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Thermal environment may affect sleep quality and sleeping thermal comfort at the same time. Up to now, there is no direct evidence or physiological theory can prove the idea that thermal comfort equal to good sleep quality, but how to balance the relationship between them is often ignored when designing thermal environment. This review took body temperature distribution as a bridge for the connection of sleep quality and sleeping thermal comfort. At first, we reviewed the quantitative relationships among thermal environment, body temperature, sleep quality and sleeping thermal comfort, and then based on the idea of reverse derivation, a recommended design process for bedroom thermal environment was proposed. Each step of the process corresponded to the impact mechanism described above. The review results showed that, body temperature distribution was closely related to both sleep quality and thermal comfort, and thus it was suitable to be used as a bridge between them; body temperatures fluctuated dynamically during sleep, and thus heat transfer and thermal regulation models should be used to describe them; most current sleep researches regarded skin temperature as the representative value of body temperature distribution, yet core body temperature needs to be paid more attention on in the future because it was more closely related to sleep rhythm; furthermore, in addition to young people, subjects of more age groups should be tested to enrich China's sleep research database. In general, it's theoretically possible to guarantee both sleep quality and sleeping thermal comfort, and this review can be used as a reliable reference for bedroom thermal environment design.

Thermal comfort is critical for ensuring the health and productivity of occupants and knowing their thermal demand could help creat a satisfying environment with the least energy waste. Theory of thermal comfort is built based on experimental studies in uniform and stable environments, while there is still a gap when applying in evaluating human thermal comfort in non-uniform thermal environments. Therefore, an insight into human thermal comfort in non-uniform thermal environments is taken. The fundamental studies of thermal comfort in non-uniform thermal environments are explicated, including thermal comfort theory applied in non-uniform thermal environments, types of non-uniform thermal environments and corresponding studies, physiological and psychological thermal responses in the environments. Besides, the evaluation indices of non-uniform thermal environments are classified according to their definitions and the comfort models are reviewed. Finally, future works in this research field are discussed. In general, the overall thermal comfort and local thermal comfort should be both taken into account in non-uniform thermal environments where skin temperatures and psychological thermal responses of occupants are different among local body segments. Moreover, as studies of local thermal comfort are mainly conducted in thermally neutral condition, the limits considering the state deviating thermal neutrality (slightly warm or cool), which is frequently found in reality, are encouraged to be studied. Finally, a well-defined comprehensive index should be proposed considering heat exchange of human body with their microenvironments and thus the comfort range of the index could be provided for designing of non-uniform thermal environments.

The ultra-fine grain Ti–6Al–4V alloy sheet was successfully achieved by friction stir processing (FSP). The low-temperature superplastic deformation mechanism of Ti–6Al–4V alloy under the strain rate of 3 × 10−4 s−1 at 600 °C was studied by scanning electron microscope, electron backscatter diffraction and superplastic tensile test. It is found that the grain size of Ti–6Al–4V alloy by FSP is refined from 7.48 μm to 0.82 μm, and there is no preferential crystallographic orientation of the uniform grain. After FSP, the β phase of the base material (BM) in the grain boundary is refined and homogenized. During the superplastic tensile processing, with the increase of strain, the grain is refined continuously, and the α→β phase transition is induced by the dislocations pile-up at the β grain boundary, and the content of β phase increases. The grain near the fracture was refined to 0.35 μm, and the stress concentration led to the formation of cavities near the β phase, which eventually caused the fracture. The dynamic recrystallization in superplastic tensile processing is mainly geometric dynamic recrystallization and discontinuous dynamic recrystallization. The elongation of superplastic tensile (1033%) is 19.7 times higher than that of BM (50%). The order of superplastic deformation mechanism in the low-temperature superplastic deformation of the ultra-fine grain Ti–6Al–4V alloy sheet is as follows: intragranular dislocation slip and diffusion, grain boundary sliding, and phase boundary sliding. Phase boundary sliding is the main deformation mechanism for low-temperature superplastic deformation.

