Quantifying the contributions of meteorology, emissions, and transport to ground-level ozone in the Pearl River Delta, China.

Ozone pollution presents a growing air quality threat in urban agglomerations in China. It remains challenge to distinguish the roles of emissions of precursors, chemical production and transportations in shaping the ground-level ozone trends, largely due to complicated interactions among these 3 major processes. This study elucidates the formation factors of ozone pollution and categorizes them into local emissions (anthropogenic and biogenic emissions), transport (precursor transport and direct transport from various regions), and meteorology. Particularly, we attribute meteorology, which affects biogenic emissions and chemical formation as well as transportation, to a perturbation term with fluctuating ranges. The Community Multiscale Air Quality (CMAQ) model was utilized to implement this framework, using the Pearl River Delta region as a case study, to simulate a severe ozone pollution episode in autumn 2019 that affected the entire country. Our findings demonstrate that the average impact of meteorological conditions changed consistently with the variation of ozone pollution levels, indicating that meteorological conditions can exert significant control over the degree of ozone pollution. As the maximum daily 8-hour average (MDA8) ozone concentrations increased from 20 % below to 30 % above the National Ambient Air Quality Standard II, contributions from emissions and precursor transport were enhanced. Concurrently, direct transport within Guangdong province rose from 13.8 % to 22.7 %, underscoring the importance of regional joint prevention and control measures under adverse weather conditions. Regarding biogenic emissions and precursor transport that cannot be directly controlled, we found that their contributions were generally greater in urban areas with high nitrogen oxides (NOx) levels, primarily due to the stronger atmospheric oxidation capacity facilitating ozone formation. Our results indicate that not only local anthropogenic emissions can be controlled in urban areas, but also the impacts of local biogenic emissions and precursor transport can be potentially regulated through reducing atmospheric oxidation capacity.

Safety and efficacy of cardioneuroablation for vagal bradycardia in a single arm prospective study.

Cardioneuroablation (CNA) is currently considered as a promising treatment option for patients with symptomatic bradycardia caused by vagotonia. This study aims to further investigate its safety and efficacy in patients suffering from vagal bradycardia. A total of 60 patients with vagal bradycardia who underwent CNA in the First Affiliated Hospital of Xinjiang Medical University from November 2019 to June 2022. Preoperative atropine tests revealed abnormal vagal tone elevation in all patients. First, the electroanatomic structures of the left atrium was mapped out by using the Carto 3 system, according to the protocol of purely anatomy-guided and local fractionated intracardiac electrogram-guided CNA methods. The upper limit of ablation power of superior left ganglion (SLGP) and right anterior ganglion (RAGP) was not more than 45W with an ablation index of 450.Postoperative transesophageal cardiac electrophysiological examination was performed 1 to 3 months after surgery. The atropine test was conducted when appropriate. Twelve-lead electrocardiogram, Holter electrocardiogram, and skin sympathetic nerve activity were reviewed at 1, 3, 6 and 12 months after operation. Adverse events such as pacemaker implantation and other complications were also recorded to analyze the safety and efficacy of CNA in the treatment of vagus bradycardia. Sixty patients were enrolled in the study (38 males, mean age 36.67 ± 9.44, ranging from 18 to 50 years old). None of the patients had a vascular injury, thromboembolism, pericardial effusion, or other surgical complications. The mean heart rate, minimum heart rate, low frequency, low/high frequency, acceleration capacity of rate, and skin sympathetic nerve activity increased significantly after CNA. Conversely, SDNN, PNN50, rMSSD, high frequency, and deceleration capacity of rate values decreased after CNA (all P < 0.05). At 3 months after ablation, the average heart rate, maximum heart rate, and acceleration capacity of heart rate remained higher than those before ablation, and the deceleration capacity of heart rate remained lower than those before ablation and the above results continued to follow up for 12 months after ablation (all P < 0.05). There was no significant difference in other indicators compared with those before ablation (all P > 0.05). The remaining 81.67% (49/60) of the patients had good clinical results, with no episodes of arrhythmia during follow-up. CNA may be a safe and effective treatment for vagal-induced bradycardia, subject to confirmation by larger multicenter trials.

Influence of ozone pollution on the mixing state and formation of oxygenated organics containing single particles.

The formation and aging processes of oxygenated organic molecules (OOMs) are important for understanding the formation mechanisms of secondary organic aerosols (SOAs) in the field. In this study, we investigated the mixing states of OOM particles by identifying several oxygenated species along with the distributions of secondary organic carbon (SOC) during both clean and ozone (O3)-polluted periods in July and September of 2022 in Guangzhou, China. OOM-containing particles accounted for 57 % and 49 % of the total detected single particles in July and September, respectively. Most of the OOM particles were internally mixed with sulfate and nitrate, while elemental carbon and hydrocarbon species were absent. Despite the higher SOC/OC ratio in September (81 %) than it in July (72 %), comparative investigations of the mass spectra, diurnal patterns, and distributions of OOM particles revealed the same composition and aging states of OOMs in two O3 pollution periods. As the O3 concentration increased from the clean to the polluted periods, the ratio of SOC to OC increased along with the relative abundance of secondary OOM particles among total OOM particles. In contrast, the relative abundance of OC-type OOM particles gradually decreased, indicating the conversion of hydrocarbon species into OOMs as the SOC/OC ratio increased. Both the bulk analysis of SOC from filter measurement and the mixing states of OOM particles suggested that OOM production and degree of oxidation were higher in the O3-polluted periods than in the clean periods. These results elucidate the effects of O3 pollution on the OOM formation process and offer new perspectives for the joint investigation of SOA production based on filter sampling and single-particle measurements.

