Non-contact assessment of cardiac physiology using FO-MVSS-based ballistocardiography: a promising approach for heart failure evaluation.

Continuous monitoring of cardiac motions has been expected to provide essential cardiac physiology information on cardiovascular functioning. A fiber-optic micro-vibration sensing system (FO-MVSS) makes it promising. This study aimed to explore the correlation between Ballistocardiography (BCG) waveforms, measured using an FO-MVSS, and myocardial valve activity during the systolic and diastolic phases of the cardiac cycle in participants with normal cardiac function and patients with congestive heart failure (CHF). A high-sensitivity FO-MVSS acquired continuous BCG recordings. The simultaneous recordings of BCG and electrocardiogram (ECG) signals were obtained from 101 participants to examine their correlation. BCG, ECG, and intracavitary pressure signals were collected from 6 patients undergoing cardiac catheter intervention to investigate BCG waveforms and cardiac cycle phases. Tissue Doppler imaging (TDI) measured cardiac time intervals in 51 participants correlated with BCG intervals. The BCG recordings were further validated in 61 CHF patients to assess cardiac parameters by BCG. For heart failure evaluation machine learning was used to analyze BCG-derived cardiac parameters. Significant correlations were observed between cardiac physiology parameters and BCG's parameters. Furthermore, a linear relationship was found betwen IJ amplitude and cardiac output (r = 0.923, R2 = 0.926, p < 0.001). Machine learning techniques, including K-Nearest Neighbors (KNN), Decision Tree Classifier (DTC), Support Vector Machine (SVM), Logistic Regression (LR), Random Forest (RF), and XGBoost, respectively, demonstrated remarkable performance. They all achieved average accuracy and AUC values exceeding 95% in a five-fold cross-validation approach. We establish an electromagnetic-interference-free and non-contact method for continuous monitoring of the cardiac cycle and myocardial contractility and measure the different phases of the cardiac cycle. It presents a sensitive method for evaluating changes in both cardiac contraction and relaxation in the context of heart failure assessment.

Research on China Cities' Total Factor Productivity of Carbon Emission: Based on Decoupling Effect.

Economic development depends on energy consumption, which is a major source of carbon emission. How to achieve economic decarbonization has become one of the key questions urgently needing to be solved on the road of carbon peak and carbon neutral development in China. Advancing total factor productivity (TFP) of carbon emission is an important way to promote economic decarbonization. For the carbon emission TFP, current research is mainly conducted from province level or an industry perspective, and studies its deference with various geographical locations, economic development levels, urbanization levels, etc., lacking the research that combines the decoupling effect to carbon emission TFP. The carbon emission TFP of Chinese cities and how to improve it remain unclear. Therefore, based on Tapio decoupling theory, this paper firstly analyzed the decoupling effect of China's 284 cities from 2005 to 2019, and aggregated the cities into four groups according to the decoupling effect. Then, using the DEA-Malmquist index, this paper researched the carbon emission TFP and its driving factors based on the aggregation. The result shows that weak decoupling is the main decoupling status in China. As a whole, carbon emission TFP of Chinese cities does not perform well, but it shows a growth trend over time. Strong decoupling cities outperform expansive negative decoupling cities on carbon emission TFP. Technical change and pure technical efficiency change have inhibiting effect and promoting effect on carbon emission TFP, respectively, which are the main factors for the difference of carbon emission TFP between strong decoupling cities and expansive negative decoupling cities. Based on these findings, some common but differentiated recommendations are provided for improving Chinese cities' carbon emission TFP.

Temporal dynamics and spatial differences of household carbon emissions per capita of China's provinces during 2000-2019.

