Contribution of Particulates to Airborne Disease Transmission and Severity: A Review.

The emergence of coronavirus disease 2019 (COVID-19) has catalyzed great interest in the spread of airborne pathogens. Airborne infectious diseases are classified into viral, bacterial, and fungal infections. Environmental factors can elevate their transmission and lethality. Air pollution has been reported as the leading environmental cause of disease and premature death worldwide. Notably, ambient particulates of various components and sizes are harmful pollutants. There are two prominent health effects of particles in the atmosphere: (1) particulate matter (PM) penetrates the respiratory tract and adversely affects health, such as heart and respiratory diseases; and (2) bioaerosols of particles act as a medium for the spread of pathogens in the air. Particulates contribute to the occurrence of infectious diseases by increasing vulnerability to infection through inhalation and spreading disease through interactions with airborne pathogens. Here, we focus on the synergistic effects of airborne particulates on infectious disease. We outline the concepts and characteristics of bioaerosols, from their generation to transformation and circulation on Earth. Considering that microorganisms coexist with other particulates as bioaerosols, we investigate studies examining respiratory infections associated with airborne PM. Furthermore, we discuss four factors (meteorological, biological, physical, and chemical) that may impact the influence of PM on the survival of contagious pathogens in the atmosphere. Our review highlights the significant role of particulates in supporting the transmission of infectious aerosols and emphasizes the need for further research in this area.

Assessing the price levels of medical service and influential factors: evidence from China.

BACKGROUND: Medical service prices play a crucial role in cost containment in China. This study aimed to assess the change in medical service price levels at the macro level and the relationship with relevant macroeconomic factors. METHODS: Data from the 2022 China Statistics Yearbook, the 2022 China Health Statistics Yearbook, and the 2020 China National Health Accounts Report were used. Time trends of health price levels, utilization, and health expenditure were examined. A time-series regression model was employed to measure the impact of service utilization and medical service prices on total medical service expenditure growth from 2000 to 2021. The Johansen cointegration test was conducted to test the cointegrating relationship between medical service price levels and total medical service expenditure, average wage of employees and CPI. The Granger causality test was performed to observe the direction of causality. RESULTS: Descriptive analyses showed consistent growth in utilization and medical service price levels from 2000 to 2021. The time-series model indicated that medical service expenditure was influenced by the rise in inpatient admissions and price levels of medical service and medicine. The Johansen cointegration test identified a long-term equilibrium relationship between medical service price levels and total medical service expenditure, average wage and CPI. The change in medical service price levels was the Granger cause of the change in medical service expenditure, but it had no impact on average wage and CPI. However, the change in medical service price levels was influenced by these three macroeconomic factors. CONCLUSIONS: The growth of medical service expenditure in China was driven by inpatient use and price level. There was a long-term equilibrium relationship between medical service price levels and relevant macroeconomic factors. However, medical service price levels only affected medical service expenditure and have no impact on average wage and CPI. It is necessary to improve the value transmission mechanism of medical service prices.

Unveiling the impact of low-molecular-weight organic acids on enrofloxacin sorption in North China agricultural soil: Insights and implications.

Low-molecular-weight organic acids (LMWOAs) play a crucial role as components of dissolved organic matter in soil, influencing the sorption/desorption, degradation, and plant uptake of diverse pollutants within the agricultural soil ecosystem. This study delves into the sorption behavior and mechanism of the fluoroquinolone antibiotic enrofloxacin (ENR) on agricultural soil in North China, focusing on the impact of LMWOAs. Through batch equilibrium experiments, we explored the sorption/desorption kinetics of ENR under varying conditions such as temperature, pH, ion strength, and ion type, with the addition of acetic acid, oxalic acid, and citric acid individually. Our findings reveal that the sorption and desorption kinetics of ENR-whether with or without LMWOAs-conformed well to the pseudo-second-order kinetic model (R2 ≥ 0.997). The presence of LMWOAs notably enhanced ENR sorption while impeding desorption in soil, with oxalic acid demonstrating the highest promotion effect followed by acetic acid and citric acid. Moreover, the sorption capacity and affinity of ENR decreased with rising solution pH, dropping from 96.8%-98.5% to 30.9%-34.4%. Acidic conditions favored ENR retention in soil, with inhibition of sorption escalating alongside increasing ionic strength. LMWOAs, soil solution pH, and coexisting ions emerge as pivotal factors shaping ENR sorption behavior. Furthermore, LMWOA presence intensified desorption hysteresis of ENR on soil, with a desorption hysteresis coefficient (HI) ≤ 0.124. These results suggest that LMWOAs restrict ENR mobility in the local soil environment, heightening the risk of its accumulation in soil and crops. This study offers valuable insights into the intricate interplay among LMWOAs, ENR sorption dynamics, and environmental outcomes, underscoring the importance of understanding such complexities in agricultural soil management.

