Assessment of lower limb proprioception after fibula free flap harvest: A pilot study.

BACKGROUND: After undergoing fibula-free flap harvest, patients may experience complications such as ankle instability. It remains unclear whether these patients have deficits of proprioception, and the recovery process is also uncertain. OBJECTIVE: This study aimed to objectively evaluate proprioception on the donor and normal side of surgical patients during long-term follow-up using the Pro-kin system. METHODS: This study enrolled 36 patients who underwent reconstruction of the head and neck using osseous free flaps harvested from the fibula. Each patient underwent pre-operative evaluations and was subsequently evaluated at postoperative months 1, 3, 6, and 12. The study assessed the proprioceptive evaluation of the lower limbs, muscle function, range of motion of the ankle, and donor side complications. RESULTS: On the donor side, the average trace error (ATE) at postoperative month 1 was significantly higher than pre-operation, postoperative months 6 and 12 (P< 0.05). The test execution time (TTE) at postoperative month 1 was significantly increased by 9.875s compared to the pre-operative levels (P= 0.012, 95% confidence interval [CI] 4: 1.877-17.873) and by 11.583s compared to postoperative month 12 (P= 0.007, 95% CI: 2.858-20.309). The reduction in range of motion of ankle dorsiflexion was most pronounced at postoperative month 1, exhibiting an 11.25∘ decrease compared to pre-operative levels (P< 0.001, 95% CI: 6.304-16.16). Although the range of motion of ankle dorsiflexion gradually improved over time at postoperative months 3, 6, and 12, it remained lower than pre-operative levels (P< 0.05). CONCLUSION: The study revealed that the patients exhibited proprioceptive disturbances in both lower limbs at postoperative month 1. The proprioceptive function gradually improved over time, with a gradual decrease in donor site complications.

Characterizing the water resource-environment-ecology system harmony in Chinese cities using integrated datasets: A Beautiful China perspective assessment.

Integrated management and synergistic improvement of the water system is a topic of widespread concern. This study innovatively integrates three functions of quality assessment, synergy evaluation, and driving influence determination to establish a systematic framework assessing water system harmony. A case study of 336 Chinese cities is further performed by combining multi-scale and multi-source datasets. The results show China's water system quality has improved from 2015 to 2022. Development in the water resource, environment, and ecology subsystems have been differentiated, with 0.05 %, 4.33 %, and -1.64 % changes, respectively. The degradation of water ecology and the weak synergy with the other two subsystems have limited China's water system harmony. Water environment improvement played a contributive role in improving the water system quality. The contribution structure of water resources, environment, and ecology has shifted towards equilibrium in recent years. We found and highlighted the north-south differentiation of water system harmony in Chinese cities. The Beijing-Tianjin-Hebei and its surroundings, the Yangtze River Delta, and the middle reaches of the Yangtze River are identified as priority regions for water system harmony improvement. The primary contribution of this study is to propose an assessing concept of water resource-environment-ecology system harmony, establish well-structured assessment methods, and integrate the multiple data sources. The novel methods and findings, including the indicator system, application of data mining and decomposing methods, and the city-level water system harmony map, deconstruct and quantify the complex and diverse water system, supporting clearer and more efficient water management policymaking.

Sodium hyaluronate hydrogel for wound healing and human health monitoring based on deep eutectic solvent.

Hydrogel dressings traditionally promote wound healing by maintaining moisture and preventing infection rather than by actively stimulating the skin to regulate cell behavior. Electrical stimulation (ES) is known to modulate skin cell behavior and to promote wound healing. This study describes the first multifunctional conductive hydrogel for wound healing and health monitoring based on a deep eutectic solvent (DES). Sodium hyaluronate and polydopamine constituted the hydrogel skeleton, and tea tree oil and Panax notoginseng extract were used as the active ingredients to induce adhesion, promote antioxidant and antibacterial activity, and support biocompatibility of the hydrogel. The inclusion of DES increases the temperature resistance of the hydrogel and improves its environmental adaptability. We used a small, portable coin battery-powered to provide electrical stimulation. Treatment with both the hydrogel and ES resulted in a stronger therapeutic effect than that provided by the commercial DuoDERM dressing. The hydrogel detected movement and strain when applied as a sensor. Overall, this study reports the development of a multifunctional conductive hydrogel dressing based on DES as a wound healing and health monitor.