To assess the characteristics of household carbon emissions per capita (HCPC), this paper divided China's provinces into 4 groups based on the decoupling relationship between household consumption and related emissions. This classification helped to analyze the correlation and reflected the decoupling status between carbon emissions and household consumption and explored the effect of consumption growth on carbon emissions. Then, according to logarithmic mean divisia index (LMDI) model, HCPC in China's provinces was decomposed into four drivers including carbon coefficient, energy structure, energy consumption, and population structure effect. Through multi-regional (M-R) analysis, temporal evolution and spatial differences of these four drivers in both national and provincial level were studied. This comparison method introduced temporal and spatial decomposition results into the same framework, which may provide a new perspective for analyzing carbon emission trends. The results showed that (a) the HCPC in all 30 provinces increased significantly especially in Inner Mongolia, Tianjin, Xinjiang, Heilongjiang, and Beijing. Energy consumption effect was the leading factor promoting HCPC growth. Energy structure and population structure also promoted HCPC growth slightly, and carbon coefficient was the effect which had inhibitory effect on HCPC growth at regional level. (b) Spatial differences of HCPC between regions narrowed during this period. This is mainly due to the rapid growth of HCPC in region IV. Energy consumption effect was the dominant factor for the spatial differences. Based on the results, this paper proposed to adopt more effective measures to improve energy efficiency, develop clean energy, and optimize energy structure, especially in the provinces with faster growth in carbon emissions.

Physiological and transcriptomic analyses reveal the toxicological mechanism and risk assessment of environmentally-relevant waterborne tetracycline exposure on the gills of tilapia (Oreochromis niloticus).

With the increasing application of tetracycline (TC) in medical treatment, animal husbandry and aquaculture in recent decades, high quantities of TC have been frequently detected in the aquatic environment, and accordingly TC-related toxicity and environmental pollution have become a global concern. The present study was performed to explore the toxicological influences of TC exposure at its environmentally relevant concentrations on the gills of tilapia Oreochromis niloticus, based on the alteration in histopathology, oxidative stress, inflammatory response, cell cycle, mitochondrial function, apoptosis, and transcriptomic analysis. Our findings revealed that TC exposure damaged the structure and function, induced oxidative stress, affected inflammatory responses, and reduced Na+/K+-ATPase (NKA) activity in the gills. TC also caused the inhibition in cell cycle, resulted in mitochondrial dysfunction and activated apoptosis. Further transcriptomic analysis indicated the extensive influences of TC exposure on the gill function, and immune system was the main target to waterborne TC exposure. These results elucidated that environmental TC had more complex toxicological effects on gills of fish than previously assessed, and provided novel insight into molecular toxicology of TC on fish and good basis for assessing the environmental risk of TC.

Optimal allocation of CO2 emission quotas at the city level in Bohai Rim Economic Circle based on multi-objective decision approach.

As the most developed city circle in northern China, allocating CO2 emission quotas at the Bohai Rim Economic Circle (BREC) city level is essential for developing specific abatement policies. Thus, with reflecting multi-principles (fairness, efficiency, sustainability, and feasibility), this paper formulates the CO2 emission quota allocation among cities in BREC in 2030 based on the multi-objective decision approach. We first propose three allocation schemes based on the principles of fairness, efficiency, and sustainability, which are conducted by entropy method, zero-sum gains data envelopment (ZSG-DEA) model, and CO2 sequestration share method, respectively. Then, the CO2 allocation satisfaction is defined and used to measure the feasibility principle which is integrated as the objective function of the multi-objective decision model together with three allocation schemes to obtain the optimal allocation results. The results show that Beijing, Tianjin, Dalian, Shijiazhuang, Yantai, Weifang, and Linyi enjoy the largest CO2 emission quotas, having 1179.94 Mt in total and accounting for 31%. Beijing has the highest quotas, and Laiwu has the lowest emission quotas. Cities with large energy consumption and less CO2 sequestration capacity, such as Tianjin, Handan, and Tangshan, experience a decrease in the emission quota shares from 2017 to 2030, indicating that these cities would undertake large emission reduction obligations. Sensitivity analysis shows that Beijing, Zibo, and Jinan are more sensitive to minimum satisfaction changes, and the total satisfaction experiences an increase first and declines thereafter. Based on the results above, cities with large pressure to reduce CO2 emissions should not only promote economic development but also improve the capacity of CO2 sequestration by enhancing environmental protection to realize emission reduction targets.

