High-time resolution PM2.5 source apportionment assisted by spectrum-based characteristics analysis.

Characteristics extraction and anomaly analysis based on frequency spectrum can provide crucial support for source apportionment of PM2.5 pollution. In this study, an effective source apportionment framework combining the Fast Fourier Transform (FFT)- and Continuous Wavelet Transform (CWT)-based spectral analyses and Positive Matrix Factorization (PMF) receptor model is developed for spectrum characteristics extraction and source contribution assessment. The developed framework is applied to Beijing during the winter heating period with 1-h time resolution. The spectrum characteristics of anomaly frequency, location, duration and intensity of PM2.5 pollution can be captured to gain an in-depth understanding of source-oriented information and provide necessary indicators for reliable PMF source apportionment. The combined analysis demonstrates that the secondary inorganic aerosols make relatively high contributions (50.59 %) to PM2.5 pollution during the winter heating period in Beijing, followed by biomass burning, vehicle emission, coal combustion, road dust, industrial process and firework emission sources accounting for 15.01 %, 11.00 %, 10.70 %, 5.31 %, 3.88 %, and 3.51 %, respectively. The source apportionment result suggests that combining frequency spectrum characteristics with source apportionment can provide consistent rationales for understanding the temporal evolution of PM2.5 pollution, identifying the potential source types and quantifying the related contributions.

Inverse identification of pollution source release information for surface river chemical spills using a hybrid optimization model.

To evaluate the liability of the spilled contaminant and to design comprehensive emergency response schemes, it is essential to estimate the contaminant source characteristic and identify where, when and how much the spilled contaminant is injected into a surface river. In this study, an effective pollution source inverse method is developed to reconstruct the release history of the injection location, time, and quantity, and provide appropriate emergency response schemes for dealing with surface river environmental pollution. The pollution source inverse method IGSAA is developed by an integration of genetic algorithm (IGA) and simulated annealing algorithm (SAA) in order to guarantee both the global searching ability and convergence speed. The pollution source inverse method IGSAA is then applied to a hypothetical study, comparing with the traditional GA-based and SAA-based methods, to verify the accuracy and efficiency of the contaminant source inverse, and to a trace study of Truckee River in west America to identify the contaminant source release history and characteristic under different scenarios. The pollution source inversion results can help decision-makers (DMs) to identify the contaminant source characteristics of a chemical spill, and carry out emergency disposal scheme for an emergency rescue in a quick response, and enhance the supervision and management ability for a real surface river system.

Clinical Efficacy of Cortex Daphnes (Zushima) Patch in Patients With Symptomatic Knee Osteoarthritis: A Multicenter Non-Inferiority Randomized Controlled Clinical Trial.

Background: Osteoarthritis (OA) is imposing substantial burdens on individuals and society with the aging population. Cortex Daphnes patch is widely used for symptomatic knee OA in China with a satisfying clinical efficacy; however, there is scant clinical evidence supporting its use. To evaluate its efficacy, we conducted a multicenter, non-inferiority, randomized, parallel-group study comparing Cortex Daphnes patch with topical nonsteroidal anti-inflammatory drugs in patients with knee OA (NCT02770950). Methods: A total of 264 symptomatic knee OA patients were treated with Cortex Daphnes or indomethacin cataplasms applied to affected sites once daily for 2 weeks. The primary outcome was improvement in knee pain on walking as assessed using a visual analog scale (VAS). The non-inferiority margin based on the full analysis population was set as -5 mm on the pain VAS. The secondary outcomes were changes of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) total score, WOMAC scores for pain, function and stiffness, the 36-item Short Form Health Survey (SF-36), and global assessment of knees by the patients. Responder rates for pain VAS, WOMAC total score, and WOMAC pain were also included in the secondary outcomes. Results: The Cortex Daphnes patch was non-inferior to indomethacin cataplasms for the primary outcome with a group difference (Cortex Daphnes patch-indomethacin cataplasm) of 2.1 mm (95% confidence interval: 2.1-6.4); similar results were found in the per-protocol population. For all other outcomes, no significant differences were found in the full analysis set or in the per-protocol analysis set, except the responder rates for WOMAC pain was higher in the Cortex Daphnes patch group than in the indomethacin cataplasm group (78.4 vs. 64.7%, p = 0.022) in the per-protocol analysis set. Overall, 28.8% patients in the Cortex Daphnes patch group and 9.8% in the indomethacin cataplasm group reported treatment-related adverse events, the vast majority of which were mild-to-moderate skin irritation, resulting in only 3.8 and 0.8% of patients dropping out, respectively. Conclusion: The Cortex Daphnes patch, which provides satisfactory analgesic efficacy and enhances the physical function of the knee, as well as improving quality of life, may be a promising alternative to knee OA.

Coexistence of Crohn's disease and systemic lupus erythematosus: a case report and literature review.

