Association between exposure to multiple metals and lung function in welders by multi-pollutant statistical models / 环境与职业医学

Background Welders' exposure to welding fumes with multiple metals leads to decreased pulmonary function. Previous studies have focused on single metal exposure, while giving little attention to the impact of metal mixtures. Objective To assess the association between metal levels in urine and blood of welders and pulmonary function indicators, and to identify key metals for occupational health risk assessment. Methods Questionnaire surveys, lung function tests, urine and blood sampling were conducted among welders and control workers in a shipyard in Shanghai. Inductively coupled plasma mass spectrometry (ICP-MS) was used to detect the concentrations of 12 metals such as vanadium, chromium, and manganese in urine and blood. Spearman correlation was applied to analyze the correlations between the metals in urine and blood. Multiple linear regression, weighted quantile sum (WQS) and Bayesian kernel machine regression (BKMR) were used to analyze the relationships between mixed metal exposure and pulmonary function parameters, such as forced vital capacity (FVC), forced vital capacity as a percentage of predicted value (FVC%), forced expiratory volume in the first second (FEV1), forced expiratory volume in the first second as a percentage of predicted value (FEV1%), and forced expiratory volume in the first second/forced vital capacity (FEV1/FVC). Results This study enrolled 445 subjects, including 322 welders (72.36%) and 123 controls (27.64%). The mean age of the 445 participants was (37.64±8.80) years, and 87.19% participants were male. The welders had significantly higher levels of urinary cadmium (0.88 vs 0.58 μg·L−1), blood chromium (5.86 vs 5.06 μg·L−1), and blood manganese (24.24 vs 21.38 μg·L−1) than the controls (P<0.05). The Spearman correlation coefficients between the metals in urine and blood ranged from −0.46 to 0.68. After adjustment for confounders, the multiple linear regression indicted that the urine molybdenum of the welders was negatively correlated with FVC and FEV1. There were also negative correlations between the molybdenum in blood and FVC, FVC%, FEV1, and FEV1%, and between the copper in blood and FEV1/FVC. The WQS model showed that FEV1 and FVC decreased by 0.112 L and 0.353 L with each quartile increase of metal mixture concentrations in urine and blood among the welders respectively, and the leading contributors were copper, zinc, vanadium, and antimony. The BKMR model showed a negative overall effect of metal mixtures in urine and blood among the welders on FVC, FVC%, FEV1, and FEV1%, and the univariate exposure response-relationship between the molybdenum concentration in urine or blood and FVC, FVC%, FEV1, or FEV1% had an approximately linear decreasing trend. Meanwhile, there may be an interaction of cadmium with manganese, nickel, or vanadium, and an interaction of vanadium with iron, molybdenum, zinc, or copper, when different metals in urine among the welders interacted with FEV1%. Conclusion Exposure to multiple metals in welders leads to a decline in lung function, with molybdenum, antimony, copper, and zinc as the leading contributors.

Association of 24hour movement behaviors with emotional and behavioral problems among left-behind children / 中国学校卫生

Objective@#To examine the association of 24 hour movement behaviors with emotional and behavioral problems among left behind children, so as to provide a theoretical reference for the practice of 24 hour activity interventions to promote emotional and behavioral problems in this population.@*Methods@#From February to May 2023, 1 117 left behind children in grades 4-6 from 10 primary schools in five cities in Zhejiang Province were selected using a convenient cluster sampling method to conduct a questionnaire survey examining 24 hour movement behaviors, as well as emotional and behavioral problems. The general linear model was adopted to analyze the association between satisfying the 24 hour movement behavior guidelines, and emotional and behavioral problems among left behind children.@*Results@#The sleep duration compliance rate was the highest (52.19%), while the moderate-to-vigorous PA (MVPA) compliance rate was the lowest (17.73%). The compliance rate of the three activities accounted for 7.43 %. There was a dose response between the number of guidelines satisfied, and the emotional and behavior of left behind children; that was, satisfaction of a higher number of guidelines was associated with a lower risk of emotional and behavioral problems among left behind children (difficulty factor: β=-0.56, 95%CI =-1.23--0.19; strength factor: β=0.50, 95%CI =-0.48-1.22, P < 0.01). Compared to satisfying none of the guidelines, satisfying the guidelines for screen time ( β=-0.23, 95%CI =-2.18- -0.14 ) and sleep duration ( β=-0.13, 95%CI =-1.66--0.11) was negatively correlated with the difficulty factor, while satisfying the guideline for MVPA ( β=0.13, 95%CI =0.09-1.08) and sleep duration ( β=0.18, 95%CI =0.09-1.40) was positively associated with the strength factor. In addition, satisfying two or all three of the guidelines was more strongly associated with these outcomes than satisfying one of the recommendations ( P <0.01).@*Conclusions@#Meeting the 24 hour movement behavior guidelines can improve emotional and behavioral problems among left behind children. It is necessary to raise their awareness of the effect of satisfying the 24 hour movement behavior guidelines and formulate comprehensive intervention measures.

