Short-term ozone exposure and cancer mortality in Brazil: A nationwide case-crossover study.

Exposure to ambient ozone (O3) is linked to increased mortality risks from various diseases, but epidemiological investigations delving into its potential implications for cancer mortality are limited. We aimed to examine the association between short-term O3 exposure and site-specific cancer mortality and investigate vulnerable subgroups in Brazil. In total 3,459,826 cancer death records from 5570 Brazilian municipalities between 2000 and 2019, were included. Municipal average daily O3 concentration was calculated from a global estimation at 0.25°×0.25° spatial resolution. The time-stratified case-crossover design was applied to assess the O3-cancer mortality association. Subgroup analyses by age, sex, season, time-period, region, urban hierarchy, climate classification, quantiles of GDP per capita and illiteracy rates were performed. A linear and non-threshold exposure-response relationship was observed for short-term exposure to O3 with cancer mortality, with a 1.00% (95% CI: 0.79%-1.20%) increase in all-cancer mortality risks for each 10-µg/m3 increment of three-day average O3. Kidney cancer was most strongly with O3 exposure, followed by cancers of the prostate, stomach, breast, lymphoma, brain and lung. The associated cancer risks were relatively higher in the warm season and in southern Brazil, with a decreasing trend over time. When restricting O3 concentration to the national minimum value during 2000-2019, a total of 147,074 (116,690-177,451) cancer deaths could be avoided in Brazil, which included 17,836 (7014-28,653) lung cancer deaths. Notably, these associations persisted despite observed adaptation within the Brazilian population, highlighting the need for a focus on incorporating specific measures to mitigate O3 exposure into cancer care recommendations.

Effects of ultra-high field MRI environment on cognitive performance in healthy participants.

INTRODUCTION: Ultra-high field MRI (UHF MRI) is rapidly becoming an essential part of our toolbox within health care and research studies; therefore, we need to get a deeper understanding of the physiological effects of ultra-high field. This study aims to investigate the cognitive performance of healthy participants in a 7 T (T) MRI environment in connection with subjectively experienced effects. METHODS: We measured cognitive performance before and after a 1-h 7T MRI scanning session using a Digit Symbol Substitution Test (DSST) in 42 subjects. Furthermore, a computer-based survey regarding the subjectively experienced effects in connection with the MRI examination was distributed. Similarly, two DSSTs were also performed by a control group of 40 participants. RESULTS: Even though dizziness was the strongest sensory perception in connection to the MRI scanning, we did not find any correlation between dizziness and cognitive performance. Whilst the control group improved (p=<0.001) on their second DSST the MRI group showed no significant difference (p=0.741) in the DSST before and after MRI scanning. CONCLUSION: Transient effect on cognition after undergoing MRI scanning can't be ruled out as the expected learning effect on the DSST was not observed. IMPLICATIONS FOR PRACTICE: Increasing understanding of the possible adverse effects may guide operators in performing UHF MRI in a safe way and with person-centered care. Furthermore, it can guide researchers in setting up research protocols to minimize confounding factors in their fMRI studies due to the transient adverse effects of the UHF environment.

Comparison of clinical efficacy of da Vinci robot-assisted lung cancer surgery with two-, three- and four-hole approaches.

Orifice reduction strategies for da Vinci robotic surgery have been a hot topic of research in recent years. We retrospectively analyzed the perioperative outcomes of robotic-assisted thoracoscopic surgery (RATS) with two, three, and four-hole approaches in radical lung cancer surgery. Our results revealed that the two-hole group has advantages in terms of operative time, postoperative 3-day drainage, postoperative drainage time, postoperative hospital stay and postoperative day 3 visual analogue scale (VAS) pain scores. There were no significant differences between the three groups in terms of intraoperative bleeding, number of lymph nodes dissected, VAS pain scores on postoperative days 1 and 2, and postoperative complications. In addition, the two-hole group was superior to the three-hole and four-hole groups in terms of C-reactive protein (CRP), procalcitonin (PCT) and interleukin 10 (IL-10). In summary, the RATS two-hole approach has advantages in operation time, rapid recovery after operation and some postoperative inflammatory indicators, and is worth promoting in hospitals that are skilled in three-hole and four-hole da Vinci robot surgery and have conditions.