Tracking short-term health impacts attributed to ambient PM2.5 and ozone pollution in Chinese cities: an assessment integrates daily population.

Joint and synergistic control of PM2.5 and ozone pollution is an urgent need in China and a global-widely concerned issue. Health impact assessment could provide a comprehensive perspective for PM2.5-ozone coordinated control strategies. For a detailed understanding of the seasonality and regionality of the health impacts attributed to PM2.5 and ozone in China, this study extended the classic health impact function by daily population and assessed the short-term (daily) health impacts in 335 Chinese cities in 2021. Population migration indexes from Baidu were introduced to estimate the cities' daily population. Using this method, we quantitatively investigated the influence of population on short-term health impact assessment and identified which was significant in the Pearl River Delta (PRD) region and other populous cities. Although the annual sums of PM2.5- and ozone-related daily health impacts were close for all Chinese cities, the PM2.5-related health impact was equivalent to 333.96% and 32.07% of that ozone-related, during the cold and warm periods. The correlation and local spatial association analysis found significant city-specific and city-cluster associations of daily health impacts during the warm period and in Beijing-Tianjin-Hebei and surrounding regions (BTHS) and the Yangtze River Delta (YRD). Policymakers could promote period- and pollutant-targeted control actions for the major city groups, especially the BTHS, YRD, and PRD. Our methods and findings investigated the various influences of the population on short-term health impact assessment and proposed the PM2.5-ozone collaborative control idea for key regions and city groups.

The burden and trend of gastric cancer and possible risk factors in five Asian countries from 1990 to 2019.

The burdens and trends of gastric cancer are poorly understood, especially in high-prevalence countries. Based on the Global Burden of Disease Study 2019, we analyzed the incidence, death, and possible risk factors of gastric cancer in five Asian countries, in relation to year, age, sex, and sociodemographic index. The annual percentage change was calculated to estimate the trends in age-standardized incidence rate (ASIR) and age-standardized death rate (ASDR). The highest ASIR per 100,000 person-years in 2019 was in Mongolia [44 (95% uncertainty interval (UI), 34 to 55)], while the lowest was in the Democratic People's Republic of Korea (DPRK) [23 (95% UI, 19 to 29)]. The highest ASDR per 100,000 person-years was in Mongolia [46 (95% UI, 37 to 57)], while the lowest was in Japan [14 (95% UI, 12 to 15)]. Despite the increase in the absolute number of cases and deaths from 1990 to 2019, the ASIRs and ASDRs in all five countries decreased with time and improved sociodemographic index but increased with age. Smoking and a high-sodium diet were two possible risk factors for gastric cancer. In 2019, the proportion of age-standardized disability-adjusted life-years attributable to smoking was highest in Japan [23% (95% UI, 19 to 28%)], and the proportions attributable to a high-sodium diet were highest in China [8.8% (95% UI, 0.21 to 33%)], DPRK, and the Republic of Korea. There are substantial variations in the incidence and death of gastric cancer in the five studied Asian countries. This study may be crucial in helping policymakers to make better decisions and allocate appropriate resources.

[Characteristics of BTEX and Health Risk Assessment During Typical Pollution Episodes in Summer and Winter in Tianjin Urban Area].