Recent advance in quality preservation of non-thermal preservation technology of fresh mushroom: a review.

Fresh mushrooms have a long history of cultivation and consumption, but high postharvest losses are a concern in the commercial production of mushrooms worldwide. Thermal dehydration is widely used in the preservation of commercial mushrooms, but the flavor and taste of mushrooms are significantly altered after dehydration. Non-thermal preservation technology, which effectively maintains the characteristics of mushrooms, is a viable alternative to thermal dehydration. The objective of this review was to critically assess the factors affecting fresh mushroom quality after preservation is remarkable, with the ultimate goal of developing and promoting non-thermal preservation technology for preserving fresh mushroom quality, effectively extending the shelf life of fresh mushrooms. The factors influencing the quality degradation process of fresh mushrooms discussed herein include the internal factors associated with the mushroom itself and the external factors associated with the storage environment. We present a comprehensive discussion of the effects of different non-thermal preservation technologies on the quality and shelf life of fresh mushrooms. To prevent quality loss and extend the shelf life after postharvest, hybrid methods, such as physical or chemical techniques combined with chemical techniques, and novel nonthermal technologies are highly recommended.

Spatial pattern and influential factors for early marriage: evidence from Bangladesh Demographic Health Survey 2017-18 data.

BACKGROUND: Early marriage is highly prevalent in Bangladesh. It is linked with a range of adverse outcomes, including maternal and child mortality. However, research on regional variations and factors associated with early marriage is scarce in Bangladesh. This study aimed to explore the geographical variations and predictors of early marriage in Bangladesh. METHODS: Data of women aged 20-24 in the Bangladesh Demographic and Health Survey 2017-18 were analysed. The occurrence of early marriage was the outcome variable. Explanatory variables were several individual-, household- and community-level factors. Geographical hot spots and cold spots of early marriage were first determined using Global Moran's I statistic. Multilevel mixed-effect Poisson regression was used to determine the association of early marriage with individual-, household-, and community-level factors. RESULTS: Almost 59% of women aged 20-24 reported they were married before reached 18. The hotspots of early marriage were mainly concentrated in Rajshahi, Rangpur and Barishal, and the cold spots were in Sylhet and Chattogram divisions. The prevalence of early marriage was lower among higher educated (adjusted prevalence ratio (aPR): 0.45; 95% CI: 0.40, 0.52), and non-Muslim women (aPR: 0.89; 95% CI: 0.79, 0.99) than their counterparts. Higher community-level poverty was significantly associated with early marriage (aPR, 1.16; 95% CI: 1.04, 1.29). CONCLUSION: The study concludes that promoting girls' education, awareness-building programs about the adverse effects of early marriage and proper application of the child marriage restraint act, particularly in disadvantaged communities are recommended.

Analyze of factors and prognosis of eyes lost to follow-up in retinal vein occlusive disease patients receiving anti-vascular endothelial growth factor therapy.

