BACKGROUND & AIMS: CONTEXT:Fine particulate matter (PM) air pollution has been associated with alterations in circulating endothelial progenitor cell (EPC) levels, which may be one mechanism whereby exposures promote cardiovascular diseases. However, the impact of coarse PM on EPCs is unknown. OBJECTIVE:We aimed to determine the effect of acute exposure to coarse concentrated ambient particles (CAP) on circulating EPC levels. METHODS:Thirty-two adults (25.9 ± 6.6 years) were exposed to coarse CAP (76.2 ± 51.5 μg m(-3)) in a rural location and filtered air (FA) for 2 h in a randomized double-blind crossover study. Peripheral venous blood was collected 2 and 20 h post-exposures for circulating EPC (n = 21), white blood cell (n = 24) and vascular endothelial growth factor (VEGF) (n = 16-19) levels. The changes between exposures were compared by matched Wilcoxon signed-rank tests. RESULTS:Circulating EPC levels were elevated 2 [108.29 (6.24-249.71) EPC mL(-1); median (25th-75th percentiles), p = 0.052] and 20 h [106.86 (52.91-278.35) EPC mL(-1), p = 0.008] post-CAP exposure compared to the same time points following FA [38.47 (0.00-84.83) and 50.16 (0.00-104.79) EPC mL(-1)]. VEGF and white blood cell (WBC) levels did not differ between exposures. CONCLUSIONS:Brief inhalation of coarse PM from a rural location elicited an increase in EPCs that persisted for at least 20 h. The underlying mechanism responsible may reflect a systemic reaction to an acute "endothelial injury" and/or a circulating EPC response to sympathetic nervous system activation.

背景与目标：

BACKGROUND & AIMS: CONCLUSIONS:Routine embolization of the ipsilateral facial artery (FA) is effective because of the high success rate. The use of different embolic materials for the internal maxillary artery (IMA) and the FA was considered safe because of the absence of major complications. OBJECTIVE:To evaluate outcomes of routine embolization of the FA as well as the IMA ipsilateral to the bleeding site for intractable epistaxis, and outcomes using different embolic materials for the FA and the IMA. PATIENTS AND METHODS:Twenty-two patients with intractable epistaxis who underwent superselective embolization were retrospectively analyzed with a mean follow-up of 7 months. The FA and the IMA ipsilateral to the bleeding site were embolized. Two embolic materials, gelatin sponge and microcoils, were used for the IMA and the FA, respectively. RESULTS:The short-term success rate within the first 7 days was 77.3% (17/22). The long-term success rate was 95.5% (21/22). There were no major complications in 22 cases. Minor complications occurred in 13 cases (59%). These minor complications usually did not last more than a week and most resolved within a day.

背景与目标：

BACKGROUND & AIMS: PURPOSE:To evaluate clinical and magnetic resonance (MR) imaging results after uterine artery embolization (UAE) in women with symptomatic adenomyosis with or without uterine leiomyomas. MATERIALS AND METHODS:Thirty-eight women with symptomatic adenomyosis with or without uterine leiomyomas were treated with UAE with calibrated tris-acryl gelatin microspheres. Based on MR findings, women were categorized as having pure adenomyosis (group A; n = 15), adenomyosis dominance with fibroid tumors (group B; n = 14), or fibroid tumor dominance with adenomyosis (group C; n = 9). RESULTS:Heavy menstrual bleeding, pain, and bulk-related symptoms at last follow-up at a median of 16.5 months (range, 3-38 months) were compared with baseline symptoms. With follow-up MR imaging at a median of 12 months (range, 3-36 months), changes in uterine volume, leiomyoma volume, junctional zone thickness, and contrast enhancement of adenomyosis were assessed. After embolization, adenomyosis infarction could be depicted on contrast medium-enhanced MR in 44.1% of cases. Median reductions of uterine volume, fibroid tumor volume, and junctional zone thickness were 44.8%, 77.1%, and 23.9%, respectively. In group A, three patients needed additional surgery after UAE, in addition to two in group B and one in group C. In the remaining 32 patients, except for one patient in group C, all preexisting symptoms (eg, bleeding, pain, bulk-related symptoms) improved or resolved after UAE. Overall, 84.2% of women were satisfied with the results of UAE. CONCLUSION:In this study, midterm results (at a median of 16.5 months) showed that UAE in symptomatic adenomyosis with or without uterine leiomyomas is effective. Hysterectomy was avoided in the vast majority of patients. MR imaging showed reduction of uterine volume and junctional zone thickness.

