Search Results (12,104)

Understanding the carbon emission efficiency of apple production (APCEE) is critical for promoting green and low-carbon agricultural development. However, the spatiotemporal dynamics and driving factors of APCEE in China remain inadequately explored. This study employs life cycle assessment, super-efficiency slacks-based measures, and a panel Tobit model to evaluate the carbon footprint, APCEE, and its determinants in China’s two major production regions from 2003 to 2022. The results reveal that: (1) Producing one ton of apples in China results in 0.842 t CO₂e emissions. Land carbon intensity and total carbon emissions peaked in 2010 (28.69 t CO₂e/ha) and 2014 (6.52 × 10⁷ t CO₂e), respectively, exhibiting inverted U-shaped trends. Carbon emissions from various production areas show significant differences, with higher pressure on carbon emission reduction in the Loess Plateau region, especially in Gansu Province. (2) The APCEE in China exhibits a W-shaped trend (mean: 0.645), with overall low efficiency loss. The Bohai Bay region outperforms the Loess Plateau and national averages. (3) The structure of the apple industry, degree of agricultural mechanization, and green innovation positively influence APCEE, while the structure of apple cultivation, education level, and agricultural subsidies negatively impact it. Notably, green innovation and agricultural subsidies display lagged effects. Moreover, the drivers of APCEE differ significantly between the two major production regions. These findings provide actionable pathways for the green and low-carbon transformation of China’s apple industry, emphasizing the importance of spatially tailored green policies and technology-driven decarbonization strategies. Full article

Rapid urbanization and demographic shifts present significant challenges to spatial justice in green space provision. Traditional static assessments have become increasingly inadequate for guiding park planning, which now requires a dynamic, future-oriented analytical approach. To address this gap, this study incorporates population dynamics into urban park planning by developing a dynamic evaluation framework for park accessibility. Building on the Gaussian-based two-step floating catchment area (Ga2SFCA) method, we propose the human-population-projection-Ga2SFCA (HPP-Ga2SFCA) model, which integrates population forecasts to assess park service efficiency under future demographic pressures. Using neighborhood-committee-level census data from 2000 to 2020 and detailed park spatial data, we identified five types of population change and forecast demographic distributions for both short- and long-term scenarios. Our findings indicate population decline in the urban core and outer suburbs, with growth concentrated in the transitional inner-suburban zones. Long-term projections suggest that 66% of communities will experience population growth, whereas short-term forecasts indicate a decline in 52%. Static models overestimate park accessibility by approximately 40%. In contrast, our dynamic model reveals that accessibility is overestimated in 71% and underestimated in 7% of the city, highlighting a potential mismatch between future population demand and current park supply. This study offers a forward-looking planning framework that enhances the responsiveness of park systems to demographic change and supports the development of more equitable, adaptive green space strategies. Full article

With the continuous increase in urban population, the subway is the main way to alleviate traffic congestion. However, the construction environment of subway stations is complex, and the safety risks are extremely high. Therefore, it is of great practical significance to scientifically and systematically evaluate the safety vulnerability of subway station construction. This paper takes the Chengdu subway project as an example, and establishes a metro station construction safety vulnerability evaluation index system based on the driving forces–pressures–state–impacts–responses (DPSIR) theory with 5 first-level indexes and 23 second-level indexes, and adopts the fuzzy hierarchical analysis method (FAHP) to calculate the subjective weights, and the improved Harris Hawks optimization–projection pursuit method (HHO-PPM) to determine the objective weights, combined with game theory to calculate the comprehensive weights of the indicators, and finally uses the improved cloud model of Bayesian feedback to determine the vulnerability level of subway station construction safety. The study found that the combined empowerment–improvement cloud model assessment method is reliable, and the case study verifies that the vulnerability level of the project is “very low risk”, and the investigations of safety hazards and the pressure of surrounding traffic are the key influencing factors, allowing for the proposal of more scientific and effective management strategies for the construction of subway stations. Full article

