Regulation of capsule spine formation in castor.

Castor (Ricinus communis L.) is a dicotyledonous oilseed crop that can have either spineless or spiny capsules. Spines are protuberant structures that differ from thorns or prickles. The developmental regulatory mechanisms governing spine formation in castor or other plants have remained largely unknown. Herein, using map-based cloning in 2 independent F2 populations, F2-LYY5/DL01 and F2-LYY9/DL01, we identified the RcMYB106 (myb domain protein 106) transcription factor as a key regulator of capsule spine development in castor. Haplotype analyses demonstrated that either a 4,353-bp deletion in the promoter or a single nucleotide polymorphism leading to a premature stop codon in the RcMYB106 gene could cause the spineless capsule phenotype in castor. Results of our experiments indicated that RcMYB106 might target the downstream gene RcWIN1 (WAX INDUCER1), which encodes an ethylene response factor known to be involved in trichome formation in Arabidopsis (Arabidopsis thaliana) to control capsule spine development in castor. This hypothesis, however, remains to be further tested. Nevertheless, our study reveals a potential molecular regulatory mechanism underlying the spine capsule trait in a nonmodel plant species.

The double flower variant of yellowhorn is due to a LINE1 transposon-mediated insertion.

As essential organs of reproduction in angiosperms, flowers, and the genetic mechanisms of their development have been well characterized in many plant species but not in the woody tree yellowhorn (Xanthoceras sorbifolium). Here, we focused on the double flower phenotype in yellowhorn, which has high ornamental value. We found a candidate C-class gene, AGAMOUS1 (XsAG1), through bovine serum albumin sequencing and genetics analysis with a Long Interpersed Nuclear Elements 1 (LINE1) transposable element fragment (Xsag1-LINE1-1) inserted into its second intron that caused a loss-of-C-function and therefore the double flower phenotype. In situ hybridization of XsAG1 and analysis of the expression levels of other ABC genes were used to identify differences between single- and double-flower development processes. These findings enrich our understanding of double flower formation in yellowhorn and provide evidence that transposon insertions into genes can reshape plant traits in forest trees.

A silver-mediated radical process of ß-keto sulfones for the synthesis of 2,3-diacyl furans.

A facile and efficient method for constructing 2,3-diacyl trisubstituted furans via a silver-mediated radical process of ß-keto sulfones is developed. The reaction mechanism has been carefully investigated, revealing that the transformation proceeds through a radical pathway, leading to moderate to good yields of desired products.

Assessment of cumulative cancer risk attributable to diagnostic X-ray radiation: a large cohort study.

OBJECTIVE: To assess the risk of cancer induced by diagnostic X-ray exposure in multiple radiological examinations and to explore the relevant influences to provide a reference for rational usage of X-ray examinations. METHODS: Data for all adult patients who underwent X-ray examinations from August 2004 to April 2020 in a general hospital was collected, including sex, age, primary diagnosis, and X-ray examination. Based on the Biological Effects of Ionizing Radiations report, age and sex and effective dose for a single X-ray examination were used to calculate the lifetime attributable risk (LAR). Patients whose cancer LAR values were in the top 5% were considered to have a high cancer risk; the factors influencing this status were explored by using multivariate logistic regression analyses. RESULTS: In total, 1,143,413 patients with 3,301,286 X-ray examinations were included. LARs of cancer incidence and death were < 0.2% and < 0.13% among 95% of patients and they were > 1% among 0.21% and 0.07% of patients. High risks of incidence and death were significantly associated with corrected exposure frequency (odds ratio [OR], 1.080 and 1.080), sex (OR, male vs. female, 0.421 and 0.372), and year of birth (OR, 1.088 and 1.054), with all p values < 0.001. Among 20 disease categories, congenital disease (OR, 3.792 and 4.024), genitourinary disease (OR, 3.608 and 3.202), digestive disease (OR, 3.247 and 3.272), and tumor disease (OR, 2.706 and 2.767) had the strongest associations with high risks of incidence and death (all p values < 0.001). CONCLUSIONS: Cancer risk induced by diagnostic X-ray examinations can be considered acceptable clinically. Patients having certain diseases are potentially at a relative higher risk due to recurrent examinations. KEY POINTS: • It was the first large-scale investigation of cumulative X-ray exposure in China, involving more than 3.3 million X-ray scans of all types of diagnostic X-ray examinations for about 1.1 million patients during the past 16 years. • The study revealed that the incidence risk of cancer induced by X-ray-related examinations was 0.01% on average, which was substantially lower than that of cancer induced by non-X-ray radiation. The risk could be considered acceptable clinically. • Patients having certain diseases were potentially at a relatively higher cancer risk due to recurrent X-ray examinations. The cumulative effect of X-ray exposure could not be ignored and was worthy of attention.