背景与目标：

BACKGROUND & AIMS: :A review of literature focused on (129)I determination in air is provided. (129)I analysis in the environment represents a vital tool for tracing transport mechanisms, distribution pathways, safety assessment and its application as environmental tracer. To achieve that, specific chemical extraction methods and high sensitivity analytical techniques have been developed. This paper is intended to give an overview about the sample collection, extraction and distribution of (129)I in the air. Sensitivity of available measurement techniques for the determination of (129)I is compared. The article also provides the summary of current worldwide distribution of (129)I in air and respective radiation exposure of man.

背景与目标： : 提供了有关 (129)I在空气中的测定的文献综述。(129)I环境分析是追踪运输机制，分配途径，安全评估及其作为环境示踪剂应用的重要工具。为此，已经开发了特定的化学萃取方法和高灵敏度分析技术。本文旨在概述 (129)I在空气中的样品收集，提取和分布。比较了用于确定 (129)I的可用测量技术的灵敏度。本文还概述了 (129)I在空气中的当前全球分布以及人类各自的辐射暴露。

BACKGROUND & AIMS: A raw, pepperoni batter (75% porkH7 (> or = 2 x 10(7) cfu/g), mixed with non-meat ingredients, and then hand-stuffed into 55 mm fibrous casings to form sticks. The numbers of the pathogen were determined before stuffing, after fermentation, after drying/slicing, and after periods of storage. For storage, slices were packaged under air, vacuum or CO2 and stored at -20, 4 and 21 degrees C. Sticks were fermented at 36 degrees C and 85% relative humidity (RH) to < or = pH 4.8 and then dried at 13 degrees C and 65% RH to a moisture/protein ratio (M/Pr) of < or = 1.

6:1. Fermentation and drying resulted in the numbers of the pathogen decreasing by about 2 log10 units. During storage, the temperature rather than the atmosphere had the greater effect on pathogen numbers. The greatest reductions in numbers were observed during storage at 21 degrees C, when numbers decreased to about 2 and 3.8 log10 cfu/g within 14 days in product stored under air and vacuum, respectively, and a 5 log10 reduction was observed for both atmospheres within 28 days. Regardless of the storage atmosphere, numbers did not decrease below 3.6 or 3.7 log10 cfu/g after 90 days of storage at -20 or 4 degrees C, respectively. These data confirm that fermentation and drying are sufficient to eliminate only about 2 log10 cfu/g of E.

coli O157:H7 from fermented sausage, and that additional strategies, such as storage for at least 2 weeks at ambient temperature in air, are required to achieve a 5 to 6 log10 reduction in the numbers of the pathogen in sliced pepperoni.

背景与目标： 生的意大利辣香肠面糊 (75% porkH7 (> 或 = 2x10(7) cfu/g)，与非肉类成分混合，然后手工填充到55毫米的纤维肠衣中，形成木条。在填充前，发酵后，确定病原体的数量。干燥/切片后，以及储存一段时间后。为了储存，切片在空气、真空或二氧化碳下包装，储存在-20，4和21 ℃。将棒在36 ℃ 和85% 相对湿度 (RH) 下发酵至 <或 = pH 4.8，然后在13 ℃ 和65% ℃ 下干燥至水分/蛋白质比 (M/Pr) <或 = 1。
<强> 6:1.发酵和干燥导致病原体数量减少约2 log10单位。在储存期间，温度而不是大气对病原体数量的影响更大。在21摄氏度的储存期间观察到数量的最大减少，当在空气和真空下储存的产品在14天内数量分别降低到约2和3.8 log10 cfu/g时，并且在28天内观察到两个大气压的5 log10减少。不管储存气氛如何，在-20或4摄氏度下储存90天后，数字没有低于3.6或3.7 log10 cfu/g，这些数据分别证实，发酵和干燥足以消除发酵香肠中仅约2 log10 cfu/g的大肠杆菌。例如，在环境温度下在空气中至少保存2周，以使切成薄片的意大利辣香肠中的病原体数量减少5至6 log10。

