI [-0.62, -0.08]). CONCLUSION: TXA at different times and doses was associated with reduced mean bleeding but not with mortality, adverse events, neurosurgical intervention, and rebleeding. More research data is needed on different detection indexes and levels of TXA in patients with TBI, as compared to those not receiving TXA; although the prognostic outcome for all harm outcomes was not affected, the potential for harm was not ruled out. TRIAL REGISTRATION: The review protocol was registered in the PROSPERO International Prospective Register of Systematic Reviews (CRD42022300484).
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Dye-sensitized solar cells represent promising alternative photovoltaic (PV) technologies with the advantages of low material cost, ease of production, and high performance for indoor applications. Solid-state DSCs (ssDSCs) have been developed to greatly diminish the problems of electrolyte leakage and electrode corrosion. However, the power conversion efficiency of ssDSCs generally is much lower than traditional liquid DSCs, resulting in low conductivity and poor pore infiltration of solid HTMs in mesoporous structures. To overcome these problems, in situ photoelectrochemical polymerization (PEP) approach is developed to synthesize polymer HTMs in the porous electrodes, enabling enhancement of pore infiltration fraction and conductivity. The PEP method offers great opportunities for engineering the HTM interfaces, tuning the charge dynamics, and improving the PV performance of ssDSCs. Here the authors aim to present a coherent review of the recent development of material engineering and interfacial optimization for ssDSCs. The recent advances in the PEP are also summarized, with special emphasis on how the influencing factors control the PEP kinetics, the polymer properties as well as the device performance. This review provides a deep understanding of the mechanism of photopolymerization across different conditions, which serves as a guidebook for further optimization of the PEP process for ssDSCs.
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Energia Solar , Corantes/química , Eletrodos , Polimerização , Luz SolarRESUMO
CIPK (calcineurin B-like-interacting protein kinase) is a kind of serine/threonine protein kinase widely existing in plants, and it plays an important role in plant growth and development and stress response. To better understand the biological functions of the GhCIPK23 gene in upland cotton, the coding sequence (CDS) of the GhCIPK23 gene was cloned in upland cotton, and its protein sequence, evolutionary relationship, subcellular localization, expression pattern and cis-acting elements in the promoter region were analyzed. Our results showed that the full-length CDS of GhCIPK23 was 1368 bp, encoding a protein with 455 amino acids. The molecular weight and isoelectric point of this protein were 50.83 KDa and 8.94, respectively. The GhCIPK23 protein contained a conserved N-terminal protein kinase domain and C-terminal regulatory domain of the CIPK gene family member. Phylogenetic tree analysis demonstrated that GhCIPK23 had a close relationship with AtCIPK23, followed by OsCIPK23, and belonged to Group A with AtCIPK23 and OsCIPK23. The subcellular localization experiment indicated that GhCIPK23 was located in the plasma membrane. Tissue expression analysis showed that GhCIPK23 had the highest expression in petals, followed by sepals, and the lowest in fibers. Stress expression analysis showed that the expression of the GhCIPK23 gene was in response to drought, salt, low-temperature and exogenous abscisic acid (ABA) treatment, and had different expression patterns under different stress conditions. Further cis-acting elements analysis showed that the GhCIPK23 promoter region had cis-acting elements in response to abiotic stress, phytohormones and light. These results established a foundation for understanding the function of GhCIPK23 and breeding varieties with high-stress tolerance in cotton.
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Gossypium , Reguladores de Crescimento de Plantas , Ácido Abscísico , Aminoácidos/metabolismo , Calcineurina/metabolismo , Regulação da Expressão Gênica de Plantas , Gossypium/fisiologia , Filogenia , Melhoramento Vegetal , Proteínas de Plantas/genética , Proteínas de Plantas/metabolismo , Proteínas Quinases/genética , Proteínas Quinases/metabolismo , Serina/metabolismo , Estresse Fisiológico/genética , Treonina/metabolismoRESUMO
We fabricated mesoporous perovskite nanocrystal for the first time, and investigated its optical properties and application in light-emitting diodes (LEDs). The transformation of mesoporous structure can be ascribed to the decomposition of nanocrystals under dilution condition, which results in the blueshift of luminescence. The mesoporous nanocrystals under proper dilution may achieve improved perovskite LEDs, with maximum luminance and current efficiency of 23370 cd m-2and 6.7 cd A-1, respectively. This work provide an avenue to the optical engineering of perovskite nanocrystals, and demonstrate that perovskite concentration is one of key factors for realizing efficient LEDs.
