Construction of an instrument to enable the assessment of the risk of falls in older outpatients: A quantitative methodological study.

OBJECTIVES: To develop an instrument to facilitate the risk assessment of falls in older outpatients. DESIGN: A quantitative methodological study using the cross-sectional data. METHODS: This study enrolled 1988 older participants who underwent comprehensive geriatric assessment (CGA) in an outpatient clinic from May 2020 to November 2022. The history of any falls (≥1 falls in a year) and recurrent falls (≥2 falls in a year) were investigated. Potential risk factors of falls were selected by stepwise logistic regression, and a screening tool was constructed based on nomogram. The tool performance was compared with two reference tools (Fried Frailty Phenotype; CGA with 10 items, CGA-10) by using receiver operating curves, sensitivity (Sen), specificity (Spe), and area under the curve (AUC). RESULTS: Age, unintentional weight loss, depression measured by the Patient Health Questionnaire-2, muscle strength measured by the five times sit-to-stand test, and stand balance measured by semi- and full-tandem standing were the most important risk factors for falls. A fall risk screening tool was constructed with the six measurements (FRST-6). FRST-6 showed the best AUC (Sen, Spe) of 0.75 (Sen = 0.72, Spe = 0.69) for recurrent falls and 0.65 (Sen = 0.74, Spe = 0.48) for any falls. FRST-6 was comparable to CGA-10 and outperformed FFP in performance. CONCLUSIONS: Age, depression, weight loss, gait, and balance were important risk factors of falls. The FRST-6 tool based on these factors showed acceptable performance in risk stratification. IMPACT: Performing a multifactorial assessment in primary care clinics is urgent for falls prevention. The FRST-6 provides a simple and practical way for falls risk screening. With this tool, healthcare professionals can efficiently identify patients at risk of falling and make appropriate recommendations in resource-limited settings. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution was received, due to our study design.

Assessment of Two Formulations of Triptorelin in Chinese Patients with Endometriosis: A Phase 3, Randomized Controlled Trial.

INTRODUCTION: This phase 3, randomized, open-label, active-controlled, multicenter study investigated the efficacy of triptorelin pamoate prolonged-release (PR) 3-month in Chinese patients with endometriosis by demonstrating the noninferiority of the 3-month formulation to the standard of care, triptorelin acetate PR 1-month. METHODS: The trial was conducted in 24 clinical centers in China, and included 300 Chinese women (18-45 years) with endometriosis and regular menstrual cycles who required treatment with a gonadotropin-releasing hormone agonist for 6 months. One group of patients (n = 150) was treated with triptorelin pamoate PR 3-month (15 mg per injection, once every 12 weeks), and the other (n = 150) with triptorelin acetate PR 1-month (3.75 mg per injection, once every 4 weeks). The primary outcome measure was the proportion of patients with estradiol (E2) concentrations suppressed to castration levels (≤ 184 pmol/L, or 50 pg/mL) after 12 weeks of treatment. RESULTS: Triptorelin pamoate PR 3-month was noninferior to triptorelin acetate PR 1-month for the treatment of endometriosis: over 98% of patients in both groups were chemically castrated at week 12. Both formulations were also equally efficacious in reducing endometriosis-associated pelvic pain, and reducing serum concentrations of E2, luteinizing hormone, and follicle-stimulating hormone over time. No new safety concerns were identified. CONCLUSION: Triptorelin pamoate PR 3-month is a valid alternative to triptorelin acetate PR 1-month for the treatment of Chinese women with endometriosis, with fewer injections and a potentially lower burden of care. TRIAL REGISTRATION: NCT03232281.

[Spatiotemporal Distribution and Risk Assessment of Pharmaceuticals in Typical Drinking Water Sources in the Middle Reaches of the Yangtze River].