Aims: Sinus tachycardia after heart transplantation (HTX) due to cardiac graft denervation is associated with reduced post-transplant survival and requires adequate treatment. We analyzed the long-term effects of heart rate control with ivabradine or metoprolol succinate in HTX recipients. Methods: This observational retrospective single-center study analyzed the ten-year results of 110 patients receiving ivabradine (n = 54) or metoprolol succinate (n = 56) after HTX. Analysis included comparison of demographics, medications, heart rates, blood pressure values, echocardiographic features, cardiac catheterization data, cardiac biomarkers, and post-transplant survival including causes of death. Results: Both groups showed no significant differences concerning demographics or medications (except for ivabradine and metoprolol succinate). At 10-year follow-up, HTX recipients with ivabradine showed a significantly lower heart rate (72.7 ± 8.5 bpm) compared to baseline (88.8 ± 7.6 bpm; p < 0.001) and to metoprolol succinate (80.1 ± 8.1 bpm; p < 0.001), a significantly lower NT-proBNP level (588.4 ± 461.4 pg/mL) compared to baseline (3849.7 ± 1960.0 pg/mL; p < 0.001) and to metoprolol succinate (1229.0 ± 1098.6 pg/mL; p = 0.005), a significantly lower overall mortality (20.4% versus 46.4%; p = 0.004), and mortality due to graft failure (1.9% versus 21.4%; p = 0.001). Multivariate analysis showed a significantly decreased risk of death within 10 years after HTX in patients with post-transplant use of ivabradine (HR 0.374, CI 0.182–0.770; p = 0.008). Conclusions: In this single-center trial, patients with ivabradine revealed a significantly more pronounced heart rate reduction, a lower NT-proBNP level, and a superior 10-year survival after HTX. Full article

Childhood obesity increases chronic disease risk, but no comprehensive synthesis has evaluated the impact of school-based combined nutrition education and physical activity interventions on cardiometabolic biomarkers in children aged 3 to 12 years. This systematic review was conducted in accordance with PRISMA guidelines and registered in PROSPERO (CRD420251085194). Five databases were systematically searched through June 2025. Twelve randomized controlled trials involving 18,231 children were included and assessed using the PEDro scale. Ten trials demonstrated significant improvements in at least one cardiometabolic biomarker. Blood pressure (8 studies) outcomes showed systolic reductions of 1.41–6.0 mmHg in six studies. Glucose metabolism (5 studies) improved in two studies with reductions of 0.20–0.22 mmol/L. Lipid profiles (7 studies) improved in three studies, including total cholesterol (−0.32 mmol/L). Insulin levels (5 studies) decreased significantly in two investigations. Anthropometric improvements included BMI and body fat. Physical activity increased by >45 min/week and dietary habits improved significantly. Programs with daily implementation (90-min sessions 4x/week), longer duration (≥12 months), family involvement (parent education), and curriculum integration (classroom lessons) showed superior effectiveness. Interventions targeting children with overweight/obesity demonstrated higher changes compared to the general population. However, methodological limitations included a lack of assessor blinding, absence of subject/therapist blinding, and inadequate retention rates. School-based interventions combining nutrition and physical activity can produce significant improvements in cardiometabolic biomarkers, supporting comprehensive, sustained multicomponent programs for early chronic disease prevention. Full article

