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The ligament, which connects bones at the joints, has both high water content and excellent mechanical properties in living organisms. However, it is still challenging to fabricate fibrous materials that possess high water content and ligament-like mechanical characteristics simultaneously. Herein, the design and preparation of a ligament-mimicking multicomponent fiber is reported through stepwise assembly of polysaccharide, calcium, and dopamine. In simulated body fluid, the resulting fiber has a water content of 40 wt%, while demonstrating strength of ≈120 MPa, a Young's modulus of ≈3 GPa, and a toughness of ≈25 MJ m-3. Additionally, the multicomponent fiber exhibits excellent creep and fatigue resistance, as well as biocompatibility to support cell growth in vitro. These findings suggest that the fiber has potential for engineering high-performance artificial ligament.
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The prevalence of papillary thyroid cancer (PTC) has been rising in recent years. Despite its relatively low mortality, PTC frequently metastasizes to lymph nodes and often recurs, posing significant health and economic burdens. The role of iodine in the pathogenesis and advancement of thyroid cancer remains poorly understood. Circular RNAs (circRNAs) are recognized to function as competing endogenous RNAs (ceRNAs) that modulate gene expression and play a role in various cancer stages. Consequently, this research aimed to elucidate the mechanism by which circRNA influences the impact of iodine on PTC. Our research indicates that high iodine levels can exacerbate the malignancy of PTC via the circ_0004851/miR-296-3p/FGF11 axis. These insights into iodine's biological role in PTC and the association of circRNA with the disease could pave the way for novel biomarkers and potentially effective therapeutic strategies to mitigate PTC progression.
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Regulação Neoplásica da Expressão Gênica , Iodo , MicroRNAs , RNA Circular , Câncer Papilífero da Tireoide , MicroRNAs/genética , MicroRNAs/metabolismo , RNA Circular/genética , RNA Circular/metabolismo , Humanos , Câncer Papilífero da Tireoide/genética , Câncer Papilífero da Tireoide/patologia , Iodo/metabolismo , Linhagem Celular Tumoral , Neoplasias da Glândula Tireoide/genética , Neoplasias da Glândula Tireoide/patologia , Sequência de BasesRESUMO
Fear of childbirth not only brings negative psychological experiences to expectant fathers and affect their ability to prepare for parenthood but can even affect children's emotional and cognitive development. It is essential to identify men with a more severe fear of birth and its related risk factors for the better transition of fathers' role. The objective of this study was to investigate the prevalence of fear of childbirth among Chinese expectant fathers, identify its contributing factors and explore the association among fear of childbirth, resilience and dyadic coping. A cross-sectional survey was conducted in the obstetric department of two tertiary hospitals in Wuhan, China. The socio-demographic questionnaire, the father's version of the Wijma Delivery Expectancy/Experience Questionnaire version A (W-DEQ A), the Connor-Davidson Resilience Scale-10 (CD-RISC), and the Dyadic Coping Inventory (DCI) were used to explore the correlation of fear of childbirth, resilience and dyadic coping of participants. Ultimately, a total of 1176 expectant fathers were included in this study. The prevalence of fear of childbirth was 32.1%. Gestational weeks of pregnant women, monthly income, adverse birth experience, gravidity and parity of pregnant women were considered risk factors for the expectant fathers with fear of childbirth. Furthermore, there was a weak negative correlation between fear of childbirth and resilience and dyadic coping. In conclusion, the prevalence of fear of childbirth in expectant fathers in China was high. Adequate identification of factors influencing the fear of childbirth among expectant fathers is necessary to reduce the fear of childbirth and to develop appropriate interventions in preparing fathers for their new parenting role.
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The water produced during the oxidative esterification reaction occupies the active sites and reduces the activity of the catalyst. In order to reduce the influence of water on the reaction system, a hydrophobic catalyst was prepared for the one-step oxidative esterification of methylacrolein (MAL) and methanol. The catalyst was synthesized by loading the active component Au onto ZnO using the deposition-precipitation method, followed by constructing the silicon shell on Au/ZnO using tetraethoxysilane (TEOS) to introduce hydrophobic groups. Trimethylchlorosilane (TMCS) was used as a hydrophobic modification reagent to prepare hydrophobic catalysts, which exhibited a water droplet contact angle of 111.2°. At a temperature of 80 °C, the hydrophobic catalyst achieved a high MMA selectivity of over 95%. The samples were characterized using XRD, N2 adsorption, ICP, SEM, TEM, UV-vis, FT-IR, XPS, and water droplet contact angle measurements. Kinetic analysis revealed an activation energy of 22.44 kJ/mol for the hydrophobic catalyst.
