The Frontal_Sup_L GMV played a partial mediating role in the relationship between overweight/obesity and SC, accounting for 36.6% of total effect values. These findings indicate the significant positive correlation between overweight/obesity and SC; GMV in the left dorsolateral superior frontal gyrus plays a mediating role in the relationship between overweight/obesity and SC. The study may provide new evidence toward comprehensively revealing the overweight/obesity and SC relationship.With advances in medical diagnostic technology, the healthy development of children with autism spectrum disorder (ASD) is receiving more and more attention. In this article, the mediating effect of brain gray matter volume (GMV) between overweight/obesity and social communication (SC) was investigated through the analysis of the relationship between overweight/obesity and SC in autism spectrum disorder children. In total, 101 children with ASD aged 3–12 years were recruited from three special educational centers . Overweight/obesity in children with ASD was indicated by their body mass index (BMI); the Social Responsiveness Scale, Second Edition (SRS-2) was used to assess their social interaction ability, and structural Magnetic Resonance Imaging (sMRI) was used to measure GMV. A mediation model was constructed using the Process plug-in to analyze the mediating effect of GMV between overweight/obesity and SC in children with ASD. The results revealed that: overweight/obesity positively correlated with SRS-2 total points ( Autism spectrum disorder (ASD) is a lifelong, severe psychoneurotic developmental disorder occurring in early childhood that limits or impairs daily functioning . One of Generally, many pieces of research found that overweight/obese children with ASD may also exhibit a range of abnormal responses, including social isolation or aggressive behavior. Notably, a study in 2021 on obesity genes and social functioning in ASD confirmed a link between obesity genes and social functioning . HoweverUp until now, the neural mechanisms affecting SC in children with ASD have become a hot research spot. Social communication in children with ASD can be affected by different mechanisms, which are mostly related to neural mechanisms ,12,13. TResearch in the field of brain science has concluded that being overweight/obese causes poor brain health , such asIn summary, overweight/obesity is significantly negatively correlated with GMV. However, the relationship between overweight/obesity and GMV among children with ASD has not been conclusively established.With the development of brain imaging technology, brain plasticity has been confirmed. Currently, correlational studies hotspot the idea to utilize GMV as a mediator in the methodology while the relationship between overweight/obesity, GMV, and SC in children with ASD has not been fully revealed, especially considering whether or not GMV is a potential neural mechanism for overweight/obesity and SC. Therefore, hypothesis two in this study is proposed: there is a mediating role of GMV in this relationship between overweight/obesity and SC.In this study, we recruited 147 children aged 3 to 12 years old who were diagnosed with ASD according to the DSM-5 criteria from the Chuying Child Development Center, Starssailor Educational Institution, and Maternal and Child Health Hospital . Only 101 participants completed the study .Inclusion criteria: (1) Han ethnicity; (2) Aged 3 to 12 years old; (3) Use of the Subject Checklist (V2.0) of the Brain Imaging Center of the Affiliated Hospital of Yangzhou University to check if the conditions for sMRI scanning are satisfied, including the absence of metal implants  and electronic, magnetic, or mechanical devices (such as pacemakers).Exclusion criteria: (1) Head injury; (2) Nervous system disorders such as phenylketonuria, epilepsy, tics, mental illness, etc.; (3) Impaired hearing and vision; (4) Use of drugs that affect the central nervous system.After further screening and exclusion based on experimental criteria, thirty-five children were excluded due to the above-mentioned reasons or declined to participate. Additionally, it was found that after the collection of behavioral and brain data, head movement in 7 children’s sMRI data was greater than 3mm, and 4 children had not undergone an sMRI scan. In total, 101 children with ASD were included in the study, of which 89 were male (88.12%) and 12 female (11.88%). The parents or guardians of all children who participated in this trial have signed an informed consent form according to the provision of the Declaration of Helsinki. The study was approved by the Ethics and Human Protection Committee of the Affiliated Hospital of Yangzhou University and was registered (ChiCTR190002497) in the Chinese Clinical Trials Registry.2. The overweight/obesity scoring criteria thresholds were based on the 2010 Chinese 2–18 years BMI values of children and adolescents [All participants’ height and weight were measured using the Meilen Smart Height and Weight Scale (Model: MSG005-H), Manufacturer: Shenzhen Mobil Electronics Wired Company. The error range of the experimental instrument is 0.5 cm and 0.1 kg, which can automatically save data and ensure the accuracy of the test data. Two disciplined physical education staff were authorized to ensure the consistency of the experimental testers during the test, and all subjects were requested to wear light clothing and undress their shoes and socks during the measurement. BMI was calculated using the traditional calculation method BMI = (weight (kg))/(height (m))lescents . Among tThe Social Responsiveness Scale, Second Edition (SRS-2) was used to evaluate the social skills of children with ASD. This scale was developed by John N. Constantino and Christian P. Gruber in 2012 to assess the social skills of individuals with autism from 2 years and 6 months to adulthood . The scaThis study was carried out at the Affiliated Hospital of Yangzhou University. Due to the duration and noise of the sMRI scan, the subjects were subjected to moderate sleep deprivation to make sure all the children with ASD were able to participate in the scan. The day before the examination, parents were informed to let the subjects sleep late and wake up early. After an interval of 6–8 h, each subject was given 10% chloral hydrate 0.3 mL/kg (30 mg/kg) by enema, without exceeding a maximum dose of 10 mL. Once the subjects fell asleep, the nurse tested their level of awareness. If the patient did not respond to mild pain stimuli, the patient was placed in the supine position and sMRI was performed.https://neuro-jena.github.io/) (accessed on 28 March 2022)) that is based on SPM (<Introduction for SPM Software> https://www.fil.ion.ucl.ac.uk/spm/ (accessed on 28 March 2022)) was applied to automate the preprocessing of T1-MPRAGE data. The preprocessed data were smoothed in SPM12 with a gaussian kernel function of 8 mm × 8 mm × 8 mm half-width full-height to improve the image signal-to-noise ratio. Referring to the gray matter volume extraction method of Aiguo Chen et al. (2018) [Image acquisition was completed using the GE Discovery MR750W 3.0T MRI. The t1-MPRAGE structural image scan parameters were: pulse repetition interval = 7.20 ms, echo time = 3.06 ms, thickness = 1.00 mm, flip angle = 12°, acquisition matrix = 256 × 256, and scan field of view = 256 × 256 mm. Based on the MATLAB (2018) platform, the CAT12 toolbox (<Introduction for CAT12 Toolbox> CAT (. (2018) , the getp < 0.05. The partial correlation analysis was then used to examine the relationship between overweight/obesity and the GMVs of the relevant brain regions. The correlations between GMV, scores on the overweight/obesity, and SC scales were then analyzed. Partial correlation analysis was used to control for age and gender and to assess the correlation between overweight/obesity, GMV (brain regions that differed significantly between groups), and SC. In addition, a mediation analysis was performed taking overweight/obesity as a predictor (X) and GMV and SC as outcome variables (Y). Model 4 of the Process plug-in in SPSS was applied to test the indirect influence of overweight/obesity on SC directly with GMV. Standardized (z-trans) formed variables were used in the mediation analysis. The bias-corrected percentile Bootstrap method was used, and the 95% confidence interval of the mediating effect was estimated from 5000 Bootstrap samples. If the confidence interval did not include 0, the indirect effect of the mediating model was considered statistically significant.SPSS22.0  was employed for all statistical analyses, and the statistical significance was defined as p < 0.05 was considered significant  in children with ASD , Frontal_Sup_L , and right hippocampus . The brain areas associated with overweight/obesity and GMV included the right amygdala , Frontal_Sup_L , and the right thalamus . Only the gray matter volume in the left dorsolateral superior frontal gyrus  was correlated with both SC and overweight/obesity in children with ASD  positively predicted SC in children with ASD in Model 1. Meanwhile, overweight/obesity  was found to negatively predict GMV in the left dorsolateral superior frontal gyrus in children with ASD in Model 2. In Model 3, overweight/obesity  and GMV in the left dorsolateral superior frontal gyrus  jointly predicted SC in children with ASD.Our study found a correlation between overweight/obesity, Frontal_Sup_L GMV, and SC. To further explore the interrelationship between the three evaluated parameters, the approach of Preacher and Hayes was employed to test the saliency of the indirect effects. A mediating effect analysis was conducted using Model 4 (simple mediation model) of the Process plug-in in the SPSS  software package, with overweight/obesity as the independent variable. In this analysis, gender and age, Frontal_Sup_L GMV, and SC were set as the control variable, mediating variable, and dependent variable, respectively. Results of the regression analysis  showed tIn the mediation effect test, the Bootstrap method was selected in the mediation model . The uppIn this study, the integration of behavioral and imaging techniques revealed that overweight/obesity in children with ASD is closely associated with SC. The GMV of the left dorsolateral superior frontal gyrus was a significant mediator in the link between overweight/obesity and SC, which validated our hypothesis. Higher BMI’s in children with ASD is associated with higher SC scores, indicating that overweight/obesity in children with ASD has a significant positive predictive effect on SC. The direct effect size was 63.4%. Regarding previous studies on overweight/obesity and social impairment in children with ASD, it was found that overweight/obesity in children with ASD was associated with reduced dorsolateral superior frontal gyrus GMV, and social impairment in children with ASD was associated with reduced dorsolateral superior frontal gyrus GMV. Therefore, the relationship between overweight/obesity and social impairment in children with ASD could be modulated by increasing the dorsolateral superior frontal gyrus GMV. Significantly, the mediating model was applied to explore the mediating role of the GMV of the left dorsolateral superior frontal gyrus in the relationship between