Manipulating solid-state spin concentration through charge transport.

Solid-state defects are attractive platforms for quantum sensing and simulation, e.g., in exploring many-body physics and quantum hydrodynamics. However, many interesting properties can be revealed only upon changes in the density of defects, which instead is usually fixed in material systems. Increasing the interaction strength by creating denser defect ensembles also brings more decoherence. Ideally one would like to control the spin concentration at will while keeping fixed decoherence effects. Here, we show that by exploiting charge transport, we can take some steps in this direction, while at the same time characterizing charge transport and its capture by defects. By exploiting the cycling process of ionization and recombination of NV centers in diamond, we pump electrons from the valence band to the conduction band. These charges are then transported to modulate the spin concentration by changing the charge state of material defects. By developing a wide-field imaging setup integrated with a fast single photon detector array, we achieve a direct and efficient characterization of the charge redistribution process by measuring the complete spectrum of the spin bath with micrometer-scale spatial resolution. We demonstrate a two-fold concentration increase of the dominant spin defects while keeping the T2 of the NV center relatively unchanged, which also provides a potential experimental demonstration of the suppression of spin flip-flops via hyperfine interactions. Our work paves the way to studying many-body dynamics with temporally and spatially tunable interaction strengths in hybrid charge-spin systems.

Predictive factors of medium-giant coronary artery aneurysms in Kawasaki disease.

BACKGROUND: We aimed to examine predictive measures for medium and giant coronary artery aneurysms (CAA) in Kawasaki disease (KD) patients. METHODS: Patients who were diagnosed with KD from 2015 to 2021 were retrospectively reviewed. The clinical and laboratory data were compared between medium-giant group and non-medium-giant group. RESULTS: A total of 1331 KD patients were investigated, of whom 63 patients (4.7%) developed medium-giant CAA including 27 patients (2%) with giant CAA. Sex, age, fever duration, intravenous immunoglobulin (IVIG) resistance, platelet count, and albumin level independently predicted medium or giant CAA by multivariate logistic regression analysis. Male, age, duration of fever, IVIG resistance, platelet count, hemoglobin, and erythrocyte sedimentation rate were independent predictors for giant CAA. The two new scoring systems using these factors in identifying patients with medium-giant CAA and giant CAA had respectively sensitivities of 86.89% and 92.59%, and specificities of 81.65% and 87.93%. Validation in 2021 dataset (193 KD patients) showed comparable sensitivity and specificity to development dataset. CONCLUSIONS: Male, age, fever duration, IVIG resistance, platelet count, albumin, hemoglobin, and erythrocyte sedimentation rate might be significant predictors of medium and giant CAA. The sensitivity and specificity in our risk prediction model were higher than in previous research. IMPACT: This is the first study to search for risk factors and establish a prediction model for the development of medium-giant CAA in the Chinese population using z-scores and absolute inner diameter values based on large sample sizes. The sensitivity and specificity in our model were higher than in previous studies. Our research could help clinicians better predict medium-giant CAA and choose more appropriate treatment.

Assessment of aortic dilatation in Chinese children and adolescents with Turner syndrome: a single center experience.