Analyzing China's coal-related carbon emissions from economic growth perspective: Through decoupling and decomposition model.

To evaluate the relationship between coal-related carbon emissions (CCE) and economic growth, this paper analyzed the decoupling relationship between CCE and economic growth from national and provincial perspectives during period 1997-2016 through Tapio Decoupling Index. Then, to recognize its spatial characteristics during 1997-2016, gravity model was adopted to study the geographical changes of CCE. Finally, to identify the changes of (CCE) in China and reveal its internal driving forces, this paper employs the logarithmic mean Divisia index (LMDI) decomposition analysis to decompose decoupling indicator into six effects including emission factors, energy intensity, fossil energy structure, energy consumption structure, activity, and population at national and provincial levels. The results reflect that (1) CCE of China rose by 168.37% from 1997 to 2016, and reached the peak of 7948.43 Mton in 2013. The center of gravity has shifted from (114.64 E, 34.70 N) to (113.48 E, 35.06 N). (2) The decoupling curve showed an inverted "U" shape. The economic growth of 18 provinces has achieved a strong decoupling from CCE by 2016. Only Xinjiang, Shanxi, and Shaanxi's economic growth has increased the dependence on CCE. (3) Activity and energy intensity effects were the dominant factors driving and curbing the increase of decoupling indicator respectively.

Understanding regional inequality in per capita CO2 emissions in China during 1997-2016: sources and driving factors.

As the largest carbon dioxide (CO2) emitter, China exists obvious regional inequality in per capita CO2 emissions. However, such inequality and its dynamic change for recent years have not been systematically studied. In this paper, we evaluate China's regional inequality in per capita CO2 emissions during 1997-2016 using the Theil index and decompose it into within-region and between-region components based on eight regions. Furthermore, we apply the decomposition analysis to explore the contribution of different factors to such inequality, including the carbonization index, energy intensity, energy structure, labor productivity, and employment rate. The results show that China's overall inequality in per capita CO2 emissions reduced first and increased thereafter during 1997-2016. Within-region inequality was the main source of overall inequality in 1997-2004, while between-region inequality contributed more during 2005-2016. Labor productivity and energy intensity were the two main drivers of overall inequality, but their contributions to the inequality between regions and within regions were quite different. Moreover, the impact of energy structure and carbonization index on regional inequality in per capita CO2 emissions significantly increased during 2012-2016, which was related to the efforts made by local governments to improve the energy mix. Policy implications were given according to the above conclusions to improve regional inequality in per capita CO2 emissions.

The impact of technology-environmental innovation on CO2 emissions in China's transportation sector.

Along with the development of urbanization and informationization, an increasing attention has been attracted to CO2 emissions of China's transportation sector and its influencing factors. Such researches mainly utilize single indicator or two indicators to represent technology process. This research aims to verify the influence of technology-environmental innovation indicator system on CO2 emissions of China's transportation sector by decoupling elasticity and econometric model. We firstly recognize the decoupling status of CO2 emissions of China's transportation sector from social economic development and aggregate China's 30 provinces into two groups according to the varied decoupling status, namely expansive coupling and weak decoupling groups. Then, we develop a relatively comprehensive technology-environmental innovation indicator system to measure technology process. Finally, the multi-region comparison of emission drivers is studied among overall China and the two groups. The result shows that the decoupling elasticity of China's transportation has experienced an evolution process trending to desired development status and all the provinces have experienced expansive coupling and weak decoupling from 2001 to 2016, except Qinghai. Innovation performance indicators exert most important influence on the CO2 emissions of transportation sector. Finally, the influences of technology-environmental innovation indicators are similar across groups with different magnitude, suggesting that common but differentiated strategies should be provided when mitigating CO2 emissions with technology process. Graphical abstract.