BACKGROUND & AIMS: OBJECTIVES:This study aimed to evaluate the associations between ambient air pollutants, obesity, and kidney function. SUBJECTS/METHODS:We enrolled 3345 people who had undergone health checkups at Seoul National University Hospital. We recorded the annual average concentrations of ambient air pollutants, including particulate matter with an aerodynamic diameter of ≤10 μm (PM10), nitrogen dioxide (NO2), sulfur dioxide (SO2), and carbon monoxide (CO), in each subject's residential area. Various obesity traits, such as body mass index, waist circumference, and visceral and subcutaneous adipose tissue areas, were measured by quantified computerized tomography (CT), and kidney function was assessed in relation to estimated glomerular filtration rate as an indicator of kidney function. RESULTS:High PM10, NO2, SO2, and CO concentrations were significantly associated with decreased kidney function (β = -2.39 and standard error = 0.32, -1.00 and 0.31, -1.23 and 0.28, and -1.32 and 0.29, respectively), and with the prevalence of chronic kidney disease (CKD). The association between air pollutant concentrations and decreased kidney function, including CKD, was stronger among those with high abdominal adiposity, as defined by CT measurement. For example, the association between increased concentrations of air pollutants and the prevalence of CKD was stronger in the group with greater visceral adiposity than in the group with less visceral adiposity (aORs = 1.29 vs 1.16 for PM10, 1.42 vs 1.21 for SO2, and 1.27 vs 1.11 for CO). CONCLUSIONS:Long-term exposure to higher concentrations of air pollutants was unfavorably associated with kidney function and CKD prevalence, especially in people with abdominal obesity. This may indicate a high susceptibility to air pollutants in obese people.

背景与目标：

BACKGROUND & AIMS: PURPOSE:To evaluate the duration of room air tamponade and its associated factors. STUDY DESIGN:Retrospective cohort study METHODS: The present study reviewed the medical records of patients who received room air tamponade after vitrectomy between Jun 2015 and Dec 2016. The room air duration was assessed by patient interviews 2 weeks after surgery. Relationships between the variables and tamponade duration were determined using logistic regression analysis. The remaining air level was determined from medical records. RESULTS:The room air tamponade had dissipated by 11.1 ± 1.3 days after surgery. The duration was 11.2 ± 1.3 days for eyes with a spared posterior capsule, longer than the duration in other eyes (10.1 ± 0.9 days). Increased axial length was correlated with increased duration. Axial length and a spared posterior capsule were significantly correlated with tamponade duration. Its half-life was presumed about 3.3 days. The room air seems to be absorbed at a constant rate. CONCLUSION:The data suggest that room air tamponade remains in the vitreous cavity for an average of 11.1 days. Axial length and posterior capsule status were associated with duration.

背景与目标：

BACKGROUND & AIMS: :A novel whole ceiling upper-room ultraviolet germicidal irradiation (UVGI) system [eggcrate ultraviolet (UV)] has been developed that incorporates open-cell 'eggcrate'-suspended ceiling panels and bare UV lamps with a ceiling fan. Upper-room UVGI is more effective for air disinfection than mechanical ventilation at much lower installation and operating costs. Conventional upper-room UVGI fixtures employ multiple tightly spaced horizontal louvers to confine UV to the upper-room. These louvered fixtures protect occupants in the lower-room from UV-induced eye and skin irritation, but at a major cost to fixture efficiency. Using a lamp and ballast from a conventional upper-room UVGI fixture in the eggcrate UV system, the germicidal efficacy was markedly improved even though the UV radiation emitted by the lamp was unchanged. This fundamental change in the application of upper-room UVGI air disinfection should permit wider, more effective application of UVGI globally to reduce the spread of airborne infection.

背景与目标： : 已开发出一种新颖的整个天花板上部房间紫外线杀菌照射 (UVGI) 系统 [eggcrate ultraviolet (UV)]，该系统结合了开放式 “eggcrate” 吊顶面板和带有吊扇的裸露紫外线灯。上部房间的UVGI比机械通风更有效地进行空气消毒，安装和运营成本要低得多。传统的上部房间UVGI固定装置采用多个紧密间隔的水平百叶窗，以将紫外线限制在上部房间。这些百叶窗式固定装置可保护下层房间的乘员免受紫外线引起的眼睛和皮肤刺激，但固定装置效率的主要成本。在eggcrate UV系统中使用传统的上层UVGI灯具的灯和镇流器，即使灯发出的UV辐射没有变化，杀菌效果也得到了显着改善。上室UVGI空气消毒应用的这一根本变化应允许在全球范围内更广泛，更有效地应用UVGI，以减少空气传播感染。