Short-term restoration effects of ecological projects detected using the turning point method in the Three River Headwater Region, China.

The Three River Headwater Region (TRHR) is an important river source area providing important ecological functions. Decades ago, climate change and human activities severely degraded the ecosystem in the TRHR. To restore vegetation, a series of ecological projects have been implemented since 1989. Using net primary productivity (NPP) data from 1988 to 2012, a sequential Mann-Kendall trend test (SQ-MK) method was applied to identify the turning point of vegetation NPP. This approach was able to represent the critical response time of the vegetation to important disturbances. A 3-year time window was set after the implementation of one ecological project to detect and analyze its short-term effects. The ecological projects included the Yangtze River Basin Shelterbelt System Construction Project (YRCP), the TRHR Nature Reserve Construction Project (TNR), the Returning Grazing Land to Grassland Project (RGLGP), and the first phase of the Ecological Conservation and Restoration Project of the TRHR (ECRP). Our results showed that the vegetation in the TRHR responded positively to restoration: 89% of pixels showed an increasing trend and 54% of pixels underwent an abrupt change. The accelerated growth type accounted for the highest proportion among all types of detected turning points. In the ECRP's window, the positive turns rose rapidly, from 41% in 2005 to 86% in 2008, and it showed the most balanced restoration effects across grasslands. The alpine meadow and montane meadow restoration was largely influenced by the ECRP and the RGLGP (both >40%). The alpine steppe restoration was mainly attributed to the ECRP (68%). On the county scale, the positive turns in Yushu at the source of the Yangtze River mainly benefited from the RGLGP (56%), while the positive turns in Maduo at the source of the Yellow River benefited from the ECRP (77%). Nangqian, Tanggula and Zaduo County were still in need of intervention for restoration (< 3%). The results of the study can enhance our understanding of the spatio-temporal distribution of the short-term ecological benefits of different ecological projects, thus provide a scientific and timely reference for future planning and adjustment of the conservation and restoration projects.

Short-term effect of coil handle orientations on fMRI-guided rTMS on insomnia: A case report.

Introduction: The coil handle orientation plays a pivotal role in the therapeutic efficacy of repetitive transcranial magnetic stimulation (rTMS). However, there is currently no consensus on the optimal individualized coil handle orientation, especially for non-motor areas. Case presentation: The present case reported a short-term effect of functional connectivity (FC)-guided rTMS with coil handle posterior-anterior 45° (PA45°) and posterior-anterior 135° (PA135°) on a patient with insomnia. Notably, in this case, the PA45° orientation was nearly perpendicular to the adjacent sulcus, while the PA135° orientation was almost parallel to it. Local brain activity and functional connectivity were assessed using resting-state functional magnetic resonance imaging (RS-fMRI). Additionally, motor evoked potentials (MEPs) were captured both pre and post-rTMS sessions. Findings: The coil handle orientation PA45° outperformed the PA135° in both RS-fMRI and MEP outcomes. Moreover, a 9-day rTMS treatment led to discernible improvements in symptoms of depression and anxiety, complemented by a modest enhancement in sleep quality.

[Review on the Long-term and Short-term Effects of Biochar Addition on Soil Greenhouse Gas Emissions].