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The rapid development of the battery industry has brought about a large amount of waste battery pollution. How to realize the high-value utilization of waste batteries is an urgent problem to be solved. Herein, cobalt and titanium compounds (LTCO) were firstly recovered from spent lithium-ion batteries (LIBs) using the carbon thermal reduction approach, and plasmonic attapulgite/Co(Ti)Ox (H-ATP/Co(Ti)Ox) nanocomposites were prepared by the microwave hydrothermal technique. H-ATP had a large specific surface area and enough active sites to capture CO2 molecules. The biochar not only reduced the spinel phase of waste LIBs into metal oxides including Co3O4 and TiO2 but also increased the separation and transmission of the carriers, thereby accelerating the adsorption and reduction of CO2. In addition, H-ATP/Co(Ti)Ox exhibited a localized surface plasmon resonance effect (LSPR) in the visible to near-infrared region and released high-energy hot electrons, enhancing the surface temperature of the catalyst and further improving the catalytic reduction of CO2 with a high CO yield of 14.7 µmol·g-1·h-1. The current work demonstrates the potential for CO2 reduction by taking advantage of natural mineral and spent batteries.
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Ulcerative colitis (UC) is a chronic idiopathic inflammatory bowel disease with a relapsing-remitting course. Although its etiology remains unknown, excessive oxidative stress in colon is a major intermediate factor that can promote the progression of UC. In the present study, we investigated the effect and the underlying mechanisms of 4-Octyl itaconate (OI) on dextran sulfate sodium (DSS)-induced UC in mice. Our work identified that OI alleviated the colitis by reducing the oxidative stress and the apoptosis in colon tissue, then increasing the tight junction proteins expression and in turn enhancing the intestinal barrier function, thereby creating less severe inflammatory responses. Moreover, our results demonstrated that OI reduced the Kelch-like ECH-associated protein 1 (KEAP1) expression and subsequent upregulated nuclear factor E2-related factor (NRF2) expression and its nuclear translocation which in turn induced the expression of glutathione S-transferase (GST) and NAD(P)H: quinone oxidoreductase 1 (NQO1). In addition, ML385, a NRF2 antagonist, can inhibit the protective effects of OI on UC, indicating that the role of OI in this colitis model could be dependent on the activation of KEAP1-NRF2 pathway. Notably, OI co-administration significantly enhanced the therapeutic effects of mesalazine or 1400W on UC. Collectively, itaconate may have a great potential for use in the treatment of IBD.
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Colite Ulcerativa , Sulfato de Dextrana , Proteína 1 Associada a ECH Semelhante a Kelch , Fator 2 Relacionado a NF-E2 , Estresse Oxidativo , Transdução de Sinais , Succinatos , Animais , Fator 2 Relacionado a NF-E2/metabolismo , Proteína 1 Associada a ECH Semelhante a Kelch/metabolismo , Colite Ulcerativa/tratamento farmacológico , Colite Ulcerativa/induzido quimicamente , Colite Ulcerativa/metabolismo , Camundongos , Estresse Oxidativo/efeitos dos fármacos , Succinatos/farmacologia , Masculino , Transdução de Sinais/efeitos dos fármacos , Modelos Animais de Doenças , Camundongos Endogâmicos C57BL , Apoptose/efeitos dos fármacosRESUMO
BACKGROUND: Facial nerve injury often results in poor prognosis due to the challenging process of nerve regeneration. Neuregulin-1, a human calmodulin, is under investigation in this study for its impact on the reparative capabilities of Dental Pulp Stem Cells (DPSCs) in facial nerve injury. METHODS: Lentivirus was used to transfect and construct Neuregulin-1 overexpressed DPSCs. Various techniques assessed the effects of Neuregulin-1: osteogenic induction, lipid induction, Reverse Transcription Polymerase Chain Reaction, Western Blot, Cell Counting Kit-8 assay, wound healing, immunofluorescence, Phalloidin staining, nerve stem action potential, Hematoxylin-eosin staining, transmission electron microscopy, and immunohistochemistry. RESULTS: Neuregulin-1 effectively enhanced the proliferation, migration, and cytoskeletal rearrangement of DPSCs, while simultaneously suppressing the expression of Ras homolog gene family member A (RhoA) and Microfilament actin (F-actin). These changes facilitated the neural differentiation of DPSCs. Additionally, in vivo experiments showed that Neuregulin-1 expedited the restoration of action potential in the facial nerve trunk, increased the thickness of the myelin sheath, and stimulated axon regeneration. CONCLUSION: Neuregulin-1 has the capability to facilitate the repair of facial nerve injuries by promoting the regenerative capacity of DPSCs. Thus, Neuregulin-1 is a significant potential gene in the reparative processes of nerve damage.
