Work from home: Facilitators for an effective ergonomic work system

Previous studies on Human Factors and Ergonomics (HFE) have primarily examined the impact of Work-From-Home (WFH) on worker health and well-being, yet little research has examined the optimal implementation process of WFH programs. Work systems perspective suggests that organizational policies, leadership, and psychological factors collectively influence the success of organizational change efforts. Our study explored the roles of managerial/supervisory, psychological, and organizational policy factors in facilitating the relationship between employees' HFE awareness and their acceptance and satisfaction with the WFH arrangement. Using data from 3195 knowledge workers in the US who use computers as their primary work tool and have worked from home at least one day in the past 30 days, we employed structural equation modeling to test our hypotheses. Transformational HFE leadership and employees' general self-efficacy are pivotal in implementing ergonomic WFH arrangements. The combination of employees' HFE awareness, transformational HFE leadership, and adequate levels of self-efficacy may foster positive process outcomes (e.g., readiness for WFH arrangement, workspace design satisfaction) in WFH arrangements. Efforts that are coordinated across organizational levels determine the effectiveness of organizational change.

Innovated surgery incision for patients of congenital malformation of the middle and outer ear with infection (CMMOEI)

BACKGROUND

It is the challenging clinical issue of combining debridement of infected lesions and retaining the blood skin flap for auricle reconstruction in patients of Congenital Malformation of the Middle and Outer Ear with Infection (CMMOEI).

AIMS/OBJECTIVES

To innovate and introduce an surgery incision to solve the challenging clinical issue of a combined debridement of infection yet retaining a well vascularized skin flap for auricle reconstruction in patients with CMMOEI.

MATERIAL AND METHODS

A combined innovated incision of ear sulcus and prefabricated earlobe was used for 23 cases (23 ears) with CMMOEI, The success in the management of the encountered infections, and the short and moderate-term outcome of the innovated incision to preserve a well-vascularized skin flap for subsequent auricle reconstruction were reviewed. The 23 cases include 10 males and 13 females, aged 4-14 years (mean 8.4 years), 7 left ears and 16 right ears. 14 ears stenosis and 9 ears atresia of the outer ear canals.

RESULTS

In all 23 cases, the infections were successfully cleared without recurrence or complication with 2-year follow-up. The local skin flap and its blood supply were well preserved for subsequent auricle reconstruction.

CONCLUSIONS AND SIGNIFICANCE

The new incision can facilitate clearance of infection in CMOMEI patients, and preserve the retroauricular tissues for subsequent harvesting of a well-vascularized skin flap for subsequent auricle reconstruction.

New strategies and methods for reconstruction of the outer ear canal (OEC)

Background: The incidence of re-stenosis or re-atresia after reconstruction of the Outer Ear Canal (OEC) in patients with Congenital Malformation of the Middle and Outer Ear (CMMOE) is very high (up to 48%), and it has been a difficult problem for otologists not being able to solve.Aims/Objectives: To explore new strategies and methods to improve re-stenosis or re-atresia after reconstruction of the OEC in patients with CMMOE.Material and Methods: According to the characteristics of reconstructed OEC (r-OEC) re-stenosis or re-atresia summarized by us, a number of new prevention strategies and methods have been proposed and related patent products have been designed, including the improvement of covering epithelium types and skin grafting methods (7 types), simulated drum ring function to prevent the formation of negative pressure in the cavity, and strengthen postoperative support to reduce skin shrinkage and bone hyperplasia. The postoperative effects of different ages and preoperative OEC malformations are statistically analyzed.Results: The incidence of re-stenosis/re-atresia is 14.3% (5/35) in the thin sectional skin of the temporal scalp overlap splicing skin grafting, which was significantly better than 45.5% (15/33) in the whole piece mosaic splicing and barrel skin grafting from the inner thin sectional thigh skin and overlay splicing other methods, including the inner thigh thin sectional skin, chest medium thick skin and subcutaneous pedicle + chest medium thick skin (p<0.05). The patent artificial drum ring and the model stent of the OEC have obvious effects. The mean operation age of postoperative atresia, stenosis, and good groups are 9.3, 13.1, and 12.5 years old, respectively. The proportion of preoperative atresia is 91.3%, 85.7%, and 57.7%, respectively. The total incidence of re-atresia and re-stenosis of r-OEC for two groups of atresia and stenosis of OEC before surgery is 40.5% (49/121) and 13.3% (8/60), respectively.Conclusions and Significance: The best result is found in overlapping the splicing thin sectional skin of the temporal scalp, combined with artificial drum ring implantation, effective support of postoperative model stent of OEC and post-pubertal surgery selection are new and effective strategies and methods to prevent re-stenosis or re-atresia of r-OEC. Atresia or stenosis of the OEC before the operation is the influence factor of the postoperative effect.

The significance of masking for the poor hearing ear in pure tone audiometry

BACKGROUND

In pure tone audiometry, when the difference of the Average Air Conduction Threshold of pure tone (AACT) between bilateral ears is more than 40 dB HL masking must be performed on the poor side, However, we found that masking also make significance difference when the binaural AACT difference (AACT-d)was less than 40 dB HL in some patients.

AIMS/OBJECTIVE

Assessing the significance of masking for the poor ear in pure tone audiometry in patients with different types of deafness to obtain preoperative accurate hearing.

MATERIAL AND METHODS

A comparative analysis of 163 cases (163 ears) with hearing difference between two ears was conducted, who were divided into three groups: G1 Congenital Malformation of the Middle and Outer Ear (CMMOE)as conductive deafness, 63 ears, G2 sudden deafness as sensorineural deafness, 65 ears, and G3 media otitis as conductive or mixed deafness,35 ears. AACT-d before and after the poor ear masking was analyzed under the following three conditions: (1) 0.125-8 KHz each frequency, (2) 0.5-4 KHz on average, (3) the frequencies of AACT-d ≥ 40 dB HL and <40 dB HL between the two ears before masking. If the sample data did not follow a normal distribution, the Wilcoxon rank sum test was used for comparasion of AACT, and p < 0.05 was considered statistically significant. It is clinically effective for AACT-d ≥ 15 dB HL at 1 frequency or 10 dB HL ≤ AACT-d at 2 frequencies <15 dB HL before and after masking.

RESULTS

Among the three groups, (1) the comparasion of AACT-d before and after the poor ear masking for each frequency of 0.125-8 KHz and 0.5-4 KHz on average with all p < 0.05, and the AACT-d of the G1 group was the largest, with an average 0.5-4KHz of 7.5 dB HL, and the first two were 14.5 dB HL and 13.8 dB HL at 0.125 KHz and 0.25 KHz, respectively. (2) AACT-d ≥ 40 dB HL and <40 dB HL between the two ears before masking were distributed at the full frequency of 0.125-8KHz, the clinically effective rates of ≥40 dB HL groups were G1 (89.3%), G2 (45.5%) and G3 (5.3%), while those of < 40 dB HL groups were G1 (69.7%), G2 (34.4%) and G3 (31.3%), respectively.

CONCLUSION AND SIGNIFICANCE

For all three groups, there was statistically significant in AACT-d before and after the poor ear masking across each frequency of 0.125-8 KHz and on average 0.5-4 KHz. The distribution of AACT-d ≥ 40 dB HL and <40 dB HL between the two ears before masking was observed throughout the full frequency range of 0.125-8 KHz. AACT-d before and after the poor ear masking showed clinical effectiveness in all three groups, with the highest effective rate observed in the G1 group and the highest AACT-d at 0.125 KHz and 0.25 KHz. Therefore, regardless of whether the AACT-d between the two ears before masking is ≥40 dB HL or <40 dB HL, the full frequency masking should be employed in three groups, especially for the G1 group of CMMOE, particularly at 0.125 KHz and 0.25 KHz.

Relationship between congenital malformation of the outer ear and hearing

Background: There is no report on the relationship between congenital malformation of the outer ear and hearing, which makes it possible to predict the hearing level just based on microtia grades.Aims/Objectives: To investigate the correlation between two types of congenital malformation of the outer ear [microtia and Outer Ear Canal Malformation (OECM)] and hearing, as well as the interrelationship among all three variables.Material and methods: A total of 535 cases (598 ears) of congenital malformation of the middle and outer ear (CMMOE) with hearing data, out of which 319 cases (349 ears) microtia with available images and graded by I-V, 449 cases (482 ears) OECM graded by atresia, stenosis and normal, and 87 cases (87 ears) OEC atresia graded I-IV, 301 cases (301 ears) with materials of microtia, OECM and hearing at the same time were carried out correlation analysis. The Average Air-Conduction Threshold of pure tone (AACT) at 0.5-4 KHz was calculated corresponding to the ears with different malformation grades. The differences in AACT among different malformation grades, the correlation between malformation severity and AACT, as well as the relationship among microtia, OECM and AACT were analyzed. The one-way analysis of variance (ANOVA) was employed to compare the differences in AACT, Kendall's tau-b rank correlation coefficient test was used for correlation analysis. A statistical significance level of p < 0 .05 was applied.Results: Among the 349 ears with microtia, the corresponding AACT values for grades I to V were 61.6, 63.0, 69.9, 75.4, and 75.0 (dB HL), respectively. Comparing grade III to grades II or IV, both p < 0 .05. However, p > 0 .05 between grade I and II or between grade IV and V. The correlation coefficient between microtia grades and AACT r = 0.219, p < 0.05. Among the 482 ears of OECM, the distribution was as follows: 73.6% atresia, 19.1% stenosis, and 7.3% normal, the corresponding AACT values were 64.1, 61.7, and 52.5 (dB HL), respectively. Comparing normal to stenosis or atresia, both p < 0.05, while between atresia and stenosis p > 0.05. The correlation between OECM and AACT was r = 0.104, p < 0.05. The AACT values corresponding to grades I to IV of OEC atresia in the 87 ears were 59.9, 65.1, 71.1, and 64.1 (dB HL), respectively. Comparing these grades, all p > 0.05. The correlation between the degree of atresia and AACT r = 0.23, p < 0 .05. The correlation coefficients for 301 ears microtia to OECM, microtia to AACT, OECM to AACT were r = 0.339, r = 0.163 and r = 0.128 respectively, with all p < 0 .05.Conclusion and significance: There are positive correlations among the degree of microtia, degree of OECM, and AACT values for each other, and so between the degree of OEC atresia and AACT, suggesting that as the severity of microtia or OECM increased, the AACT also tended to be higher, which make it possible to predict the hearing level and the degree of OECM based on microtia grades in clinical practice. Additionally, there are significant differences in AACT values in microtia grade III to grades II or IV, OEC normal to stenosis or atresia, while no differences in microtia grade I to II and grade IV to V, OEC stenosis to atresia, and among the grades I-IV of the OEC atresia.

