Perovskite Crystallization Control for Large, Oriented Grains with Residual Solvent Restrain via Hydrogen-Bonded Organic Frameworks.

Void-free perovskite films with oriented large grains are considered good performance. However, contradictory requirements on solvent volatilization arise that the growth of large grains requires slow volatilization while the residual solvent problem, which leads to difficult-handled voids at buried interface, requires quick and complete volatilization. Currently, although grain boundary additives help reach large and oriented grains, the occupation of additives in the grain boundary volatilization channel may further deteriorate the residual solvent problem. Herein, porous structures with "switchable pore" nature are constructed based on flexible hydrogen-bonded (HOF-FJU-2) in perovskite grain boundaries to meet both contradictory requirements with achieving crystallization control and residual solvent restrain. The additive molecules prolongs the perovskite crystallization through the Pb-O bond and guides the growth of (100) facet based on its strong ordered accumulation trend. The pre-embedded porous structure opens up the solvent volatilization channel for complete volatilization in annealing stage and then switches to a closed pore state via phase transformation after the solvent completely leaves, preventing the intrusion of the external environment. Combined with theoretical calculations and in situ spectrum tests, the crystallization thermodynamics and dynamics are analyzed. As expected, the target device exhibits enhanced performance (improved from 22.14% to 24.18%) and stability.

Integrating Polyoxometalates and Silver Clusters into Atomically Precise Molecular Heterojunction.

The Ag cluster-POM assemblies have been shown to possess interesting and potentially useful properties. However, there is no precedent example of atomically precise Ag cluster-POM assemblies showing heterojunction effects in photocatalysis. Herein, the synthesis and total structure determination of the periodically distributed molecular heterojunction [Ag12(SCy)6(CH3CN)12(PW12O40)]n (Ag12-PW12) are reported. The assembly of Ag/W clusters into 3D network can endow the resulting binary structure with an aesthetic topology and unique physicochemical properties. More remarkably, the incorporation of Ag12 cluster with PW12 can efficiently facilitate the separation of photogenerated electrons and holes, thus significantly promoting the catalytic efficiency in selective oxidation of sulfides. The Ag12-PW12 heterojunction can be recovered and reused five times with no drastic change in the catalytic performance. This research is expected to assist in the rational design of cluster-based heterojunction catalysts. The increase of catalytic activity of the Ag12-PW12 assembly in comparison with the unassembled Ag12 and PW12 clusters is attributed to the synergistic effect of Ag12 and PW12 clusters, offering the splendid opportunity for deciphering structure-reactivity relationship of heterostructure-coupled photosystem.

Burden of non-communicable diseases attributable to high temperature in a changing climate from 1990 to 2019: a global analysis.

BACKGROUND: With global climate change, the health threats of ambient high temperature have received widespread attention. However, latest spatio-temporal patterns of the non-communicable diseases (NCDs) burden attributable to high temperature have not been systematically reported. We aimed to analyze vulnerable areas and populations based on a detailed profile for the NCDs burden attributable to high temperature globally. METHODS: We obtained data from the Global Burden of Diseases (GBD) Study (2019) to describe the temporal and spatial patterns of NCDs burden attributable to high temperature globally from 1990-2019. Then we analyzed the differences by region, sex, and socio-demographic index (SDI). Finally, the age­period­cohort (APC) model was utilized to explore the age, period, and cohort effects of NCDs mortality caused by high temperature. RESULTS: In 2019, the number of deaths and Disability-adjusted life years (DALYs) from high-temperature-related NCDs was about 150,000 and 3.4 million globally, of which about 70% were in South Asia and North Africa and Middle East, and the burden was higher in men. Among 204 countries and territories, the highest age-standardized mortality rate (ASMR) and age-standardized DALY rate (ASDR) were observed in Oman and United Arab Emirates, respectively. The global burden showed an upward trend from 1990 to 2019, with an EAPC of 3.66 (95%CI: 3.14-4.18) for ASMR and 3.68 (95%CI: 3.16-4.21) for ASDR. Cardiovascular diseases were the main contributors to the global burden of high-temperature-related NCDs in 2019. The age and period effect in APC model showed an increasing trend globally. There was a significant negative correlation between SDI and both ASMR (r = -0.17) and ASDR (r = -0.20) from 1990 to 2019. CONCLUSION: There was an increasing trend of the global burden of high-temperature-related NCDs. The burden was likely to be higher in males and the elderly, as well as in countries and regions with less economically and socially developed and in tropical climates. Surveillance and prevention measures should be implemented with a focus on these vulnerable areas and susceptible populations.