Representation of time-varying and time-invariant EMR data and its application in modeling outcome prediction for heart failure patients.

OBJECTIVE: To represent a patient record with both time-invariant and time-varying features as a single vector using an end-to-end deep learning model, and further to predict the kidney failure (KF) status and mortality of heart failure (HF) patients. MATERIALS AND METHODS: The time-invariant EMR data included demographic information and comorbidities, and the time-varying EMR data were lab tests. We used a Transformer encoder module to represent the time-invariant data, and refined a long short-term memory (LSTM) with a Transformer encoder attached to the top to represent the time-varying data, taking the original measured values and their corresponding embedding vectors, masking vectors, and two types of time intervals as inputs. The proposed representations of patients with time-invariant and time-varying data were used to predict KF status (949 out of 5268 HF patients diagnosed with KF) and mortality (463 in-hospital deaths) for HF patients. Comparative experiments were conducted between the proposed model and some representative machine learning models. Ablation experiments were also performed around the time-varying data representation, including replacing the refined LSTM with the standard LSTM, GRU-D and T-LSTM, respectively, and removing the Transformer encoder and the time-varying data representation module, respectively. The visualization of the attention weights of the time-invariant and time-varying features was used to clinically interpret the predictive performance. We used the area under the receiver operating characteristic curve (AUROC), the area under the precision-recall curve (AUPRC), and the F1-score to evaluate the predictive performance of the models. RESULTS: The proposed model achieved superior performance, with average AUROCs, AUPRCs and F1-scores of 0.960, 0.610 and 0.759 for KF prediction and 0.937, 0.353 and 0.537 for mortality prediction, respectively. Predictive performance improved with the addition of time-varying data from longer time periods. The proposed model outperformed the comparison and ablation references in both prediction tasks. CONCLUSIONS: Both time-invariant and time-varying EMR data of patients could be efficiently represented by the proposed unified deep learning model, which shows higher performance in clinical prediction tasks. The way to use time-varying data in the current study is hopeful to be used in other kinds of time-varying data and other clinical tasks.

Thermal responses of face-masked pedestrians during summer: An outdoor investigation under tree-shaded areas.

During the SARS-CoV-2 (COVID-19) pandemic, most citizens were cooperative towards the face-masking policy; however, undeniably, face masking has increased complaints of thermal discomfort to varying degrees and resulted in potential health hazards during summer. Thus, a thermal comfort survey was conducted under tree-shaded areas generally preferred by pedestrians to explore the thermal response of face-masked pedestrians. Thirty-two subjects, with and without masks, participated in walking experiments, and their thermal parameters and physiological indicators were recorded; moreover, the subjects were asked to fill in subjective questionnaires. The results showed that although tree shades significantly reduced the average radiant temperature, dampness in the mask may cause some discomfort symptoms, among which intense sweating (54.55%) and tachycardia (42.18%) accounted for the largest proportion. Based on thermal indices, it could be concluded that face-masking does not significantly affect the thermal comfort of subjects walking in shaded areas. Notably, a 30-min walk in tree-shaded areas with face masking does not adversely affect human health or quality of life. Thus, the present assessment of the thermal safety of humans in shaded environments provides reference data for determining thermal comfort levels during outdoor walking with face masking.

Improving the Performance of Outcome Prediction for Inpatients With Acute Myocardial Infarction Based on Embedding Representation Learned From Electronic Medical Records: Development and Validation Study.