Lupus enteritis and Crohn's disease are two common immune diseases involving the gastrointestinal tract. There are many similar clinical manifestations, therefore it is very difficult to distinguish between them. The digestive system is involved anywhere from 8 to 40% of patients with systemic lupus erythematosus (SLE) and up to 53% of these go on to develop lupus enteritis. In patients with Crohn's disease, 6-40% were presented with oral mucosa ulceration, nodular erythema of skin, arthritis, eye disease and other extraintestinal manifestations. The concomitant of Crohn's disease and SLE is extremely rare; however, here we described a case of concomitant Crohn's disease and SLE characterized by recurrent intestinal obstruction. A systematic literature review of lupus concomitant with Crohn's disease was then conducted.

Emergency material location-allocation planning using a risk-based integration methodology for river chemical spills.

It is critical for emergency material preparedness in the pre-accident phase to provide location-allocation planning and improve rescue capacity in an effective emergency response time due to increasing frequency of river chemical spills. In this study, an effective two-stage evaluation and selection framework is developed integrating fuzzy multi-criteria decision-making (MCDM) method and multi-objective optimization model to obtain the optimal emergency material location-allocation (EMLA) scheme for coping with river chemical spills. In the evaluation stage, the emergency material warehouse alternatives are evaluated by a fuzzy TOPSIS method based on environmental risk assessment. In the selection stage, the EMLA optimization scheme is identified by a multi-objective optimization model to allocate emergency materials for all the risk sources in a time-effective manner. The two-stage evaluation and selection framework is then applied in Jiangsu province, China. The EMLA optimization scheme finally selects the best five emergency material warehouses (WZ1, WZ 4, WZ 5, WZ 18, and WZ 25) for Jiangsu province with the relative closeness 0.6014, 0.4676, 0.5179, 0.3360, and 0.2935, respectively. The EMLA results demonstrate that the developed framework could obtain EMLA optimization scheme with the objective of minimum emergency rescue points and maximum integrative rescue abilities and provide all the risk resources emergency materials in a quick response for river chemical spills in the pre-accident phase.

Successful treatment of adult-onset still disease caused by pulmonary infection-associated hemophagocytic lymphohistiocytosis: A case report.

BACKGROUND: Adult-onset still disease (AOSD) and hemophagocytic syndrome (HPS) are two inflammatory diseases with very similar clinical manifestations. HPS is one of the most serious complications of AOSD and its risk of death is very high. It is difficult to identify HPS early in patients with AOSD, but early identification and proper treatment directly affects the prognosis. CASE SUMMARY: A 39-year-old male showed a high spiking fever and myalgia. Laboratory data revealed elevated white blood cell, serum ferritin, and neutrophil percentage. However, his fever failed to relieve after a clear diagnosis of AOSD caused by pulmonary infection and treatment by antibiotics and corticosteroids; further laboratory data showed elevated serum ferritin, C-reactive protein, erythrocyte sedimentation rate and triglyceride, as well as liver abnormalities. Bone marrow smear showed hemophagocytosis. Secondary HPS was definitely diagnosed. The high fever disappeared and the laboratory findings returned to normal values after treatment by high-dose intravenous methylprednisolone and methotrexate. CONCLUSION: For AOSD patients with high suspicion of HPS, active examination needs to be considered for early diagnosis, and timely using of adequate amount of corticosteroids is the key to reducing risk of HPS death.

A data-driven model for real-time water quality prediction and early warning by an integration method.

Due to increasingly serious deterioration of surface water quality, effective water quality prediction technique for real-time early warning is essential to guarantee the emergency response ability in advance for sustainable water management. In this study, an effective data-driven model for surface water quality prediction is developed to analyze the inherent water quality variation tendencies and provide real-time early warnings according to the historical observation data. The developed data-driven model is integrated by an improved genetic algorithm (IGA) for selecting optimal initial weight parameters of neural a network and a back-propagation neural network (BPNN) for adjusting appropriate connection architectures of neural network. First, improved genetic algorithm is used to optimize the reasonable initial weight parameters and prevent the developed model from selecting a local optimal result. Second, BPNN is applied to adjust appropriate connection architectures and identify the features of water quality variation. The developed model is then applied to forecast the surface water quality variations for real-time early warning in Ashi River, China, comparing with simple BPNN model. The prediction results demonstrate that the developed data-driven model can significantly improve the prediction performance both in prediction accuracy and reliability, and effectively provide real-time early warning for emergency response.

Emergency material allocation with time-varying supply-demand based on dynamic optimization method for river chemical spills.