A clinical epidemiological study on congenital ear malformation (CEM)

BACKGROUND

There is no report about the definition, classification and clinical epidemiological study of congenital ear malformation (CEM).Aims/Objectives: To investigate the definition, clinical classification and distribution of a large number of CEM cases, along with the clinical and epidemiological characteristics associated with congenital malformation of the middle and outer ear (CMMOE).

MATERIAL AND METHODS

A total of 3231 cases (4714 ears) with CEM and related malformations were retrospectively analyzed, including 2,658 cases (4,064 ears) CEM and 573 cases (650 ears) preauricular fistulas and accessory ears, specifically related malformations to CEM.

RESULTS

Among the 2,658 cases (4,064 ears) CEM, 64.9% cases were male and 35.1% were female. 52.9% cases with bilateral, 29.1% with right and 18.0% with left CEM. A subgroup of 1,050 cases (1,331 ears) was identified as CMMOE out of 1,090 cases (1,379 ears) microtia. In the CMMOE subgroup, 74.0% cases were male, 46.3% on the right side, 26.8% showed bilateral involvement. Out of the CMMOE with available images, there were 947 cases (1,105 ears). Additionally, related malformations including preauricular fistulas and accessory ears, were solely occured in 573 cases (650 ears), except for their occurrence simultaneously with CEM. The classification and distribution of CEM are as follows:1. 2658 cases of CEM (1) 69.9% of them were confined to the ear, including: ① the outer ear 2.6%, the middle ear 17.0% and the inner ear 32.4%, ② two parts simultaneous malformations of the outer ear, the middle ear and the inner ear 17.2%, ③ three parts simultaneous malformations of the outer ear, the middle ear and the inner ear 0.6%, (2) Multiple malformations including in CEM 29.1%; (3) syndromes related to CEM 1.0%.2. 1050 cases of CMMOE (1) 36.3% of them were confined to the middle and outer ears; (2) Multiple malformations associated with CMMOE 61.4%, including hemifacial microsomia 50.5%, accessory ears 9.8%, preauricular fistulas 9.2%, heart malformation 7.1%, and kidney malformation 2.0%; and (3) syndromes related to CMMOE 2.3%, (4) Complications of the ear 16.9%, mainly including otitis media 7.9%, outer ear canal cholesteatoma 6.3%, retroauricular abscess 1.1%, and nasal and pharyngeal complications 18.6%. The proportions of microcia grades I-Ⅴ based on the images of 1105 ears CMMOE were 5.2%, 10.5%, 74.1%, 6.9%, and 3.3%, respectively. Among the 1331 ears CMMOE, the incidence rates of outer ear canal atresia, stenosis, normal, and ossicles malformation were 86.5%, 9.9%, 3.6%, and 98.3%, respectively.Conclusion and Significance: Approximately 69.9% of CEM cases were confined to the ear itself, with the highest proportion being inner ear malformation alone. Multiple malformations were predominantly associated with CMMOE. Syndromes related to CEM were relatively rare. Among cases of microtia, 96.3% were classified as CMMOE. These cases were predominantly observed in males, right ear and exhibited characteristics such as grade III microtia, atresia of the outer ear canal, ossicles malformation, and multiple malformations. The multiple malformations frequently included hemifacial microsomia, accessory ear, preauricular fistula, as well as heart and kidney deformities. CMMOE often coexisted with ear infections, cholesteatoma, and complications in the nasal and pharyngeal regions.

Physiological responses, trunk posture, and work pace in commercial building cleaning in Washington State: An observational field study

INTRODUCTION

This study aimed to investigate whether work pace is a critical indicator for predicting a janitor's risk of work-related musculoskeletal disorders (WMSDs).

METHOD

Field measurements were obtained from commercial building janitors as well as the determination of work pace. Physiological responses collected were heart rate, energy expenditure (calories), activity level (METs), steps, trunk posture. Data were obtained using direct measurements, along with a time study, which was performed by shadowing 13 janitors in Washington State. The measured values were summarized descriptively, and five of the most common janitorial tasks were compared. The relationships between work pace and the physiological response variables were determined by calculating the Pearson product-moment correlation coefficients.

RESULTS

The highest average percent heart rate reserve (47.4%) was reported during restroom cleaning, while the highest activity and energy expenditure levels (3.6 METs and 217.1 calories/h) were reported for mopping. The top 90% of trunk flexion angles and the highest percentage of time in trunk flexion from 20° to 60° were recorded during restroom cleaning. Restroom cleaning showed the highest correlation between all the physiological response variables and work pace. In most of the tasks, a high work pace may have increased the degree and duration of severe trunk flexion.

CONCLUSION

Overall, when several tasks were considered, the extent of physiological responses, trunk joint angles, and exposure time to awkward postures tended to increase with an increase in work pace.

PRACTICAL APPLICATIONS

This study showed the feasibility of using the work pace measured from time studies as a predictive indicator of WMSDs risks. Using this information, managers may compose a schedule that can minimize WMSDs risks while considering actual work pace deviations that may impact a janitor's ability to complete assigned tasks properly within a shift.

[Difference of urinary protein components and the correlation between urinary protein quantification and glomerular filtration rate in pregnant women with pre-eclampsia]

Objective: To investigate the difference of urinary protein components in pregnant women with pre-eclampsia (PE) with different degrees of proteinuria and the correlation between 24-hour urinary protein quantification and estimated glomerular filtration rate (eGFR). Methods: Clinical data of 101 PE pregnant women who were delivered in Renji Hospital, Shanghai Jiao Tong University School of Medicine from July 2018 to June 2022 were retrospectively analyzed. According to 24-hour urinary protein quantification, they were divided into 3 groups, including 40 cases of mild proteinuria group (24-hour urinary protein quantification ≤2.0 g), 21 cases of moderate proteinuria group (2.0 g<24-hour urinary protein quantification ≤5.0 g), 40 cases of severe proteinuria group (24-hour urinary protein quantification >5.0 g). The general clinical data, urinary protein index and renal function index of PE pregnant women in 3 groups were compared. The eGFR was calculated based on age, serum creatinine (sCr), blood urea nitrogen (BUN) and serum albumin (sAlb). Correlation analysis was conducted between 24-hour urinary protein quantification and each index of eGFR. Results: (1) General clinical data: the median PE onset week (31 weeks) and delivery gestational week [(36.4±3.6) weeks] of PE pregnant women in the mild proteinuria group were later than those in the moderate proteinuria group [median PE onset: 22 weeks, delivery: (32.2±4.2) weeks] and severe proteinuria group [median PE onset: 25 weeks, delivery: (29.6±3.4) weeks]; systolic blood pressure, diastolic blood pressure, alanine aminotransferase, aspartate aminotransferase levels and the incidence of fetal growth restriction were lower than those in the moderate and severe proteinuria groups; median newborn birth weight (3 150 g) was higher than those in the moderate proteinuria group (1 305 g) and the severe proteinuria group (1 042 g), respectively. The differences were statistically significant (all P<0.05). (2) Urinary protein index: the 24-hour urinary protein quantification, urinary microalbumin (mAlb) and urinary transferrin (TRF) levels of PE pregnant women in the mild proteinuria group, moderate proteinuria group and severe proteinuria group were increased successively, and the differences were statistically significant (all P<0.05). The median urinary α1-microglobulin (α1-MG) level of PE pregnant women in the severe proteinuria group (50 mg/L) was significantly higher than those in the mild proteinuria group (17 mg/L) and moderate proteinuria group (22 mg/L; all P<0.05), but there was no significant difference between the mild proteinuria group and the moderate proteinuria group (P>0.05). There was no significant difference in the median urinary β2-microglobulin (β2-MG) level among the 3 groups (P=0.632). (3) Renal function index: sAlb and eGFR of PE pregnant women in the mild proteinuria group, moderate proteinuria group and severe proteinuria group were successively decreased, and BUN was successively increased, respectively, and the differences were statistically significant (all P<0.05). The sCr level of PE pregnant women in the severe proteinuria group was significantly higher than those in the mild proteinuria group and the moderate proteinuria group (all P<0.05), but there was no significant difference between the mild proteinuria group and the moderate proteinuria group (P>0.05). (4) Correlation analysis: the 24-hour urinary protein quantification of PE pregnant women was significantly negatively correlated with eGFR (r=-0.645, P<0.001), and was correlated with the variables sAlb (r=-0.549, P<0.001), sCr (r=0.582, P<0.001) and BUN (r=-0.657, P<0.001) in the eGFR calculation formula. The 24-hour urinary protein quantification were significantly negatively correlated with the gestational weeks of PE onset, gestational weeks of termination of pregnancy and newborn birth weight (all P<0.05). Conclusions: The protein composition in the urine of PE pregnant women with different degrees of proteinuria is not different, but the protein level is significantly different. There is a significant negative correlation between the increase of 24-hour urinary protein quantification and the decrease of eGFR.

