A Retrospective Cohort Study of vNOTES Extraperitoneal Versus Laparoscopic Sacral Hysteropexy With Uterine Preserving Regarding Surgical Outcomes and 2 Year Follow-up Results.

STUDY OBJECTIVE: To explore the effectiveness of transvaginal natural orifice transluminal endoscopic surgery extraperitoneal sacral hysteropexy (vNOTES-ESH) in women with symptomatic uterine prolapse over a 2 year follow-up. DESIGN: Retrospective cohort study. SETTING: Gynecological minimally invasive center. PATIENTS: Women undergoing sacral hysteropexy either by vNOTES (n = 25) or laparoscopic (n = 74) between November 2016 and December 2020. INTERVENTIONS: Both vNOTES-ESH and laparoscopic sacral hysteropexy (LAP-SH) were used for uterine prolapse. Demographic data, operative characteristics, perioperative outcomes, and follow-up information 2 years postsurgery in the 2 groups were retrospectively evaluated. RESULTS: Both procedures showed similar operation time, estimated blood loss, hospital stays, and pain scores (p >0.05). During a median follow-up of 59 (24-72) months, the surgical success rate was 96% for vNOTES-ESH and 97.3% for LAP-SH (p >0.05), with no differences in anatomical position or pelvic organ function after the operation. Women in the LAP-SH group experienced more bothersome symptoms of constipation compared to those in the vNOTES-ESH group (5.41% vs 0, p <0.05). Lastly, 1 case in the vNOTES-ESH group had a mesh exposed area of less than 1 cm2, and 1 patient in the LAP-SH group experienced stress incontinence. CONCLUSIONS: In this retrospective study, vNOTES-ESH met our patients' preference for uterine preservation and was a successful and effective treatment for uterine prolapse, providing good functional improvement in our follow-up. This procedure should be considered as an option for patients with pelvic organ prolapse.

Identifying Genes that Affect Differentiation of Human Neural Stem Cells and Myelination of Mature Oligodendrocytes.

Human neural stem cells (NSCs) are self-renewing, multipotent cells of the central nervous system (CNS). They are characterized by their ability to differentiate into a range of cells, including oligodendrocytes (OLs), neurons, and astrocytes, depending on exogenous stimuli. An efficient and easy directional differentiation method was developed for obtaining large quantities of high-quality of human OL progenitor cells (OPCs) and OLs from NSCs. RNA sequencing, immunofluorescence staining, flow cytometry, western blot, label-free proteomic sequencing, and qPCR were performed in OL lines differentiated from NSC lines. The changes in the positive rate of typical proteins were analyzed expressed by NSCs, neurons, astrocytes, OPCs, and OLs. We assessed Gene Ontology (GO) enrichment and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways of differentially expressed (DE) messenger RNAs (mRNAs) related to the differentiation of NSCs and the maturation of OLs. The percentage of NSCs differentiated into neurons, astrocytes, and OLs was 82.13%, 80.19%, and 90.15%, respectively. We found that nestin, PAX6, Musashi, and vimentin were highly expressed in NSCs; PDGFR-α, A2B5, NG2, OLIG2, SOX10, and NKX2-2 were highly expressed in OPCs; and CNP, GALC, PLP1, and MBP were highly expressed in OLs. RNA sequencing, western blot and qPCR revealed that ERBB4 and SORL1 gradually increased during NSC-OL differentiation. In conclusion, NSCs can differentiate into neurons, astrocytes, and OLs efficiently. PDGFR-α, APC, ID4, PLLP, and other markers were related to NSC differentiation and OL maturation. Moreover, we refined a screening method for ERBB4 and SORL1, which may underlie NSC differentiation and OL maturation. Potential unreported genes and proteins may regulate differentiation of human neural stem cells into oligodendrocyte lineage. Neural stem cells (NSCs) can differentiate into neurons, astrocytes, and oligodendrocyte (OLs) efficiently. By analyzing the DE mRNAs and proteins of NSCs and OLs lineage, we could identify reported markers and unreported markers of ERBB4 and SORL1 that may underlie regulate NSC differentiation and OL maturation.