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Polpa Dentária , Traumatismos do Nervo Facial , Humanos , Axônios , Diferenciação Celular , Proliferação de Células , Células Cultivadas , Traumatismos do Nervo Facial/metabolismo , Regeneração Nervosa/fisiologia , Neuregulina-1/metabolismo , Células-Tronco/metabolismoRESUMO
In this paper, a novel broadband balanced-to-balanced (BTB) filtering power divider (FPD) utilizing the half-mode substrate-integrated waveguide and spoof surface plasmon polariton (HMSIW-SSPP) hybrid transmission line is introduced. Initially, a new HMSIW-SSPP unit cell is proposed, demonstrating a lower upper cut-off frequency compared to the classical HMSIW-SSPP unit cell. Building upon this unit cell, a bandpass BTB FPD is devised employing dual-layer stacked substrates, enabling independent control over the passband's lower and upper cut-off frequencies through specific physical dimensions. Additionally, the incorporation of isolation resistors and defected ground structures in the BTB FPD enhances differential-mode isolation and common-mode (CM) suppression between output ports. A manufactured and tested BTB FPD prototype validates this design method, showcasing a broad fractional bandwidth of 52.31% (6.72-11.48 GHz), output port isolation surpassing 14.25 dB, and transmitted CM suppression exceeding 34.05 dB.
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RATIONALE: Multiple myeloma (MM) with secondary amyloidosis (AL) is a rare clonal plasma cell proliferation disease, which causes dysfunction of multiple organs and tissues. We report a case of dysphagia as the first symptom in a patient with MM and secondary AL. PATIENT CONCERNS: The patient was a 73-year-old female, was admitted to our hospital, because of progressive dysphagia for 4 months and limb weakness for 1 month. DIAGNOSES: The bone marrow smear and pathology diagnosis revealed the presence of MM, while the biceps myopathy diagnosis indicated AL. INTERVENTIONS: The VCD regimen consisted of bortezomib at a dosage of 1.9 mg on days 1, 8, 15, and 22, cyclophosphamide 0.4 g on days 1, 8, and 15, and dexamethasone at a dosage of 40 mg on days 1, 8, 15, and 22. The patient simultaneously received comprehensive treatment including anti-infective therapy, enhanced cardiac function, and nutritional support. OUTCOMES: The M protein in the blood and urine protein were negative, indicating a reduction in bone marrow plasma cells to 2%. Flow cytometric analysis revealed a minimal percentage 0.04%. As a result, complete remission was achieved. LESSONS: The clinical manifestations of MM exhibit a wide range, with the symptoms of secondary injury causing significant disturbing, while the atypical symptoms of extramedullary manifestations pose challenges in diagnosing the disease.
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Amiloidose , Transtornos de Deglutição , Mieloma Múltiplo , Humanos , Mieloma Múltiplo/complicações , Mieloma Múltiplo/diagnóstico , Feminino , Idoso , Transtornos de Deglutição/etiologia , Amiloidose/complicações , Amiloidose/diagnóstico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Bortezomib/uso terapêutico , Bortezomib/administração & dosagemRESUMO
Document classification is a challenging task to the data being high-dimensional and sparse. Many transfer learning methods have been investigated for improving the classification performance by effectively transferring knowledge from a source domain to a target domain, which is similar to but different from the source domain. However, most of the existing methods cannot handle the case that the training data of the target domain does not have labels. In this study, we propose a transductive transfer learning system, utilizing solutions evolved by genetic programming (GP) on a source domain to automatically pseudolabel the training data in the target domain in order to train classifiers. Different from many other transfer learning techniques, the proposed system pseudolabels target-domain training data to retrains classifiers using all target-domain features. The proposed method is examined on nine transfer learning tasks, and the results show that the proposed transductive GP system has better prediction accuracy on the test data in the target domain than existing transfer learning approaches including subspace alignment-domain adaptation methods, feature-level-domain adaptation methods, and one latest pseudolabeling strategy-based method.