BACKGROUND: Patients with macular edema (ME) secondary to retinal vein occlusion (RVO) who received at least one intravitreal injection of anti-vascular endothelial growth factor therapy (VEGF) and lost to follow-up (LTFU) for more than six months were analyzed to investigate the factors contributing to the LTFU and the prognosis. METHOD: This was a retrospective, single-center study to analyze the causes and prognosis of LTFU over six months in RVO-ME patients treated with intravitreal anti-VEGF injections at our institution from January 2019 to August 2022 and to collect patients' baseline characteristics along with the number of injections before LTFU, primary disease, best corrected visual acuity (BCVA) before LTFU and after return visit, central macular thickness (CMT), months before LTFU and after LTFU, reasons for LTFU, and complications, to analyze the factors affecting visual outcome at a return visit. RESULTS: This study included 125 patients with LTFU; 103 remained LTFU after six months, and 22 returned after LTFU. The common reason for LTFU was "no improvement in vision" (34.4%), followed by "transport inconvenience" (22.4%), 16 patients (12.8%) were unwilling to visit the clinic, 15 patients (12.0%) had already elected to seek treatment elsewhere, 12 patients (9.6%) were not seen in time due to the 2019-nCov epidemic, and 11 patients (8.8%) cannot do it due to financial reasons. The number of injections before LTFU was a risk factor for LTFU (P < 0.05). LogMAR at the initial visit (P < 0.001), CMT at the initial visit (P < 0.05), CMT before the LTFU (P < 0.001), and CMT after the return visit (P < 0.05) were influential factors for logMAR at the return visit. CONCLUSION: Most RVO-ME patients were LTFU after anti-VEGF therapy. Long-term LTFU is greatly detrimental to the visual quality of patients; thus, the management of RVO-ME patients in follow-up should be considered.

Factors that influence genetic counselors' participation in research.

Genetic counselors have skills and expertise in genetics and patient care that make them an asset to research and research teams. However, the National Society of Genetic Counselors (NSGC) found in 2020 that more than half of practicing genetic counselors do not participate in research activities. Information describing factors that influence their research participation is lacking in the literature. This study ascertained genetic counselors' workplace and graduate training experiences to provide insight into factors that increase or decrease participation in research activities. A survey was distributed through the NSGC Student Research Survey Program. Practicing genetic counselors that graduated in or before 2020 were eligible to participate. The survey included questions about demographics, implementation of student research projects, research-specific resources in their graduate programs, perceived barriers and motivations, and current research activities. Interestingly, the majority of respondents participated in research activities between 2017 and 2021; the most common activities included: recognizing a gap(s) in knowledge (68%) and presenting an abstract or poster (64%). Factors that most significantly influenced genetic counselors' research participation included their interest in research (p = 0.0037), their motivation to do research (p = 0.0014), and their perceived intimidation by the research process (p < 0.001). These results provide insight into solutions for the workplace and graduate programs that could increase genetic counselors' research participation.

User Compliance With the Health Emergency and Disaster Management System: Systematic Literature Review.

BACKGROUND: Health-related hazards have a detrimental impact on society. The health emergency and disaster management system (Health EDMS), such as a contact-tracing application, is used to respond to and cope with health-related hazards. User compliance with Health EDMS warnings is key to its success. However, it was reported that user compliance with such a system remains low. OBJECTIVE: Through a systematic literature review, this study aims to identify the theories and corresponding factors that explain user compliance with the warning message provided by Health EDMS. METHODS: The systematic literature review was conducted using Preferred Reporting Items for Systematic reviews and Meta-Analyses 2020 guidelines. The search was performed using the online databases Scopus, ScienceDirect, ProQuest, IEEE, and PubMed, for English journal papers published between January 2000 and February 2022. RESULTS: A total of 14 papers were selected for the review based on our inclusion and exclusion criteria. Previous research adopted 6 theories when examining user compliance, and central to the research was Health EDMS. To better understand Health EDMS, based on the literature reviewed, we mapped the activities and features of Health EDMS with the key stakeholders involved. We identified features that require involvement from individual users, which are surveillance and monitoring features and medical care and logistic assistance features. We then proposed a framework showing the individual, technological, and social influencing factors of the use of these features, which in turn affects compliance with the warning message from Health EDMS. CONCLUSIONS: Research on the Health EDMS topic increased rapidly in 2021 due to the COVID-19 pandemic. An in-depth understanding of Health EDMS and user compliance before designing the system is essential for governments and developers to increase the effectiveness of Health EDMS. Through a systematic literature review, this study proposed a research framework and identified research gaps for future research on this topic.

Willingness to practice medicine and related influential factors among medical undergraduates during COVID-19: a cross-sectional study.

