Usefulness of risk assessment tools in predicting hemodynamic outcome after balloon pulmonary angioplasty: a comparative analysis.

OBJECTIVES: Several parameters of widely used risk assessment tools for pulmonary arterial hypertension (PAH) have been linked to hemodynamic outcomes of balloon pulmonary angioplasty (BPA). Therefore, we aimed to determine whether these risk assessment tools could be used to predict hemodynamic outcomes following BPA. METHODS: In this retrospective study, we included 139 patients with chronic thromboembolic pulmonary hypertension who had undergone BPA at Center for Pulmonary Vascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College (Beijing, China). We compared the accuracies of seven well-validated risk assessment tools for predicting hemodynamic outcomes following BPA. A favorable hemodynamic outcome was defined as a mean pulmonary arterial pressure < 30 mmHg at follow-up. RESULTS: The baseline risk profiles varied significantly among the risk assessment tools. The US Registry to Evaluate Early and Long-Term PAH Disease Management risk scales and the French risk assessment tools rated most patients as high-risk, while the Comparative, Prospective Registry of Newly Initiated Therapies for Pulmonary Hypertension (COMPERA) series and laboratory examination-based risk scales categorized most patients as having intermediate-risk profile. COMPERA 2.0 (4-strata) exhibited the highest predictive power among all risk stratifications. Noninvasive risk stratification (COMPERA 2.0 [3-strata]) showed a comparable predictive ability to that of invasive risk stratification (COMPERA 1.0) (area under the curve 0.649 vs. 0.648). Moreover, incorporating diffusing capacity of the lungs for carbon monoxide and tricuspid regurgitation velocity into COMPERA 2.0 (4-strata) further enhanced its predictive power (net reclassification index 0.153, 95% confidence interval 0.009-0.298, p = 0.038). Additionally, this refined COMPERA version had a high calibration accuracy (slope 0.96). CONCLUSION: Although the risk strata distribution varied among different risk assessment tools, the proportion of patients achieving favorable hemodynamics decreased with the escalation of risk stratification in most models. The well-validated risk assessment tools for PAH could also predict hemodynamic outcomes following BPA, and the refined COMPERA 2.0 model exhibited the highest predictive ability among these. Applying risk assessment tools before BPA can facilitate early identification of patients in need of closer monitoring and more intensive interventions, contributing to a better prognosis after BPA.

Aptamer-free upconversion nanoparticle/silk biosensor system for low-cost and highly sensitive detection of antibiotic residues.

The detection of antibiotics is crucial for safeguarding the environment, ensuring food safety, and promoting human health. However, developing a rapid, convenient, low-cost, and sensitive method for antibiotic detection presents significant challenges. Herein, an aptamer-free biosensor was successfully constructed using upconversion nanoparticles (UCNPs) coated with silk fibroin (SF), based on Förster resonance energy transfer (FRET) and the charge-transfer effect, for detecting roxithromycin (RXM). A synergistic FRET efficiency was achieved by utilizing alizarin red and RXM complexes as energy acceptors, with UCNP as the energy donor, and immobilizing an ultrathin SF protein corona within 10 nm. The biosensor detects RXM in deionized water with high sensitivity primarily through monolayer adsorption, with a detection range of 1.0 nM-141.6 nM and a detection limit as low as 0.68 nM. The performance of this biosensor was compared with the ultra-performance liquid chromatography-mass spectrometry (UPLC-MS/MS) method for detecting antibiotics in river water separately and a strong correlation between the two methods was observed. The biosensor exhibited long-term stability in aqueous solutions (up to 60 d) with no attenuation of fluorescence intensity. Furthermore, the biosensor's applicability extended to the highly sensitive detection of other antibiotics, such as azithromycin. This study introduces a low-cost, eco-friendly, and highly sensitive method for antibiotic detection, with broad potential for future applications in environmental, healthcare, and food-related fields.

Nitrogen Application Timing and Levels Affect the Fate and Budget of Fertilizer Nitrogen in the Apple-Soil System.