BACKGROUND: The widespread secondary use of electronic medical records (EMRs) promotes health care quality improvement. Representation learning that can automatically extract hidden information from EMR data has gained increasing attention. OBJECTIVE: We aimed to propose a patient representation with more feature associations and task-specific feature importance to improve the outcome prediction performance for inpatients with acute myocardial infarction (AMI). METHODS: Medical concepts, including patients' age, gender, disease diagnoses, laboratory tests, structured radiological features, procedures, and medications, were first embedded into real-value vectors using the improved skip-gram algorithm, where concepts in the context windows were selected by feature association strengths measured by association rule confidence. Then, each patient was represented as the sum of the feature embeddings weighted by the task-specific feature importance, which was applied to facilitate predictive model prediction from global and local perspectives. We finally applied the proposed patient representation into mortality risk prediction for 3010 and 1671 AMI inpatients from a public data set and a private data set, respectively, and compared it with several reference representation methods in terms of the area under the receiver operating characteristic curve (AUROC), area under the precision-recall curve (AUPRC), and F1-score. RESULTS: Compared with the reference methods, the proposed embedding-based representation showed consistently superior predictive performance on the 2 data sets, achieving mean AUROCs of 0.878 and 0.973, AUPRCs of 0.220 and 0.505, and F1-scores of 0.376 and 0.674 for the public and private data sets, respectively, while the greatest AUROCs, AUPRCs, and F1-scores among the reference methods were 0.847 and 0.939, 0.196 and 0.283, and 0.344 and 0.361 for the public and private data sets, respectively. Feature importance integrated in patient representation reflected features that were also critical in prediction tasks and clinical practice. CONCLUSIONS: The introduction of feature associations and feature importance facilitated an effective patient representation and contributed to prediction performance improvement and model interpretation.

Experimental investigation of the effects of personal protective equipment on thermal comfort in hot environments.

Since the outbreak of COVID-19, wearing personal protective equipment (PPE) has become increasingly common, especially for healthcare workers performing nucleic acid sample collection. A field experiment and questionnaire survey were conducted in a semi-open transition space of a university building in Guangzhou, southern China. Thirty-two subjects wore PPE to simulate nucleic acid sample collection, during which thermal parameters were recorded and subjective questionnaires were completed. The relationship between thermal sensation and thermal index was analyzed to determine the neutral temperature and comfort temperature zones. Subjects had higher requirements for thermal environment parameters when wearing PPE than when not wearing PPE, and were found to have statistically significant differences in thermal perception when wearing and not wearing PPE. Wearing PPE significantly raised the subjects' thermal and humidity sensations and restricted their airflow. Wearing PPE resulted in thermal discomfort for the subjects and a high unacceptability rate for environmental thermal parameters. The subjects wore PPE for an acceptable duration of approximately 1.5 h. The neutral operative temperatures were significantly lower when wearing PPE than when not wearing PPE, and the deviation from the neutral temperature was 9.7 °C. The neutral operative temperature was 19.5 °C and the comfort temperature zone was 17.4-21.5 °C when subjects wore PPE, demonstrating that subjects who wore PPE preferred lower temperatures. These results suggest that people who wear PPE for work, especially outdoors, should receive more attention to ensure thermal comfort and safety.

Investigation of the effects of face masks on thermal comfort in Guangzhou, China.

Wearing masks to study and work places has become a daily protective measure during the COVID-19 pandemic. In the summer of 2021, environmental parameters were monitored, and students in a university library in Guangzhou, China, were surveyed to analyze the possible symptoms of wearing masks for a long time, and to assess the sensitivity of various body parts to the environmental parameters. Concurrently, the preference of subjects wearing masks for various environmental parameters was also analyzed. Additionally, the relationship between thermal sensation and thermal index was analyzed to identify acceptable and comfortable temperature ranges. The expected duration of wearing masks was counted. Subjects wearing masks had greater requirements for environmental comfort, and reported increased thermal discomfort of the face and head, compared to those without masks. More than 70% of the subjects wearing masks reported that they experienced discomfort on their faces. Among the subjects who experienced discomfort, 62.7% reported that facial fever was the main symptom; while some reported symptoms of dyspnea (25.4%) and rapid heartbeat (9.1%). More than 75% of the subjects were expected to wear masks for 2.0 h or less. Evaluation of environmental thermal sensation, including overall, facial, and head thermal sensation, differed among subjects who wore and did not wear masks. The indexes of neutral Operative temperature/Standard Effective Temperature (T op /SET*) and preferred T op /SET* were lower among subjects with masks than among those without masks. The neutral T op /SET* deviation was 0.3 °C, and the preferred T op /SET* deviation was 0.5 °C. Additionally, the acceptable and comfortable temperature zones differed between the two cases. The subjects who wore masks preferred colder temperatures. These findings indicated that the environmental parameters should be adjusted to improve the thermal comfort of the human body while wearing masks in work or study places.

A Pre-mRNA-splicing factor is required for RNA-directed DNA methylation in Arabidopsis.