HIV infection and hypertensive disorders of pregnancy (HDP), particularly preeclampsia (PE) with severe features, are leading causes of maternal mortality worldwide. This study investigates the role of asymmetric dimethylarginine (ADMA) and prostacyclin (PGI2) concentrations in endothelial impairment in normotensive pregnant versus PE women within an HIV endemic setting in KwaZulu-Natal Province, South Africa. The study population (n = 84) was grouped according to pregnancy type, i.e., normotensive (n = 42) and PE (n = 42), and further stratified by HIV status. Clinical factors were maternal age, weight, blood pressure (both systolic and diastolic) levels, and gestational age. Plasma concentrations of ADMA and PGI2 were measured using the enzyme-linked immunoassay (ELISA). Differences in outcomes were analyzed using the Mann–Whitney U and Kruskal–Wallis test together with Dunn’s multiple-comparison post hoc test. The non-parametric data were presented as medians and interquartile ranges. Gravidity, gestational age, and systolic and diastolic blood pressures were significantly different across the study groups where p < 0.05 was deemed significant. Furthermore, the concentration of ADMA was significantly elevated in PE HIV-positive vs. PE HIV-negative (p = 0.0174) groups. PGI2 did not show a significant difference in PE compared to normotensive pregnancies (p = 0.8826) but was significantly different across all groups (p = 0.0212). An increase in plasma ADMA levels was observed in the preeclampsia HIV-negative group compared to the normotensive HIV-negative group. This is linked to the role played by ADMA in endothelial impairment, a characteristic of PE development. PGI2 levels were decreased in PE compared to the normotensive group regardless of HIV status. These findings draw attention to the importance of endothelial indicators in pathogenesis and possibly early prediction of PE development. Full article

Background: The consumption of coffee has been widely debated regarding its effects on health. This study aims to analyze the correlations between daily coffee intake and sleep, blood pressure, anthropometric measurements, and biochemical markers in individuals with type 2 diabetes (T2D) and hypertension over a 12-month period. Methods: An observational study was conducted with 40 participants with T2D and hypertension, comprising 20 females and 20 males. Participants were monitored for their daily coffee consumption over a 12-month period, being assessed every 3 months. Linear regression was utilized to assess interactions and relationships between variables, providing insights into potential predictive associations. Additionally, correlation analysis was performed using Pearson’s and Spearman’s tests to evaluate the strength and direction of linear and non-linear relationships. Statistical significance was set at p < 0.05. Results: Significant changes were observed in fasting blood glucose (FBG), glycated hemoglobin (HbA1c), body weight, body mass index, sleep duration, nocturnal awakenings, and waist-to-hip ratio (p < 0.05) over the 12-month study in both sexes. No significant differences were noted in the remaining parameters (p > 0.05). The coffee consumed by the participants was of the “traditional type” and contained sugar (2g per cup) for 100% of the participants. An intake of 4.17 ± 0.360 cups per day was found at baseline and 5.41 ± 0.316 cups at 12 months (p > 0.05). Regarding correlation analysis, a higher coffee intake was significantly associated with shorter sleep duration in women (r = −0.731; p = 0.037). Conversely, greater coffee consumption correlated with lower LDL cholesterol (LDL-C) levels in women (r = −0.820; p = 0.044). Additionally, a longer sleep duration was linked to lower FBG (r = -0.841; p = 0.031), HbA1c (r = -0.831; p = 0.037), and LDL-C levels in women (r = -0.713; p = 0.050). No significant correlations were observed for the other parameters in both sexes (p > 0.05). Conclusions: In women, coffee consumption may negatively affect sleep duration while potentially offering beneficial effects on LDL-C levels, even when sweetened with sugar. Additionally, a longer sleep duration in women appears to be associated with improvements in FBG, HbA1c, and LDL-C. These correlations emphasize the importance of a balanced approach to coffee consumption, weighing both its potential health benefits and drawbacks in postmenopausal women. However, since this study does not establish causality, further randomized clinical trials are warranted to investigate the underlying mechanisms and long-term implications—particularly in the context of T2D and hypertension. Full article