overweight/obesity and SC. It was found that potential neural pathways were involved in the association, which provides new evidence to comprehensively uncover the relationship between overweight/obesity, GMV, and SC.A positive association between overweight/obesity in children with ASD and SC impairment was found, indicating that a higher BMI in children with ASD resulted in an increased risk of catching SC. The results are consistent with hypothesis one, and provide preliminary confirmation of the association between overweight/obesity in children with ASD and SC. In a previous study in islanders, children with overweight/obesity and ADHD were found to have severe social impairment . AdditioIn this study, a significant negative correlation was found between the GMV of the left dorsolateral superior frontal gyrus and SC in children with ASD. Previous studies showed a significant relationship between GMV and SC in patients with ASD, specifically in the frontal and temporal regions , the supIn this study, there was a negative correlation between overweight/obese children with ASD and the GMV of the left dorsolateral superior frontal gyrus. The rise in the BMI in children with ASD may be associated with changes in the GMV of the left dorsolateral superior frontal gyrus. In the field of brain research, many studies have shown that BMI is inversely associated with GMV, although regional patterns often differ across studies ,61. FurtThis study further employed PROCESS to establish the mediating effect based on correlations among overweight/obesity, GMV, and SC. It was established that the Frontal_Sup_L GMV of children with ASD played a partial mediating role between overweight/obesity and SC. Higher BMI’s resulted in smaller Frontal_Sup_L GMV, thereby affecting neural connections in areas such as the frontal lobe. Thus, the activity of the dorsolateral superior frontal gyrus neural network is reduced. This may make social barriers to ASD elevated. Firstly, previous studies have shown that overweight/obesity may lead to structural and functional brain abnormalities in children with ASD, such as abnormally reduced GMV in the frontal and superior temporal sulci , which mThis study expands on previous studies that primarily preliminarily confirmed the association between overweight/obesity and SC in children with ASD, and reveals that GMV may be one of the neural mechanisms of the association between overweight/obesity and SC. However, the present study also has some limitations. First, the sample size of overweight/obese children with ASD was relatively small. The study population included children with ASD, which involved difficulties in recruiting participants. Second, this paper is mainly a preliminary exploration of the whole-brain neural mechanisms between overweight/obesity and social impairment, without analysis of brain regions of interest, and in the future, analysis of interest in both can be considered. Third, this study is a cross-sectional study. Longitudinal interventions can be used in future studies to further confirm the neural mechanisms of this study. The factors affecting SC are complex and diverse, and subsequent studies can consider the effects of other factors such as molecular and cellular levels.A positive association between overweight/obesity and SC was observed in children with ASD. At the same time, in children with ASD, a negative association was found between overweight/obesity and the GMV of the left dorsolateral superior frontal gyrus, and a negative association between SC and the GMV of the left dorsolateral superior frontal gyrus. The GMV of the left dorsolateral superior frontal gyrus mediated the association between overweight/obesity and SC. In conclusion, we have demonstrated that GMV is one of the neural mechanisms underlying the association between overweight/obesity and social impairment. Moreover, findings in this article may have some public health implications by giving suggestions to overweight/obese children with ASD who are vulnerable to social impairment in the future. For instance, by participating in physical activity, children with ASD who are overweight/obese can reduce their BMI and be effective in slowing down abnormalities in brain GMV, thereby improving their social interaction skills.


We found a significant positive correlation between body mass index (BMI) and LV myocardial fat (p = 0.033). In the RV, this correlation was only at the borderline of significance (p = 0.052). The EAT volume was positively correlated with both RV and LV myocardial fat. We found no association with the waist–hip ratio (WHR) or the omental or kidney fat as measures of VAT. The myocardial fat was normal, most prominent in the RV, and correlated with the EAT and, partly, BMI. We found no association with VAT.The normal human heart contains epicardial adipose tissue (EAT) and myocardial fat. The associations between obesity, myocardial fat, visceral adipose tissue (VAT), and cardiovascular disease are not fully understood. The objective of this study was to estimate myocardial fat using stereological methods and investigate its relations with obesity, EAT, and VAT. To establish the EAT volume, 115 deceased individuals were included, and postmortem computed tomography was conducted on their eviscerated hearts. Six samples from the left and right ventricles (LV and RV) of the heart were stereologically examined to calculate the percentage of myocardial fat. Kidney and omental fat were weighed at autopsy, and the waist–hip ratio was calculated. Females had a slightly non-significantly ( Adipose tissue is present in and around the normal human heart. Epicardial adipose tissue (EAT) is fat tissue around the myocardium without a separation from the fascia. This includes the pericoronary adipose tissue, which surrounds the coronary arteries, extends into the myocardium, and is a type of visceral fat. Visceral adipose tissue (VAT) is fat that is around the organs, unlike subcutaneous and intramuscular fat. This also includes perirenal and omental fat. Myocardial fat comprises bundles of adipocytes that infiltrate the myocardium . There iMyocardial fat is typically located in the right ventricle (RV) , but it Classically, obesity is defined by a high body mass index (BMI) and is related to an increase in LV mass . The fatIn this study, we had the unique opportunity to combine whole-body CT scans, CT of eviscerated hearts, autopsy findings, and stereological techniques to assess the relations between BMI and different types of visceral adipose tissue.The aim of this study was to quantify myocardial fat using stereology and to investigate its correlations with BMI, EAT, and VAT. This study was a part of the SURVIVE study, a Danish national autopsy study from 2013 to 2015 [All cases were autopsied according to a standardized and accredited autopsy protocol that followed international guidelines, and the autopsies were extended for sampling regarding both tissue and data. Information regarding the included individuals was collected from police reports. The SURVIVE protocol thoroughly described the registration of physical parameters, organ-specific dissection, and sampling. The height, waist- and hip circumference was measured in the supine position  (REF). TThe occurrence of metabolic syndrome was defined with postmortem factors, as described in the article by Christensen et al. . ® software , as described by Hindsø et al. [PMCT scans were performed by using a standardized scan protocol on a 64-slice Definition Dual-Source CT scanner from Siemens. The total volume of EAT was obtained using the semi-automatic Mimicsø et al. .To determine the myocardial fat, gold-standard stereological principles were applied ,16. The As illustrated in p-value < 0.05 was deemed significant. The data were analyzed by using IBM SPSS Statistics for Windows, Version 27.0 Armonk, NY, USA: IBM Corp. To analyze correlations between continuous data, we used the Pearson correlation coefficient. The Mann–Whitney U test was used to analyze differences between groups. A The study was approved by the National Committee on Health Research Ethics, Denmark (registration number: 1305373). The final cohort consisted of 57% males and 43% females. The characteristics of the study group are summarized in n = 31), with the primary etiology being ischemic heart disease. Only one individual had myocarditis, and no cardiomyopathies were found. No significant differences in myocardial fat in the RV or LV were found between the group with a cardiovascular cause of death and the group with other causes of death .The most frequent manners of death were natural and accidental . Accidenp = 0.12), and for the LV (p = 0.54), the results were not significant. In addition, when analyzing the correlations of age with LV and RV myocardial fat and EAT, no significant differences were found. A significant positive correlation was found between RV and LV myocardial fat  , and that for the LV was 2.2% (±0.4). The highest percentage of myocardial fat was in the RV in women (13.2% ± 4.4). Men had a percentage of RV myocardial fat of 11.5% (±2.7). The difference between the sexes was only borderline significant for the RV ( < 0.01) C.r = 0.2, p = 0.03) was found; the variance explained was only 4.0%. The correlation of the RV with the BMI was borderline significant . A comparison of the total volume of the EAT and the myocardial fat in both ventricles yielded a moderate significant positive correlation; the variance explained was 10.5% and 14.5% for the LV and RV, respectively .The SURVIVE protocol, with its standardized information and thorough sampling of fat tissues, was an essential part of this study. However, the cohort is very selective, and in general, autopsy subjects are a very specific population not necessarily representing the background population. In this study, we chose not to distinguish among severe mental illness, other (aside from cardiac) comorbidities, and the use of medication, though all factors could be important for the development of visceral and/or myocardial fat. However, when comparing cardiovascular causes of death—which are suspected to involve myocardial fat—no significant differences were found in comparison with the other causes of death.Height, weight, and hip and waist circumferences were measured postmortem in the supine position. This does not always compare to the antemortem measurements. The waist size could be too large due to the development of gases during decomposition; however, one exclusion criterion was moderate to severe decomposition. This study has shown how myocardial fat is not correlated with sex, age, or visceral adipose tissue, and only LV myocardial fat showed a correlation with BMI. While LV myocardial fat seems to be associated with obesity, RV myocardial fat does not seem to be. The myocardial fat in both ventricles, however, was associated with EAT, and EAT was correlated with all types of VAT. Perhaps other factors—heart disease, mental illness, or medications—are more important for the accumulation of myocardial fat, which needs further exploration. In our setting, the possibility of combining imaging and autopsy studies could yield interesting results in the exploration of the interconnections among EAT, myocardial fat, and cardiac steatosis.