BackgroundThere is a need to update the understanding of treatment refusal among cancer patients in China, taking into account recent developments. This study investigated how public insurance coverage of the first breast cancer targeted therapy contributed to the changes in treatment refusal among HER2-positive breast cancer patients in China. And it intensively examined and discussed additional barriers affecting patient utilization of innovative anticancer medicines based on the types and reasons for treatment refusal.MethodsThis retrospective study included female breast cancer patients diagnosed as HER2-positive who received treatment at a provincial oncology center in southern China between 2014 and 2020. Multivariable analysis was conducted using a binary logistic regression model. Subgroup analysis was performed with the same regression model.ResultsAmong the 1,322 HER2-positive breast cancer patients who received treatment at the study hospital between 2014 and 2020, 327 (24.55%) had ever refused treatment. Economic reasons were reported as the primary cause by 142 patients (43.43%). Patients diagnosed after September 2017, when the first breast cancer targeted therapy was included in the public health insurance, were less likely to refuse treatment (OR = 0.64, 95% CI:0.45 ~ 0.91, p = 0.01) compared to those diagnosed before September 2017. Patients enrolled in the resident health insurance were more likely to refuse treatment (OR = 2.43, 95% CI:1.77 ~ 3.35, p

Abstract Heating and cooling in buildings accounts for over 20% of total energy consumption in China. Therefore, it is essential to understand the thermal requirements of building occupants when establishing building energy codes that would save energy while maintaining occupants’ thermal comfort. This paper introduces the Chinese thermal comfort dataset, established by seven participating institutions under the leadership of Xi’an University of Architecture and Technology. The dataset comprises 41,977 sets of data collected from 49 cities across five climate zones in China over the past two decades. The raw data underwent careful quality control procedure, including systematic organization, to ensure its reliability. Each dataset contains environmental parameters, occupants’ subjective responses, building information, and personal information. The dataset has been instrumental in the development of indoor thermal environment evaluation standards and energy codes in China. It can also have broader applications, such as contributing to the international thermal comfort dataset, modeling thermal comfort and adaptive behaviors, investigating regional differences in indoor thermal conditions, and examining occupants’ thermal comfort responses.

Abstract Background Although several studies in high-income countries have suggested a positive association between subjective well-being (SWB) and mortality, studies conducted in low- and middle-income countries, such as China, are scarce. The purpose of this study is to examine the association between SWB and all-cause mortality among the older Chinese population. Methods Data were from the Chinese Longitudinal Healthy Longevity Survey (CLHLS), a population-based longitudinal cohort study in 22 of 31 provinces in mainland China. A total of 13,282 individuals aged 65 ≥ years who were recruited in 2002 and followed-up until 2018 were included. SWB was assessed with an eight-item tool covering life satisfaction, positive affect (including optimism, happiness, personal control and conscientiousness) and negative affect (including anxiety, loneliness and uselessness). Cox proportional hazards regression methods were carried out to estimate the association between SWB and total mortality, adjusting for a wide range of potential confounders. Subgroup analyses and interaction analyses were further conducted. Results During the 16.5 years of follow-up, 8459 deaths were identified. Greater SWB was independently associated with a reduced risk of all-cause mortality (adjusted hazard ratio [HR] = 0.85, 95% confidence interval [CI] = 0.81–0.89) after adjustment for age, sex, marital status, education level, place of residence, smoking status, drinking, exercise, diet, BMI, hypertension, diabetes, heart disease, cerebrovascular diseases and cancer. Of the eight individual SWB symptoms, only 2 items, feelings of uselessness (adjusted HR = 0.94, 95% CI = 0.89–0.99) and happiness (adjusted HR = 0.91, 95% CI = 0.86–0.95), were significantly associated with total mortality. Associations remained significant across all subgroups regardless of different characteristics. Conclusions Higher SWB overall and 2 certain symptoms (feelings of uselessness and happiness) were independently associated with all-cause mortality risk among older Chinese adults. The association was consistent across different groups, suggesting that promoting a healthier SWB may be beneficial to all older individuals irrespective of their characteristics.