Thermal wick-debinding, commonly used in low-pressure injection molding, remains challenging due to complex interactions between binder transport, capillary forces, and thermal effects. This study presents a numerical simulation of binder removal kinetics by coupling Darcy’s law with the Phase Transport in Porous Media interface in COMSOL Multiphysics. The model was validated and subsequently used to study the influence of key debinding parameters. Contrary to the Level Set method, which predicts isolated binder clusters, the Multiphase Flow in Porous Media method proposed in this work more accurately reflects the physical behavior of the process, capturing a continuous binder extraction throughout the green part and a uniform binder distribution within the wicking medium. The model successfully predicted the experimentally observed decrease in binder saturation with increasing debinding temperature or time, with deviation limited 3–10 vol. % (attributed to a mandatory brushing operation, which may underestimate the residual binder mass). The model was then used to optimize the debinding process: for a temperature of 100 °C and an inter-part gap distance of 5 mm, the debinding time was minimized to 7 h. These findings highlight the model’s practical utility for process design, offering a valuable tool for determining optimal debinding parameters and improving productivity. Full article

This study aims to investigate the effects of phase synchronisation on tonal noise reduction in a multi-rotor UAV using an electronic phase-locking system. Experiments at the University of Bristol explored the impact of relative phase angle, propeller spacing, and blade geometry on acoustic performance, including psychoacoustic annoyance. Results show that increasing the phase angle consistently reduces the sound pressure level (SPL) due to destructive interference. For the two-bladed configuration, the highest noise reduction occurred at relative phase angle $\Delta \psi ={90}^{\circ }$, with a 19 dB decrease at the first blade-passing frequency (BPF). Propeller spacing had minimal impact when phase synchronisation was applied. The pitch-to-diameter ($P/D$) ratio also influenced results: for $P/D=0.55$, reductions ranged from 13–18 dB; and for $P/D=1.0$, reductions ranged from 10–20 dB. Maximum psychoacoustic annoyance was observed when propellers were in phase ($\Delta \psi =0^{\circ }$), while annoyance decreased with increasing phase angle, confirming the effectiveness of phase control for noise mitigation. For the five-bladed configuration, the highest reduction of 15 dB occurred at $\Delta \psi ={36}^{\circ }$, with annoyance levels also decreasing with phase offset. Full article

Industry 4.0 represents a significant transformation in industrial systems through digital integration, presenting both opportunities and challenges for aligning the workforce, especially in emerging economies like Thailand. This study adopts a sequential exploratory mixed-method approach to investigate how strategic human resource development (HRD) contributes to sustainable transformation, defined as the enduring alignment between workforce capabilities and technological advancement. The qualitative phase involved case studies of five Thai manufacturing firms at varying levels of Industry 4.0 adoption, utilizing semi-structured interviews with executives and HR leaders. Thematic findings informed the development of a structured survey, distributed to 144 firms. Partial Least Squares Structural Equation Modeling (PLS SEM) was used to test the hypothesized relationships among business pressures, leadership support, HRD preparedness, and technological readiness. The analysis reveals that business pressures significantly influence leadership and HRD, which in turn facilitate technological readiness. However, business pressures alone do not directly enhance readiness without the support of intermediaries. These results underscore the critical role of integrated HRD and leadership frameworks in enabling sustainable digital transformation. This study contributes to theoretical perspectives by integrating HRD, leadership, and technological readiness, offering practical guidance for firms aiming to navigate the complexities of Industry 4.0. Full article

Objective: This study aimed to determine the possibility of creating a new animal model in which diabetic retinopathy (DR) progresses due to hypertension caused by salt loading. Methods: Male Spontaneously Diabetic Torii (SDT) fatty rats were divided into two groups: one group received 0.3% saline water starting at 8 weeks of age for a duration of 16 weeks (salt SDT fatty group), while the control group was provided with tap water (SDT fatty group). In addition, Sprague-Dawley (SD) rats receiving tap water served as normal controls. Retinal function was assessed by electroretinography (ERG) at 8 and 24 weeks of age. At 24 weeks, following perfusion with fluorescein dextran, the eyes were enucleated, and retinal flat mounts were prepared for vascular evaluation. Retinal thickness and the number of retinal folds were assessed histologically, and ultrastructural changes in the retina were examined using transmission electron microscopy. Results: Saline administration did not lead to significant changes in food consumption or body weight among the groups. In the salt SDT fatty group, blood pressure was significantly elevated, while blood glucose levels showed a slight reduction. ERG analysis showed that the amplitude of oscillatory potential (OP)1 waves was suppressed, and the latencies of OP3, OP4, and OP5 waves were prolonged. Although no significant changes were noted in retinal thickness or the number of retinal folds, thickening of the retinal capillary basement membrane was evident in the salt SDT fatty group. Conclusions: Hypertension induced by 0.3% saline promotes DR progression in SDT fatty rats. This model may help clarify the role of hypertension in DR. Full article