Comparison of the observer, single-frame video and computer vision hand activity levels

Observer, manual single-frame video, and automated computer vision measures of the Hand Activity Level (HAL) were compared. HAL can be measured three ways: (1) observer rating (HALO), (2) calculated from single-frame multimedia video task analysis for measuring frequency (F) and duty cycle (D) (HALF), or (3) from automated computer vision (HALC). This study analysed videos collected from three prospective cohort studies to ascertain HALO, HALF, and HALC for 419 industrial videos. Although the differences for the three methods were relatively small on average (<1), they were statistically significant (p < .001). A difference between the HALC and HALF ratings within ±1 point on the HAL scale was the most consistent, where more than two thirds (68%) of all the cases were within that range and had a linear regression through the mean coefficient of 1.03 (R2 = 0.89). The results suggest that the computer vision methodology yields comparable results as single-frame video analysis.Practitioner summary: The ACGIH Hand Activity Level (HAL) was obtained for 419 industrial tasks using three methods: observation, calculated using single-frame video analysis and computer vision. The computer vision methodology produced results that were comparable to single-frame video analysis.

[Regional analysis of high risk factors of hypertensive disorders in pregnancy with organ or system impairment]

Objective: To explore the influencing factors of pregnancy-induced hypertensive disorders in pregnancy (HDP) with organ or system impairment in pregnant women, and to analyze and compare the differences of HDP subtypes in different regions of China. Methods: A total of 27 680 pregnant women with HDP with complete data from 161 hospitals in 24 provinces, autonomous regions and municipalities were retrospectively collected from January 1, 2018 to December 31, 2018. According to their clinical manifestations, they were divided into hypertension group [a total of 10 308 cases, including 8 250 cases of gestational hypertension (GH), 2 058 cases of chronic hypertension during pregnancy] and hypertension with organ or system impairment group [17 372 cases, including 14 590 cases of pre-eclampsia (PE), 137 cases of eclampsia, 2 645 cases of chronic hypertension with PE]. The subtype distribution of HDP in East China (6 136 cases), North China (4 821 cases), Central China (3 502 cases), South China (8 371 cases), Northeast China (1 456 cases), Southwest China (2 158 cases) and Northwest China (1 236 cases) were analyzed. By comparing the differences of HDP subtypes and related risk factors in different regions, regional analysis of the risk factors of HDP pregnant women with organ or system impairment was conducted. Results: (1) The proportions of HDP pregnant women with organ or system impairment in Northeast China (79.05%, 1 151/1 456), Central China (68.42%, 2 396/3 502) and Northwest China (69.34%, 857/1 236) were higher than the national average (62.76%, 17 372/27 680); the proportions in North China (59.18%, 2 853/4 821), East China (60.85%, 3 734/6 136) and South China (59.56%, 4 986/8 371) were lower than the national average, and the differences were statistically significant (all P<0.05). (2) Univariate analysis showed that the proportions of primiparas, non-Han, non-urban household registration, irregular prenatal examination and PE history in the hypertension with organ or system impairment group were higher than those in the hypertension group, and the differences were statistically significant (all P<0.05). Multivariate logistic regression analysis showed that primiparas, non-Han, non-urban household registration, irregular prenatal examination and PE history were independent risk factors for HDP pregnant women with organ or system impairment (all P<0.05). (3) Primipara: the rates of primipara in Northeast China, North China and Southwest China were higher than the national average level, while those in South China, Central China and Northwest China were lower than the national average level. Non-Han nationality: the rates of non-Han nationality in Northeast China, North China and Northwest China were higher than the national average, while those in East China, South China and Central China were lower than the national average. Non-urban household registration: the rates of non-urban household registration in Northeast China, North China, and Southwest China were lower than the national average, while those in East China, Central China were higher than the national average. Irregular prenatal examination: the rates of irregular prenatal examination in North China, South China and Southwest regions were lower than the national average level, while those in Northeast China, Central China and Northwest China were higher than the national average level. History of PE: the incidence rates of PE in Northeast China, North China, South China and Southwest China were lower than the national average level, while those in Central China and Northwest China were higher than the national average level. Conclusions: Primiparas, non-Han, non-urban household registration, irregular prenatal examination, and PE history are risk factors for HDP pregnant women with organ or system impairment. Patients in Northeast, Central and Northwest China have more risk factors, and are more likely to be accompanied by organ or system function damage. It is important to strengthen the management of pregnant women and reduce the occurrence of HDP.

[EBF1 Promotes the Sensitivity of Cervical Cancer Cells to Cisplatin via Activating FBN1 Transcription]

Cisplatin (DDP) is widely used in the chemotherapy of cervical cancer (CC), the fourth most common female malignancy worldwide. However, some patients progress to chemotherapy resistance, which leads to chemotherapy failure, tumor recurrence, and poor prognosis. Therefore, strategies to identify the regulatory mechanisms underlying CC development and increase tumor sensitivity to DDP will help improve patient survival. This research was designed to ascertain the mechanism of EBF1-dependent regulation of FBN1 which promotes chemosensitivity of CC cells. The expression of EBF1 and FBN1 was measured in CC tissues resistant or sensitive to chemotherapy and in DDP-sensitive or -resistant cells (SiHa and SiHa-DDP cells). SiHa-DDP cells were transduced with lentiviruses encoding EBF1 or FBN1 to evaluate the influence of these two proteins on cell viability, expression of MDR1 and MRP1, and cell aggressiveness. Moreover, the interaction between EBF1 and FBN1 was predicted and demonstrated. Finally, to further verify the EBF1/FB1-dependent mechanism of DDP sensitivity regulation in CC cells a xenograft mouse model of CC was established using SiHa-DDP cells transduced with lentiviruses carrying EBF1 gene and shRNA directed to FBN1 EBF1 and FBN1 showed decreased expression in CC tissues and cells, particularly in those resistant to chemotherapy. Transduction of SiHa-DDP cells with lentiviruses encoding EBF1 or FBN1 lead to decreased viability, IC50, proliferation capacity, colony formation ability, aggressiveness, and increased cell apoptosis. We have shown that EBF1 activates FBN1 transcription by binding to FBN1 promoter region. Additionally, it was revealed that FBN1 silencing reversed the promoting effect of EBF1 overexpression on chemosensitivity of CC cells in vivo. EBF1 facilitated chemosensitivity in CC cells by activating FBN1 transcription.

Rupture of a non sinus of Valsalva aneurysm during pregnancy: Case report and review of literatures

Ruptured Sinus of Valsalva aneurysms during pregnancy is rare and presents a threat both to the mother and the fetus. We report a case of ruptured nonsinus of Valsalva aneurysms in a 26-year-old woman diagnosed at 32⁺⁴ weeks of gestation. A successful elective lower-segment cesarean section was conducted under general anesthesia. A successful surgical correction of the ruptured aneurysm under cardiopulmonary bypass (CPB) was performed with patch repair after 13 days. A multidisciplinary approach with respect to the pregnant patient's diagnosis, indications, and timing of surgery is necessary in ensuring the best possible outcomes for both the mother and the child.

The job demand-control-support model and work-related musculoskeletal complaints in daytime and nighttime janitors: The mediating effect of burnout

Janitors' jobs require repetitive work with low control (skill discretion, decision authority) and social support. Previous studies have found this constellation of work conditions leads to high stress levels. This study investigated the relationships among job demand-control-support, burnout, and musculoskeletal symptoms for commercial janitors in Washington State. Structural equation modeling was performed using data from 208 participants with analyses comparing models of daytime and nighttime janitors. Burnout fully mediated the relationship between job demands and musculoskeletal complaints among daytime janitors. Among nighttime janitors, burnout mediated between job demands, job control, and social support, and musculoskeletal complaints. The nighttime janitors' model was more fully supported compared to the daytime model. This study is one of a small number that examine and bring attention to the importance of janitors' burnout. Recommendations to improve the psychosocial work environment toward mitigating burnout and reducing musculoskeletal complaints are provided.

Cleaning in the 21st Century: The musculoskeletal disorders associated with the centuries-old occupation - A literature review

Workers performing cleaning duties experience higher injury rates, especially in the form of musculoskeletal disorders (MSDs), than other industries. It is essential to understand the inherent risks associated with the nature of this occupation. Based on the Balance Theory (Smith & Carayon-Sainfort, 1989), this review surveys the current literature, especially those published since the previous review paper (Kumar & Kumar, 2008), and identifies which elements contributing to MSD risks were examined: task, technology, organization, environment, individual, and their interactions. Thirty-nine research papers published between 2005 and 2021 are identified and summarized. Among these papers, task and individual elements received the most attention, at 42 and 34 occurrences, respectively. The interaction elements of technology-organization, technology-environment, and organization-environment received less than three mentions. The goal of this literature review is to update the knowledge base and identify current trends for the cleaning occupation. Possible interventions for risk reduction and future research directions are suggested.