This study aimed to determine the effects of the nitrogen (N) application period and level on the fate of fertilizer N and the contribution of N absorption and translocation to apple organ N. Two N application periods (labeled by the 15N tracer technique in spring and summer, represented by SP and SU, respectively) and three N levels (N0, MN, and HN) were used to determine the physiological indexes and aboveground, root, and soil 15N content of 4-year-old dwarf ('Red Fuji'/M9T337) and arborized ('Red Fuji'/Malus hupehensis Rehd.) apple trees. The results showed that HN led to shoot overgrowth, which was not conducive to the growth of the apple root system (root length, root tips, root surface area, and root volume) or the improvement of root activity. The contribution of soil N to apple organ N accounted for more than 50%, and the contribution of N application in summer to fruit N was higher than that in spring. Under HN treatment, the proportion of soil N absorbed by trees decreased, while that of fertilizer N increased; however, the highest proportion was still less than 50%, so apple trees were highly dependent on soil N. Under MN treatment, fertilizer N residue was similar to soil N consumption, and soil N fertility maintained a basic balance. Under HN treatment, fertilizer N residue was significantly higher than soil N consumption, indicating that excessive N application increased fertilizer N residue in the soil. Overall, the 15N utilization rate of arborized trees (17.33-22.38%) was higher than that of dwarf trees (12.89-16.91%). A total of 12.89-22.38% of fertilizer 15N was absorbed by trees, 30.37-35.41% of fertilizer 15N remained in the soil, and 44.65-54.46% of fertilizer 15N was lost. The 15N utilization rate and 15N residual rate of summer N application were higher than those of spring N application, and the 15N loss rate was lower than that of spring N application. High microbial biomass N (MBN) may be one of the reasons for the high N utilization rate and the low loss rate of N application in summer.

Exploring the potential of the sit-to-stand test for self-assessment of physical condition in advanced knee osteoarthritis patients using computer vision.

Introduction: Knee osteoarthritis (KOA) is a prevalent condition often associated with a decline in patients' physical function. Objective self-assessment of physical conditions poses challenges for many advanced KOA patients. To address this, we explored the potential of a computer vision method to facilitate home-based physical function self-assessments. Methods: We developed and validated a simple at-home artificial intelligence approach to recognize joint stiffness levels and physical function in individuals with advanced KOA. One hundred and four knee osteoarthritis (KOA) patients were enrolled, and we employed the WOMAC score to evaluate their physical function and joint stiffness. Subsequently, patients independently recorded videos of five sit-to-stand tests in a home setting. Leveraging the AlphaPose and VideoPose algorithms, we extracted time-series data from these videos, capturing three-dimensional spatiotemporal information reflecting changes in key joint angles over time. To deepen our study, we conducted a quantitative analysis using the discrete wavelet transform (DWT), resulting in two wavelet coefficients: the approximation coefficients (cA) and the detail coefficients (cD). Results: Our analysis specifically focused on four crucial joint angles: "the right hip," "right knee," "left hip," and "left knee." Qualitative analysis revealed distinctions in the time-series data related to functional limitations and stiffness among patients with varying levels of KOA. In quantitative analysis, we observed variations in the cA among advanced KOA patients with different levels of physical function and joint stiffness. Furthermore, there were no significant differences in the cD between advanced KOA patients, demonstrating different levels of physical function and joint stiffness. It suggests that the primary difference in overall movement patterns lies in the varying degrees of joint stiffness and physical function among advanced KOA patients. Discussion: Our method, designed to be low-cost and user-friendly, effectively captures spatiotemporal information distinctions among advanced KOA patients with varying stiffness levels and functional limitations utilizing smartphones. This study provides compelling evidence for the potential of our approach in enabling self-assessment of physical condition in individuals with advanced knee osteoarthritis.

Health risk assessment of heavy metals in wild fish and seasonal variation and source identification of heavy metals in sediments: a case study of typical urban river in Xi'an, China.

