Previous studies revealed that fine particulate matter (PM 2.5 ) exposure adversely affected blood pressure (BP), but factors that might attenuate this association were still unclear. Using a multicenter panel study among 277 hypertensive participants with intermediate-to-high risk of cardiovascular disease from 4 cities in China, we aimed to explore whether BP control status and antihypertensive medications were potential modifying factors. Each participant carried personal-portable monitors to record individual real-time PM 2.5 levels and 24-hour ambulatory BP up to 3× within 1 year. Generalized linear mixed model with individual-specific random intercept was used to assess effect sizes. We identified adverse impacts of short-term PM 2.5 exposure on BP. However, these impacts were attenuated among patients with controlled BP. For example, per interquartile range (43.78 µg/m 3 ) increment in the prior 10-hour moving average of PM 2.5 , systolic BP increased −0.20 (95% CI, −0.57 to 0.18) mm Hg and 0.85 (95% CI, 0.36–1.35) mm Hg among those with controlled and uncontrolled BP, respectively ( P interaction , 0.0009). Furthermore, among those with uncontrolled BP, treatment with angiotensin receptor blocker would potentially lower BP in responses to PM 2.5 , with systolic BP associated with per interquartile range increment in 10-hour moving average PM 2.5 of 0.32 (95% CI, −0.37 to 1.00) mm Hg and 1.53 (95% CI, 0.74–2.33) mm Hg among those taking angiotensin receptor blocker or not, respectively ( P interaction , 0.0229). In conclusion, although PM 2.5 exposure would increase BP, keeping well-controlled BP status and using angiotensin receptor blockers might attenuate these adverse impacts, which might provide supporting evidence for guiding hypertensive patients who live in areas with high level of PM 2.5 .

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This paper presents a virtual reality training system for the lower limb rehabilitation robot, which can simulate the bike riding and encourage patients to join in the recovery training through the built-in competitive game. The virtual reality training is a variable speed active training under the constraint trajectory, and it has adapting training posture function which can provide individual riding training track according to the legs length of patients. The movement synchronization between the robot and virtual model is achieved by interaction control strategy, and robot can change the training velocity based on the signal from feedback terrains in game. A serious game about bike match in forest was designed, and the user can select the training level as well as change perspective through the user interface. The training can be paused at any time, and the timer function could reflect the recovery of patient.

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Background: Heart failure (HF) poses a significant global disease burden. The current evidence on the impact of air pollution on HF remains inconsistent. Objectives: We aimed to conduct a systematic review of the literature and meta-analysis to provide a more comprehensive and multiperspective assessment of the associations between short- and long-term air pollution exposure and HF from epidemiological evidences. Methods: Three databases were searched up to 31 August 2022 for studies investigating the association between air pollutants ( , , , , CO, ) and HF hospitalization, incidence, or mortality. A random effects model was used to derive the risk estimations. Subgroup analysis was conducted by geographical location, age of participants, outcome, study design, covered area, the methods of exposure assessment, and the length of exposure window. Sensitivity analysis and adjustment for publication bias were performed to test the robustness of the results. Results: Of 100 studies covering 20 countries worldwide, 81 were for short-term and 19 were for long-term exposure. Almost all air pollutants were adversely associated with the risk of HF in both short- and long-term exposure studies. For short-term exposures, we found the risk of HF increased by 1.8% [relative risk , 95% confidence interval (CI): 1.011, 1.025] and 1.6% ( , 95% CI: 1.011, 1.020) per increment of and , respectively. HF was also significantly associated with , , and CO, but not . Positive associations were stronger when exposure was considered over the previous 2 d (lag 0–1) rather than on the day of exposure only (lag 0). For long-term exposures, there were significant associations between several air pollutants and HF with RR (95% CI) of 1.748 (1.112, 2.747) per increment in , 1.212 (1.010, 1.454) per increment in , and 1.204 (1.069, 1.356) per increment in , respectively. The adverse associations of most pollutants with HF were greater in low- and middle-income countries than in high-income countries. Sensitivity analysis demonstrated the robustness of our results. Discussion: Available evidence highlighted adverse associations between air pollution and HF regardless of short- and long-term exposure. Air pollution is still a prevalent public health issue globally and sustained policies and actions are called for to reduce the burden of HF. https://doi.org/10.1289/EHP11506