Physical activity changes among office workers during the COVID-19 pandemic lockdown and the agreement between objective and subjective physical activity metrics

After the onset of the COVID-19 pandemic, many office workers transitioned to working-from-home (WFH) which altered routine physical activity (PA). To understand how these workers' PA were affected throughout the pandemic, PA data collected in January, April, June, and December 2020 with an activity tracker and a validated survey were analyzed. Between January and December, it was found that step counts during the weekday decreased (p < 0.01), weekday heart rate was higher than weekends (p < 0.01), activity-tracker and self-reported PA decreased (p < 0.01), and sitting time increased (p < 0.01). To understand the agreement between the objective and subjective METs, Bland-Altman analyses were completed and demonstrated an acceptable level of agreement. Findings show decreased level of PA amongst WFH office workers and that the activity tracker and survey are reliable methods of recording WFH PA.

[A multicenter cross-sectional study of quality of life and nonsurgical treatment in patients with knee osteoarthritis]

Objective: To explore the influencing factors of health-related quality of life (HRQoL) in patients with knee osteoarthritis, and to analyze the non-surgical treatment of knee osteoarthritis. Methods: Demographic variables, treatment modalities, imaging data, and 12-item short form health survey (SF-12) scores of patients with knee osteoarthritis in orthopedic outpatient departments of five hospitals in Beijing from December 2017 to November 2018 were collected to analyze influencing factors of HRQoL and non-surgical treatment. Results: A total of 2 034 patients were included. There were 530 males (26.1%) and 1 504 females (73.9%), with a mean age of (59.17±10.22) years. In terms of physical quality of life, female patients with knee osteoarthritis had lower physical components summary (PCS) compared with male patients (β=-0.521, P=0.036); patients aged ≥64 years had lower PCS than those aged<55 years (β=-0.636, P=0.026). Patients with an education of more than 12 years had higher PCS than those with less than 10 years (β=1.063, P<0.001). Compared to patients with mild clinical symptoms, the PCS of patients with moderate clinical symptoms was lower (β=-0.860, P=0.002), while the PCS of those with severe clinical symptoms was much lower (β=-1.126, P<0.001). Patients treated with combination therapy had higher PCS than untreated patients (β=0.731, P=0.005). In terms of mental quality of life, compared to patients engaged in sedentary work, the mental components summary (MCS) of patients engaged in mild manual labor jobs was lower (β=-0.712, P=0.015); Compared to patients with a Charson comorbidity index of 0, patients with a Charlson comorbidity index ≥ 2 had lower MCS (β=-1.183, P=0.007). In the past 12 months, 648 (31.9%), 143 (7.0%), 406 (20.0%), 680 (33.4%), 343 (16.9%), 681 (33.5%), 170 (8.4%) patients had used non-steroid anti-inflammatory drugs (NSAIDs), acetaminophen, glucosamine/chondroitin formulations, physical therapy, articular cavity puncture injection, traditional Chinese medicine treatment and exercise therapy, respectively. Total of 451 patients (22.2%) received monotherapy and 889 patients (43.7%) received combination therapy. Conclusions: The major non-surgical treatment methods for patients with knee osteoarthritis in Beijing are NSAIDs, physiotherapy and traditional Chinese medicine. Combination therapy is used more frequently than monotherapy. Physical quality of life is related to gender, age, education, severity of symptoms and treatment, while mental quality of life is related to occupational labor and comorbidities.

[Bioinformatics analysis of differently expressed genes in osteoblastic sarcoma and screening of key genes]

Objective: To screen the different expressed genes between osteosarcoma and normal osteoblasts, and find the key genes for the occurrence and development of osteosarcoma. Methods: The gene expression dataset GSE33382 of normal osteoblasts and osteosarcoma was obtained from Gene Expression Omnibus (GEO) database. The different expressed genes between normal osteoblasts and osteosarcoma were screened by limma package of R language, and the different expressed genes were analyzed by Kyoto encyclopedia of genes and genomes (KEGG) pathway enrichment analysis. The protein interaction network was constructed by the String database, and the network modules in the interaction network were screened by the molecular complex detection (MCODE) plug-in of Cytoscape software. The different expressed genes contained in the first three main modules screened by MCODE were analyzed by gene ontology (GO) using the BiNGO module of Cytoscape software. The MCC algorithm was used to screen the top 10 key genes in the protein interaction network. The gene expression and survival dataset GSE39055 of osteosarcoma was obtained from GEO database, and the survival analysis was performed by Kaplan-Meier method. The data of 48 patients with osteosarcoma treated in the First Affiliated Hospital of Fujian Medical University from January 2005 to December 2015 were selected for verification. The expression of STC2 protein in osteosarcoma was detected by immunohistochemical method, and the survival analysis was carried out combined with the clinical data of the patients. Results: A total of 874 different expressed genes were identified from GSE33382 dataset, including 402 down-regulated genes and 472 up-regulated genes. KEGG enrichment analysis showed that different expressed genes were mainly related to p53 signal pathway, glutathione metabolism, extracellular matrix receptor interaction, cell adhesion molecules, folate tolerance, and cell senescence. The top 10 key genes in the interaction network were GAS6, IL6, RCN1, MXRA8, STC2, EVA1A, PNPLA2, CYR61, SPARCL1 and FSTL3. STC2 was related to the survival rate of patients with osteosarcoma (P<0.05). The results showed that the expression of STC2 protein was related to tumor size and Enneking stage in 48 cases of osteosarcoma. The median survival time of 25 cases with STC2 high expression was 21.4 months, and that of 23 cases with STC2 low expression was 65.4 months. The survival rate of patients with high expression of STC2 was lower than that of patients with low expression of STC2 (P<0.05). Conclusions: Bioinformatics analysis can effectively screen the different expressed genes between osteosarcoma and normal osteoblasts. STC2 is one of the important predictors for the prognosis of osteosarcoma.

[Comparative analysis of high risk factors between early-onset pre-eclampsia and late-onset pre-eclampsia]

Objective: To explore the difference of high-risk factors between early-onset and late-onset pre-eclampsia, and to further understand high-risk factors of pre-eclampsia. Methods: Clinical data of pre-eclampsia pregnant women in 160 medical institutions in China in 2018 were retrospectively analyzed, including 8 031 cases of early-onset pre-eclampsia and 12 969 cases of late-onset pre-eclampsia. The proportion of high-risk factors, different body mass index (BMI) and age stratification between early-onset group and late-onset group were compared. Results: (1) Univariate analysis of high-risk factors: the proportions of high-risk factors in early-onset group and late-onset group were compared, and the differences were statistically significant (all P<0.05). Among them, the proportions of primipara and multiple pregnancy in early-onset group were lower than those in late-onset group, while the proportions of pregnant women with advanced age, irregular antenatal examination, obesity, family history of hypertension, pre-eclampsia, diabetes, kidney diseases, immune system diseases and assisted reproductive technology were higher than those in late-onset group. (2) Hierarchical analysis of BMI: the proportion of pregnant women with BMI≥24 kg/m² in early-onset group [48.2% (2 828/5 872) vs 45.5% (4 177/9 181), respectively; P=0.001] and the proportion of pregnant women with BMI ≥28 kg/m² in early-onset group [19.5% (1 143/5 872) vs 18.0% (1 656/9 181), respectively; P=0.028] were significantly higher than those in late-onset group. (3) Age stratification analysis: the proportion of pregnant women aged 35-39 years in the early-onset group [21.8% (1 748/8 023) vs 17.5% (2 110/12 068), respectively; P<0.01], the proportion of pregnant women 40-44 years old [6.8% (544/8 023) vs 5.4% (648/12 068), respectively; P<0.01], and the proportion of pregnant women ≥45 years old [0.7% (58/8 023) vs 0.5% (57/12 068), respectively; P=0.021] were significantly higher than those in the late-onset group. (4) Multivariate analysis: advanced age (≥35 years old), multiple pregnancy, irregular antenatal examination or transfer from other hospitals, family history of hypertension (including paternal, maternal and parental lines), previous history of pre-eclampsia, kidney diseases, immune system diseases (systemic lupus erythematosus, antiphospholipid antibody syndrome) and assisted reproductive technology pregnancy were the risk factors affecting the severity of pre-eclampsia (all P<0.05). Conclusion: Pregnant women with high risk factors such as age ≥35 years old, BMI ≥24 kg/m² before pregnancy, family history of hypertension, history of pre-eclampsia, chronic kidney diseases, immune diseases (mainly including systemic lupus erythematosus and antiphospholipid syndrome) and assisted reproductive technology are more likely to have early-onset pre-eclampsia.

Risk Factors for Maternal and Perinatal Complications during Pregnancy among Women with Tetralogy of Fallot

Background

Tetralogy of Fallot (TOF) is the most common cyanotic congenital heart disease during pregnancy. Studies of risk factors are of great significance to maternal and fetal outcomes in patients with TOF.

Aims

To identify predictive risk factors for maternal and perinatal complications in women with TOF.

Subjects and Methods

78 patients with TOF who delivered at Shanghai Obstetrical Cardiology Intensive Care Center between January 1993 and December 2017 were retrospective reviewed. A logistic regression model was used to identify risk factors for maternal and perinatal complications.

Results

There was no maternal death, five patients developed cardiac failure, sustained arrhythmias requiring treatments were recorded among 2 patients. Factors identified for maternal complications included previous cardiac events and oxygen saturation <90%. Oxygen saturation <90% was found to be independent predictor of maternal cardiac complications (RR = 21.455, 95%CI 2.186-210.572, P = 0.009). The perinatal survival rate was 87.18%, there were 52 term deliveries (66.67%). Perinatal poor outcomes include 9 therapeutic abortions (11.54%), 1 neonatal death (1.28%), 16 premature births (20.51%), 18 small for gestational age children (23.08%), 3 neonatal asphyxia (3.85%), and 3 neonatal cardiac malformations (3.85%). Factors identified for perinatal complications included without cardiac surgery, higher hemoglobin values, higher hematocrit values, oxygen saturation <90%, right ventricular hypertrophy, pulmonary stenosis, ventricular septal defect, and pulmonary hypertension. Oxygen saturation <90% was found to be independent predictor of perinatal complications (RR = 8.270, 95%CI 1.374-49.790, P = 0.021).