Diabetic nephropathy affects approximately 30–40% of individuals with diabetes mellitus (DM) and is a major contributor to end-stage renal disease (ESRD). While angiotensin II receptor blockers (ARBs) have long served as a standard treatment, sodium-glucose cotransporter-2 inhibitors (SGLT2i) have recently gained attention for their renal and cardiovascular benefits. However, comparative real-world data on their long-term renal effectiveness remain limited. We conducted a retrospective, longitudinal study over a 2-year period to compare the impact of ARB monotherapy versus SGLT2i and angiotensin-converting enzyme inhibitor (ACEi) combination therapy on the progression of chronic kidney disease (CKD) in patients with DM. A total of 126 patients were included and grouped based on treatment regimen. Renal biomarkers were analyzed using t-tests and ANOVA (p < 0.01). Albuminuria was qualitatively classified via urinalysis as negative, level 1 (+1), level 2 (+2), or level 3 (+3). The ARB group demonstrated higher estimated glomerular filtration rate (eGFR) and lower serum creatinine (sCr) levels than the combination therapy group, with glycated hemoglobin (HbA1c), potassium (K⁺), and blood pressure remaining within normal limits in both cohorts. Albuminuria remained stable over time, with 60.8% of ARB users and 73.1% of combination therapy users exhibiting persistently or on-average negative results. Despite the expected additive benefits of SGLT2i/ACEi therapy, ARB monotherapy was associated with slightly more favorable renal function markers and a lower incidence of severe albuminuria. These findings suggest a need for further controlled studies to clarify the comparative long-term renal effects of these treatment regimens. Full article

The escalating environmental noise pollution along urban rail transit corridors, exacerbated by rapid urbanization, necessitates innovative and efficient noise control measures. A comprehensive investigation was conducted that utilized field measurements of train passing-by noise to establish a statistical energy analysis model for evaluating the acoustic performance of both vertical (VB) and fully enclosed (FB) barrier configurations. The study incorporated Maa’s theory of micro-perforated plate (MPP) parameter optimization and developed a neural network surrogate model focused on insertion loss maximization for barrier geometric design. Key findings revealed significant barrier-induced near-track noise amplification, with peak effects observed at the point located 1 m from the barrier and 2 m above the rail. Frequency-dependent analysis demonstrated a characteristic rise-and-fall reflection pattern, showing maximum amplifications of 1.47 dB for VB and 4.13 dB for FB within the 400–2000 Hz range. The implementation of optimized MPPs was found to effectively eliminate the near-field noise amplification effects, achieving sound pressure level reductions of 4–8 dB at acoustically sensitive locations. Furthermore, the high-precision surrogate model (R² = 0.9094, MSE = 0.8711) facilitated optimal geometric design solutions. The synergistic combination of MPP absorption characteristics and geometric optimization resulted in substantially enhanced barrier performance, offering practical solutions for urban rail noise mitigation strategies. Full article