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PURPOSE: To clarify the effect of genistein(GEN) on osteogenic differentiation and explore the effect of GEN loaded by platelet-rich fibrin (PRF) on the repair process of bone defects in obese mice. METHODS: In in vitro experiments, the effect of GEN(0, 0.1, 1, 10, 50 µmol/L) on the proliferation of mouse embryonic osteoblast precursor cells (MC3T3-E1) was determined by CCK 8. Alkaline phosphatase(ALP) staining and quantitative detection of ALP activity were performed to determine the changes of ALP activity in cells; RNA and protein expression levels of ALP, osteopontin (OPN) and osteocalcin (OCN) were detected by quantitative real-time PCR(qRT-PCR) and Western blot. Alizarin red staining was used to define the effect of GEN on mineralization of MC3T3-E1. To verify the feasibility of the PRF drug loading, the ultrastructure of PRF was subsequently observed under SEM. In in vivo experiments, obese C57 mouse models were established by high-fat diet feeding. On this basis, skull defect models with a diameter of 2.8 mm were established, and the prepared GEN/PRF complexes were placed into the bone defect area. The effects of GEN on skull defect repair in obese mice were evaluated by Micro-CT scanning and hematoxylin-eosin(H-E) staining. Statistical analysis was performed with GraphPad Prism 5.0 software package. RESULTS: CCK 8 results showed that 0.1, 1 µmol/L GEN promoted cell proliferation within 7 days(Pï¼0.05); 10 µmol/L GEN had no significant effect on the process of cell proliferation. From the second day, 50 µmol/L GEN significantly inhibited cell growth and showed cytotoxicity(Pï¼0.05). These two concentrations had similar effects in promoting cellular osteogenic differentiation. SEM results showed that PRF presented a 3-dimensional network structure, providing space for loading drug molecules. In in vivo experiments, the body weight of mice in the high-fat diet (HFD) group was 27.7% greater than that in the normal diet group(Pï¼0.05) and had abnormal glucose tolerance (Pï¼0.05). Micro-CT showed that compared with the normal diet group, the number of bone trabeculae in the femur of obese mice was decreased(Pï¼0.05), the distance between bone trabeculae was widened(Pï¼0.05), and the bone density was decreased (Pï¼0.05). In addition, GEN (0.1, 1.0 µmol/L) loaded by PRF increased bone volume fraction in the skull of obese mice (Pï¼0.05). H-E results showed that GEN/PRF promoted the healing of the bone defects. CONCLUSIONS: GEN promotes osteogenic differentiation of MC3T3-E1, and it can effectively accelerate the healing of cranial bone defects after loading with PRF in obese mice.
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Osteogênese , Fibrina Rica em Plaquetas , Animais , Camundongos , Osteogênese/genética , Genisteína/farmacologia , Camundongos Obesos , Sincalida/farmacologia , Diferenciação Celular/genética , OsteoblastosRESUMO
Multi-dimensional diffusion-relaxation correlation (DRC) magnetic resonance imaging (MRI) techniques have recently been developed to investigate tissue microstructures. Sub-voxel tissue heterogeneity is resolved from the local correlation distributions of relaxation time and molecular diffusivity. However, the implementation of these techniques considerably increases the total acquisition time, and simply reducing the scan time may be at the expense of detailed structural resolution. To overcome these limitations, an optimised framework was proposed for acquiring microstructural maps of the human brain on a clinically feasible timescale. First, the acquisition parameters of the multi-dimensional DRC MRI method were sparsely optimised using a genetic algorithm with a fitness function according to the spectral resolution of the correlation map, hardware requirements, and total scan time. Next, the acquired DRC MRI data were processed using a proposed numerical algorithm based on the dynamic inverse Laplace transform (ILT). Prior knowledge from one-dimensional data was then utilised in the iterative procedure to improve the spectral resolution. Finally, the proposed framework was validated using Monte Carlo simulations and experimental data acquired from healthy participants on an MRI scanner. The results demonstrated that the suggested approach is feasible for offering high-resolution DRC maps that correspond to distinct microstructures with a limited amount of optimised acquisition data from two-dimensional DRC sampling space. By significantly reducing scan time while retaining structural resolution, this approach may enable multi-dimensional DRC MRI to be more widely used for quantitative evaluation in biological and medical settings.