In order to determine the status of heavy metal pollution in river sediments and wild fish in Xi'an, concentrations of heavy metals (Cr, Ni, Cu, Zn, As, and Pb) were collected and analyzed in sediments and wild fish during dry season (October-November 2020) and wet season (June-July 2021). This study aimed to investigate the spatial and temporal variations of heavy metals in urban rivers of Xi'an, China. Their distribution characteristics and sources as well their pollution levels and health risks were assessed. The findings revealed that influenced by human activities, the heavy metal content in sediments (mg·kg-1 dry weight) in wet season was ranked as follows: Cr (73.09) > Zn (63.73) > Pb (40.31) > Ni (31.52) > Cu (24.86) > As (6.83); in the dry season: Zn (94.07) > Cr (69.59) > Cu (34.24) > Ni (33.60) > Pb (32.87) > As (7.60). Moreover, 32 fish samples from six species indicated an average metal content trend (mg·kg-1 wet weight) of Zn (8.70) > Cr (0.57) > Pb (0.28) > Ni (0.27) > Cu (0.24) > As (0.05). The potential ecological risk indices for sediment heavy metal concentrations in both seasons were well below the thresholds, which indicates that the aquatic environment is in safe level. The analysis of the potential ecological risk of sediment heavy metal concentrations indicates that the aquatic environment is safe for the time being. Based on the estimated daily intake (EDI), target risk quotient (THQ), total target risk quotient (TTHQ), cancer risk (CR), total cancer risk (TCR), and the permissible safety limits set by the agencies, the consumption of the fish examined is safe for human health. However, the presence of Cr and As in wild fish should still be a concern for human health, especially for children. The cumulative effect of heavy metals and the bioconcentration factor (BCF) suggest that sediment and heavy metals in fish are closely related, with higher concentrations in fish living in the bottom layer of the water column than in other water layers, and increasing with increasing predator levels. Correlation analysis and PMF modeling identified and determined four comparable categories of potential sources, namely, (1) atmospheric deposition and traffic sources, (2) agricultural sources, (3) industrial sources, and (4) natural sources.

Source identification and risk assessment of trace metals in surface sediment of China Sea by combining APCA-MLR receptor model and lead isotope analysis.

This study aimed to investigate the distribution, pollution, risk and sources of trace metals in sediments along China Sea. Clear spatial variations were found for Cr, Mn, Co, Ni, Cu, Zn, Se, Mo, Ag, Cd, and Pb, whereas As did not show spatial variation. East China Sea (ECS) contained the highest concentrations of Mn, Co, Ni, Cu, Zn, South China Sea (SCS) shallow sea contained the highest concentrations of Zn, Se, Mo, Ag, Cd, and Pb, whereas coral reefs contained the lowest concentrations of trace metals. Spatial variations could be explained by economic development characteristics along China Sea. As, Se and Cd exhibited low to moderate pollution in China Sea sediment, yet pollution for Cu, Zn, Ni, and Ag appeared in some regions. Sediment in ECS had moderate ecological risks and other regions at low ecological risks. The absolute principle component score-multiple linear regression (APCS-MLR) and Pb stable isotope indicated that 43-74% of trace metals (Ni, Cu, Zn, As, Se, Cd, and Pb) were derived from anthropogenic sources like traffic emission, agricultural activities, industrial source. No pollution and ecological risk were observed in coral reefs, yet 39-71% (Pb) was derived from anthropogenic activities such as motor vessels.

A cost-effectiveness analysis of pre-pregnancy genetic screening for deafness: an empirical study in China.

