BACKGROUND: In recent years, the discovery of clinical pathways (CPs) from electronic medical records (EMRs) data has received increasing attention because it can directly support clinical doctors with explicit treatment knowledge, which is one of the key challenges in the development of intelligent healthcare services. However, the existing work has focused on topic probabilistic models, which usually produce treatment patterns with similar treatment activities, and such discovered treatment patterns do not take into account the temporal process of patient treatment which does not meet the needs of practical medical applications.
METHODS: Based on the assumption that CPs can be derived from the data of EMRs which usually record the treatment process of patients, this paper proposes a new CPs mining method from EMRs, an extended form of the traditional topic model - the temporal topic model (TTM). The method can capture the treatment topics and the corresponding treatment timestamps for each treatment day.
RESULTS: Experimental research conducted on a real-world dataset of patients\' hospitalization processes, and the achieved results demonstrate the applicability and usefulness of the proposed methodology for CPs mining. Compared to existing benchmarks, our model shows significant improvement and robustness.
CONCLUSIONS: Our TTM provides a more competitive way to mine potential CPs considering the temporal features of the EMR data, providing a very prospective tool to support clinical diagnostic decisions.

Parents with dependent children are at a high risk of physical inactivity. While previous studies have mostly focused on how parents\' time constraints and changing social network may inhibit leisure time physical activity (LTPA) over the long-term, less is known about the integrated effects of parenting and spatial-temporal environmental exposure on the execution of LTPA during certain episodes of a day. By adopting an integrated social-spatiotemporal-environmental model (ST-ISEM) based on micro-timescale retrospective longitudinal analysis, we examine the association between LTPA participation and spatial-temporal environmental exposure at a micro-timescale, i.e., at the episode-level in working adults\' workday, and specifically how parenting integrated with spatial-temporal environmental exposure can jointly influence episode-level LTPA participation. Using data from the day reconstruction method from 701 individuals in Shenzhen, China, we find that parenting may affect the participation of LTPA on workdays not only by shaping temporal environmental factors (time constraint path and social network path), but also by interacting with built environmental exposures (spatial path), both at the episode-level. This study contributes to the theorizing of an integrated social-environmental model for health and wellbeing by extending the ISEM from the life span to the micro-timescale and also by highlighting the importance of temporality in environmental exposure and health studies. It also contributes to the spatial temporal behavioral perspective of time geography literature by clarifying multiple pathways through which social and spatiotemporal environmental factors could interact and jointly affect health behaviors at a micro-timescale. This study contributes to the literature on parenting and LTPA decline by enriching and deepening the understanding of the time constraint and social network pathways through which parenting leads to LTPA change at the micro-timescale. While time constraints may decrease parents\' LTPA at long-term, increasing physical activities related to childcare after work may strongly obstruct moderate-to-vigorous LTPA at a micro-timescale. This study also identifies a spatial pathway by which parenting hinders LTPA due to changing understanding and usage of urban spaces. This pathway warrants attention from social epidemiologists, health geographers, and urban planners since existing interventions promoting physical activity in urban spaces may be ineffective for parents.

Research on environmental exposure and its impacts on people\'s mood has attracted increasing attention. Most studies focus on the spatiality of geographic contexts, but they neglect the influence of temporality in the relationships between environments and mood. To this end, a survey was conducted in January 2019 in Guangzhou, China, and measured data (micro-environments, built environments, EMA records, GPS trajectories, and activity logs) covering a weekday were collected from 125 participants. Then, multiple linear regression models are employed to examine and compare the associations between environments and mood based on three possible types of temporal responses (cumulative response, momentary response, and time-lagged response). The results indicate that there are great differences in environmental mood effects based on different types of temporal responses. Specifically, (i) for three types of temporal responses, exposure to PM2.5 and noise have mood-blunting effects, whereas exposure to green spaces has mood-augmenting effects. (ii) For two types of temporal responses, higher temperature (in winter) may positively influence individual mood based on cumulative and time-lagged response, and higher POI density can positively affect mood based on cumulative and momentary response. (iii) Relative humidity may not have time-related effects on mood. Although all three types of temporal responses are observed in this study, the most significant manifestation is momentary response. These findings not only enrich theoretical research on environmental mood effects and temporality, but also inform the practice of more refined and humanistic urban planning, environmental governance, and public services.