The seasonal variation and spatial distribution of pharmaceuticals in typical drinking water sources in the middle reaches of the Yangtze River were analyzed using the solid-phase extraction and high-performance liquid chromatography-tandem mass spectrometry methods. Combined with the risk entropy method, the corresponding ecological risks for aquatic organisms were evaluated. The results showed that 80% of the target pharmaceuticals were detected in the drinking water sources, with average concentrations of 0.07-13.00 ng·L-1. The concentrations of the target pharmaceuticals were lower than or comparable with those in other drinking water sources reported in China. The spatiotemporal distribution of different pharmaceuticals varied. Generally, the detection level in winter was higher than that in summer, and there was no significant difference between that upstream and that downstream. This might be mainly attributed to seasonal/regional use and emissions of the pharmaceuticals, the impact of flow rate on dilution, and the impact of temperature on biodegradation. Compared with those before the COVID-19 epidemic, the detection concentrations of the target pharmaceuticals were relatively low. The reason for this might be that the prevention and control of the epidemic reduced the use and emission of the pharmaceuticals to a certain extent, and the high rainfall and runoff strengthened the dilution of water flow. The target pharmaceuticals, especially antibiotics, posed medium or low risks to aquatic organisms (especially algae). Considering the ecological risks and genotoxicity of pharmaceuticals and the potential risks of antibiotic-resistant genes, it is suggested to strengthen the investigation, evaluation, treatment, and control of pharmaceuticals in the water environment.

Echocardiographic assessment of intimal thickness growth of patent ductus arteriosus in neonates and analysis of influencing factors.

The spontaneous closure rate of patent ductus arteriosus (PDA) is high, and the necessity of early intervention is debated. Quantitative echocardiographic assessment of the intima in PDA has not been reported. This study evaluated intimal thickness growth in neonatal cases of PDA via echocardiography and investigated its correlation with clinical factors. Seventy-three neonates were enrolled, and echocardiography was performed three times: within 24 h post-birth (first echo), 48 h after the first echo (second echo), and before discharge (third echo). According to PDA outcome, the neonates were divided into the PDA-open group (n = 18 cases), PDA-closure at second echo group (n = 32 cases), and non-PDA at first echo group (n = 23 cases). We measured the intimal thickness (IT1 and IT2 at first and second echo, respectively), lumen diameter of ductus arteriosus (D1 and D2 at first and second echo, respectively), IT1/D1 ratio, and intimal thickness growth rate (V). Correlations between echocardiographic indicators, perinatal factors, and clinical treatment were analyzed. On first echo, the PDA-open group showed a significantly lower IT1/D1 than the combined PDA-closure group (P < 0.05). On second echo, the PDA-open group showed a significantly lower IT2 and V than the PDA-closure group as well as a significantly higher D2 (P < 0.05). Smaller gestational age correlated with a larger D2 but smaller IT2 and V (P < 0.05) and a higher level of respiratory support within 72 h post-birth correlated with a larger D2 and smaller IT 2 (P < 0.05). Increasing oxygen demand within 72 h of birth correlated with a larger D1 and D2 (P < 0.05). Echocardiographic assessment of intimal thickness growth in PDA may provide an approach for predicting spontaneous PDA closure, thereby guiding decision-making regarding early intervention.

Effect of economic growth on environmental quality: Evidence from tropical countries with different income levels.

The growth of the economy in the tropics is faster than that in the rest of the world. However, whether this growth can have impacts on the environmental quality in the tropics is still a question. Here, we first introduce the terrestrial carbon sequestration capacity as an environmental indicator and then investigate the relationships between gross domestic product per capita, sectoral economies, and the terrestrial carbon sequestration capacity for different income countries in the tropics from 1995 to 2018. By using panel models, we find that there exists a significantly negative effect of the growth of gross domestic product per capita on terrestrial carbon sequestration capacity in the full panel and at low-income and lower middle-income levels but not at the upper middle-income level. The sectoral economies have different effects on the terrestrial carbon sequestration capacity at different income levels. Interestingly, the industrial sector dominates the degradation of the terrestrial carbon sequestration capacity in the lower middle-income countries; the agricultural sector exerts a significantly negative impact on the terrestrial carbon sequestration capacity at the low-income and upper middle-income levels, but largely offset by the growth of the service sector. These findings suggest that the balance between economic development and the natural environment is required for economic sustainability in the tropics.

[Temporal and Spatial Occurrence of NSAIDs in Taihu Lake and Relevant Risk Assessment].