Investigation of interfacial adsorption between microplastics and methylparaben in aqueous solution.

Microplastics and parabens are considered to be a global contaminants, especially in the aquatic ecosystem. The interfacial interaction between four types of microplastics including polystyrene, polyethylene, polyethylene terephthalate, and polyvinyl chloride, and methylparaben were investigated in this study. The results showed that molecular layer dominates the adsorption, with the rate significantly affected by both internal diffusion and external diffusion. Among the four types, polystyrene and polyvinyl chloride showed the smallest and biggest adsorption capability, with the values were 0.656 and 1.269 mg g-1, respectively. For the adsorption capability, smaller particle size and higher pH value possessed positive effects. However, the existence of metal ions could inhibit the adsorption process, except for a weak promotion at low salinity. Physical adsorption effects, such as electrostatic interaction, hydrogen bond formation, and covalent bond formation, had been identified that dominated the adsorption. This finding could be served as a speculative foundation for the further study of the toxicity, migration, and ecological risk assessment of microplastics in aquatic ecosystem.

Ambient Particulate Air Pollution and Daily Mortality in 652 Cities.

BACKGROUND: The systematic evaluation of the results of time-series studies of air pollution is challenged by differences in model specification and publication bias. METHODS: We evaluated the associations of inhalable particulate matter (PM) with an aerodynamic diameter of 10 µm or less (PM10) and fine PM with an aerodynamic diameter of 2.5 µm or less (PM2.5) with daily all-cause, cardiovascular, and respiratory mortality across multiple countries or regions. Daily data on mortality and air pollution were collected from 652 cities in 24 countries or regions. We used overdispersed generalized additive models with random-effects meta-analysis to investigate the associations. Two-pollutant models were fitted to test the robustness of the associations. Concentration-response curves from each city were pooled to allow global estimates to be derived. RESULTS: On average, an increase of 10 µg per cubic meter in the 2-day moving average of PM10 concentration, which represents the average over the current and previous day, was associated with increases of 0.44% (95% confidence interval [CI], 0.39 to 0.50) in daily all-cause mortality, 0.36% (95% CI, 0.30 to 0.43) in daily cardiovascular mortality, and 0.47% (95% CI, 0.35 to 0.58) in daily respiratory mortality. The corresponding increases in daily mortality for the same change in PM2.5 concentration were 0.68% (95% CI, 0.59 to 0.77), 0.55% (95% CI, 0.45 to 0.66), and 0.74% (95% CI, 0.53 to 0.95). These associations remained significant after adjustment for gaseous pollutants. Associations were stronger in locations with lower annual mean PM concentrations and higher annual mean temperatures. The pooled concentration-response curves showed a consistent increase in daily mortality with increasing PM concentration, with steeper slopes at lower PM concentrations. CONCLUSIONS: Our data show independent associations between short-term exposure to PM10 and PM2.5 and daily all-cause, cardiovascular, and respiratory mortality in more than 600 cities across the globe. These data reinforce the evidence of a link between mortality and PM concentration established in regional and local studies. (Funded by the National Natural Science Foundation of China and others.).

Differential Mortality Risks Associated With PM2.5 Components: A Multi-Country, Multi-City Study.

BACKGROUND: The association between fine particulate matter (PM2.5) and mortality widely differs between as well as within countries. Differences in PM2.5 composition can play a role in modifying the effect estimates, but there is little evidence about which components have higher impacts on mortality. METHODS: We applied a 2-stage analysis on data collected from 210 locations in 16 countries. In the first stage, we estimated location-specific relative risks (RR) for mortality associated with daily total PM2.5 through time series regression analysis. We then pooled these estimates in a meta-regression model that included city-specific logratio-transformed proportions of seven PM2.5 components as well as meta-predictors derived from city-specific socio-economic and environmental indicators. RESULTS: We found associations between RR and several PM2.5 components. Increasing the ammonium (NH4+) proportion from 1% to 22%, while keeping a relative average proportion of other components, increased the RR from 1.0063 (95% confidence interval [95% CI] = 1.0030, 1.0097) to 1.0102 (95% CI = 1.0070, 1.0135). Conversely, an increase in nitrate (NO3-) from 1% to 71% resulted in a reduced RR, from 1.0100 (95% CI = 1.0067, 1.0133) to 1.0037 (95% CI = 0.9998, 1.0077). Differences in composition explained a substantial part of the heterogeneity in PM2.5 risk. CONCLUSIONS: These findings contribute to the identification of more hazardous emission sources. Further work is needed to understand the health impacts of PM2.5 components and sources given the overlapping sources and correlations among many components.