People spend most of their time indoors. However, indoor temperature and individual thermal exposure are generally not considered in epidemiological studies of temperature and health. Based on the American Society of Heating, Refrigerating, and Air-Conditioning Engineers (ASHRAE) RP-884 Database, the ASHRAE Global Thermal Comfort Database II and the Chinese Thermal Comfort Database, this study first explored the relationship between outdoor temperature, indoor temperature and thermal sensation from a global perspective. Moreover, the potential influence of spatiotemporal heterogeneity on health studies was explored. A breakpoint was found at approximately 11.5 °C in the segmented regression of indoor and outdoor temperature, and the slope of the curve was greater when outdoor temperature was above the breakpoint (n = 67,896). Based on multi-group propensity score matching (PSM) and generalized additive models (GAM), spatiotemporal heterogeneity was found in the relationship between indoor and outdoor temperatures after adjusting for building type and year. Furthermore, the relationship between indoor temperature and thermal sensation was influenced by the outdoor temperature. This study highlights the importance of considering indoor temperature or individual thermal exposure in temperature-related health studies.

Abstract Background Although studies have shown that depressive symptoms are associated with an increased risk of hip fracture (HF). Depressive symptoms are dynamic, and it is unclear whether HF risk persists if depressive symptoms remit. This study aims to examine the associations between changes in depressive symptoms and HF risk. Methods Data were from the China Health and Retirement Longitudinal Study from 2011 to 2018. Depressive symptoms were measured using the 10-item version of the Center for Epidemiological Studied Depression scale (cutoff ≥ 10). Changes in depressive symptoms were classified into four groups by two successive surveys (stable low/no, recent-onset, recently remitted, and stable high depressive symptoms). Multivariable logistic regressions were performed to assess whether changes in depressive symptoms were associated with HF incidents reported through 2018, adjusting for age, sex, educational level, marital status and other potential confounding factors. Results In total, 8574 participants were included, 265 (3.1%) of whom had reported HF incidents in the subsequent 5-year period. Participants with recent-onset (OR = 1.97, 95% CI = 1.40–2.77) or stable high (OR = 2.15, 95% CI = 1.53–3.02) symptoms had a higher risk of HF than those with stable low/no depressive symptoms, whereas those with improved depressive symptoms (OR = 1.27, 95% CI = 0.89–1.82) had no elevation in HF risk. Conclusion Stable high and recent-onset depressive symptoms were associated with increased HF risk, and no elevated HF risk was observed if symptoms remitted, suggesting that strategies to reduce depressive symptoms may be beneficial for HF prevention.

Abstract Background The effect of depressive symptoms on hip fracture (HF) and falls among the Chinese population is unclear. This study aims to examine the prospective association between depressive symptoms and HF as well as fall accidents in a nationally representative Chinese population. Methods We used data from 10,596 participants in the Chinese Health and Retirement Longitudinal Study (from 2011 to 2018) who were aged ≥45 years and had no HFs at baseline. Depressive symptoms were assessed using the 10-item version of the Center for Epidemiological Studied Depression scale (cutoff for distinguishing high versus low at ≥12). Logistic regression analyses adjusted for demographic characteristics, lifestyle factors and physical comorbidities were performed. Results For the analysis of baseline depressive symptoms and HF, 399 (3.8%) participants reported HF accidents in the following 7-year period. Individuals with elevated depressive symptoms at baseline experienced a markedly higher HF risk (odds ratio [OR] = 1.33, 95% confidence interval [CI] = 1.06–1.67) than those without elevated depressive symptoms, after adjusting for a wide range of potential confounders. For the analysis of baseline depressive symptoms and falls, 3974 (37.5%) experienced fall accidents during the follow-up. The presence of elevated depressive symptoms was independently associated with an increased risk of fall events (OR = 1.21, 95% CI = 1.10–1.33). These associations were consistent across multiple characteristics. Conclusions In conclusion, elevated depressive symptoms were associated with an increased risk of HF and falls, which may have considerable clinical and preventive implications.