Increasing concentrations of greenhouse gases in the atmosphere caused by human activities are the main cause of climate warming. Global warming is a severe challenge confronted by human society today. Reducing greenhouse gas emissions and increasing carbon sinks are the keys to addressing climate warming. Biochar addition is considered to be a promising way to reduce greenhouse gas emissions and increase carbon sinks, due to its unique physical, chemical, and biological properties. Therefore, it is of great significance to study the effects of biochar on soil greenhouse gas emissions to mitigate the greenhouse effect and achieve "carbon neutrality." The long-term and short-term effects of biochar on soil greenhouse gas emissions and their influencing mechanism were reviewed. It was found that the effects of biochar on soil greenhouse gas emissions varied with the types of biochar feedstock, pyrolysis temperature, application ratio, and soil and vegetable types. In addition, due to the different aging times and modes and cultivation methods, the mitigation effect of aged biochar on soil greenhouse gas could be enhanced or weakened or even disappeared. Further, based on the deficiencies of the previous research, the direction and focus of future research on the effects of biochar on soil greenhouse gas emissions were analyzed and prospected. It was proposed to strengthen simultaneous research on the effects of biochar on CO2, N2O, and CH4 emissions; reducing greenhouse gas emissions and carbon sequestration; different aging modes and cultivation methods of biochar; and revealing the influencing mechanism at the process level, through exploring the effects of biochar on soil carbon and nitrogen dynamics and tracing the source of greenhouse gases using 13C and 15N tracer technology.

Short-term effect of COVID-19 pandemic on cryptocurrency markets: A DCC-GARCH model analysis.

This research examines the impact of the coronavirus index on the returns and volatility of ten major cryptocurrencies during the COVID-19 pandemic. For this purpose, we applied a multivariate volatility GARCH model with an integrated dynamic conditional correlation (DCC) approach to daily cryptocurrency values observed data during the January-December, 2020 period. Moreover, we used the Granger causality test to study return-volume correlations. The findings indicate that cryptocurrency volatility declined after the World Health Organization declared on March 11, 2020, that the coronavirus was a pandemic. Unlike most of the relevant previous studies, we found that the COVID-19 crisis did not have a long-term effect on cryptocurrency returns and volatility but only presented a short-term effect. Our results have implications for investors who need to determine an optimal portfolio for a scenario other than the base.

Rapid Adaptation of Chimonobambusa opienensis Leaves to Crown-Thinning in Giant Panda Ecological Corridor, Niba Mountain.

Leaf traits reflect the ecological strategy in heterogeneous contexts and are widely used to explore the adaption of plant species to environmental change. However, the knowledge of short-term effect of canopy management on understorey plant leaf traits is still limited. Here, we studied the short-term effect of crown-thinning on the leaf morphological traits of bamboo (Chimonobambusa opienensis), an important understorey plant and staple food for the giant panda (Ailuropoda melanoleuca) of Niba Mountain. Our treatments were two crown-thinnings (spruce plantation, CS, and deciduous broad-leaved forest, CB) and two controls (broad-leaved forest canopy, FC, and the bamboo grove of clearcutting, BC). The results showed that: the CS enhanced the annual leaf length, width, area, and thickness, CB decreased almost all annual leaf traits, and perennial leaf traits in CS and CB were the opposite. The log-transformed allometric relationships of length vs. width, biomass vs. area were significantly positive while those of specific leaf area vs. thickness were significantly negative, which varied largely in treatments and age. The leaf traits and allometric relationships suggested that the CS created a more suitable habitat for bamboo growth. This study highlighted that the understorey bamboo leaf traits could adapt the improved light environment induced by crown-thinning rapidly.

Use of symptom diary in primary students: association of nitrogen dioxide with prevalence of symptoms.

