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In this work, the nucleation and growth kinetics of pearlitic transformation are quantitatively investigated to unveil the distinctive microstructural evolution behavior under a high undercooling degree. Both intra-granular and inter-granular nucleation increasingly occur with 1-2 orders of magnitude increase in nucleation rate N˙. However, a moderate increase in the growth rate GV, namely a larger N˙/GV ratio, leads to a 30%–40% size reduction in pearlitic colonies. The avalanche-type increase in nucleation events induces a more random distribution of ferrite orientation among colonies that possess a slight increase in relative misorientation but a pronounced increase in accumulative misorientation, and an arbitrary alignment of Fe3C lamellas in colony interior. Such improved microstructural homogeneity ensures more uniform and localized deformability, which allows compatible deformation between colonies or within colonies and prevents the expansion of newly-formed cracks. These results provide guidance for industrial manufacture of high-carbon pearlitic products with high safety and reliability, resulting from the improvement in localized deformability, and for low-cost wires via reducing the drawing passes, stemming from the significant increase in uniform deformability.

BackgroundChildren are vulnerable to the respiratory effects of air pollution, and their lung function has been associated with long-term exposure to low air pollution level in developed countries. However, the impact of contemporary air pollution level in developing countries as a result of recent efforts to improve air quality on children's lung function is less understood.MethodsWe obtained a cross-sectional sample of 617 schoolchildren living in three differently polluted areas in Anhui province, China. 2-year average concentrations of air pollutants at the year of spirometry and the previous year (2017–2018) obtained from district-level air monitoring stations were used to characterize long-term exposure. Forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), and forced expiratory flow between 25 and 75% of FVC (FEF25−75) were determined under strict quality control. Multivariable regression was employed to evaluate the associations between air pollution level and lung function parameters, overall and by demographic characteristics, lifestyle, and vitamin D that was determined by liquid chromatography tandem mass spectrometry.ResultsMean concentration of fine particulate matter was 44.7 μg/m3, which is slightly above the interim target 1 standard of the World Health Organization. After adjusting for confounders, FVC, FEV1, and FEF25−75 showed inverse trends with increasing air pollution levels, with children in high exposure group exhibiting 87.9 [95% confidence interval (CI): 9.5, 166.4] mL decrement in FEV1 and 195.3 (95% CI: 30.5, 360.1) mL/s decrement in FEF25−75 compared with those in low exposure group. Additionally, the above negative associations were more pronounced among those who were younger, girls, not exposed to secondhand smoke, non-overweight, physically inactive, or vitamin D deficient.ConclusionsOur study suggests that long-term exposure to relatively high air pollution was associated with impaired lung function in children. More stringent pollution control measures and intervention strategies accounting for effect modification are needed for vulnerable populations in China and other developing countries.

Background There has been a focus on alternative cardiac rehabilitation (CR) delivery models aimed at improving CR adherence and completion. We examined pre‐ and post‐CR health outcomes, reasons for discharge, and predictors of completion using a patient‐driven appointment‐based CR approach that uses center‐scheduled class start times. Methods and Results Data were used from an urban single‐center CR program at Yale New Haven Health (2012–2017) that enrolled 2135 patients. We evaluated pre‐ and post‐CR outcomes (12 weeks) using paired t tests and used a multivariable logistic regression model to examine predictors of CR completion (≥36 sessions) for the overall cardiovascular disease population. The mean age of participants was 65±12 years, 27.9% were women, and 5.1% were Black patients, and patients completed a median of 30 of 36 sessions. Patients achieved significant improvements in health outcomes, including across age and sex subgroups. The primary reason for discharge was completion of all 36 sessions of CR (46.4%). The final logistic regression model contained 12 predictors: age, sex, Black race, marital status, employment, number of physician‐reported risk factors, dietary fat intake >30%, obesity, lack of exercise, benign prostatic hyperplasia, and self‐reported stress and physical activity. Conclusions We demonstrated that patients participating in an appointment‐based CR program achieved significant improvements in health outcomes and across sex/age subgroups. In addition, older individuals were more likely to complete CR. An appointment‐based approach could be a viable alternative CR method to aid in optimizing the dose‐response benefit of CR for patients with cardiovascular disease.

Background: Migration is at an all-time high worldwide, and despite increased focus on international migrants, there is little evidence about internal migrants’ exposures to socioeconomic, occupational, and environmental risk factors in low-and middle-income countries. Objective: The aim of this study was to examine differences in occupational health and access to water, sanitation, and hygiene (WASH) between internal migrants and non-migrants. Methods: A face-to-face survey (n = 937) was conducted in Mandalay, Myanmar. Bivariate and multivariate analysis included traditional social determinants such as education, income, occupation, gender, age, and location in addition to internal migration status. Findings: The majority of internal migrants (23% of the total sample) were labor migrants (67.3%), and while common social determinants (e.g., household income, education, and gender) were not statistically different between migrants and non-migrants, these groups reported different occupational profiles (p < 0.001). Migrants had higher odds of being street vendors (AOR = 2.26; 95% CI 1.33–3.85; p = 0.003) and were less likely to work labor jobs such as in factories or construction (AOR = 0.44; 95% CI 0.19–1.00; p = 0.051) when controlling for age, gender, education, and location. Internal migrants had significantly greater probabilities of experiencing some injuries and illness symptoms, such as cuts, vomiting, coughing, heatstroke, and diarrhea at work (p < 0.001). Compared to non-migrants, migrants’ households were approximately three times more likely (AOR = 3.45; 95% CI 2.17–5.62; p < 0.001) to have an unimproved source of drinking water and twice as likely (AOR = 1.98; 95% CI 1.10–3.58; p < 0.05) to have unimproved sanitation facilities in their homes. Conclusions: The results underscore the importance of considering internal migration as an aspect of social determinants analyses, and the need for targeting appropriate WASH interventions to address inequities.