Study of some morphometric and meristic characteristics of Alepes vari (Cuvier, 1833) collected from the Arabian coast

Abstract The present study examines the correlations between fifteen morphometric and ten meristic characters and total length (TL) of males, females, and combined sexes of Alepes vari (Cuvier, 1833) collected from Karachi fish harbor, West Wharf of Karachi Coast. Statistical analyses of linear regression relationships show mostly strong correlations (r0.70; p 0.05) between total length (TL) and most morphometric characters in males, females, and combined sexes, except the height of pectoral-fin (PFH), and pelvic-fin base length (PelFL); whereas, meristic characters were found to be constant and indicate weak or negative type correlations (r0.50; p>0.05) with total length (TL). Hence, according to our present results, there is a direct relationship between the total length of fish and all morphometric characters, which were found to be the best indicators of positive allometric pattern growth in fish. Moreover, analysis of the 2-sample t-test revealed (t-test; p>0.05) that no sexual dimorphism was reported in Alepes vari. Thus, our present study could be valuable in systematic classification, sexual dimorphism, and management of this species on the Karachi coast.

Resumo O presente estudo examina as correlações entre 15 caracteres morfométricos e 10 caracteres merísticos e comprimento total (CT) de machos, fêmeas e sexos combinados de Alepes vari (Cuvier, 1833), coletados do porto de Karachi, West Wharf, na costa de Karachi. As análises estatísticas das relações de regressão linear mostraram, principalmente, correlações fortes (r 0,70; p 0,05) entre o CT e a maioria dos caracteres morfométricos em machos, fêmeas e sexos combinados, exceto a altura da nadadeira peitoral e o comprimento da base da nadadeira pélvica, enquanto os caracteres merísticos foram constantes, indicando correlações fracas ou negativas (r 0,50; p > 0,05) com o CT. Portanto, de acordo com nossos resultados, existe uma relação direta entre o CT dos peixes e todos os caracteres morfométricos, que foram considerados os melhores indicadores de crescimento do padrão alométrico positivo em peixes. Além disso, a análise do teste t de duas amostras revelou (teste t; p > 0,05) que nenhum dimorfismo sexual foi relatado em A. vari. Assim, o presente estudo pode ser valioso na classificação sistemática, dimorfismo sexual e manejo dessa espécie na costa de Karachi.

Study of some morphometric and meristic characteristics of Alepes vari (Cuvier, 1833) collected from the Arabian coast / Estudo de características morfométricas e merísticas de Alepes vari (Cuvier, 1833) coletados na costa da Arábia

The present study examines the correlations between fifteen morphometric and ten meristic characters and total length (TL) of males, females, and combined sexes of Alepes vari (Cuvier, 1833) collected from Karachi fish harbor, West Wharf of Karachi Coast. Statistical analyses of linear regression relationships show mostly strong correlations (r≥0.70; p<0.05) between total length (TL) and most morphometric characters in males, females, and combined sexes, except the height of pectoral-fin (PFH), and pelvic-fin base length (PelFL); whereas, meristic characters were found to be constant and indicate weak or negative type correlations (r≤0.50; p>0.05) with total length (TL). Hence, according to our present results, there is a direct relationship between the total length of fish and all morphometric characters, which were found to be the best indicators of positive allometric pattern growth in fish. Moreover, analysis of the 2-sample t-test revealed (t-test; p>0.05) that no sexual dimorphism was reported in Alepes vari. Thus, our present study could be valuable in systematic classification, sexual dimorphism, and management of this species on the Karachi coast.

O presente estudo examina as correlações entre 15 caracteres morfométricos e 10 caracteres merísticos e comprimento total (CT) de machos, fêmeas e sexos combinados de Alepes vari (Cuvier, 1833), coletados do porto de Karachi, West Wharf, na costa de Karachi. As análises estatísticas das relações de regressão linear mostraram, principalmente, correlações fortes (r ≥ 0,70; p < 0,05) entre o CT e a maioria dos caracteres morfométricos em machos, fêmeas e sexos combinados, exceto a altura da nadadeira peitoral e o comprimento da base da nadadeira pélvica, enquanto os caracteres merísticos foram constantes, indicando correlações fracas ou negativas (r ≤ 0,50; p > 0,05) com o CT. Portanto, de acordo com nossos resultados, existe uma relação direta entre o CT dos peixes e todos os caracteres morfométricos, que foram considerados os melhores indicadores de crescimento do padrão alométrico positivo em peixes. Além disso, a análise do teste t de duas amostras revelou (teste t; p > 0,05) que nenhum dimorfismo sexual foi relatado em A. vari.