Air pollution is a global public health concern, and numerous studies have attempted to identify the health effects of air pollutants, including nitrogen dioxide (NO2). In China, there are few studies investigating the relationship between NO2 exposure and symptoms among children at an individual level. The aim of the study was to evaluate the acute effects of NO2 on prevalence of symptoms of primary students. An environmental and health questionnaire survey was administered to 4240 primary students in seven districts of Shanghai. Daily symptoms, as well as the daily air pollution and meteorological data from each community, were recorded during the corresponding period. A multivariable logistic regression model was utilized to analyze the relationship between the prevalence of symptoms and NO2 exposure in school-age children. A model with interaction items was adopted to estimate the interactive effects of NO2 and confounding factors on symptoms. The average NO2 level in central urban, industrial and rural areas were 62.07 ± 21.66, 54.86 ± 18.32 and 36.62 ± 21.23 µg m-3, respectively. Our findings demonstrate that the occurrence of symptoms was significantly affected by NO2 exposure in the short-term. The largest associations were observed for a 10 µg m-3 increase in 5-day moving average (lag04) NO2 concentration with prevalence of general symptoms (odds ratio [OR] = 1.15, 95% confidence interval [95% CI]: 1.07-1.22), throat symptoms (OR = 1.23, 95% CI: 1.13-1.35) and nasal symptoms (OR = 1.142, 95% CI: 1.02-1.27). Subgroup analysis showed that non-rural areas, boys, nearby environmental pollution source and history of present illness were all susceptible factors to the effects of NO2 exposure. Furthermore, there were interactive effects between NO2 exposure and area types on reported symptoms. NO2 can increase the risk of symptoms in primary students in the short-term, which could be significantly enhanced in central urban and industrial areas.

The influence of meteorological factors and total malignant tumor health risk in Wuhu city in the context of climate change.

With the increasing severity of the malignant tumors situation worldwide, the impacts of climate on them are receiving increasing attention. In this study, for the first time, all-malignant tumors were used as the dependent variable and absolute humidity (AH) was innovatively introduced into the independent variable to investigate the relationship between all-malignant tumors and meteorological factors. A total of 42,188 cases of malignant tumor deaths and meteorological factors in Wuhu City were collected over a 7-year (2014-2020) period. The analysis method combines distributed lagged nonlinear modeling (DLNM) as well as generalized additive modeling (GAM), with prior pre-analysis using structural equation modeling (SEM). The results showed that AH, temperature mean (T mean) and diurnal temperature range (DTR) all increased the malignant tumors mortality risk. Exposure to low and exceedingly low AH increases the malignant tumors mortality risk with maximum RR values of 1.008 (95% CI: 1.001, 1.015, lag 3) and 1.016 (95% CI: 1.001, 1.032, lag 1), respectively. In addition, low and exceedingly low T mean exposures also increased the risk of malignant tumors mortality, the maximum RR was 1.020 (95% CI: 1.006, 1.034) for low T mean and 1.035 (95% CI: 1.014, 1.058) for exceedingly low T mean. As for DTR, all four levels (exceedingly low, low, high, exceedingly high, from low to high) of exposure increased the risk of death from malignant tumors, from exceedingly low to exceedingly high maximum RR values of 1.018 (95% CI: 1.004, 1.032), 1.011 (95% CI: 1.005, 1.017), 1.006 (95% CI: 1.001, 1.012) and 1.019 (95% CI: 1.007, 1.031), respectively. The results of the stratified analysis suggested that female appear to be more sensitive to humidity, while male require additional attention to reduce exposure to high level of DTR.

The pollution reduction effect of official turnover: evidence from China.

Under the political system with Chinese characteristics, the turnover of regional officials becomes a norm. So the uncertainty generated by the turnover of officials can often have an impact on the pollution emissions of regional enterprises. This paper examines the impact of official turnover on corporate pollution emissions using the Chinese industrial enterprise database and pollution emission database from 2004 to 2014 in China, while matching urban panel data of prefecture-level cities. The empirical study finds that official turnover significantly reduces the pollution emission of enterprises in that year, while the effect of official turnover from economically developed to economically backward regions and from economically backward to economically developed regions on enterprises' pollution emissions is significantly different. Also, this paper finds that the turnover of officials has a short-term effect on the reduction of corporate pollution emissions. The pollution abatement effect of official turnover is more pronounced in non-resource cities and non-state enterprises. Further analysis reveals that the pollution reduction effect of official turnover is more pronounced when the age of officials is greater than the promotion age threshold of 54 years. Finally, a series of robustness tests were conducted in this paper, while the Heckman two-step method was used to test for endogeneity, and the conclusions reached remained consistent with the benchmark regression.