Cytosine DNA methylation is a stable epigenetic mark that is frequently associated with the silencing of genes and transposable elements (TEs). In Arabidopsis, the establishment of DNA methylation is through the RNA-directed DNA methylation (RdDM) pathway. Here, we report the identification and characterization of RDM16, a new factor in the RdDM pathway. Mutation of RDM16 reduced the DNA methylation levels and partially released the silencing of a reporter gene as well as some endogenous genomic loci in the DNA demethylase ros1-1 mutant background. The rdm16 mutant had morphological defects and was hypersensitive to salt stress and abscisic acid (ABA). Map-based cloning and complementation test led to the identification of RDM16, which encodes a pre-mRNA-splicing factor 3, a component of the U4/U6 snRNP. RNA-seq analysis showed that 308 intron retention events occurred in rdm16, confirming that RDM16 is involved in pre-mRNA splicing in planta. RNA-seq and mRNA expression analysis also revealed that the RDM16 mutation did not affect the pre-mRNA splicing of known RdDM genes, suggesting that RDM16 might be directly involved in RdDM. Small RNA expression analysis on loci showing RDM16-dependent DNA methylation suggested that unlike the previously reported putative splicing factor mutants, rdm16 did not affect small RNA levels; instead, the rdm16 mutation caused a decrease in the levels of Pol V transcripts. ChIP assays revealed that RDM16 was enriched at some Pol V target loci. Our results suggest that RDM16 regulates DNA methylation through influencing Pol V transcript levels. Finally, our genome-wide DNA methylation analysis indicated that RDM16 regulates the overall methylation of TEs and gene-surrounding regions, and preferentially targets Pol IV-dependent DNA methylation loci and the ROS1 target loci. Our work thus contributes to the understanding of RdDM and its interactions with active DNA demethylation.

A review of common influencing factors and possible mechanisms associated with allergic diseases complicating tic disorders in children.

Over the past few decades, the incidence of childhood allergic diseases has increased globally, and their impact on the affected child extends beyond the allergy itself. There is evidence of an association between childhood allergic diseases and the development of neurological disorders. Several studies have shown a correlation between allergic diseases and tic disorders (TD), and allergic diseases may be an important risk factor for TD. Possible factors influencing the development of these disorders include neurotransmitter imbalance, maternal anxiety or depression, gut microbial disorders, sleep disturbances, maternal allergic status, exposure to tobacco, and environmental factors. Moreover, gut microbial disturbances, altered immunological profiles, and DNA methylation in patients with allergic diseases may be potential mechanisms contributing to the development of TD. An in-depth investigation of the relationship between allergic diseases and TD in children will be important for preventing and treating TD.

Brain-Inspired Image Perceptual Quality Assessment based on EEG: A QoE Perspective.

Human-oriented image communication should take the quality of experience (QoE) as an optimization goal, which requires effective image perceptual quality metrics. However, traditional user-based assessment metrics are limited by the deviation caused by human high-level cognitive activities. To tackle this issue, in this paper, we construct a brain response-based image perceptual quality metric and develop a brain-inspired network to assess the image perceptual quality based on it. Our method aims to establish the relationship between image quality changes and underlying brain responses in image compression scenarios using the electroencephalography (EEG) approach. We first establish EEG datasets by collecting the corresponding EEG signals when subjects watch distorted images. Then, we design a measurement model to extract EEG features that reflect human perception to establish a new image perceptual quality metric: EEG perceptual score (EPS). To use this metric in practical scenarios, we embed the brain perception process into a prediction model to generate the EPS directly from the input images. Experimental results show that our proposed measurement model and prediction model can achieve better performance. The proposed brain response-based image perceptual quality metric can measure the human brain's perceptual state more accurately, thus performing a better assessment of image perceptual quality.

Suppression of KIF14 expression inhibits hepatocellular carcinoma progression and predicts favorable outcome.

The mitotic kinesin superfamily protein KIF14 is essential for cytokinesis and chromosome segregation and increased KIF14 expression is related to a variety of human cancers. In this study, we investigate KIF14 expression in association with clinical variables and the role of KIF14 during tumorigenesis. We found that KIF14 is overexpressed in most primary hepatocellular carcinoma (HCC) tissues compared with the adjacent normal liver tissues and KIF14 overexpression is associated with tumor grade (P = 0.002), stage (P = 0.013) and poor survival (P < 0.001). Downregulation of KIF14 decreased the capacity of proliferation both in vitro and in vivo. Furthermore, suppression of KIF14 not only decreases cancer cell migration but also induces apoptosis of cells with inactivation of the phosphatidylinositol 3-kinase-Akt signaling pathway. Therefore, our current study indicates that KIF14 promotes HCC carcinogenesis and may serve as a potential therapeutic target for human HCC.