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Algoritmos , Encéfalo , Processamento de Imagem Assistida por Computador , Humanos , Encéfalo/diagnóstico por imagem , Processamento de Imagem Assistida por Computador/métodos , Imagem de Difusão por Ressonância Magnética/métodos , Método de Monte CarloRESUMO
Effective treatment of pesticide residue-induced pollution in the aqueous environment is the key to improving the water quality of rivers and lakes. Modified biomass material (Fe-Al-PS) was successfully prepared by impregnating Fe and Al bimetallic compounds to peanut shell powder for adsorption of glyphosate isopropylamine salt herbicide residues in aqueous environments. Fe-Al-PS reached adsorption equilibrium for 10 mg·L-1 of glyphosate isopropylamine salt at the adsorbent dosage and adsorption time of 0.14 g and 10 min, respectively, and the removal rates were stabilized at 99.9 % and 99.6 %, respectively. The adsorption process followed the pseudo-secondary kinetic and Freundlich adsorption isotherm models and belonged to multi-molecular layer chemisorption. The removal of glyphosate isopropylamine salt by Fe-Al-PS was greater than 95 % in a wide range of pH (2-11). The thermodynamic results indicated that the adsorption was a spontaneous exothermic process. Fe-Al-PS materials were easy to access and involved simple synthesis and low energy consumption, had high anti-interference ability, were reusable, and could be used not only for the effective removal of glyphosate isopropylamine salt herbicide in real water bodies but also for the removal of inorganic phosphorus.
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The quantitative analysis of spatio-temporal variations of vegetation cover and its correlation with climate are of great significance for understanding of ecological environment, ecological civilization construction, and sustainable development in semi-arid areas. We investigated the spatio-temporal variations of normalized difference vegetation index (NDVI) and its response to climate change during 2000-2020 in Xilin Gol, Inner Mongolia, by using trend analysis, regression analysis and partial correlation analysis based on the data of MODIS-NDVI, tempe-rature, precipitation, digital elevation model. The results showed that vegetation cover in Xilin Gol had been increased from 2000 to 2020, which generally included three phases, i.e., stable fluctuation, rapid growth, and steady growth. The mean NDVI showed a zonal increasing distribution from southwest to northeast, and had a strong correlation with elevation and population density in Xilin Gol region. The high values of NDVI were mainly in the east, with a significant increasing trend, and the low values were in the southwest, with a local degradation. The sensitivity of vegetation cover to climate change showed spatial and temporal variations. The spatial variation of vegetation was more sensitive to temperature and the interannual variation was sensitive to annual precipitation. In summary, vegetation cover improved overall in Xilin Gol, but there was degradation in some areas. We should formulate differentiated and precise vegetation restoration and ecological environmental protection policies.
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Mudança Climática , Conservação dos Recursos Naturais , China , Desenvolvimento Sustentável , Temperatura , EcossistemaRESUMO
PURPOSE: To investigate the prevalence of occupational lower back pain (OLBP) among medical workers and identify the contributing factors. METHODS: An electronic questionnaire was distributed to medical workers at Yuebei People's Hospital to gather information on various factors, including gender, age, body mass index (BMI), length of employment, job role, education level, professional title, marital status, fertility status, frequency of night shift, weight lifting daily, duration of daily standing at work, frequency of bending, work-related stress, experience with low back protection training, and frequency of waist exercises. Univariate and multivariate logistic regression analyses were conducted to identify the factors associated with OLBP in medical workers. RESULTS: Out of the 98 medical workers surveyed, 67 experienced OLBP (68.37%). The results of multivariate logistic regression analysis revealed that working for more than 5 years, holding a nursing position, and lacking training in low back protection were significant risk factors for developing OLBP in medical workers (all P<0.05). CONCLUSION: OLBP is a prevalent issue among medical workers, and various factors such as length of employment, job role, and training in low back protection can influence its occurrence.
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Although existing reconstruction-based multivariate time series anomaly detection (MTSAD) methods have shown advanced performance, most assume the training data is clean. When faced with noise or contamination in training data, they can also reconstruct the anomaly well, weakening the distinction between normal and anomaly. Some probabilistic generation-based methods have been used to address this issue because of their implicit robust structure to noise, but the training process and suppression of anomalous generalization are not stable. The recently proposed explicit method based on the memory module would also sacrifice the reconstruction effect of normal patterns, resulting in limited performance improvement. Moreover, most existing MTSAD methods use a single fixed-length window for input, which weakens their ability to extract long-term dependency. This paper proposes a robust multi-scale feature extraction framework with the dual memory module to comprehensively extract features fusing different levels of semantic information and lengths of temporal dependency. First, this paper designs consecutive neighboring windows as inputs to allow the model to extract local and long-term dependency information. Secondly, a dual memory-augmented encoder is proposed to extract global typical patterns and local common features. It ensures the reconstruction ability of normal data while suppressing the generalization of the anomaly. Finally, this paper proposes a multi-scale fusion module to fuse latent variables representing different levels of semantic information and uses the reconstructed latent variables to reconstruct samples for anomaly detection. Experimental results on five datasets from diverse domains show that the proposed method outperforms 16 typical baseline methods.