Non-steroidal anti-inflammatory drugs (NSAIDs) are a class of drug residues with a high frequency of detection in Taihu Lake. However, little information is available about the occurrence of typical NSAID mixtures in Taihu Lake as a whole across the four seasons. Therefore, for each season, the concentrations of five typical NSAIDs including diclofenac, ibuprofen, indomethacin, naproxen, and ketoprofen were monitored in the water of Taihu Lake by the method of high-performance liquid chromatography-mass spectrometry (HPLC-MS/MS) at 19 transects covering the entire lake. The temporal and spatial occurrence of NSAID mixtures in the water of Taihu Lake and their correlation with environmental factors were analyzed, and the mixture risk quotient (MRQ) model was also used to assess the ecological risk of the NSAID mixtures. The research results are as follows:① The concentrations of NSAIDs in the northern, western, and eastern waters of Taihu Lake are at a higher level compared to those in the central waters. Ketoprofen is the main contributor to the contamination of NSAID mixtures in all regions of Taihu Lake. ② The concentrations of NSAIDs in Taihu Lake are higher in summer (15.9-134.3 ng·L-1) and autumn (16.4-144.6 ng·L-1) but lower in spring (25.3-72.5 ng·L-1) and winter (14.6-57.4 ng·L-1), being significantly correlated with water conductivity and pH, respectively. ③ The MRQ model evaluation reveals that there are nine sections in Taihu Lake showing a high ecological risk (MRQ>1) from NSAID mixtures throughout the year. The ecological risk of the NSAID mixtures at a medium or high level (MRQ>0.1) lasts for a long time spanning the spring, summer, and autumn seasons, of which the risk is greatest in autumn. Overall, the pollution caused by the NSAID mixtures in the water of Taihu Lake should not be ignored, and especially great attention should be paid to the pollution in autumn.

Global protected areas boost the carbon sequestration capacity: Evidences from econometric causal analysis.

Carbon sequestration capacity is the key factor in maintaining biodiversity and ecosystem services. However, further research is required on how to evaluate the impact of protected areas on carbon sequestration capacity from a global scale. To date, we propose a carbon density index of global protected areas (>10 km2, 32,756 samples) by the Integrated Valuation of Ecosystem Services and Trad'eoffs carbon model over the period 1994-2015. Then, we use the propensity score matching and difference-in-difference methods to separate the time effect and policy effect of the construction of protected areas on carbon sequestration capacity. Our analysis reveals that the carbon sequestration capacity can be improved by 0.39% by constructing global protected areas. There are regional differences with carbon sequestration capacity improvement globally. Africa has the largest value of increased carbon sequestration capacity, followed by Asia, Oceania and Europe. Upgrading protected areas (0.05%), strictly implementing planning (0.18%) and enhancing the power of local governments (0.08%) are conducive to improving carbon sequestration capacity. The assessment of the carbon sequestration capacity dynamic with protected areas is of great significance to meet the Convention on Biological Diversity.

The Impact of Trainee Nationality on Patient Acceptance of Obstetrics and Gynecology Care: A Chinese Study.

Phenomenon: China is a relatively homogenous nation where the majority of people are Han Chinese. In recent years, a large number of international students have begun to study medicine in China. Due to the privacy and intimacy associated with obstetrical and gynecological diseases, Chinese women's acceptance toward international students' involvement in their care has not been reported thus far. This survey aims (1) to determine Chinese women's attitudes toward both Chinese and international medical student involvements in obstetrical and gynecological outpatient departments and (2) to investigate possible reasons, if any, for their rejection of the medical students. Approach: We conducted a cross-sectional survey study using a locally-developed questionnaire. The survey was conducted in the obstetrical and gynecological outpatient department of a tertiary hospital in a Chinese harbor city. We surveyed 600 patients for their attitudes towards the involvement of four groups of medical student in clinical practice: Chinese female, International female, Chinese male, and International male. Among the returned questionnaires, 501 satisfied the criteria for analysis. Findings: Patient's acceptance rates of the four groups of students (Chinese female, International female, Chinese male, and International male) were 59.7%, 55.9%, 32.1%, and 25.9%, respectively. Analysis revealed that language barriers and lack of friendliness were the two main reasons leading to patients' low acceptance rates of international students. Insights: Obstetrical and gynecological patients are more likely to accept female students over male students, regardless of their nationality, however International male students receive the least acceptance. For international students, improving their Chinese language skills and using more friendly expressions may facilitate their practice in China.