BACKGROUND: As the medical undergraduates constitute the future workforce in China, their career preferences hold a significant bearing on the quality of healthcare services, particularly in light of the ongoing COVID-19 pandemic. We aim to understand the current state of the willingness to practice medicine among medical undergraduates and to analyze the related influential factors. METHODS: During the COVID-19 epidemic, we conducted a cross-sectional survey via an online platform from February 15, 2022, to May 31, 2022, to collect participants' demographic information, psychology, and factors influencing their career choices. The general self-efficacy scale (GSES) was used to evaluate medical students' perceptions of their self-efficacy. Futhermore, we conducted multivariate logistic regression analyses to explore the influencing factors of medical undergraduates' willingness to pursure a caree in medicine. RESULTS: A total of 2348 valid questionnaires were included, and 1573 (66.99%) were willing to practice medicine for medical undergraduates after graduation. The mean GESE scores in the willingness group (2.87 ± 0.54) were significantly higher than those of the unwillingness group (2.73 ± 0.49). The multiple logistic regression showed that several factors were positively associated with willingness to practice medicine as a career, including students' GSES score (OR = 1.87), current major, household income, personal ideals (OR = 1.97), family support (OR = 1.44), high income (OR = 1.77), and social respect (OR = 2.19). Compared with those who were very afraid of COVID-19, students who did not express any fear towards the COVID-19 pandemic had a higher preference for choosing the medical profession as a career. Conversely, students thinking of high tension in the doctor-patient relationship, heavy workload, and long training were less likely to choose medical work after graduation. CONCLUSIONS: The study highlights a noteworthy prevalence of medical undergraduates who expressed their willingness to pursue medicine as a career post-graduation. Several factors, including but not limited to current major, household income, psychological factors, personal preferences, and career needs or preferences, were significantly associated with this willingness. Moreover, the impact of the COVID-19 pandemic on medical students' career choices cannot be overlooked.

Factors associated with lymphedema self-management behaviours among breast cancer survivors: A cross-sectional study.

AIMS AND OBJECTIVES: The purpose of this empirical study was to explore the current status and associated factors of lymphedema self-management behaviours among Chinese breast cancer survivors. BACKGROUND: Breast cancer-related lymphedema is a lifetime concern for survivors and is currently incurable. Lifetime lymphedema self-management takes a significant role in preventing development and progression of lymphedema. Understanding influencing factors of lymphedema self-management behaviours can help to develop targeted intervention programs. DESIGN: A multicentre cross-sectional study. METHODS: From December 2021 to April 2022, a convenience sample of 586 participants were recruited at four tertiary hospitals in four cities in China. Self-reported questionnaires were used to measure socio-demographic characteristics, disease-and treatment-related characteristics, lymphedema self-management behaviours, lymphedema knowledge, illness perception, self-efficacy, self-regulation and social support. Descriptive analysis, bivariate analysis and hierarchical multiple regression were conducted. This study was registered at Chinese Clinical Trial Registry (ChiCTR2200057084), and was reported followed the STROBE checklist. RESULTS: Breast cancer survivors reported moderate level of lymphedema self-management behaviours. Promotion of lymph reflux management was ranked the least performed self-management behaviours, while the affected limb protection management ranked the most. 36.2% of self-management behaviours was explained by exercise regularly, level of attention on lymphedema prevention, unclear about the tumour stage (vs. stage I), knowledge, self-efficacy, emotional illness representation and social support. CONCLUSIONS: Lymphedema self-management behaviours of breast cancer survivors was insufficient. Performance of lymphedema self-management varied with different socio-demographic characteristics, along with different levels of knowledge, self-efficacy, perception and social support. All these identified predictors should be reckoned in assessment and intervention of lymphedema self-management behaviours. RELEVANCE TO CLINICAL PRACTICE: This study addressed that breast cancer survivors' lymphedema self-management behaviours should be promoted. Focusing on identified predictors, further lymphedema surveillance, knowledge education or social facilitation programs are recommended to enhance their self-management performance and adherence.

Comparative evaluation and prioritization of key influences on biodegradation of 2,2',4,4'-tetrabrominated diphenyl ether by bacterial isolate B. xenovorans LB400.