Objectives: This research aims to assess the effectiveness and cost-effectiveness of pre-pregnancy deafness screening policies. Methods: Married couples from Shanghai, Beijing, and Suzhou in China were enrolled. We conducted high-throughput, pre-pregnancy genetic screenings for deafness in women and their partners. We compared the cost-effectiveness of deafness genetic screening with the status quo. The two-step screening (wife then partner) and following treatments and interventions were included in the decision tree model. We conducted a cost-effectiveness analysis based on the decrease in deaf newborns, healthy newborn births, and cost-utility analysis of pre-pregnancy deafness genetic screening separately. Cost, utility, and probability data used in the three models were collected from a survey combined with literature and expert consultants. A 5% discount rate and a series of one-way sensitivity analyses along with a Monte Carlo simulation were used to test the reliability of this research. Results: Between Jan 1, 2019, and Dec 31, 2021, we recruited 6,200 females and 540 male spouses from community health service centers in Shanghai, Beijing, and Suzhou. The incremental cost-effectiveness ratio (ICER) for reducing deaf newborn births was USD 32,656 per case and USD 1,203,926 per case for increasing one healthy newborn birth. This gap exists because of the overall decrease of newborn births. From the perspective of the whole society, deafness genetic screening is not cost-effective for reducing the overall quality-adjusted life years (QALY) in the population. Discussion: Pre-pregnancy genetic testing is effective in decreasing the occurrence of congenital deafness. It is a cost-saving measure when compared with the costs of future medical expenditure and income loss for the affected families. However, such screening and preventive avoidance of pregnancy will decrease the population size and QALY. Only post-screening ART with PGT was shown to increase the birth of healthy newborns. Focusing on key groups such as premature births or consanguineous couples may improve the societal effects of screening.

Theoretical Investigation of Spectroscopic Properties of the Alkaline-Earth-Metal Monohydrides toward Laser Cooling and Magneto-Optical Trapping.

Alkaline-earth-metal monohydrides MH (M = Be, Mg, Ca, Sr, Ba) have long been regarded as promising candidates toward laser cooling and trapping; however, their rich internal level structures that are amenable to magneto-optical trapping have not been completely explored. Here, we first systematically evaluated Franck-Condon factors of these alkaline-earth-metal monohydrides in the A2Π1/2 ← X2Σ+ transition, exploiting three respective methods (the Morse potential, the closed-form approximation, and the Rydberg-Klein-Rees method). The effective Hamiltonian matrix was introduced for MgH, CaH, SrH, and BaH individually in order to figure out their molecular hyperfine structures of X2Σ+, the transition wavelengths in the vacuum, and hyperfine branching ratios of A2Π1/2(J' = 1/2,+) ← X2Σ+(N = 1,-), followed by possible sideband modulation proposals to address all hyperfine manifolds. Lastly, the Zeeman energy level structures and associated magnetic g factors of the ground state X2Σ+(N = 1,-) were also presented. Our theoretical results here not only shed more light on the molecular spectroscopy of alkaline-earth-metal monohydrides toward laser cooling and magneto-optical trapping but also can contribute to research in molecular collisions involving few-atom molecular systems, spectral analysis in astrophysics and astrochemistry, and even precision measurement of fundamental constants such as the quest for nonzero detection of electron's electric dipole moment.

Clinical expert consensus on the assessment and protection of pancreatic islet ß-cell function in type 2 diabetes mellitus.

Islet ß-cell dysfunction is a basic pathophysiological characteristic of type 2 diabetes mellitus (T2DM). Appropriate assessment of islet ß-cell function is beneficial to better management of T2DM. Protecting islet ß-cell function is vital to delay the progress of type 2 diabetes mellitus. Therefore, the Pancreatic Islet ß-cell Expert Panel of the Chinese Diabetes Society and Endocrinology Society of Jiangsu Medical Association organized experts to draft the "Clinical expert consensus on the assessment and protection of pancreatic islet ß-cell function in type 2 diabetes mellitus." This consensus suggests that ß-cell function can be clinically assessed using blood glucose-based methods or methods that combine blood glucose and endogenous insulin or C-peptide levels. Some measures, including weight loss and early and sustained euglycemia control, could effectively protect islet ß-cell function, and some newly developed drugs, such as Sodium-glucose cotransporter-2 inhibitor and Glucagon-like peptide-1 receptor agonists, could improve islet ß-cell function, independent of glycemic control.

Full-information item bifactor model for mathematical ability assessment in Chinese compulsory education quality monitoring.