Promoting Charge-Carriers Dynamics by Relaxed Lattice Strain in A-site-doped Halide Perovskite for Photocatalytic H2 Evolution.

Because of the unique and superior optoelectronic properties, metal halide perovskites (MHPs) have attracted great interests in photocatalysis. Element doping strategy is adopted to modify perovskite materials to improve their photocatalytic performance. However, the contribution of bare doping-site onto photocatalytic efficiency, and the correlation between doping locations and activity have not yet to be demonstrated. This promoted us to explore the potential of A-site-doped MHPs for photocatalysis. Herein, we dope potassium (K+) into CsPbBr3 and first reveal that the occupied locations of K+ in CsPbBr3 is lattice incorporation rather than surface segregation, which would change from A-site substitution to interstitial site in lattice with the increase of K+ concentrations. Taking H2 evolution as a model reaction, photocatalytic activity of CsPbBr3 after K+ doping could be significantly improved ~11-fold with A-site substitution, which is superior to that of interstitial site doping. Moreover, other alkali metals including Li, Na, and Rb doping give the same results. The structure of photocatalysts during reaction confirmed the contribution of A-site doping onto enhanced photocatalytic activity. Mechanistic insights show it is a result of the relaxed residual lattice strain induced promoted charge-carriers dynamics and formed upward shifting of band after K+ A-site doping.

Mo2 N-ZrO2 Heterostructure Engineering in Freestanding Carbon Nanofibers for Upgrading Cycling Stability and Energy Efficiency of Li-CO2 Batteries.

Li-CO2 batteries have attracted considerable attention for their advantages of CO2 fixation and high energy density. However, the sluggish dynamics of CO2 reduction/evolution reactions restrict the practical application of Li-CO2 batteries. Herein, a dual-functional Mo2 N-ZrO2 heterostructure engineering in conductive freestanding carbon nanofibers (Mo2 N-ZrO2 @NCNF) is reported. The integration of Mo2 N-ZrO2 heterostructure in porous carbons provides the opportunity to simultaneously accelerate electron transport, boost CO2 conversion, and stabilize intermediate discharge product Li2 C2 O4 . Benefiting from the synchronous advantages, the Mo2 N-ZrO2 @NCNF catalyst endows the Li-CO2 batteries with excellent cycle stability, good rate capability, and high energy efficiency even under high current densities. The designed cathodes exhibit an ultrahigh energy efficiency of 89.8% and a low charging voltage below 3.3 V with a potential gap of 0.32 V. Remarkably, stable operation over 400 cycles can be achieved even at high current densities of 50 µA cm-2 . This work provides valuable guidance for developing multifunctional heterostructured catalysts to upgrade longevity and energy efficiency of Li-CO2 batteries.

Hydrogen-Bonded Organic Framework to Upgrade Cycling Stability and Rate Capability of Li-CO2 Batteries.

