Effects of Heart Rate Variability (HRV) Biofeedback for Women Undergoing First-time In Vitro Fertilization and Embryo Transfer.

Context: Patients receiving in vitro fertilization and embryo transfer (IVF-ET) treatments can be anxious and depressed and have other negative emotions. Psychological interventions might improve the clinical pregnancy rate of infertile patients. Heart rate variability (HRV) biofeedback can be an effective technique to treat anxiety and stress symptoms. Objective: The study intended to investigate the effects and clinical outcomes of HRV biofeedback for women undergoing in vitro fertilization-embryo transfer (IVF-ET) for the first time. Design: The research team performed a prospective randomized controlled study. Setting: The study took place at the Reproduction Center of the First Affiliated Hospital of Hebei Medical University in Shijiazhuang, Hebei, China. Participants: Participants were 60 women who received IVF-ET for the first time at the hospital between January 2015 and December 2017. Intervention: Participants were randomly divided into the intervention group (n = 30), who received HRV biofeedback, and the control group, who received routine education (n = 30). Outcome Measures: At baseline and postintervention, the research team analyzed outcomes using: (1) the scores from a self-rating anxiety scale (SAS) and a self-rating depression scale (SDS); (2) HRV indexes, including the standard deviation of normal to normal (SDNN), root mean square of successive differences (RMSSD), percentage of successive R-R intervals that differ by more than 50 milliseconds (PNN50), total power (TP), low frequency (LF), high frequency (HF), and rate of LF and HF (LF/HF); and (3) pregnancy rates. Results: The control group's SAS scores were significantly higher postintervention, at 48.63 ± 4.75, than those of the intervention group, at 39.23 ± 7.60 (P = .000). The control group's SDS scores, at 53.07 ± 3.89, were also significantly higher postintervention than those of the intervention group, at 41.40 ± 9.60 (P = .000). For the intervention group, between baseline and postintervention four of the HRV indexes significantly increased: (1) SDNN-from 53.67 ± 9.03 to 79.57 ± 20.48 (p=0.000), (2) RMSSD-from 54.97 ± 13.94 to. 83.74 ± 34.40 (P = .000), (5) PNN50-15.04 ± 6.06 to 22.92 ± 9.90 (P = .001) and (4) TP-from 851.32 ± 486.47 to 1579.59 ± 746.86 (P = .000). The clinical pregnancy rate in the intervention group was higher than that in the control group but the difference wasn't statistically significant, at 60.00% and 46.67%, respectively (P = .438). Conclusions: HRV biofeedback treatment significantly increased four HRV indexes and decreased the anxiety and depression of women undergoing IVF-ET for the first time, showing a potential clinical application.

PM2.5 air quality and health gains in the quest for carbon peaking: A case study of Fujian Province, China.

China faces a dual challenge of improving air quality and reducing greenhouse gas (GHG) emissions. Stringent clean air actions gradually narrow the end-of-pipe (EOP) pollution control potential. Meanwhile, pursuing carbon peaking will reduce air pollution and health risks. However, the impact on air quality and health gains in individual Chinese provinces has not been assessed with a specific focus on local policies. Here, typical shared socio-economic pathways (SSPs) and local policies (i.e., business as usual, BAU; end-of-pipe controls, EOP; co-control mitigation, CCM) are combined to set three scenarios (i.e., BAU-SSP3, EOP-SSP4, CCM-SSP1). Under these three scenarios, we couple the Low Emissions Analysis Platform (LEAP) model, an air quality model and health risk assessment methodology to evaluate the characteristics of carbon peaking in Fujian Province. PM2.5 air quality and impacts on public health are assessed, using the metric of the deaths attributable to PM2.5 pollution (DAPP). The results show that energy-related CO2 emissions will only peak before 2030 in the CCM-SSP1 scenario. In this context, air pollutant emission pathways reveal that mitigation is limited under the EOP-SSP4 scenario, necessitating further mitigation under the CCM-SSP1 scenario. The annual average PM2.5 level is projected to be 16.5 µg·m-3 in 2035 with a corresponding decrease in DAPP of 297 (95 % confidence intervals: 217-308) compared with that of 2020. Despite the significant improvements in PM2.5 air quality and health gains under the CCM-SSP1 scenario, reaching the 5 µg·m-3 target of the World Health Organization (WHO) remains difficult. Furthermore, population aging will require stronger PM2.5 mitigation to enhance health gains. This study provides a valuable reference for other developing regions to co-control air pollution and GHGs.

Clinical observation of laparoscopic sleeve gastrectomy and metformin treatment in obese PCOS patients.

Background: To observe the basic metabolic characteristics of obese patients with polycystic ovarian syndrome (PCOS), and observe and compare the effect of laparoscopic sleeve gastrectomy and metformin treatment after 3 months. Methods: In January to December 2018, the Second Hospital of Hebei Medical University selected 104 women who were classified as obese with a body mass index (BMI) of 28 kg/cm2 or higher and had PCOS. They were divided into obese PCOS group (53 cases) and obese non-PCOS group (51 cases). Results: 1. There was no significant difference in waist circumference and WHR between patients who are obese with PCOS and patients who are obese without PCOS (P > 0.05). Obese PCOS patients were significantly higher in anti-Müllerian hormone (AMH), LH/FSH, T, FAI, homa-ir, triglyceride (TG), low density lipoprotein (LDL), Apo-B and uric acid than the group of non-PCOS patients who were obese. (P<0.05). The SHBG levels of obese patients with PCOS were obviously lower when contrasted with the levels in obese patients without PCOS (P < 0.05). 2. Body weight, BMI, INS, homa-ir and TG of obese PCOS patients were significantly decreased 3 months after laparoscopic sleeve gastrectomy compared with that before surgery (P < 0.05). After three months of medical treatment with metformin, the patients' homeostatic model assessment of insulin resistance (HOMA-IR) was obviously reduced when contrasted with the pre-treatment HOMA-IR levels (P < 0.05), and there was no significant difference in the improvement degree of homa-ir between the two groups (P > 0.05). Conclusions: 1. Obese patients with PCOS demonstrated higher expression of AMH, LH/FSH, T, SHBG, and FAI when contrasted with the control group. Additionally, they experienced more severe insulin resistance and lipid metabolism disorders. 2. The weight and BMI of obese PCOS patients were significantly decreased after weight loss, while IR and blood lipid were significantly improved, while IR was improved in metformin group, and no significant discrepancy was observed in the degree of improvement of insulin resistance between both groups.