BACKGROUND & AIMS: :This study was undertaken to determine whether there was a correlation between ambient ozone (O3) levels and number of hospital admissions for myocardial infarction (MI) in Taipei, Taiwan. Hospital admissions for MI and ambient air pollution data for Taipei were obtained for the period from 2006 to 2010. The relative risk (RR) of hospital admissions for MI was estimated using a time-stratified case-crossover approach, controlling for weather variables, day of the week, seasonality, and long-term time trends. For the single-pollutant model (without adjustment for other pollutants), increased RR for a number of MI admissions was significantly associated with higher O3 levels both on warm days (>23°C) and on cool days (<23°C). This observation was accompanied by an interquartile range elevation correlated with a 7% (95% CI = 2%-12%) and 17% (95% CI = 11%-25%) rise in number of MI admissions, respectively. In the two-pollutant models, no significant associations between ambient O3 concentrations and number of MI admissions were observed on warm days. However, on cool days, correlation between ambient O3 after inclusion of each of the other five pollutants, particulate matter (PM10 or PM2.5), sulfur dioxide (SO2), nitrogen dioxide (NO2) or carbon monoxide (CO), and number of MI admissions remained significant. This study provides evidence that higher levels of ambient O3 increase the RR of number of hospital admissions for MI.

背景与目标： : 这项研究旨在确定台湾台北的环境臭氧 (O3) 水平与心肌梗死 (MI) 住院人数之间是否存在相关性。在2006年2010年期间，获得了台北的MI住院人数和环境空气污染数据。使用时间分层的病例交叉方法 (控制天气变量，星期几，季节性和长期时间趋势) 来估计MI的住院相对风险 (RR)。对于单污染物模型 (不调整其他污染物)，在温暖的日子 (>23 °C) 和凉爽的日子 (<23 °C)，许多MI入院的RR升高与较高的O3水平显着相关。)。此观察结果伴随着四分位间距升高，分别与MI入院人数的7% (95% CI = 2%-12%) 和17% (95% CI = 11%-25%) 相关。在两种污染物模型中，在温暖的日子里，没有观察到环境O3浓度与MI入院次数之间的显着关联。然而，在凉爽的日子里，加入其他五种污染物，颗粒物 (PM10或PM2.5)，二氧化硫 (SO2)，二氧化氮 (NO2) 或一氧化碳 (CO) 后的环境O3之间的相关性以及MI的入院数量仍然很重要。这项研究提供了证据，表明较高的环境O3水平会增加MI住院人数的RR。

BACKGROUND & AIMS: :As the techniques to connect percutaneous coronary intervention (PCI) balloons and the inflation syringe vary in the instructions for use and in practice, we measured the amount of air in PCI balloons after testing three connection methods to an inflation syringe. Following the preparation using one of the three methods, 114 balloons and stent balloons were tested four times. Method 1 connected the syringe and the balloon catheter directly after purging and filling the lumen, while method 3 omitted the purging and filling process. With method 2, the catheter lumen was purged, filled and fully vented via a three-way valve. The primary endpoint answered whether air remained in the balloon, and if so, the secondary endpoint indicated the total volume of remaining air. The connection with a three-way valve achieved significantly less air in the inflated balloon as compared with either direct connection approach (27% vs. 44% and 51%; p = 0.015). For the direct connection, no significant difference between purging and filling the lumen prior to making the connection or not existed. According to these findings, the best method to connect a PCI balloon to the inflation syringe while removing air involves using a three-way valve.

背景与目标： : 由于连接经皮冠状动脉介入治疗 (PCI) 球囊和充气注射器的技术在使用说明书和实践中有所不同，我们在测试了三种与充气注射器的连接方法后测量了PCI球囊中的空气量。在使用三种方法之一制备之后，测试114球囊和支架球囊四次。方法1在吹扫和填充管腔后直接连接注射器和球囊导管，而方法3省略了吹扫和填充过程。使用方法2，通过三通阀清除，填充并完全排出导管腔。主要终点回答了气球中是否残留有空气，如果是，则次要终点指示剩余空气的总体积。与任一直接连接方式 (27% 相对于44% 和51%; p = 0.015) 相比，与三通阀的连接显著减少了充气气球中的空气。对于直接连接，在进行连接之前或不存在清除和填充管腔之间没有显着差异。根据这些发现，在去除空气的同时将PCI气球连接到充气注射器的最佳方法是使用三通阀。