Background Acute myeloid leukemia (AML) is one of the most common blood cancers, and is characterized by impaired hematopoietic function and bone marrow (BM) failure. Under normal circumstances, autophagy may suppress tumorigenesis, however under the stressful conditions of late stage tumor growth autophagy actually protects tumor cells, so inhibiting autophagy in these cases also inhibits tumor growth and promotes tumor cell death. Methods AML gene expression profile data and corresponding clinical data were obtained from the Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO) databases, from which prognostic-related genes were screened to construct a risk score model through LASSO and univariate and multivariate Cox analyses. Then the model was verified in the TCGA cohort and GEO cohorts. In addition, we also analyzed the relationship between autophagy genes and immune infiltrating cells and therapeutic drugs. Results We built a model containing 10 autophagy-related genes to predict the survival of AML patients by dividing them into high- or low-risk subgroups. The high-risk subgroup was prone to a poorer prognosis in both the training TCGA-LAML cohort and the validation GSE37642 cohort. Univariate and multivariate Cox analysis revealed that the risk score of the autophagy model can be used as an independent prognostic factor. The high-risk subgroup had not only higher fractions of CD4 naïve T cell, NK cell activated, and resting mast cells but also higher expression of immune checkpoint genes CTLA4 and CD274. Last, we screened drug sensitivity between high- and low-risk subgroups. Conclusion The risk score model based on 10 autophagy-related genes can serve as an effective prognostic predictor for AML patients and may guide for patient stratification for immunotherapies and drugs.

Abstract Elevated ground-level ozone (O3), which is an important aspect of air quality related to public health, has been causing increasing concern. This study investigated the spatiotemporal distribution of ground-level O3 concentrations in China using a dataset from the Chinese national air quality monitoring network during 2013–2015. This research analyzed the diurnal, monthly and yearly variation of O3 concentrations in both sparsely and densely populated regions. In particular, 6 major Chinese cities were selected to allow a discussion of variations in O3 levels in detail, Beijing, Chengdu, Guangzhou, Lanzhou, Shanghai, and Urumchi, located on both sides of the Heihe-Tengchong line. Data showed that the nationwide 3-year MDA8 of ground-level O3 was 80.26 μg/m3. Ground-level O3 concentrations exhibited monthly variability peaking in summer and reaching the lowest levels in winter. The diurnal cycle reached a minimum in morning and peaked in the afternoon. Yearly average O3 MDA8 concentrations in Beijing, Chengdu, Lanzhou, and Shanghai in 2015 increased 12%, 25%, 34%, 22%, respectively, when compared with those in 2013. Compared with World Health Organization O3 guidelines, Beijing, Chengdu, Guangzhou, and Shanghai suffered O3 pollution in excess of the 8-hour O3 standard for more than 30% of the days in 2013 to 2015.

Background: Migration is at an all-time high worldwide, and despite increased focus on international migrants, there is little evidence about internal migrants' exposures to socioeconomic, occupational, and environmental risk factors in low-and middle-income countries. Objective: The aim of this study was to examine differences in occupational health and access to water, sanitation, and hygiene (WASH) between internal migrants and nonmigrants. Methods: A face-to-face survey (n = 937) was conducted in Mandalay, Myanmar. Bivariate and multivariate analysis included traditional social determinants such as education, income, occupation, gender, age, and location in addition to internal migration status. Findings: The majority of internal migrants (23% of the total sample) were labor migrants (67.3%), and while common social determinants (e.g., household income, education, and gender) were not statistically different between migrants and non-migrants, these groups reported different occupational profiles (p < 0.001). Migrants had higher odds of being street vendors (AOR = 2.26; 95% CI 1.33-3.85; p = 0.003) and were less likely to work labor jobs such as in factories or construction (AOR = 0.44; 95% CI 0.19-1.00; p = 0.051) when controlling for age, gender, education, and location. Internal migrants had significantly greater probabilities of experiencing some injuries and illness symptoms, such as cuts, vomiting, coughing, heatstroke, and diarrhea at work (p < 0.001). Compared to nonmigrants, migrants' households were approximately three times more likely (AOR = 3.45; 95% CI 2.17-5.62; p < 0.001) to have an unimproved source of drinking water and twice as likely (AOR = 1.98; 95% CI 1.10-3.58; p < 0.05) to have unimproved sanitation facilities in their homes. Conclusions: The results underscore the importance of considering internal migration as an aspect of social determinants analyses, and the need for targeting appropriate WASH interventions to address inequities. [ABSTRACT FROM AUTHOR]