[Air quality assessment and health site guidelines for city squares based on RANS method]. / 基于RANS的城市广场空气质量评价及健康场所指引.

The concentration of pollutants and pathogens in the air directly affects human health. When the pollution source remains unchanged, effective ventilation determines air quality. It is therefore critically needed to establish a quantitative determination index for effective ventilation, which can be used for real-time evaluation of air quality in specific areas, so as to guide residents to choose healthy outdoor activity places. In this study, Reynolds average Navier-Stokes (RANS) method was used to establish urban air pollution simulation system by computational fluid dynamics (CFD) technology. The correlations among wind speed, pollutant concentration, and pollutant diffusion efficiency were analyzed. With real-time meteorological data, wind field simulation and air quality evaluation were carried out for different periods of urban square space. The results showed that the critical wind speed value at pedestrian height (1.5 m) for the effective diffusion of pollutants was 1.0 m·s-1, which could be used as an air quality evaluation standard. With reference to this judgment index and the real-time weather system link, the pedestrian height wind speed distribution could be obtained through simulation. Therefore, the spatial variation of air quality could be visually displayed in real time, which help realize fair, efficient and reasonable use of urban space resources. This work could provide guidelines for choosing healthy outdoor venues, and provide technologies and means for public disease prevention and health promotion.

The effect of a virtual ward program on emergency services utilization and quality of life in frail elderly patients after discharge: a pilot study.

INTRODUCTION: Attendance at emergency departments and unplanned hospital readmissions are common for frail older patients after discharge from hospitals. A virtual ward service was piloted to deliver "hospital-at-home" services by community nurses and geriatricians to frail older patients immediately after their discharge from hospital to reduce emergency services utilization. OBJECTIVES: This study examined the impacts of the virtual ward service on changes in the patients' emergency attendance and medical readmissions, and their quality of life (QOL). METHODS: A matched-control quasi-experimental study was conducted at four hospitals, with three providing the virtual ward service (intervention) and one providing the usual community nursing care (control). Subjects in the intervention group were those who are at high risk of readmission and who are supported by home carers recruited from the three hospitals providing the virtual ward service. Matched control patients were those recruited from the hospital providing usual care. Outcome measures include emergency attendance and medical readmission in the past 90 days as identified from medical records, and patient-reported QOL as measured by the modified Quality-of-Life Concerns in the End of Life Questionnaire (Chinese version). Wilcoxon signed-rank tests compared the changes in the outcome variables between groups. RESULTS: A total of 39 patients in each of the two groups were recruited. The virtual ward group showed a greater significant reduction in the number of unplanned emergency hospital readmissions (-1.41±1.23 versus -0.77±1.31; P=0.049) and a significant improvement in their overall QOL (n=18; 0.60±0.56 versus 0.07±0.56; P=0.02), but there was no significant difference in the number of emergency attendances (-1.51±1.25 versus -1.08±1.48; P=0.29). CONCLUSION: The study results support the effectiveness of the virtual ward service in reducing unplanned emergency medical readmissions and in improving the QOL in frail older patients after discharge.

Co-administration of vismodegib with rosiglitazone or combined oral contraceptive in patients with locally advanced or metastatic solid tumors: a pharmacokinetic assessment of drug-drug interaction potential.

PURPOSE: Vismodegib, a first-in-class oral hedgehog pathway inhibitor, is an effective treatment for advanced basal cell carcinoma. Based on in vitro data, a clinical drug-drug interaction (DDI) assessment of cytochrome P450 (CYP) 2C8 was necessary; vismodegib's teratogenic potential warranted a DDI study with oral contraceptives (OCs). METHODS: This single-arm, open-label study included two cohorts of patients with locally advanced or metastatic solid malignancies [Cohort 1: rosiglitazone 4 mg (selective CYP2C8 probe); Cohort 2: OC (norethindrone 1 mg/ethinyl estradiol 35 µg; CYP3A4 substrate)]. On Day 1, patients received rosiglitazone or OC. On Days 2-7, patients received vismodegib 150 mg/day. On Day 8, patients received vismodegib plus rosiglitazone or OC. The effect of vismodegib on rosiglitazone and OC pharmacokinetic parameters (primary objective) was evaluated through pharmacokinetic sampling over a 24-h period (Days 1 and 8). RESULTS: The mean ± SD vismodegib steady-state plasma concentration (Day 8, N = 51) was 20.6 ± 9.72 µM (range 7.93-62.4 µM). Rosiglitazone AUC(0-inf) and C(max) were similar with concomitant vismodegib [≤8% change in geometric mean ratios (GMRs); N = 24]. Concomitant vismodegib with OC did not affect ethinyl estradiol AUC(0-inf) and C(max) (≤5% change in GMRs; N = 27); norethindrone C(max) and AUC(0-inf) GMRs were higher (12 and 23%, respectively) with concomitant vismodegib. CONCLUSIONS: This DDI study in patients with cancer demonstrated that systemic exposure of rosiglitazone (a CYP2C8 substrate) or OC (ethinyl estradiol/norethindrone) is not altered with concomitant vismodegib. Overall, there appears to be a low potential for DDIs when vismodegib is co-administered with other medications.