Aiming to minimize the damage caused by river chemical spills, efficient emergency material allocation is critical for an actual emergency rescue decision-making in a quick response. In this study, an emergency material allocation framework based on time-varying supply-demand constraint is developed to allocate emergency material, minimize the emergency response time, and satisfy the dynamic emergency material requirements in post-accident phases dealing with river chemical spills. In this study, the theoretically critical emergency response time is firstly obtained for the emergency material allocation system to select a series of appropriate emergency material warehouses as potential supportive centers. Then, an enumeration method is applied to identify the practically critical emergency response time, the optimum emergency material allocation and replenishment scheme. Finally, the developed framework is applied to a computational experiment based on south-to-north water transfer project in China. The results illustrate that the proposed methodology is a simple and flexible tool for appropriately allocating emergency material to satisfy time-dynamic demands during emergency decision-making. Therefore, the decision-makers can identify an appropriate emergency material allocation scheme in a balance between time-effective and cost-effective objectives under the different emergency pollution conditions.

Emergency material allocation and scheduling for the application to chemical contingency spills under multiple scenarios.

In the emergency management relevant to chemical contingency spills, efficiency emergency rescue can be deeply influenced by a reasonable assignment of the available emergency materials to the related risk sources. In this study, an emergency material scheduling model (EMSM) with time-effective and cost-effective objectives is developed to coordinate both allocation and scheduling of the emergency materials. Meanwhile, an improved genetic algorithm (IGA) which includes a revision operation for EMSM is proposed to identify the emergency material scheduling schemes. Then, scenario analysis is used to evaluate optimal emergency rescue scheme under different emergency pollution conditions associated with different threat degrees based on analytic hierarchy process (AHP) method. The whole framework is then applied to a computational experiment based on south-to-north water transfer project in China. The results demonstrate that the developed method not only could guarantee the implementation of the emergency rescue to satisfy the requirements of chemical contingency spills but also help decision makers identify appropriate emergency material scheduling schemes in a balance between time-effective and cost-effective objectives.

A two-stage optimization model for emergency material reserve layout planning under uncertainty in response to environmental accidents.

In the emergency management relevant to pollution accidents, efficiency emergency rescues can be deeply influenced by a reasonable assignment of the available emergency materials to the related risk sources. In this study, a two-stage optimization framework is developed for emergency material reserve layout planning under uncertainty to identify material warehouse locations and emergency material reserve schemes in pre-accident phase coping with potential environmental accidents. This framework is based on an integration of Hierarchical clustering analysis - improved center of gravity (HCA-ICG) model and material warehouse location - emergency material allocation (MWL-EMA) model. First, decision alternatives are generated using HCA-ICG to identify newly-built emergency material warehouses for risk sources which cannot be satisfied by existing ones with a time-effective manner. Second, emergency material reserve planning is obtained using MWL-EMA to make emergency materials be prepared in advance with a cost-effective manner. The optimization framework is then applied to emergency management system planning in Jiangsu province, China. The results demonstrate that the developed framework not only could facilitate material warehouse selection but also effectively provide emergency material for emergency operations in a quick response.

Effects of cold-damp and hot-damp environment on VEGF and IL-1 expression in joint cartilage cells in adjuvant arthritis in rats.

OBJECTIVE: To study the effects of environmental factors on the degree of injury and expression of vascular endothelial growth factor (VEGF) and interleukin-1 (IL-1) in cartilage cells of the joint in a rat model of adjuvant arthritis (AA). METHODS: SD rats aged 10 months were randomly divided into 4 groups that varied by temperature and humidity housing conditions and induction of AA: a control group, a model group, a cold-damp group, and a hot-damp group. All groups except the control group were induced with AA. After 4 w, VEGF and IL-1 expression in cartilage cells of ankle joints of hind limbs were observed. RESULTS: Mean area, optical density, and numbers of VEGF- and IL-1-positive cells in the model group, the cold-damp group, and the hot-damp group were significantly higher than that of the control group (all P < 0.05). Optical density and positive cell numbers in the cold-damp group and the hot-damp group were significantly higher than that of the model group (all P < 0.05). Optical density and positive cell numbers in the hot-damp group were significantly higher than that of the cold-damp group. Bone in the hot-damp and cold-damp groups was severely injured. CONCLUSION: Environmental factors such as high humidity combined with either high or low temperature increase the severity of damage and expression of VEGF and IL-1 in cartilage cells of joints in rats induced with AA.

Calcification of bilateral ureters: a novel association with systemic lupus erythematosus.

A 16-year-old female patient with systemic lupus erythematosus (SLE) presented with abdominal pain and oliguria, after one month of hospital treatment with methylprednisolone and cyclophosphamide. Computed tomography of the abdomen revealed the calcification of bilateral superior segmental ureteral wall. Computed tomography urography revealed stenosis of bilateral ureters. This calcification may be associated with lupus-induced inflammatory reaction of ureteral endomembrane. By receiving the ureteral catheters, her abdominal pain and oliguria had been completely resolved. After discharge, she underwent the surgery of cutaneous ureterostomy in the local hospital. During two years follow-up, her condition is stable without any symptom of the urinary system.