Efecto de factores sociodemográficos en la mortalidad del COVID-19 en Costa Rica: un enfoque geográfico

Introducción: La enfermedad por coronavirus (COVID-19) se ha extendido entre la población de todo el país y ha tenido un gran impacto a nivel mundial. Sin embargo, existen diferencias geográficas importantes en la mortalidad de COVID-19 entre las diferentes regiones del mundo y en Costa Rica. Objetivo: Explorar el efecto de algunos de los factores sociodemográficos en la mortalidad de COVID-19 en pequeñas divisiones geográficas o cantones de Costa Rica. Métodos: Usamos registros oficiales y aplicamos un modelo de regresión clásica de Poisson y un modelo de regresión ponderada geográficamente. Resultados: Obtuvimos un criterio de información de Akaike (AIC) más bajo con la regresión ponderada (927.1 en la regresión de Poison versus 358.4 en la regresión ponderada). Los cantones con un mayor riesgo de mortalidad por COVID-19 tuvo una población más densa; bienestar material más alto; menor proporción de cobertura de salud y están ubicadas en el área del Pacífico de Costa Rica. Conclusiones: Una estrategia de intervención de COVID-19 específica debería concentrarse en áreas de la costa pacífica con poblaciones más densas, mayor bienestar material y menor población por unidad de salud.

Introduction: The coronavirus disease (COVID-19) has spread among the population of Costa Rica and has had a great global impact. However, there are important geographic differences in mortality from COVID-19 among world regions and within Costa Rica. Objective: To explore the effect of some sociodemographic factors on COVID-19 mortality in the small geographic divisions or cantons of Costa Rica. Methods: We used official records and applied a classical epidemiological Poisson regression model and a geographically weighted regression model. Results: We obtained a lower Akaike Information Criterion with the weighted regression (927.1 in Poisson regression versus 358.4 in weighted regression). The cantons with higher risk of mortality from COVID-19 had a denser population; higher material well-being; less population by health service units and are located near the Pacific coast. Conclusions: A specific COVID-19 intervention strategy should concentrate on Pacific coast areas with denser population, higher material well-being and less population by health service units.

A Nonlinear Identification Approach for Gait Analysis of Amyotrophic Lateral SclerosisPatients

Gait data analysis, is giving mixing results regarding locomotion changes associated to Amyotrophic Lateral Sclerosis (ALS) development; the need has been claimed for new tools. We applied a nonlinear identification approach to the study of gait data from both healthy and ALS patients, available from Physionet.org. Kernel nonparametric nonlinear autoregression allowed to obtain noise-free realizations (NFR) that mimicked original traces, though correlation between original data and corresponding NFR was lower among ALS patients (p=0.03), suggesting a higher contribution of stochastic influences. Visual inspection of phase portraits, reconstructed from NFR via Takens theorem application, suggested dynamics differences between control subjects and patients. This was confirmed when phase portrait features were quantified and submitted to discriminant analysis (89% of correct classifications; 24/28). Application of a nonlinear dissimilarity measure for comparing pairs gait recordings, defined as a distance between underlying nonlinear autoregressive functions allowed an excellent separation between ALS and controls, via multidimensional scaling. Obtained projection map clearly suggested that ALS traces lay in a narrower dynamical space. This might reflect the known fact about neuronal degeneration accompanying ALS progression. When dissimilarity matrix principal components were introduced as predicting variables, discriminant analysis yielded an 82% of correct classifications (23/28). Overall, our results suggest that a nonlinear identification approach, centered in the characterization of the dynamics of the gait process can bring new insights to gait data interpretation.

El análisis de datos de la marcha, está dando resultados mixtos con respecto a los cambios de locomoción asociados con el desarrollo de la esclerosis lateral amiotrófica (ELA). Se ha reivindicado la necesidad de nuevas herramientas de análisis de datos de la marcha. Aplicamos un enfoque de identificación no lineal al estudio de los datos de la marcha de pacientes sanos y con ELA, disponibles en Physionet.org. La auto-regresión no lineal no paramétrica del núcleo, permitió obtener realizaciones libres de ruido (NFR) que imitaban las trazas originales, aunque la correlación entre los datos originales y la NFR correspondiente fue menor entre los pacientes con ELA (p = 0,03), lo que sugiere una mayor contribución de las influencias estocásticas. La inspección visual de los retratos de fase, reconstruidos a partir de NFR mediante la aplicación del teorema de Takens, sugirió diferencias dinámicas entre los sujetos de control y los pacientes. Esto se confirmó cuando se cuantificaron las características del retrato de fase y se sometieron a un análisis discriminante (89 % de clasificaciones correctas; 24/28). La aplicación de una medida de disimilitud no lineal para comparar registros de marcha de pares, definida como una distancia entre funciones auto-regresivas no lineales subyacentes, permitió una excelente separación entre ALS y controles, a través de una escala multidimensional. El mapa de proyección obtenido sugirió claramente que las huellas de ALS se encuentran en un espacio dinámico más estrecho. Esto podría reflejar el hecho conocido sobre la degeneración neuronal que acompaña a la progresión de la ELA. Cuando se introdujeron los componentes principales de la matriz de disimilitud como variables predictoras, el análisis discriminante arrojó un 82% de clasificaciones correctas (23/28). En general, nuestros resultados sugieren que un enfoque de identificación no lineal, centrado en la caracterización de la dinámica del proceso de la marcha, puede aportar nuevos conocimientos a la interpretación de los datos de la marcha.