DNA replication factor C1 mediates genomic stability and transcriptional gene silencing in Arabidopsis.

Genetic screening identified a suppressor of ros1-1, a mutant of REPRESSOR OF SILENCING1 (ROS1; encoding a DNA demethylation protein). The suppressor is a mutation in the gene encoding the largest subunit of replication factor C (RFC1). This mutation of RFC1 reactivates the unlinked 35S-NPTII transgene, which is silenced in ros1 and also increases expression of the pericentromeric Athila retrotransposons named transcriptional silent information in a DNA methylation-independent manner. rfc1 is more sensitive than the wild type to the DNA-damaging agent methylmethane sulphonate and to the DNA inter- and intra- cross-linking agent cisplatin. The rfc1 mutant constitutively expresses the G2/M-specific cyclin CycB1;1 and other DNA repair-related genes. Treatment with DNA-damaging agents mimics the rfc1 mutation in releasing the silenced 35S-NPTII, suggesting that spontaneously induced genomic instability caused by the rfc1 mutation might partially contribute to the released transcriptional gene silencing (TGS). The frequency of somatic homologous recombination is significantly increased in the rfc1 mutant. Interestingly, ros1 mutants show increased telomere length, but rfc1 mutants show decreased telomere length and reduced expression of telomerase. Our results suggest that RFC1 helps mediate genomic stability and TGS in Arabidopsis thaliana.

RAS1, a quantitative trait locus for salt tolerance and ABA sensitivity in Arabidopsis.

Soil salinity limits agricultural production and is a major obstacle for feeding the growing world population. We used natural genetic variation in salt tolerance among different Arabidopsis accessions to map a major quantitative trait locus (QTL) for salt tolerance and abscisic acid (ABA) sensitivity during seed germination and early seedling growth. A recombinant inbred population derived from Landsberg erecta (Ler; salt and ABA sensitive) x Shakdara (Sha; salt and ABA resistant) was used for QTL mapping. High-resolution mapping and cloning of this QTL, Response to ABA and Salt 1 (RAS1), revealed that it is an ABA- and salt stress-inducible gene and encodes a previously undescribed plant-specific protein. A premature stop codon results in a truncated RAS1 protein in Sha. Reducing the expression of RAS1 by transfer-DNA insertion in Col or RNA interference in Ler leads to decreased salt and ABA sensitivity, whereas overexpression of the Ler allele but not the Sha allele causes increased salt and ABA sensitivity. Our results suggest that RAS1 functions as a negative regulator of salt tolerance during seed germination and early seedling growth by enhancing ABA sensitivity and that its loss of function contributes to the increased salt tolerance of Sha.

Human thermal physiological response of wearing personal protective equipment: An educational building semi-open space experimental investigation.

With the outbreak and spread of the COVID-19 epidemic, HCWs are frequently required to wear personal protective equipment (PPE) for nucleic acid sample collection in semi-open transition spaces. Wearing PPE causes significant psychological and physical stress in HCWs. In this study, operative temperature (Top) and wet-bulb globe temperature (WBGT) were used to assess thermal conditions through field experiments, while multiple physiological parameters were measured in the subjects. The results indicated that the subjects showed statistically significant differences in thermal perception and physiological parameters with and without PPE. Using observed increases in heart rate (HR), auditory canal temperature (Tac), mean skin temperature (MST), and end-tidal CO2 pressure, subjects were shown to have an increased metabolic rate and heat storage while wearing PPE. Additionally, a decrease in oxygen concentration was also observed, and this decrease may be linked to fatigue and cognitive impairment. Moreover, HR, MST, and Tac showed a significant linear relationship, which increased with temperature and operative temperature, and the HR response was stronger with PPE than without PPE. The neutral, preferred, and acceptable temperatures were significantly lower with PPE than without PPE, and the deviations for neutral Top/WBGT were 9.5/7.1 °C and preferred Top/WBGT was 2.2/4.0 °C, respectively. Moreover, the upper limits of acceptable WBGT, 29.4 °C with PPE and 20.4 °C without PPE, differed significantly between the two phases. Furthermore, the recorded physiological parameter responses and thermal perception responses of the subjects while wearing PPE indicated that they were at risk of thermal stress. Overall, these results suggest that people who wear PPE should focus on their health and thermal stress. This study provides a reference for the development of strategies to counteract heat stress and improve thermal comfort.