Conclusions

Oxygen saturation <90% is associated with maternal and perinatal risks. Women with TOF whose oxygen saturation <90% are not recommended for pregnancy because of high maternal and perinatal complications.

Simple benchmarking method for determining the accuracy of depth cameras in body landmark location estimation: Static upright posture as a measurement example

To evaluate the postures in ergonomics applications, studies have proposed the use of low-cost, marker-less, and portable depth camera-based motion tracking systems (DCMTSs) as a potential alternative to conventional marker-based motion tracking systems (MMTSs). However, a simple but systematic method for examining the estimation errors of various DCMTSs is lacking. This paper proposes a benchmarking method for assessing the estimation accuracy of depth cameras for full-body landmark location estimation. A novel alignment board was fabricated to align the coordinate systems of the DCMTSs and MMTSs. The data from an MMTS were used as a reference to quantify the error of using a DCMTS to identify target locations in a 3-D space. To demonstrate the proposed method, the full-body landmark location tracking errors were evaluated for a static upright posture using two different DCMTSs. For each landmark, we compared each DCMTS (Kinect system and RealSense system) with an MMTS by calculating the Euclidean distances between symmetrical landmarks. The evaluation trials were performed twice. The agreement between the tracking errors of the two evaluation trials was assessed using intraclass correlation coefficient (ICC). The results indicate that the proposed method can effectively assess the tracking performance of DCMTSs. The average errors (standard deviation) for the Kinect system and RealSense system were 2.80 (1.03) cm and 5.14 (1.49) cm, respectively. The highest average error values were observed in the depth orientation for both DCMTSs. The proposed method achieved high reliability with ICCs of 0.97 and 0.92 for the Kinect system and RealSense system, respectively.

[Energy metabolism characteristic with risk of secondary bacterial infection in patients with hepatitis B virus-related chronic liver disease]

Objective: To investigate and analyze the energy metabolism characteristics and the correlation between energy metabolism and the risk of secondary bacterial infection in patients with hepatitis B virus-related chronic liver disease (HBV-CLD). Methods: Data of 183 cases admitted to the Mengchao Hepatobiliary Hospital of Fujian Medical University from November 2017 to November 2020 were retrospectively analyzed. 79 cases of chronic hepatitis B, 51 cases of hepatitis B-related liver cirrhosis, and 53 cases of hepatitis B-related liver failure were collected. Among them patients with liver failure and decompensated liver cirrhosis were defined as severe liver disease group. The Quark RMR indirect calorimetry (COSMED Corporation, Italy) was used to exam the patients' energy metabolism condition, and the incidences of secondary bacterial infection of the patients during hospitalization were recorded. Shapiro-Wilk test and normal QQ plot were used to analyze the normal distribution of continuous variable data, which was consistent with the normal distribution and was described by mean ± standard deviation. In addition, if it did not conform to the normal distribution, the median and interquartile distance were used to describe it. Levene's test was used to test the homogeneity of variance of the data, which was consistent with the normal distribution. The t-test was used to compare the means of the two groups of samples. One-way analysis of variance was used to compare the mean values of the three groups of samples, and then the Tukey's test was used to compare the two groups. If the variance was uneven or did not conform to the normal distribution, the Wilcoxon rank sum test was used to compare the differences between the two groups. Kruskal-Wallis test (H test) was used to compare the differences between the three groups of samples, and then the Dunnett's test (Z test) was used for comparison between the two groups. Categorical variable data were analyzed using chi-square test. Logistic regression analysis was used to screen independent risk factors, and the criteria for variable inclusion (P < 0.05). Results: The respiratory entropy (RQ) and non-protein respiratory entropy (npRQ) of the three groups had statistically significant difference (P < 0.05). Among them, the RQ and npRQ of the chronic hepatitis B group were higher than hepatitis B-related liver cirrhosis group and hepatitis B-related liver failure group. There were statistically significant differences in fat oxidation rate (FAT%) and carbohydrate oxidation rate (CHO%) between the three groups (P < 0.05). Compared with hepatitis B-related liver cirrhosis group and hepatitis B-related liver failure group, chronic hepatitis B group (P < 0.05) had lower FAT% and higher CHO%. There were no statistically significant differences in the measured and predicted resting energy expenditure and protein oxidation rate (PRO%) between the three groups. The incidence of secondary bacterial infection in patients with severe liver disease was 48.39% (45/93). Compared with the non-infected group, the RQ and npRQ values ​​of the infected group were significantly decreased (P < 0.05), while FAT% was significantly increased (P < 0.05). Logistic regression analysis showed that glutamyltransferase, cholesterol, and npRQ were independent risk factors for secondary bacterial infections in patients with severe liver disease. Glutamyltransferase elevation, and cholesterol and npRQ depletion had suggested an increased risk of secondary bacterial infection. Subgroup analysis of patients with hepatitis B-related liver failure also showed that compared with non-infected group, RQ value and npRQ value of secondary bacterial infection group were significantly decreased (P < 0.05), while FAT% was significantly increased (P < 0.05). Conclusion: Patients with hepatitis B virus-related chronic liver disease generally have abnormal energy metabolism. Low RQ, npRQ, CHO% and high FAT% are related to the severity of the disease; while npRQ reduction is related to the risk of secondary bacterial infection in patients with severe liver disease, and thus can be used as a clinical prognostic indicator.

Activation patterns of shoulder internal and external rotators during pure axial moment generation across a postural range

Musculoskeletal risk is mediated by body posture, especially for static tasks. Workstations that require non-neutral postures can lead to increased load, muscular fatigue and injury risk. However, demands during simple axial rotation tasks are not well-defined. The purpose of this study is to quantify the muscular activity of during static axial rotation in a range of postures. Eighteen participants performed 76 axial rotation exertions in varying combinations of humeral elevation angles (30°-60°-90°-120°-150°), plane of elevation (30°-60°-90°-120°) and exertion intensity (20-40%). Six unilateral (right) muscles (pectoralis major (clavicular and sternal), posterior deltoid, teres major, infraspinatus, latissiumus dorsi) were monitored using surface electromyography (EMG). EMG was normalized and integrated over 2 s. The influences of elevation, plane, and intensity on activity levels were then tested with a 3-way ANOVAs (p < .05). During internal rotation, activity was highest at low elevation/high plane combinations for the internal rotators, but at high elevation/low plane combinations for the external rotators. During the 40% intensity exertions, activity levels were highest at lower elevations for internal rotator but at high elevations for the external rotators. During external rotation, as the degree of elevation increased, the activity of the external rotator muscles also increased while internal rotators were unaffected. Humeral muscles responsible for axial rotation are influenced by arm posture during axial rotation exertions. High elevation and plane combinations resulted in high demands for external rotator muscles and this should be considered for job design and injury risk.

[Effects of neuromuscular exercise therapy on the joint stability of patients with knee osteoarthritis]

Objective: To evaluate the effects of neuromuscular exercise therapy on joint stability of knee osteoarthritis (OA) patients. Methods: One hundred and ten patients with knee OA were enrolled in this ongoing prospective cohort study at Arthritis Clinic and Research Center, Peking University People's Hospital from September 2017 to October 2018. The treatment consisted of six-week neuromuscular exercise therapy. The participants were followed up at 6 weeks and 3 months after the therapy. The stability of the joint was evaluated by the index of knee joint stability (IKJS), which was extracted by a novel knee-aiming task combined with the multiscale entropy (MSE) analysis of the complexity of the light spot trajectories. The secondary outcomes were pain on the visual analogue scale (VAS, 0-100), the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), quality of life on the Euro-quality of life-5 Dimensional (EQ-5D) VAS form, 30-second chair stand test and 40-meter walk test. One-way repeated measures ANOVA analysis was applied to compare the outcomes at baseline and 6 weeks and 3 months. Pearson partial analysis was used to investigate the correlation between the IKJS and the Kellgren-Lawrence (K/L) rate, pain and knee function. Results: Ninety-six participants ((65±8) years, 21 males, 75 females) completed 3-month follow-up. There was a significant improvement in IKJS at the 6-week visit compared with that at baseline (0.369, 95% confidence interval (CI) 0.241-0.496, P<0.001). The IKJS dropped at 3-month visit compared with 6-week visit, but was still better than that at baseline (0.178, 95%CI: 0.042-0.314, P=0.008). The correlation between IKJS and K/L rate, severity of pain, WOMAC or knee function was not significant (r=-0.131, -0.059, -0.231, 0.124, all P>0.05). There was improvement in pain VAS, WOMAC, EQ-5D-VAS, 30-second chair stand test and 40-meter walk test at 6 weeks and 3 months (all P<0.05). Conclusion: The neuromuscular exercise therapy is effective in improving the joint stability of the knee OA patients. However, the effect gradually diminished over time. In addition, neuromuscular exercise can help relieve pain, improve the function and quality of life in patients with knee OA.

Are Work-Related Musculoskeletal Disorders Claims Related to Risk Factors in Workplaces of the Manufacturing Industry?