Switchable multi-functional broadband polarization converter in terahertz band.

In this work, we propose a multi-functional broadband terahertz polarization converter based on graphene-VO2 hybrid metamaterial, which can switch between transmissive linear-to-linear conversion and reflective linear-to-circular conversion. The function of the metamaterial can be controlled by both the temperature and the Fermi energy of the graphene. At 298K, the metamaterial converts the y-polarized wave into x-polarized wave in 0.39-1.22THz. In the meanwhile, changing the Fermi energy of graphene, the converted polarization angle can be tuned from 90° to 45°. Increasing the temperature to 358K, the incident linearly polarized wave is reflected into circularly polarized wave. On this condition, tuning the Fermi energy, the metamaterial can separately convert the linear polarization wave into left-circularly polarized wave in 1.57-2.74THz and right-circularly polarized wave in 1.13-1.59THz. Such a switchable multi-functional broadband polarization converter may achieve potential applications in compact terahertz devices and integrated terahertz circuits.

Function switchable broadband wave plate based on the Au-VO2 hybrid metasurface.

In recent years, the integration of active materials into a metasurface to achieve tunable devices has attracted much attention. Here, we design an Au-VO2 hybrid metasurface, which can switch between quarter-wave plate and half-wave plate due to the phase transition of VO2. At 298 K, the proposed structure acts as a quarter-wave plate in the 0.87-1.2 THz band, achieving the mutual conversion between linear polarization and circular polarization. Raising the temperature to 358 K, it works as a broadband half-wave plate in the range of 0.65-1.45 THz, with the reflective chirality preservation of circular polarization and the cross-polarization conversion of linear polarization. In the above cases, the response efficiencies are both above 90%. The switchable multifunction results from the tunable geometric phase of the metasurface, where the elaborately designed Au and VO2 blocks separately bring the phase of π/2. Furthermore, the electric field and current density distributions are employed to explain the physical mechanisms leading to the different functions. Such an active broadband metasurface is expected to find applications in tunable and multifunction devices manipulating the polarization and phase of terahertz waves.

Green Synthesis of Carbon Nitride-Based Conjugated Copolymer for Efficient Photocatalytic Degradation of Tetracycline.

Upcycling waste plastics into advanced semiconductor photocatalysts provides a new strategy to reasonably and economically solve the huge amount of waste plastics, which remains challenging. Herein, a carbon nitride-based donor-acceptor (D-A) conjugated copolymer by copolymerization of dicyandiamide and terephthalic acid from discarded polyethylene terephthalate (PET) using Zn(OH)2 as catalyst and template at 360-440 °C is synthesized. The morphology and structure of the conjugated copolymer are well regulated by the calcination temperature. The resultant conjugated copolymer exhibits merits of high light absorption and low electron-hole recombination probability. Consequently, it works excellently in the persulfate-based advanced oxidation process for visible light-driven photocatalytic degradation of tetracycline. The kinetic constant (3.4 × 10-2  min-1 ) is 40.5 and 2.3 times that of the conjugated copolymer system and persulfate system, respectively. Furthermore, the reactive species (including •OH, SO4 •- , •O2 - , 1 O2 , and h+ ) and degradation intermediates of tetracycline are analyzed to expound its degradation process. This work not only pioneers design guidelines on upcycling of waste plastics in a sustainable manner, but also provides a facile strategy to synthesize carbon nitride-based D-A conjugated copolymers for the efficient activation of persulfate-based advanced oxidation process in wastewater treatment.

Associations of Postoperative Hemoglobin Level and Clinical Outcomes in Patients Undergoing Mitral Valve Surgery.