BACKGROUND & AIMS: :The aim of this study was to identify prognostic factors affecting intrahepatic progression-free survival (ihPFS) and overall survival (OS) in patients with colorectal cancer liver metastases (CRCLM) undergoing portal vein embolization (PVE) and subsequent (extended) right hemihepatectomy. A total of 59 patients (mean age: 60.8 ± 9.3 years) with CRCLM who underwent PVE in preparation for right hemihepatectomy were included. IhPFS and OS after PVE were calculated using the Kaplan-Meier method. Cox regression analyses were conducted to investigate the association between the following factors and survival: patient age, laterality of the colorectal cancer (right- versus left-sided), tumor location (colon versus rectal cancer), time of occurrence of hepatic metastases (synchronous versus metachronous), baseline number and size of hepatic metastases, presence or absence of metastases in the future liver remnant (FLR) before PVE, preoperative carcinoembryogenic antigen (CEA) levels, time between PVE and surgery, history of neoadjuvant or adjuvant chemotherapy, and the presence or absence of extrahepatic disease before PVE. Median follow up was 18 months. The median ihPFS was 8.2 months (95% confidence interval: 6.2-10.2 months), and median OS was 34.1 months (95% confidence interval: 27.3-40.9 months). Laterality of the primary colorectal cancer was the only statistically significant predictor of ihPFS after PVE (hazard ratio (HR) = 2.242; 95% confidence interval: 1.125, 4.465; p = 0.022), with patients with right-sided colorectal cancer having significantly shorter median ihPFS than patients with left-sided cancer (4.0 ± 1.9 months versus 10.2 ± 1.5 months; log rank test: p = 0.018). Other factors, in particular also the presence or absence of additional metastases in the FLR, were not associated with intrahepatic progression-free survival. The presence of extrahepatic disease was associated with worse OS (HR = 3.050, 95% confidence interval: 1.247, 7.459; p = 0.015).

背景与目标： : 这项研究的目的是确定影响接受门静脉栓塞 (PVE) 和随后 (扩展) 右半肝切除术的大肠癌肝转移 (CRCLM) 患者肝内无进展生存期 (ihPFS) 和总生存期 (OS) 的预后因素。总共包括59例CRCLM患者 (平均年龄: 60.8 ± 9.3岁)，他们接受了PVE准备进行右半肝切除术。使用Kaplan-Meier方法计算PVE后的IhPFS和OS。进行Cox回归分析以调查以下因素与生存率之间的关系: 患者年龄，结直肠癌的偏向性 (右侧与左侧)，肿瘤位置 (结肠癌与直肠癌)，肝转移发生时间 (同步与异时)，肝转移的基线数量和大小，PVE前未来肝残留 (FLR) 是否存在转移，术前癌胚抗原 (CEA) 水平，PVE与手术之间的时间，新辅助或辅助化疗史以及PVE前是否存在肝外疾病。中位随访时间为18个月。ihPFS中位数为8.2个月 (95% 置信区间: 6.2-10.2个月)，OS中位数为34.1个月 (95% 置信区间: 27.3-40.9个月)。原发性结直肠癌的偏侧性是PVE后ihPFS的唯一具有统计学意义的预测指标 (风险比 (HR) = 2.242; 95% 置信区间: 1.125，4.465; p = 0.022)，右侧结直肠癌患者的中位ihPFS明显短于左侧癌患者 (4.0 ± 1.9个月对10.2 ± 1.5个月; 对数秩检验: p = 0.018)。其他因素，特别是FLR中是否存在其他转移，与肝内无进展生存期无关。肝外疾病的存在与较差的OS相关 (HR = 3.050，95% 置信区间: 1.247，7.459; p = 0.015)。

BACKGROUND & AIMS: :In a 71-year-old man with a history of coronary artery bypassing using the left internal thoracic and gastroepiploic arteries, the first jejunal artery aneurysms were found by chance at 3D-CT performed to evaluate conditions of the grafts. He was successfully treated by transcatheter embolization using interlocking detachable coils. During a follow-up period of 5 months, the patient did well and had no sign of intestinal ischemia.