BACKGROUND: Patients with Turner syndrome (TS) face an increased risk of developing aortic dilatation (AD), but diagnosing AD in children presents greater complexity compared to adults. This study aimed to investigate the application of various assessment indicators of AD in Chinese children and adolescents with TS. METHODS: This study included TS patients admitted to Shenzhen Children's Hospital from 2017 to 2022. Cardiovascular lesions were diagnosed by experienced radiologists. Patients without structural heart disease were divided into different body surface area groups, then the Chinese TS population Z-score (CHTSZ-score) of the ascending aorta was calculated and compared with other indicators such as aortic size index (ASI), ratio of the ascending to descending aortic diameter (A/D ratio), and TSZ-score (Quezada's method). RESULTS: A total of 115 TS patients were included, with an average age of 10.0 ± 3.7 years. The incidences of the three most serious cardiovascular complications were 9.6% (AD), 10.4% (coarctation of the aorta, CoA), and 7.0% (bicuspid aortic valve, BAV), respectively. The proportion of developing AD in TS patients aged ≥ 10 years was higher than that in those < 10 years old (16.6% vs. 1.8%, P = 0.009), and the proportion of patients with CoA or BAV who additionally exhibited AD was higher than those without these conditions (31.6% vs. 5.2%, P < 0.001). The ASI, A/D ratio, TSZ-score, and CHTSZ-score of the 11 patients with AD were 2.27 ± 0.40 cm/m2, 1.90 ± 0.37, 1.28 ± 1.08, and 3.07 ± 2.20, respectively. Among the AD patients, only 3 cases had a TSZ-score ≥ 2, and 2 cases had a TSZ-score ≥ 1. However, based on the assessment using the CHTSZ-score, 6 patients scored ≥ 2, and 5 patients scored ≥ 1. In contrast, the TSZ-score generally underestimated the aortic Z-scores in Chinese children with TS compared to the CHTSZ-score. CONCLUSIONS: The applicability of ASI and A/D ratio to children with TS is questionable, and racial differences can affect the assessment of TSZ-score in the Chinese population. Therefore, establishing the CHTSZ-score specifically tailored for Chinese children and adolescents is of paramount importance.

25-hydroxycholesterol inhibits human papillomavirus infection in cervical epithelial cells by perturbing cytoskeletal remodeling.

Persistent high-risk human papilloma virus (HR-HPV) infection is the main risk factor for cervical cancer, threatening women's health. Despite growing prophylactic vaccination, annual cervical cancer cases are still increasing and show a trend of younger onset age. However, therapeutic approaches towards HPV infection are still limited. 25-hydrocholesterol (25HC) has a wide-spectrum inhibitory effect on a variety of viruses. To explore efficient interventions to restrict HPV infection at an early time, we applied different pseudoviruses (PsV) to evaluate anti-HPV efficacy of 25HC. We tested PsV inhibition by 25HC in cervical epithelial-derived HeLa and C-33A cells, using high-risk (HPV16, HPV18, HPV59), possibly carcinogenic (HPV73), and low-risk (HPV6) HPV PsVs. Then we established murine genital HPV PsV infection models and applied IVIS to evaluate anti-HPV efficacy of 25HC in vivo. Next, with the help of confocal imaging, we targeted 25HC activity at filopodia upon HPV exposure. After that, we used RNA-seq and Western blot analysis to investigate (1) how 25HC disturbs actin cytoskeleton remodeling during HPV infection and (2) how prenylation regulates the cytoskeletal remodeling signaling pathway. Our findings suggest that 25HC perturbs F-actin rearrangement by reducing small GTPase prenylation. In this way, the phenomenon of HPV virion surfing was restricted, leading to failed infection.

Communication-Efficient Quantum Algorithm for Distributed Machine Learning.

The growing demands of remote detection and an increasing amount of training data make distributed machine learning under communication constraints a critical issue. This work provides a communication-efficient quantum algorithm that tackles two traditional machine learning problems, the least-square fitting and softmax regression problems, in the scenario where the dataset is distributed across two parties. Our quantum algorithm finds the model parameters with a communication complexity of O(log_{2}(N)/ε), where N is the number of data points and ε is the bound on parameter errors. Compared to classical and other quantum methods that achieve the same goal, our methods provide a communication advantage in the scaling with data volume. The core of our methods, the quantum bipartite correlator algorithm that estimates the correlation or the Hamming distance of two bit strings distributed across two parties, may be further applied to other information processing tasks.

Genome-Wide Characterization and Comparative Genomic Analysis of the Serpin Gene Family in Microsporidian Nosema bombycis.