Algorithm for pediatric orbital blowout fractures: a 20-year retrospective cohort study

Abstract Objective Pediatric orbital blowout fractures can include pathologies that seem mild but require urgent release; serious sequelae can occur with standby surgery or conservative treatment. We sought to validate an algorithm for the treatment of pediatric orbital blowout fractures. Methods This retrospective cohort study included 61 pediatric patients, aged 18 years or younger, treated for pure orbital blowout fractures according to the algorithm from April 1, 2000, to August 31, 2020, at the Japanese Red Cross Asahikawa Hospital. Results There were 52 males (85%). Median age was 14 years (range, 5-18 years). There were 9 patients categorized as needing urgent release, 16 as needing repair, and 36 as needing conservative treatment. Mean follow-up ocular movement was 98.0 (95% Confidence Interval [95% CI], 96.8-99.2). Postoperative diplopia was not observed in 96% (79.6%-99.9%) of patients, better than in previous studies. A higher proportion of patients aged 0-12 years needed urgent repair than those aged 13-18 years (Odds Ratio [OR] = 14.2; 95% CI 1.6-683.4; p= 0.0046). There were no differences in Hess area ratio by age group. Conclusion Clinical results with the algorithm were satisfactory. The algorithm is suitable for treatment of pediatric orbital blowout fractures. Level of evidence 4.

HEATING TANK SYSTEM FAULT DIAGNOSTIC MECHANISM USING KERNEL PRINCIPAL COMPONENT ANALYSIS

Nowadays, global industry is witnessing the explosion of exible manufacturing systems considered as key role for the fourth industrial revolution. Almost hardware and software producers tried their best to assure the best performance for those system. However, some chemical processes in particular requires more strict conditions beside high-accuracy operation of actuators. Chemical reactions may lead to a poor quality for output product even a small change. Therefore, beside the necessary of high-performance integrated control system, monitoring operation should be fast and correct enough to detect and isolate faults when any problems happened in system. In this paper, a method for process fault detection and diagnostic based on data-driven estimation is investigated. In this method, the process fault is detected based on the error between process model response and process response. The Kernel Principal Component Analysis (KPCA) is utilized to classify errors for fault diagnostic. In this research, the method is veried on Stirred-Tank Heating Process. The simulation results demonstrate the effectiveness of proposed method

Analysis of Association of Brain Natriuretic Peptide Levels and Blood Pressure Variability

Objective: The present study aimed to investigate the relationship between brain natriuretic peptide (BNP) levels and blood pressure variability among hypertensive patients aged over 40 years. Methods: The study recruited 120 patients from a cardiology outpatient clinic who had been diagnosed with hypertension and taking antihypertensive medication for at least 6 months. Demographic and clinical information, blood pressure measurements, and blood samples were collected to measure BNP levels. The standard deviation of the mean arterial pressure over 24 hours was calculated as a measure of blood pressure variability. Linear regression was used to examine the association between BNP levels and blood pressure variability while controlling for age, sex, BMI, and medication history. Results: The study found a significant positive association between BNP levels and blood pressure variability (?=0.31, p=0.002), even after controlling for other variables. The linear regression model explained 20% of the variance in blood pressure variability (R2=0.20, F=9.52, p<0.001). Conclusion: The findings suggest that higher BNP levels are associated with increased blood pressure variability among hypertensive patients. Further studies are needed to explore the underlying mechanisms and the potential implications of this association.

Evaluación de los indicadores demográficos de Pocillopora (Scleractinia: Pocilloporidae) en sitios insulares vs. costeros: implicaciones para un programa de restauración regional

