Cooking with liquefied petroleum gas or biomass and fetal growth outcomes: a multi-country randomised controlled trial.

BACKGROUND: Household air pollution might lead to fetal growth restriction during pregnancy. We aimed to investigate whether a liquefied petroleum gas (LPG) intervention to reduce personal exposures to household air pollution during pregnancy would alter fetal growth. METHODS: The Household Air Pollution Intervention Network (HAPIN) trial was an open-label randomised controlled trial conducted in ten resource-limited settings across Guatemala, India, Peru, and Rwanda. Pregnant women aged 18-34 years (9-19 weeks of gestation) were randomly assigned in a 1:1 ratio to receive an LPG stove, continuous fuel delivery, and behavioural messaging or to continue usual cooking with biomass for 18 months. We conducted ultrasound assessments at baseline, 24-28 weeks of gestation (the first pregnancy visit), and 32-36 weeks of gestation (the second pregnancy visit), to measure fetal size; we monitored 24 h personal exposures to household air pollutants during these visits; and we weighed children at birth. We conducted intention-to-treat analyses to estimate differences in fetal size between the intervention and control group, and exposure-response analyses to identify associations between household air pollutants and fetal size. This trial is registered with ClinicalTrials.gov (NCT02944682). FINDINGS: Between May 7, 2018, and Feb 29, 2020, we randomly assigned 3200 pregnant women (1593 to the intervention group and 1607 to the control group). The mean gestational age was 14·5 (SD 3·0) weeks and mean maternal age was 25·6 (4·5) years. We obtained ultrasound assessments in 3147 (98·3%) women at baseline, 3052 (95·4%) women at the first pregnancy visit, and 2962 (92·6%) at the second pregnancy visit, through to Aug 25, 2020. Intervention adherence was high (the median proportion of days with biomass stove use was 0·0%, IQR 0·0-1·6) and pregnant women in the intervention group had lower mean exposures to particulate matter with a diameter less than 2·5 µm (PM2·5; 35·0 [SD 37·2] µg/m3vs 103·3 [97·9] µg/m3) than did women in the control group. We did not find differences in averaged post-randomisation Z scores for head circumference (0·30 vs 0·39; p=0·04), abdominal circumference (0·38 vs 0·39; p=0·99), femur length (0·44 vs 0·45; p=0·73), and estimated fetal weight or birthweight (-0·13 vs -0·12; p=0·70) between the intervention and control groups. Personal exposures to household air pollutants were not associated with fetal size. INTERPRETATION: Although an LPG cooking intervention successfully reduced personal exposure to air pollution during pregnancy, it did not affect fetal size. Our findings do not support the use of unvented liquefied petroleum gas stoves as a strategy to increase fetal growth in settings were biomass fuels are used predominantly for cooking. FUNDING: US National Institutes of Health and Bill & Melinda Gates Foundation. TRANSLATIONS: For the Kinyarwanda, Spanish and Tamil translations of the abstract see Supplementary Materials section.

Extraction of moiré fringes' phase information based on the Morlet wavelet.

The extraction of phase information is crucial in moiré tomography for achieving accurate results. In this paper, a method for extracting phase information of moiré fringes based on the Morlet continuous wavelet transform is introduced. A detailed exposition of the theoretical deduction and algorithmic procedure of this method is provided. And then, to validate the feasibility and applicability of this approach, four flow fields are conducted as test objects for experiments. Based on that, the phase results provided by the Morlet continuous wavelet transform are compared with those obtained by the reported techniques such as Fourier transform and Gabor wavelet transform. It is evident that Morlet continuous wavelet transform demonstrates superior accuracy and smoothness, which proves the reliability of this method. In summary, the method presented in this study probably offers an effective method with broad applications.

Optimizing nicardipine dosage for effective control of pituitrin-induced hypertension in laparoscopic myomectomy undergoing total intravenous anesthesia.