Mixing states and secondary formation processes of organic nitrogen-containing single particles in Guangzhou, China.

Organic nitrogen (ON) compounds play a significant role in the light absorption of brown carbon and the formation of organic aerosols, however, the mixing state, secondary formation processes, and influencing factors of ON compounds are still unclear. This paper reports on the mixing state of ON-containing particles based on measurements obtained using a high-performance single particle aerosol mass spectrometer in January 2020 in Guangzhou. The ON-containing particles accounted for 21% of the total detected single particles, and the particle count and number fraction of the ON-containing particles were two times higher at night than during the day. The prominent increase in the content of ON-containing particles with the enhancement of NOx mainly occurred at night, and accompanied by high relative humidity and nitrate, which were associated with heterogeneous reactions between organics and gaseous NOx and/or NO3 radical. The synchronous decreases in ON-containing particles and the mass absorption coefficient of water-soluble extracts at 365 nm in the afternoon may be associated with photo-bleaching of the ON species in the particles. In addition, the positive matrix factorization analysis found five factors dominated the formation processes of ON particles, and the nitrate factor (33%) mainly contributed to the production of ON particles at night. The results of this study provide unique insights into the mixing states and secondary formation processes of the ON-containing particles.

Feasibility study of cryoballoon ablation for atrial fibrillation with KODEX-EPD: a single center experience.

To evaluate the feasibility of cryoballoon (CB) ablation of atrial fibrillation (AF) under the guidance of a new three-dimensional (3D) mapping system KODEX-EPD. 40 patients scheduled for CB ablation of AF in the first affiliated Hospital of Xinjiang Medical University from August 2021 to July 2022 were randomly divided into two groups: KODEX-EPD 3D mapping system guidance group (KODEX group, n = 20) and conventional two-dimensional perspective group (standard group, n = 20). The ablation time, operation time, fluoroscopy time, fluoroscopy dose, contrast agent dosage and follow-up data were compared between the two groups. Besides, the feasibility and accuracy of the dielectric sensing system in evaluating pulmonary vein (PV) occlusion in patients with AF during CB ablation were verified. All pulmonary veins were being isolated. The ablation time (36.40 ± 6.72 min vs 35.15 ± 6.29 min, P > 0.05) and the operation time (64.20 ± 11.82 min vs 66.00 ± 13.18 min, P > 0.05) were not statistically different in the two groups. The standard group has longer fluoroscopy time, dose and contrast medium dosage. There were significant differences in fluoroscopy time (532.30 ± 72.83 s vs 676.25 ± 269.33 s, P < 0.05), fluoroscopy dose (110.00 ± 28.64 mGy vs 144.68 ± 66.66 mGy, P < 0.05), and contrast medium dosage (71.90 ± 5.97 ml vs 76.05 ± 5.93 ml, P < 0.05) between the two groups. The learning curves of the first 5 patients and the last 15 patients in the KODEX group were compared. There was no statistical difference in the ablation time (36.80 ± 8.56 min vs 36.27 ± 6.34 min, P > 0.05) or the operation time (69.00 ± 5.00 min vs 62.60 ± 13.10 min, P > 0.05); however, compared to the first 5 patients, fluoroscopy time (587.40 ± 38.34 s vs 513.93 ± 73.02 s, P < 0.05), fluoroscopy dose (147.85 ± 35.19 mGy vs 97.39 ± 8.80 mGy, P < 0.05) and contrast medium dosage (79.60 ± 1.14 ml vs 69.33 ± 4.45 ml, P < 0.05) were significantly decreased. Using pulmonary venography as the gold standard, the sensitivity, specificity of the completely occlusion in KODEX group was 93.6% (95% CI 85-97.6%) and 69.6% (95% CI 54-81.8%); and the sensitivity, specificity of the small leak in KODEX group was 93.1% (95% CI 82.4-97.8%) and 82.0% (95% CI 65.9-91.9%). During an average follow-up of (9.90 ± 1.06) months, there was no statistical difference in arrhythmia recurrence and antiarrhythmic drugs taking after CB ablation between the two groups (P > 0.05). Using the KODEX-EPD system, the CB ablation procedure can correctly evaluate the PV occlusion, and significantly reduce fluoroscopy exposure and contrast medium without significantly increasing the operation time.