OBJECTIVES

Varied work-related musculoskeletal disorders (WMSDs) claim rates were found between companies even when they were in the same sectors with similar sizes. This study aimed to (i) identify common risk factors for back, shoulder, hand/wrist, and knee WMSDs among manufacturing jobs, and (ii) characterize the biomechanical exposures in jobs and work organizational practices between high and low WMSD claim rate companies so that more focused, industry-specific intervention strategies may be developed.

METHODS

Using historical workers' compensation data, manufacturing companies were divided into two paired groups (low and high in the lower 25%ile and higher 75%ile, respectively). On-site job evaluations were conducted in 16 companies to determine job biomechanical risk levels. Management and workers' representatives in 32 paired companies were interviewed to identify possible differences between management strategies and management/worker relationships. A total of 39 injured workers were also interviewed to gather information of self-reported injury causes and suggested preventive measures.

RESULTS

Analyses of 432 job evaluations showed that more jobs had higher risk levels of prolonged standing and heavy lifting in the high back WMSD claim rate companies than the low claim rate ones. No high biomechanical risk factors were found to be associated with jobs in high shoulder claim rate companies. High repetition, pinch force, and Strain Index were associated with high hand/wrist WMSD claim rate companies. High work pace and job stress were common among high knee WMSD claim rate companies. There were no statistically significant differences for the organizational factors between high and low WMSD claim rate companies. Heavy lifting, fast work pace, high hand/wrist repetition, high hand force, and awkward shoulder postures were identified as major contributing factors by the injured workers.

CONCLUSIONS

High WMSD claim rate companies appeared to have more high biomechanical exposure jobs than low WMSD claim rate companies. Available job evaluation methods for the low back and hand/wrists are satisfactory in quantifying job risk levels in the manufacturing industry. Research into more sensitive job evaluation methods for the shoulder and knee are needed.

[Survey of related factors of maternal venous thromboembolism in nine hospitals of China]

Objective: To investigate and analyze disease status and risk factors of venous thromboembolism (VTE) during pregnancy and puerperium in our country. Methods: Clinical datas were collected from 575 patients diagnosed with VTE during pregnancy and puerperium and hospitalized in nine medical institutions in our country from January 1, 2015 to November 30, 2019, and retrospectively analyzed it's disease status and risk factors. Results: (1) The proportion of VTE in pregnancy and puerperium was 50.6% (291/575) and 49.4% (284/575), respectively. Four patients died, the mortality rate was 0.7% (4/575). The cause of death was pulmonary embolism. (2) The location of VTE during pregnancy and puerperium was mainly in the lower limb vascular (76.2%, 438/575), followed by pulmonary vessels (7.1%, 41/575). (3) In the risk factors of VTE, cesarean section accounted for 32.3% (186/575), maternal advance age accounted for 27.7% (159/575), braking or hospitalization during pregnancy accounted for 13.6% (78/575), other risk factors accounted for more than 5% were previous VTE, obesity, preterm birth, assistant reproductive technology conception and so on, pre-eclampsia and multiple pregnancy accounted for 4.9% (28/575) respectively. In addition, some patients with VTE did not have any of the above risk factors, and the incidence rate was as high as 23.1% (133/575). Conclusions: The occurrence of VTE during pregnancy and puerperium is related to multiple risk factors, and could lead to matemal death, It is very necessary to screen VTE risk factors for all pregnant women, to make corresponding prevention and control measures.

[Analysis of maternal deaths with cardiovascular diseases in Shanghai obstetric heart disease intensive care unit within twenty-six years]

Objective: To analyze risk factors, cardiovascular complications, time of death, gestational age of delivery and offspring outcomes in the maternal deaths with cardiovascular diseases (CVD). Methods: Totally 4 112 cases of pregnant women with CVD in Shanghai obstetric heart disease intensive care unit within 26 years (from January 1993 to December 2018) were collected, and 20 maternal deaths within these cases were analyzed retrospectively. Results: (1) Among the 20 deaths, structural heart diseases accounted for 90% (18/20), pregnancy induced heart diseases was 10% (2/20) while there was no dysfunctional heart disease. The mortality of pregnant women with CVD was 0.486% (20/4 112). (2) The following risk factors were common in these women, getting pregnant without counselling (95%, 19/20) , New York Heart Association classⅢ or Ⅳcardiac function (70%, 14/20), complicated with pulmonary hypertension (75%, 15/20) and prior heart events (60%, 12/20). And 85% (17/20) deaths occurred in puerperium, 15% (3/20) occurred before labor,while no death occurred during labor. And 65% (13/20) deaths died due to heart failure, 20% (4/20) deaths were due to pulmonary hypertension crisis, 5% (1/20) died on sudden cardiac arrest, rupture of aortic dissection and sudden death, respectively. Conclusions: Women with CVD should get pregnant after strict evaluation. Pulmonary hypertension is one of the most severe contraindications to pregnancy, especially in patients with moderate to severe pulmonary hypertension. The puerperium period is a critical period that threatens the safety of these patients. Since heart failure is the most common cause of death, it is necessary to prevent and treat heart failure and to monitor heart function dynamically, especially in those with structural abnormal heart diseases. Moreover, it is also of importance to standardize antenatal care and to identify the severity of heart diseases in time.

The effect of sit-stand schedules on office work productivity: A pilot study

BACKGROUND

Sit-stand workstations have been introduced in the workplaces to address the adverse sedentary effect inherent to typical office jobs. Existing field or laboratory studies showed that standing interventions are not a detriment to work productivity or performance. The effect of gradient standing proportion on these measures is still unknown.

OBJECTIVE

The current naturalistic pilot study aimed to examine the controlled sit-stand ratio effect on office performances.

METHODS

Eleven musculoskeletal symptom free office employees from a large government agency volunteered in this study. They were all equipped with electronic sit-stand desks. Computer usage (N=11) and productivity (N=3) were collected using software and organizational metrics, respectively, for four typical workdays of four different sit-stand ratios (7 : 1, 3 : 1, 2 : 1, and 1 : 1).

RESULTS

There were no statistically significant schedule effects on any computer usage measures. While not significant, time using computer, keystrokes, word count, and keyboard errors were all less as standing time increased. Sit-stand ratio and job productivity did not observe a clear cause and effect relationship.

CONCLUSIONS

The amount of time spent standing in typical office jobs might not affect computer usage and productivity. Further study with a larger sample is needed for a stronger evidence.

S doped NiCo2O4 nanosheet arrays by Ar plasma: An efficient and bifunctional electrode for overall water splitting

Transition metal oxides show great potential as electrocatalysts, owing to the low cost and rich chemical states. However, the limited surface areas, low intrinsic activity and poor hydrogen evolution reaction (HER) activity greatly restrict the application for overall water splitting. Herein, we have constructed S doped NiCo₂O₄ nanosheet arrays by Ar plasma (Ar-NiCo₂O₄|S) to enhance active sites and boost catalytic kinetics. Consequently, the Ar-NiCo₂O₄|S shows the improved performances for HER and oxygen evolution reaction (OER). Further, as bifunctional electrocatalysts, Ar-NiCo₂O₄|S exhibit a voltage of 1.63 V at 10 mA cm^-2, as well as good stability.

264The long noncoding RNA H19 modulates cardiac remodeling after infarction

Noncoding RNAs account for 80% of human transcripts, but functional studies on noncoding RNAs are relatively few and limited. Long noncoding RNAs (lncRNAs) are known to have an important role in cardiac development, and lately, high-throughput RNA sequencing has been extensively utilized to profile and explore the transcriptome landscape of lncRNAs in failing hearts. These studies have revealed that lncRNAs are mostly dysregulated in failing hearts and their expression signature can discriminate failing hearts of different etiologies.

H19 is abundantly expressed in failing human hearts and its polymorphism was shown to possess a significant correlation with the risk of coronary artery diseases. In our study using murine hearts, we discovered that H19 was significantly up regulated in the heart after ischemic injury, with predominant expression in cardiac fibroblasts. This finding piqued our interest to further investigate the function of H19 in the heart.

We demonstrated that ectopic overexpression of H19 using the AAV approach led to severe cardiac fibrosis in mouse hearts following myocardial infarction. In light of this finding, we generated H19 knockout mice to further investigate the functionality of H19 and we found that cardiac fibrosis was attenuated in these mice. Altogether, these findings suggested that H19 is a fibrosis regulator during cardiac remodeling process after infarction. Due to the multiple regulatory roles of lncRNAs, we then took advantage of chromatin isolation by RNA purification (ChIRP) to identify the H19-interacting protein, YB-1. Surprisingly, mice with YB-1 knockdown displayed severe cardiac fibrosis even without injury. Furthermore, we demonstrated that YB-1 is a transcriptional suppressor of collagen 1A1. Knockout of H19 in YB-1 knockdown partially suppressed Col1a1 expression, which suggests a negative regulatory role of H19 on YB-1 towards the expression of Col1a1.

Taking into account all of these findings, we concluded that H19 mediates collagen expression in fibroblasts through the inhibition of YB-1 activity during cardiac remodeling.