Elaborately designed multifunctional electrocatalysts capable of promoting Li+ and CO2 transport are essential for upgrading the cycling stability and rate capability of Li-CO2 batteries. Hydrogen-bonded organic frameworks (HOFs) with open channels and easily functionalized surfaces hold great potential for applications in efficient cathodes of Li-CO2 batteries. Herein, a robust HOFS (HOF-FJU-1) is introduced for the first time as a co-catalyst in the cathode material of Li-CO2 batteries. HOF-FJU-1 with cyano groups located periodically in the pore can induce homogeneous deposition of discharge products and accommodate volumetric expansion of discharge products during cycling. Besides, HOF-FJU-1 enables effective interaction between Ru0 nanoparticles and cyano groups, thus forming efficient and uniform catalytic sites for CRR/CER. Moreover, HOF-FJU-1 with regularly arranged open channels are beneficial for CO2 and Li+ transport, enabling rapid redox kinetic conversion of CO2 . Therefore, the HOF-based Li-CO2 batteries are capable of stable operation at 400 mA g-1 for 1800 h and maintain a low overpotential of 1.96 V even at high current densities up to 5 A g-1 . This work provides valuable guidance for developing multifunctional HOF-based catalysts to upgrade the longevity and rate capability of Li-CO2 batteries.

Privacy protection framework for face recognition in edge-based Internet of Things.

Edge computing (EC) gets the Internet of Things (IoT)-based face recognition systems out of trouble caused by limited storage and computing resources of local or mobile terminals. However, data privacy leak remains a concerning problem. Previous studies only focused on some stages of face data processing, while this study focuses on the privacy protection of face data throughout its entire life cycle. Therefore, we propose a general privacy protection framework for edge-based face recognition (EFR) systems. To protect the privacy of face images and training models transmitted between edges and the remote cloud, we design a local differential privacy (LDP) algorithm based on the proportion difference of feature information. In addition, we also introduced identity authentication and hash technology to ensure the legitimacy of the terminal device and the integrity of the face image in the data acquisition phase. Theoretical analysis proves the rationality and feasibility of the scheme. Compared with the non-privacy protection situation and the equal privacy budget allocation method, our method achieves the best balance between availability and privacy protection in the numerical experiment.

RADICLELESS 1 (RL1)-mediated nad4 intron 1 splicing is crucial for embryo and endosperm development in rice (Oryza sativa L.).

Pentatricopeptide repeat (PPR) proteins are one of the largest protein families in land plants. PPR proteins exhibit sequence-specific RNA-binding activity and are implicated in plant growth and development related processes. In this study, we report that the radicleless 1 (rl1) mutant in rice (Oryza sativa L.) exhibited defective radicle emergence in embryos and compromised grain filling in endosperms. Gene cloning and confirmation via genetic complementation analyses showed that RL1 encodes a P-type PPR protein, which is localized to mitochondria. The RL1 protein was specifically involved in the splicing of intron 1 of the mitochondrial nad4 transcript, which encodes a subunit of the mitochondrial NADH dehydrogenase complex. Consistent with this observation, the rl1 mutant exhibited altered mitochondrial morphology and lower ATP accumulation compared with the wild type. Thus, our findings suggest that RL1-mediated nad4 splicing is crucial for embryo and endosperm development in rice.

Autoxidated linolenic acid inhibits aflatoxin biosynthesis in Aspergillus flavus via oxylipin species.

Aflatoxins produced by Aspergillus species are among the most toxic and carcinogenic compounds in nature. Although it has been known for a long time that seeds with high oil content are more susceptible to aflatoxin contamination, the role of fatty acids in aflatoxin biosynthesis remains controversial. Here we demonstrate in A. flavus that both the saturated stearic acid (C18:0) and the polyunsaturated linolenic acid (C18:3) promoted aflatoxin production, while C18:3, but not C18:0, inhibited aflatoxin biosynthesis after exposure to air for several hours. Further experiments showed that autoxidated C18:3 promoted mycelial growth, sporulation, and kojic acid production, but inhibited the expression of genes in the AF biosynthetic gene cluster. Mass spectrometry analyses of autoxidated C18:3 fractions that were able to inhibit aflatoxin biosynthesis led to the identification of multiple oxylipin species. These results may help to clarify the role of fatty acids in aflatoxin biosynthesis, and may explain why controversial results have been obtained for fatty acids in the past.

ZnO@Ag2S core-shell nanowire arrays for environmentally friendly solid-state quantum dot-sensitized solar cells with panchromatic light capture and enhanced electron collection.