Introduction: Congestive heart failure (CHF), a complex clinical syndrome characterized by the heart’s inability to pump blood effectively due to structural or functional impairments, is a growing public health concern, with profound implications for patients’ physical and emotional well-being. In India, the burden of CHF is rising due to aging demographics and increasing prevalence of lifestyle-related risk factors. Among the subtypes of CHF, heart failure with preserved ejection fraction (HFpEF), i.e., heart failure with left ventricular ejection fraction of ≥50% with evidence of spontaneous or provokable increased left ventricular filling pressure, and heart failure with reduced ejection fraction (HFrEF), i.e., heart failure with left ventricular ejection fraction of 40% or less and is accompanied by progressive left ventricular dilatation and adverse cardiac remodeling, may present differing impacts on health-related quality of life (HRQoL), i.e., an individual’s or a group’s perceived physical and mental health over time, yet comparative data remains limited. This study assesses HRQoL among CHF patients using the Minnesota Living with Heart Failure Questionnaire (MLHFQ), one of the most widely used health-related quality of life questionnaires for patients with heart failure based on physical and emotional dimensions and identifies sociodemographic and clinical variables influencing these outcomes. Methods: A cross-sectional analytical study was conducted among 233 CHF patients receiving inpatient and outpatient care at the Department of Cardiology at a quaternary care teaching hospital in coastal Karnataka in India. Participants were enrolled using convenience sampling. HRQoL was evaluated through the MLHFQ, while sociodemographic and clinical characteristics were recorded via a structured proforma. Statistical analyses included descriptive measures, independent t-test, Spearman’s correlation and stepwise multivariable linear regression to identify associations and predictors. Results: The mean HRQoL score was 56.5 ± 6.05, reflecting a moderate to high symptom burden. Patients with HFpEF reported significantly worse HRQoL (mean score: 61.4 ± 3.94) than those with HFrEF (52.9 ± 4.64; p < 0.001, Cohen’s d = 1.95). A significant positive correlation was observed between HRQoL scores and age (r = 0.428; p < 0.001), indicating that older individuals experienced a higher burden of symptoms. HRQoL also varied significantly across NYHA functional classes (χ² = 69.9, p < 0.001, ε² = 0.301) and employment groups (χ² = 17.0, p < 0.001), with further differences noted by education level, gender and marital status (p < 0.05). Multivariable linear regression identified age (B = 0.311, p < 0.001) and gender (B = –4.591, p < 0.001) as significant predictors of poorer HRQoL. Discussion: The findings indicate that patients with HFpEF experience significantly poorer HRQoL than those with HFrEF. Older adults and female patients reported greater symptom burden, underscoring the importance of demographic-sensitive care approaches. These results highlight the need for routine integration of HRQoL assessment into clinical practice and the development of comprehensive, personalized interventions addressing both physical and emotional health dimensions, especially for vulnerable subgroups. Conclusions: CHF patients, especially those with HFpEF, face reduced HRQoL. Key factors include age, gender, education, employment, marital status, and NYHA class, underscoring the need for patient-centered care. Full article

This review explores the advantages of ivabradine in the management of cardiac surgery patients, particularly highlighting its heart rate (HR)-reducing properties, its role in minimizing the impact of atrial fibrillation, and its contributions to improving left ventricular diastolic function, as well as reducing pain, stress, and anxiety. In parallel, studies provide evidence that ivabradine influences endothelial inflammatory responses through mechanisms such as biomechanical modulation. Unlike traditional beta-blockers that may induce hypotension, ivabradine selectively inhibits hyperpolarization-activated cyclic nucleotide-gated (HCN) channels, allowing for effective HR reduction without compromising blood pressure stability. This characteristic is particularly beneficial for patients at risk of atrial fibrillation post-surgery, where HR control is crucial for cardiovascular stability. This is an area in which ivabradine appears to play a role prophylactically, possibly in combination with beta-blockers. Furthermore, ivabradine has been associated with enhanced diastolic parameters in left ventricular function, reflecting its potential to improve surgical outcomes in patients with compromised heart function. In addition to its cardiovascular benefits, it appears to alleviate psychological stress and anxiety, common in postoperative settings, by moderating the neuroendocrine response to stress, thereby reducing stress-induced hormone levels. Furthermore, it has notable analgesic properties, contributing to pain management through its action on HCN channels in both the peripheral and central nervous systems. Collectively, these findings indicate that ivabradine may serve as a valuable therapeutic agent in the perioperative care of cardiac surgery patients, addressing both physiological and psychological challenges during recovery. Full article