BACKGROUND: This study aimed to determine the median effective dose (ED50) and 95% effective dose (ED95) of nicardipine for treating pituitrin-induced hypertension during laparoscopic myomectomy, providing guidance for the management of intraoperative blood pressure in such patients. METHODS: Among the initial 40 participants assessed, 24 underwent elective laparoscopic myomectomy. A sequential up-and-down method was employed to ascertain the ED50 of nicardipine based on its antihypertensive efficacy. Nicardipine was initially administered at 6 µg/kg following the diagnosis of pituitrin-induced hypertension in the first patient. Dosing adjustments were made to achieve the desired antihypertensive effect, restoring systolic blood pressure and heart rate to within ± 20% of baseline within 120 s. The dosing increment or reduction was set at 0.5 µg/kg for effective or ineffective responses, respectively. The ED50 and ED95 of nicardipine were calculated using Probit regression by Maximum Likelihood Estimation (MLE) to establish dose-response curves and confidence intervals. RESULTS: 24 patients were included for analysis finally. The ED50 and ED95 of nicardipine for blood pressure control after pituitrin injection were determined. The study found that the ED50 of nicardipine for treating pituitrin-induced hypertension was 4.839 µg/kg (95% CI: 4.569-5.099 µg/kg), and the ED95 was estimated at 5.308 µg/kg (95% CI: 5.065-6.496 µg/kg). Nicardipine effectively mitigated the hypertensive response caused by pituitrin without inducing significant tachycardia or hypotension. CONCLUSIONS: Nicardipine effectively controlled blood pressure after pituitrin injection during laparoscopic myomectomy, with ED50 and ED95 values established. This research highlights the potential utility of nicardipine in addressing hypertensive responses induced by pituitrin, particularly in clinical settings where pituitrin is routinely administered.

The Relationship between Concentration Effort, Focus Back Effort, Focus Back State, and Mind Wandering.

Focus back effort, concentration effort, and focus back state are factors associated with mind wandering. Focus back effort, proposed in alignment with the definition of focus back state, has been previously regarded as one manifestation of concentration effort. The primary goals of the current study are to explore the relationship between concentration effort, focus back effort, focus back state, and mind wandering. To shed light on the issue, we assessed the level of each cognitive measure in a single task. The findings revealed significant correlations between concentration effort, focus back effort, focus back state, and mind wandering. Mediation analysis suggested that focus back effort played a mediating role in the relationship between concentration effort and focus back state. Additionally, we observed that these measures independently influenced task performance through their impact on mind wandering. Our results provide potential avenues for interventions aimed at addressing individuals' mind wandering and enhancing task performance.

Thin film characterization by learning-assisted multi-angle polarized microscopy.

Thin film characterization is a necessary step in the semiconductor industry and nanodevice fabrication. In this work, we report a learning-assisted method to conduct the measurement based on a multi-angle polarized microscopy. By illuminating the film with a tightly focused vectorial beam with space-polarization nonseparability, the angle-dependent reflection coefficients are encoded into the reflected intensity distribution. The measurement is then transformed into an optimization problem aiming at minimizing the discrepancy between measured and simulated image features. The proposed approach is validated by numerical simulation and experimental measurements. As the method can be easily implemented with a conventional microscope, it provides a low cost solution to measure film parameters with a high spatial resolution and time efficiency.

The enhancement of temporal binding effect after negative social feedback.

The present study investigated the effect of social feedback on the experiences of our actions and the outcomes (e.g. temporal binding between an action and its outcome, reflecting individuals' causal beliefs modulated by their agency judgments). In Experiment 1a, participants freely decided (voluntary action) their action timing to cause an outcome, which was followed by social feedback. A larger temporal binding (TB) following negative vs. positive events was found. This effect appeared neither in the random context where the causal belief between the action and outcome was absent (Experiment 1b) nor in the involuntary action context where participants' action timing was instructed (Experiment 1c). Experiments 2a and 2b examined the effect when the action-outcome was occluded, including reversing the order of outcome and feedback in Experiment 2b. Experiments 3a and 3b investigated the effect with only social feedback or only action-outcome presented. Results revealed that the effect found in Experiment 1 was driven by social feedback and independent of the availability of the action-outcome and the position of social feedback. Our findings demonstrate a stronger temporal integration of the action and its outcome following negative social feedback, reflecting fluctuations in sense of agency when faced with social feedback.

Laparoscopic Duodenum-Preserving Pancreatic Head Resection: A Technique for the Treatment of Benign or Low-Grade Malignant Tumors (10 Cases Report).

