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Abstract Background Physical activity (PA) is essential and effective for chronic heart failure (CHF) patients. A greater understanding of the longitudinal change in PA and its influencing factors during the postdischarge transition period may help create interventions for improving PA. The aims of this study were (1) to compare the change in PA, (2) to examine the influencing factors of PA change, and (3) to verify the mediating pathways between influencing factors and PA during the postdischarge transition period in CHF patients. Methods A total of 209 CHF patients were recruited using a longitudinal study design. The Chinese version of the International Physical Activity Questionnaire (IPAQ), Patient-reported Outcome Measure for CHF (CHF-PRO), and the Chinese version of the Tampa Scale for Kinesiophobia Heart (TSK-Heart) were used to assess PA, CHF-related symptoms, and kinesiophobia. The IPAQ score was calculated (1) at admission, (2) two weeks after discharge, (3) two months after discharge, and (4) three months after discharge. Two additional questionnaires were collected during admission. Generalized estimating equation (GEE) models were fitted to identify variables associated with PA over time. We followed the STROBE checklist for reporting the study. Results The PA scores at the four follow-up visits were 1039.50 (346.50-1953.00) (baseline/T1), 630.00 (1.00-1260.00) (T2), 693.00 (1-1323.00) (T3) and 693.00 (160.88–1386.00) (T4). The PA of CHF patients decreased unevenly, with the lowest level occurring two weeks after discharge, and gradually improving at two and three months after discharge. CHF-related symptoms and kinesiophobia were significantly associated with changes in PA over time. Compared with before hospitalization, an increase in CHF-related symptoms at two weeks and two months after discharge was significantly associated with decreased PA. According to our path analysis, CHF-related symptoms were positively and directly associated with kinesiophobia, and kinesiophobia was negatively and directly related to PA. Moreover, CHF-related symptoms are indirectly related to PA through kinesiophobia. Conclusion PA changed during the postdischarge transition period and was associated with CHF-related symptoms and kinesiophobia in CHF patients. Reducing CHF-related symptoms helps improve kinesiophobia in CHF patients. In addition, the reduction in CHF-related symptoms led to an increase in PA through the improvement of kinesiophobia. Trial Registration The study was registered in the Chinese Clinical Trial Registry (11/10/2022 ChiCTR2200064561 retrospectively registered).

The carbon emission from energy consumption sector is the main emission source in Shanxi Province. It is necessary for Shanxi Province to study the characteristics and influencing factors of energy consumption carbon emission, which can help Shanxi make scientific and reasonable policies and achieve “carbon peak and carbon neutrality” at an early date. With the provincial energy balance sheet of Shanxi Province and the provincial greenhouse gas inventory accounting method, the carbon emissions from the energy consumption sector were calculated and the character of the emissions was analyzed. On this basis, Kaya and Logarithmic Mean Divisia indx(LMDI)methods were adopted to quantitatively analyze the contribution from population, economic development, energy consumption intensity, and energy consumption structure. The results show that the total carbon emissions from the energy consumption sector in Shanxi Province had an increasing fluctuant tendency from 2005 to 2019, with a cumulative increase of 68.81% and an average annual increase of 3.81%. Carbon emission intensity per GDP has declined year by year, but the decline is far less than GDP growth, and energy efficiency needs to be further improved. Population effect and economic effect play positive roles on carbon emission, especially, the economic effect is the main factor leading to the increase of carbon emission in Shanxi Province, indicating that the economic structure of Shanxi Province, which is mainly heavy, has not been fundamentally improved. Energy intensity and structure of energy consumption mainly show inhibition effects and are the main influencing factors of carbon emission reduction. Among them, the energy intensity contribution is more than the energy structure contribution, indicating that there is still a large space for emission reduction in the future.

Abstract Background Noma is a rare disease, which is characterized by rapid progression and a high rate of mortality; however, relatively few cases of noma infection accompanied by septic shock in children have been described. Further, most health care professionals have no knowledge of this disease or of its clinical significance. Case presentation Herein, we present a case report of a six-year-old male patient who was diagnosed with noma infection at a Chinese pediatric medical intensive care unit (PMICU), at which time, it was discovered that he had septic shock. Following treatment by continuous renal replacement therapy (CRRT) for septic shock arising from noma, the patient was in generally good condition, and the local wound was seen to be essentially healed five weeks post-admission. Conclusion Noma is an opportunistic infectious disease condition. Treatment of the acute phase of noma predominantly focuses on controlling the infection and improving systemic conditions. In addition, CRRT could be considered as a treatment option for cases that present with noma accompanied by septic shock.

This paper addresses the distributed secure estimation problem over wireless sensor networks subject to random multichannel jamming attacks. Each sensor's measurement is divided into ny (the dimension of measurement signal) components and transmitted via ny relevant wireless channels. The attacker is an active adversary in the sense that sensors' measurements through wireless transmission channels are randomly dropped if the corresponding channels are successfully jammed. By employing a piecewise homogeneous Markov chain, a sophisticated two-level switching multichannel jamming attack model is developed. From the perspective of the attacker, this attack model is promising and makes the wireless channels highly vulnerable, because the attacker can randomly and arbitrarily decide when and where to launch the attacks. We then focus our attention on the secure estimation of a target signal with the caveat that some of the measurements can be incomplete induced by the attacks. A system theoretic framework is then developed to cast the network-based security problem into an H∞ estimation theory problem of a piecewise homogeneous Markov jump system. Criteria for analyzing H∞ estimation performance and designing resilient estimators against noises and attacks are also presented. The effectiveness of the proposed results is illustrated through a military F404 aircraft engine system.

Virtual coupling of railway trains is an emerging technology that has the potential to significantly increase railway operational efficiency by reducing the train following distance from absolute braking distances to relative braking distances. Current research in this topic is mainly focused on passenger trains and uses distance-based headways. This paper studied virtual coupling for heavy haul freight trains and demonstrated that the distance headway scheme was challenging and sometimes impractical for heavy haul trains to achieve virtual coupling. A time-based headway scheme was then proposed to set the follower train to be a certain time behind the schedule of the leader train rather than a distance headway. The time-based headway required the follower train to reproduce the leader train's operational status at the same track location. This also allowed the follower train to copy any optimized train driving strategies from the leader train. Demonstrative simulations were carried out without the consideration of communication errors and train localization errors. The results show that a conventional distance headway simulation had maximum distance and speed errors of 716 m (36%, reference 2 km) and 24 km/h (66%, reference 36 km/h), respectively. A time-based headway simulation reduced the maximum distance and speed errors to 0.07 m (0%, reference 2 km) and 0.1 km/h (9%, reference 1.18 km/h), respectively. [ABSTRACT FROM AUTHOR]