Abstract Background The combined impact of healthy lifestyle factors on total mortality among elder Chinese is unclear. This study aimed to investigate the overall impact of lifestyle factors on total mortality in a senior Chinese population, and determine whether these associations were consistent in the presence of different characteristics, including physical comorbidities. Methods The Chinese Longitudinal Healthy Longevity Survey (CLHLS) is a large population-based prospective cohort study in 22 of 31 provinces from mainland China. We included 15,163 adults aged ≥65 years recruited from 1998- to 2002 and followed-up until 2014. A healthy lifestyle score was calculated considering five lifestyle factors (exercise, smoking, dietary diversity, body mass index and drinking). The scores ranged from zero to five points and were classified into the following three categories: unhealthy (0-1 point), intermediate (2-3 points) and healthy (4-5 points). Cox proportional hazards regression analyses were used to assess the associations between the combined healthy lifestyle score and total mortality, adjusting for demographic characteristics and physical comorbidities, as appropriate. Stratification analyses and interaction analyses were further performed. Results Among the 15,163 participants, the mean age (SD) was 86.2 (11.6) years. During an average follow-up period of 12.5 (SD = 3.9) years, 9655 deaths occurred. The adjusted hazard ratios (HRs) of total mortality decreased as the number of healthy lifestyle factors increased. Compared to the unhealthy lifestyle group, the healthy lifestyle group had a HR and 95% CI of 0.78 and 0.72-0.83. The population attributable risk of total death among those without a healthy lifestyle was 25.2%. A healthier lifestyle pattern was associated with a lower total mortality risk among individuals with different severities of physical comorbidities, although the associations were stronger among those with fatal physical comorbidities (p -interaction

Objective: To investigate the factors associated with the treatment of breast cancer with biosimilars from the perspectives of physicians and patients, and to generate evidence for promoting the uptake of biosimilars.Methods: This study targeted trastuzumab and its indicated human epidermal growth factor receptor 2 (HER2) positive breast cancer and included female HER2 positive breast cancer patients under treatment of trastuzumab at a provincial oncology medical center in southern China from 1 January 2021, to 31 December 2021. The study extracted patients’ demographic, socioeconomic and clinical information and the basic information of their attending physicians from the hospital information system. We performed a bivariate multiple logistic regression analysis of predictive factors of the use of trastuzumab biosimilar.Results: A total of 446 patients (aged ranging between 26 and 74, 51.4 ± 9.06) were included in the analysis, and 19.1% chose biosimilar trastuzumab. Older patients, patients enrolled in the urban and rural resident health insurance program compared with those enrolled in the urban employee health insurance program, patients who initiated treatment after January 2021 when biosimilar entered clinical use compared with those who initiated treatment before, patients with female attending physicians, younger attending physicians and with chief attending physicians compared with deputy chief attending physicians were more likely to adopt biosimilar trastuzumab for treatment (p < 05). Controlling the other factors unchanged, when the patient’s attending physician was deputy chief physician, increasing 1 year age of the patient was associated with an increased probability of adopting biosimilar by .8% (dy/dx = .008, 95%CI: .002–.01, p = .01). When the patient was aged between 26 and 60, the probability of adopting biosimilar for the patient whose attending physician was a chief physician was higher than for those whose attending physician was a deputy chief physician, and the gap was the largest when the patient was at the age of 45 (dy/dx = .20, 95%CI: .13–.27, p < .01).Conclusion: The uptake rate of biosimilars is still low at its initial development stage in China. Educational policies and physicians making recommendations to the indicated patients at the initiation stage of treatment are helpful to avoid reduced willingness to switch to biosimilars due to non-clinical reasons. Patients with lower ability-to-pay will have better accessibility to biologic regimens through the uptake of biosimilars. Official guidelines and professional training are critical to enhancing physicians’ willingness and confidence in adopting biosimilars.

Abstract Background This study aimed to assess the association between baseline symptoms and changes in depressive symptoms and stroke incidents. Methods We used data from the Chinese Health and Retirement Longitudinal Study conducted in 2013, 2015, and 2018. In total, 10,100 individuals aged ≥45 years and without a history of stroke in 2013 were included. Depressive symptoms were measured using the 10-item version of the Center for Epidemiological Studied Depression scale (elevated depressive symptoms cutoff ≥10). Changes of depressive symptoms were assessed by two successive surveys (stable low/no, recent onset, recently remitted, and stable high depressive symptoms). We assessed whether baseline depressive symptoms and changes of them were associated with stroke incidents reported through 2018. Logistic regression analyses adjusted for age, gender, education, marital status and other potential confounders were performed. Results For the analysis of baseline depressive symptoms and stroke (n = 10,100), 545 (5.4%) reported stroke incidents in the following 5-year period. Individuals with elevated depressive symptoms in 2013 experienced a markedly higher stroke risk (odds ratio (OR) = 1.53, 95% confidence interval (CI) = 1.28–1.84) compared with those without elevated depressive symptoms. In the analysis of changes in depressive symptoms (n = 8491, 430 (5.1%) stroke events), participants with stable high (OR = 2.01, 95% CI = 1.58–2.56) and recent-onset (OR = 1.39, 95% CI = 1.04–1.85) depressive symptoms presented higher stroke risk compared to those with stable low/no depressive symptoms, while recently remitted symptoms (OR = 1.12, 95% CI = 0.80–1.57) were not associated with stroke risk. Conclusions In conclusion, stable high and newly started depressive symptoms were associated with increased stroke risk, whereas the improvement of depressive symptoms was not related to increase in stroke risk, suggesting that stroke risk may be decreased by effective management of depressive symptoms.