A solid-state environmentally friendly Ag2S quantum dot-sensitized solar cell (QDSSC) is demonstrated. The photovoltaic device is fabricated by applying ZnO@Ag2S core-shell nanowire arrays (NWAs) as light absorbers and electron conductors, and poly-3-hexylthiophene (P3HT) as a solid-state hole conductor. Ag2S quantum dots (QDs) were directly grown on the ZnO nanowires by the successive ionic layer adsorption and reaction (SILAR) method to obtain the core-shell nanostructure. The number of SILAR cycles for QD formation and the length of the core-shell NWs significantly affect the photocurrent. The device with a core-shell NWAs photoanode shows a power conversion efficiency increase by 32% compared with the device based on a typical nanoparticle-based photoanode with Ag2S QDs. The enhanced performance is attributed to enhanced collection of the photogenerated electrons utilizing the ZnO nanowire as an efficient pathway for transporting the photogenerated electrons from the QD to the contact.

The non-metabolizable glucose analog D-glucal inhibits aflatoxin biosynthesis and promotes kojic acid production in Aspergillus flavus.

BACKGROUND: Aflatoxins (AFs) are potent carcinogenic compounds produced by several Aspergillus species, which pose serious threats to human health. As sugar is a preferred carbohydrate source for AF production, we examined the possibility of using sugar analogs to inhibit AF biosynthesis. RESULTS: We showed that although D-glucal cannot be utilized by A. flavus as the sole carbohydrate source, it inhibited AF biosynthesis and promoted kojic acid production without affecting mycelial growth when applied to a glucose-containing medium. The inhibition occurred before the production of the first stable intermediate, norsolorinic acid, suggesting a complete inhibition of the AF biosynthetic pathway. Further studies showed that exogenous D-glucal in culture led to reduced accumulation of tricarboxylic acid (TCA) cycle intermediates and reduced glucose consumption, indicating that glycolysis is inhibited. Expression analyses revealed that D-glucal suppressed the expression of AF biosynthetic genes but promoted the expression of kojic acid biosynthetic genes. CONCLUSIONS: D-glucal as a non-metabolizable glucose analog inhibits the AF biosynthesis pathway by suppressing the expression of AF biosynthetic genes. The inhibition may occur either directly through interfering with glycolysis, or indirectly through reduced oxidative stresses from kojic acid biosynthesis.

The relationship between loneliness and problematic social media usage in Chinese university students: a longitudinal study.

BACKGROUND: A significant number of cross-sectional studies have explored the correlation between loneliness and problematic social media use. However, the causal relationship between these two key variables remains controversial, and the developmental relationship over time is unclear. METHODS: We conducted a one-year longitudinal study with 538 Chinese college students using questionnaires and employing cross-lagged and latent growth models to investigate the causal relationship and developmental dynamics between loneliness and problematic social media use. RESULTS: The results indicate that (a) loneliness and problematic social media use mutually and positively influence each other, establishing a bidirectional causal relationship; (b) Chinese college students experience a gradual increase in levels of loneliness and problematic social media use during their time in college; and (c) the intercept and slope of loneliness significantly and positively affect the intercept and slope of problematic social media use, and conversely, the intercept and slope of problematic social media use significantly and positively influence the intercept and slope of loneliness. CONCLUSION: These findings reveal the longitudinal relationship between loneliness and problematic social media use among Chinese college students and offer insights for researchers and educators to intervene in college students' loneliness and problematic social media use from a developmental perspective.

The association between insomnia and cognitive decline: A scoping review.