The role of meteorological factors in suicide mortality in Wuhu, a humid city along the Yangtze River in Eastern China.

As the climate continues to change, suicide is becoming more frequent. In this study, absolute humidity (AH) was included for the first time and Wuhu, a typical subtropical city along the Yangtze River, was taken as the research object to explore the impact of suicide death risk on meteorological factors. The daily meteorological factors and suicide mortality data of Wuhu city from 2014 to 2020 were collected. Guided by structural equation model (SEM), a time series analysis method combining distributed lag nonlinear model (DLNM) and generalized additive model (GAM) was adopted. To investigate the correlation among different populations, we stratified age and gender at different meteorological levels. A total of 1259 suicide deaths were collected in Wuhu. The results indicated that exceedingly low and low levels of AH short-term exposure increased suicide mortality, with the maximum effect occurring at lag 14 for both levels of exposure, when the relative risk (RR) was 1.131 (95% CI: 1.030, 1.242) and 1.065 (95% CI: 1.006, 1.127), respectively. Exposure to exceedingly high and exceedingly low levels of temperature mean (T mean) also increased suicide mortality, with maximum RR values of 1.132 (lag 14, 95% CI: 1.015, 1.263) and 1.203 (lag 0, 95% CI: 1.079, 1.340), sequentially. As for diurnal temperature range (DTR), low-level exposure decreased the risk of suicide, while high-level exposure increased this risk, with RR values of 0.955 (lag 0, 95% CI: 0.920, 0.991, minimum) and 1.060 (lag 0, 95% CI: 1.018, 1.104, maximum), sequentially. Stratified analysis showed that AH and DTR increased the suicide death risk in male and elderly people, while the risk effect of T mean have no effect on young people only. In summary, male and elderly people appear to be more vulnerable to adverse weather effects.

Influence of air pollution on influenza-like illness in China: a nationwide time-series analysis.

BACKGROUND: Evidence concerning effects of air pollution on influenza-like illness (ILI) from multi-center is limited and little is known about how regional factors might modify this relationship. METHODS: In this ecological study, ILI cases defined as outpatients with temperature ≥38 °C, accompanied by cough or sore throat, were collected from National Influenza Surveillance Network in China. We adopted generalized additive model with quasi-Poisson to estimate province-specific association between air pollution and ILI in 30 Chinese provinces during 2015-2019, after adjusting for time trend and meteorological factors. We then pooled province-specific association by using random-effect meta-analysis. Potential effect modifications of season and regional characteristics were explored. FINDINGS: A total of 26, 004, 853 ILI cases and 777, 223, 877 hospital outpatients were collected. In general, effects of air pollutants were acute. An inter-quartile range increase of PM2.5, SO2, PM10, NO2 and CO at lag0, and O3 at lag0-2 was associated with 3.08% (95% CI: 1.91%, 4.27%), 3.00% (1.86%, 4.16%), 6.46% (4.71%, 8.25%), 7.21% (5.73%, 8.71%), 4.37% (3.05%, 5.70%), and -9.26% (-11.32%, -7.14%) change of ILI at national level, respectively. Associations between air pollutants and ILI varied by season and regions, with higher effect estimates in cold season, eastern and central regions and provinces with more humid condition and larger population. INTERPRETATION: This study indicated that most air pollutants increased the risk of ILI in China. Our findings might provide implications for the development of policies to protect public health from air pollution and influenza. FUNDING: National Natural Science Foundation of China and Chongqing Health Commission Program.

Six weeks effect of different nanocellulose on blood lipid level and small intestinal morphology in mice.