Though subjective feelings affected by lighting have been studied a lot, multivariate experimental studies are lacking in this research field. Central composite rotatable design (CCRD) was applied to investigate the influence of illuminance, correlated color temperature (CCT) and illuminance uniformity on satisfaction in this study. A series of subject experiments were carried out and polynomial regression models of luminous satisfaction for different activity scenarios were generated. Illuminance and CCT affected the satisfaction significantly in visual task scenarios, and the effect of them was independent with each other, which was demonstrated by the regression model (R2 = 0.89). The variation of luminous satisfaction in general activity scenarios cannot be fully explained by the three investigated factors. The results contributed to the knowledge of multivariate analysis of luminous environment and indicated that much could be expected referring to the application of CCRD in this field.

In the past several years, thermal comfort, especially development and application of thermal comfort model, has been a research focus of building environment. Since the 1970s, a series of thermal comfort models based on people's thermal sensation to environment have been established, and gradually became an important part of the field of thermal comfort research. In this review, the existing thermal comfort models are summarized from various perspectives, such as models applied in different environments like sleeping environment and outdoor environment. Besides, models used for different groups people, such as elderly and different races are discussed. In the part, adaptive models are mentioned. In additions, data-driven models were reviewed. This paper introduced the advantages and disadvantages of each model. Based on the above review, future research work of thermal comfort model is proposed.

BackgroundThe relative contributions of demographic and lifestyle behaviors to the association between physical activity (PA) and cancer are poorly understood. This study assesses the relationship between PA level and cancer status considering the full activity spectrum within a large and representative Chinese population.MethodsData were derived from the Chinese Health and Retirement Longitudinal Study (using four-stage stratified probability-proportional-to-size sampling), including 416 cancer survivors and 14,574 individuals without cancer from 28 provinces in China. Cancer status and sites were self-reported, and PA, other health behaviors (e.g., smoking, drinking) and comorbidities (e.g., hypertension, diabetes) were assessed by a questionnaire. The total PA score was calculated using metabolic equivalent (MET) multipliers. Multivariable logistic regression was used to estimate differences in PA levels between cancer survivors and those without a cancer diagnosis, adjusting for age, sex, and other potential confounding factors.ResultsCancer survivors (416, 2.8%) were more likely to be women than men (65.4 vs. 34.6%). They were older (age ≥65 years, 43.8 vs. 38.9%) and more likely to be overweight (18.3 vs. 13.3%), be depressed (49.5 vs. 37.6%), have quit smoking (17.8 vs. 14.4%), drink less (17.5 vs. 26.6%), sleep less (65.9 vs. 56.8%) and have more chronic comorbidities (≥2 comorbidities, 26.0 vs. 19.2%) than those without cancer. There was a significant associations between cancer status and participation in vigorous-intensity activity for at least 10 min every week, when compared with the inactivity [odds ratio (OR) = 0.56, 95% CI = 0.39–0.80], while no differences were observed in the moderate and light activity groups. Individuals who spent more than half an hour performing moderate or vigorous intensity activity every day were significantly less likely to report a cancer diagnosis than inactive individuals (moderate OR = 0.64, 95% CI = 0.48–0.86; vigorous OR = 0.50, 95% CI = 0.37–0.68). Participants who spent more than 2 h performing light, moderate or vigorous intensity activity reported fewer cancer cases than their inactive counterparts. In addition, there was an inverse dose-response relationship between the total PA score and cancer status (P–trend < 0.001).ConclusionAssociations between PA and cancer status were independent of demographics, lifestyle confounders, and comorbidities. Cancer survivors are less physically active than those without cancer.