OBJECTIVE: This study aimed to investigate the association between insomnia and cognitive decline to provide insights for clinical interventions and future research. METHODS: The PubMed, Embase, Web of Science, Scopus, Cochrane Library, and ProQuest databases were systematically searched to identify studies on the association between insomnia and cognitive decline published within the last decade. The quality of the included studies was evaluated, followed by data extraction and summary analysis. RESULTS: A total of 36 studies were included in the review. Both subjective and objective measures were utilized across 12 indices to assess sleep status, while cognitive function was evaluated using 5 scales and 34 tests. The results revealed a significantly increased risk of cognitive decline or Alzheimer's disease among patients with insomnia, alongside notable impairments in attention, memory, visuospatial abilities, executive function, and verbal memory. Comprehensive assessments of cognitive domains were more sensitive in detecting group differences compared to assessments of specific cognitive sub-functions. Furthermore, MRI analyses showed reduced gray matter volumes in regions such as the prefrontal cortex, cingulate gyrus, temporal lobe, and hippocampus, together with reduced integrity of the white matter in patients with insomnia. CONCLUSIONS: The findings indicate a potentially bidirectional relationship between insomnia and cognitive decline, suggesting that each may influence and exacerbate the other. Insomnia may increase the risk of cognitive decline and appears to be associated with reduced gray matter volume and compromised white matter integrity in the brain, which could potentially lead to declines in attention, memory, visuospatial abilities, executive function, and verbal memory. Conversely, cognitive decline may contribute to the onset of insomnia, further deteriorating sleep quality. However, further research is necessary to fully comprehend this intricate relationship.

Pristine MOF Materials for Separator Application in Lithium-Sulfur Battery.

Lithium-sulfur (Li-S) batteries have attracted significant attention in the realm of electronic energy storage and conversion owing to their remarkable theoretical energy density and cost-effectiveness. However, Li-S batteries continue to face significant challenges, primarily the severe polysulfides shuttle effect and sluggish sulfur redox kinetics, which are inherent obstacles to their practical application. Metal-organic frameworks (MOFs), known for their porous structure, high adsorption capacity, structural flexibility, and easy synthesis, have emerged as ideal materials for separator modification. Efficient polysulfides interception/conversion ability and rapid lithium-ion conduction enabled by MOFs modified layers are demonstrated in Li-S batteries. In this perspective, the objective is to present an overview of recent advancements in utilizing pristine MOF materials as modification layers for separators in Li-S batteries. The mechanisms behind the enhanced electrochemical performance resulting from each design strategy are explained. The viewpoints and crucial challenges requiring resolution are also concluded for pristine MOFs separator in Li-S batteries. Moreover, some promising materials and concepts based on MOFs are proposed to enhance electrochemical performance and investigate polysulfides adsorption/conversion mechanisms. These efforts are expected to contribute to the future advancement of MOFs in advanced Li-S batteries.

Effects of traditional Chinese exercises in fibromyalgia syndrome: A meta-analysis of randomized controlled trials.

OBJECTIVES: To explore the efficacy and safety of five traditional Chinese exercises (TCEs) in patients with fibromyalgia syndrome (FMS). METHODS: The PubMed, Embase, Scopus, ProQuest, Web of Science, Cochrane, CNKI, WanFang, and VIP databases were comprehensively searched for randomized controlled trials (RCTs) related to TCEs published from inception until February 2023. Standardized mean differences (SMD) and 95% confidence intervals (CI) were used to determine the combined effects of the intervention, and the Cochrane risk-of-bias assessment tool and Review 5.2 software were used to assess methodological quality. The data were extracted and analyzed by the Stata15.0 random effects model. RESULTS: Nineteen RCTs including 1315 participants were included in the analysis. The studies were found to be heterogeneous (I2 =86.2, P = 0.000), and thus a random effects model was used to combine the data. The results showed that traditional Chinese exercises had potentially beneficial effects on reducing pain (SMD =-0.66,95% CI [-1.08, -0.25], P = 0.002), improving sleep (SMD = -0.35,95% CI [-0.68,0. 01], P = 0.041) and relieving depression (SMD= -0.24,95% CI [-0.47, -0.02], P = 0.034) in FMS patients. However, no significant effects were found on improved quality of life (SMD =-0.20,95% CI [-0.48,0.09], P = 0.176). CONCLUSIONS: TCEs can improve pain, sleep quality and depression in patients with FMS and are safe. However, they do not improve the quality of life significantly. Further large-scale, high-quality, and multi-center RCTs are required to verify the efficacy of TCEs.

Factors associated with under-five mortality in Rwanda: An analysis of the Rwanda Demographic and Health Survey 2020.