[Treatment Effect and Ecological Risk Assessment of Typical Antibiotics in Wastewater from Large-scale Dairy Farms in Tianjin].

To obtain the content level and treatment efficiency of typical antibiotics in wastewater treatment in large-scale dairy farms in Tianjin, the SPE-UPLC-MS/MS (ultra-high performance liquid chromatography tandem triple quadruple mass spectrometry combined with solid-phase extraction for pretreatment) technology was utilized to investigate and monitor seven typical antibiotics in wastewater from 12 large-scale dairy farms in Tianjin. Antibiotic residues were detected in 12 large-scale dairy farms before and after wastewater treatment. In the wastewater before treatment, the detection rates of tilmicosin (TIL), oxytetracycline hydrochloride (OTC), sparfloxacin (SPA), sulfathiazloe (STZ), ofloxacin (OFL), and sarafloxacin hydrochloride (SAR) were all 100%, whereas the detection rate of sulfadiazine (SDZ) was 83.33%. Among them, TIL and OTC were the main antibiotic components in untreated wastewater, the concentrations were 25.21 µg·L-1 and 9.87 µg·L-1, respectively. The detection rates of SDZ and OFL in the treated wastewater dropped to 25.00% and 41.66%, respectively. The main components were TIL and OTC and the concentrations were 11.30 µg·L-1 and 3.71 µg·L-1, respectively. There were significant decreases in the concentrations. The treatment effect on antibiotics from different farms ranged from 24.95% to 81.05%. The comprehensive treatment effect of the anaerobic-anoxic-oxic (AAO) treatment process was better than that of the anoxic-oxic (AO) treatment process. OFL, SAR, and OTC were the main high-risk pollutants in treated wastewater. Each large-scale dairy farm contained one or more antibiotic with RQs>1, and their emissions pose an ecological risk to the environment.

Workshop Report: FDA Workshop on Improving Cardiotoxicity Assessment With Human-Relevant Platforms.

Given that cardiovascular safety concerns remain the leading cause of drug attrition at the preclinical drug development stage, the National Center for Toxicological Research of the US Food and Drug Administration hosted a workshop to discuss current gaps and challenges in translating preclinical cardiovascular safety data to humans. This white paper summarizes the topics presented by speakers from academia, industry, and government intended to address the theme of improving cardiotoxicity assessment in drug development. The main conclusion is that to reduce cardiovascular safety liabilities of new therapeutic agents, there is an urgent need to integrate human-relevant platforms/approaches into drug development. Potential regulatory applications of human-derived cardiomyocytes and future directions in employing human-relevant platforms to fill the gaps and overcome barriers and challenges in preclinical cardiovascular safety assessment were discussed. This paper is intended to serve as an initial step in a public-private collaborative development program for human-relevant cardiotoxicity tools, particularly for cardiotoxicities characterized by contractile dysfunction or structural injury.

International Multisite Study of Human-Induced Pluripotent Stem Cell-Derived Cardiomyocytes for Drug Proarrhythmic Potential Assessment.

To assess the utility of human-induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CMs) as an in vitro proarrhythmia model, we evaluated the concentration dependence and sources of variability of electrophysiologic responses to 28 drugs linked to low, intermediate, and high torsades de pointes (TdP) risk categories using two commercial cell lines and standardized protocols in a blinded multisite study using multielectrode array or voltage-sensing optical approaches. Logistical and ordinal linear regression models were constructed using drug responses as predictors and TdP risk categories as outcomes. Three of seven predictors (drug-induced arrhythmia-like events and prolongation of repolarization at either maximum tested or maximal clinical exposures) categorized drugs with reasonable accuracy (area under the curve values of receiver operator curves ∼0.8). hiPSC-CM line, test site, and platform had minimal influence on drug categorization. These results demonstrate the utility of hiPSC-CMs to detect drug-induced proarrhythmic effects as part of the evolving Comprehensive In Vitro Proarrhythmia Assay paradigm.