背景与目标： : 在一名71岁的男性中，他有使用左胸腔和胃内动脉绕过冠状动脉的病史，在3D-CT上偶然发现了第一个空肠动脉瘤，以评估移植物的状况。他通过使用互锁可拆卸线圈经导管栓塞术成功治疗。在5个月的随访期内，患者表现良好，没有肠缺血的迹象。

BACKGROUND & AIMS: :Endosaccular coiling is recognized as a feasible method for treating unruptured intracranial aneurysms (UIAs). We retrospectively reviewed cases of UIAs treated by coiling in the Japanese Registry of Neuroendovascular Therapy (JR-NET) 3, a nationwide survey of NET between 2010 and 2014, the beginning period of intracranial stents in Japan. Data were extracted for 6844 UIAs (6619 procedures) from 40,169 registered records of all NETs in the JR-NET 3 databases. The features of the aneurysms and procedures, immediate radiographic findings, procedure-related complications, and clinical outcomes at 30 days after the procedures were assessed. Of 6844 UIAs, 81.8% were located in the anterior circulation. The mean patient age was 61.3 years (72.4% females). Compared with the preceding JR-NET 1 and 2, there were significant increases (P <0.05) in the rates of the following in JR-NET 3: wide-necked and small UIAs measuring <10 mm (from 56.4% to 58.8%), adjunctive techniques (54.8% to 71.8%), and stent usage (1.1% to 22.1%). Both pre- (85.6% to 96.7%) and post-procedural (84.0% to 94.6%) antiplatelet therapy were more frequently administered in JR-NET 3. Although procedure-related complication rates did not differ between the two groups, ischemic complication rates increased from 4.6% to 5.9%, leading to an increase in the 30-day morbidity (modified Rankin Scale >2) from 2.1% to 2.8%. In conclusion, introduction of neck-bridge stent was associated with an increase in cases of wide-necked aneurysms. However, the ischemic complication rate increased despite the greater use of periprocedural antiplatelet therapy.

背景与目标： : 腔内盘绕术被认为是治疗未破裂颅内动脉瘤 (UIAs) 的可行方法。我们回顾性地回顾了在日本神经血管内治疗注册中心 (jr-net) 3中通过盘绕治疗的UIAs病例，该调查是对日本的净2010年和2014 (日本颅内支架的开始时期) 的全国性调查。从jr-net 3数据库中所有NET的40,169登记记录中提取6844 UIAs (6619程序) 的数据。评估了动脉瘤和手术的特征，影像学检查结果，手术相关并发症以及手术后30天的临床结局。在6844个UIAs中，81.8% 个位于前循环。患者平均年龄为61.3岁 (72.4% 名女性)。与之前的JR-NET 1和2相比，JR-NET 3中的以下比率显着增加 (P <0.05): 宽颈和小型UIAs测量 <10毫米 (从56.4% 到58.8%)，辅助技术 (54.8% 到71.8%)，和支架的使用 (1.1% 至22.1%)。在JR-NET 3中，术前 (85.6% 至96.7%) 和术后 (84.0% 至94.6%) 抗血小板治疗均更为频繁。尽管两组之间与手术相关的并发症发生率没有差异，但缺血性并发症发生率从4.6% 增加到5.9%，导致30天发病率从2.1% 增加到2.8% (改良Rankin量表> 2)。总之，颈桥支架的引入与宽颈动脉瘤病例的增加有关。然而，尽管更多地使用围手术期抗血小板治疗，缺血并发症发生率仍增加。

BACKGROUND & AIMS: :The prevalence of habitual snoring has been extensively explored in paediatric populations. Although exposure to cigarette smoke increases the risk of habitual snoring in a dose-dependent fashion, the potential contribution of air quality to habitual snoring remains unclear. 6000 questionnaires were distributed to 6- to 12-year-old children attending public schools in five distinct neighbourhoods within the city of Tehran, Iran, that were preselected based on air quality measures. Habitual snoring was defined as loud snoring ≥3 nights per week. Information regarding clinical and family-related habitual snoring risk factors was also obtained. Descriptive statistics followed by adjusted risk assessments were conducted. Among the 4322 (72%) completed datasets, the prevalence of habitual snoring was 11.6%. Partition of habitual snoring rates according to neighbourhood air quality characteristics revealed significantly higher habitual snoring frequencies among children residing in neighbourhoods with greatest pollution (24.5% and 12.1% in South and Central neighbourhoods versus 7.0% and 7.7% in North and East neighbourhoods, respectively). The regional variance in habitual snoring was primarily accounted for by an integrated measure of air quality, even after controlling for other risk factors. Environmental air quality emerges as a significant and potentially modifiable contributor to the risk for developing habitual snoring during childhood.