Microsporidia are ubiquitous in the environment, infecting almost all invertebrates, vertebrates, and some protists. The microsporidian Nosema bombycis causes silkworms pébrine disease and leads to huge economic losses. Parasite secreted proteins play vital roles in pathogen-host interactions. Serine protease inhibitors (serpins), belonging to the largest and most broadly distributed protease inhibitor superfamily, are also found in Microsporidia. In this study, we characterized 19 serpins (NbSPNs) in N. bombycis; eight of them were predicted with signal peptides. All NbSPN proteins contain a typical conserved serpin (PF00079) domain. The comparative genomic analysis revealed that microsporidia serpins were only found in the genus Nosema. In addition to N. bombycis, a total of 34 serpins were identified in another six species of Nosema including N. antheraeae (11), N. granulosis (8), Nosema sp. YNPr (3), Nosema sp. PM-1 (3), N. apis (4), and N. ceranae (5). Serpin gene duplications in tandem obviously occurred in Nosema antheranae. Notably, the NbSPNs were phylogenetically clustered with serpins from the Chordopoxvirinae, the subfamily of Poxvirus. All 19 NbSPN transcripts were detected in the infected midgut and fat body, while 19 NbSPN genes except for NbSPN12 were found in the transcriptome of the infected silkworm embryonic cell line BmE-SWU1. Our work paves the way for further study of serpin function in microsporidia.

Initial Clinical Experience with the Biodegradable AbsnowTM Device for Percutaneous Closure of Atrial Septal Defect: A 3-Year Follow-Up.

OBJECTIVE: We reported the 3-year follow-up results of initial clinical experience with the AbsnowTM device, a novel biodegradable occluder for percutaneous closure of atrial septal defect (ASD). BACKGROUND: The AbsnowTM device is a total biodegradable septal occluder with double-disc poly-L-lactic acid (PLLA) framework and PLLA membranes intergraded into the device to ensure its biodegradability, clinical safety, and efficacy. METHODS: Five pediatric patients were enrolled from May to June 2018 in our institution and were followed up for 3 years. A clinical evaluation and transthoracic echocardiography were performed at 24 hr, 1 month, 3 months, 6 months, 12 months, and yearly after implantation. Primary endpoints were a composite clinical success, comprising of clinical closure success and safety at the 36-month follow-up evaluation. Secondary endpoints included technical success, procedure success, closure success, and safety at each of the follow-up visits. RESULTS: The median subject age was 3.6 years (range 3.1-6.5 years). The mean ASD diameter was (13.7 ± 2.9) mm. The median device size was 20 mm (range 14 to 24 mm). Technical and procedure success was achieved in 100% (5/5) of the patients. At 2-year follow-up, 3 of the 5 patients developed new-onset residual shunts and 2 of them reached a moderate degree. At 3-year follow-up, the residual shunt size increased over time in all the 3 patients, and 1 of them had right ventricular enlargement. All of the 5 patients were free from serious adverse events during the 3-year follow-up, with no device embolization, thromboembolization, or reintervention to the target defect. CONCLUSION: This 3-year follow-up result of initial experience with the biodegradable AbsnowTM device has demonstrated acceptable safety with no procedural complications. Notably, the high rate of residual shunt significantly affected its efficacy. The long-term safety and efficacy of the device should be further evaluated in a large cohort of patients in future studies.

Analysis of single-cell microbial mass spectra profiles from single-particle aerosol mass spectrometry.

RATIONALE: Single-particle aerosol mass spectrometry is a practical method for studying microbial aerosols. However, the related mass spectral characteristics of single-cell microorganisms have not yet been studied systematically; hence, further investigations are necessary. METHODS: Different microbial cells were grown and directly aerosolized in the laboratory. These aerosols were then drawn into a single-particle mass spectrometer platform, and single-cell mass spectra profiles were obtained in real-time. The biological characteristics, ion variation trends, and microbial types were analyzed with either laser pulse energy or laser fluence. RESULTS: The single-particle mass spectra contained prominent peaks that could be attributed to the presence of biological matter, such as organic phosphate and nitrogen, amino acids, and spore-associated calcium complexes. Limited types of average mass spectral patterns were present, and a significant correlation was found between the ion intensity trend (presence and absence of peaks) and laser ionization energy (expressed by the total positive ion intensity). Although a single spectral data point does not contain all the peaks of the average spectrum, it covers most of the characteristic peaks and could be identified using a machine learning algorithm. After the analysis of single-particle mass spectra, we found that using multi-group features (e.g., peak intensity ratio of m/z +47 and +41, peak intensity ratio of 59 N(CH3 )3 + and 74 N(CH3 )4 + , and 12 peak variables) led to an identification accuracy of approximately 92.4% with the random forest algorithm. CONCLUSIONS: The results indicate that single-cell mass spectral profiles can be used to distinguish microbial aerosols and further illustrate their origin in a laboratory setting.