Polybrominated diphenyl ethers (PBDEs) are a class of persistent organic pollutants being widely distributed and harmful to human health and wildlife, and the development of sustainable rehabilitation strategies including microbial degradation is of great concern. Although the increasing number of bacteria, especially the broad-spectrum and potent aerobes have been isolated for the efficient removal of PBDEs, the external influences and the corresponding influential mechanism on biodegradation are not fully understood yet. Given the wide-spectrum biodegradability of aerobic bacterial isolate, B. xenovorans LB400 for PBDEs, the dual impacts of many pivotal factors including pH, temperature, presence of dissolved organic matter (DOM) and cadmium ion etc. were comprehensively revealed on biodegradation of 2,2',4,4'-tetrabromodiphenyl ether (BDE-47). Due to the structural resemblance and stimulation of specific enzyme activity in bacteria, the biphenyl as substrates showed the greater capacity than non-aromatic compounds in improving biodegradation. The individual adaptation to neutrality and cultivation at about 30 °C was beneficial for biodegradation since the bacterial cellular viability and enzyme activity was mostly preserved. Although it was possibly good for the induction of hormesis and favorable to enhance the permeability or bioavailability of pollutant, the exceeding increase of Cd2+ or DOM may not give the profitable increase of biodegradation yet for the detrimental effect. For biodegradation, the mechanistic relationship that took account of the integrative correlation with the influential factors was artfully developed using partial least square (PLS) regression technique. Relative to the most significant influence of culture time and initial concentration of BDE-47, the larger relevance of other factors primarily marked as pH and DOM was consecutively shown after the quantitative prioritization. This may not only help understand the influential mechanism but provide a prioritizing regulation strategy for biodegradation of BDE-47. The PLS-derived relationship was validated with the certain predictability in biodegradation, and could be used as an alternative to accelerate a priori evaluation of suitability or improve the feasibility of such bacteria in remediation of PBDEs in the environment.

Recent advances in quality preservation of postharvest golden needle mushroom (Flammulina velutiper).

The golden needle mushroom (Flammulina velutiper) is one of the most productive mushrooms in the world. However, F. velutiper experiences continuous quality degradation in terms of changes in color and textural characteristics, loss of moisture, nutrition and flavor, and increased microbial populations due to its high respiratory activity during the postharvest phase. Postharvest preservation techniques, including physical, chemical and biological methods, play a vital role in maintaining postharvest quality and extending the shelf life of mushrooms. Therefore, in this study, the decay process of F. velutiper and the factors affecting its quality were comprehensively reviewed. Additionally, the preservation methods (e.g., low-temperature storage, packaging, plasma treatment, antimicrobial cleaning and 1-methylcyclopropene treatment) for F. velutiper used for the last 5 years were compared to provide an outlook on future research directions. Overall, this review aims to provide a reference for developing novel, green and safe preservation techniques for F. velutiper. © 2023 Society of Chemical Industry.

Spatial and temporal dynamics of base flow in semi-arid montane watersheds and the effects of landscape patterns and topography.

Base flow (BF) is harder to predict than other hydrological signatures. The lack of hydrologically relevant information or adequately broad spectrum of typically selected catchment attributes (particularly landscape and topography) hinders the explanatory power. Our goals were to identify the most influential controls on base flow spatially and temporally and to elucidate the response relationships. Base flow in 19 semi-arid sub-watersheds was separated by digital filtering. One hundred and fourteen sub-watershed attributes were related to base flow using random forest regression. The main results were as follows: (1) Annual BF significantly declined since 1999 due to decreased precipitation, increased air temperature, afforestation, urban expansion, and increasing water consumption. Annual base flow index (BFI), varying between 0.319 and 0.695, showed less noticeable temporal trends. (2) Precipitation (P) and underlying carbonate rocks primarily controlled the spatial variation of annual BF and total flow (TF), with the impacts being positive. Landscape was less influential. After the abrupt runoff decline, landscape composition rather than configuration exerted greater impacts on spatial BF and TF, and the importance of forest increased, whereas landscape configuration was decisive for BFI during the whole observation period. The absence of significant links between landscape configuration and water quantity may result from a scale issue. Concave profile curvatures were found to be topographic variables more important than slopes. The impact of soil was the least. This study would benefit the selection of catchment attributes and spatial extents to quantify these attributes in building BF predicting models in future studies.