This study focuses on the measurement of mathematical ability in the Chinese Compulsory Education Qualification Monitoring (CCEQM) framework using bifactor theory. First, we propose a full-information item bifactor (FIBF) model for the measurement of mathematical ability. Second, the performance of the FIBF model is empirically studied using a data set from three representative provinces were selected from CCEQM 2015-2017. Finally, Monte Carlo simulations are conducted to demonstrate the accuracy of the model evaluation indices and parameter estimation methods used in the empirical study. The obtained results are as follows: (1) The results for the four used model selection indices (AIC, SABIC, HQ, BIC) consistently showed that the fit of the FIBF model is better than that of the UIRT; (2) All of the estimated general and domain-specific abilities of the FIBF model have reasonable interpretations; (3) The model evaluation indices and parameter estimation methods exhibit excellent accuracy, indicating that the application of the FIBF model is technically feasible in large-scale testing projects.

Role of social organization engagement in high-risk groups intervention against HIV/AIDS: a case study from 176 cities of China.

BACKGROUND: A high-risk prevention strategy is an effective way to fight against human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS). The China AIDS Fund for Non-Governmental Organizations (CAFNGO) was established in 2015 to help social organizations intervene to protect high-risk populations in 176 cities. This study aimed to evaluate the role of social organizations in high-risk population interventions against HIV/AIDS. METHODS: This study was based on the CAFNGO program from 2016 to 2020. The collected data included the number and types of social organizations participating in high-risk group interventions and the amount of funds obtained by these organizations each year. We explored the factors influencing the number of newly diagnosed AIDS cases using a spatial econometric model. Furthermore, we evaluated the effectiveness of intervention activities by comparing the percentages of the individuals who initially tested positive, and the individuals who took the confirmatory test, as well as those who retested positive and underwent the treatment. RESULTS: Overall, from 2016 to 2020, the number of social organizations involved in interventions to protect HIV/AIDS high-risk populations increased from 441 to 532, and the invested fund increased from $3.98 to $10.58 million. The number of newly diagnosed cases decreased from 9128 to 8546 during the same period. Although the number of cities with overall spatial correlations decreased, the spatial agglomeration effect persisted in the large cities. City-wise, the number of social organizations (direct effect 19.13), the permanent resident population (direct effect 0.12), GDP per capita (direct effect 17.58; indirect effect - 15.38), and passenger turnover volume (direct effect 5.50; indirect effect - 8.64) were the major factors influencing new positive cases confirmed through the testing interventions performed by the social organizations. The initial positive test rates among high-risk populations were below 5.5%, the retesting rates among those who initially tested positive were above 60%, and the treatment rates among diagnosed cases were above 70%. CONCLUSIONS: The spatial effect of social organizations participating in interventions targeting high-risk populations funded by CAFNGO is statistically significant. Nevertheless, despite the achievements of these social organizations in tracking new cases and encouraging treatment, a series of measures should be taken to further optimize the use of CAFNGO. Working data should be updated from social organizations to CAFNGO more frequently by establishing a data monitoring system to help better track newly diagnosed AIDS cases. Multichannel financing should be expanded as well.

A Decade of Scientific and Technological Innovation at Chinese Academy of Medical Sciences & Peking Union Medical College: Retrospect and Prospect.

Focusing on the reform initiatives of Chinese Academy of Medical Sciences (CAMS) & Peking Union Medical College (PUMC) in medical scientific and technological innovation from perspectives of deepening the reform and optimizing the ecosystem of science and technology innovation, this article summarizes the highlights of CAMS & PUMC's efforts in safeguarding people's health and promoting the Healthy China 2030 strategy through scientific and technological innovation in the fields including basic research, disease prevention and treatment, and medical technology in the past ten years. These achievements embody the endeavors and responsibility of CAMS & PUMC in realizing self-reliance and self-improvement of Chinese medical science and technology and highlight its contributions to the development of medical science and technology of China.

The original and two new derivative versions of the COMPERA 2.0 risk assessment model: useful tools for guiding balloon pulmonary angioplasty.

