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OBJECTIVES: Earlier electrocardiogram (ECG) acquisition for ST-elevation myocardial infarction (STEMI) is associated with earlier percutaneous coronary intervention (PCI) and better patient outcomes. However, the exact relationship between timely ECG and timely PCI is unclear. METHODS: We quantified the influence of door-to-ECG (D2E) time on ECG-to-PCI balloon (E2B) intervention in this three-year retrospective cohort study, including patients from 10 geographically diverse emergency departments (EDs) co-located with a PCI center. The study included 576 STEMI patients excluding those with a screening ECG before ED arrival or non-diagnostic initial ED ECG. We used a linear mixed-effects model to evaluate D2Es influence on E2B with piecewise linear terms for D2E times associated with time intervals designated as ED intake (0-10 min), triage (11-30 min), and main ED (>30 min). We adjusted for demographic and visit characteristics, past medical history, and included ED location as a random effect. RESULTS: The median E2B interval was longer (76 vs 68 min, p 10 min than in those with timely D2E. The proportion of patients identified at the intake, triage, and main ED intervals was 65.8%, 24.9%, and 9.7%, respectively. The D2E and E2B association was statistically significant in the triage phase, where a 1-minute change in D2E was associated with a 1.24-minute change in E2B (95% confidence interval [CI]: 0.44-2.05, p = 0.003). CONCLUSION: Reducing D2E is associated with a shorter E2B. Targeting D2E reduction in patients currently diagnosed during triage (11-30 min) may be the greatest opportunity to improve D2B and could enable 24.9% more ED STEMI patients to achieve timely D2E.

Background: Delayed intervention for ST-segment elevation myocardial infarction (STEMI) is associated with higher mortality. The association of door-to-ECG (D2E) with clinical outcomes has not been directly explored in a contemporary US-based population. Methods: This was a three-year, 10-center, retrospective cohort study of ED-diagnosed patients with STEMI comparing mortality between those who received timely (10 min) diagnostic ECG. Among survivors, we explored left ventricular ejection fraction (LVEF) dysfunction during the STEMI encounter and recovery upon post-discharge follow-up. Results: Mortality was lower among those who received a timely ECG where one-week mortality was 5% (21/420) vs. 10.2% (26/256) among those with untimely ECGs (p = 0.016), and in-hospital mortality was 6.0% (25/420) vs. 10.9% (28/256) (p = 0.028). Data to compare change in LVEF metrics were available in only 24% of patients during the STEMI encounter and 46.5% on discharge follow-up. Conclusions: D2E within 10 min may be associated with a 50% reduction in mortality among ED STEMI patients. LVEF dysfunction is the primary resultant morbidity among STEMI survivors but was infrequently assessed despite low LVEF being an indication for survival-improving therapy. It will be difficult to assess the impact of STEMI care interventions without more consistent LVEF assessment.

BackgroundSchizophrenia patients often face high level of stigma and low level of self-esteem， significantly hindering their recovery. Mindfulness-based intervention has proven be effective in reducing stigma and improving self-esteem. However， traditional mindfulness intervention typically involve high costs and require long-term professional involvement.ObjectiveTo explore the effects of blended mindfulness interventions on stigma and self-esteem in patients with stable schizophrenia， so as to provide references for reducing stigma， enhancing self-esteem and promoting recovery.MethodsPatients receiving outpatient treatment at the Third Hospital of Daqing from June 2022 to January 2023， who met the diagnostic criteria for schizophrenia in the International Classification of Diseases， tenth edition （ICD-10） and were in a stable phase， were recruited for the study （n=84）. According to the random number table method， participants were randomly assigned to study group and control group， with 42 cases in each group. Both groups received treatment with the second-generation antipsychotic medications， while the study group additionally received blended mindfulness intervention for 8 weeks， with sessions lasting 45~60 minutes， three times a week. Both groups were evaluated with Five Facet Mindfulness Questionnaire （FFMQ）， Internalized Stigma of Mental Illness Inventory （ISMI） and Rosenberg Self-Esteem Scale （RSES） at baseline and after 8-week intervention. Covariance analysis was used to compare the FFMQ， ISMI and SES scores between two groups after 8-week intervention.ResultsAfter 8-week intervention， there were statistically significant differences between two groups in total FFMQ scores， as well as in the observation， acting with awareness， non-judgment and non-reactivity subscale scores （F=50.680， 12.952， 13.567， 22.799， 14.043， P