Stereotactic radiosurgery (SRS) alone versus whole brain radiotherapy plus SRS in patients with 1 to 4 brain metastases from non-small cell lung cancer stratified by the graded prognostic assessment: A meta-analysis (PRISMA) of randomized control trials.

BACKGROUND: The present study aims to assess the therapeutic effect of whole brain radiotherapy (WBRT) for brain metastases from non-small cell lung cancer stratified by graded prognostic assessment (GPA) through meta-analysis. METHODS: The Cochrane Library, PubMed, Ovid (Elsevier) were retrieved. The included randomized controlled trials (RCT) were evaluated, and the statistical analysis was performed using RevMan 5.3 software. Cochrane handbook was applied to evaluate the methodological quality. Statistical significance was considered as P < .05. RESULTS: There were 2 randomized control trials identified eligible for the meta-analysis. Stereotactic radiosurgery (SRS)+WBRT did not significantly improved overall survival (OS) in 2 subgroups. (GPA <2: HR, 0.93; 95% confidence interval [CI], 0.61-1.40; P = .71), (GPA ≥2: HR, 1.28; 95% CI, 0.58-2.80; P = .54). The use of SRS+WBRT significantly extended brain tumor recurrence (BTR) free time in both subgroups (GPA <2: HR, 5.46; 95% CI: 2.09-14.22; P = .0005), (GPA ≥2: HR, 4.24; 95% CI: 2.24-8.04; P < .00001). The meta-analysis showed salvage therapy was more frequent among the SRS-alone in 2 subgroups (GPA <2: RR, 5.83; 95% CI: 1.47-23.06; P = .01), (GPA ≥2: RR, 2.53; 95% CI: 1.30-4.93; P = .006). The rate of grade 3 or 4 late radiation toxic effects was similar in 2 subgroups between SRS and SRS+WBRT CONCLUSIONS:: Because there are few studies to meet inclusion criteria, we cannot include more researches. The results of this analysis must be carefully interpreted in view of the unclear risk of bias in inclusion in the study. This meta-analysis of 2 randomized trails indicated that the combined treatment group did not show a survival benefit over SRS alone. However, SRS+WBRT improved BTR free time in the subgroup both GPA <2 and GPA ≥2 with the similar grade 3 or 4 late radiation toxicities.

The Development Evaluation of Economic Zones in China.

After the Chinese reform and opening up, the construction of economic zones, such as Special Economic Zones, Hi-tech Zones and Bonded Zones, has played an irreplaceable role in China's economic development. Currently, against the background of Chinese economic transition, research on development evaluation of economic zones has become popular and necessary. Similar research usually focuses on one specific field, and the methods that are used to evaluate it are simple. This research aims to analyse the development evaluation of zones by synthesis. A new hybrid multiple criteria decision making (MCDM) model that combines the DEMATEL technique and the DANP method is proposed. After establishing the evaluation criterion system and acquiring data, the influential weights of dimensions and criteria can be calculated, which will be a guide for forming measures of development. Shandong Peninsula Blue Economic Zone is used in the empirical case analysis. The results show that Transportation Conditions, Industrial Structure and Business Climate are the main influencing criteria and measures based on these criteria are proposed.

[Assessment on the ecological suitability in Zhuhai City, Guangdong, China, based on minimum cumulative resistance model].