[Microbiology analysis of periprothetic joint infection post total hip and knee arthroplasty of 9 centers in Beijing between 2014 and 2016]

Objective: To investigate the microbiological test, antibiotic sensitivity and surgical treatment of periprosthetic joint infection(PJI) cases in post total hip arthroplasty (THA) and total knee arthroplasty (TKA) patients. Methods: A retrospective cross-sectional survey was conducted on 318 patients who underwent THA or TKA in 9 clinical centers in Beijing from January 2014 to December 2016.The data of microbiology, antibiotic sensitivity and surgical treatment were collected.The average age of patients was (62.3±13.1) years old (range: 21-86 years old), including 145 males and 173 females.The body mass index was (25.6±3.8) kg/m (2) (range: 15.6-38.1 kg/m(2)). Results: In total, 318 patients had microorganisms detected by periprosthetic tissue culture or synovial fluid culture, 209 cases (65.7%) had Gram-positive bacteria, 29 cases (9.1%) had Gram-negative bacteria, 10 cases (3.1%) had fungi, 3 cases (0.9%) had non-tuberculous mycobacteria, 72 cases (22.6%) were negative, 69 cases (21.7%) had methicillin-resistant bacteria. The antibiotic sensitivity results showed that the overall resistance rate of penicillin, cefuroxime, amoxicillin+clavulanic acid was 79.9%, 69.9%, and 68.1%, respectively; meropenem, vancomycin, and linezolid resistance rate was 0. For the treatment methods of hip and knee PJI, two-stage revision surgery acounted for 72.9% (108/148) and 64.1% (109/170), respectively. One-stage revision surgery accounted for 21.6% (32/148) and 7.6% (13/170), and open debridement surgery accounted for 4.7%(7/148) and 26.4% (45/170). Conclusions: Gram-positive bacteria was still the main pathogen of PJI.The methicillin-resistant bacteria and rare bacteria should be payed attention to. The Majority of hip and knee PJI cases were treated by two-stage revision surgery.

Predicting Sagittal Plane Lifting Postures From Image Bounding Box Dimensions

OBJECTIVE

A method for automatically classifying lifting postures from simple features in video recordings was developed and tested. We explored if an "elastic" rectangular bounding box, drawn tightly around the subject, can be used for classifying standing, stooping, and squatting at the lift origin and destination.

BACKGROUND

Current marker-less video tracking methods depend on a priori skeletal human models, which are prone to error from poor illumination, obstructions, and difficulty placing cameras in the field. Robust computer vision algorithms based on spatiotemporal features were previously applied for evaluating repetitive motion tasks, exertion frequency, and duty cycle.

METHODS

Mannequin poses were systematically generated using the Michigan 3DSSPP software for a wide range of hand locations and lifting postures. The stature-normalized height and width of a bounding box were measured in the sagittal plane and when rotated horizontally by 30°. After randomly ordering the data, a classification and regression tree algorithm was trained to classify the lifting postures.

RESULTS

The resulting tree had four levels and four splits, misclassifying 0.36% training-set cases. The algorithm was tested using 30 video clips of industrial lifting tasks, misclassifying 3.33% test-set cases. The sensitivity and specificity, respectively, were 100.0% and 100.0% for squatting, 90.0% and 100.0% for stooping, and 100.0% and 95.0% for standing.

CONCLUSIONS

The tree classification algorithm is capable of classifying lifting postures based only on dimensions of bounding boxes.

APPLICATIONS

It is anticipated that this practical algorithm can be implemented on handheld devices such as a smartphone, making it readily accessible to practitioners.

Occupational cranking operations: The scapula perspective

Cranking the landing gear is a common task performed by truck drivers to raise or lower trailers. This task poses a risk to the shoulder joint due to the required forceful exertion and the posture constrained to the hand-handle interface. As a potential occupational risk, there has been no definitive guideline for best practices among truck drivers. An operator can crank perpendicular (frontal) or parallel (sagittal) to the crank rotation. In this laboratory study, the effects of cranking method and resistance on scapular range of motion and shoulder muscle activity were observed in 12 participants. Scapular posture was measured using an optical motion tracking system. EMG was monitored on 16 muscles contributing to shoulder movement. The results show that during frontal cranking, the scapular range of protraction was 28 ± 11.6°, which was more than the sagittal cranking (23 ± 10.4°), indicating a decreased subacromial space and elevated shoulder impingement risk. Seven muscles (all three deltoid muscles, middle trapezius, supraspinatus, infraspinatus, and teres minor) demonstrated that when the crank resistance was low, the front cranking method resulted in lower activity than the side cranking. When the crank resistance was 20 Nm, the muscle activity on these seven muscles was greater when cranking from the front than from the side. Based on these observations, we suggest that when the resistance is low (lowering the trailer) the driver should stand facing the trailer. On the contrary, it is advantageous to stand parallel to the trailer and crank while raising the trailer to apply the full body strength to reduce the shoulder load.

[Exploration on developing the diagnosis and treatment guidelines for osteoarthritis in primary care of China]

At present, several clinical practice guidelines for osteoarthritis have been developed. Although contradictions about some recommendations are still in dispute, large number of clinical practice guidelines recommended core treatments, namely education, weight loss and exercise therapy. Thus, the diagnosis and treatment of primary osteoarthritis should focus on the above three treatments. However, we have to develop the clinical practice guidelines for osteoarthritis in primary hospital, based on the characteristics of osteoarthritis in China, the burden of disease, the health literacy of patients and the clinical decision-making of diagnosis and treatment of primary osteoarthritis in primary medical care.We suggest to formulate guidelines for the diagnosis and treatment of osteoarthritis in primary medical care to regulate primary interventions.

Case of twin pregnancy complicated by idiopathic thrombocytopenic purpura treated with intravenous immunoglobulin: Review of the literature

Idiopathic thrombocytopenic purpura (ITP) is an acquired thrombocytopenia without other clear cause of thrombocytopenia. It is not common in a singleton pregnancy and less common in twin pregnancy. We report a 33-year-old ITP pluripara whose first pregnancy was uneventful. She carried twin pregnancy, complicated by recurrent very low platelets, and gave birth to preterm twins. This patient received multiple courses of intravenous immunoglobulin (IVIG) and showed a significant platelet count improvement with IVIG therapy.

[Analysis of the difference of serum immunoglobulins, β2-microglobulin and transferrin in pre-eclampsia and pregnancies complicated with chronic kidney disease]

Objective: To observe and analyze the difference of serum immunoglobulin IgA, IgG, IgM, β2-microglobulin and transferrin in pre-eclampsia (PE) and pregnancies complicated with chronic kidney disease. Methods: Totally 46(40.0%) pregnancies with PE (PE group), 36(31.3%) pregnancies with chronic kidney disease (chronic kidney disease group) and 33(28.7%) normal pregnancies with normal blood pressure and proteinuria without any complication (control group) delivered in Renji Hospital were recruicted in this study from February 2017 to July 2017. Serum IgA, IgG, IgM, β2-microglobulin and transferrin levels were detected. Correlation tests were conducted between these indicators and blood pressure, 24 hours proteinuria value and delivery weeks. Results: (1) Comparison of general situation of pregnancies in the 3 groups: there were no significant difference in the age and child bearing history between the 3 groups (all P>0.05), while there was a significant difference in the blood pressure and deliver week (all P<0.01). There was no significant difference in 24 hours proteinuria values between PE group and chronic kidney disease group (Z=-0.187, P=0.852). (2) Comparison of serum immunoglobulin, β2-microglobulin and transferrin levels in pregnant women with three groups: serum IgA level in chronic kidney disease group was significantly higher than those in PE and control groups [(2.4±0.9) vs (1.8±0.9) vs (1.6±0.6) g/L; F=9.959, P<0.01]. The serum IgG and IgM values had no significant difference between the 3 groups (all P>0.05). Serum β2-microglobulin in chronic kidney disease group was significantly higher than those in PE and control groups [(4.0±2.6) vs (2.7±0.7) vs (2.0±0.5) mg/L; F=15.892, P<0.01]. Serum transferrin in chronic kidney disease group was significantly lower than those in PE and control groups [(3.0±0.8) vs (3.7±1.1) vs (3.6±0.6) g/L; F=6.284, P<0.01]. (3) The correlation between serum immunoglobulin, β2-microglobulin, transferrin and blood pressure, proteinuria value and delivery weeks in PE group: the blood pressure level was not correlated with serum IgA, β2-microglobulin and transferrin values in PE group (all P> 0.05). So, 24 hours proteinuria value was positively correlated with β2-microglobulin (r=0.557, P<0.01), which was negatively correlated with transferrin (r=-0.442, P<0.01) and was not correlated with IgA(r=0.089, P=0.556). There was a negative correlation between delivery weeks and β2-microglobulin (r=-0.328, P=0.026), and positive correlation with transferrin (r=0.315, P=0.035) and no correlation with IgA (r=-0.169, P=0.260). (4) The correlation between serum immunoglobulin, β2-microglobulin, transferrin and blood pressure, proteinuria value and delivery weeks in chronic kidney disease group: the blood pressure level was positively correlated with β2- microglobulin (systolic pressure: r=0.598, P<0.01; diastolic pressure:r=0.557, P<0.01), which was not correlated with IgA and transferrin in chronic kidney disease group (all P>0.05). So, 24 hours proteinuria value was positively correlated with β2-microglobulin and IgA (r=0.568, r=0.330, both P<0.05), and not correlated with transferrin (r=0.255, P=0.133). Delivery weeks had a negative correlation with β2-microglobulin (r=-0.574, P<0.01), while it had a positive correlation with transferrin (r=0.369, P=0.027). No correlation was found between delivery weeks and IgA values (r=-0.257, P=0.131). Conclusion: The serum levels of IgA, β2-microglobulin and transferrin in PE and pregnancies with chronic kidney disease are significantly different, which may provide clinical value for the diagnosis of PE and pregnancies with chronic kidney disease in future.