Background: The purpose of this study was to measure physical activity (PA), sedentary behavior (SB), and hour-by-hour PA patterns with an accelerometer in a population-based sample of Finnish children and adolescents. Methods: A total of 3274 participants  from 176 schools wore a hip-worn triaxial accelerometer for seven days during waking hours. Mean amplitude deviation of the acceleration data was used to assess PA intensity that was converted to metabolic equivalents and categorized into light, moderate, and vigorous PA. Angle for posture estimation was used to measure SB and standing. Results: The majority of participants’ PA consisted of light PA, and they were sedentary for more than half of their waking hours. Children were more active than adolescents, and boys were more active than girls. Participants took, on average, 9890 steps daily, and one third met the PA recommendation. The participants were divided into tertiles based on daily steps to investigate the variation in PA patterns. Compared to the least active tertile, the most active tertile took twice as many steps on weekdays and nearly three times as many steps on the weekend. Conclusions: The majority of the participants were not active enough, and there was a great variation in PA levels and patterns, especially among the adolescents and on weekends. Physical activity (PA) is important for children and adolescents to enhance growth and health ,2. At thPA is a multi-dimensional construct, and no single measure can assess all its facets . In contDaily step count is one indicator of PA. In adults, daily step counts less than 5000 steps per day have been used to define a sedentary lifestyle, whereas step counts exceeding 10,000 steps per day indicate a physically active lifestyle . There iBoth subjective and device-based measurements have shown that younger children are, on average, more active than adolescents ,5,7,8,13The purpose of the present population-based study was to describe accelerometer-measured PA and SB among a large sample of Finnish children and adolescents. In addition, we analyzed PA according to step levels and how many of the participants met the PA recommendations. A further aim was to examine hour-by-hour patterns of PA and SB during waking hours on weekdays and weekend days, and to make age and sex group comparisons of the daily PA patterns.This study is based on the Finnish School-age Physical Activity (FSPA) 2016 study on children’s and adolescents’ PA and SB. This national study was carried out for the first time in 2014 as a survey in connection with the World Health Organization (WHO) Cross-national Health Behavior in School-aged Children (HBSC) survey . In 2016A random sample of schools was drawn from the Statistics Finland database based on the HBSC protocol  for the A total of 285 schools with 10,513 possible participants were willing to participate in the FSPA study’s online survey, whereas 176 of those schools with 7061 possible participants were willing to participate in the accelerometer measurements. Altogether, 3274 children and adolescents (57% girls) used the accelerometer . The incThe accelerometer-measured PA and SB data were collected with triaxial hip-worn UKK AM30 and RM42 accelerometers , which have been validated in adolescents  and adulStudy coordinators in the ten regional organizations, together with local school teachers, delivered the accelerometers during school hours, and gave both oral and written instructions to the children and adolescents about the proper use of the device. One week later, the devices were returned to the schools. The participants were instructed to wear the accelerometer on an elastic belt on the right side of their hip for seven consecutive days during waking hours. The participants were advised to remove the device during shower or water-based activities. Raw triaxial acceleration data were collected at 100 Hz sampling frequency. The data were analyzed with validated algorithms based on the mean amplitude deviation (MAD) of the acceleration signal analyzed in 6-s epochs and angle for posture estimation (APE) ,24,25. TThe steps were identified from the vertical component of the acceleration with the algorithm proposed by Vähä-Ypyä et al. .p < 0.05. The Benjamini–Hochberg procedure [p-values for all 354 statistical tests in this manuscript resulted in an adjusted significance level of p = 0.044. All p-values < 0.044 were considered statistically significant. All analyses were conducted by IBM SPSS version 24.0 .Mean and standard deviation (SD) are shown separately for boys and girls by the school grade. The Mann–Whitney U test was used to test the differences between sexes and grades. In order to study the variation in PA and SB patterns within the age groups, children and adolescents were divided into sex- and grade-specific tertiles  based on their daily step counts. In this study, these tertiles are called simply ‘tertiles’. The Kruskal–Wallis H test was used to test the differences between the tertiles for hour-by-hour data. Sex and grade differences for meeting the PA recommendation were analyzed by logistic regression. Inverse probability weighting was used to correct the differences in area, sex, and age between the sample and population. The significance level was set at rocedure  for adjuChildren, adolescents, and their guardians were informed about the FSPA study beforehand via schools. Despite the school-level consent for participation, individual participation was completely voluntary. Written informed consent was obtained from children’s and adolescents’ guardians before the accelerometer measurements. Participants had a right to withdraw from the study at any time without a specific reason. The study followed the ethical principles of the Declaration of Helsinki, and was approved by the Ethics Committee of the University of Jyväskylä.Children’s and adolescents’ PA and SB times, and mean daily step counts during the accelerometer wearing time are presented in p < 0.001). Girls had significantly more LPA than boys between the 3rd and 5th grades (p < 0.001), but significant between-sex differences disappeared among the 7th and 9th graders.Most of the children’s and adolescents’ daily PA consisted of LPA . On average, younger participants had significantly more LPA than the older ones (p < 0.001). On average, boys had more MVPA than girls in every age group (p < 0.001). Vigorous PA  covered only a few percentages of the waking hours among both sexes. Children and adolescents spent 8–18% of their waking hours in MVPA , and the levels of MVPA among the older age groups were significantly lower than those among the younger groups (p < 0.001), and boys were, on average, more sedentary than the girls (p < 0.05) in all age groups except the 7th grade. Moreover, standing increased with age. However, there was no statistically significant difference in standing between the 3rd and 5th graders (p = 0.562). Among adolescents, girls stood, on average, more than boys (p < 0.001). Children and adolescents were sedentary  or standing  more than half of their daily waking hours. SB increased significantly with age (p < 0.001). On average, boys took significantly more steps per day than girls (p < 0.027).Children and adolescents took, on average, 9890 steps per day. The mean number of steps decreased almost 30% from 3rd to 9th grade . All other grades differed statistically significantly from the 3rd graders  of the FSPA study participants met the PA recommendation, accumulating at least 60 min of MVPA each day. A total of 45.4% of children (3rd and 5th graders) and 18.6% of adolescents (7th and 9th graders) met the PA recommendation. Girls were less likely to meet the recommendation than boys .Tertile-wise daily steps broken down by sex and grade are shown in p < 0.001) from each other when analyzing the differences between grades and sex. All the tertiles differed statistically significantly (When looking at the tertiles hour-by-hour a and makp < 0.05) between mean hourly step counts in all hours between 8 a.m. to 11 p.m.  between all tertiles from 8 a.m. and 10 p.m. during both weekdays and weekends (weekends .p < 0.001). On weekdays, there were statistically significant differences (p < 0.05) between the tertiles in LPA minutes per hour from 10 a.m. to 24 p.m. among girls, but only after school hours (from 3 p.m. onwards) among boys. The tertiles of all grades were closer to each other on LPA than the step counts during weekdays, especially during school hours b. The mip < 0.05). On the weekends, the patterns of MET peaks were again flatter compared to weekdays c. All teThis is the first population-based study of accelerometer-measured PA and SB levels and patterns among children and adolescents in Finland presented by sex and grade. To our knowledge, this study is also the first one to compare children’s and adolescents’ hourly steps, LPA, and MET patterns in step tertiles during waking hours. With this analysis of the FSPA study, we achieved detailed knowledge about children’s and adolescents’ hour-by-hour PA and SB during weekdays and weekends.The main results of our study indicate that PA levels vary greatly between grades and sexes. Younger children were significantly more active than adolescents, and boys were more active than the girls. Most of the children’s and adolescents’ PA consisted of LPA, and only a tiny proportion of PA was vigorous. Furthermore, the participants spent more than half of their waking hours sedentary or standing. The amount of SB increased significantly with grades, and boys were, on average, more sedentary than girls. In general, one third of all participants met the PA recommendation. The variation in meeting the recommendation between grades was significant; children met the PA recommendation more often than adolescents. Boys also met the PA recommendation more often than girls. Similar results have been reported in previous studies in other countries ,29,30,31Participants’ PA patterns according to grade- and sex-specific tertiles, especially during their leisure time, varied significantly. The mean daily step count was about double on school days, and nearly triple on weekends in the most active tertile compared to the least active one. All the children and adolescents were able to gain at least a moderate PA (≥3 MET) level. On weekdays, all the tertiles of boys attained, on average, the VPA (≥6 MET) level, but among girls, only the most active tertile achieved the VPA level. On weekends, only the most active tertile of boys attained, on average, the VPA level.Due to the great variability in measurement devices, analysis algorithms, and