Background: Laparoscopic duodenum-preserving pancreatic head resection (LDPPHR) is a surgical procedure that involves the removal of the pancreatic head while aiming to preserve the integrity of the digestive and biliary tracts. With advancements in laparoscopic techniques, the utilization of LDPPHR has been increasing. Methods: We retrospectively analyzed the clinical data of 10 patients who underwent laparoscopic duodenum-preserving total pancreatic head resection (LDPPHR-t) at our center from June 2019 to October 2021. Additionally, we analyzed the use of indocyanine green (ICG) in the initial stage of LDPPHR, based on current reports. Results: LDPPHR-t was successfully performed in all patients. After surgery, 3 patients experienced pancreatic fistula (Grade B), 2 patients experienced bile leakage, and 2 patients experienced postoperative hemorrhage. However, no patient exhibited recurrence or required secondary surgery. Conclusion: LDPPHR-t is a new method for treating benign and low-grade malignant tumors in the pancreatic head. However, it is associated with a high incidence of postoperative complications. In the initial stage, the use of ICG can assist surgeons in identifying the biliary duct and pancreaticoduodenal artery arcade.

When Good Intention Goes Away: Social Feedback Modulates the Influence of Outcome Valence on Temporal Binding.

The retrospective view of temporal binding (TB), the temporal contraction between one's actions and their effects, proposes that TB is influenced by what happens after the action. However, the role of the interaction between multiple sources of information following the action in the formation of TB has received limited attention. The current study aims to address this gap by investigating the combined influence of social feedback and outcome valence (i.e., positive or negative outcomes) on TB. In Experiment 1, the valenced outcome was followed by either positive or negative social feedback. The results showed that negative social feedback enlarged the difference between TB over negative and positive outcomes relative to positive social feedback. The modulatory effect of social feedback on TB was not observed in the absence of causal beliefs between actions and outcomes (Experiment 2). These results highlight the importance of considering the complex interplay between cognitive, emotional, and social factors in shaping our subjective temporal experience.

Liquefied Petroleum Gas or Biomass Cooking and Severe Infant Pneumonia.

BACKGROUND: Exposure to household air pollution is a risk factor for severe pneumonia. The effect of replacing biomass cookstoves with liquefied petroleum gas (LPG) cookstoves on the incidence of severe infant pneumonia is uncertain. METHODS: We conducted a randomized, controlled trial involving pregnant women 18 to 34 years of age and between 9 to less than 20 weeks' gestation in India, Guatemala, Peru, and Rwanda from May 2018 through September 2021. The women were assigned to cook with unvented LPG stoves and fuel (intervention group) or to continue cooking with biomass fuel (control group). In each trial group, we monitored adherence to the use of the assigned cookstove and measured 24-hour personal exposure to fine particulate matter (particles with an aerodynamic diameter of ≤2.5 µm [PM2.5]) in the women and their offspring. The trial had four primary outcomes; the primary outcome for which data are presented in the current report was severe pneumonia in the first year of life, as identified through facility surveillance or on verbal autopsy. RESULTS: Among 3200 pregnant women who had undergone randomization, 3195 remained eligible and gave birth to 3061 infants (1536 in the intervention group and 1525 in the control group). High uptake of the intervention led to a reduction in personal exposure to PM2.5 among the children, with a median exposure of 24.2 µg per cubic meter (interquartile range, 17.8 to 36.4) in the intervention group and 66.0 µg per cubic meter (interquartile range, 35.2 to 132.0) in the control group. A total of 175 episodes of severe pneumonia were identified during the first year of life, with an incidence of 5.67 cases per 100 child-years (95% confidence interval [CI], 4.55 to 7.07) in the intervention group and 6.06 cases per 100 child-years (95% CI, 4.81 to 7.62) in the control group (incidence rate ratio, 0.96; 98.75% CI, 0.64 to 1.44; P = 0.81). No severe adverse events were reported to be associated with the intervention, as determined by the trial investigators. CONCLUSIONS: The incidence of severe pneumonia among infants did not differ significantly between those whose mothers were assigned to cook with LPG stoves and fuel and those whose mothers were assigned to continue cooking with biomass stoves. (Funded by the National Institutes of Health and the Bill and Melinda Gates Foundation; HAPIN ClinicalTrials.gov number, NCT02944682.).

Effects of Cooking with Liquefied Petroleum Gas or Biomass on Stunting in Infants.