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Coronavirus disease 2019 (COVID-19) is a highly contagious respiratory disease that threatens global health. During the pandemic period of COVID-19, the task for prevention in the general ward of cardiovascular surgery is fairly arduous. The present study intends to summarize our experience with infection control, including ward setting, admission procedures, personnel management, health education, and so on, to provide references for clinical management.
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COVID-19/prevenção & controle , Procedimentos Cirúrgicos Cardíacos/normas , Doenças Cardiovasculares/epidemiologia , Guias como Assunto , Pandemias/prevenção & controle , Quartos de Pacientes/normas , Centros de Atenção Terciária , COVID-19/epidemiologia , Doenças Cardiovasculares/cirurgia , China/epidemiologia , Comorbidade , Humanos , Estudos Retrospectivos , SARS-CoV-2RESUMO
BACKGROUND: We aimed to explore the relationship between the neutrophil to lymphocyte ratio (NLR) and the early clinical outcomes in children with congenital heart disease (CHD) associated with pulmonary arterial hypertension (PAH) after cardiac surgery. METHODS: A retrospective observational study involving 190 children from January 2013 to August 2019 was conducted. Perioperative clinical and biochemical data were collected. RESULTS: We found that pre-operative NLR was significantly correlated with AST, STB, CR and UA (P < 0.05), while post-operative NLR was significantly correlated with ALT, AST, BUN (P < 0.05). Increased post-operative neutrophil count and NLR as well as decreased lymphocyte count could be observed after cardiac surgery (P < 0.05). Level of pre-operative NLR was significantly correlated with mechanical ventilation time, ICU stay time and total length of stay (P < 0.05), while level of post-operative NLR was only significantly correlated to the first two (P < 0.05). By using ROC curve analysis, relevant areas under the curve for predicting prolonged mechanical ventilation time beyond 24 h, 48 h and 72 h by NLR were statistically significant (P < 0.05). CONCLUSION: For patients with CHD-PAH, NLR was closely related to early post-operative complications and clinical outcomes, and could act as a novel marker to predict the occurrence of prolonged mechanical ventilation.
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Procedimentos Cirúrgicos Cardíacos/efeitos adversos , Procedimentos Cirúrgicos Cardíacos/métodos , Cardiopatias Congênitas/cirurgia , Linfócitos/patologia , Neutrófilos/patologia , Hipertensão Arterial Pulmonar/cirurgia , Biomarcadores/sangue , Criança , Feminino , Cardiopatias Congênitas/sangue , Cardiopatias Congênitas/complicações , Humanos , Contagem de Linfócitos , Masculino , Período Pré-Operatório , Prognóstico , Hipertensão Arterial Pulmonar/sangue , Hipertensão Arterial Pulmonar/complicações , Estudos Retrospectivos , Volume Sistólico , Função Ventricular EsquerdaRESUMO
BACKGROUND: Air pollution, especially PM2.5 (particulate matter with a diameter of below 2.5 µm), has been recognized as a key environmental factor that affects mental health, but few studies have focused on its influence on older adults, who are a vulnerable group. OBJECTIVE: This study focused on the influence of PM2.5 on health-related behaviors, such as physical activities and social contact, to assess their role as mediators of depression among older adults in China. METHODS: We used data (N = 24 623) from the CHARLS (China Health and Retirement Longitudinal Study) of 2011-2015. CES-D 10 (Center for Epidemiology Studies of Depression scale) was used to measure depression. Using multilevel linear models, we examined the relationships between the variables, with different times nested within the same individual and individuals nested within the cities. RESULTS: Before mediators were added, depression symptoms among older adults increased with annual concentration of PM2.5 (Coeff = 0.57, SE = 0.11). However, after the mediators were added, the coefficient of the annual concentration of PM2.5 decreased (Coeff = 0.37, SE = 0.10). While both physical activities (Sobel test Z score = 2.37, P value = .02) and social contact (Z score = 7.33, P value = .00) mediated the relationship between PM2.5 and depression, the mediating effects decreased with increasing PM2.5 . CONCLUSIONS: Exposure to PM2.5 , therefore, increases depressive symptoms in older Chinese adults by decreasing their physical activities and social contact. Also, the positive effects of physical activities and social contact on depression decreased with increasing PM2.5 concentrations.