An investigation into four different sit-stand workstation use schedules

Twelve office workers participated in a study investigating effects of four sit/stand schedules (90-min sit/30-min stand, 80/40, 105/15, and 60/60) via several objective and subjective measures (muscle fatigue, foot swelling, spinal shrinkage, and self-reported discomfort). Results showed that there were no significant differences in shoulder and low back static muscle activities between sitting and standing. Muscle fatigue was developed during workday under all schedules. The longest standing schedule seemed to have a tendency of reducing muscle fatigue. None of the schedules helped or worsened foot swelling and spinal shrinkage. More active break-time activities seemed reducing muscle fatigue and foot swelling. While the self-reported bodily discomfort levels were generally low, the preferred schedules among the participants were varied, although the least standing schedule was the least preferred. We may conclude that effects of using sit-stand workstation to improve musculoskeletal health may be limited but promoting more active break-time activities can help. Practitioner Summary: Sit-stand workstations are used to reduce work-related musculoskeletal disorders. This study shows that office workers prefer sit/stand durations in the range between 1:1 and 3:1. Longer standing may have the potential to reduce muscle fatigue. However, active break-time activities may be more effective in reducing muscle fatigue and foot swelling.

Using the Microsoft Kinect™ to assess 3-D shoulder kinematics during computer use

Shoulder joint kinematics has been used as a representative indicator to investigate musculoskeletal symptoms among computer users for office ergonomics studies. The traditional measurement of shoulder kinematics normally requires a laboratory-based motion tracking system which limits the field studies. In the current study, a portable, low cost, and marker-less Microsoft Kinect™ sensor was examined for its feasibility on shoulder kinematics measurement during computer tasks. Eleven healthy participants performed a standardized computer task, and their shoulder kinematics data were measured by a Kinect sensor and a motion tracking system concurrently. The results indicated that placing the Kinect sensor in front of the participants would yielded a more accurate shoulder kinematics measurements then placing the Kinect sensor 15° or 30° to one side. The results also showed that the Kinect sensor had a better estimate on shoulder flexion/extension, compared with shoulder adduction/abduction and shoulder axial rotation. The RMSE of front-placed Kinect sensor on shoulder flexion/extension was less than 10° for both the right and the left shoulder. The measurement error of the front-placed Kinect sensor on the shoulder adduction/abduction was approximately 10° to 15°, and the magnitude of error is proportional to the magnitude of that joint angle. After the calibration, the RMSE on shoulder adduction/abduction were less than 10° based on an independent dataset of 5 additional participants. For shoulder axial rotation, the RMSE of front-placed Kinect sensor ranged between approximately 15° to 30°. The results of the study suggest that the Kinect sensor can provide some insight on shoulder kinematics for improving office ergonomics.

[Influence of different inner dressings in negative-pressure wound therapy on escharectomy wound of full-thickness burn rabbits]

Objective: To explore the influence of different inner dressings in negative-pressure wound therapy (NPWT) on escharectomy wound of full-thickness burn rabbits. Methods: Eighteen Japanese white rabbits were inflicted with full-thickness burn on unilateral back. They were divided into polymer dressing group (PD), biological dressing group (BD), and silver biological dressing group (SBD), according to the random number table, with 6 rabbits in each group. On 3 days post burn, the wounds were performed with escharectomy, and then wounds of rabbits in group PD were covered with polyurethane foam. Wounds of rabbits in group BD were covered with porcine acellular dermal matrix (ADM) and wounds of rabbits in group SBD were covered with silver porcine ADM. Then continuous NPWT was performed on rabbits of the three groups for 7 days. Immediately after surgery and on post surgery day (PSD) 7, general observation of wound was conducted and tissue around the wound was harvested for determination of dry to wet weight ratio. The content of bacteria was counted and the content of tumor necrosis factor α (TNF-α), interleukin-1β (IL-1β), and IL-6 in wound was determined by enzyme-linked immunosorbent assay. Fibroblasts in wound were counted after Masson staining and number of microvessels was counted after CD31 antibody immunohistochemical staining. Data were processed with analysis of variance for repeated measurement, LSD-t test, paired samples t test, and Bonferroni correction. Results: (1) Immediately after surgery, there was no granulation tissue in basal wound of rabbits in the three groups, with rich blood supply and obvious edema. On PSD 7, much granulation tissue was found in basal wound of rabbits in the three groups, with no or mild edema and no obvious redness and swelling in wound edge. (2) There were no significant differences in dry to wet weight ratios of tissue around the wound among and within the three groups immediately after surgery and on PSD 7 (with F values respectively 0.70 and 0.09, t values from 0.17 to 0.52, P values above 0.05). (3) Immediately after surgery, the content of bacteria in wounds of rabbits in groups PD, BD, and SBD was respectively (603.0±146.0) ×10(4,) (573.0±63.0) ×10(4,) and (590.0±100.0)×10(4) colony-forming unit (CFU)/g, with no significant difference among them (F=0.13, P>0.05). On PSD 7, the content of bacteria in wounds of rabbits in groups PD, BD, and SBD were respectively (5.4±0.8) ×10(4,) (4.6±0.9) ×10(4,) and (3.5±0.9)×10(4) CFU/g. Among them, the content of bacteria in wounds of rabbits in group SBD was lower than that in groups PD and BD, respectively (with t values respectively 3.78 and 2.29, P<0.05 or P<0.01). The content of bacteria in wounds of rabbits in the three groups on PSD 7 was decreased compared with that immediately after surgery (with t values from 10.05 to 21.81, P values below 0.01). (4) There was no significant difference in content of TNF-α, IL-1β, and IL-6 in wounds of rabbits in the three groups immediately after surgery and on PSD 7 (with F values from 0.10 to 1.89, P values above 0.05). The content of TNF-α in wounds of rabbits in the three groups on PSD 7 was significantly higher than that immediately after surgery (with t values from 2.93 to 5.01, P<0.05 or P<0.01). (5) There was no significant difference in amount of fibroblasts in wounds of rabbits in the three groups immediately after surgery and on PSD 7 (with F values respectively 0.01 and 0.81, P values above 0.05). The amount of fibroblasts in wounds of rabbits in the three groups on PSD 7 was larger than that immediately after surgery (with t values from 4.78 to 11.58, P values below 0.01). (6) There was no significant difference in number of microvessels in wounds of rabbits in the three groups immediately after surgery and on PSD 7 (with F values respectively 2.42 and 2.49, P values above 0.05). The number of microvessels in wounds of rabbits in the three groups on PSD 7 was larger than that immediately after surgery (with t values from 7.17 to 11.14, P values below 0.01). Conclusions: SBD is better at inhibiting the growth of bacteria. PD, BD, and SBD have almost the same effects on reducing tissue edema and inflammatory reaction, and on promoting the accumulation of collagen fibers and tissue vascularization.

[Efficacy and safety of oseltamivir in children with suspected influenza: a multicenter randomized open-label trial]

Objective: To evaluate the efficacy and safety of oseltamivir in the treatment of suspected influenza in children. Method: A multicenter, randomized and open-label trial was conducted among 229 individuals with suspected influenza which were collected from the clinic of 5 hospitals in Guangdong province (Guangzhou Women and Children's Medical Center, Shenzhen Baoan District Maternity and Child Care Service Center, the Second Affiliated Hospital of Shantou University Medical College, Dongguan Maternity and Child Care Service Centre, Yuexiu District Children's Hospital of Guangzhou) from April to July 2015. They were randomized either to oseltamivir group (oseltamivir 30-75 mg, twice daily for 5 days) or control group who were given symptom relief medicines for 5 days. Result: No significant difference was found between two groups in influenza symptoms of the patients before the treatment(P>0.05). Altogether 229 individuals (114 in oseltamivir group, 115 in control group) were analyzed for efficacy, in which 73 individuals (42 oseltamivir, 31 control), 31.9%, were identified as influenza-infected through laboratory test. No significant difference was found between the two groups in the duration of fever although shortened. In the 229 individuals , the cumulative alleviation proportion between oseltamivir and control group was not significantly different (P>0.05): the median duration of illness was 69.9 hours (95% CI 65.3-91.5) in oseltamivir group and 75.4 hours (95%CI 63.9-91. 7) in control group; the median duration of fever was 40.4 hours (95%CI 31.5-53.4) in oseltamivir group and 44.0 hours (95%CI 33.2-50.0) in control group. In the 73 individuals, the cumulative alleviation proportion between oseltamivir and control group was significantly different (P<0.05). The median duration of illness was 61.2 hours (95%CI 48.0-121. 0) in oseltamivir group, being significantly shorter than that of 116.0 hours (95%CI 91.5-175.0) in control group. But it was not significantly different that the median duration of fever was 32.8 hours (95%CI 24.0-47.0 ) in oseltamivir group and 55.8 hours (95%CI 43.6-78.3 ) in control group (P>0.05). And the median duration of fever in 60 individuals (38 oseltamivir, 22 control) was significantly different between two groups(P<0.05), who had finished a course of taking oseltamivir in the 73 individuals, 34.8 hours (95%CI 24.0-48.5 ) in oseltamivir group being significantly shorter than that of 53.3 hours (95%CI 43.6-104.0 ) in control group. There was certain difference in side effects rate between the two groups (oseltamivir 10%, control 2%, P<0.05). The main side-effects were gastrointestinal symptoms (stomachache, diarrhea, poor appetite, vomiting). Conclusion: The duration of illness and fever in suspected influenza patients treated with oseltamivir was shorter than those in the patients treated with no oseltamivir, the difference was not statistically significant, when 31.9% was confirmed with positive result of virus test in suspected influenza in children. But in these patients with positive result of virus test, the duration of illness was significantly shortened with treatment with oseltamivir as compared with no treatment with oseltamivir, and it would be better if full oseltamivir course was completed for reducing the duration of fever. Oseltamivir treatment was safe with mild side effects.