BACKGROUND: Both extreme heat and air pollution exposure during pregnancy have been associated with preterm birth; however, their combined effects are unclear. OBJECTIVES: Our goal was to estimate the independent and joint effects of heatwaves and fine particulate matter [PM <2:5 lm in aerodynamic diameter (PM 2:5 )], exposure during the final gestational week on preterm birth. METHODS: Using birth registry data from Guangzhou, China, we included 215,059 singleton live births in the warm season (1 May-31 October) between January 2015 and July 2017. Daily meteorological variables from 5 monitoring stations and PM 2:5 concentrations from 11 sites were used to estimate district-specific exposures. A series of cut off temperature thresholds and durations (2, 3, and 4 consecutive d) were used to define 15 different heatwaves. Cox proportional hazard models were used to estimate the effects of heatwaves and PM 2:5 exposures during the final week on preterm birth, and departures from additive joint effects were assessed using the relative excess risk due to interaction (RERI). RESULTS: Numbers of preterm births increased in association with heatwave exposures during the final gestational week. Depending on the heatwave definition used, hazard ratios (HRs) ranged from 1.10 (95% CI: 1.01, 1.20) to 1.92 (1.39, 2.64). Associations were stronger for more intense heatwaves. Combined effects of PM 2:5 exposures and heatwaves appeared to be synergistic (RERIs >0) for less extreme heatwaves (i.e., shorter or with relatively low temperature thresholds) but were less than additive (RERIs <0) for more intense heatwaves. CONCLUSIONS: Our research strengthens the evidence that exposure to heatwaves during the final gestational week can independently trigger preterm birth. Moderate heatwaves may also act synergistically with PM 2:5 exposure to increase risk of preterm birth, which adds new evidence to the current understanding of combined effects of air pollution and meteorological variables on adverse birth outcomes. https://doi.
Background : Nonpharmaceutical interventions (NPIs) are public health measures that aim to suppress the transmission of infectious diseases, including border restrictions, quarantine and isolation, community management, social distancing, face mask usage, and personal hygiene. This research aimed to assess the co-benefits of NPIs against COVID-19 on notifiable infectious diseases (NIDs) in Guangdong Province, China.Methods: Based on NID data from the Notifiable Infectious Diseases Surveillance System in Guangdong, we first compared the incidence of NIDs during the emergency response period (weeks 4-53 of 2020) with those in the same period of 2015-2019 and then compared that with the expected incidence during the synchronous period of 2020 for each city by using a Bayesian structural time series model. Findings: A total of 514,341 cases of 39 types of NIDs were reported in Guangdong during the emergency response period in 2020, which decreased by 50 •7% compared with the synchronous period during 2015-2019. It was estimated that the number of 39 NIDs during the emergency response in 2020 was 65 •6% (95% credible interval [CI]: 64 •0% -68 •2%) lower than expected, which means that 982,356 (95% CI: 913,443 -1,105,170) cases were averted. The largest reduction (82 •1%) was found for children aged 0-14 years. For different categories of NIDs, natural focal diseases and insect-borne infectious diseases had the greatest reduction (89 •4%), followed by respiratory infectious diseases (87 •4%), intestinal infectious diseases (59 •4%), and blood-borne and sexually transmitted infections (18 •2%). Dengue, influenza, and hand-foot-and-mouth disease were reduced by 99 •3%, 95 •1%, and 76 •2%, respectively. Larger reductions were found in the regions with developed economies and a higher number of COVID-19 cases.Interpretation: NPIs against COVID-19 may have a large co-benefit on the prevention of other infectious diseases in Guangdong, China, and the effects have heterogeneity in populations, diseases, time and space.
We report an experimental study on how the spin Seebeck effect in magnetic insulators depends on damping.
Acupuncture is an ancient Chinese therapy with its mode of action unclear and efficacy inconclusive. A lack of attention given to the role of psychosocial context presented in clinical provision of acupuncture may mainly account for the current dilemma in acupuncture research. This psychosocial context induces various cognitive and affective processes in the patient while receiving this treatment. On the basis of the analysis of these psychological factors involved in clinical provision of acupuncture and in light of prior studies on the placebo effect, the author hypothesizes that acupuncture works through potentiation and modulation of a highly organized and somatotopic network of endogenous opioids that links expectation, attention and body schema. This hypothesis, which focuses on the contextual factors involved in clinical provision of acupuncture, has immediate clinical and experimental implications and will take the acupuncture debate much further forward.
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