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Poluição do Ar , Depressão , Idoso , Poluição do Ar/efeitos adversos , Poluição do Ar/análise , China/epidemiologia , Depressão/epidemiologia , Depressão/etiologia , Humanos , Estudos Longitudinais , Pessoa de Meia-Idade , Material Particulado/efeitos adversos , Material Particulado/análiseRESUMO
BACKGROUND: Multiple mechanisms have been proposed to explain how greenery in the vicinity of people's homes enhances their mental health and wellbeing. Mediation studies, however, focus on a limited number of mechanisms and rely on remotely sensed greenery measures, which do not accurately capture how neighborhood greenery is perceived on the ground. OBJECTIVE: To examine: 1) how streetscape and remote sensing-based greenery affect people's mental wellbeing; 2) whether and, if so, to what extent the associations are mediated by physical activity, stress, air quality and noise, and social cohesion; and 3) whether differences in the mediation across the streetscape greenery and NDVI exposure metrics occurred. METHODS: We used a population sample of 1029 adult residents of the metropolis of Guangzhou, China, from 2016. Mental wellbeing was quantified by the World Health Organization Well-Being Index (WHO-5). Two objective greenery measures were extracted at the neighborhood level: 1) streetscape greenery from street view data via a convolutional neural network, and 2) the normalized difference vegetation index (NDVI) from Landsat 8 remote sensing images. Single and multiple mediation analyses with multilevel regressions were conducted. RESULTS: Streetscape and NDVI greenery were weakly and positively, but not significantly, correlated. Our regression results revealed that streetscape greenery and NDVI were, individually and jointly, positively associated with mental wellbeing. Significant partial mediators for the streetscape greenery were physical activity, stress, air quality and noise, and social cohesion; together, they explained 62% of the association. For NDVI, only physical activity and social cohesion were significant partial mediators, accounting for 22% of the association. CONCLUSIONS: Mental health and wellbeing and both streetscape and satellite-derived greenery seem to be both directly correlated and indirectly mediated. Our findings signify that both greenery measures capture different aspects of natural environments and may contribute to people's wellbeing by means of different mechanisms.
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Saúde Mental/estatística & dados numéricos , Características de Residência , Adulto , Poluição do Ar , China , Estudos Transversais , Planejamento Ambiental , HumanosRESUMO
BACKGROUND: Neighbourhood environment characteristics have been found to be associated with residents' willingness to conduct physical activity (PA). Traditional methods to assess perceived neighbourhood environment characteristics are often subjective, costly, and time-consuming, and can be applied only on a small scale. Recent developments in deep learning algorithms and the recent availability of street view images enable researchers to assess multiple aspects of neighbourhood environment perceptions more efficiently on a large scale. This study aims to examine the relationship between each of six neighbourhood environment perceptual indicators-namely, wealthy, safe, lively, depressing, boring and beautiful-and residents' time spent on PA in Guangzhou, China. METHODS: A human-machine adversarial scoring system was developed to predict perceptions of neighbourhood environments based on Tencent Street View imagery and deep learning techniques. Image segmentation was conducted using a fully convolutional neural network (FCN-8s) and annotated ADE20k data. A human-machine adversarial scoring system was constructed based on a random forest model and image ratings by 30 volunteers. Multilevel linear regressions were used to examine the association between each of the six indicators and time spent on PA among 808 residents living in 35 neighbourhoods. RESULTS: Total PA time was positively associated with the scores for "safe" [Coef. = 1.495, SE = 0.558], "lively" [1.635, 0.789] and "beautiful" [1.009, 0.404]. It was negatively associated with the scores for "depressing" [- 1.232, 0.588] and "boring" [- 1.227, 0.603]. No significant linkage was found between total PA time and the "wealthy" score. PA was further categorised into three intensity levels. More neighbourhood perceptual indicators were associated with higher intensity PA. The scores for "safe" and "depressing" were significantly related to all three intensity levels of PA. CONCLUSIONS: People living in perceived safe, lively and beautiful neighbourhoods were more likely to engage in PA, and people living in perceived boring and depressing neighbourhoods were less likely to engage in PA. Additionally, the relationship between neighbourhood perception and PA varies across different PA intensity levels. A combination of Tencent Street View imagery and deep learning techniques provides an accurate tool to automatically assess neighbourhood environment exposure for Chinese large cities.