Impact of electronic cigarette usage on the onset of respiratory symptoms and COPD among Chinese adults.

The prevalence of dual usage and the relatively low cessation rate among e-cigarette (EC) users suggest that ECs have not demonstrated significant effectiveness as a smoking cessation tool. Furthermore, there has been a substantial increase in the prevalence of EC usage in recent years. Therefore, the objective of this study is to investigate the association between EC use and the incidence of respiratory symptoms and chronic obstructive pulmonary disease (COPD). A total of 10,326 participants aged between 20 and 55 years, without any respiratory diseases or COPD, were recruited for the study. These individuals attended employee physical examinations conducted at 16 public hospitals in Hebei province, China from 2015 to 2020. Logistic regression models were utilized to assess the association between EC use and the risk of respiratory symptoms and COPD using risk ratios along with their corresponding 95% confidence intervals. Restricted cubic spline functions were employed to investigate the dose-response non-linear relationship. The robustness of the logistic regression models was evaluated through subgroup analyses, and sensitivity analyses. During the 5-year follow-up period, a total of 1071 incident cases of respiratory symptoms and 146 incident cases of COPD were identified in this cohort study. After adjusting for relevant confounding factors, EC users demonstrated a respective increase in the risk of reporting respiratory symptoms and COPD by 28% and 8%. Furthermore, dual users who used both ECs and combustible cigarettes exhibited an elevated risk of incident respiratory symptoms and COPD by 41% and 18%, respectively, compared to those who had never used non-users of any cigarette products. The association between daily EC consumption and the development of respiratory symptoms, as well as COPD, demonstrated a significant J-shaped pattern. The potential adverse association between the consumption of ECs, particularly when used in combination with combustible cigarettes, and the development of respiratory symptoms and COPD necessitates careful consideration. Policymakers should approach ECs cautiously as a prospective smoking cessation tool.

Effect of high-level fine particulate matter and its interaction with meteorological factors on AECOPD in Shijiazhuang, China.

Epidemiological evidence of the effect of high-level air pollution and its interaction with meteorological factors on the risk of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is limited. Daily data on AECOPD cases, air pollutants and meteorological factors were collected from 2015 to 2018 in Shijiazhuang. A distributed lag non-linear model (DLNM) was used to explore the lag and cumulative effect of PM2.5 on the risk of AECOPD. The effect of the interaction between PM2.5 and meteorological factors on AECOPD was estimated by a generalized additive model (GAM) and a stratification model. A total of 4766 patients with AECOPD were enrolled. After controlling for confounders, each 10 µg/m3 increase in PM2.5 led to a 5.8% increase in the risk of AECOPD on day lag 0. The cumulative effect of PM2.5 on AECOPD risk showed an increasing trend after 3 days. Similar results were observed in both smoking and non-smoking patients. There was an interaction between PM2.5 and meteorological factors, and the risk of AECOPD was higher in cold and lower humidity conditions than in other conditions. High-level PM2.5 exposure is positively associated with the risk of AECOPD onset, and the effect of PM2.5 can be modified by the temperature and relative humidity. Public health guidelines should pay close attention to AECOPD risk under the condition of high-level PM2.5 with low temperature or low humidity.

Refined UNet v3: Efficient end-to-end patch-wise network for cloud and shadow segmentation with multi-channel spectral features.

Semantic segmentation is one of the essential prerequisites for computer vision tasks, but edge-precise segmentation stays challenging due to the potential lack of a proper model indicating the low-level relation between pixels. We have presented Refined UNet v2, a concatenation of a network backbone and a subsequent embedded conditional random field (CRF) layer, which coarsely performs pixel-wise classification and refines edges of segmentation regions in a one-stage way. However, the CRF layer of v2 employs a gray-scale global observation (image) to construct contrast-sensitive bilateral features, which is not able to achieve the desired performance on ambiguous edges. In addition, the naïve depth-wise Gaussian filter cannot always compute efficiently, especially for a longer-range message-passing step. To address the aforementioned issues, we upgrade the bilateral message-passing kernel and the efficient implementation of Gaussian filtering in the CRF layer in this paper, referred to as Refined UNet v3, which is able to effectively capture ambiguous edges and accelerate the message-passing procedure. Specifically, the inherited UNet is employed to coarsely locate cloud and shadow regions and the embedded CRF layer refines the edges of the forthcoming segmentation proposals. The multi-channel guided Gaussian filter is applied to the bilateral message-passing step, which improves detecting ambiguous edges that are hard for the gray-scale counterpart to identify, and fast Fourier transform-based (FFT-based) Gaussian filtering facilitates an efficient and potentially range-agnostic implementation. Furthermore, Refined UNet v3 is able to be extended to segmentation on multi-spectral datasets, and the corresponding refinement examination confirms the development of shadow retrieval. Experiments and corresponding results demonstrate that the proposed update can outperform its counterpart in terms of the detection of vague edges, shadow retrieval, and isolated redundant regions, and it is practically efficient in our TensorFlow implementation. The demo source code is available at https://github.com/92xianshen/refined-unet-v3.

Impact of percutaneous poking reduction combined with minimally invasive plate internal fixation on foot function and complications of patients with Sanders type II and III calcaneal fractures.

OBJECTIVE: To investigate the impact of percutaneous poking reduction (PPR) combined with minimally invasive plate internal fixation on foot function and complications of Sanders type II and III calcaneal fractures (CFs). METHODS: In this prospective study, 76 patients with Sanders type II and III CFs were randomly divided into the control group (n=38, "L" incision open reduction and plate internal fixation) and the study group (n=38, PPR combined with minimally invasive plate internal fixation (MIPIF)). The operation related indexes, skin necrosis rate, Gissane angle, Bohler angle, calcaneal height and ankle-hindfoot score before and after the operation were compared between the two groups. Complications of the two groups were recorded. RESULTS: Compared with the control group, the operation time of the study group was significantly prolonged, but the intraoperative blood loss was significantly reduced, and the fracture healing time and hospitalization time were significantly shortened (P<0.05). The skin necrosis rate of the study group was slightly lower than that of the control group without statistical significance (P>0.05). The Gissane angle, Bohler angle and calcaneal height of the two groups increased 6 months after the operation, and the changes in the study group were more obvious than those in the control group (P<0.05). Six months after the operation, the ankle-hindfoot scores of the two groups significantly increased, and the changes of the study group were more significant than that of the control group (P<0.05). The total incidence of postoperative complications in the study group was significantly lower than that in the control group (P<0.05). CONCLUSION: PPR combined with MIPIF can significantly promote the healing of Sanders type II and III CFs and the recovery of the Gissane angle and Bohler angle, effectively improve the foot function of patients and induce fewer complications, which is worthy of clinical promotion.