BACKGROUND: The COMPERA 2.0 4-stratum (4-S) risk score has been demonstrated superior over the 3-stratum (3-S) one in patients with pulmonary arterial hypertension and medically managed patients with chronic thromboembolic pulmonary hypertension (CTEPH). We aimed to determine the prognostic value of the original 4-S and 3-S COMPERA 2.0 risk score and two new derivative versions in CTEPH patients who underwent balloon pulmonary angioplasty (BPA). METHODS: We retrospectively enrolled 175 BPA-treated patients with CTEPH. We assessed the risk stratification before and after each BPA session of CTEPH patients by the original 4-S and 3-S COMPERA 2.0 risk score (by rounding decimal to the nearest integer) and two new proposed derivative versions: the modified version (by rounding decimal to the next integer) and a hybrid version that fuses the original and modified versions. The primary endpoint was clinical worsening events. The secondary outcomes were achieving low-risk profile and mean pulmonary arterial pressure (mPAP) < 30 mmHg at follow-up. We used the Kaplan-Meier curve analysis to assess the survival differences between stratified patients. The comparative model's performance was evaluated in terms of discrimination by Harrell's C-index. RESULTS: All versions of COMPERA 2.0 4-S model outperformed the 3-S one in discriminating the differences in echocardiographic and hemodynamic parameters and clinical worsening-free survival rates. The original and hybrid 4-S model could independently predict the primary and secondary endpoints, and the hybrid version seemed to perform better. The first BPA session could significantly improve risk profiles, and these changes were associated with the likelihood of experiencing clinical worsening events, achieving a low-risk profile and mPAP < 30 mmHg at follow-up. The number of BPA sessions required to achieve low risk/mPAP < 30 mmHg increased as the baseline risk score escalated. CONCLUSIONS: The COMPERA 2.0 4-S model outperformed the 3-S one in BPA-treated patients with CTEPH. The 4-S model, especially its hybrid version, could be used to predict clinical outcome before the initiation of BPA and monitor treatment response.

Construction and assessment of a joint prediction model and nomogram for colorectal cancer.

Background: Colorectal cancer (CRC) is one of the most common tumors in the digestive system, and all its risk factors are not yet known. It is important to identify valuable clinical indicators to predict the risk of CRC. Methods: A total of 227 participants, comprising 162 healthy adults and 65 patients diagnosed with CRC at Tianjin Hospital from January 2017 to March 2022, were included in this study. Electrochemiluminescence was adopted to test the expression levels of carcinoembryonic antigen (CEA), carbohydrate antigen 19-9 (CA199). Univariate and multivariate logistic regression analyses were performed to identify independent risk factors for CRC, and a joint prediction model was then constructed. A nomogram was prepared, and the model was later assessed using the receiver operating characteristic curve and calibration curve. Results: The univariate analysis showed that there were statistically significant differences between the two groups in terms of smoking (χ2=8.67), fecal occult blood (χ2=119.41), Helicobacter pylori (H. pylori) infection (χ2=30.87), a history of appendectomy (χ2=5.47), serum total bile acid levels (t=19.80), serum CEA levels (t=37.82), serum CA199 levels (t=6.82), and serum ferritin levels (t=54.31) (all P<0.05). The multiple logistic regression analysis showed that smoking, fecal occult blood, H. pylori infection, a history of appendectomy, serum CEA levels, and serum CA199 levels were independent risk factors for CRC (all P<0.05). Based on the above findings, a joint prediction model was constructed, and the area under the receiver operator characteristic (ROC) curve of the model was 0.842. A nomogram and calibration curve was drawn, and the internal validation results indicated that the model had good diagnostic value. Conclusions: Smoking, fecal occult blood, H. pylori infection, a history of appendectomy, serum CEA levels, and serum CA199 levels are independent risk factors for CRC, and the prediction model based on these factors had good predictive ability.

A systematic study of independently-tuned room-specific PBS beam model in a beam-matched multiroom proton therapy system.