AIMS: Cellulose nanofibrils (CNF, or NFC), cellulose nanocrystals (CNC, or NCC), and Tempo (2,2,6,6-tetramethylpiperidine-1-oxyl radical) oxidized CNF (Tempo-CNF) were compared for the short-term effect on mice fed with a high-fat and high-sugar (Western diet, WD) to investigate their effect when combined with a sub-optimal diet. SCOPE: Thirty C57B/C female mice (10 weeks old; 5-6 mice/group) were given water, cellulose, or three types of nanocellulose once daily in a dose of 30 mg/kg body weight by oral gavage. After six weeks, weight changes, fecal output, glucose homeostasis, and gut permeability showed no significant among groups. Serum analysis including triglycerides, cholesterol and total bile acids and small intestinal morphology including villus length, villus width, crypt depth, goblet cell count and goblet cell density were no difference for all groups. Only CNC group had higher excretion of bile acids in the feces. CONCLUSIONS: These results suggest that current treated dose using three types of nanocellulose had no detrimental effects on blood lipid level and small intestinal morphology.

Tumor-feeding artery diameter reduction is associated with improved short-term effect of hepatic arterial infusion chemotherapy plus lenvatinib treatment.

BACKGROUND: Recently, hepatic arterial infusion chemotherapy (HAIC) plus lenvatinib has been frequently used to treat unresectable hepatocellular carcinoma (uHCC) in China. In the clinic, the hepatic arteries of some patients shrink significantly during this treatment, leading to improved short-term efficacy. AIM: To investigate the relationship between the shrinkage of hepatic arteries and the short-term effect of HAIC plus lenvatinib treatment. METHODS: Sixty-seven participants with uHCC were enrolled in this retrospective study. The patients received HAIC every 3 wk, followed by oral lenvatinib after the first HAIC course. Hepatic artery diameters were measured on CT before treatment and after 1 and 2 mo of treatment. Meanwhile, the changes in tumor capillaries were also examined on pathological specimens before and after 1 mo of treatment. The antitumor response after 1, 3, and 6 mo of treatment was assessed using the modified Response Evaluation Criteria in Solid Tumors (mRECIST). The relationship between the changes in vessel diameters and the short-term effect of the combination treatment was evaluated by receiver-operating characteristic and logistic regression analyses. RESULTS: The hepatic artery diameters were all significantly decreased after 1 and 2 mo of treatment (P < 0.001), but there was no difference in the vessel diameters between 1 and 2 mo (P > 0.05). The microvessel density in the tumor lesions decreased significantly after 1 mo of combination treatment (P < 0.001). According to mRECIST, 46, 41, and 24 patients had complete or partial responses after 1, 3, and 6 mo of treatment, respectively, whereas 21, 21, and 32 patients had a stable or progressive disease at these times, respectively. Shrinkage of the tumor-feeding artery was significantly associated with the tumor response after 1, 3, and 6 mo of treatment (P < 0.001, P = 0.004, and P = 0.023, respectively); however, changes in other hepatic arteries were not significantly associated with the tumor response. Furthermore, shrinkage of the tumor-feeding artery was an independent factor for treatment efficacy (P = 0.001, P = 0.001, and P = 0.002 and 1, 3, and 6 mo, respectively). CONCLUSION: The hepatic arteries shrank rapidly after treatment with HAIC plus lenvatinib, and shrinkage of the tumor-feeding artery diameter was closely related to improved short-term efficacy.

Short Term Effect of Corona Virus Diseases Vaccine on the Menstrual Cycles.