Despite global and Rwandan progress in reducing under-five mortality, the risk of children dying before their fifth birthday persists, necessitating intensified research on determinants. Thus, this study analyzed the birth history data to shed light on the underlying causes of under-five mortality in Rwanda. The study is a secondary analysis of data sourced from the 2020 Rwanda Demographic and Health Survey (RDHS) cross-sectional design. Using SPSS, the data was cleaned, recoded, and weighted, with descriptive and inferential statistics applied. The dependent variable was the child's living status, while independent variables included socio-demographic, media exposure status of mothers, child, and environmental factors. A total of 10267 under-five children of all interviewed mothers were included in the final analysis, of which 12.3% (1260) died. Maternal age (25-34 years: AOR = 1.514, 95% CI = 1.130-2.029, p = 0.005; 45+: AOR = 13.226, 95% CI = 9.253-18.905, p<0.001), occupational status (agricultural workers and other services), and three or more births within five years (AOR = 1.895, 95% CI = 1.433-2.508, p<0.001) significantly increase the risk of under-five mortality. Conversely, maternal education (primary: AOR = 0.821, p = 0.023; secondary: AOR = 0.533, p<0.001; higher: AOR = 0.365, p = 0.010) and higher wealth indexes (middle: AOR = 0.743, p = 0.001; rich: AOR = 0.612, p<0.001), as well as current breastfeeding (AOR = 0.524, 95% CI = 0.455-0.603, p-value <0.001), are associated with lower under-five mortality. Child sex significantly impacts under-five mortality (AOR = 0.873, 95% CI = 0.770-0.991, p = 0.035), favoring females over males. Conversely, multiple birth type children face higher under-five mortality (AOR = 3.541, 95% CI = 2.727-4.599, p<0.001) compared to singletons. Children in the northern (AOR = 1.478, 95% CI = 1.086-2.011, p = 0.013) and eastern (AOR = 1.470, 95% CI = 1.097-1.971, p = 0.010) regions are more susceptible to mortality compared to those in the central (Kigali) region. Additionally, under-five mortality is higher when using water from tanks and other sources (AOR = 2.240, 95% CI = 1.471-3.411, p<0.001) than piped water. This study identifies crucial factors linked to under-five mortality, underscoring the importance of prioritizing them in interventions to enhance Rwandan under-five survival rates.

Disease burden of COPD attributable to PM2.5 in China, Japan and South Korea from 1990 to 2019: a comparative study based on Global Burden of Disease Study 2019.

OBJECTIVE: We hope to reveal the changing trends of chronic obstructive pulmonary disease (COPD) burden attributable to particulate matter pollution (PM2.5) and its age, period and cohort effects in China, Japan and Korea. DESIGN: We analysed the trend of COPD disease burden attributable to PM2.5 from 1990 to 2019 based on the latest Global Burden of Disease Database (GBD 2019) using JoinPoint model and analysed the effect of age, period and cohort on COPD burden attributable to PM2.5 in China, Japan and Korea from 1990 to 2019 using age-period-cohort model (model). SETTING: GBD data from 1990 to 2019. PARTICIPANTS: Data were publicly available and individuals were not involved. MAIN OUTCOMES: Outcomes included the age standardised mortality rate (ASMR), the age-standardised disability-adjusted life year (DALY), average annual per cent change (AAPC), net drift, local drift, longitudinal age curves, period (cohort) rate ratios, age (period, cohort) bias coefficient. RESULTS: From 1990 to 2019, the ASMR of COPD attributable to PM2.5 in China (AAPC=-5.862), Japan (AAPC=-1.715) and Korea (AAPC=-1.831) showed a downward trend. The age-standardised DALY of COPD attributable to PM2.5 in China (AAPC=-5.821), Japan (AAPC=-1.39) and Korea (AAPC=-1.239) showed a downward trend. Mortality of COPD attributable to PM2.5 increased slowly with age in Korea and Japan. Mortality of COPD attributable to PM2.5 in China decreased after rising (95% CI: 404.66 to 466.01). Mortality of COPD attributable to PM2.5 decreased over time in China and Korea, while it increased in Japan from 2015 to 2019. In China and Japan, mortality of COPD attributable to PM2.5 was approximately lower the later the birth, while in Korea it decreased after an increase (95% CI: 2.13 to 2.40) in the 1900-1910. CONCLUSIONS: Most COPD burden attributable to PM2.5 is on the decline; COPD mortality attributable to PM2.5 both increased with age and decreased with time and cohort. Countries with high burden should develop targeted measures to control PM2.5.