BACKGROUND: In the existing application of beam-matched multiroom proton therapy system, the model based on the commissioning data from the leading treatment room was used as the shared model. The purpose of this study is to investigate the ability of independently-tuned room-specific beam models of beam-matched gantries to reproduce the agreement between gantries' performance when considering the errors introduced by the modeling process. METHODS: Raw measurements of two gantries' dosimetric characteristics were quantitatively compared to ensure their agreement after initially beam-matched. Two gantries' beam model parameters, as well as the model-based computed dosimetric characteristics, were analyzed to study the introduced errors and gantries' post-modeling consistency. We forced two gantries to share the same beam model. The model-sharing patient-specific quality assurance (QA) tasks were retrospectively performed with 36 cancer patients to study the clinical impact of beam model discrepancies. RESULTS: Intra-gantry comparisons demonstrate that the modeling process introduced the errors to a certain extent indeed, which made the model-based reproduced results deviate from the raw measurements. Among them, the deviation introduced to the IDD curves was generally larger than that to the beam spots during modeling. Cross-gantry comparisons show that, from the beam model perspective, the introduced deviations deteriorated the high agreement of the dosimetric characteristics originally shown between two beam-matched gantries, but the cross-gantry discrepancy was still within the clinically acceptable tolerance. In model-sharing patient-specific QA, for the particular gantry, the beam model usage for intensity-modulated proton therapy (IMPT) QA plan generation had no significant effect on the actual delivering performance. All reached a high level of 95.0% passing rate with a 3 mm/3% criterion. CONCLUSIONS: It was preliminary recognized that among beam-matched gantries, the independently-tuned room-specific beam model from any gantry is reasonable to be chosen as the shared beam model without affecting the treatment efficacy.

Assessment of radiolucent lines in patients with lateral unicompartmental knee arthroplasty and the relationship between these lines and the outcome.

PURPOSE: To assess the radiolucent lines (RLLs) around both tibial and femoral components in patients following lateral unicompartmental knee arthroplasty (UKA). METHODS: We performed a retrospective review of the records of a consecutive series of patients who had undergone lateral UKA. The RLLs were assessed with standard anteroposterior and lateral radiographs post-operatively. The patient-reported outcome measures included the Hospital for Special Surgery (HSS) score and Oxford knee score (OKS). The femoral component position (FCP) and femoral-tibial angle (FTA) were also recorded. RESULTS: A total of 198 UKAs that had appropriate radiographs and outcome scores were reviewed with a median follow-up of 33 (range, 12-71) months. The results suggested that 69 cases (34.8%) had RLLs on the standard radiographs. The incidence rates of femoral and tibial physiological RLLs were 11.6% (23/198) and 26% (52/198), respectively, of which 3% (6/198) concerned both components. All RLLs were considered "physiologic lines" that developed within one year after surgery. There were no significant differences among the types of RLLs in any of the outcome measures. No differences in FCP (P = .359) or FTA (P = .111) at the last follow-up were seen. CONCLUSIONS: It was found that one-third of UKAs had RLLs on radiographs following lateral UKA. All RLLs developed within one year after surgery. As a clinical consequence, the development of RLLs does not affect the short-term outcomes after lateral UKA.

Underestimated or overestimated? Dynamic assessment of hourly PM2.5 exposure in the metropolitan area based on heatmap and micro-air monitoring stations.

Spatio-temporal distributions of air pollution and population are two important factors influencing the patterns of mortality and diseases. Past studies have quantified the adverse effects of long-term exposure to air pollution. However, the dynamic changes of air pollution levels and population mobility within a day are rarely taken into consideration, especially in metropolitan areas. In this study, we use the high-resolution PM2.5 data from the micro-air monitoring stations, and hourly population mobility simulated by the heatmap based on Location Based Service (LBS) big data to evaluate the hourly active PM2.5 exposure in a typical Chinese metropolis. The dynamic "active population exposure" is compared spatiotemporally with the static "census population exposure" based on census data. The results show that over 12 h on both study periods, 45.83% of suburbs' population-weighted exposure (PWE) is underestimated, while 100% of rural PWE and more than 34.78% of downtown's PWE are overestimated, with the relative difference reaching from -11 µg/m3 to 7 µg/m3. More notably, the total PWE of the active population at morning peak hours on weekdays is worse than previously realized, about 12.41% of people are exposed to PM2.5 over 60 µg/m3, about twice as much as that in census scenario. The commuters who live in the suburbs and work in downtown may suffer more from PM2.5 exposure and uneven environmental resource distribution. This study proposes a new approach of calculating population exposure which can also be extended to quantify other environmental issues and related health burdens.