Introducción: El mantenimiento de las comunidades coralinas depende directamente de la capacidad de los individuos para crecer como colonia. Dado que el crecimiento forma la base de la estructura física del arrecife, determinar la tasa de crecimiento de las especies de corales constructores y su respuesta a las variaciones ambientales nos permitirá identificar su potencial particular para implementar estrategias de restauración más efectivas. Objetivo: Determinar la tasa de crecimiento del coral constructor de arrecifes Pocillopora en todo el Pacífico Central Mexicano (PCM) y su relación con las fluctuaciones en las condiciones ambientales. Métodos: De agosto de 2019 a octubre de 2020, se monitorearon y trasplantaron un total de 153 fragmentos de coral ramificado del género Pocillopora como parte del programa de restauración en diferentes sitios de la PCM: Parque Nacional Islas Marietas y en la Caleta de Cuastecomates. Se calculó el crecimiento del coral (cm·año-1) y sobrevivencia (%), y se correlacionó con la temperatura, PAR y Kd490 para cada localidad. Resultados: Patrones similares en los parámetros examinados entre los fragmentos de coral fueron encontrados para todos los sitios, con un rango de sobrevivencia de 61.6 - 68 %, cuya mortalidad estuvo relacionada principalmente con huracanes y tormentas que afectaron la región. Sin embargo, la tasa de crecimiento oscila entre 2.0 - 8.0 cm·año-1, sin diferencias significativas entre localidades. Además, no se registraron diferencias en las condiciones ambientales entre las localidades. Conclusiones: Los corales ramificados del género Pocillopora presentan una tasa de crecimiento similar en sitios insulares y costeros de la PCM, por lo que se podría esperar que la implementación de un programa de restauración en toda esta región del Pacífico Mexicano sería potencialmente exitoso, ya que, las condiciones ambientales locales no son factores limitantes.

Introduction: The maintenance of the coral communities depends directly on the capacity of the individuals to grow as a whole colony. Since growth shapes the basis of the physical structure of the reef, determining the growth rate of builder coral-species and their response to environmental variations will allow us to identify their particular potential to implement more effective restoration strategies. Objective: To determine the growth rate of the reef-building coral Pocillopora throughout the Mexican Central Pacific (PCM) and its relationship with fluctuations in environmental conditions. Methods: From August 2019 - October 2020, a total of 153 branched coral fragments of the genus Pocillopora were monitored and transplanted as part of the restoration program in different PCM locations: Islas Marietas National Park and in the Caleta de Cuastecomates. Coral growth (cm·year-1) and survival rate (%), was calculated and correlated with temperature, PAR and Kd490 for each locality. Results: The results show similar patterns in the parameters examined among the coral fragments were found for all sites, with a survival range of 61.6 - 68 %, whose mortality was mainly related to hurricanes and storms that affected the region. However, growth rate range from 2.0 - 8.0 cm·year-1, with no significant differences between locations. Also, no differences in environmental conditions between locations were recorded. Conclusions: The branching corals of the genus Pocillopora present a similar growth rate in insular and coastal sites of the PCM, so it could be expected that the implementation of a restoration program throughout this region of the Mexican Pacific would be potentially successful, since local environmental conditions are not limiting factors.

Preliminary studies on microbial induced corrosion of ferrous materials (EN-8 and 411143 steels) in the presence of Acidithiobacillus ferrooxidans

An electrochemical investigation was conducted to evaluate the corrosion behaviour of Iron alloys such as EN-8 and 411143 in absence and in presence of microbes Acidithiobacillus ferrooxidans. Linear polarization technique was employed to measure the Polarization Resistance and corrosion rates of two different ferrous metal samples. Polarization resistance (Rp) values of EN-8 were initially higher in the presence of Acidithiobacillus ferrooxidans than the values of 411143. Growth rate of the Acidithiobacillus ferrooxidans was more and sustained longer period with EN-8 in the presence of media than in the case of alloy ‘411143’. It was observed that there was a 1.5 fold increase in corrosion rate in both the cases of EN-8 and 411143 in the presence of bacteria.High corrosion rates were recorded with the steel 41143 rather than the En-8 with respect to the optical density of the microbes. It was concluded that EN-8 was exhibited high resistance to the microbial attack.

Linear trends over 20 years in sexually transmitted infections among patients attending a tertiary care centre in north Kerala, India

Background: Worldwide, a declining trend is observed in sexually transmitted infections of bacterial origin which is reflected as a rise in the proportion of viral sexually transmitted infections. Aims: To find out the clinical referral patterns of sexually transmitted infections among patients who attended the sexually transmitted infection clinic attached to Dermatology and Venereology Department of Government Medical College, Kozhikode from 1.1.1998 to 31.12.2017 and to study the linear trends in the pattern of sexually transmitted infections over 20 years. Methods: After clearance from the institutional ethics committee, a retrospective study was conducted among patients who attended the sexually transmitted infection clinic of Government Medical College, Kozhikode from 1.1.1998 to 31.12.2017 and were diagnosed to have sexually transmitted infections. Results: During the 20 year study period 5227 patients, attended the sexually transmitted infection clinic of our institution. Diagnosis of sexually transmitted infection was made in 2470 (47.3%) cases. Predominant sexually transmitted infections were herpes genitalis (964, 39%), condyloma acuminata (921, 37.9%) and syphilis (418, 17.2%). Viral sexually transmitted infections (1885, 76.3%) outnumbered bacterial sexually transmitted infections (575, 23.3%). A declining trend was noted for both bacterial and viral sexually transmitted infections over the 20 year period, which was more marked for the former. But the latter years of the study documented a rising trend in total sexually transmitted infections including bacterial sexually transmitted infections. Limitations: The study does not reflect the status of sexually transmitted infections in the general population since it was conducted in a tertiary referral center. Conclusion: The disturbing ascending trend recorded in sexually transmitted infections including syphilis during the final years of the 20-year period needs to be watched closely, to plan future strategies