BACKGROUND: Household air pollution is associated with stunted growth in infants. Whether the replacement of biomass fuel (e.g., wood, dung, or agricultural crop waste) with liquefied petroleum gas (LPG) for cooking can reduce the risk of stunting is unknown. METHODS: We conducted a randomized trial involving 3200 pregnant women 18 to 34 years of age in four low- and middle-income countries. Women at 9 to less than 20 weeks' gestation were randomly assigned to use a free LPG cookstove with continuous free fuel delivery for 18 months (intervention group) or to continue using a biomass cookstove (control group). The length of each infant was measured at 12 months of age, and personal exposures to fine particulate matter (particles with an aerodynamic diameter of ≤2.5 µm) were monitored starting at pregnancy and continuing until the infants were 1 year of age. The primary outcome for which data are presented in the current report - stunting (defined as a length-for-age z score that was more than two standard deviations below the median of a growth standard) at 12 months of age - was one of four primary outcomes of the trial. Intention-to-treat analyses were performed to estimate the relative risk of stunting. RESULTS: Adherence to the intervention was high, and the intervention resulted in lower prenatal and postnatal 24-hour personal exposures to fine particulate matter than the control (mean prenatal exposure, 35.0 µg per cubic meter vs. 103.3 µg per cubic meter; mean postnatal exposure, 37.9 µg per cubic meter vs. 109.2 µg per cubic meter). Among 3061 live births, 1171 (76.2%) of the 1536 infants born to women in the intervention group and 1186 (77.8%) of the 1525 infants born to women in the control group had a valid length measurement at 12 months of age. Stunting occurred in 321 of the 1171 infants included in the analysis (27.4%) of the infants born to women in the intervention group and in 299 of the 1186 infants included in the analysis (25.2%) of those born to women in the control group (relative risk, 1.10; 98.75% confidence interval, 0.94 to 1.29; P = 0.12). CONCLUSIONS: An intervention strategy starting in pregnancy and aimed at mitigating household air pollution by replacing biomass fuel with LPG for cooking did not reduce the risk of stunting in infants. (Funded by the National Institutes of Health and the Bill and Melinda Gates Foundation; HAPIN ClinicalTrials.gov number, NCT02944682.).

Targeting the SOX2/CDP protein complex with a peptide suppresses the malignant progression of esophageal squamous cell carcinoma.

Emerging evidence indicates that SOX2 is an oncogene for esophageal squamous cell carcinoma (ESCC). However, direct targeting of SOX2 is not feasible given that this transcription factor plays important roles in the maintenance of tissues such as the brain. Here, we identified CDP (Homeobox protein cut-like 1 or CASP) as a unique SOX2 binding partner enriched in ESCC with Duolink proximity ligation assay, bimolecular fluorescence complementation (BiFc) and immunoprecipitation. We then screened a peptide aptamer library using BiFc and immunoprecipitation and identified several peptide aptamers, including P58, that blocked the CDP/SOX2 interaction, leading to the inhibition of ESCC progress in vitro and in vivo. Upon administration, synthetic peptide P58, containing the YGRKKRRQRRR cell-penetrating peptide and the fluorophore TAMRA, also blocked the growth and metastasis of ESCC in both mice and zebrafish. Therefore, targeting the SOX2 binding partner CDP with peptide P58 offers an alternative avenue to treat ESCC with increased SOX2 levels.

Information Support Provided by Specialized Nurses via Mobile Healthcare App May Improve Treatment Adherence of Breast Cancer Patients: An Observational Study.

OBJECTIVES: Mobile devices facilitate the healthcare management of breast cancer. Meanwhile, specialist nurses play an important role in disease management. We established a smartphone-based app that enables patients to raise questions to specialist nurses. We aimed to evaluate whether the information support provided by specialist nurses via smartphone app could improve the treatment adherence of breast cancer patients. DATA SOURCE: Breast cancer patients who received surgery and registered for the app between March 2013 and April 2020 were included. Data related to the use of the app, the number of raised questions, and the specific content of each question were retrieved. Overall, 2675 patients were included, with 560 patients raising questions to specialist nurses via the app. Patients with higher educational levels, postmenopause status, and more advanced diseases were more likely to seek informational support via a smartphone app. The treatment adherence was 86.4%. Multivariate analysis demonstrated that raising questions was associated with better compliance. Regarding the distribution of questions, 78.8% of patients had questions about the treatment schedule and procedure, 65.9% of patients had questions during the adjuvant treatment, and only 19.6% of patients raised questions about follow-up and rehabilitation. After a median follow-up of 44 months, there was no survival difference between patients who raised questions and those who did not. CONCLUSION: Seeking information support from specialist nurses was associated with better treatment adherence. The smartphone-based healthcare app enables specialist nurses to provide more conducive service for patients, and validation of this finding in further studies is warranted. IMPLICATIONS FOR NURSING PRACTICE: Breast cancer patients were more interested in problems with treatment procedures and schedules. Those who asked questions had better treatment adherence. The smartphone-based app could not only provide patients with a platform to seek information support but also help specialist nurses understand the needs of patients.