Initial experiences with a novel biodegradable device for percutaneous closure of atrial septal defects: From preclinical study to first-in-human experience.

OBJECTIVE: To evaluate the feasibility, safety, and effectiveness of a novel, absorbable atrial septal defect (ASD) closure device made of poly-l-lactic acid (PLLA) in a swine model of ASD and for the first time in humans. METHODS: A preclinical safety study was conducted using a swine model of ASD. In a clinical setting, five pediatric patients underwent ASD closure with the PLLA device with fluoroscopic and transthoracic echocardiography guidance. The procedural results and clinical outcomes at 1 day, 30 days, 3 months, and 6 months after closure were analyzed. RESULTS: The 24- and 36-month follow-up results of the preclinical study demonstrated that the PLLA device exhibited good endothelialization and degradability in the swine model. In the clinical study, successful device implantation was achieved in all five patients (median age, 3.6 years; range, 3.1-6.5 years). The mean defect size was (13.6 ± 2.7) mm. Follow-up at 30 days, 3 months, and 6 months was completed in all five cases. The complete defect closure rates with no residual shunt at 30 days, 3 months, and 6 months follow-up were 60% (3/5), 80% (4/5), and 80% (4/5), respectively. No device dislodgement, significant aortic valve or mitral valve regurgitation, new onset cardiac arrhythmia, or other adverse events were reported. CONCLUSION: The study results demonstrated that it is feasible to implant the PLLA device for closure of small to medium sized ASDs without significant residual shunts or severe adverse events in humans. The PLLA device exhibited good endothelialization and degradability in the swine model at 24 and 36 months. Further studies to evaluate long-term safety and effectiveness with the device in a large cohort of patients are warranted.

Study of biodegradable occluder of atrial septal defect in a porcine model.

OBJECTIVE: To evaluate the safety and feasibility of a modified poly(l-lactic acid) (PLLA) atrial septal defect (ASD) occluder. METHODS: Forty-five piglets were divided into two groups: an experimental group (n = 27) and a control group (n = 18). The experimental group underwent percutaneous implantation of a modified PLLA ASD device while the control group underwent percutaneous implantation of a widely used metal ASD device. X-ray imaging, transthoracic echocardiography (TTE), electrocardiogram (ECG), histopathology and electron microscopic examination were performed at 7 days, 1, 3, 6, and 12 months after implantation. RESULTS: Twenty-seven experimental piglets and 18 control piglets were all successfully implanted with modified biodegradable and metal ASD devices, respectively. While both devices exhibited very good occluding effects, the modified PLLA ASD devices were completely endothelialized at 3 months after implantation, and the endothelialization appeared to be more complete compared to the control group. Degradation of the PLLA devices was noted at 12 months follow-up with no loss of integrity at the atrial septum. CONCLUSION: This animal model with implanting of the occluders was effective and not associated with complications. The modified PLLA ASD devices are more controllable and practical than our previous devices. The implanted devices demonstrated good endothelialization and degradability in short and moderate term follow-up. Long-term studies are now underway to further evaluate the biodegradability of this novel device.

Artemisinin derivatives inhibit epithelial ovarian cancer cells via autophagy-mediated cell cycle arrest.

Epithelial ovarian cancer (EOC) is the most fatal gynecologic malignancy due to its late diagnosis and lack of curative therapy. The antimalaria compound artemisinin and its derivatives, such as artesunate (ART) and dihydroartemisinin (DHA), have proven to be potent anticancer drugs and act through various anticancer mechanisms. To identify novel targets of artemisinin derivatives in EOC cells, we investigated the effects of ART and DHA on SKOV3 and primary EOC cell growth via CCK-8 assay. Both ART and DHA inhibited EOC cell growth. A cell cycle distribution analysis showed that ART and DHA caused G2/M cell cycle arrest. Moreover, ART and DHA induced autophagy in EOC cells, whereas autophagy inhibitors reversed the cell growth inhibition and cell cycle arrest induced by ART and DHA. Western blot analysis showed that ART and DHA also suppressed the cell cycle-related NF-κB-signaling pathway in EOC cells. These data suggest that artemisinin derivatives induce autophagy, block the cell cycle, and inhibit cell growth in EOC cells. Our research provides new targets for artemisinin derivatives for EOC treatment.