Urban landscape has the characteristics of spatial heterogeneity. Because the expansion process of urban constructive or ecological land has different resistance values, the land unit stimulates and promotes the expansion of ecological land with different intensity. To compare the effect of promoting and hindering functions in the same land unit, we firstly compared the minimum cumulative resistance value of promoting and hindering functions, and then looked for the balance of two landscape processes under the same standard. According to the ecology principle of minimum limit factor, taking the minimum cumulative resistance analysis method under two expansion processes as the evaluation method of urban land ecological suitability, this research took Zhuhai City as the study area to estimate urban ecological suitability by relative evaluation method with remote sensing image, field survey, and statistics data. With the support of ArcGIS, five types of indicators on landscape types, ecological value, soil erosion sensitivity, sensitivity of geological disasters, and ecological function were selected as input parameters in the minimum cumulative resistance model to compute urban ecological suitability. The results showed that the ecological suitability of the whole Zhuhai City was divided into five levels: constructive expansion prohibited zone (10.1%), constructive expansion restricted zone (32.9%), key construction zone (36.3%), priority development zone (2.3%), and basic cropland (18.4%). Ecological suitability of the central area of Zhuhai City was divided into four levels: constructive expansion prohibited zone (11.6%), constructive expansion restricted zone (25.6%), key construction zone (52.4%), priority development zone (10.4%). Finally, we put forward the sustainable development framework of Zhuhai City according to the research conclusion. On one hand, the government should strictly control the development of the urban center area. On the other hand, the secondary urban center area such as Junchang and Doumen need improve the public infrastructure to relieve the imbalance between eastern and western development in Zhuhai City.

The effect of community stress and problems on psychopathology: A structural equation modeling study.

This research aimed to estimate the effect of perceived social factors in the community stress and problems on the residents' psychopathology such as depression and suicidal behaviors. Subjects of this study were the informants (N=1618) in a psychological autopsy (PA) study with a case-control design. We interviewed two informants (a family member and a close friend) for 392 suicides and 416 living controls, which came from 16 rural counties randomly selected from three provinces of China. Community stress and problems were measured by the WHO SUPRE-MISS scale. Depression was measured by CES-D scale, and suicidal behavior was assessed by NCS-R scale. Multivariable liner and logistic regression models and the Structural Equation Modeling (SEM) were applied to probe the correlation of the depression and the suicidal behaviors with some major demographic variables as covariates. It was found that community stress and problems were directly associated with rural Chinese residents' depression (Path coefficient=0.127, P<0.001). There was no direct correlation between community stress and problem and suicidal behaviors, but community stress and problem can affect suicidal behaviors indirectly through depression. The path coefficient between depression and suicidal behaviors was 0.975. The current study predicts a new research viewpoint, that is, the depression is the intermediate between community stress and problem and suicidal behaviors. It might be an effective route to prevent depression directly and suicidal behaviors indirectly by reducing the community stress and problems.

Hemodynamic assessment and computation on vertebral artery stenosis.

Cerebral vascular diseases are associated with cerebral hemodynamic parameter, which is difficult to observe and examine. This paper has proposed a new modeling method based on network and hemodynamics. The harmonic solution to the 18 branches of the circle of Willis is acquired through the plane network. We use this method to explain the development processes of vertebral artery diseases, and the hemodynamic assessment of vertebral artery stenosis have been done to prove this method.

[Health-based risk assessment in the excavating process of VOCs contaminated site].

The dissipative concentration test of VOCs in the remediation process of a typical contaminated site was operated, and three routes of exposure were set up for health risk assessment in the repair process. Analysis showed that carbon tetrachloride was the single pollutant with highest multi-route cumulative non-carcinogenic index, which was as high as 8.86E + 01, and its contribution rate to the integrated non-carcinogenic effects was 74.45%. Respiratory exposure was the exposure route with highest multi-pollutant hazard index, which was 1.01E + 02, accounting for 84. 87% of the comprehensive risk index, and the index of integrated non-carcinogenic damage was 1.19E + 02. 1,2-dichloroethane was the single pollutant with highest multi-route cumulative carcinogenic index, which was as high as 3.08E-02, and its contribution rate to the integrated carcinogenic effects was 69.53%. Respiratory exposure was the exposure route with highest multi-pollutant hazard index, which was 3.96E -02, accounting for 89.39% of the comprehensive risk index, and the index of integrated carcinogenic damage was 4.43E-02.

Simultaneous detection of three arboviruses using a triplex RT-PCR: enzyme hybridization assay.