A Study to Analyse Covid-19 Outbreak Using Multiple Linear Regression: A Supervised Machine Learning Approach

Introduction: Globally, COVID-19 have impacted people's quality of life. Machine learning have recently be-come popular for making predictions because of their precision and adaptability in identifying diseases. This study aims to identify significant predictors for daily active cases and to visualise trends in daily active, posi-tive cases, and immunisations. Material and methods: This paper utilized secondary data from Covid-19 health bulletin of Uttarakhand and multiple linear regression as a part of supervised machine learning is performed to analyse dataset. Results: Multiple Linear Regression model is more accurate in terms of greater score of R2 (=0.90)as com-pared to Linear Regression model with R2=0.88. The daily number of positive, cured, deceased cases are signif-icant predictors for daily active cases (p <0.001). Using time series linear regression approach, cumulative number of active cases is forecasted to be 6695 (95% CI: 6259 - 7131) on 93rd day since 18 Sep 2022, if simi-lar trend continues in upcoming 3 weeks in Uttarakhand. Conclusion: Regression models are useful for forecasting COVID-19 instances, which will help governments and health organisations to address this pandemic in future and establish appropriate policies and recom-mendations for regular prevention.

Visual Contribution to Motor Skill DCD Disorders & Walking Physiology Using Spatial Cognition and Linear Geometries as Landmark Coordination Cues

Problem: Awareness of children, who experience movement, particularly motor coordination difficulties, has increased dramatically over the last ten years. These motor coordination problems of children with Developmental Coordination Disorder (DCD) or/and Attention-Deficit / Hyperactivity Disorder (ADHD) have been frequently associated with poor visual and spatial eye-vision processing.Background: Motor control difficulties for DCD and ADHD children have been discussed in detail. However, just a little is known about the influence of the natural environment on these disorders. Even more, the built environment’s impact as a spatial cognition and coordination functionality has never been considered.Aim: This pilot and innovative study aim to identify the correlation between and evaluate the visual contribution of the so-called “spatial compound linear geometries” and DCD children’s motor/walking control.Methodology: Twenty children aged 5 to 8 years with DCD difficulties (two intervention groups, one with 10 boys and the other one with 10 girls) were assessed by a statistical structural evaluation in three built environments (two urban parks and one pocket park), under two conditions (rich or not in trees, flora, and PnP linear geometries), and different motor coordination control situations (static balance, dynamic balances, dark condition).Results: The worst performances (regarding movement disorders and motor coordination problems) were observed for both groups with DCD children playing in parks poor in or without trees, flora, and spatial compound linear geometries. Instead, a significant performance (strong statistical correlation) was found for the same intervention group (DCD children’s boys or girls) playing in parks rich in trees, flora, and vegetation (natural environment). The best performance (very strong statistical correlation) was detected in parks rich in a natural environment and linear geometries. Conclusions: While the natural environment contribution is bibliographically known, the best performance finding of the visual contribution of the spatial compound linear geometries, as spatial landmarks enriching the visual-spatial motor/walking functionalities for Children with DCD disorder, could provide new cognitive approaches towards an understanding of children’s Developmental Coordination Disorder and walking physiology. DCD children’s performance, scores, and cues were related to both the natural environment and the spatial compound linear geometries as spatial landmark motor coordination cues and spatio-temporal clues. The significant variability in sensory processing among children with DCD, ADHD, and co-occurring symptoms can contribute to understanding how neurological and social factors correlate across diagnoses. Also, derived observations for stepping errors, Gait analysis (variables), and spatio-temporal clues conclude that visual eye-based processing interrelates with motor coordination problems, performance, inattention, environmental conditions (dark), sex identity (boys, girls), and DCD hyperactivity. Applications: Development of interactive visual applications for (i) human spatial cognition and movement improvement; and (ii) children’s motor control and coordination refinement.