outcomes used in the previous PA and SB research articles ,11,26,27According to the present FSPA study, younger children were more active than adolescents, and boys were, on average, more active than girls. These findings are consistent with previous studies ,31,32,33The most active tertile took, on average, three times more steps than the least active tertile at all grades during the weekend. The mean step count of the least active tertile on the weekend was close to that reported among adult cardiovascular disease patients . During These FSPA study findings highlight that the children and adolescents were more active during weekdays than weekends. Particularly, the least active tertiles had the highest step count and the highest MET peak level during school hours. The results underline that the PA levels of the least active children and adolescents may benefit from daily school routines that include various forms of PA. Furthermore, there are notable differences in daily patterns between weekdays and weekends between the tertiles.Quite little is known about the patterns of PA in children and adolescents, whereas the comparisons between studies remain challenging due to heterogeneous research methods, e.g., regarding the chosen outcomes and definitions of time segments. Steele et al.  investigFew studies have employed tertiles or quartiles to explore daily MVPA patterns. Belton et al.  used quaA major strength of the present FSPA study pertains to the yet largest population-based sample of Finnish children and adolescents, whose PA and SB were measured using accelerometers. The participants’ eagerness to wear the accelerometer among all four grades is also a strength. The participants wore the accelerometers, on average, for 13 h 49 min in the 3rd grade, and the wearing time increased up to 14 h and 14 min in the 9th grade. The wearing hours are in line with previous studies ,7. The hThere are also some limitations. First, this study describes only the results from accelerometer measurements of the FSPA study. The results of the simultaneously conducted FSPA survey were not utilized in the present analysis, but they have been and will be reported later elsewhere . WithoutVersatile and easily-implemented means would be needed to reduce sedentary time and promote PA in children’s and adolescents’ everyday life. The present findings indicate, parallel to the previous research, that the most active children and adolescents are more active, on average, because they accumulate more PA throughout the days ,39,40,42In the present FSPA study, there was great variation in children’s and adolescents’ PA levels and patterns between grades, sex, and the tertiles, especially during leisure time. Furthermore, the participants spent more than half of their waking hours sedentary or standing, SB increased significantly with grades, and boys were both more active and more sedentary compared to girls. The children and adolescents accumulated, on average, just under 10,000 steps per day, and they were more active on weekdays than weekends. On average, only one third of schoolchildren met the PA recommendation, and a higher proportion of lower-graders and boys met the recommendation more often than upper-graders and girls.There is a need for targeted multi-level PA interventions among children and especially among adolescents to increase PA and reduce SB. Future research should focus on more detailed accelerometer-based measurements to identify the time segments of the week with the greatest potential to attain positive behavior changes among children and adolescents.


The rate of perioperative satisfaction for patients was higher, the hospital stays and days to return to normal activity were shorter, and the cost was less in the LA group than in the patients in the GA or SA group . This prospective PSM cohort demonstrated that LA has the advantages of perioperative pain relief, reduced anesthesia-associated side effects, and cost, compared with GA or SA. It indicated that LA is an effective and safe technique for subinguinal MSV, and may guide clinical practice.It is unclear whether local anesthesia (LA) is a viable and safe alternative to general anesthesia (GA) or spinal anesthesia (SA) for microscopic varicocelectomy. As a result, we designed a prospective trial to compare the pain relief, complications, and cost of LA with GA or SA in subinguinal microscopic varicocelectomy (MSV), using the propensity score matching method (PSM). This prospective study was conducted in a tertiary hospital from February 2021 to April 2022. Patients who underwent subinguinal MSV for varicocele were enrolled. The perioperative visual analog scale (VAS) scores, anesthesia-associated side effects, and cost data were recorded, and PSM analysis was performed. Finally, 354 patients were included, of whom 61.0% (216) were treated with LA, and 39.0% (138) underwent GA or LA. After PSM, the patients in the LA group exhibited lower VAS scores both three hours and one day after surgery, and a lower incidence of postoperative analgesic requirement; a lower ratio of patients who experienced anesthesia-associated side effects was also observed in the LA group, compared with the GA or SA group (all  Varicocele is characterized by abnormal dilatation of testicular veins in the pampiniform plexus, and is caused by impaired venous drainage . It is aVaricocelectomy is the most frequently performed procedure. The goal of varicocele treatment is to eliminate the dilatation of the pampiniform venous plexus and, hence, to obstruct the refluxing venous drainage to the testis . SeveralSubinguinal MSV can be successfully performed under general anesthesia (GA), spinal anesthesia (SA), or local anesthesia (LA). The preferred anesthesia technique depends on several factors, including the procedure’s suitability for the patient, surgeon choice, patient acceptance, safety, perioperative pain control, the time to return to normal activity, the need for monitoring, and cost-effectiveness. LA is associated with reduced pain, decreased postoperative analgesic requirement, less need for postoperative care, lowered postoperative nausea and vomiting complications, a short anesthesia time and a short hospital stay, compared with GA ,11. AlthA retrospective study that included 3565 patients with varicocele demonstrated that inguinal MSV under LA (2% lidocaine) was superior to subinguinal MSV under GA or SA in operating duration and time to return to normal activity. However, no statistical difference was found in pain scores due to surgery . An RCT Ropivacaine is a new long-acting local anesthetic. It produces cutaneous vasoconstriction that restricts systemic absorption of the drug and increases its local duration of action. Moreover, ropivacaine produces an anti-inflammatory effect that may further reduce the pain when administered locally. A mixture of equal volumes of 0.5% ropivacaine and 2% lidocaine has been widely used for LA among many diseases . LidocaiThis prospective study was conducted at the Shengjing Hospital of China Medical University, from February 2021 to April 2022. A total of 389 consecutive patients who underwent subinguinal microscopic varicocelectomy were enrolled in the present study. After screening, there were 354 patients included in the final analysis; of these, 216 patients were treated under local anesthesia, and 138 patients were treated under general anesthesia or spinal anesthesia, respectively .Inclusion criteria: age more than 18 years; clinically palpable varicocele; infertility with abnormal semen parameters , nonobstructive azoospermia, symptomatic varicocele , American Society of Anesthesiologists (ASA) physical classification I or II.Exclusion criteria: patients who had previous varicocelectomy (recurrent) or other types of inguinal surgery (such as hernia repair); history of substance abuse, chronic analgesic use, and allergies to local anesthetics; malformation of the reproductive system; the presence of lower urinary-tract infection or prostatitis, epididymitis, and seminal vesiculitis.Decision-making process: patients were given a choice to undergo local anesthesia, spinal, or general anesthesia, after receiving counseling about the advantages and drawbacks of the procedures . After receiving the explanation, the patients selected the method they preferred, and provided informed consent; their chosen procedure was performed by senior experts with vast experience in using these techniques.Local anesthesia was delivered by infiltrating 2% lidocaine (10 mL) and 0.5% ropivacaine (20 mL). The patient was placed in a supine position. First, local infiltration into the incision site was applied layer by layer, and then an incision of about 2–3 cm was made below t the external inguinal ring. Second, after incising the skin and subcutaneous tissue and blocking the spermatic nerve , the speOn the day of admission, the patient could eat and drink freely, intraoperative monitoring of blood pressure and an electrocardiogram (ECG) was performed, and the nervousness and anxiety of the patient were relieved by a conversation with the doctor and by enjoying music. After surgery, patients were monitored for one hour and discharged if vital signs were stable.2O. Anesthesia was maintained with propofol (target-controlled infusion 3–5 μg/mL) and remifentanil (continuous infusion 0.05–0.3 μg/kg/min). Anesthesia management was left to the attending anesthesiologist. No other analgesics were administered intraoperatively.All patients underwent inguinal varicocelectomy by general anesthesia induced with fentanyl (0.2–0.3 μg/kg), cisatracurium (0.15 mg/kg), and propofol (3–5 μg/mL). Patients were intubated and ventilated with 50% oxygen and 50% NThe patients in the SA group were preloaded with 10 mL/kg of isotonic lactated Ringer’s solution. They were administered SA using the midline approach with a 25-gauge Quincke needle at the L3–L4 or L2–L3 intervertebral space in the lateral decubitus position, with the operative side remaining dependent. The subarachnoid injection contained 2.5 mL of 5 mg/mL heavy bupivacaine . These blocks were administered by one of the anesthetists. After removing the spinal needle, the patients were placed in a horizontal position for surgery. The sensory block was assessed using the pinprick test, and surgery was allowed to begin when the sensory block was higher than T10. The motor block was evaluated using a modified Bromage scale.Patient demographics (age and body mass index (BMI)), comorbidity (ASA classification), indications for varicocelectomy ), varicocele data , grade , the 2-tailed t-test, to compare the mean of two continuous