Real-time BTEX(including benzene, toluene, ethylbenzene, m-, p-, and o-xylenes) were measured continuously in Tianjin urban site in July 2019 and January 2020 using a Syntech Spectras GC955 analyzer. The BTEX concentration levels, composition, and evolutionary mechanisms during typical pollution episodes were investigated. The potential sources of BTEX were analyzed qualitatively using the diagnostic ratios method. Finally, the BTEX health risk was evaluated by using the human exposure analysis and evaluation method according to US EPA. The averaged total mixing ratio of BTEX were 1.32×10-9 and 4.83×10-9 during ozone pollution and haze episodes, respectively. Benzene was the most abundant species, followed by toluene. The mixing ratio of BTEX was largely affected by short southwestern distance transportation in January, while local emissions in July. In addition, the BTEX mixing ratio depended on the influence of temperature and relative humidity(RH) in July, while the concentration was more sensitive to changes in RH when the temperature was low in January. Diagnostic ratios and source implications suggested that the BTEX was affected mainly by biomass/biofuel/coal burning during haze episodes. The traffic related emissions also had an impact except for the influence of biomass/biofuel/coal burning in July. The averaged hazard quotient(HQ) values were 0.072 and 0.29 during ozone pollution and haze episodes, respectively, which were in the upper safety range limit recommended by the US EPA. The carcinogenic risk posed by benzene in both cleaning and pollution processes was higher than the safety threshold set by the US EPA, which should be monitored carefully.

Nitrogen budgets of contrasting crop-livestock systems in China.

The crop-livestock system is responsible for a large proportion of global reactive nitrogen (Nr) losses, especially from China. There are diverse livestock systems with contrasting differences in feed, livestock and manure management. However, it is not yet well understood which factors greatly impact on the nitrogen (N) budgets and losses of each system. In this study, we systematically evaluated the N budgets of the crop-livestock production system from 1980 to 2050 in China by identifying the differences of 20 distinct livestock systems. During 1980 to 2010, the total N flow through the crop-livestock system increased from 21.4 to 49.7 Tg, with large variations in different input/output pathways, due to the strong livestock transitions of production towards to a monogastric and landless industrial system. Different systems contributed differently to the total N budgets in 2010. For example, the landless industrial system contributed 67% of livestock product N output, but accounted for 80% of total mineral N fertilizer use and feed N imports by the whole crop-livestock system. The mixed system had the highest rate of N use efficiency at system level due to high dependence on recycled N. N losses were diversely distributed by different systems, with the mixed ruminant system responsible for the majority of NH3-N emission in livestock production, and the grazing ruminant system dominant in NO3-N losses in feed production. The total N entering the crop-livestock system is estimated to be 53.9 Tg with total N losses of 41.3 Tg in 2050 under a business-as-usual scenario. However, this amount could be significantly decreased through combined measures that indicate a considerable potential for future improvements. Overall, our results provide new insights into N use and the management of livestock production.

Reducing Ammonia Emissions from Dairy Cattle Production via Cost-Effective Manure Management Techniques in China.

This study analyzed ammonia reduction potential and related costs and benefits of several ammonia emission reduction technologies applicable for dairy production from cattle in China. Specifically, these included diet manipulation, manure acidification, manure/slurry covers, and solid manure compaction. Ammonia emissions for China were estimated using the GAINS and NUFER models, while mitigation potentials of technologies were determined from laboratory studies. Ammonia reduction potentials from dairy production in China ranged from 0.8 to 222 Gg NH3 year-1 for the selected technologies. Implementation costs ranged from a savings of US$15 kg-1 NH3 abated to an expenditure of US$45 kg-1 NH3 abated, while the total implementation costs varied from a savings of US$1.5 billion in 2015 to an expenditure of a similar size. The best NH3 reduction technology was manure acidification, while the most cost-effective option was diet optimization with lower crude protein input. For most abatement options, material costs were the critical element of overall costs. The fertilizer value of manure could partly offset the implementation cost of the options tested. Furthermore, benefits due to avoided health damage, as a result of reducing NH3 emissions, could make all abatement options (except for manure compaction) profitable on the scale of a national economy.