Chemical composition and sources of submicron aerosol in a coastal city of China: Results from the 2017 BRICS summit study.

Chemical compositions of non-refractory submicron aerosol (NR-PM1) were measured via an Aerodyne Aerosol Chemical Speciation Monitor at the coastal city Xiamen during the 2017 BRICS summit from August 10 to September 10. Mean hourly concentration of NR-PM1 was 13.55 ± 8.83 µg m-3 during the study period, decreasing from 18.83 µg m-3 before-BRICS to 13.02 µg m-3 in BRCIS I and 8.42 µg m-3 in BRICS II. Positive matrix factor analyses resolved four organic aerosols (OA): a hydrocarbon-like OA (HOA, 14.78%), a cooking-related OA (COA, 28.21%), a biomass burning OA (BBOA, 18.00%), and an oxygenated OA (OOA, 39.22%). The contributions of local pollutants like nitrate and HOA reduced, while the proportions of sulfate and OOA increased during the control episodes. The diurnal patterns of NR-PM1 species and OA components in each episode were characterized. The results showed that BC, nitrate, COA, and HOA had peaks in the morning and evening, which became less obvious under the emission control. Moreover, the diurnal variations of all species in Ep 3 with emission control were much flatter due to the effect of transport. Backward trajectories analysis confirmed the long-range transport of air masses from the continent, which resulted in the high proportions of sulfate (43.69%) and OOA (50.28%) in Ep 3. Our study implies the significant effect of emission control on reducing primary pollutants, but the formation of particles during the long-range transport need to be paid more attention when set the air quality control strategies in coastal cities.

The air pollution governed by subtropical high in a coastal city in Southeast China: Formation processes and influencing mechanisms.

To investigate the impact of the Western Pacific subtropical high (WPSH) on the air pollution episode of Xiamen, a coastal city in Southeastern China, this study focused on formation processes and influencing mechanisms of an air pollution episode from 17th to 23rd September 2017. The results showed that the WPSH fluctuated in this period and intensified this air pollution with local emissions. The episode was divided into four stages according to WPSH center locations to diagnose the air pollution. Visibility declined below 10 km twice while fine particulate matte (PM2.5) concentration was up to 89.05 µg/m3 during this episode. As a consequence of high temperature (28.33 ±â€¯1.25 °C) resulted from WPSH, atmospheric oxidation at high level (140.81 ±â€¯56.49 µg/m3) was the driving force of secondary aerosols generations. Oxidation determined photo-chemical reactions with the pathways of gas-phase and heterogeneous formation. Sulfate was formed from gas-phase oxidation by SO2 in daytime while heterogeneous reaction occurred at night. Nitrate generation was dominated by not only excess ammonium but also intense oxidation. Reconstruction light extinction results coupling with trajectories revealed that (NH4)2SO4, NH4NO3 and OM were the priority factors to the reduction of atmospheric visibility. These findings provided new insights of air pollution episode diagnosis and indicative function of WPSH impacts on local air quality in Southeast China.

Recent developments of anthropogenic air pollutant emission inventories in Guangdong province, China.

Emission inventory (EI) requires continuous updating to improve its quality and reduce its uncertainty. In this study, recent developments on source classification, emission methods, emission factors and spatial-temporal surrogates in the Guangdong regional anthropogenic emission inventory are presented. The developments include: ~40 additional emission sources in a re-classified source classification system, >50 improved spatial and temporal surrogates, 85% of local/domestic emission factors used, and updated estimation methods of on-road mobile, marine, and solvent use sources. The developments were updated to the recent 2012-based high resolution emission inventories, and their results were compared with previous 2006- and 2010-based emission inventories. The results indicated: (1) The total SO2, NOx, CO, PM10, PM2.5, BC, OC, VOCs and NH3 emissions in 2012 were 777.0kt, 1532.2kt, 7305.4kt, 1176.4kt, 480.9kt, 54.2kt, 79.9kt, 1255.1kt and 584.1kt, respectively, for Guangdong province, with higher emission densities observed in the central PRD region. (2) No great changes on source structures were found among three years, but their contributions varied. (3) SO2, PM10 and PM2.5 emissions showed downward trends, likely a result of strict control measures on power plant and industrial combustion sources. (4) NOx emission exhibited relatively stable levels in 2010 and 2012, but contributions from industrial, on-road and non-road mobile sources increased. (5) VOCs emissions showed an upward trend, mainly resulting from dramatically increased light-duty passenger car population and solvent use. (6) Spatial and temporal allocations were updated with constant improvements of spatial and temporal surrogates. (7) Uncertainty ranges of emission estimates were reduced, indicating that the 2012-based PRD regional EI are more reliable. The work shown in this study can be a reference example for other regions to continuously update their emission inventories.