BACKGROUND: Postoperative hemoglobin could indicate useful information for transfusion practices. The aim of this study was to investigate the association of optimal hemoglobin level and clinical outcomes after mitral valve surgery (MVS). METHODS: This investigation was a multicenter observational cohort study including 1,518 patients undergoing mitral valve surgery from 2016 through 2018. Patients were separated into six predefined groups based on initial postoperative hemoglobin (< 7.5 g/dL, 7.5 - 8.4 g/dL, 8.5 - 9.4 g/dL, 9.5 - 10.4 g/dL, 10.5 - 11.4 g/dL, ≥ 11.5 g/dL). Multivariable regression analysis was used to adjust laboratory results and surgical features of patients to evaluate the relationships between initial hemoglobin after MVS and clinical outcomes. RESULTS: Patients with initial postoperative hemoglobin below 7.5 g/dL had longer length of stays [mean (95% confidence interval [CI]), 1.9 (1.093 - 1.367)] in comparison with the reference group of 9.5 - 10.4 g/dL. Similarly, for those with hemoglobin below 7.5 g/dL, the odds (95% CI) for secondary outcomes included myocardial infraction 11.801 (1.353 - 22.966) and thrombosis 5.113 (1.340 - 9.508). However, for clinical outcomes, there was no significant difference between the five groups with hemoglobin greater than 7.5 g/dL. CONCLUSIONS: In patients after MVS, initial postoperative hemoglobin values below 7.5 g/dL was associated with worse outcomes compared to other values. Given similar outcomes between hemoglobin more than 7.5 g/dL groups, targeting treatment to an initial postoperative hemoglobin value at the lower value may be more desirable.

Electronic transfusion consent and blood delivering pattern improve the management of blood bank in China.

BACKGROUND: The aim of this study was to improve the blood transfusion treatment consent accuracy, simplify the verification process, prolong the temperature control time before the blood transfusion, and save the blood transportation labor cost. METHODS: We designed the blood transfusion consent electronic signing process, which can generate personalized the text content and can automatically check the filling accuracy. The signal can be transmitted to the blood transfusion management system (TMS) to relieving the blood distribution. For blood delivering pattern, we established the blood transport center, recruited full-time nurses and used temperature-controlled blood transfer boxes to deliver blood in batches on a regular basis. RESULTS: A quarterly data analysis of blood transfusion quality showed a 100% blood transfusion consent accuracy after an electronic signing process was implemented. The average confirmation time savings between the electronic content and paper content was 26 min for the Department of Emergency (estimated difference 95% CI = 26 (20 to 36), p < 0.05). The blood delivering pattern reduced the time for each unit by leaving the average temperature control by 7.24 min (estimated difference 95% CI = 7.24 (6.92 to 7.56), p < 0.05). Furthermore, $3.67 was saved for the blood transportation labor cost for each unit as well. CONCLUSION: Blood transfusion consent electronic signing process not only ensures the accuracy, but also saves the verification time. Moreover, the blood delivering pattern prolongs the blood temperature control time and saves blood transportation labor costs. Thus, these two improvements could enhance transfusion management.

Effects of garbage salvaging and suspended crossbar on microplastic pollution along a typical urban river.

Microplastic pollution has been considered as a global environmental issue that potentially threatens human health. However, research about microplastic pollution in urban rivers is still insufficient. This study analyzed the abundance and distribution of microplastics in surface water of the Nanfei River in Hefei, China. Microplastic concentrations ranged from 0.8 to 27 items/L along the studied river. The small size (50-333 µm) (47.58-84.89%) and white (55.65-88.89%) were predominant among all samples, except that collected from the source reach. Pellet was a typical and abundant microplastic type and accounted for 60.30%. PE and PP were the major polymers, occupying 55.24% and 22.86%, respectively. The results showed that traditional environmental management practices including salvaging surface garbage regularly and setting wooden suspended crossbars at tributary confluences could significantly mitigate the pollution degree of microplastics. The polymer risk index was calculated to describe the potential risk of microplastics, and the pollution level was still at high risk under various management practices. This study provides a valuable finding for future research on microplastics in urban city rivers, which may improve the knowledge that how to control and prevent microplastic pollution.

Tunable polarization-independent and angle-insensitive broadband terahertz absorber with graphene metamaterials.