A novel comprehensive model of set pair analysis with extenics for river health evaluation and prediction of semi-arid basin - A case study of Wei River Basin, China.

The accelerated development of urbanization in semi-arid areas is easy to cause varying degrees of disturbance to its fragile aquatic ecosystem. To find a general method for assessing the health status in semi-arid basins in China, and to provide theoretical basis for river health management and sustainable development, this study is that health evaluation index system is established in the Wei River Basin, covering a huge semi-arid area, and analyzed the biological structure of plankton obtained by field sampling and identified in laboratory, chemical conditions including dissolved oxygen, water temperature, ammonia nitrogen, pH, chlorophyll and other water physical and chemical factors determined by field instruments and sediment heavy metals analyzed in laboratory, physical habitat scored on site and social factors including water resource utilization rate and water consumption per 10,000 yuan of GDP collected in local water resource bulletin. Based on the idea of game theory, an improved coupling model of set pair analysis with extenics is established to assess and predict health. The results show that Wei River System and Jing River System are healthy, Beiluo River System is sub-healthy, and the whole Wei River Basin is also healthy; most of the cross-sections have a tendency to change to a bad level. Compared with simple weighting, set pair analysis and variable fuzzy set methods based on the corresponding sampling data and the weight in this paper, the coupling model can explain the transition and its trend between levels, reflect the certainty and uncertainty, and get more accurate results. It is suggested that daily monitoring and management should be strengthened in most sections to improve their health. And improve the development level of ecological function and social service function, give priority to the development of downstream water resources economy.

Characterization on Polyester Fibrous Panels and Their Homogeneity Assessment.

Nowadays, fibrous polyester materials are becoming one of the most important alternatives for controlling reverberation time by absorbing unwanted sound energy in the automobile and construction fields. Thus, it is worthy and meaningful to characterize their acoustic behavior. To do so, non-acoustic parameters, such as tortuosity, viscous and thermal characteristic lengths and thermal permeability, must be determined. Representative panels of polyester fibrous material manufactured by perpendicular laying technology are thus tested via the Bayesian reconstruction procedure. The estimated porosity and airflow resistivity are found in good agreement with those tested via direct measurements. In addition, the homogeneity of polyester fibrous panels was characterized by investigating the mean relative differences of inferred non-acoustic parameters from the direct and reverse orientation measurements. Some parameters, such as tortuosity, porosity and airflow resistivity, exhibit very low relative differences. It is found that most of the panels can be assumed homogeneous along with the panel thickness, the slight inhomogeneity mostly affecting the thermal characteristic length.

Characterization of phthalates in sink and source materials: Measurement methods and the impact on exposure assessment.

The fate and transport of semi-volatile organic compounds (SVOCs) in residential environments is significantly influenced by emission and sorption processes, which can be characterized by three key parameters: the gas-phase SVOC concentration adjacent to the material surface (y0); the diffusion coefficient (Dm); and the partition coefficient (K). Accurate determination of these three key parameters is critical for investigating SVOC mass transfer principles, and for assessing human health risks. Based on the mass transfer process of phthalates in a ventilated chamber, a novel method is developed to simultaneously measure Dm and K (key sorption parameters) in sink materials. The Dm and K of four target phthalates in a common T-shirt (sink material) are determined, and compared with those reported in literature. Results demonstrate that the measured parameters are in good agreement with those previously reported (relative deviation < 20 %), validating the effectiveness of proposed method. In addition, this method can be applied to determine y0, a key parameter from source materials. Results indicate that y0 determined with this method is consistent with that measured by literature method. Finally, dermal exposure analysis is performed, showing that dermal uptake of target phthalates is greatly affected by clothes.