Critical Role of Simultaneous Reduction of Atmospheric Odd Oxygen for Winter Haze Mitigation.

The lockdown due to COVID-19 created a rare opportunity to examine the nonlinear responses of secondary aerosols, which are formed through atmospheric oxidation of gaseous precursors, to intensive precursor emission reductions. Based on unique observational data sets from six supersites in eastern China during 2019-2021, we found that the lockdown caused considerable decreases (32-61%) in different secondary aerosol components in the study region because of similar-degree precursor reductions. However, due to insufficient combustion-related volatile organic compound (VOC) reduction, odd oxygen (Ox = O3 + NO2) concentration, an indicator of the extent of photochemical processing, showed little change and did not promote more decreases in secondary aerosols. We also found that the Chinese provinces and international cities that experienced reduced Ox during the lockdown usually gained a greater simultaneous PM2.5 decrease than other provinces and cities with an increased Ox. Therefore, we argue that strict VOC control in winter, which has been largely ignored so far, is critical in future policies to mitigate winter haze more efficiently by reducing Ox simultaneously.

Fetal heart rate short term variation during labor in relation to scalp blood lactate concentration.

INTRODUCTION: Fetal heart rate short term variation (STV) decreases with severe chronic hypoxia in the antenatal period. However, only limited research has been done on STV during labor. We have tested a novel algorithm for a valid baseline estimation and calculated STV. To explore the value of STV during labor, we compared STV with fetal scalp blood (FBS) lactate concentration, an early marker in the hypoxic process. MATERIAL AND METHODS: Software was developed which estimates baseline frequency using a novel algorithm and thereby calculates STV according to Dawes and Redman in up to four 30-minute blocks prior to each FBS. Cardiotocography traces from 1070 women in labor who had had FBS performed on 2134 occasions were analyzed. RESULTS: In acidemic cases (lactate >4.8 mmol/L; Lactate Pro™), median STV 30 minutes prior to FBS was 7.10 milliseconds compared with 6.09 milliseconds in the preacidemic (4.2-4.8 mmol/L) and 5.23 milliseconds in the normal (<4.2 mmol/L) groups (P < .05). There was a positive correlation between lactate and STV (rho = 0.16-0.24; P < .05). Median lactate concentration in cases with STV <3.0 milliseconds (n = 160) was 2.3 mmol/L. When 2 FBS were performed within 60 minutes the change rate of lactate correlated to STV (rho = 0.33; P < .001). Cases with increasing lactate concentration had a median STV of 5.29 milliseconds vs 4.41 milliseconds in those with decreasing lactate (P < .001). CONCLUSIONS: In the early stages of intrapartum hypoxia, STV increases, contrary to findings regarding chronic hypoxia in the antenatal period. The increase in the adrenergic surge is a likely explanation.

Detecting driver fatigue using heart rate variability: A systematic review.

Driver fatigue detection systems have potential to improve road safety by preventing crashes and saving lives. Conventional driver monitoring systems based on driving performance and facial features may be challenged by the application of automated driving systems. This limitation could potentially be overcome by monitoring systems based on physiological measurements. Heart rate variability (HRV) is a physiological marker of interest for detecting driver fatigue that can be measured during real life driving. This systematic review investigates the relationship between HRV measures and driver fatigue, as well as the performance of HRV based fatigue detection systems. With the applied eligibility criteria, 18 articles were identified in this review. Inconsistent results can be found within the studies that investigated differences of HRV measures between alert and fatigued drivers. For studies that developed HRV based fatigue detection systems, the detection performance showed a large variation, where the detection accuracy ranged from 44% to 100%. The inconsistency and variation of the results can be caused by differences in several key aspects in the study designs. Progress in this field is needed to determine the relationship between HRV and different fatigue causal factors and its connection to driver performance. To be deployed, HRV-based fatigue detection systems need to be thoroughly tested in real life conditions with good coverage of relevant driving scenarios and a sufficient number of participants.

Reducing postural load in order picking through a smart workwear system using real-time vibrotactile feedback.

Vibrotactile feedback training may be one possible method for interventions that target at learning better work techniques and improving postures in manual handling. This study aimed to evaluate the short term effect of real-time vibrotactile feedback on postural exposure using a smart workwear system for work postures intervention in simulated industrial order picking. Fifteen workers at an industrial manufacturing plant performed order-picking tasks, in which the vibrotactile feedback was used for postural training at work. The system recorded the trunk and upper arm postures. Questionnaires and semi-structured interviews were conducted about the users' experience of the system. The results showed reduced time in trunk inclination ≥20°, ≥30° and ≥45° and dominant upper arm elevation ≥30° and ≥45° when the workers received feedback, and for trunk inclination ≥20°, ≥30° and ≥45° and dominant upper arm elevation ≥30°, after feedback withdrawal. The workers perceived the system as useable, comfortable, and supportive for learning. The system has the potential of contributing to improved postures in order picking through an automated short-term training program.

Application of the Chinese Aircraft-shaped Sleeve system in the treatment of tibial shaft fractures using a suprapatellar approach for tibial intramedullary nailing: a randomised controlled trial.