In this paper, we design a polarization-independent and angle-insensitive broadband THz graphene metamaterial absorber based on the surface plasmon-polaritons resonance. Full-wave simulation is conducted, and the results show that the designed metamaterial absorber has an absorption above 99% in the frequency range from 1.23 THz to 1.68 THz, which refers to a very high standard. Furthermore, the absorber has the properties of tunability, and the absorption can be nearly adjusted from 1% to 99% by varying the Fermi energy level of the graphene from 0 eV to 0.7 eV. In the simulation, when the incident angles of TE and TM waves change from 0° to 60°, the average absorption keeps greater than 80%. The proposed absorber shows promising performance, which has potential applications in developing graphene-based terahertz energy harvesting and thermal emission.

Absorption and speciation of arsenic by microalgae under arsenic-copper Co-exposure.

Combined pollutions of arsenic (As) and copper (Cu) are common in water bodies near mines, non-ferrous metal smelting and power plants. This study investigated the effect of Cu(II) on the absorption and speciation of As(V) by microalgae. We compared the absorption and speciation of arsenic by microalgae (mainly Cyanophyta and Chlorophyta) when exposed to single As(V) with that exposed to As-Cu co-exposure in laboratory. The results showed that in the case of single As(V) exposure, the inhibitory effect of As(V) on microalgae was primarily affected by the exposure time, instead of the concentration of As(V) in the water solution. Compared with single As(V) exposure, the presence of Cu(II) under As-Cu co-exposure promoted the absorption and accumulation of As(V) by algae. The combination effect of As and Cu on algae was antagonistic instead of synergistic within the tolerance range of algae to them. In the presence of Cu(II), more monomethylarsonous acid (MMA) and dimethylarsinous acid (DMA), which are volatile organic arsenic compounds, were produced in algae compared with the control. The finding that Cu(II) can mediate the absorption and speciation processes of arsenic in algae has significance in possible bioremediation of arsenic pollution in aquatic environment.

Periconceptional exposure to air pollution and congenital hypospadias among full-term infants.

BACKGROUND: Evidence regarding whether prenatal exposure to air pollution increases the risk of hypospadias remains limited. The aim of the study is to evaluate the association between exposure to ambient air pollution during early pregnancy and the incidence of hypospadias. METHODS: We conducted a 1:10 case-control study using the Taiwanese Birth Registry database. Male full-term infants reported to have hypospadias were defined as cases, and controls were randomly selected from male full-term infants without any congenital anomaly. The monthly average of ambient air pollutants, including PM10, PM2.5, PM2.5-10, NO2, NOx, O3, and O3 8-h maximum, from 3 months before conception to 6 months post conception was retrieved from air quality monitoring stations and interpolated to the level of township using the kriging method. Multivariable logistic regression models were utilized to evaluate the associations. RESULTS: A total of 200 hypospadias cases, with 2000 healthy controls sampled, were reported during 2007-2014. The results revealed that PM2.5 exposure during the first 3 months after conception (odds ratio [OR] = 1.29, 95% confidence interval [CI]: 1.01-1.65, per interquartile range [IQR] = 15.6 µg/m3) and O3 exposure during the first month after conception (OR = 1.40, 95% CI: 1.08-1.82, per IQR = 8.0 ppb) were associated with a higher incidence of hypospadias. CONCLUSIONS: The results of the study suggest that early gestational exposure to ambient air pollution increases the risk of hypospadias among full-term infants.

Association between air pollution exposure and diabetic retinopathy among diabetics.

