Spatiotemporal impact of COVID-19 on Taiwan air quality in the absence of a lockdown: Influence of urban public transportation use and meteorological conditions.

The unprecedented outbreak of COVID-19 significantly improved the atmospheric environment for lockdown-imposed regions; however, scant evidence exists on its impacts on regions without lockdown. A novel research framework is proposed to evaluate the long-term monthly spatiotemporal impact of COVID-19 on Taiwan air quality through different statistical analyses, including geostatistical analysis, change detection analysis and identification of nonattainment pollutant occurrence between the average mean air pollutant concentrations from 2018-2019 and 2020, considering both meteorological and public transportation impacts. Contrary to lockdown-imposed regions, insignificant or worsened air quality conditions were observed at the beginning of COVID-19, but a delayed improvement occurred after April in Taiwan. The annual mean concentrations of PM10, PM2.5, SO2, NO2, CO and O3 in 2020 were reduced by 24%, 18%, 15%, 9.6%, 7.4% and 1.3%, respectively (relative to 2018-2019), and the overall occurrence frequency of nonattainment air pollutants declined by over 30%. Backward stepwise regression models for each air pollutant were successfully constructed utilizing 12 meteorological parameters (R2 > 0.8 except for SO2) to simulate the meteorological normalized business-as-usual concentration. The hybrid single-particle Lagrangian integrated trajectory (HYSPLIT) model simulated the fate of air pollutants (e.g., local emissions or transboundary pollution) for anomalous months. The changes in different public transportation usage volumes (e.g., roadway, railway, air, and waterway) moderately reduced air pollution, particularly CO and NO2. Reduced public transportation use had a more significant impact than meteorology on air quality improvement in Taiwan, highlighting the importance of proper public transportation management for air pollution control and paving a new path for sustainable air quality management even in the absence of a lockdown.

Rapid Profiling of Tumor-Immune Interaction Using Acoustically Assembled Patient-Derived Cell Clusters.

Tumor microenvironment crosstalk, in particular interactions between cancer cells, T cells, and myeloid-derived suppressor cells (MDSCs), mediates tumor initiation, progression, and response to treatment. However, current patient-derived models such as tumor organoids and 2D cultures lack some essential niche cell types (e.g., MDSCs) and fail to model complex tumor-immune interactions. Here, the authors present the novel acoustically assembled patient-derived cell clusters (APCCs) that can preserve original tumor/immune cell compositions, model their interactions in 3D microenvironments, and test the treatment responses of primary tumors in a rapid, scalable, and user-friendly manner. By incorporating a large array of 3D acoustic trappings within the extracellular matrix, hundreds of APCCs can be assembled within a petri dish within 2 min. Moreover, the APCCs can preserve sensitive and short-lived (≈1 to 2-day lifespan in vivo) tumor-induced MDSCs and model their dynamic suppression of T cell tumor toxicity for up to 24 h. Finally, using the APCCs, the authors succesully model the combinational therapeutic effect of a multi-kinase inhibitor targeting MDSCs (cabozantinib) and an anti-PD-1 immune checkpoint inhibitor (pembrolizumab). The novel APCCs may hold promising potential in predicting treatment response for personalized cancer adjuvant therapy as well as screening novel cancer immunotherapy and combinational therapy.

Insights into aerosol chemical composition and optical properties at Lulin Atmospheric Background Station (2862 m asl) during two contrasting seasons.