normally distributed variables. The Mann–Whitney U test was used to compare the mean of two continuous non-normally distributed variables. The χ2 test or Fisher’s exact test was used for categorical variables. After PSM, the categorical variables were compared using binary conditional logistic regression. Paired samples subjected to the Student’s t-test were used to compare the mean of two continuous normally distributed variables, and the Wilcoxon test was used to compare the mean of two continuous non-normally distributed variables, using univariate analysis. A p-value of less than 0.05 was considered statistically significant.Data were analyzed by the SPSS 22.0 for Windows . To determine the normality of continuous variables, the Kolmogorov–Smirnov test was applied. Continuous variables were presented as the median (interquartile range) or mean ± standard deviation. Categorical variables were reported as the numbers (percentage). Before PSM, independent samples were subjected to the Student’s We used the propensity score matching (PSM) method to adjust baseline confounding variables between the LA and GA or SA groups to derive more accurate conclusions. Multivariate logistic regression analysis was used to determine propensity scores for each patient based on age, BMI, ASA, surgical indications, varicocele data, and semen parameters before MSV , and the mean BMI of patients in the LA group was lower compared with the patients in the control group . After PSM, we balanced baseline variables between the two groups. Finally, there were 161 patients treated under LA and 102 patients treated under GA or SA, respectively . The number of ligated veins was also equivalent between the two groups. The VAS score for patients in the LA group during surgery was 1.01 ± 0.15, and no patient needed intraoperative conversion from LA to GA/SA. The patients in the GA or SA group suffered from higher VAS scores both three hours and one day after surgery; a higher incidence of postoperative analgesic requirement was observed in the GA or SA group , see details in After PSM, we found that the operating duration was comparable between the LA and GA or SA groups for unilateral MSV and bilateral MSV . There was no patient who experienced either postoperative surgery-related complications or re-admission among these two groups. The rate of perioperative satisfaction for patients based on their overall feeling concerning comfort and activity was higher, and the hospital stay and days to return to normal activity were shorter in the LA group, compared with the patients in the GA or SA group . The patients in the LA group spent less money than the patients in the GA or SA group (p < 0.001); see details in A higher ratio of patients experienced anesthesia-related side effects in the GA or SA group than in the LA group, such as nausea or vomiting, headache or postspinal backache, urinary retention, and hypotension  was comparable to the patients treated with subinguinal MSV under GA or SA . This diNo significant difference was found in the operating duration and the number of ligated veins between the two groups. This indicates that LA does not affect the operative process. Al-Said et al.  reportedIn this study, LA was also accompanied by fewer anesthesia-associated side effects than GA or SA in patients undergoing subinguinal MSV, such as nausea or vomiting, headache or postspinal backache, and urinary retention; these are known common side effects of GA or SA, which might delay postoperative recovery . In addiAll patients in the LA group were discharged on the day of operation, meaning that it was day surgery, and they were able to achieve normal activity as soon as they returned to their rooms. Therefore, LA was superior to GA or SA in both hospital stay and days to return to normal activity. In line with this, Watanabe et al. , in a reApart from the benefit mentioned above, there were other latent advantages. Firstly, LA could facilitate understanding of the nerve distribution in the spermatic cord by the intraoperative conversation between patient and surgeon. Therefore, it can avoid nerve injury and thus prevent postoperative chronic orchialgia. Secondly, this technique could also be used for overweight patients, because the subinguinal approach deals with a superficial site and avoids the need for opening the abdominal muscles and external oblique aponeurosis.However, there are several potential risks. Firstly, short-term hospital stay may also lead to poor wound care and complications (such as hemorrhage or hematoma and infection) if the compliance is poor. Secondly, preoperative and intraoperative anxiety is common among all patients undergoing LA. A detailed explanation of the procedure should be provided before surgery, to address this problem. In additions, playing music and conversing with the patient throughout the procedure may also be helpful. The combined use of sedative drugs and anti-anxiety drugs is also beneficial. Thirdly, compared with LA, patients treated with GA or SA may have a lower risk of intra-operative movement, which is critical in preventing complications such as arterial injury or lymphatic injury. However, there was no such intra-operative movement or subsequent complications observed in this study. In addition, both the number of ligated veins and the duration of surgery were comparable between the two groups, indicating no limitation on executed surgery and operative time.This study had several limitations. Firstly, the study was non-randomized, and from a single center. Secondly, we self-reported and established part of the postoperative complications and satisfaction level of patients. Thirdly, in other countries, men undergoing MSV may be treated as outpatients, limiting the generalizability of the outcomes measured in terms of hospital length of stay. Fourthly, fertility-related outcomes  and surgery-related complications were not reported. Nevertheless, this is the first prospective PSM cohort study to explore pain relief, safety, and cost among LA and GA or SA in patients who underwent subinguinal MSV. Multi-center RCTs with fertility-related outcomes and long-term surgery-related complications are needed in the future, for confirming these results.This prospective PSM cohort demonstrated that LA has the advantages of perioperative pain relief, reduced anesthesia-associated side effects, and cost compared with GA or SA. It indicated that LA is an effective and safe technique for subinguinal MSV and may guide clinical practice.


Geohazard prevention and mitigation are highly complex and remain challenges for researchers and practitioners. Artificial intelligence (AI) has become an effective tool for addressing these challenges. Therefore, for decades, an increasing number of researchers have begun to conduct AI research in the field of geohazards leading to rapid growth in the number of related papers. This has made it difficult for researchers and practitioners to grasp information on cutting-edge developments in the field, thus necessitating a comprehensive review and analysis of the current state of development in the field. In this study, a comprehensive scientometric analysis appraising the state-of-the-art research for geohazard was performed based on 9226 scientometric records from the Web of Science core collection database. Multiple types of scientometric techniques, including coauthor analysis, co-citation analysis, and cluster analysis were employed to identify the most productive researchers, institutions, and hot research topics. The results show that research related to the application of AI in the field of geohazards experienced a period of rapid growth after 2000, with major developments in the field occurring in China, the United States, and Italy. The hot research topics in this field are ground motion, deep learning (DL), and landslides. The commonly used AI algorithms include DL, support vector machine (SVM), and decision tree (DT). The obtained visualization on research networks offers valuable insights and an in-depth understanding of the key researchers, institutions, fundamental articles, and salient topics through animated maps. We believe that this scientometric review offers useful reference points for early-stage researchers and provides valuable in-depth information to experienced researchers and practitioners in the field of geohazard research. This scientometric analysis and visualization are promising for reflecting the global picture of AI-based geohazard research comprehensively and possess potential for the visualization of the emerging trends in other research fields. Geohazards refer to events caused by geological conditions or processes that pose a threat to human life, property, or the natural environment [https://public.emdat.be/, accessed on 7 July 2022), a global database of technical and natural disasters, 1877 large-scale geohazards occurred worldwide between 1 January 1990 and 7 July 2022. These disasters killed 2.43 million people, left 25.74 million people homeless, and caused $862 million in damages. Japan and China are the countries with the highest losses due to geohazards, which caused approximately $392 million and $114 million in damages, respectively  is a comprehensive database with high-quality citation analysis [analysis  that is analysis ) and canData filtering and refining: Subject terms were identified, subject searches were performed in the Web of Science database , and Boolean operators (OR/AND) were used to expand the search and exclude irrelevant papers. After filtering and refining the search results to determine the time frame, the search results were downloaded and prepared for the next step of the analysis.Data analysis and visualization: After filtering and refining the papers, the data were visually represented by using the visualization tool CiteSpace. Cluster analysis, an exploratory data mining technique, was adopted for the identification of the salient term and context, research trend, and interconnection. Log-likelihood ratio was used as the clustering index due to advantages of high-quality classification with high intra-class similarity and low inter-class similarity. A cluster overlap indicates that there are relationships between keywords of these different clusters. CiteSpace was used as a tool for performing cluster analysis. A visualization map generated by CiteSpace consists of color-coded nodes and links that describe co-citations or cooccurrences between these nodes. Each representative node, which is made up of a “tree ring” of different colors, denotes one specific item . The spectrum of colors denotes the