Spatial assessment of air resources in China from 2013 to 2017.

The concept of air resource management originated in the United States and subsequently became the foundation of most air quality control programs in developed countries. However, little is known about its validity and quantitative assessment methods in regional atmospheric environment management. The aim of this study was to construct an air resource endowment (ARE) index and apply it in a case study for assessing the distribution of ARE across mainland China from 2013 to 2017. The quantification of the ARE index includes two terms: the atmospheric diffusion coefficient (A value) and self-purification ability (B value), which can be calculated via Weather Research and Forecasting modeling (WRF-CALMET). The results indicated that about 15% of China's land area enjoys high ARE, around 20-25% of China's land area was considered to have relatively high or relatively low ARE indices, and ARE in the rest of China's land area (40%) was considered to be low. Further, a complex network correlation model was created and used to demarcate highly inter-correlated regions based on the data mining of the ARE index. Six key Joint Prevention and Control of Atmospheric Pollution (JPCAP) regions with strong synchronicity in the ARE index were identified, which suggests that JPCAP could be implemented separately within each of these demarcated regions. The concepts and analysis methods proposed in this study for determining ARE and regional divisions can have broad significance for JPCAP implementation in China.

Environmental impacts and resource use of milk production on the North China Plain, based on life cycle assessment.

Life cycle assessment methodology was used to quantify the environmental impacts and resource use of milk production on the North China Plain, the largest milk production area in China. Variation in environmental burden caused by cow productivity was evaluated, as well as scenario analysis of the effects of improvement practices. The results indicated that the average environmental impact potential and resource use for producing 1kg of fat and protein corrected milk was 1.34kgCO2eq., 9.27gPO43-eq., 19.5gSO2eq., 4.91MJ, 1.83m2 and 266L for global warming potential (GWP), eutrophication potential (EP), acidification potential (AP), non-renewable energy use (NREU), land use (LU) and blue water use (BWU; i.e. water withdrawal), respectively. Feed production was a significant determinant of GWP, NREU, LU and BWU, while AP and EP were mainly affected by manure management. Scenario analysis showed that reducing use of concentrates and substituting with alfalfa hay decreased GWP, EP, AP, NREU and LU (by 1.0%-5.5%), but caused a significant increase of BWU (by 17.2%). Using imported soybean instead of locally-grown soybean decreased LU by 2.6%, but significantly increased GWP and NREU by 20% and 6.9%, respectively. There was no single perfect manure management system, with variable effects from different management practices. The environmental burden shifting observed in this study illustrates the importance of assessing a wide range of impact categories instead of single or limited indicators for formulating environmental policies, and the necessity of combining multiple measures to decrease the environmental burden. For the North China Plain, improving milking cow productivity and herd structure (i.e. increased proportion of milking cows), combining various manure management systems, and encouraging dairy farmers to return manure to nearby crop lands are promising measures to decrease multiple environmental impacts.

Health risk assessment of heavy metals in the water environment of Zhalong Wetland, China.

Concentrations of the Cu, Cd, Cr, As, Zn and Ni in water samples from 272 sampling stations in the water environment of Zhalong Wetland, China were studied. Health risk assessment associated with six heavy metals and metalloid was conducted using health risk assessment model from United States Environmental Protection Agency. It can be concluded that the mean concentrations of Cu, Ni, Zn, As, Cd and Cu were 0.19, 0.45, 0.52, 4.9, 0.12 and 0.24 µg L(-1), respectively. The carcinogenic risk of Cr, As and Cd in the discharged area, experimental area, buffer area and core area were lower than the maximum allowance risk level recommended by International Commission on Radiological Protection (ICRP 5.0 × 10(-5) a(-1)). The non-carcinogenic risks (Cu, Zn, Ni) was also lower than the maximum allowance levels recommended by ICRP. Though it was lower than the level, it was very approaching to maximum acceptable risk level, need to draw attention to the relevant departments.