Establishment of platform for screening insulin-like growth factor-1 receptor inhibitors and evaluation of novel inhibitors.

AIM: The insulin-like growth factor-1 receptor (IGF1R) is over-expressed in a wide variety of tumors and contributes to tumor cell proliferation, metastasis and drug resistance. The aim of this study was to establish a sensitive screening platform to identify novel IGF1R inhibitors. METHODS: The catalytic domain of IGF1R was expressed using the Bac-to-Bac baculovirus expression system. The screening platform for IGF1R inhibitors was established based on ELISA. The binding profile of IGF1R with the inhibitors was predicted with molecular docking and then subjected to the surface plasmon resonance (SPR) approach. The growth inhibition of cancer cells by the inhibitors was assessed with MTT assay. Apoptosis was analyzed using flow cytometry and Western blotting. RESULTS: A naturally occurring small molecule compound hematoxylin was identified as the most potent inhibitor (IC50 value=1.8±0.1 µmol/L) within a library of more than 200 compounds tested. Molecular simulation predicted the possible binding mode of hematoxylin with IGF1R. An SPR assay further confirmed that hematoxylin bound directly to IGF1R with high binding affinity (Kd=4.2 × 10⁻6 mol/L). In HL-60 cancer cells, hematoxylin inactivated the phosphorylation of IGF1R and downstream signaling and therefore suppressed cell proliferation. Mechanistic studies revealed that hematoxylin induced apoptosis in HL-60 cells via both extrinsic and intrinsic pathways. CONCLUSION: A simple, sensitive ELISA-based screening platform for identifying IGF1R inhibitors was established. Hematoxylin was identified as a promising IGF1R inhibitor with effective antitumor activity that deserves further investigation.

Low-cost high-performance fiber-optic pH sensor based on thin-core fiber modal interferometer.

A new fiber-optic pH sensor based on a thin-core fiber modal interferometer with electrostatic self-assembled nanocoating is presented. After inserting a segment of thin-core fiber into a standard single-mode fiber, high-order cladding modes are excited and interfere with the core mode to form an in-fiber modal interferometer. The side surface of the sensor is then deposited with poly(allylamine hydrochloride) and poly(acrylic acid) nanocoating by electrostatic self-assembly technique. A fast and linear response is obtained in either acid or alkali solution (in the pH range 2.5 to 10) with resolution of 0.013 pH unit.

Patient decision making: use of and adherence to telephone-based nurse triage recommendations.

OBJECTIVE: Health plans, employer groups, and medical providers offer telephone-based nurse triage services to provide ready access to medical advice and information to assist patients in making decisions about their medical needs. The purpose of this study is to assess patient adherence to nurse triage recommendations. PATIENTS AND METHODS: The study includes data for members of an HMO located in a large metropolitan area who used the triage service during 1997 (n = 22,998). The nurse triage call data are linked with medical claims and encounter data to assess patient medical service utilization following a call to the triage service to assess triage adherence. The authors consider no use of medical services following a triage call with the recommendation to use self-care advice at home an indicator of adherence to this recommendation. RESULTS: The percentage of callers who adhered to triage recommendations to use hospital emergency services, physician office services, or self-care advice was 79.2%, 57.4%, and 65.8%, respectively. Adherence varies somewhat by age. CONCLUSION: The reported adherence levels are lower than those obtained from self-reported data reported elsewhere. Given the inherent limitations of both types of data, actual telephone-based nurse triage adherence may lie between the 2 levels.