BACKGROUND: Exposure to air pollution has been linked to adverse effects on vascular diseases. However, the effects of air pollution exposure on diabetic retinopathy (DR), a vascular disease, have not been studied. OBJECTIVE: To determine the association of ambient air pollution exposure with DR risk. METHODS: Patients newly diagnosed as having diabetes mellitus (DM) during 2003-2012 from Longitudinal Health Insurance Database 2005), a subset of National Health Insurance Research Database, were included as the study cohort. Newly diagnosed DR patients one year or later after DM diagnosis were identified as cases. Kriging was used to interpolate yearly concentrations of air pollutants at township levels and linked with every individual's residence in each year; average concentrations during the follow-up period were then calculated as personal exposure. Conditional logistic regressions with adjustments for age at DM diagnosis and comorbidities were applied. RESULTS: Of newly diagnosed DM cases during 2003-2012, 579 were newly diagnosed as having DR over a mean follow-up period of 5.6 years. The Odds ratio (95% confidence interval) of DR occurrence for every 10-µg/m3 increase in particulate matter with ≤2.5 and 2.5-10-µm diameter was 1.29 (1.11-1.50) and 1.37 (1.17-1.61), respectively. CONCLUSION: In patients with DM, the higher particulate matter exposure, the higher is the DR risk.

[Effect of nanostructured lipid carriers (NLCs) in improving stability of essential oils and its application].

Essential oils are easy to cause oxidative damage, chemical transformation or polymerization, and have some intrinsic problems, such as instability, low water solubility and low bioavailability, which restrict their application in the fields of product development. Nanostructured lipid carriers(NLCs) can overcome some of the restrictions of other colloidal carriers, such as emulsions, liposomes, polymer nanoparticles and solid lipid nanoparticles. NLC is an efficient and stable delivery system for bioactive substances. With unique lipid properties(mixture of solid and liquid lipid), it can overcome the disadvantages of essential oils and protect them from adverse environments, thus improving the stability, bioavailability and safety of essential oils, and achieve sustained release and controlled release. In EOs-NLCs system, essential oils, as special liquid lipid with biological activities and medicinal properties, can fully play the role of medicine-adjuvant integration by changing the structural characteristics of mixed lipid. Based on the development of nanocarriers system, this paper introduces the composition and structural characteristics of EOs-NLCs, and clarifies how to improve the stability of essential oils based on the effects of NLCs on physical and chemical properties, physical stability and release of active components of essential oils. In addition, it also introduces the application of the system in the fields of pharmaceutical, food, cosmetics and skin care products. This review aims to provide some references for improving the stability of essential oils and their applications by using NLCs.

Changes in the relationship between childhood asthma and ambient air pollution in Taiwan: Results from a nationwide survey repeated 5 years apart.

BACKGROUND: Childhood asthma is a common disease whose prevalence is changing. Shift in environmental exposure was one of the plausible explanations. This study investigated changes in the association between childhood asthma and ambient air pollution occurring over time. METHOD: A nationwide questionnaire survey concerning respiratory illness and symptoms was administered to Taiwanese elementary and middle school students in 2011 and repeatedly in 2016-2017. During the study period, the concentrations of ambient air pollutants were obtained from the Environmental Protection Administration (EPA) monitoring stations. Generalized estimating equation models were applied to examine the association between air pollution in the past year and the risk of current asthma. RESULTS: A total of 6346 children from the 2011 survey and 11 585 children from the 2016-2017 survey attended schools located within a 1-km radius of Taiwan EPA monitoring stations. The prevalence of childhood current asthma (children with physician-diagnosed asthma and persistent asthma symptoms in the past year) increased from 7.5% to 9.6% during this period. The level of exposure to particulate matter with an aerodynamic diameter of ≤2.5 µm (PM2.5 ) in the past year was found to be associated with current asthma both in the 2011 survey (odds ratio (OR): 1.90, 95% confidence interval (CI): 1.41-2.57) and in the 2016-2017 survey (OR: 1.24, 95% CI: 1.04-1.48). CONCLUSION: Improved air quality has reduced the effect of PM2.5 on childhood asthma, but air quality remains a health concern in Taiwan.

Significant effects of exposure to relatively low level ozone on daily mortality in 17 cities from three Eastern Asian Countries.