A positive doctor-patient relationship is believed to play a key role in the healing process in clinics. While challenges to the doctor-patient relationship are a global concern, complex social contexts which introduce familial collectivism and totalitarian bureaucracy to maintain a doctor\'s authority have complicated doctor-patient relationships in China. This study delineates a multi-dimensional therapeutic landscape of hospitals in China, focusing on the doctor-patient relationship performances used to improve patients\' healing experiences. Based on fieldwork in two primary hospitals in Eastern China, we find that primary hospitals in China are not only professional spaces, but hybrids of professional and non-professional spaces. In these spaces, both professional and other discourses in various forms of social-environmental engagement affect therapeutic experiences. Varying time and space in hospitals allow doctors to construct multi-dimensional therapeutic landscapes vis-a-vis patients to secure patients\' compliance with their recommendations, and thus improve health outcomes. We argue that these dimensions may also cause negative therapeutic experience such as unnecessary health care. This study contributes to the literature on therapeutic landscapes of health care by providing a critical view on the construction of multi-dimensional therapeutic hospital landscapes. Furthermore, it links the critical health geographies literature with China\'s broader social context to explicate the cultural and social transformation of health care spaces in contemporary China. Findings from this study inform both theoretical and empirical debates regarding therapeutic landscapes of health care by embedding the professional spaces of health care into broader geographical discourses. This calls for health professionals to reflect on ethical concerns in multi-dimensional health care landscapes.

Ecological psychology (EP) and the enactive approach (EA) may benefit from a more focused view of lived temporality and the underlying temporal multiscalar nature of human living. We propose multiscalar temporality (MT) as a framework that complements EP and EA, and moves beyond their current conceptualisation of timescales and inter-scale relationships in organism-environment dynamical systems. MT brings into focus the wide ranging and meshwork-like interdependencies at play in human living and the questions concerning how agents are intimately entangled in such meshworks, utilising them as resources for skilful living. We develop a conceptual toolkit that highlights temporality: Firstly, we address lived temporality. We use a case study from psychotherapy to show how a person\'s skilful engagement with the world is best described as adaptive harnessing of interdependencies of constraints residing across a wide range of timescales. We call this skill time-ranging. Secondly, the case study provides a proof of concept of the integration of an idiographic approach to human conversing and a more general theory of emergent organisation rooted in theoretical biology. We introduce the existing concept of constraint closure from theoretical biology and scale it up to human interactivity. The detailed conceptualisation of constraint interdependencies constitutes the backbone of the proposal. Thirdly, we present a heuristic mapping of what we call organising frames. The mapping guides the conceptualisation of the emergence of inter-scale relationships and serves as an epistemic tool that brings together nomothetic and idiographic approaches. Finally, we combine new ideas with re-interpretations of existing EP and EA concepts and elaborate on the need of a fresh new look at the implicit and sometimes missing conceptualisations of temporality in the EP and EA literature.

Heat stress seriously threatens the growth of Pleurotus ostreatus. Various studies have been performed to study the resistance of P. ostreatus to heat stress. Here, the metabolome was evaluated to determine the response of P. ostreatus mycelia to heat stress at different times (6, 12, 24, 48 h). More than 70 differential metabolites were detected and enriched in their metabolic pathways. Dynamic metabolites changes in enrichment pathways under heat stress showed that heat stress enhanced the degradation of unsaturated fatty acids and nucleotides, increased the content of amino acids and vitamins, and accelerated glycolysis and the tricarboxylic acid cycle in P. ostreatus. The time course changes of P. ostreatus metabolites under continuous heat stress demonstrated that amino acids continuously changed with heat stress, nucleotides clearly changed with heat stress at 12 and 48 h, and lipids exhibited an increasing trend with prolonged heat stress, while few types saccharides and vitamins changed under heat stress. Additionally, heat-treated P. ostreatus produced salicylic acid and other stress-resistant substances that were reported in plants. This study first reported the metabolites changes in P. ostreatus mycelia during 48 h of heat stress. The metabolic pathways and substances that changed with heat stress in this research will aid future studies on the resistance of P. ostreatus and other edible fungi to heat stress.

The overall details of causality frames in the objective world remain obscure, which poses difficulty for causality research. Based on the temporality of cause and effect, the objective world is divided into three time zones and two time points, in which the causal relationships of the variables are parsed by using Directed Acyclic Graphs (DAGs). Causal DAGs of the world (or causal web) is composed of two parts. One is basic or core to the whole DAGs, formed by the combination of any one variable originating from each time unit mentioned above. Cause effect is affected by the confounding only. The other is an internal DAGs within each time unit representing a parent-child or ancestor-descendant relationship, which exhibits a structure similar to the confounding. This paper summarizes the construction of causality frames for objective world research (causal DAGs), and clarify a structural basis for the control of the confounding in effect estimate.
客观世界因果关系的整体框架较为笼统而缺乏明晰的细节，给因果关系的研究带来困难。本文基于因果关系的时序特性结合有向无环图（DAGs），以因和果的发生时间为界，将客观世界的时间维度划分为3个时间域和2个时间点。通过对5个时间单位上变量间存在着的完整的因果关系的病因网络DAGs进行分析发现，其病因结构由两部分叠加组成：第一部分是各个时间域间/时间点上任取一变量间的组合DAGs，为因果关系的基本结构，构成病因网络的核心，仅混杂路径影响其因果效应估计；第二部分是各个时间域内/时间点上变量间的母子或祖先-后代关系，其DAGs表现为与混杂类似的结构。本文简洁明了地构建了客观世界因果关系研究的整体框架（病因网络DAGs），解释了控制混杂以解决因果效应估计的结构基础，为正确研究和识别因果关系奠定基础。.