Background: The latest threat to world health is coronavirus disease-2019 (COVID-19), and the exact death rate of SARS-CoV-2 infection is still to be explored and varies widely throughout the world. Inactivated virus vaccines, recombinant viral vaccines, subunit vaccines, DNA vaccines, and attenuated vaccinations have all been investigated in the hunt for an optimal SARS-CoV vaccine. Some women had menstrual abnormalities after immunisation, including heavy menstrual bleeding (menorrhagia), frequent bleeding (metrorrhagia/polymenorrhea), and postmenopausal haemorrhage. Vaccine-induced thrombocytopenia might be one of the underlying reasons. Purpose: The aim to carry out this study was to survey by recruiting the female participants who were vaccinated with one or two shots of the available vaccine and observe short-term menstrual changes. Patients and Methods: This web-based survey cross-sectional study included women who were above 18 years, had the vaccine at least one month (one menstrual period) before participating in the study, had access to social media platforms and were willing to take part in the study. Women were excluded if, at the time of the study, they were pregnant or had amenorrhea of more than 6 months. Results: Analysing the menstrual flow more, we saw that 24.5% of the patients had increased flow, while 15.5% had reduced flow which for both changes in the flow, the p-value was 0.017. However, 23.65 showed delayed periods, and 51.6% showed no changes. The changes in the timing were significant, indicating a p-value of 0.008. The study will be a significant contribution to the literature as this pandemic is new, and the vaccination against COVID-19 is still in the trial phase. Conclusion: We observed in our study that there was a change in the menstruation timings and flow after vaccination. However, further longitudinal studies are needed to conclude the impact of the COVID-19 vaccine on the menstruation cycle.

Do Animations Impair Executive Function in Young Children? Effects of Animation Types on the Executive Function of Children Aged Four to Seven Years.

This study used a three (animation types: educational, entertainment, and control groups) × four (age group: four-, five-, six-, and seven-year-olds) between-group experimental design to investigate the short-term effects of animation type and age on each component of children's executive function (EF) (inhibitory control [IC], cognitive flexibility [CF], and working memory [WM]). One hundred twenty-six kindergarten and first-grade elementary school students in a city in Henan Province of China were selected for the experimental study. The results showed that briefly watching animation affected children's EF. Specifically, watching entertainment cartoons weakened children's IC and CF, while cartoons did not affect children's WM. The moderating effect of age in the relationship between animation type and EFs was non-significant. This study suggests that researchers should focus on the uniqueness of each component of EF in children aged four to seven years, and parents should try to limit children's viewing of animation, especially entertainment animation.

Short-term effects of ambient temperature on the risk of preeclampsia in Nanjing, China: a time-series analysis.

OBJECTIVES: Previous studies on the association between temperature and preeclampsia mainly considered temperature on a monthly or seasonal time scale. The objective of this study was to assess the preeclampsia risk associated with short-term temperature exposure using daily data. STUDY DESIGN: Daily preeclampsia hospitalization data, daily meteorological data and daily air pollutant data from Nanjing were collected from 2016 to 2017. Both the T test and distributed lag nonlinear model (DLNM) were applied to assess the short-term effect of temperature on preeclampsia risk. Three kinds of daily temperature, including the daily mean temperature, daily minimum temperature and daily maximum temperature, were analysed. RESULTS: When the daily number of preeclampsia hospital admissions was divided into two subgroups based on temperature, it was significantly larger on cold days than on hot days. Regarding the mean temperature, a very low level of mean temperature (4.5 °C, lag = 0-20) and a low level of mean temperature (9.1 °C, lag = 0-20) increased the cumulative relative risk of preeclampsia by more than 60%. At the same time, a very high level of mean temperature (28.7 °C, lags = 0-10, 0-15, 0-20) and a high level of mean temperature (24.1 °C, lags = 0-10, 0-15) decreased the cumulative relative risk of preeclampsia by more than 35%. At a minimum temperature, a very low level of minimum temperature (0.9 °C, lag 0-5) and a low level of minimum temperature (5.6 °C, lag 0-5) increased the cumulative relative risk of preeclampsia by more than 55%. At the same time, a high level of mean temperature (20.9 °C, lags = 0, 0-5) decreased the cumulative relative risk of preeclampsia by more than 20%. The maximum temperature result was similar to the mean temperature result. CONCLUSIONS: Both direct and lag effects of low temperature on preeclampsia were demonstrated to be significant risk factors. These results could be used to help pregnant women and the government reduce preeclampsia risk.