Influence of population aging on balance of medical insurance funds in China.

PURPOSE: The increasing intensification of population aging can affect the balance of social medical insurance funds, an issue that has aroused much research attention. Against this background, this paper studies the impact of population aging on the balance of medical insurance funds in China. FINDINGS: With the introduction of six intermediate variables, ie, economic level, dependency ratio of the elderly population, physical condition, medical demand, medical expenses, and medical resources, a structural equation model is constructed. Then, the relations among these variables are analyzed to explore how population aging affects the medical insurance fund balance. The direct impact of aging is found not to be significant. Physical condition, medical resources, and medical demand are intermediate variables that can affect the relationship. CONCLUSION: The results show that population aging does not have a significant impact on the balance of the medical insurance fund. However, China's aging trend suggests that the population aging level is very likely to continue to intensify in the future. Moreover, the proportion of revenue in the medical insurance fund is progressively declining, and population aging may threaten the balance between revenue and expenditure. Finally, based on the above analysis, several corresponding recommendations and future studies are proposed.

Simultaneous ureteroscopic lithotripsy and contralateral percutaneous nephrolithotomy for ureteral calculi combined with renal staghorn calculi.

OBJECTIVES: To investigate the efficacy, safety, and cost-effectiveness of simultaneous ureteroscopic lithotripsy and contralateral percutaneous nephrolithotomy for ureteral calculi combined with contralateral renal staghorn calculi. METHODS: The present prospective controlled trial had been registered with the Chinese Clinical Trial Registry (Registration number: ChiCTR-ONRC-13004146). Patients with ureteral calculi and contralateral renal staghorn calculi were enrolled into the staged (ureteroscopic lithotripsy first followed by a staged percutaneous nephrolithotomy) or the simultaneous (synchronous ureteroscopic lithotripsy and contralateral percutaneous nephrolithotomy) treatment group according to the odd or even number of the last hospitalization number. All patients signed informed consent. The primary outcomes were the stone-free rate and total hospital costs. The second outcomes were the operative and anesthesia times, the complication rate, and hospital stay. RESULTS: A total of 51 patients were enrolled into the staged group and 52 patients were enrolled into the simultaneous group. There were no statistically significant differences in patients' characteristics. The overall stone-free rate was 94.1% in the staged group and 92.3% in the simultaneous group. No severe complication was observed. The total hospital stay of the staged group was longer, and it was negatively correlated to different procedures. The cost in the staged group was higher, and it was correlated with total operation time and postoperative hospital stay. CONCLUSIONS: Simultaneous ureteroscopic lithotripsy and contralateral percutaneous nephrolithotomy represent safe and effective procedures, and they can be considered as a first-line treatment for selected patients presenting with ureteral calculi combined with contralateral renal calculi.

Assessment of the Fluorescence Spectra Characteristics of Dissolved Organic Matter Derived from Organic Waste Composting Based on Projection Pursuit Classification (PPC).