Relationship between polycyclic aromatic hydrocarbons internal exposure and lung function change among healthy college students / 中国学校卫生

Objective@#To investigate the relationship between urinary monohydroxylated metabolites of hydroxyl polycyclic aromatic hydrocarbons (OH-PAHs) and lung function, as well as the role of oxidative stress in these associations, so as to provide a scientific basis for air pollution control and policy formulation.@*Methods@#A panel study was carried out among 45 young healthy adults. Four follow up surveys and health examinations were conducted from November 2017 to October 2018 to measure lung function parameters [forced vital capacity (FVC), second forced expiratory volume in one second (FEV1), peak expiratory flow (PEF), FEV1/FVC, and forced expiratory flow between 25% and 75% vital capacity (FEF 25%~75% )], markers of exposure to 7OHPAHs [∑ 7OH PAHs], and markers of oxidative stress[8 hydroxy 2 deoxyguanosine (8 OHdG) and 8 isoprostaglandin F 2α (8 iso PGF 2α )]. The relationship between urinary PAH metabolites and lung function was quantified by linear mixed effects models. Mediation analysis was performed to assess the role of oxidative stress in the relationship between OH PAHs and lung function.@*Results@#The median values of FVC, FEV1, FEVI/FVC, PEF, and FEF 25%-75% were 4.37 L, 3.58 L, 83.00%, 4.38 L/s, and 3.32 L/s, respectively. The results showed that each 1 unit increase in log transformed value of 2 Hydroxyfluorene (2 OHFlu) was associated with a 5.05% decrease ( β %=-5.05%，95% CI =-8.85%--1.09%) in FVC, 4.15% decrease ( β %=-4.15%，95% CI =-7.94%- -0.22% ) in FEV1 and 5.87% decrease ( β %=-5.87%，95% CI =-11.35%--0.05%) in FEF 25%-75% , respectively. Each 1 unit increase in log transformed values of 2 OHFlu and 9 Phenanthrol (9 OHPhe) was associated with a 7.03% decrease ( β %=-7.03%，95% CI =-12.60%--1.11%) and a 7.08% decrease ( β%=-7.08%，95% CI =-13.50%--0.17%) in PEF, respectively. Additionally, urinary ∑ 7OH PAHs had a positive correlation with the levels of urinary 8 OHdG and 8 iso PGF 2α ( r =0.64, 0.69, P <0.01). Meanwhile, the levels of 8 OHdG mediated 17.06% and 15.71% of the association between 2 OHFlu with FVC and FEV1.@*Conclusion@#The finding reveales a negative relationship between urinary OH PAHs and lung function among young healthy adults. The 8 OHdG plays a mediated role in the correlation of 2 OHFlu with FVC and FEV1. Active relevant policies are needed to control air pollution and maintain the healthy living conditions of young people.

Analysis of factors influencing the medical insurance balance of hospitalization expenses for gastric cancer surgery patients under DRG payment / 中华医院管理杂志

Objective:To analyze the influencing factors of the medical insurance balance of hospitalization expenses for gastric cancer surgery patients under DRG payment, for reference for promoting the reform of DRG payment in public hospitals and controlling hospitalization expenses reasonably.Methods:The gastric cancer patients enrolled in the gastroenterology department of a tertiary comprehensive hospital from January to July 2022 were selected as the research subjects. The indicators such as patient age, medical insurance balance, hospitalization expenses and their composition were extracted from the hospital information management system and the medical insurance settlement system a certain city. Descriptive analysis was conducted for all data, and stepwise multiple linear regression was used to analyze the influencing factors of patients′ medical insurance balance. Monte Carlo simulation method was used to simulate different combination scenarios of various influencing factors to analyze the probability of medical insurance balance.Results:A total of 205 patients were contained, including 117 in the medical insurance balance group and 88 in the loss group. The difference in hospitalization expenses and medical insurance balance between the two groups of patients were statistically significant ( P<0.05). The intervention of medical insurance specialists, correct DRG enrollment, parenteral nutrition preparation costs, anti infective drug costs, examination costs, and consumables costs were the influencing factors of patient medical insurance balance ( P<0.05). Through Monte Carlo simulation verification, patients with different cost parenteral nutrition preparations, or different anti infective drug schemes had the higher probability of medical insurance balance in the scenario where the medical insurance commissioner intervenes and the DRG enrollment was correct. Conclusions:The hospital adopted interventions from medical insurance specialists to ensure the correct DRG enrollment of patients, accurate use of parenteral nutrition and anti infective drugs, and reasonable control the cost of examinations and consumables, which could increase the probability of medical insurance balance for gastric cancer surgery patients. In the future, hospitals should further promote the procurement of drug consumables in bulk, reduce unnecessary examinations, develop standardized perioperative nutritional interventions and anti infection treatment pathways, ensure the accuracy of DRG enrollment, optimize clinical diagnosis and treatment pathways to improve the efficiency of medical insurance fund utilization and provide high-quality medical services for patients.

Neonatal linear IgA bullous dermatosis / 中华皮肤科杂志

A 10-day-old male infant presented with skin erythema and blisters for 6 days. Skin examination showed scattered or confluent erythema all over the body, tense blisters of varying sizes on the normal skin or an erythematous base, and some blisters were ulcerated and erosive; bloody bullae and erythematous erosive patches could be seen on the oral mucosa. Histopathological examination revealed subepidermal blisters, and there were some neutrophils and a few eosinophils in the blisters. Direct immunofluorescence assay showed homogeneous linear IgA and granular C3 deposits along the basement membrane zone, without IgG deposits. The diagnosis of neonatal linear IgA bullous dermatosis was confirmed. After comprehensive treatments including nutritional support and anti-infection treatment, skin erythema and blisters subsided, and the mucosal damage was attenuated. The telephone follow-up 16 months after discharge showed that the infant was in good general condition with normal growth and development, and the oral mucosal lesions had subsided and healed, without new skin lesions.