Working memory capacity predicts focus back effort under different task demands.

According to the cognitive flexibility view, individuals with higher cognitive control ability are more flexible in experiencing on task or mind wandering during tasks with different loads. On the other hand, the resource-control theory posits that executive control is essential for allocating attentional resources between mind wandering and tasks. Focus back effort may reflect the adjustment of executive control in the resource-control theory. Here, 121 participants completed two span tasks, as well as high- and low-load tasks, while mind wandering and focus back effort were measured. Our findings indicated that mind wandering was influenced by working memory capacity (WMC) and focus back effort. Additionally, participants demonstrated a higher focus back effort during the higher load task. This effect was particularly pronounced in individuals with lower WMC, which was treated as a continuous variable. These findings integrate the cognitive flexibility view and resource-control theory to describe how individuals modulate mind wandering.

The CARES Program: Improving Viral Suppression and Retention in Care Through a Comprehensive Team-Based Approach to Care for People with HIV and Complex Psychosocial Needs.

Retention in HIV care and viral suppression rates remain suboptimal, especially among people with HIV (PWH) facing complex barriers to care such as mental health conditions, substance use disorders, and housing insecurity. The Center for Adherence, Retention, and Engagement Support (CARES) program utilizes an interdisciplinary team that delivers integrated services in a drop-in setting to provide individualized care to PWH with complex psychosocial needs. We describe the CARES program and evaluate its effectiveness in retaining patients in care to achieve virological suppression. We characterized 119 referrals of PWH experiencing homelessness, mental health conditions, and substance use disorders to CARES between 2011 and 2017, and collected data for a 24-month observation period through 2019. Outcomes of patients who participated in CARES were compared with those who were referred but did not participate. The primary outcome was viral suppression (<200 copies/mL) at least once during 2-year follow-up. Retention in care (≥2 completed medical visits ≥90 days apart in each year post-referral) was a secondary outcome. Of 119 PWH referred to CARES, 59 participated with ≥2 visits. Those who participated in CARES were more likely to achieve viral suppression [adjusted odds ratio (aOR) 3.50, 95% confidence interval (CI) 1.19-10.32] and to be retained in care (aOR 3.73, 95% CI 1.52-9.14) compared with those who were referred but did not participate. This analysis found that the CARES program improved retention in care and viral suppression among PWH with complex psychosocial needs and suggests that it may represent a useful model for future programming.

The role of focus back effort in the relationships among motivation, interest, and mind wandering: an individual difference perspective.

Considerable research suggests a link between mind wandering and diminished levels of motivation and interest. During episodes of mind wandering, individuals may engage in efforts to redirect their attention back to the task at hand (known as focus back effort). Building on the resource-control hypothesis, we hypothesized that the influence of interest and motivation on mind wandering may be mediated by focus back effort. In Study 1, we employed a latent-variable approach to investigate these relationships across three tasks with varying cognitive demands. The results showed that individual differences in interest indirectly influenced mind wandering through the mediating factors of motivation and focus back effort. Furthermore, individual differences in interest indirectly predicted task performance through the mediating factors of motivation, focus back effort, and mind wandering during the high-load task. In Study 2, we replicated the relationships among these factors in a reading comprehension task. The results consistently support the role of focus back effort as an adaptive mechanism for executive control, enabling the allocation of cognitive resources to both mind wandering and task performance. These findings underscore the significance of focus back effort in elucidating the interplay between mind wandering, motivation, interest, and task performance. Importantly, our results align with the resource-control theory.

Association between preoperative diagnosis of sarcopenia and postoperative pneumonia in resectable esophageal squamous cell carcinoma patients: a retrospective cohort study.