temporal order: oldest in blue and newest in orange. The size of the ring represents the frequency of the corresponding item in a particular year. A red ring present in a particular year denotes a burst, that is, a surge of occurrences or citations in that year. Based on the data visualization, scientometrics and content analysis of the search results in the field are performed and discussed and the results are derived.The characteristics of the publications on AI for geohazard research over time are shown in The spatial distribution characteristics of publications are shown in Natural Hazards and Remote Sensing, with 5.96% and 4.58% of the total number of papers, respectively, are among the top two source journals in this field. Among the top 15 sources, Geomorphology , Journal of Hydrology , and Catena  are the most cited. Those results correspond well with the bibliometric review of Wu et al. [Geomorphology (61.52), Earthquake Spectra (50.59), and Catena (47.62) have the highest average number of citations. Geomorphology and Catena not only have a high total number of citations but also a high average number of citations. Therefore, they are considered to be the most active journals in this field.To provide researchers with references to authoritative publication sources and to facilitate access to relevant and cutting-edge papers, the top 15 sources of AI for geohazard research are shown in u et al.  in the fThe affiliations of the top 15 most productive authors in terms of AI research in the field of geohazards and their H-index, total number of papers, and total number of citations are shown in The most productive authors are Pradhan, Biswajeet (136); Dieu Tien Bui (70); and Pourghasemi, Hamid Reza (65); who are also the most cited authors. Six of the top 15 authors have a higher number of average citations  than the rest. They are Pourghasemi, Hamid Reza (97.42); Pradhan, Biswajeet (96.66); Shahabi, Himan (84.60); Dieu Tien Bui (80.06); Rahmati, Omid (76.93); and Hong, Haoyuan (69.94). Four authors have an H-index above 60: Pradhan, Biswajeet (94); Dieu Tien Bui (68); Pourghasemi, Hamid Reza (66); and Lee, Saro (64). Six authors have a relative citation impact greater than 1 relative to the other top 15 authors. They are Pourghasemi, Hamid Reza (1.41); Pradhan, Biswajeet (1.39); Shahabi, Himan (1.22); Dieu Tien Bui (1.16); Rahmati, Omid (1.11); and Hong, Haoyuan (1.01). According to these data, Pradhan, Biswajeet; Dieu Tien Bui; and Pourghasemi, Hamid Reza have better performances under all parameters. Therefore, they are considered to be strong influential researchers in the field.Among 9226 scientometric records of AI studies in the field of geohazards, 841 institutions are identified. The average citations per paper for all papers related to AI research in the field of geohazards from the top 15 institutions is 28.46%. Six institutions have higher average citations per paper than the others. These institutions include the U.S. Geological Survey (57.23); University of California, Berkeley (50.91); Sejong University (42.82); Duy Tan University (36.02); Islamic Azad University (35.74); and China Earthquake Administration (28.60). From 1990 to 2022, the relative citation impact of the top 15 most productive institutions relative to the total global research output of AI in geohazards was 1.00. Five institutions exceeded this relative citation impact, including the U.S. Geological Survey (2.00); University of California, Berkeley (1.78); Sejong University (1.5); Duy Tan University (1.26); and Islamic Azad University (1.25).According to average citations per paper and relative citation impact, the U.S. Geological Survey; University of California, Berkeley; and Sejong University are considered to be the most active institutions in this field.Information on publications by country and region is closely related to publication characteristics but reflects different information see . This taIn this study, we selected papers ranked in the top 40% of references each year as the prominent research clusters for identifying the development of AI in geohazard research. By applying the log-likelihood ratio algorithm, 10 prominent research clusters were identified based on the keywords of the top-cited references see . The ideGround motion: The largest cluster (#0) is labeled ground motion, with a total of 70 members and a silhouette value of 0.81. A representative paper is that by Boore and Atkinson [Atkinson . Ground Deep learning: The second largest cluster (#1) is labeled DL, with 64 members and a silhouette value of 0.91. A representative paper is that by Bui et al. [i et al. . DL, a mi et al. . With thi et al. , includiGIS: The third largest cluster (#2) is labeled GIS, with 61 members and a silhouette value of 0.97. A representative paper is that by Guzzetti et al. [i et al. . GIS, ori et al. .Landslide: The fourth largest cluster (#3) is labeled landslide, with a total of 54 members and a silhouette value of 0.91. Landslides are one of the most common geohazards, causing large economic losses and safety threats to people every year. Representative papers include those by Pradhan [ Pradhan , Tien Bu Pradhan , and Pou Pradhan . These pImpact: The fifth largest cluster (#4) is labeled impact, with 47 members and a profile value of 0.92. The impact label includes both the impact factors and the impacts caused by geohazards. In representative papers by Kim et al. and Ma et al. [a et al. ,49, the a et al.  studied In addition to the keyword characteristic analysis of publications, the 10 keywords with the strongest keyword citation burst are all related to AI technology. Seven of these keywords are AI algorithms. This also indicates that AI algorithms have become an important method in geohazard research. Therefore, it is necessary to summarize and analyze the AI algorithms commonly used in geohazard research. AI has been extensively applied to geohazard research, yielding tremendous success. Based on the scientometric analysis of the literature to date, we recommend the following aspects should be addressed for AI-based geohazard research.http://study.rsgis.whu.edu.cn/pages/download/, accessed on 4 October 2022) containing landslide images, landslide boundary information, landslide area DEM data, etc. Mousavi et al. [https://github.com/smousavi05/STEAD, accessed on 4 October 2022) which contain local seismic waveforms, seismic noise waveforms, and no seismic signals. These publicly available high-quality datasets can be used as benchmark datasets for the evaluation of the performance of different AI algorithms in this field and provide a reproducible evaluation environment. In addition, a standardized baseline database not only provides researchers with high-quality datasets but also eases the work of researchers in data management [AI modeling is driven by data ; therefoi et al.  contribunagement . TherefoAI techniques provide good performances in geohazards such as landslide susceptibility evaluation , earthquA strong mastery of expert knowledge is required for AI-based geohazard research. A general workflow for AI modeling usually consists of data preprocessing, feature engineering, selection of a machine learning model, and optimization of the associated hyperparameters ,111. RedAI analyzes geohazard data by building corresponding models to predict the occurrence of geohazards and provide evidence and suggestions for its prevention and mitigation. In this process, the uncertainties existing in the data and models may bias the analysis results. Data uncertainty is generated due to class overlap and noise in the training data and is non-approachable due to limitations in how the data are collected. Epistemic uncertainty results from errors caused by model inference or model performance . With thCurrently, accurate uncertainty quantification is the key to enhance the reliability and accuracy of AI analysis results and the future direction of AI in the field of geohazards. A few researchers have started research on uncertainty quantification. The most common approaches can be divided into Bayesian uncertainty quantification that focuses on specifying the training set to approximate the posterior probability distribution, such as Monte Carlo  and MarkSome AI algorithms cannot provide a reasonable interpretation for their results which makes researchers and practitioners distrust results obtained from AI. This has limited the development of AI-based geohazard research to a large extent and has brought increasing attention to interpretable AI . Based oNatural Hazards and Remote Sensing are the top two source journals. Geomorphology and Catena are considered to be the most active journals in this field. The analysis of keyword features revealed that ML is a popular research method in this field. Pradhan, Biswajeet; Dieu Tien Bui, and Pourghasemi, Hamid Reza are among the three most productive researchers in this field. Three organizations including the U.S. Geological Survey; University of California, Berkeley; and Sejong University are considered to be the most productive institutions in this field. China, the United States, and Italy are the countries with the highest number of publications and the highest number of total citations among all countries. Identification of salient research clusters indicates that ground motion, DL, GIS, and landslides are current research hotspots.AI has been extensively applied to geohazard research and yielding tremendous success. The present study performed a scientometric-assisted review for AI-based geohazard research by visualization of the research status quo and identification of the salient term and context, research trend, and mapping interconnection based on 9226 scientometric records. The analysis of the research publication trend indicates that AI has obtained continuous development in geohazard research over the past 30 years and entered a period of rapid growth beginning in 2000. An analysis of publication source characteristics has revealed that Future studies on AI-based geohazard research themes may focus on the establishment of benchmark database, integration of AI with physical processes, Auto ML, uncertainty quantification and interpretable AI.This scientometric review offers useful reference points for early-stage researchers and provides valuable in-depth information to experienced researchers and practitioners in the field of geohazard research. This scientometric analysis and visualization are promising for comprehensively reflecting the global picture of AI-based geohazard research and are potential for visualization the emerging trends in other research fields.