[Objective] Accurately forecasting energy demand and carbon emissions is the key to realize carbon peaking and neutrality. However, how to manipulate scenario measures to change the Environmental Kuznets Curve (EKC) inflection point, which signifies the timing of carbon peaking, remains a crucial research topic. As the forefront of China’s economy, it is of great guiding value for Zhejiang Province to explore its peak carbon dioxide emissions turning point and path. [Methods] This paper constructs a localized LEAP-Zhejiang model, designs baseline and comprehensive scenarios, and simulates energy consumption and greenhouse gas emissions in various sectors such as residential life, transportation, industry, agriculture, services, and energy conversion in Zhejiang Province from 2020 to 2050, and pays special attention to the impact of policies on the turning point of EKC. [Results] (1) Under the comprehensive scenario, the greenhouse gas emissions of Zhejiang Province will be greatly reduced during the forecast period compared with the baseline scenario, and will reach the peak in 2029. The emission intensity is significantly reduced to only 17.65% of the baseline scenario. This remarkable improvement is primarily attributed to the proactive transformation of the energy structure, successfully shifting from a coal and oil-dominated baseline scenario to an electricity-dominated comprehensive scenario. (2) The green energy sector sub-scenario emerges as the primary driving force for emissions reduction, delivering notable contributions through the green transformation of the energy structure. While the industrial sector remains a significant player in emissions reduction, its contribution rate is declining year by year. In contrast, the tertiary industry, particularly the transportation sector, is experiencing a steady increase in its energy-saving and emission-reduction contribution rate, showcasing a positive trend towards green transformation. (3) The popularization of new energy vehicles has been proved that it can effectively change the position of inflection point of EKC and achieve inflection point crossing, intuitively reflecting the positive effect of this measure in accelerating the arrival of carbon peaking in the province. [Conclusion] Zhejiang Province can adopt three major strategies to address climate change. Firstly, optimize the energy structure by increasing the proportion of renewable energy and constructing an intelligent energy system. Secondly, promote new energy vehicles by providing policy support and charging facilities to lead the way towards green transportation. Thirdly, enhance public environmental awareness, support carbon sequestration technologies, and encourage afforestation and low-carbon lifestyles.

Vascular cognitive impairment (VCI) denotes a wide range of cognitive deficiencies resulting from cerebrovascular risk factors and cerebrovascular diseases. Sirtuin 1 (SIRT1), as a deacetylase, can mediate the deacetylation of histones and non-histone proteins. It is involved in regulating multiple pathophysiological processes of VCI, including neuroinflammation reduction, oxidative stress inhibition, cell apoptosis decrease, and blood-brain barrier protection, serving as a target for VCI treatment. This paper summarizes SIRT1 and the molecular mechanisms of targeting SIRT1 in order to provide a reference for the clinical treatment of VCI.

Ticks are obligate blood-feeding arthropods that cause significant economic losses in domestic animal husbandry and threaten public health. However, information about soft ticks (Acari: Argasidae) and tick-borne pathogens in the Xinjiang Uygur Autonomous Region (XUAR) of China is scarce.

Stroke is a common neurological disease. Post-stroke sensory disorder is one of the common complications of stroke， which has severe negative impact on motor function and activity participation of patients. Transcranial direct current stimulation （tDCS）， a technique that uses 1 to 2 mA of direct current to modulate the cerebral cortex， is non-invasive， safe and well tolerated by patients. This study elaborates on the theoretical basis and mechanism of action of tDCS in treating post-stroke sensory disturbances， and analyzes and summarizes the application of tDCS in post-stroke sensory disturbances， confirming the effectiveness of tDCS， providing strong support for further clinical research of tDCS in the field of post-stroke rehabilitation.