Background: Postoperative outcomes for patients suffering from resectable esophageal squamous cell carcinoma (ESCC) are related to sarcopenia. In patients with resectable ESCC, this study investigated the link between sarcopenia and postoperative pneumonia. Methods: The McKewon procedure was the only one used to treat resectable ESCC patients from January 2018 to December 2021 in this retrospective analysis. Sarcopenia was assessed using skeletal muscles at L3 and planning CT scans. It was defined when PMI was below 6.36 cm2/m2 and 3.92 cm2/m2 for men and women, separately. Analyses of multivariate and univariate logistic regression were applied for identifying the risk factors for postoperative pneumonia. Results: The study included 773 patients with resectable ESCC in total. Sarcopenia was an independent risk factor for postoperative pneumonia in individuals with resectable ESCC based on univariate and multivariate analysis (P < 0.05). The stratified analysis indicated that neither of the clinical outcomes in the logistic regression model were affected by gender, age, BMI, smoking, or pre-albumin (P for interaction > 0.006). Conclusion: Following the McKewon procedure, patients with resectable ESCC who were sarcopenic had a higher postoperative pneumonia rate. To prevent the development of postoperative pneumonia during the perioperative period, it may be important to control the incidence of sarcopenia.

Loss of TRIM24 promotes IL-10 expression via CBP/p300-dependent IFNß1 transcription during macrophage activation.

BACKGROUND: As an anti-inflammatory cytokine, interleukin 10 (IL-10) plays a vital role in preventing inflammatory and autoimmune pathologies while also maintaining immune homeostasis. IL-10 production in macrophages is tightly regulated by multiple pathways. TRIM24, a member of the Transcriptional Intermediary Factor 1 (TIF1) family, contributes to antiviral immunity and macrophage M2 polarization. However, the role of TRIM24 in regulating IL-10 expression and its involvement in endotoxic shock remains unclear. METHODS: In vitro, bone marrow derived macrophages cultured with GM-CSF or M-CSF were stimulated with LPS (100ng/ml). Murine models of endotoxic shock were established by challenging the mice with different dose of LPS (i.p). RTPCR, RNA sequencing, ELISA and hematoxylin and eosin staining were performed to elucidate the role and mechanisms of TRIM24 in endotoxic shock. RESULTS: The expression of TRIM24 is downregulated in LPS-stimulated bone marrow-derived macrophages (BMDMs). Loss of TRIM24 boosted IL-10 expression during the late stage of LPS-stimulation in macrophages. RNA-seq analysis revealed the upregulation of IFNß1, an upstream regulator of IL-10, in TRIM24 knockout macrophages. Treatment with C646, a CBP/p300 inhibitor, diminished the difference in both IFNß1 and IL-10 expression between TRIM24 knockout and control macrophages. Loss of TRIM24 provided protection against LPS-induced endotoxic shock in mice. CONCLUSION: Our results demonstrated that inhibiting TRIM24 promoted the expression of IFNß1 and IL-10 during macrophage activation, therefore protecting mice from endotoxic shock. This study offers novel insights into the regulatory role of TRIM24 in IL-10 expression, making it a potentially attractive therapeutic target for inflammatory diseases.

High security optical OFDM transmission scheme with four-dimensional region joint encryption based on power division multiplexing.

In this paper, a high security chaotic encryption scheme for orthogonal frequency division multiplexing (OFDM) transmission system is proposed by using power division multiplexing (PDM) technology and four-dimensional region joint encryption. The scheme uses PDM to realize simultaneous transmission of multiple user information, which can achieve a good compromise among system capacity, spectral efficiency and user fairness. In addition, bit cycle encryption, constellation rotation disturbance (CRD) and region joint constellation disturbance (RJCD) are used to realize four-dimensional region joint encryption, effectively improving the physical layer security. The masking factor is generated by the mapping of two-level chaotic systems, which can enhance the nonlinear dynamics and improve the sensitivity of encrypted system. A 11.76 Gb/s OFDM signal transmission over 25 km standard single-mode fiber (SSMF) is experimentally demonstrated. At the forward-error correction (FEC) bit error rate (BER) limit -3.8×10-3, the proposed receiver optical power based on quadrature phase shift keying (QPSK) without encryption, QPSK with encryption, variant-8quadrature amplitude modulation (V-8QAM) without encryption and V-8QAM with encryption are about -13.5dBm, -13.6dBm, -12.2dBm, and -12.1dBm. The key space is up to 10128. The results show that this scheme not only improves the security of the system and the ability to resist attackers, but also improves the system capacity and has the potential to serve more users. It has a good application prospect in the future optical network.