How does air pollution affect household consumption? Evidence from China.

Increasing air pollution not only affects the population's health but also changes its consumption structures and patterns. Using China Family Panel Studies, this study investigates the relationship between air pollution and household consumption. The findings reveal that household consumption is considerably affected by air pollution: One standard deviation rise of PM2.5 concentration will decrease the household consumption by 8.7%. Moreover, this effect is irreversible in the short term. What is more, air pollution has significantly changed consumption structure and patterns. Heterogeneous analysis indicates that the influence of air pollution on consumption generates the so-called Matthew Effect, wherein medium and low-income and rural households are exposed to a greater negative effect. Mechanism tests indicate that air pollution may reduce household consumption through three channels: increase negative emotions, decrease outdoor activities, and depress future expectations. The conclusions drawn in this paper enrich our understanding of the economic impact caused by air pollution and bring important significance to the government in promoting the coordination and sustainable development of the environment and economy.

Classification of coma/brain-death EEG dataset based on one-dimensional convolutional neural network.

Electroencephalography (EEG) evaluation is an important step in the clinical diagnosis of brain death during the standard clinical procedure. The processing of the brain-death EEG signals acquisition always carried out in the Intensive Care Unit (ICU). The electromagnetic environmental noise and prescribed sedative may erroneously suggest cerebral electrical activity, thus effecting the presentation of EEG signals. In order to accurately and efficiently assist physicians in making correct judgments, this paper presents a band-pass filter and threshold rejection-based EEG signal pre-processing method and an EEG-based coma/brain-death classification system associated with One Dimensional Convolutional Neural Network (1D-CNN) model to classify informative brain activity features from real-world recorded clinical EEG data. The experimental result shows that our method is well performed in classify the coma patients and brain-death patients with the classification accuracy of 99.71%, F1-score of 99.71% and recall score of 99.51%, which means the proposed model is well performed in the coma/brain-death EEG signals classification task. This paper provides a more straightforward and effective method for pre-processing and classifying EEG signals from coma/brain-death patients, and demonstrates the validity and reliability of the method. Considering the specificity of the condition and the complexity of the EEG acquisition environment, it presents an effective method for pre-processing real-time EEG signals in clinical diagnoses and aiding the physicians in their diagnosis, with significant implications for the choice of signal pre-processing methods in the construction of practical brain-death identification systems.

Ectopic Kidney with an Ectopic Ureter Masquerading Adnexal Mass: A Case Report and Literature Review.

An ectopic kidney is a rare congenital defect that is often asymptomatic, but can be incidentally discovered during imaging examinations. Moreover, the morphological characteristics and laboratory features of ectopic kidneys are nonspecific, which may lead to misleading diagnostic approaches, particularly when there are additional factors, such as infection, obstruction, or other anomalies. A 43-year-old female presented with a mass in the left adnexal area. She had septate uterus and a history of congenital urinary incontinence. Ultrasound and MRI findings indicated that the mass was a cyst originating from the ovary. However, it is possible that the lump was derived from the urinary system. To confirm the diagnosis, laparoscopy was performed, followed by pathological examination, which confirmed the presence of an ectopic kidney with a single-system ectopic ureter. The patient underwent nephroureterectomy, and her symptoms successfully resolved, leading to a favorable prognosis. This case report highlights a rare case involving an ectopic kidney with a vaginal ectopic ureter that initially presented as an adnexal cyst and caused urinary dribbling. This case emphasizes the importance of early recognition and accurate diagnosis in women with similar symptoms.

Reinforcement Learning-Guided Long-Timescale Simulation of Hydrogen Transport in Metals.