Continental outflows from peninsular Southeast Asia and East Asia dominate the widespread dispersal of air pollutants over subtropical western North Pacific during spring and autumn, respectively. This study analyses the chemical composition and optical properties of PM10 aerosols during autumn and spring at a representative high-altitude site, viz., Lulin Atmospheric Background Station (23.47°N, 120.87°E; 2862 m a.s.l.), Taiwan. PM10 mass was reconstructed and the contributions of major chemical components were also delineated. Aerosol scattering (σsp) and absorption (σap) coefficients were regressed on mass densities of major chemical components by assuming external mixing between them, and the site-specific mass scattering efficiency (MSE) and mass absorption efficiency (MAE) of individual components for dry conditions were determined. NH4NO3 exhibited the highest MSE among all components during both seasons (8.40 and 12.58 m2 g-1 at 550 nm in autumn and spring, respectively). (NH4)2SO4 and organic matter (OM) accounted for the highest σsp during autumn (51%) and spring (50%), respectively. Mean MAE (mean contribution to σap) of elemental carbon (EC) at 550 nm was 2.51 m2 g-1 (36%) and 7.30 m2 g-1 (61%) in autumn and spring, respectively. Likewise, the mean MAE (mean contribution to σap) of organic carbon (OC) at 550 nm was 0.84 m2 g-1 (64%) and 0.83 m2 g-1 (39%) in autumn and spring, respectively. However, a classification matrix, based on scattering Ångström exponent, absorption Ångström exponent, and single scattering albedo (ω), demonstrated that the composite absorbing aerosols were EC-dominated (with weak absorption; ω = 0.91-0.95) in autumn and a combination of EC-dominated and EC/OC mixture (with moderate absorption; ω = 0.85-0.92) in spring. This study demonstrates a strong link between chemical composition and optical properties of aerosol and provides essential information for model simulations to assess the imbalance in regional radiation budget with better accuracy over the western North Pacific.

The Trend, Feasibility, and Safety of Salpingectomy as a form of Permanent Sterilization.

STUDY OBJECTIVE: To assess the change in the rate of laparoscopic salpingectomy for sterilization after the release of the November 2013 Society of Gynecologic Oncology Clinical Practice Statement and the January 2015 American College of Obstetricians and Gynecologists Committee Opinion: Salpingectomy for Ovarian Cancer Prevention. We hypothesized there would be an increase in salpingectomy as a percentage of total laparoscopic sterilizations performed without an increase in complications when compared with conventional bilateral tubal ligation (BTL). DESIGN: A retrospective cohort study. SETTING: Four university-affiliated hospitals in Houston, TX, and New York, NY. PATIENTS: All women 21 years or older who underwent interval laparoscopic permanent sterilization between April 2013 and September 2016. INTERVENTIONS: Sterilization by bilateral salpingectomy or conventional tubal ligation. MEASUREMENTS AND MAIN RESULTS: There were 454 sterilization procedures identified; 60% were BTLs, whereas 40% were salpingectomies. The rate of use of salpingectomy significantly increased from 5% to 9% in 2013 to 2014 to 78% by 2016. There was no significant difference in intraoperative or postoperative complications or estimated blood loss. The mean procedure time was 54 minutes for salpingectomy compared with 45 minutes for BTL (p <.0001). Salpingectomy was more likely to require 3 ports compared with 2 ports for BTL (p <.0001). CONCLUSIONS: The Society of Gynecologic Oncology and the American College of Obstetricians and Gynecologists' support of salpingectomy for ovarian cancer prevention increased its use for sterilization. Based on this study, laparoscopic bilateral salpingectomy is a safe method of sterilization without an increase in perioperative risk compared with conventional tubal ligation. Physicians should incorporate these findings and implications when counseling patients regarding contraception and permanent sterilization.

Data Acquisition System for In Situ Monitoring of Chemoelectrical Potential in Living Plant Fuel Cells.

Photosynthesis process in plants generates numerous sources of bioenergy. However, only a small fraction is readily exploited for electrical energy. The impact of environmental factors is one of the significant physiological influences on the electrical potential of the plants. Hence, we developed a data acquisition (DAQ) system for instantaneous monitoring of electrical potential in plants and Aloe vera was used as a plant sample. The static response characterization, capability index (P/T), and Pearson's coefficient of correlation procedures were applied to assess the reliability of the obtained data. This developed system offers the capability of in situ monitoring and detecting gradual changes in the electrical potential of plants up to a correlational strength of greater than 0.7. Interpretation of the electrical signal mechanisms in the Aloe vera plant and the optimization of the electricity can be achieved through the application of this monitoring system. This system, therefore, can serve as a tool to measure and analyze the electrical signals in plants at different conditions.

Building a Fab on a Chip.

Semiconductor fabs are large, complex industrial sites with costs for a single facility approaching $10B. In this paper we discuss the possibility of putting the entire functionality of such a fab onto a single silicon chip. We demonstrate a path forward where, for certain applications, especially at the nanometer scale, one can consider using a single chip approach for building devices with significant potential cost savings. In our approach, we build micro versions of the macro machines one typically finds in a fab, and integrating all the components together. We argue that the technology now exists to allow one to build a Fab on a Chip.