Levels, distributions and influential factors of residential airborne culturable bacteria in 12 Chinese cities: Multicenter on-site survey among dwellings.

Residential airborne culturable bacteria (RAB) are commonly used to assess indoor microbial loads, which is a very effective and recognized indicator of public concern about residential air quality. Many countries and organizations have set exposure limits for residential bacteria. Nevertheless, few studies have been conducted in multicenter cities about the distribution and influencing factors of RAB. It is a challenge to investigate the distribution of RAB and identify the association between indoor influencing variables and RAB in China. The current finding implied the comparative results from a one-year on-site survey of 12 cities in China. The concentration of RAB ranged from 0 CFU/m3 to 18,078 CFU/m3, with an arithmetic median of 350 CFU/m3. RAB concentrations were more in the warm season than those in the cold season, and were more in the bedrooms than those in the living rooms. Indoor environmental indicators (including PM2.5 and PM10) showed the mediating role in the process of temperature and relative humidity effects on RAB. . Influential factors including family-related information (income), architectural characteristics (house type, building history, living floor, the layers of window glass, and decoration) and lifestyle behaviors (heating, new furniture, incense-burned, insecticides-used, air condition-used, and plants-growed) were related with the concentration of RAB. This study presents essential data on the distribution of RAB in some Chinese cities, and reveals the residential influential factors that might minimize health risk from RAB.

Adsorption of benzene on soils under different influential factors: an experimental investigation, importance order and prediction using artificial neural network.

The adsorption of benzene on soils is specifically associated with its migration and transformation. Although previous studies have proved that the adsorption of benzene is affected by various factors, studies simultaneously considering the effects of multiple factors are rare. This study aimed to identify the qualitative and quantitative relationships between multiple influential factors and the adsorption capacity of benzene (BC). Batch adsorption experiments considering different influential factors, including initial concentration (IC), pH, temperature (T), ion strength (IS) and organic matter content (OMC), were conducted in three kinds of soils collected in a chemical industry park. The correlation analysis between different influential factors and BC was carried out based on the experimental data. The artificial neural network (ANN) was applied to predict BC. The results showed that BC increased with the increase of T. As the pH increased, BCs on silty loam and loam increased, while that on sandy loam decreased. Besides, BCs on silty loam and loam raised with increasing OMC, while that on sandy loam remained unchanged. BCs on all three kinds of soils attained their peaks when IS was small and then become stable with an increase in IS. The sequence of correlation between BC and influential factors is listed as IC > OMC > T > IS > pH for silty loam, OMC > IC > T > IS > pH for loam and IC > T > IS > pH > OMC for sandy loam. ANN analysis showed satisfactory accuracy in predicting BC under different influential factors. These results help us understand the important factors affecting benzene adsorption and provide a tool to get the adsorption information easily in complex site conditions.

Unraveling the dynamics, heterogeneity, determinants of eco-efficiency in Beijing-Tianjin-Hebei urban agglomeration, China.

Eco-efficiency has been considered a valuable gauge for evaluating how efficient economic activities are in regard to resource inputs and eco-environmental pressures. Even though Ecosystem services (ESs) are inseparable from sustainable eco-environment, a paucity of literature has considered ESs in eco-efficiency research lines. Therefore, this study aims to construct a novel eco-efficiency evaluation framework by integrating ESs as natural capital input and measure it utilizing the Epsilon-based measure model for the county-level cities in Beijing-Tianjin-Hebei urban agglomeration (BTHUA) during the period 2005-2015. The spatial econometric technique is further performed to acquire quantitative evidence about whether ESs and other determinants impact eco-efficiency. The results revealed that eco-efficiency increased continuously in the whole BTHUA and BTHUA's optimized development functional areas, whereas eco-efficiency of BTHUA's sub-regions showed a significant temporal diversity. The average eco-efficiency values of cities in key development functional areas and restricted development functional areas showed the V-shaped trend (declining before 2010 and then rising). Interestingly, this study found that ESV economic loss may result in eco-efficiency decline for cities located in key development functional areas. From the spatial heterogeneity perspective, the city with high EE is mainly located in eastern BTHUA, whereas cities in the northern plateau areas, southwestern, and western BTHUA have relatively low EE. Furthermore, there existed a significant spatial autocorrelation and a spatial agglomeration heterogeneity, which suggests that the low-low correlation regions gradually being the most dominant spatial pattern. The results of spatial econometric model verified that water yield has the strongest positive effect on EE while soil erosion will lead to declining EE. This paper potentially provides new insights for future policy design of urban agglomeration sustainable deployment.