Evaluation of the Immediate Effects of Web-Based Intervention Modules for Goals, Planning, and Coping Planning on Physical Activity: Secondary Analysis of a Randomized Controlled Trial on Weight Loss Maintenance.

BACKGROUND: The use of digital interventions can be accurately monitored via log files. However, monitoring engagement with intervention goals or enactment of the actual behaviors targeted by the intervention is more difficult and is usually evaluated based on pre-post measurements in a controlled trial. OBJECTIVE: The objective of this paper is to evaluate if engaging with 2 digital intervention modules focusing on (1) physical activity goals and action plans and (2) coping with barriers has immediate effects on the actual physical activity behavior. METHODS: The NoHoW Toolkit (TK), a digital intervention developed to support long-term weight loss maintenance, was evaluated in a 2 x 2 factorial randomized controlled trial. The TK contained various modules based on behavioral self-regulation and motivation theories, as well as contextual emotion regulation approaches, and involved continuous tracking of weight and physical activity through connected commercial devices (Fitbit Aria and Charge 2). Of the 4 trial arms, 2 had access to 2 modules directly targeting physical activity: a module for goal setting and action planning (Goal) and a module for identifying barriers and coping planning (Barriers). Module visits and completion were determined based on TK log files and time spent in the module web page. Seven physical activity metrics (steps; activity; energy expenditure; fairly active, very active and total active minutes; and distance) were compared before and after visiting and completing the modules to examine whether the modules had immediate or sustained effects on physical activity. Immediate effect was determined based on 7-day windows before and after the visit, and sustained effects were evaluated for 1 to 8 weeks after module completion. RESULTS: Out of the 811 participants, 498 (61.4%) visited the Goal module and 406 (50.1%) visited the Barriers module. The Barriers module had an immediate effect on very active and total active minutes (very active minutes: before median 24.2, IQR 10.4-43.0 vs after median 24.9, IQR 10.0-46.3; P=.047; total active minutes: before median 45.1, IQR 22.9-74.9 vs after median 46.9, IQR 22.4-78.4; P=.03). The differences were larger when only completed Barriers modules were considered. The Barriers module completion was also associated with sustained effects in fairly active and total active minutes for most of the 8 weeks following module completion and for 3 weeks in very active minutes. CONCLUSIONS: The Barriers module had small, significant, immediate, and sustained effects on active minutes measured by a wrist-worn activity tracker. Future interventions should pay attention to assessing barriers and planning coping mechanisms to overcome them. TRIAL REGISTRATION: ISRCTN Registry ISRCTN88405328; https://www.isrctn.com/ISRCTN88405328.

Automated Detection of Caffeinated Coffee-Induced Short-Term Effects on ECG Signals Using EMD, DWT, and WPD.

The effect of coffee (caffeinated) on electro-cardiac activity is not yet sufficiently researched. In the current study, the occurrence of coffee-induced short-term changes in electrocardiogram (ECG) signals was examined. Further, a machine learning model that can efficiently detect coffee-induced alterations in cardiac activity is proposed. The ECG signals were decomposed using three different joint time-frequency decomposition methods: empirical mode decomposition, discrete wavelet transforms, and wavelet packet decomposition with varying decomposition parameters. Various statistical and entropy-based features were computed from the decomposed coefficients. The statistical significance of these features was computed using Wilcoxon's signed-rank (WSR) test for significance testing. The results of the WSR tests infer a significant change in many of these parameters after the consumption of coffee (caffeinated). Further, the analysis of the frequency bands of the decomposed coefficients reveals that most of the significant change was localized in the lower frequency band (<22.5 Hz). Herein, the performance of nine machine learning models is compared and a gradient-boosted tree classifier is proposed as the best model. The results suggest that the gradient-boosted tree (GBT) model that was developed using a db2 mother wavelet at level 2 decomposition shows the highest mean classification accuracy of 78%. The outcome of the current study will open up new possibilities in detecting the effects of drugs, various food products, and alcohol on cardiac functionality.