Inflammatory-related chronic diseases are increasing in Iran with high consumption of a diet containing pro-inflammatory potential and a sedentary lifestyle. The empirical dietary inflammatory index (EDII) was developed as a tool to assess dietary effects on systemic inflammation. We examined the hypothesis that specific dietary patterns reflecting systemic inflammation are associated with cardiorespiratory fitness (CRF) in Tehranian adults.This cross-sectional study was carried out on 270 adults who are residents of Tehran. Dietary intake was assessed using a 168-item valid and reliable food frequency questionnaire. The EDII score was developed according to participant dietary intakes of 21-item pre-defined food groups. CRF was assessed by using a graded exercise treadmill test. Anthropometric measurements were assessed using standard methods. To discover the association between CRF and EDII, we used multivariable logistic regression analysis.2Max (ml/kg/min) than those in the first tertile . There were no significant differences between tertiles of the EDII score in terms of VO2 (L·min) and VO2 (LBM) before and after adjusting for confounders. There was a significant decrease in VO2Max (ml/kg/min) across tertiles of the EDII after controlling for covariates . There was a significant inverse association between the EDII score and VO2Max (ml/kg/min) .Those who were in the third tertile of the EDII had 57% lower odds of having better VOOur finding demonstrated that a higher EDII might be associated with lower CRF in Tehranian adults. Prospective studies are needed to shed light on the causal link between the EDII and CRF. Chronic inflammation is a process in which inflammation develops slowly and lasts for a long period, ranging from months to years . An incrCRF refers to the maximum capacity of the cardiovascular and respiratory systems to supply oxygen to skeletal muscles during activities such as exercise , 11. TheAccording to studies, diet is one of the main determinants of inflammation , 15. Beca priori index focusing on the inflammatory potential of dietary nutrients  and an empirical dietary inflammatory index (EDII) –18. The utrients , while tividuals –17. Accoividuals . Recentlividuals . On the ividuals .Given that Iran is a country with an increasing rate of several inflammatory diseases, we designed this cross-sectional study to investigate whether the inflammatory potential of diet (using the EDII to achieve a new dimension of results in the inflammation of food groups) is related to cardiorespiratory readiness in Tehranian adults.2 were recruited by using the convenience sampling method. Based on the previously calculated correlation coefficient between the dietary pattern and cardiorespiratory fitness (r) = 256, where α = 0.05, 1–β = 0.95, and r = 0.34]. To compensate for the potential exclusion of participants due to under- and overreporting of total energy intake, or attrition due to other reasons, the final sample size of 270 participants was selected for inclusion. The inclusion criteria were age range of 18–45 years, being healthy, desire to participate in the study, and being residents of Tehran. Some people were excluded from the study who had a dietary intake of less than 800 kcal/d or more than 4200 kcal/d, infectious conditions, and active inflammatory diseases; who were pregnant and lactating; or who used drugs such as hormonal drugs or sedatives, as well as people who used any supplements for weight loss such as caffeine and green tea supplements and conjugated linoleic acid (CLA).This is a cross-sectional study in which 270 apparently healthy  adults aged between 18 and 45 years living in Tehran from February 2017 to December 2018 with a mean age of 36.77 ± 13.19 years and an average BMI of 62.25 Kg/m fitness , our tarIn this study, written consent was obtained from all participants to participate in the study. Also, all methods were based on the Helsinki guideline and ethical standards of the Tehran University of Medical Sciences (TUMS.VCR.REC.1396.4085), which approved the protocol and the form of informed consent.Participants' lifestyle information including age, gender, cardiovascular disease (yes or no), respiratory disease (yes or no), and smoking (yes or no) was collected through a self-administered questionnaire. Participants' physical activity was also evaluated using the Iranian version of the International Physical Activity Questionnaire (IPAQ) . Then, tBody weight was measured in the participants while wearing light clothes to the nearest 0.1 kg by using a Seca scale. Participants' height was first measured by using a stadiometer , and their waist circumference (WC) was measured by placing a non-stretch tape measure in the middle of the last rib to just above the hipbones, and hip circumference (HC) was measured around the widest portion of the buttocks. By dividing the WC (cm) by the HC (cm), the waist-to-hip ratio (WHR) was obtained, and by dividing the weight (kg) by height (square meter), the body mass index (BMI) was calculated. The participants' body composition was assessed using InBody 720 . The participants were required to follow the following conditions before the measurements: not consume any foods for at least 4 hours, at least 2 liters of water consumption the day before, at least 8 h without physical activity, and at least 12 h without coffee or alcoholic beverages and also at least 24 h without using diuretics before the assessment.Max). According to the gold standard, VO2Max is the best indicator of CRF and is measured by graded treadmill exercise tests. The participants were asked to accomplish a graded exercise protocol until exhaustion while they could breathe through a respiratory gas analyzer mask. The graded exercise test constitutes of seven steps with different treadmill settings, starting from 1.7 mph speed with 10% gradient. The speed and gradient of the treadmill are elevated every 3 minutes and the next step begins. The test was terminated when the subject was not able to keep exercising because of tiredness, pain, or any other medical symptom. Respiratory gases were analyzed by MetaLyzer3B during the test. Criteria used were as follows: (1) the respiratory exchange ratio and maximum heart rate reached 1.1 and (220_age) respectively. (2) The participant not to able to continue requested test interruption. CRF was measured with L/min, ml/min/kg body weight units. The resting metabolic rate (RMR) was measured by MetaLyzer3B and bioelectrical impedance analysis.CRF is an important test of physical fitness measurements which is related to the maximum oxygen consumption .Participants' dietary intakes were evaluated by trained nutritionists through face-to-face interviews using a valid, reliable, semi-quantitative 168-item food frequency questionnaire (FFQ) . This quWe used the method introduced by Tubong et al. to calculate empirically derived daily and meal-based DII (EDII) . For thiMax, VO2 (L·min), and VO2 (LBM) across tertiles of the EDII, we used multiple linear regression analysis after adjustment for covariates such as age, sex, smoking, physical activity, body mass index, and energy intake. To find the association between the EDII with high/low CRF, we used multivariable logistic regression analysis. In the first model, we adjusted for energy intake, age, and sex. In the second model, we controlled for the confounding impact of more confounders such as age, sex, smoking, physical activity, cardiovascular disease, respiratory disease, and energy intake. In the last model, we adjusted all the variables adjusted in the second model along with the body mass index. The overall trend of odds ratios across tertiles of the EDII was calculated by considering the median of the EDII in each tertile as a continuous variable. All statistical analyses were performed with the Statistical Package for Social Sciences (SPSS) for Windows 25.0 software package . The level of statistical significance was defined at p < 0.05.All the participants were grouped based on tertiles of the EDII. We used one-way ANOVA for quantitative data and chi-square tests for qualitative data, to compare general characteristics across EDII tertiles. The analysis of covariance (ANCOVA) was performed to assess the association between the EDII score with dietary intakes of the study participants after adjusting for potential confounders. The first tertile was considered the reference group. To evaluate the association between VO2p < 0.001 for all).General characteristics of the participants based on tertiles of the EDII are shown in 2Max (ml/kg/min) across tertiles of the EDII. After adjusting for potential confounders , the relationship remained unchanged . There was no significant difference in terms of VO2Max (L·min) and VO2Max (LBM) among tertiles of the EDII. After controlling for covariates, these associations remained non-significant.2Max (ml/kg/min)  than those in the first tertile, there was no association between a higher EDII and VO2Max (ml/kg/min) (p = 0.07) after adjusting for age, sex, smoking, physical activity, cardiovascular disease, respiratory disease, and energy intake; also, this result remained non-significant.Multivariate adjusted odds ratios and 95% confidence intervals for having better CRF across tertiles of the EDII are presented in 2Max (ml/kg/min) had no significant linear association with EDII . Moreover, after controlling for covariates, these associations changed to significant .The linear associations between the EDII score and CRF are shown in Max (ml/kg/min), and there is an inverse association between the EDII and Vo2Max (ml/kg/min).Overall, we found that higher adherence to a diet containing higher pro-inflammatory potential may be associated with less Vo2Cardiorespiratory fitness reflects the ability of cardiovascular and respiratory systems to transport oxygen to skeletal muscle mitochondria for energy production needed during physical activity . CRF is Most available studies have used the nutrient-based DII score to assess the inflammatory potential of the diet, and they assessed the association of the DII score with various diseases, including cardiovascular disease (CVD), cancer, metabolic syndrome (Mets), and respiratory disease , 28–30. In a study by Wood et al., it was suggested that the Western diet may lead to systemic inflammation and subsequent inflammation of the airways and respiratory problems . By contOn the contrary, some studies reported no association between the DII score and metabolic syndrome in young adults , 35. TheThe possible mechanisms by which an anti-inflammatory diet can reduce chronic disease or improve cardiorespiratory fitness are unclear. Despite this, it has been hypothesized that unhealthy dietary patterns with pro-inflammatory effects are associated with an innate immune response (increased production of pro-inflammatory cytokines and decreased production of anti-inflammatory cytokines). This eventually causes chronic inflammation and ultimately increases the risk of endothelial dysfunction, metabolic syndrome, cardiovascular disease, and cancer , 31.Contradictory results of studies on the factors affecting CRF include different demographic characteristics of participants, other aspects of diet such as acidity and carcinogenic potential of the diet, different study design, different confounding factors, and the use of two different indicators to assess the inflammatory potential of the diet.There are strengths in our study. The present study is the first Iranian study that examined the more complete EDII to evaluate the inflammatory potential of diet and its relationship with CRF and its components. We have used the valid 168-item FFQ that have been prepared to estimate the Iranian eating habits. In addition, we adjusted several important confounders, which could affect our results. Finally, using the EDII, instead of the DII, refers to the inflammatory potential of foods in the participants' diet. In addition, the use of an inflammatory index based on dietary groups can facilitate the recommendations of the anti-inflammatory diet by nutritionists. Also, unlike the DII, the EDII is not affected by the use of dietary supplements, which is a good advantage in clinical trials. However, the cross-sectional study we conducted has some limitations, which should be addressed in future studies. First, the study design was cross-sectional, which makes the conclusion of causality difficult. Second, we used the FFQ as a standard instrument to assess long-term dietary intake; however, estimates of food consumption from the FFQ are not precise, and there is always a probability of measurement error, although our FFQ was validated to have reasonably high validity . Third, Eventually, cardiorespiratory fitness appears to be affected by a variety of diet-related factors, including carcinogenicity of the diet and high acidity of the food –40. AlthMax after adjusting for confounding variables. The importance of following a healthy diet with a lower inflammatory index and having higher CRF should be considered as part of a healthy lifestyle approach, and longitudinal studies are needed to confirm our findings.In summary, we found that a higher empirical DII is associated with increased VO2The original contributions presented in the study are included in the article/supplementary material, further inquiries can be directed to the corresponding author/s.The studies involving human participants were reviewed and approved by Tehran University of Medical Sciences (Ethic Number: IR.TUMS.VCR.REC.1396.4085). The patients/participants provided their written informed consent to participate in this study.NP and SS-B contributed to conception and design of the research. ME, SD, and NB contributed to acquisition, analysis, or interpretation of the data. HS and NP drafted the manuscript. KD and SS-B critically revised the manuscript. SS-B agrees to be fully accountable for ensuring the integrity and accuracy of the work. All authors read and approved the final manuscript.The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.