Diffusion in alloys is an important class of atomic processes. However, atomistic simulations of diffusion in chemically complex solids are confronted with the timescale problem: the accessible simulation time is usually far shorter than that of experimental interest. In this work, long-timescale simulation methods are developed using reinforcement learning (RL) that extends simulation capability to match the duration of experimental interest. Two special limits, RL transition kinetics simulator (TKS) and RL low-energy states sampler (LSS), are implemented and explained in detail, while the meaning of general RL are also discussed. As a testbed, hydrogen diffusivity is computed using RL TKS in pure metals and a medium entropy alloy, CrCoNi, and compared with experiments. The algorithm can produce counter-intuitive hydrogen-vacancy cooperative motion. We also demonstrate that RL LSS can accelerate the sampling of low-energy configurations compared to the Metropolis-Hastings algorithm, using hydrogen migration to copper (111) surface as an example.

The circulating level of endothelial progenitor cells after transcatheter closure of congenital heart disease in children.

Data have shown that circulating endothelial progenitor cells (EPCs) closely correlate with the vascular endothelial layer state. The present study was designed to describe the evolution of EPCs in children before and 24 h after transcatheter closure surgery for occluding congenital heart disease. Three groups of patients were studied: the transcatheter closure of atrial septal defect (ASD) group (group 1), the transcatheter closure of patent ductus arteriosus (PDA) group (group 2), and the transcatheter closure of ventricular septal defect (VSD) group (group 3). The circulating EPC level was detected using flow cytometry measuring CD34 and kinase insert receptor double-positive mononuclear cells. The concentration of vascular endothelial growth factor (VEGF) was assessed by enzyme-linked immunosorbent assay. The fluoroscopy time was correctly recorded during the surgery. All of the data were collected before and 24 h after surgery. EPC level and VEGF concentration did not change significantly before and at 24 h after surgery in groups 1 and 2. In group 3, the level of circulating EPCs and VEGF concentration increased significantly 24 h after surgery. The fluoroscopy time in group 3 was significantly longer than in groups 1 and 2. The increased volume of EPCs and VEGF were positively correlated in group 3. Our results showed that transcatheter closure of PDA and ASD in children does not lead to increased circulating level of EPCs. Transcatheter closure of VSD may result in vascular endothelium injury as indicated by increased circulating EPC level.

Application of Geographic Information Systems to Identify the Oversummering Regions of Blumeria graminis f. sp. tritici in China.

Blumeria graminis f. sp. tritici, the pathogen that causes wheat powdery mildew, can oversummer as mycelia or conidia on leaves of volunteer wheat plants in cool mountainous areas in China. In this study, the regions in China where B. graminis f. sp. tritici can oversummer were identified on the basis of the probability that temperature remains below a critical temperature that is lethal to B. graminis f. sp. tritici. Two methods, one describing the relationship between the average temperature (20 to 26°C) in a given continuous 10-day period and wheat powdery mildew severity, the other describing the relationship between the average temperature (26 to 33°C) and the number of lethal days on powdery mildew development, were used to calculate the oversummering probability using weather data for 743 sites across China. Spatial interpolation based on the ordinary kriging method was conducted for the regions without observation. Oversummering probability values were similar for most locations estimated between the two methods. The B. graminis f. sp. tritici oversummering regions in China were identified to be in mountainous or high-elevation areas, including most regions of Yunnan, west and central areas of Guizhou, south and northwest Sichuan, south and east Gansu, south Ningxia, north and west Shaanxi, central-north Shanxi, west Henan and Hubei, and some regions in Qinghai, Tibet, and Xinjiang. When the oversummering sites from this study were compared with observed survey data for some of these sites, about 90% of sites where B. graminis f. sp. tritici oversummering was observed had been found suitable by both methods. The coincidence frequency and the area under the receiver operating characteristic curve for model 2 were higher, albeit only slightly, than those for model 1. Thus, both methods may be used to assist in disease management and further investigation on pathogen oversummering.

Net Dzyaloshinskii-Moriya interaction in defect-enriched ferromagnet.