Use of magnetic resonance scanner with a linear accelerator during precision radiotherapy for breast cancer / 中华放射肿瘤学杂志

Magnetic resonance-guided radiotherapy (MRgRT) not only offers real time magnetic resonance (MR) imags with high-resolution and good soft tissue contrast to guide the delineation of the target volume during simulation and daily radiotherapy, but also reveals the position and shape changes of the target volumes and organs at risk (OAR) during treatment dynamically, which provides the evidence for the individual-adptive planning revision. Thus, MRgRT has the potential to dramatically impact cancer research and treatment. And this treatment mode is theoretically more suitable for the disease with obvious tissue deformation, such as breast. In this review, application of MR scanner with a linear accelerator (MR-linac) in radiotherapy workflows for breast cancer patients was summarized, and its implications and opportunities on breast cancer irradiation were highlighted.

The remote training system for quality assurance of medical electronic linear accelerators based on extended reality technology / 中华放射肿瘤学杂志

Objective:To improve the quality assurance (QA) skills of radiotherapy personnel and medical students and reduce the radiation risk of training by developing a remote training system for QA of medical electronic linear accelerators.Methods:This training system was built based on radiotherapy technology and quality control contents of medical electronic linear accelerators, and a virtual reality interactive software was developed using extended reality (XR) technology Unity 3D. A remote control module of multi-terminal platform was also developed. A multi-perspective evaluation system was adopted and a questionnaire was designed to analyze the application value of this system.Results:The training system reproduced the live environment and physical objects of medical electronic linear accelerator treatment room. It built a multi-terminal virtual simulation training system with radiotherapy technology as well as QA knowledge system. This system could provide 5G remote control of medical electronic linear accelerator for off-site quality control demonstration and guidance. By March 1, 2022, a total number of 133 people had been trained using this system, 76 valid questionnaires had been taken, of which 90.79% (69/76) of the respondents trusted the experimental results shown by the system and 88.16% (67/76) of the respondents considered the training system necessary.Conclusions:The training effect of this system is widely recognized. It fundamentally reduces the training radiation hazard and provides reference for the reform and progress of QA training mode of medical electronic linear accelerators.

Influence of selection of domain shape on parameters of microdosimetric kinetic model / 中华放射医学与防护杂志

Objective:To calculate the single-event dose-averaged specific energy of particles delivered in spherical domains based on the track structure model and using triple integration, and to investigate the influence of the domain shape on the key model parameters of microdosimetric kinetic model (MKM) and its corresponding physical significance.Methods:The domains are assumed to be cylinders and spheres, respectively. With α 0, domain radius, rd, and nucleus radius, Rn, as undetermined coefficients, the nuclear charge numbers, kinetic energies and their corresponding LETs of three kinds of charged particles ( 3He, 12C, 20Ne) as independent variables, D10 as dependent variable, the mean value of squared residuals, J2, between the D10 calculated values and D10 experimental values as the optimization objective, the final fitting values of the above undetermined coefficients of human salivary gland (HSG) cells and Chinese hamster lung (V79) cells obtained after iteration by the robust least square method are the optimal model parameter values of MKM. Results:For HSG cells, cylindrical domain: α 0=0.073/Gy, rd=0.29 μm, Rn=4.1 μm, J2=0.039 7 Gy 2; spherical domain: α 0=0.023/Gy, rd=0.29 μm, Rn=4.4 μm, J2=0.039 3 Gy 2; For V79 cells, cylindrical domain: α 0=0.114/Gy, rd=0.25 μm, Rn=3.8 μm, J2=0.097 4 Gy 2; spherical domain: α 0=0.095/Gy, rd=0.26 μm, Rn=4.1 μm, J2=0.096 9 Gy 2. Conclusions:For the same type of cells, cylindrical and spherical domains were selected respectively, and there are significant differences in MKM parameters obtained by fitting. The fitting values of the domain radius, rd of the two shapes of domains show no significant difference, while the fitting values of α0 of spherical domains are smaller than those of cylindrical domains, the fitting values of nucleus radius, Rn, of spherical domain are larger than those of cylindrical domains, closer to the nucleus radius observed by fluorescence microscopy. In the low LET (<20 keV/μm) region, D10 calculated according to the parameters of the two different shapes of domains are different, so the selection of the domain shape will cause differences in the relative biological effectiveness(RBE) calculation of proton in the region near Bragg peak.