Exposure-response relationships for personal exposure to fine particulate matter (PM2·5), carbon monoxide, and black carbon and birthweight: an observational analysis of the multicountry Household Air Pollution Intervention Network (HAPIN) trial.

BACKGROUND: Household air pollution (HAP) from solid fuel use is associated with adverse birth outcomes, but data for exposure-response relationships are scarce. We examined associations between HAP exposures and birthweight in rural Guatemala, India, Peru, and Rwanda during the Household Air Pollution Intervention Network (HAPIN) trial. METHODS: The HAPIN trial recruited pregnant women (9-<20 weeks of gestation) in rural Guatemala, India, Peru, and Rwanda and randomly allocated them to receive a liquefied petroleum gas stove or not (ie, and continue to use biomass fuel). The primary outcomes were birthweight, length-for-age, severe pneumonia, and maternal systolic blood pressure. In this exposure-response subanalysis, we measured 24-h personal exposures to PM2·5, carbon monoxide, and black carbon once pre-intervention (baseline) and twice post-intervention (at 24-28 weeks and 32-36 weeks of gestation), as well as birthweight within 24 h of birth. We examined the relationship between the average prenatal exposure and birthweight or weight-for-gestational age Z scores using multivariate-regression models, controlling for the mother's age, nulliparity, diet diversity, food insecurity, BMI, the mother's education, neonate sex, haemoglobin, second-hand smoke, and geographical indicator for randomisation strata. FINDINGS: Between March, 2018, and February, 2020, 3200 pregnant women were recruited. An interquartile increase in the average prenatal exposure to PM2·5 (74·5 µg/m3) was associated with a reduction in birthweight and gestational age Z scores (birthweight: -14·8 g [95% CI -28·7 to -0·8]; gestational age Z scores: -0·03 [-0·06 to 0·00]), as was an interquartile increase in black carbon (7·3 µg/m3; -21·9 g [-37·7 to -6·1]; -0·05 [-0·08 to -0·01]). Carbon monoxide exposure was not associated with these outcomes (1·7; -3·1 [-12·1 to 5·8]; -0·003 [-0·023 to 0·017]). INTERPRETATION: Continuing efforts are needed to reduce HAP exposure alongside other drivers of low birthweight in low-income and middle-income countries. FUNDING: US National Institutes of Health (1UM1HL134590) and the Bill & Melinda Gates Foundation (OPP1131279).

Comparison of visual performance between peripheral gradient high-addition multifocal soft contact lenses and orthokeratology.

PURPOSE: The aim of this study was to evaluate the short-term effects of peripheral gradient high-addition multifocal soft contact lenses (MFSCLs) and orthokeratology (Ortho-K lenses) on visual performance in myopic children. METHODS: Thirty myopic children participated in this prospective study. Each participant wore different sets of lenses in the following sequence: single-vision spectacles (SVSPs) as a control, MFSCLs and Ortho-K lenses. Ocular aberrations, topography, high-contrast visual acuity (HCVA), low-contrast visual acuity (LCVA) and accommodation of the right eye were measured with each type of correction on a different day. RESULTS: Compared with SVSPs, high-addition MFSCLs and Ortho-K lenses significantly increased all items of aberrations (all p < 0.05) except trefoil (p = 0.17). MFSCLs induced less coma, root mean square of the third-order aberration (RMS3) and higher order aberrations than Ortho-K lenses (all p < 0.05). No significant difference in HCVA was found across the three correction types (F = 1.19, p = 0.39). In terms of LCVA, MFSCLs performed significantly poorer than SVSPs (difference, 0.16 logMAR; p = 0.001) and slightly worse than Ortho-K lenses (difference, 0.08 logMAR; p = 0.35). No significant difference in decentration was found between the two types of contact lenses, and no associations were observed between decentration and visual acuity at both high- and low-contrast levels (all p > 0.05). For MFSCLs, decentration was positively related to coma (r = 0.43, p = 0.02) and RMS3 (r = 0.44, p = 0.02), which was not the case for Ortho-K lenses. Accommodative facility was worse with MFSCLs than Ortho-K lenses (p = 0.001). CONCLUSION: Multifocal soft contact lenses differed from Ortho-K lenses in aberration profile and LCVA, although decentration was similar. Decentration <1 mm had minimal influence on both HCVA and LCVA for either type of correction, but significantly increased third-order aberrations for MFSCLs, but not Ortho-K lenses.