Conopeptides from the marine cone snails are a mixture of cysteine-rich active peptides, representing a unique and fertile resource for neuroscience research and drug discovery. The ConoServer database includes 8,134 conopeptides from 122 Conus species, yet many more natural conopeptides remain to be discovered. Here, we identified 517 distinct conopeptide precursors in Conus quercinus using de novo deep transcriptome sequencing. Ten of these precursors were verified at the protein level using liquid chromatography-mass spectrometry/mass spectrometry (LC-MS/MS). The combined gene and protein analyses revealed two novel gene superfamilies (Que-MNCLQ and Que-MAMNV), and three other gene superfamilies (N, P, and I1) were reported for the first time in C. quercinus. From the Que-MAMNV superfamily, a novel conotoxin, Que-0.1, was obtained via cloning and prokaryotic expression. We also documented a new purification process that can be used to induce the expression of conopeptides containing multiple pairs of disulfide bonds. The animal experiments showed that Que-0.1 strongly inhibited neuroconduction; the effects of Que-1.0 were 6.25 times stronger than those of pethidine hydrochloride. In addition, a new cysteine framework (CC-C-C-C-C-C-CC-C-C-C-C-C) was found in C. quercinus. These discoveries accelerate our understanding of conopeptide diversity in the genus, Conus and supply promising materials for medical research.

Aims: To examine the association of social networks and community engagement with cognitive impairment among community-dwelling Chinese older adults. Methods: From November 2017 to May 2018, we selected 1,115 elderly individuals from 3 Chinese communities (Beijing, Hefei, and Lanzhou) using a random-cluster sampling method, and recorded data on demographics, social network characteristics, community activities, and cognitive function. The odds ratios (ORs) of these associations were adjusted for potential confounders in logistic regression models. Results: The prevalence of cognitive impairment was 25.7% (n = 287). An adequate social network (OR 0.55; 95% confidence interval [CI] 0.33–0.91) and enough social support from friends (OR 0.43; 95% CI 0.29–0.62) were negatively associated with cognitive impairment. Family support was not significantly associated with cognitive impairment (OR 0.64; 95% CI 0.34–1.21). Taking part in elderly group travel, communication with others using WeChat, and community activities such as Tai Chi and walking together were negatively associated with cognitive impairment. Conclusion: Social network characteristics and community engagement were found to be related to cognitive function among community-dwelling Chinese elderly adults.

Abstract Direct chemical vapor deposition (CVD) growth of graphene on dielectric/insulating materials is a promising strategy for subsequent transfer-free applications of graphene. However, graphene growth on noncatalytic substrates is faced with thorny issues, especially the limited growth rate, which severely hinders mass production and practical applications. Herein, graphene glass fiber fabric (GGFF) is developed by graphene CVD growth on glass fiber fabric. Dichloromethane is applied as a carbon precursor to accelerate graphene growth, which has a low decomposition energy barrier, and more importantly, the produced high-electronegativity Cl radical can enhance adsorption of active carbon species by Cl–CH2 coadsorption and facilitate H detachment from graphene edges. Consequently, the growth rate is increased by ~3 orders of magnitude and carbon utilization by ~960-fold, compared with conventional methane precursor. The advantageous hierarchical conductive configuration of lightweight, flexible GGFF makes it an ultrasensitive pressure sensor for human motion and physiological monitoring, such as pulse and vocal signals.

Phytoremediation is acknowledged as a sustainable solution for mitigating heavy metals contamination in soils yet faces challenges in transitioning from laboratory experiments to practical field applications, essential for widespread adoption and commercialization. Phytoremediation techniques employing high biomass plants and hyperaccumulators have demonstrated promise in various contexts, such as extracting heavy metals from tailings using short rotation forestry. However, the disparity between laboratory and field results underscores the need for a framework to bridge this gap. This review screened and reviewed papers published in international peer-reviewed journals indexed in Web of Science Core from 2014 to 2024. The potential of effect and response traits as early plant selection tools and predictors of phytoremediation efficacy, respectively, to assess plant performance and response in heavy metal phytoremediation is outlined. In addition, a comprehensive framework for heavy metal phytoremediation is proposed to enhance the understanding and practical application of phytoremediation technologies.