背景与目标： : 习惯性打鼾的患病率已在儿科人群中得到广泛探讨。尽管暴露于香烟烟雾会以剂量依赖的方式增加习惯性打鼾的风险，但空气质量对习惯性打鼾的潜在贡献仍不清楚。向伊朗德黑兰市五个不同社区的公立学校就读的6至12岁儿童分发了6000份问卷，这些问卷是根据空气质量指标预先选择的。习惯性打鼾被定义为每周大声打鼾 ≥ 3晚。还获得了有关临床和家庭相关的习惯性打鼾危险因素的信息。进行描述性统计，然后进行调整后的风险评估。在4322 (72%) 完成的数据集中，习惯性打鼾的患病率为11.6%。根据邻里空气质量特征对习惯性打鼾率的划分表明，居住在污染最大的社区中的儿童习惯性打鼾频率明显更高 (南部和中部分别为24.5% 和12.1%，北部和东部分别为7.0% 和7.7%)。即使在控制了其他危险因素之后，习惯性打鼾的区域差异也主要是通过对空气质量的综合衡量来解释的。环境空气质量成为导致儿童时期习惯性打鼾风险的重要且潜在的可改变因素。

BACKGROUND & AIMS: :This study is designed to evaluate the various physiologic maneuvers (Valsalva, humming, breath-hold) for the potential prevention of air embolism during central venous catheter placement. Central venous pressure measurements were prospectively obtained in 40 patients undergoing central venous catheter placement. The average central venous pressure at baseline was 3.275 mm Hg (range = -4 to 16, SD = 5.99). The average central venous pressure during breath hold was 6.1 mm Hg (range = -6 to 24, SD = 7.99). The average central venous pressure during humming was 5.1 mm Hg (range = -4 to 20, SD = 6.4) The average central venous pressure during the Valsalva maneuver was 18.43 (range = -3 to 48, SD = 14.73). Forty percent of patients (16 of 40) had negative central venous pressures at rest, 25% (10 of 40) had negative pressures during breath hold, 20% (8 of 40) had negative pressures during humming, and 2.5% (1 of 40) had negative pressures during Valsalva maneuver. The average increases in central venous pressure during breath hold, humming, and Valsalva were 2.85, 1.82, and 15.2 mm Hg, respectively. The difference between pressures during Valsalva and other maneuvers was statistically significant (P <.05). The conclusion is that the Valsalva maneuver is superior to breath-hold and humming for increasing central venous pressure during central venous catheter placement and, therefore, it is more likely to prevent air embolism in cooperative patients.

背景与目标： : 本研究旨在评估各种生理动作 (Valsalva，嗡嗡声，屏气)，以预防中央静脉导管放置过程中空气栓塞的可能性。前瞻性地获得了40例接受中心静脉导管放置的患者的中心静脉压测量值。基线时的平均中心静脉压为3.275毫米Hg (范围 = -4至16，SD = 5.99)。屏气期间的平均中心静脉压为6.1毫米Hg (范围 = -6至24，SD = 7.99)。嗡嗡声期间的平均中心静脉压为5.1毫米Hg (范围 = -4至20，SD = 6.4)。Valsalva动作期间的平均中心静脉压为18.43 (范围 = -3至48，SD = 14.73)。40% 的患者 (40例中的16例) 在休息时中心静脉压力为负，25% 例 (40例中的10例) 在屏气期间有负压，20% 例 (40例中的8例) 在嗡嗡声期间有负压，2.5% 例 (40例中的1例) 在Valsalva操作期间有负压。屏气，嗡嗡声和Valsalva期间中心静脉压的平均升高分别为2.85，1.82和15.2毫米Hg。Valsalva期间的压力与其他动作之间的差异具有统计学意义 (P <.05)。结论是，在中心静脉导管放置过程中，Valsalva动作优于屏气和嗡嗡声，可提高中心静脉压，因此，在合作患者中，它更有可能预防空气栓塞。