Objective To investigate the clinical characteristics of patients with coronary artery spasm (CAS) combined with obstructive stenosis and the impact of stent implantation on their prognosis. Methods A retrospective observational study was conducted on patients admitted to Nanjing Jiangbei Hospital from June 2009 to June 2021, diagnosed with coronary artery spasm syndrome (CASS). Based on the results of coronary angiography (CAG), patients were divided into two groups: those combined with obstructive stenosis (n=24) and those without obstructive stenosis (n=20). The efficacy of medical treatment or combined stent implantation was observed, and major adverse cardiovascular events (MACE) or death were monitored during follow-up. Results There were no statistically significant differences between the group CAS combined with obstructive stenosis and the group CAS without obstructive stenosis in terms of gender, age, risk factors (hypertension, diabetes, alcohol abuse, smoking), laboratory test indicators ［peak values of blood glucose (Glu), low-density lipoprotein cholesterol (LDL-C),total cholesterol］, myocardial injury markers ［cardiac troponin T (cTnT), creatine kinase isoenzyme (CK-MB)］, ejection fraction (EF), and proportion of inferior wall ST segment elevation on electrocardiogram (P>0.05). Among 24 cases of spastic coronary artery complicated with obstructive stenosis, 5 cases (20.83%) were treated with drugs, and 19 cases (79.17%) underwent PCI ［15 cases (78.95%) had PCI on spastic and obstructive stenostic coronary arteries and 4 cases (21.05%) had PCI on non-spastic coronary arteries］. Among 20 cases of spastic coronary artery without stenosis, 16 cases had right coronary artery (RCA)spasm (including 13 cases had RCA completely normal with spasm, 3 cases with 20%-30% stenosis), 4 cases of left anterior descending artery (LAD) spasm (2 cases of completely normal, 2 cases with 30%-40% stenosis), and only 1 case (5.00%) underwent PCI in non-spastic coronary artery. in the group with coronary artery spasm and obstructive stenosis, the follow-up period ranged from 24 to 129 (64.13±29.80) months, with 4 cases of angina recurrence, 1 case of in-stent stenosis, and 1 case of very late stent thrombosis leading to acute myocardial infarction requiring emergency PCI. In the group without stenosis, the follow-up period ranged from 30 to 168 (64.75±32.54) months, with 7 cases of angina recurrence and 1 death. The incidence of MACE (25.00% vs40.00%) was not statistically significant between the two groups (P＞0.05). Conclusion Patients with CAS and obstructive stenosis can choose medical treatment combined with stent implantation for good prognosis, but guidance under intracoronary imaging is necessary.

Objective To investigate the related influence factors of neonatal transfusion-associated necrotizing enterocolitis （TANEC）. Methods Clinical data of neonates with necrotizing enterocolitis （NEC） treated by surgery were retrospectively analyzed. All participants were divided into the TANEC and non-TANEC groups. Clinical characteristics， maternal conditions， laboratory test results， intraoperative conditions and clinical prognosis were subject to univariate and multivariate Logistic regression analyses. Related factors of TANEC were identified. The predictive values of these factors were determined by the receiver operating characteristic （ROC） curve and the area under the ROC curve （AUC）. Results A total of 51 infants were enrolled in this study， including 13 cases in the TANEC group and 38 in the non-TANEC group. Univariate analysis showed statistically significant differences in birth weight， Apgar-1 score， gestational age， number of transfusions， patent ductus arteriosus and hemoglobin level between two groups （all P < 0.05）. Multivariate Logistic regression analysis revealed that the number of transfusions and hemoglobin level were the related factors for the incidence of TANEC （both P < 0.05）. ROC curve verified that the AUC of the number of transfusions was 0.882 （95% CI 0.794-0.969）， 0.857 （95% CI 0.747-0.968） for hemoglobin level， and 0.907 （95% CI 0.822-0.992） for the two combined， respectively. Conclusion The number of blood transfusion and hemoglobin level are associated with the occurrence of TANEC， and the combination of these two can better predict the incidence of TANEC.

Abstract For the integration detection of near space hypersonic weak targets by high pulse repetition frequency (PRF) radar, a novel method named Multi‐Hypothesis Fuzzy‐Matching Radon transform (MHFM‐RT) is proposed for the near space hypersonic target detection and tracking. For remote hypersonic target detection, to avoid range ambiguity, current radars always use a low PRF mode, which limit the number of pulse accumulations. Using the high PRF mode, the fuzzy folding will appear in the target range measurements when target trajectory crosses range fuzzy intervals. Therefore, there is a contradiction between range ambiguity and energy accumulation. The proposed method is used to match the fuzzy measurements, so as to realise the correct integration in the condition of range ambiguity. Firstly, considering the need of range ambiguity resolution, the mode of staggered PRF is used. Secondly, the first frame measurements are periodically extended for multiple‐fuzzy hypothesis. Finally, the weak target track is accumulated in MHFM‐RT domain, and the signal integration and ambiguity resolution can be realised simultaneously. The proposed method expands the Variable‐Diameter‐Arc‐Helix Radon transform (VDAH‐RT) method to fuzzy folding conditions. Compared with the existing methods, for 7‐scan measurements non‐coherent integration, the detection sensitivity of the proposed method is about 0.5–1 dB higher than that of the IMM hybrid filter algorithm, and about 1 dB higher than that of the RHT‐TBD approach, and it needs less storage space and has higher detection probability.