Quantification and influencing factors of perioperative hidden blood loss in patients undergoing laparoscopic ovarian cystectomy for benign ovarian tumours.

This retrospective, monocentric study quantified hidden blood loss (HBL) and investigated its influencing factors in benign ovarian tumour patients undergoing laparoscopic ovarian cystectomy. Data from 153 patients who underwent laparoscopic ovarian cystectomy were retrospectively reviewed. HBL was calculated using the formula derived from 'Nadler' and 'Cross'. Pearson correlation was carried out to measure the association between HBL and potential risk factors. The average HBL was 280.22 ± 168.42 mL, accounting for 84.13 ± 19.20% of total blood loss (TBL) (347.48 ± 179.05 mL), which was a change of almost fourteen-fold relative to median visible blood loss [20.00 mL (10.00 mL, 57.5 mL)]. Surgical time, number of excisional tumours and preoperative albumin values were risk factors for HBL. HBL represents a large proportion more than 80% of TBL in patients undergoing laparoscopic ovarian cystectomy. Collectively, HBL is helpful for estimating intraoperative blood loss and better guidance of haemostatic agents, which reduces postoperative complications and expedites postoperative recovery. Additionally, the estimation of HBL also contributes to the summary, reflection and improvement of surgical technique.IMPACT STATEMENTWhat is already known on this subject? There has been a growing number of surgical patients with perioperative anaemia, which appears to be inconsistent with measured levels of visible intraoperative blood loss and postoperative drainage. This substantial but easily underestimated blood loss is known as hidden blood loss. To date, no published articles have evaluated HBL and its related risk factors in benign ovarian tumour patients undergoing laparoscopic ovarian cystectomy.What the results of this study add? HBL accounts for a large amount of TBL in laparoscopy for benign ovarian tumours. Surgical time, number of excisional tumours and preoperative albumin values are risk factors for HBL.What the implications are of these findings for clinical practice and/or further research? The management of HBL is important for the administration of perioperative blooding loss. In this context, HBL can be applied to estimate intraoperative blood loss and be better guidance of haemostatic agents to reduce postoperative complications and hasten postoperative rehabilitation. Additionally, the estimation of HBL also contributes to the summary, reflection and improvement of surgical technique.

[Concentration of osteopontin in human milk and associated factors in Chinese populations from 2011 to 2013].

OBJECTIVE: To analyze content of human milk osteopontin(OPN) and to explore associated factors in Chinese populations. METHODS: The samples and data were extracted from the database for human milk composition in China between 2011 and 2013. A sub-sample of 459 mothers was randomly selected after stratification according to lactation stage, and human milk OPN concentrations were determined by ultra performance liquid chromatography-tandem mass spectrometer(UPLC/MS). RESULTS: The average OPN concentration(M(P25, P75)) in breast milk was 44.0(30.1-72.0) mg/L within 0-330 days postpartum. OPN concentrations were independent of lactation stage, which were 45.6(31.8, 80.7) mg/L in colostrum, 41.3(29.2, 70.0) mg/L in transitional milk and 46.9(30.2, 71.9) mg/L in mature milk, corresponding to 0.40%、0.42% and 0.65% of the total milk protein content(OPN/protein%). The percentage of OPN to total protein in milk showed an increasing trend with lactation progression(r=0.21, P<0.001). Multivariate analysis showed that sleep quality of mothers within one week prior to milk collection was correlated with the breast milk OPN level(P=0.04). The OPN level in breast milk from mothers with good sleep quality was significantly higher than that from mothers with poor sleep quality(46.5 mg/L vs.34.7 mg/L). The median level of milk OPN concentration in mothers from Yunnan was higher than mothers from Beijing(50.5 mg/L vs.36.1 mg/L, P=0.03). Maternal age, mode of delivery, prepregnancy body mass index, weight gain during pregnancy, passive smoking and outdoor activities 24 hours prior to milk collection were not correlated with milk OPN concentration. OPN concentration in breast milk was not related to preterm birth. Also, milk OPN concentration did not correlate with diarrhoea, respiratory disease, or allergic disease in infants during two weeks before milk collection. CONCLUSION: The concentration of OPN in breast milk of Chinese woman may be similar among different lactation stages. Geographic region and sleep quality of mothers may be related to the milk OPN concentration.