[Development and optimization of a cell screening system for farnesoid X receptor agonist].

This study aims to develop an improved cell screening system for farnesoid X receptor (FXR) agonists based on a dual luciferase reporter gene system. FXR response element (FXRE) fragments from FXR target genes were cloned and inserted into upstream of firefly luciferase (Luc) gene in the plasmid pGL4-luc2P-Hygro. In combination with the internal reference plasmid containing renilla luciferase, a dual luciferase reporter gene system was developed and used for high throughput screening of FXR agonists. After studying the effects of over-expression of RXR, mouse or human FXR, various FXRE fragments, and different ratio of FXR plasmid amount to reporter gene plasmid, induction efficiency of the screening system was optimized by the known FXR agonist GW4064, and Z factor for the system reached 0.83 under optimized conditions. In summary, an improved cell screening system based on double luciferase reporter gene detection system was developed to facilitate the discovery of FXR agonists, where a new enhanced FXRE element was formed by a superposition of multiple FXRE fragments from FXR target genes, instead of a superposition of traditional IR-1 (inverted repeats-1) fragments.

Effectiveness of telehealth interventions on depression symptoms after stroke: A systematic review and meta-analysis.

BACKGROUND: Depression symptoms are common after stroke, and affect survivors' recovery of neurological function, ability to return to society, and quality of life. Telehealth has been shown to improve depression symptoms and quality of life among patients post-stroke. However, evidence from clinical trials has not previously been systematically synthesized. OBJECTIVE: This study aimed to systematically evaluate the effectiveness of telehealth interventions in reducing depression symptoms among patients post-stroke. METHODS: Following the PRISMA guidelines, we conducted a meta-analysis of randomized control trials of telehealth interventions for post-stroke depression symptoms. The quality of included studies was assessed using the Cochrane risk of bias tool. RevMan 5.4 software was used for the meta-analysis. Data were synthesized by fixed (I2 ≤ 50 %) or random (I2 > 50 %) effects models based on a heterogeneity test. RESULTS: In total, ten studies with 1717 participants were included, eight of which were eligible for the meta-analysis. There were no significant differences in efficacy between the telehealth and control groups for depression symptoms (standardized mean difference [SMD] = -0.16, 95 % confidence interval [CI] -0.67 to 0.36; P = .54), quality of life (SMD = 0.00, 95%CI -0.18 to 0.18; P = .99), limb function (SMD = 0.46, 95%CI -0.26 to 1.18; P = .21), and daily living ability (SMD = 0.38, 95%CI -1.39 to 2.15; P = .67). The telemedicine group had significantly lower anxiety scores than the control group (SMD = -1.05, 95%CI -1.22 to -0.89; P < .001). LIMITATIONS: The number of randomized controlled trials (RCTs) included in the review was relatively small. CONCLUSIONS: This study suggests that telehealth interventions have comparable effects to usual nursing care in improving depression symptoms after a stroke. However, large-scale, high-quality RCTs are needed to further explore the potential of telehealth interventions in improving mental health among patients post-stroke.

Field investigation of the heat stress in outdoor of healthcare workers wearing personal protective equipment in South China.

Since the advent of coronavirus disease 2019 (COVID-19), healthcare workers (HCWs) wearing personal protective equipment (PPE) has become a common phenomenon. COVID-19 outbreaks overlap with heat waves, and healthcare workers must unfortunately wear PPE during hot weather and experience excessive heat stress. Healthcare workers are at risk of developing heat-related health problems during hot periods in South China. The investigation of thermal response to heat stress among HCWs when they do not wear PPE and when they finish work wearing PPE, and the impact of PPE use on HCWs' physical health were conducted. The field survey were conducted in Guangzhou, including 11 districts. In this survey, HCWs were invited to answer a questionnaire about their heat perception in the thermal environment around them. Most HCWs experienced discomfort in their back, head, face, etc., and nearly 80% of HCWs experienced "profuse sweating." Up to 96.81% of HCWs felt "hot" or "very hot." The air temperature had a significant impact on thermal comfort. Healthcare workers' whole thermal sensation and local thermal sensation were increased significantly by wearing PPE and their thermal sensation vote (TSV) tended towards "very hot." The adaptive ability of the healthcare workers would decreased while wearing PPE. In addition, the accept range of the air temperature (T a) were determined in this investigation. Graphical Abstract.