The characteristics of fluorescence spectra of dissolved organic matter (DOM) derived from composting is one of the key ways to assess the compost maturity. However, the existing methods mainly focus on the qualitative description for the humification degree of compost. In this paper, projection pursuit classification (PPC) was conducted to quantitative assess the grades of compost maturity, based on the characteristics of fluorescence spectra of DOM. Eight organic wastes (chicken manure, swine manure, kitchen waste, lawn waste, fruits and vegetables waste, straw, green waste, and municipal solid waste) composting were conducted, the germination percentage (GI) and fluorescence spectra of DOM were measured during composting. Statistic analysis with all fluorescence parameters of DOM indicated that I436/I383 (a ratio between the fluorescence intensities at 436 and 383 nm in excitation spectra), FLR (an area ratio between fulvic-like region from 308 to 363 nm and total region in emission spectra), P(HA/Pro) (a regional integration ratio between humic acid-like region to protein-like region in excitation emission matrix (EEM) spectra), A4/A1 (an area ratio of the last quarter to the first quarter in emission spectra), r(A,C) (a ratio between the fluorescence intensities of peak A and peak C in EEM spectra) were correlated with each other (p < 0.01), suggesting that this fluorescence parameters could be considered as comprehensive evaluation index system of PPC. Subsequently, the four degrades of compost maturity included the best degree of maturity (I, GI > 80%), better degree of compost maturity (II, 60% < GI < 80%), maturity (III, 50% < GI < 60%), and immaturity (IV, GI < 50%) were divided according the GI value during composting. The corresponding fluorescence parameter values were calculated at each degrade of compost maturity. Then the projection values were calculated based on PPC considering the above fluorescence parameter values. The projection value was 2.01 - 2.22 for I grade, 1.21 - 2.0 for II grade, 0.57 - 1.2 for III grade, and 0.10 - 0.56 for IV grade. Model validation was then carried out with composts samples, the results indicated that the simulated values were agreed with the observed values, and the accuracy of PPC was 75% for four grades of maturity, and 100% for maturity and immaturity, suggesting that PPC could meet the need of the assessment of compost maturity.

Three-dimensional phase-sensitive inversion-recovery Turbo FLASH sequence for the assessment of left ventricular myocardial scar in swine.

OBJECTIVES: We sought to evaluate the feasibility and accuracy of free-breathing three-dimensional (3D) phase-sensitive inversion-recovery (PSIR) Turbo FLASH sequence for noninvasive assessment of left ventricular myocardial scar in swine models. MATERIALS AND METHODS: Nine Chinese minipigs with experimentally induced acute myocardial infarction were studied. At 1 week and the study endpoint 4 weeks after myocardial infarction surgery, the 3D and 2D contrasted cardiac magnetic resonance (CMR) imaging were performed randomly by using a 1.5 T clinical MR imaging system. Comparisons of myocardial scar volume (in cubic centimeters), scar transmurality (on a 5 points scale) and image quality (on a 4 points Likert scale) were performed by using the Pearson correlation and Bland-Altman analysis (for myocardial scar volume) or κ statistics (for transmurality) or Wilcoxon signed rank test (for image quality). RESULTS: In 6 of the 9 pigs, all procedures were successfully completed. In these pigs, a total of 48 segments with myocardial scars were detected by both 3D and 2D sequences, and there was good agreement for classification of scar transmurality (κ=0.930). The scar volume determined by triphenyltetrazolium chloride (TTC) staining (3.52 ± 1.40 cm(3)) showed a good correlation with both 3D (3.54 ± 1.36 cm(3), r=0.957, P=0.003) and 2D sequence (3.53 ± 1.26 cm(3), r=0.942, P=0.005) at 4 weeks. And there were good correlation between scar volumes obtained from 3D and 2D techniques (r=0.859, P<0.001) at both time points. Both 3D and 2D images detected a small reduction of scar volume from week 1 to week 4 by a factor of 1.179 and 1.176, respectively. Although slightly more artifacts were observed on 2D PSIR images, the overall image quality was not significantly different between the two sequences (3.17 ± 0.83 for 2D vs. 3.25 ± 0.75 for 3D, P =0.655). CONCLUSIONS: The free-breathing 3D PSIR Turbo FLASH sequence enables accurate assessment of left ventricular myocardial scar.

Assessment of left ventricular myocardial scar in coronary artery disease by a three-dimensional MR imaging technique.