BACKGROUND: The use of the suprapatellar approach for intramedullary nailing has recently become popular for the treatment of tibial fractures. This study aimed to investigate the effectiveness of using the Chinese Aircraft-shaped Sleeve (CASS) system on the clinical outcomes of tibial intermedullary nailing using a suprapatellar approach for the treatment of tibial fractures in a cohort of adult Chinese patients. METHODS: Magnetic resonance images (MRI) of the knee joints of 212 healthy adults with normal lower limb function from May 2011 to May 2015 were obtained from a level I Chinese regional trauma centre. Sixty inpatients at the same trauma centre who underwent treatment for tibial shaft fractures from June 2015 to June 2018 were enrolled. Tibial intramedullary nailing fixation of tibial shaft fractures via the suprapatellar approach was performed with either a CASS system or a conventional sleeve. The measurements of patellofemoral joint anatomy, the surgical time, the assessments of the patellofemoral joint cartilage conditions, and information of residual debris based on arthroscopic analysis were subsequently collected. RESULTS: The mean patellar angle (PA), sulcus angle (SA), sulcus width (SW) and sulcus depth (SD) were 135.40 ± 6.20°, 142.37 ± 5.33°, 33.37 ± 2.73 mm, and 4.29 ± 0.63 mm, respectively. The surgical time until entry reaming commencement and the irrigation time were significantly lower in the CASS group (P < 0.001). The difference in cartilage damage rate between groups was statistically significant (P = 0.031); the difference in residual debris conditions was not statistically significant (P = 0.1967). CONCLUSION: The use of the CASS system could improve clinical outcomes of intramedullary nailing via suprapatellar approach for patients with a small patellofemoral joint space.

Elimination of schistosomiasis japonica from formerly endemic areas in mountainous regions of southern China using a praziquantel regimen.

Schistosomiasis japonica is a major public health problem in China. Domestic animals play a major role in the transmission of Schistosoma japonicum to humans. To better understand the epidemiology of schistosomiasis japonica in domestic animals in the mountainous areas of China, we performed a 5-year longitudinal study of schistosomiasis in cattle and horses in Yunnan Province from 2009 to 2013. We also performed a concurrent drug-based intervention study in three settlement groups in Yunnan Province aimed at developing an effective means of controlling transmission in this region. The prevalence of infection in cattle fluctuated between 1.67% and 3.05% from 2009 to 2011, and monthly treatments of schistosome-positive animals reduced the prevalence to 0% (P<0.05) from 2012 to 2013. Prior to the intervention, we found that schistosomiasis was prevalent from May to October, with the highest prevalence observed in June (10.00%). We surveyed for environmental schistosome contamination, and 94.29% of the miracidia found were from cattle. Our study showed that it is possible to eliminate schistosomiasis in domestic animals in the mountainous regions of China by monthly treating cattle and horses from schistosome-positive households from May to October.

[Cost-effectiveness of schistosomiasis comprehensive control in Lushan County from 2007 to 2012].

OBJECTIVE: To evaluate the cost-effectiveness of comprehensive control strategy which mainly controls the schistosomiasis infection source in Lushan County from 2007 to 2012. METHODS: The data of the schistosomiasis endemic, Oncomelania hupensis snail status, control technology, and funding were collected and analyzed statistically in the endemic villages of Lushan County from 2007 to 2012. RESULTS: The schistosome infection rate of the residents decreased from 0.04% in 2007 to 0 in 2012. The numbers of advanced schistosomiasis patients decreased from 128 in 2007 to 121 in 2012. No acute schistosomiasis patients were found. The average density of living snails decreased from 0.06 snial/0.1 m2 to 0.05 snail/0.1 m2, with the decreased rate of 16.67%, and no schistosome infected snails were found. However, the snail area increased from 15.84 hm2 in 2007 to 52.12 hm2 in 2012, with the rise rate of 229.04%. The year per capita was 200.48 yuan, the cost of the infection rate decreasing by 1% was 949,900 yuan, and the cost of living snail density decreasing by 1% was 5,698,200 yuan. CONCLUSION: The cost-effectiveness of comprehensive control strategy which mainly controls the schistosomiasis infection source is relatively good in Lushan County from 2007 to 2012.

Clipping the extremity of ureter prior to nephroureterectomy is effective in preventing subsequent bladder recurrence after upper urinary tract urothelial carcinoma.

BACKGROUND: Bladder recurrent disease is still a challenge in the treatment of upper tract urothelial carcinoma (UTUC). This controlled study aims to investigate the efficacy of early clipping of the distal ureter prior to nephroureterectomy (NU) to prevent bladder recurrence after UTUC. METHODS: Patients with clinical diagnosis of UTUC were subjected to open trans-peritoneal NU and were randomly divided into two groups. One group received modified NU: clipping the distal ureter prior to NU; while the other group underwent traditional standard NU. Subsequent bladder recurrence was the primary endpoint. RESULTS: From January 2007 to December 2009, 85 eligible cases were enrolled in this study. Modified NU and standard NU were performed on 42 and 43 patients, respectively. Operation time ((215.73 ± 21.26) minutes vs. (220.19 ± 15.35) minutes), blood loss ((105.15 ± 11.32) ml vs. (110.12 ± 9.07) ml), transfusion event (11.20% vs. 9.78%), and the in-patient time (10.0 days vs 9.5 days) were not significant between the two groups. After a median follow-up of 28 months (5 - 60), six (14.3%) cases who received modified NU had bladder recurrence, which was significantly lower compared with 15 (34.9%) patients from the group that underwent standard NU (P = 0.026). In univariate and multivariate analysis, tumor grade (HR 4.33, 95%CI 2.66 - 6.30, P = 0.01) and operation type (HR 2.35, 95%CI 1.53 - 3.48, P = 0.041) were independent risk factors for subsequent bladder recurrence after UTUC. CONCLUSIONS: Clipping the distal ureter at the beginning of NU significantly reduces bladder recurrence after UTUC. It is reasonable to conclude that clipping the distal portion of ureter trans-peritoneal is an effective surgical procedure for the treatment of UTUC.