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Diagnosis performance is critical for the safety of high-consequence industrial systems. It depends highly on the information provided, perceived, interpreted and integrated by operators. This article examines the influence of information congruence (congruent information vs. conflicting information vs. missing information) and its interaction with time pressure (high vs. low) on diagnosis performance on a simulated platform. The experimental results reveal that the participants confronted with conflicting information spent significantly more time generating correct hypotheses and rated the results with lower probability values than when confronted with the other two levels of information congruence and were more prone to arrive at a wrong diagnosis result than when they were provided with congruent information. This finding stresses the importance of the proper processing of non-congruent information in safety-critical systems. Time pressure significantly influenced display switching frequency and completion time. This result indicates the decisive role of time pressure. Practitioner Summary: This article examines the influence of information congruence and its interaction with time pressure on human diagnosis performance on a simulated platform. For complex systems in the process control industry, the results stress the importance of the proper processing of non-congruent information in safety-critical systems.

Repair of lower abdominal incisional hernia is always a surgical challenge. TAPE technique has been described for the repair of supra-pubic midline incisional hernia with satisfactory outcome. Its indication can be extended for treatment of non-midline lower abdominal hernia. Peritoneal incision is created just below the hernia defect with pre-peritoneal dissection to expose supra-pubic preperitoneal space with Cooper's ligament exposed. Non-adhesive mesh then placed over preperitoneal space and partially intra-peritoneally, and cover the whole extra-peritoneal space prepared to ensure enough overlapping. Mesh is fixed by tackers for intra-peritoneal part, most inferior fixation points were at peritoneal incision line. Extra-peritoneal part of meshes is fixed at the safety zone and covered up by the peritoneal flap to avoid mesh migration. Fixation of the meshes at the lateral aspects were facilitated by the peritoneal flap and subsequent fibrosis and adhesion to the extra-peritoneal structures in cases of lateral lower abdominal hernia. Repair of midline and lateral lower abdominal incisional hernia with this novel modified technique with prosthetic mesh is safe and effective. A larger case series and longer follow-up is required for validation of this technique.

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Background Air pollution is becoming an increased burden to the world. Previous studies have confirmed its effects on adverse birth outcomes, but few associated with premature small for gestational age (SGA). We report a retrospective cohort study conducted in Changzhou city to evaluate the association between air pollutants (PM 2.5 , SO 2 and NO 2 ) and premature SGA during pregnancy. Methods A total of 46,224 births were collected from January, 2013 to December, 2016, in Changzhou Maternity and Child Health Care Hospital, finally 2709 preterm births were admitted for study. Corresponding air monitoring data were collected from Changzhou Environmental Protection Agency. Generalized estimating equations were used to examine the association between these air pollutants and premature SGA controlling for individual covariates in single- and multi-pollutant models. Results We found that, in the third trimester, every 10 μg/m 3 increments in PM 2.5 concentration were associated with premature SGA (OR = 1.18, 95% CI: 1.03–2.83; OR = 1.37, 95% CI: 1.03–3.58) in two- and three-pollutants models. In the whole gestation, a 10 μg/m 3 increment in PM 2.5 concentration in two- and three-pollutant models were related to premature SGA (OR = 1.53, 95% CI: 1.38–2.47; OR = 1.73, 95% CI: 1.18–2.57). The OR (95% CI) of premature SGA were increasing across quintiles of PM 2.5 , SO 2 , NO 2 concentrations during the whole gestation period adjusting for confounders ( P for trend < 0.001). Conclusions These results indicated that pregnant women exposed to PM 2.5, combined with other pollutants in the third trimester have a higher risk to deliver premature SGA babies, providing further evidence linking PM 2.5 and pregnancy outcomes.