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Redes Neurais de Computação , Algoritmos , Análise Multivariada , Humanos , Fatores de Tempo , Memória/fisiologiaRESUMO
Universal access to clean fuels in household use is one explicit indicator of sustainable development while currently still billions of people rely on solid fuels for daily cooking. Despite of the recognized clean transition trend in general, disparities in household energy mix in different activities (e.g. cooking and heating) and historical trends remain to be elucidated. In this study, we revealed the historical changing trend of the disparity in household cooking and heating activities and associated carbon emissions in rural China. The study found that the poor had higher total direct energy consumption but used less modern energy, especially in cooking activities, in which the poor consumed 60 % more energy than the rich. The disparity in modern household energy use decreased over time, but conversely the disparity in total residential energy consumption increased due to the different energy elasticities as income increases. Though per-capita household CO2 and Black Carbon (BC) emissions were decreasing under switching to modern energies, the disparity in household CO2 and BC deepened over time, and the low-income groups emitted â¼ 10 kg CO2 more compared to the high-income population. Relying solely on spontaneous clean cooking transition had limited impacts in reducing disparities in household energy and carbon emissions, whereas improving access to modern energy had substantial potential to reduce energy consumption and carbon emissions and its disparity. Differentiated energy-related policies to promote high-efficiency modern heating energies affordable for the low-income population should be developed to reduce the disparity, and consequently benefit human health and climate change equally.
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Poluição do Ar em Ambientes Fechados , Carbono , Humanos , Dióxido de Carbono , Características da Família , Fatores Socioeconômicos , China , População Rural , Culinária , Poluição do Ar em Ambientes Fechados/análiseRESUMO
Global warming has led to a surge in heat health risks (HHRs), the impacts of which are particularly pronounced in metropolitan areas of developing countries. In the current study, six metropolitan areas - Beijing, China; Cairo, Egypt; Jakarta, Indonesia; Mumbai, India; Rio de Janeiro, Brazil; and Tehran, Iran - were selected as the study area to further differentiate the built-up landscapes by utilizing the concept of local climate zones. Moreover, we assessed the similarities and differences in HHR associated with the landscape. Results revealed a 30.67% higher HHR in compact built-up landscapes than in the open built-up type. Urban green spaces played an effective but differentiated role in mitigating HHR. That is, low vegetation in urbanized areas and trees in suburban areas significantly mitigated HHR. Collectively, our findings emphasize the role of effective planning and management in addressing HHR and provide empirical support for implementing HHR mitigation and adaptation strategies.
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Urban heat-islands reportedly expose densely populated areas to higher temperatures. However, the magnitude of the impact of extra hot-day exposure (EHDE) and its association with the effects of urbanization on a global scale remain unclear. As local climate zones (LCZs) refine the impact of differences in urban built-type on heat-island effects, this study aimed to quantify the global EHDE caused by the urban heat-island effect based on LCZs and explored the joint impacts of low gross-domestic product and an increasing vulnerable-age population on EHDE. The results showed that EHDE accounted for 48.01 % of overall hot-day exposure. Additionally, despite a significant geographic differentiation among LCZ types with the highest EHDE intensity, they are almost typically building-intensive LCZs. Furthermore, our study revealed regional differences in the structure of the EHDE share in LCZs, which support the adoption of targeted EHDE mitigation strategies.
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Ventricular septal rupture (VSR) is a catastrophic mechanical complication of acute myocardial infarction (AMI) that can result in acute heart failure. Delaying operative intervention frequently leads to cardiogenic shock and multi-organ failure. Here we report a case of massive anterior MI complicated with VSR that was discovered through cardiac Doppler ultrasound and suspected multiple organ hemorrhage. The patient showed signs of rapid cardiogenic shock and eventually died. The morphological changes of VSR and MI were identified during necropsy, and microscopic examinations of the heart, brain, and kidney revealed multiple organ hemorrhage. This autopsy case suggested that the complication of VSR caused by AMI results in a reduction of oxygen and nutrient content of the circulating blood throughout the body and, eventually, functional failure of multiple organs. We provide clinical and pathological evidence elucidating changes in multiple organs under the severe condition of post-infarction VSR and demonstrate the consequences of a lack of immediate surgery and sufficient medical intervention for a patient suffering from AMI with VSR.