The Dzyaloshinskii-Moriya interaction (DMI), which typically occurs in lattices without space inversion symmetry, can also be induced in a highly symmetric lattice by local symmetry breaking due to any lattice defect. We recently presented an experimental study of polarized small angle neutron scattering (SANS) on the nanocrystalline soft magnet Vitroperm (Fe73Si16B7Nb3Cu1), where the interface between the FeSi nanoparticles and the amorphous magnetic matrix serves as such a defect. The SANS cross sections exhibited the polarization-dependent asymmetric term originating from the DMI. One would naturally expect the defects characterized by a positive and a negative DMI constantDto be randomly distributed and this DMI-induced asymmetry to disappear. Thus, the observation of such an asymmetry indicates that there exists an extra symmetry breaking. In the present work we experimentally explore the possible causes by measuring the DMI-induced asymmetry in the SANS cross sections of the Vitroperm sample tilted in different directions with respect to the external magnetic field. Furthermore, we analyzed the scattered neutron beam using a spin filter based on polarized protons and confirm that the asymmetric DMI signal originates from the difference between the two spin-flip scattering cross-sections.

Research Paradigm of Network Approaches in Construction Safety and Occupational Health.

Construction safety accidents seriously threaten the lives and health of employees; however, the complexity of construction safety problems continues to increase. Network approaches have been widely applied to address accident mechanics. This study aims to review related studies on construction safety and occupational health (CSOH) and summarize the research paradigm of recent decades. We solicited 119 peer-reviewed journal articles and performed a bibliometric analysis as the foundation of the future directions, application bottlenecks, and research paradigm. (1) Based on the keyword cluster, future directions are divided into four layers: key directions, core themes, key problems, and important methods. (2) The network approaches are not independently applied in the CSOH research. It needs to rely on different theories or be combined with other methods and models. However, in terms of approach applications, there are still some common limitations that restrict its application and development. (3) The research paradigm of network analysis process can be divided into four stages: description, explanation, prediction, and control. When the same network method encounters different research objects, it focuses on different analysis processes and plays different roles.

Efficacy and safety of sacubitril/valsartan in the treatment of middle-aged and elderly patients with hypertension: a systematic review and meta-analysis of randomized controlled trials.

BACKGROUND: With the increase of hypertensive patients worldwide, the need for better antihypertensive drugs to achieve blood pressure standards and reduce complications is of great clinical significance. As an angiotensin receptor-neprilysin inhibitor, sacubitril/valsartan has been widely used in the treatment of heart failure, but its efficacy and safety in the treatment of middle-aged and elderly hypertensive patients are still controversial. Therefore, we performed a meta-analysis to compare the efficacy and safety of sacubitril/valsartan and other antihypertensive drugs in the treatment of middle-aged and elderly patients with hypertension. METHODS: The databases of PubMed, Embase, and Web of Science were systematically searched from their establishment to February 2022 to collect the randomized controlled trials (RCTs) of sacubitril/valsartan and other antihypertensive drugs in the treatment of middle-aged and elderly hypertensive patients. The Cochrane Collaboration's tool was used to assess risk of bias for included studies, and the meta-analysis was performed by using RevMan 5.3. RESULTS: In all, 7 studies which met the criteria were included, with a total sample size of 3,323 patients, including 1,899 patients treated with sacubitril/valsartan, and 1,424 patients treated with angiotensin II receptor blockers (ARBs). The meta-analysis showed that compared with other antihypertensive drugs, sacubitril/valsartan can significantly reduce mean reductions in sitting systolic blood pressure [mean difference (MD) =-4.70, 95% confidence interval (CI): -5.79 to -3.61, P<0.001], mean reductions in sitting diastolic blood pressure (MD =-2.29, 95% CI: -2.53 to -2.04, P<0.001), 24-hour mean reductions in ambulatory systolic blood pressure (MD =-3.36, 95% CI: -4.08 to -2.64, P<0.001), and 24-hour mean reductions in ambulatory diastolic blood pressure (MD =-1.49, 95% CI: -1.99 to -0.99, P<0.001), while there was no significant difference in the incidence of adverse events [odds ratio (OR) =1.14, 95% CI: 1.00 to 1.31, P=0.06], serious adverse events (OR =1.06, 95% CI: 0.64 to 1.76, P=0.81), and discontinuations due to adverse events (OR =0.86, 95% CI: 0.51 to 1.46, P=0.58). DISCUSSION: Compared with other antihypertensive drugs, sacubitril/valsartan may be more effective in lowering blood pressure, and its safety may be comparable to that of ARBs. However, these results have to be confirmed by future RCTs with larger sample sizes and higher quality, and the long-term benefits of sacubitril/valsartan require further observation.