BACKGROUND: Studies have examined the variation in mortality risk associated with ambient ozone. We conducted an international cooperation study for investigating the non-linear ozone-mortality association accounting for lag effect and for examining the ozone level with significant health effect. METHODS: Daily counts of total non-accidental death and ambient air pollutant concentration were obtained in 17 cities from 3 Eastern Asian countries or regions (Taiwan, Korea, and Japan). The total study period was from 1979 to 2010 and differed by city based on data availability. The ozone-mortality association in each city was estimated by running a time-series quasi-Poisson regression model, allowing for overdispersion. The city-specific estimates were then pooled by country by using multivariate random effects meta-analysis. RESULTS: The non-linear ozone exposure-mortality response curves were generated in 17 cities from Taiwan, Korea, and Japan. The association curves in the three countries all showed increased mortality with elevated ozone, and the significant mortality effects of ozone exposure were observed at level higher than 40, 50, and 40 ppb for Taiwan, Korea, and Japan, respectively. These associations are unaffected by co-pollutant of particulate matter in Taiwan and Japan. But the potential confounding effect of co-pollutant could not be ignorable in Korea. CONCLUSIONS: Our study provides evidence that exposure to a relative low level of ambient ozone is associated with an increased risk of mortality. Our results emphasize the continual need to examine the existing standard by documenting potential human adverse effects.

Changes in the relationship between ambient fine particle concentrations and childhood lung function over 5 years.

BACKGROUND: Exposure to ambient fine particles, particulate matter with an aerodynamic diameter of ≤2.5 µm (PM2.5), is a public health concern. Concentrations of ambient PM2.5 have changed temporally in the past 10 years after a series of action policies for improving air quality were implemented in Taiwan. In this study, temporal changes in the relationship between PM2.5 and lung function among children were investigated. METHODS: A nationwide respiratory health survey was conducted among Taiwanese elementary and middle school students in 2011 and again in 2016-2017. A questionnaire was administered to students, for whom forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1) were measured using spirometry. During the study period, monthly concentrations of ambient PM2.5 were obtained from the monitoring stations of the Environmental Protection Administration. Lung function measurements were compared with ambient PM2.5 exposure using mixed-effects models. RESULTS: In the 2011 survey (mean PM2.5: 40.6 µg/m3), exposure to PM2.5 in the preceding 1-2 months was associated with a 2.2% decrease (95% confidence interval [CI]: -4.1%, -0.3%) in FVC and a 2.3% decrease (95% CI: -4.0%, -0.5%) in FEV1. By contrast, a significant relationship between PM2.5 concentrations and lung function was not observed in the 2016-2017 survey (mean PM2.5: 30.0 µg/m3). CONCLUSIONS: As improvement in air quality over time, the negative relationship between PM2.5 and childhood lung function tend to be not significant.

Probiotics in preventing and treating chemotherapy-induced diarrhea: a meta-analysis.

BACKGROUND AND OBJECTIVES: To systematically assess the safety and effectiveness of probiotics in preventing and treating chemotherapy-induced diarrhea (CID), so as to provide the evidence-based evidence for clinical practice. METHODS AND STUDY DESIGN: Electronic databases, including EMbase, Cochrane Library, pubMed, CNKI, VIP, CBM, and Wanfang databases, were retrieved to search for the randomized controlled trials (RCTs) of CIDs among patients with malignant tumors treated with probiotics as of March 2019. Later, the Rev Man 5.3 statistical software was employed to extract data and assess the quality of the identified literature for metaanalysis. RESULTS: Finally, 13 RCTs involving a total of 1024 patients were included into the current metaanalysis. Results of this meta-analysis showed that the addition of probiotics to conventional symptomatic treatment could evidently reduce the total diarrhea rate in patients with cancer [RR=0.47, 95% CI (0.35, 0.63), p<0.00001] and grade III-IV diarrhea [RR=0.16, 95% CI (0.05, 0.42), p=0.0008], increase the total effective rate [OR=4.26, 95% CI (2.55, 7.12), p<0.00001], and shorten the duration of diarrhea [MD=-1.92, 95% CI (-1.96, - 1.88), p<0.00001]; meanwhile, the difference was statistically significant. But in patients with grade I-II diarrhea [RR=0.81, 95% CI (0.53, 1.24), p=0.34], the difference was not statistically significant. Besides, none of the enrolled study had reported adverse reactions. CONCLUSIONS: The application of probiotics before or during chemotherapy can effectively prevent the occurrence of CID among cancer patients. Moreover, the combination of probiotics in treating CID can also improve the therapeutic effect on CID, with less adverse events.