Atomic calligraphy: the direct writing of nanoscale structures using a microelectromechanical system.

We present a microelectromechanical system (MEMS) based method for the resist-free patterning of nanostructures. Using a focused ion beam to customize larger MEMS machines, we fabricate apertures with features less than 50 nm in diameter on plates that can be moved with nanometer precision over an area greater than 20 × 20 µm(2). Depositing thermally evaporated gold atoms though the apertures while moving the plate results in the deposition of nanoscale metal patterns. Adding a shutter positioned micrometers above the aperture enables high speed control of not only where but also when atoms are deposited. With this shutter, different-sized apertures can be opened and closed selectively for nanostructure fabrication with features ranging from nano- to micrometers in scale. The ability to evaporate materials with high precision, and thereby fabricate circuits and structures in situ, enables new kinds of experiments based on the interactions of a small number of atoms and eventually even single atoms.

Laparoscopy for the management of early-stage endometrial cancer: from experimental to standard of care.

We performed a search of PUBMED and MEDLINE for articles concerning surgical management of early stage endometrial cancer from 1950 to 2011. From the articles collected we extracted data such as estimated blood loss, operating room time, complications, conversion to laparotomy, and length of hospital stay. Forty-seven relevant sources were analyzed. The patients in the laparoscopy group had less blood loss, fewer complications, longer operating room times, and a shorter length of stay. Lymph node count was similar in both groups. Although obesity is not a contraindication to laparoscopy, it does lead to a higher conversion rate. Route of surgical treatment had no impact on recurrence or survival. Robotic surgery has significant advantages over laparotomy, but advantages over laparoscopy are not as distinct. Laparoscopic hysterectomy offers several advantages over laparotomy. These advantages relate to improvements in patient care with comparable clinical outcome. After careful analysis we believe laparoscopy should be the standard of care for surgical management of early stage endometrial cancer.

Robotic-assisted laparoscopic transection and repair of an obturator nerve during pelvic lymphadenectomy for endometrial cancer.

BACKGROUND: Obturator nerve injury may occur in gynecologic surgery, particularly in cases in which extensive pelvic sidewall retroperitoneal dissection is performed. The lack of tactile feedback from the robotic surgical system may contribute to obturator nerve injury. If surgical division occurs, microsurgical end-to-end anastomosis of the obturator nerve may be performed. CASE: A 76-year-old woman with stage IA endometrial adenocarcinoma sustained a left obturator nerve transection during pelvic lymphadenectomy that was recognized immediately. Robotic-assisted laparoscopic repair was performed successfully, with the patient experiencing no residual neuropathy 6 months postoperatively. CONCLUSION: Robotic-assisted laparoscopic repair is feasible for the treatment of obturator nerve injury.

Leiomyoma recurrent at the cervical stump: report of two cases.

Although supracervical hysterectomy is an increasingly popular modality for surgical management of benign uterine conditions data exploring all of its consequences are still forth coming. This case report will discuss the scenario of leiomyoma recurrence at the cervical stump after supracervical hysterectomy. After supracervical hysterectomy, the remnant cervix has the potential for leiomyoma formation. Surgeons performing supracervical hysterectomy should be aware of this possible outcome.

Robotic-assisted laparoscopic repair of a vesicouterine fistula.

BACKGROUND: As cesarean sections become a more common mode of delivery, they have become the most likely cause of vesicouterine fistula formation. The associated pathology with repeat cesarean deliveries may make repair of these fistulas difficult. Computer-enhanced telesurgery, also known as robotic-assisted surgery, offers a 3-dimensional view of the operative field and allows for intricate movements necessary for complex suturing and dissection. These qualities are advantageous in vesicouterine fistula repair. CASE: A healthy 34-year-old woman who underwent 4 cesarean deliveries presented with a persistent vesicouterine fistula. Conservative management with bladder decompression and amenorrhea-inducing agents failed. RESULTS: Robotic-assisted laparoscopic repair was successfully performed with the patient maintaining continence after surgery. CONCLUSION: Robotic-assisted laparoscopic repair of vesicouterine fistulas offers a minimally invasive approach to treatment of a complex disease process.