The sequence of full-length amino acids of the four caseins for the five species was retracted from the NCBI GenBank database. Multiple sequence alignment is used to examine further the candidate sequences for phylogenetic analysis using Clustal X and NJ-Plot tools. The results revealed that sheep and goats possess strong similarities (98.06%) because of their common ancestor. The same was observed with cattle and water buffalos (96.25%). The Arabian camel was located in a single subclade due to low similarity in casein residues and compositions with other dairy animals. Protein modeling showed that alpha-S1- and alpha-S2-caseins possess the highest number of phosphoserine residues. The in silico computed chemical properties showed that β-casein recorded highest hydrophobicity index and lowest basic amino acid content, while α-S2-casein showed the opposite. The computed biological parameters revealed that α-S2-casein presented the highest bactericidal stretches. Only Arabian camel β-casein and k-casein showed one bactericidal stretches. The analysis also revealed that β-casein, particularly in Arabian camels, possesses the highest antioxidant activity index. These results support the importance of the bioinformatics resources to determine milk casein micelles' chemical and biological activities.Caseins determine the physicochemical, physiological, and biological characteristics of milk. Four caseins—alpha-S-1, alpha-S-2, beta, and kappa—were analyzed phylogenetically and  Casein in milk is widely consumed in the human diet worldwide, particularly in developing countries. Because of its widespread availability and enormous production quantities, cattle milk is the most consumed milk worldwide as a valued source of human nutrition. Non-bovine milk is essential to people in developing countries , 2. For The majority of studies on milk casein have been conducted on cow milk as the most produced and consumed milk around the world ; howeverComparative genomic analysis can provide new insights into the functionality of casein genes with respect to the caseins. Comparative genomic analysis is a rapidly emerging field in computational biology whereby two or more genomes are compared to obtain a global view of genomes and their deduced proteomes and assign previously unknown functions to genes with respect to their proteins .50) value for each amino acid alteration, serves as a useful benchmark for evaluating protein sequence determinants. Because low IC50 values imply greater antimicrobial activity, amino acids having a lower bactericidal propensity value (PV) are more likely to be used in antimicrobial peptides. Residues with positive charges  and some hydrophobic residues  are unfavorable and present a low propensity index, whereas negatively charged residues are unflavored and show a high propensity index. Antimicrobial proteins would require positively charged residues to drive them to the negatively charged bacterial cell wall and cytoplasmic membrane, where they exert their antimicrobial effect  in FASTA format. The accession number of each protein is presented in P-distance method was used for distance analysis. Rattus norvegicus (rat) was used as the out-group. To generate a consensus tree, these trees were evaluated using the Clustalx software. The NJ Plot software application was used to plot a rooted tree. Because of the enormous number of sequences in the alignment, the bootstrapping of the “alignment dataset” was limited to 1,000 times. Sequences with more than 90% bootstrap support value were confirmed and categorized.Amino acid sequences for casein subunits—alpha-S1, alpha-S2, β-, and k-casein—were retracted from the NCBI , assisted by some manual adjustments to indicate the regions of similarity, identifying probably functional, structural, and evolutionary relationships between the sequences. A phylogenetic tree was rooted in a taxonomically distant organism (Rattus norvegicus).For further analysis, combined alpha-S1-, alpha-S2-, beta-, and kappa-casein amino acid sequences in sheep, goats, cattle, Arabian camels, and water buffalos, respectively, were subjected to multiple sequence alignment using the Clustal Omegadatabase [CLUSTAL O (1.2.4)]  method under the default parameters , a tool of the ExPASy database that allows the computation of various physical and chemical features for a certain protein stored in Swiss-Prot or TrEMBL or for a user-entered protein sequence. The computed parameters include the molecular weight, instability index, hydrophobicity index, basic amino acids (%), negatively charged residues, and positively charged residues  was used to predict antimicrobial peptides. AMPA: an automated web server for the prediction of antimicrobial protein regions . The phylogeny analysis revealed that the Arabian camel, which belongs to the Camelidae family, possesses low similarity with other domestic animals that belong to the Bovidae family, ranging between 60.55 with sheep to 62.22 with water buffalos  were individually  and in cbuffalos . Thus, tbuffalos , 2. The buffalos  appearedbuffalos , 2. The buffalos , which ibuffalos , 2.Protein modeling is considered a routine approach to provide structural models of proteins when no experimental structures are available. Protein modeling uses template protein structures to predict the conformations of other proteins with similar amino acids because small changes in the protein sequence usually result in small changes in the 3D structure. The 3D structure of caseins of cattle was used as a model for the rest of the domestic animals because it is the most popular and the most studied .Protein modeling analysis revealed that the C-terminal ends had fewer secondary structures than the N-terminal of all caseins . In conts1-, αs2-, β-, and κ-casein) are present in all types of milk as self-assembled particles  in water buffalos to 11.10 in Arabian camels . The anaIn silico, antimicrobial index and bactericidal stretches were calculated for caseins αs1-, αs2-, β-, and κ-casein in the five animals understudy to discover the antimicrobial patterns of milk casein. The analysis showed that all caseins have hydrophobicity indexes , the second contained both cattle and water buffalos, and the third included sheep and goats. This result could be explained by the zoological taxa of these animals. The Arabian camel belongs to the Camelidae family; the Bovidae family comprises cows, buffalos, sheep, and goats, and the Bovinae family consists of both cows and buffalos.The positions of the Arabian camel in all phylogenetic tree topologies are the same. In the same context, the rest of all species topologies are mostly the same, whether in the tree constructed based on the combined caseins or in the trees constructed based on the individual caseins. The genetic distances and common ancestors, either between sheep and goats or cattle and water buffalos in all trees, are quite similar.The 3D modeling of casein molecules identifies regions with different levels of organization within each casein type that affect the biological functions of the protein. When purified caseins were utilized as substrates, the proteinases were efficiently hydrolyzed at the sites with the least secondary structure. The C-terminal ends of all casein sequences are highly unstructured compared to their N-terminal ends, which are well-structured. The phosphorylated sites of the casein were poorly hydrolyzed, which is in agreement with previous studies –44.Divergence in casein genes and the presence or absence of one or more genes encoding caseins explain the different biological and chemical functions of the casein micelles . The genAmino acid composition and the type of protein residue sequence determine the structure, hydrophobicity, biological functions, and nutritional value of milk casein . Milk caThe antimicrobial activity of caseins against pathogens is specific due to their affinity for polarized bacterial membranes rather than the depolarized membranes of eukaryotic cells . There iPeptides and proteins' antibacterial activity could be related to their net charge or hydrophobic characteristics. Because the majority of antibacterial peptides are positively charged, they electrostatically bond to the negatively charged components of the bacterial cell wall, potentially causing cell wall disintegration , 54.in silico analysis indicated the antimicrobial characteristics of caseins based on the hydrophobicity, basic amino acid content, negatively charged residues (Asp + Glu), and positively charged residues (Arg + Lys) were consistent with the results of several studies (Helicobacter pylori, an early-life pathogen, is prevented from adhering to human stomach mucosa by the small subunit of k-casein.Our  studies , 55–63.  studies . Strömqv studies  found thin silico analysis gave the lion's share to the casein of the Arabian camel, which is consistent with the in vitro results of several studies (Our  studies , 64, 65, studies , 67 to aThe antioxidant activity index presented in in silico determination of the biological activities of milk proteins. This study determined the relationship between five domestic dairy animals based on phylogenetic analysis of caseins. The results enhanced our knowledge of casein micelles, their chemical features, and potential biological functions. Therefore, it is likely that the presence of such features in the milk structure could have additional beneficial health effects, such as reduction of oxidative stress in the stomach and antimicrobial agents against harmful pathogens.This study is a step toward a better understanding of the great importance and utility of bioinformatics tools in the accurate prediction, comprehensive characterization, and The raw data supporting the conclusions of this article will be made available by the authors, without undue reservation.AH, MA, and AE: conceptualization and investigation. AH and OA: methodology. AH, AA, and OA: software. AH, AO, and SA: validation. AH, HE, and AO: formal analysis. ME-S, IA, HE, and OA: resources. OA, AM, AO, and AH: data curation. AH, HE, and SA: writing original draft preparation. AH and AE: writing, review, and editing. AH and MA: visualization and supervision. AA, MA, and IA: funding acquisition. All authors have read and agreed to the published version of the manuscript.The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.