Environmental pollution, trade openness and the health of middle-aged and elderly people: an analysis of threshold effect based on data from 111 prefecture-level cities in China.

BACKGROUND: Environmental pollution seriously endangers people's physical and mental health, especially the health of middle-aged and elderly people. Environmental pollution, trade openness, and population health are interconnected. Environmental pollution may have a nonlinear impact on health, and the impact of trade openness on the health effects of environmental pollution may not be a simple strengthening or weakening effect. However, few studies have used threshold effects model to explore the nonlinear mechanisms of environmental pollution's impact on health in China. As a result, this study incorporates trade openness into the research framework on the health effects of environmental pollution, aiming to study the mechanism of environmental pollution on health. METHODS: Using the China Health and Retirement Longitudinal Study (CHARLS) data from 2013 to 2020 and the data of 111 prefecture-level cities in China, we combine two-way fixed-effects models and threshold models to explore the effects of environmental pollution on the health of middle-aged and elderly people and the role of trade openness in the path of environmental pollution affecting health. RESULTS: Environmental pollution impairs the health of middle-aged and elderly people, and there is a single threshold effect and regional heterogeneity in this negative impact. Trade openness has the effect of first weakening and then strengthening in the inhibitory effect of environmental pollution on health. CONCLUSION: The negative impact of environmental pollution on health has regional heterogeneity, and there is a nonlinear relationship between environmental pollution and the health of middle-aged and elderly people. The health effect of environmental pollution is mainly long-term effect, and trade openness has a threshold effect on the impact of environmental pollution on health. Therefore, instead of adopting a one-size-fits-all policy, environmental and economic policies should be customized according to the degree of environmental pollution, trade openness, and regional variations, so as to safeguard the health of middle-aged and elderly individuals through effective environmental governance.

Combining intralesional steroid injection with oral steroids in patients with idiopathic granulomatous mastitis.

Idiopathic granulomatous mastitis (IGM) is a chronic inflammatory breast disease. Currently, there is no international standard for steroid use in IGM, particularly for intralesional steroid injections. This study aimed to determine whether patients with IGM who received oral steroids could benefit from intralesional steroid injection. We analyzed 62 patients with IGM whose main clinical presentation was mastitis masses and who received preoperative steroid therapy. Group A (n = 34) received combined steroid treatment: oral steroids (starting dose, 0.25 mg/kg/d; tapered off) and intralesional steroid injection (20 mg per session). Group B (n = 28) received oral steroids only (starting dose, 0.5 mg/kg/d; tapered off). Both groups underwent lumpectomy at the end of steroid treatment. We analyzed the preoperative treatment time, preoperative mass maximum diameter reduction rate, side effects, postoperative satisfaction, and rate of IGM recurrence. The mean age of the 62 participants was 33.6 ± 2.3 (range, 26-46) years, and all had unilateral disease. We found that oral steroids combined with intralesional steroid injection yielded better therapeutic effects than did oral steroids alone. The median maximum diameter reduction of the breast mass was 52.06% in group A and 30.00% in group B (P = .002). Moreover, the use of intralesional steroids reduced the duration of oral steroid use; the median durations of preoperative steroid therapy were 4 and 7 weeks in groups A and B, respectively (P < .001). Group A patients were more satisfied (P = .035) with the postoperative results, including postoperative appearance and function. No statistically significant between-group differences were noted regarding side effects and recurrence rates. Preoperative administration of oral steroids combined with intralesional steroid injection yielded better therapeutic effects than did oral steroids alone and may be an effective future treatment for IGM.