PURPOSE: To evaluate the feasibility of free-breathing three-dimensional (3D) phase sensitive inversion recovery (PSIR) Turbo FLASH late gadolinium enhancement (LGE) magnetic resonance images (MRI) on left ventricular scar in patients with coronary artery disease (CAD) compared with clinically established breathhold two-dimensional (2D) PSIR Turbo FLASH images. MATERIALS AND METHODS: In 58 consecutive patients with confirmed CAD, LGE MRI using the two sequences have been acquired. Image quality was graded on a four-point scale according to the image appearance. Qualitative evaluation including the distribution area and the transmural extent of the scar based on the American Heart Association's (AHA's) 17-segment model was performed in both of 2D and 3D images. The scar volumes were compared quantitatively between 2D and 3D images. RESULTS: A total of 51 individuals were used for final statistical analysis. No differences were noted in image quality (P = 0.80), scar distribution area (P = 0.17), and scar transmural extent (P = 0.20) between 3D and 2D images. There was strong correlation in scar volume between the 3D and 2D results (r = 0.940; P < 0.001; Y = 0.298 + 1.251X, R(2) = 0.876). But the scar volume derived from 3D images was significantly larger than that derived from 2D images (2D versus 3D, 20.08 ± 9.41 cm(3) versus 25.41 ± 12.57 cm(3) , t = -7.60; P < 0.001). The trend toward a larger scar volume identified by 3D method was indicated through Bland-Altman analysis. CONCLUSION: Free-breathing 3D PSIR Turbo FLASH imaging is another feasible method to identify left ventricular myocardial scar in patients with CAD and detects more scar volume compared with breathhold 2D PSIR Turbo FLASH imaging.

Characterization of in vivo antioxidant constituents and dual-standard quality assessment of Danhong injection.

Antioxidants and oxidative stress play a critical role in cardiovascular diseases. Danhong injection (DHI) is a well prescribed cardiovascular medication in China, but its detailed chemical basis and mechanisms of action remain unknown. To prove the antioxidant activity of DHI, its free radical scavenging capacity (RSC) was assessed by 2,2-diphenyl-1-picrylhydrazyl (DPPH) spectrophotometric assay. The 50% radical scavenging activity value was 1:129.2 mL/mL, against 0.95 mM DPPH. To further identify the antioxidant compounds, modified thin-layer chromatography combined with DPPH bioautography assay was used. Compared with vitamin C, 11 of 16 available compounds displayed strong antioxidant activity, which were also detected in rat serum after intravenous administration of DHI by ultra-performance liquid chromatography-tandem mass spectrometry, except for hydroxysafflor yellow A. Therefore, 10 antioxidants remaining in the blood as key markers, and six other compounds as general markers, were employed to perform the quality control of DHI by ultra-performance liquid chromatography-ultraviolet detection after systematic methodological validation. The analytical results indicate a high correlation (r = 0.9) between the total content of those antioxidants remaining in blood and RSC of DHI among 10 batches. Further, the antioxidant profiling and chemical marker quantification as dual-standard quality assessment was successfully applied to evaluate Danshen and safflower injections.

[Assessment of intraventricular mechanical synchrony in systole by tissue synchronization imaging in normal subjects].

OBJECTIVE: To evaluate intraventricular mechanical synchrony in systole by real-time tri-plane tissue synchronization imaging (TSI). METHODS: Real-time tri-plane TSI was performed in 20 normal subjects, and the apical 4-chamber, 2-chamber and long-axis views of the left ventricular (LV) were obtained simultaneously. The data were post-processed offline, and a TSI surface map of LV colorized according to the time-to-positive peak systolic velocity (TTP) was generated to reflect the segment TTP semi-quantitatively. The segmental TTP of the six-basal and six-mid segments of LV was measured and compared. RESULTS: The myocardium was color-coded mainly by well-distributed green, and only a small portion displayed yellow or red color in the apical area; the TTP showed no significant differences between the segments measured (P>0.05). CONCLUSIONS: In normal subjects, the long-axis systolic motions of the LV are highly synchronized. TSI allows immediate visual identification of intraventricular mechanical synchrony and quantitative measurement of regional TTP.