[Snacking behaviors of Chinese female adults aged 18 to 49 years old in 2004-2015].

OBJECTIVE: To describe shift in snacking behavior among Chinese female adults aged 18 to 49 years old in 2004-2015, and to analyze the contribution of snacks to energy and nutrients among them. METHODS: The present study used data from "China Health and Nutrition Health" where a multistage stratified cluster design was employed to select a stratified probability sample. A total of 12 523 female participants aged 18-49 years old who participated in surveys conducted in 2004-2015 with completed data of demographic characteristics and dietary measurementswere selectedas subjects. There were 2376, 2149, 2142, 2844 and 3012 subjects in waves of 2004, 2006, 2009, 2011, and 2015, respectively. Multivariate Logistic regression model was used to analyze the relationship between socioeconomic factors and snack consumption. Generalized linear model was used to analyze the energy and nutrient intake of snack consumers and non-snack consumers, as well as the contribution of snacks to energy and nutrients. RESULTS: The consumption rate of snacking for women aged 18 to 49 years old had an increasing trend over time(P<0.05), and the rate was 14.24% in 2015, 3.5 times as high as that in 2004. Participants aged 18 to 29 years old whose snake consumption rates were relatively higher compared to those of other aged groups in general waves; also, female adults from the higher education group, the higher yearly income group, and the higher urbanicity index group, and those with the history of smoking or the alcohol use tended to consumed snacks. The change of the influential factors in relation to the consumption of the participant's snack was observed, and age, income level, education level, living area, and the behavior of smoking and drinking were all important factors of snacking. The daily energy and nutrient intake of female snack consumers aged 18 to 49 years old was higher than that of non-snack consumers. The contribution rate of snacks to energy and nutrients varies significantly between survey years; and the contribution of snacks to energy and main nutrients was more than 20% in 2011. CONCLUSION: Snacks have become an important part of the diet of Chinese women aged 18 to 49 years old. Future health promotion programs should be targeted on nutrition education and intervention to guide a reasonable diet structure.

Supervision behaviours of customs supervisors on solid waste import in Shanghai, People's Republic of China.

Waste management is a key challenge the world currently faces. Solid waste imports (SWIs) are counteractive to the construction of ecological civilization. The comprehensive prohibition of "foreign waste" (FW) imports (FWIs) is an iconic measure to promote ecological civilization and ecological environment safety. Strengthening the People's Republic of China (PRC)'s supervision of SWI (SSWIs) is an important means of implementing the comprehensive prohibition of FWIs, while existing research has paid little attention to the behaviour of SSWIs. This paper firstly analyses the influential factors of the behaviour of SSWIs based on the theory of planned behaviour (TPB), and five corresponding research hypotheses are put forward accordingly. Then, it uses 262 micro questionnaires regarding the behaviour of SSWIs in the Port of Waigaoqiao in Shanghai, PRC, and constructs a structural equation model based on the TPB to identify the influential factors and effects of the behaviour of SSWIs. Some interesting findings are observed in this research. Firstly, it indicates that attitude, subjective norms (SNs) and perceived behavioural control (PBC), all indirectly act upon supervision behaviour by influencing supervision intention. Secondly, PBC acts directly on the behaviour of SSWIs, which is consistent with the TPB. Thirdly, the direct effects on supervision intention from strongest to weakest are SNs, attitude, and PBC, respectively. The conclusion provides important policy enlightenment for the supervision optimization of the behaviour of SSWIs. The supervision intention can be motivated from various angles by strengthening the attitude, SNs and PBC of customs supervisors, subsequently strengthening their supervision intention and behaviour.