Arboviruses represent a serious problem to public health and agriculture worldwide. Fast, accurate identification of the viral agents of arbovirus-associated disease is essential for epidemiological surveillance and laboratory investigation. We developed a cost-effective, rapid, and highly sensitive one-step "triplex RT-PCR enzyme hybridization" assay for simultaneous detections of Japanese Encephallitis virus (JEV, Flaviviridae), Getah virus (GETV, Togaviridae), and Tahyna virus (TAHV, Bunyaviridae) using three pairs of primers to amplify three target sequences in one RT-PCR reaction. The analytical sensitivity of this assay was 1 PFU/mL for JEV, 10 PFU/mL for GETV, and 10 PFU/mL for TAHV. This assay is significantly more rapid and less expensive than the traditional serological detection and single RT-PCR reaction methods. When "triplex RT-PCR enzyme hybridization" was applied to 29 cerebrospinal fluid (CSF) samples that were JEV-positive by normal RT-PCR assay, all samples were strongly positive for JEV, but negative for GETV and TAHV, demonstrating a good sensitivity, specificity, and performance at CSF specimen detection.

[Effects of intervene on occupational health knowledge, attitude and practice of people with occupational disease risk in private enterprises].

OBJECTIVE: To evaluate the effects of health promotion on occupational health based on the changes in knowledge, attitude and practice (KAP) before and after intervention of people with occupational disease risk in private enterprises. METHODS: 202 people with occupational disease risk in private leather enterprises of Wenzhou were surveyed, who were rechecked with the same questionnaire after three months intervention. RESULTS: The knowledge, attitude and practice scores (9.34 ± 2.57, 7.79 ± 2.58 and 7.24 ± 2.50, respectively) of post-intervention group were significantly increased more than those of pre-intervention (8.06 ± 2.71, 7.63 ± 2.67, 7.11 ± 2.60, respectively) (P < 0.01, P < 0.05). The net increases of knowledge, attitude and practice scores were significantly different with different length of service, educational level, registered residence and training experience (P < 0.05, P < 0.01). CONCLUSIONS: Health promotion could increase knowledge, attitude and practice levels; The effect of intervention on people with short length of service, low educational level, coming from country and had not attended training is significant.

Two-dimensional strain combined with adenosine stress echocardiography assessment of viable myocardium.

The objective of this study was to explore a new method for the identification of viable myocardium by means of two-dimensional (2D) strain imaging combined with adenosine stress echocardiography. A total of 15 anesthetized open-chest healthy mongrel dogs underwent left anterior descending coronary artery occlusion for 90 min followed by 120-min reperfusion. Adenosine was infused at 140 µg kg(-1) min(-1) over a period of 6 min. Images were acquired at baseline (when pericardial cradle was made), after reperfusion (when reperfusion finished) and after adenosine administration (while administration stopped). Measurements of the regional peak-systolic strain in radial, circumferential, and longitudinal motion on anterior wall and anterior septum were, respectively, performed under different conditions. The dogs were killed after the echocardiographic studies finished and then the area of infracted myocardium was defined by triphenyltetrazolium chloride histology. A segment with equal or less than 50% area of infracted myocardium was considered to be viable. As a result, 37 regions were viable whereas 53 were non-viable among 90 regions in 15 dogs. At baseline, there was no significant difference in peak-systolic radial strain (Rs), circumferential strain (Cs), and longitudinal strain (Ls) between the viable and non-viable groups. After reperfusion, Rs, Cs, and Ls in absolute value decreased compared to those at baseline in both groups, although there was no significant difference between these groups. Rs and Ls increased after adenosine administration compared to reperfusion (p < 0.01; p < 0.05) in viable group while there were no changes in non-viable group. Compared with non-viable group Rs, Cs and Ls in viable group increased significantly (p < 0.01; 0.05) after adenosine administration. There was a negative correlation between Rs and infarct size (r = -0.72). Cs and Ls correlated well with infarct size, respectively (r = 0.40; 0.67). A change of Rs more than 13.5% has a sensitivity of 83.8% and a specificity of 83.0% for viable whereas a change of Ls more than 11% allowed a sensitivity of 78.4% and a specificity of 88.7%. Combined with these two variables, the sensitivity and specificity could reach 91.9 and 79.2%. Two-dimensional strain imaging combined with adenosine stress echocardiography can provide a new way to distinguish viable myocardium from the non-viable.