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Our results suggest that APA may provide an inexpensive and effective complementary approach for the management of symptom clusters for breast cancer patients, and further study is warranted.

Most of the state governments in United States (U.S.) issued lockdown or business restrictions amid the COVID-19 pandemic in March 2020, which created a unique opportunity to evaluate the air quality response to reduced economic activities. Data acquired from 28 long-term air quality stations across the U.S. revealed widespread but nonuniform reductions of nitrogen dioxide (NO 2 ) and carbon monoxide (CO) during the first phase of lockdown (March 15–April 25, 2020) relative to a pre-lockdown reference period and historical baselines established in 2017–2019. The reductions, up to 49% for NO 2 and 37% for CO, are statistically significant at two thirds of the sites and tend to increase with local population density. Significant reductions of particulate matter (PM 2.5 and PM 10 ) only occurred in the Northeast and California/Nevada metropolises where NO 2 declined the most, while the changes in ozone (O 3 ) were mixed and relatively minor. These findings are consistent with lower transportation and utility demands that dominate NO 2 and CO emissions, especially in major urban areas, due to the lockdown. This study provides an insight into potential public health benefits with more aggressive air quality management, which should be factored into strategies to reopen the U.S. and global economy.

Objective. The objective of this systematic review and meta-analysis was to assess the efficacy of auricular therapy by including a sham therapy control group. Methods. Relevant, randomized clinical trials (RCTs) were identified by searching medical related databases from, depending on journal, 1900 (at the earliest) to 1994 (at the latest) through May 2013. The outcome measure was a pain intensity score. Results. Twenty-two RCTs were identified and 13 RCTs were included for meta-analysis. In these studies, auricular therapy provided significant pain relief when compared to a sham or control group. The overall standardized mean differences (SMD) was 1.59 (95% CI [−2.36, −0.82]) (13 trials, total subject numbers = 806), indicating that, on average, the mean decrease in pain score for auricular therapy group was 1.59 standard deviations greater than the mean decrease for the sham control. In terms of the efficacy of the different treatment methods, auricular acupressure boasts the largest strength of evidence for pain relief, followed by auricular acupuncture. Electroacupuncture stimulation did not show significant evidence for efficacy, which may be due to the small sample size (i.e., only 19 subjects were included). Conclusion. Further large-scale RCTs are needed to determine the efficacy of auricular therapy for pain.

Objectives Previous studies of clinical samples of adults with bipolar disorder (BD) suggest that there is increased prevalence of obesity and that obesity is associated with greater BD severity. We therefore examined this topic in a representative epidemiologic sample. Methods The 2001–2002 National Epidemiologic Survey on Alcohol and Related Conditions was used to determine whether the prevalence of obesity is elevated among subjects with lifetime BD, and whether obesity is associated with greater severity of BD. Results The age-, race-, and sex-adjusted prevalence of obesity was significantly greater among subjects with BD versus controls [odds ratio (OR) = 1.65, 95% confidence interval (CI): 1.45–1.89, p < 0.001]. Obesity among subjects with BD was significantly positively associated with greater age, female sex, comorbid anxiety and medical conditions, and depression-related treatment utilization, and significantly negatively associated with past-year substance use disorder (SUD). In multivariable analyses, obesity among adults with BD was positively associated with age, comorbid anxiety disorders, duration of depressive episodes, and history of hospitalization for depression, and negatively associated with past-year SUD. Conclusions The increased prevalence of obesity in BD and its association with illness severity, particularly in relation to depression, cannot be attributed to biases inherent in treatment-seeking samples. Future studies are needed to examine the direction of the observed associations and to develop preventive and treatment strategies seeking to mitigate the burden of obesity in BD.

Emergency admissions for cerebrovascular diseases among adults were positively associated with increasing urban air pollution levels of O(3) lagged 0 day and CO lagged 2 days in Taipei.

"Reduction in nausea and vomiting in children undergoing cancer chemotherapy by either appropriate or sham auricular acupuncture points with standard care." The Journal of Alternative and Complementary Medicine.18,4. 334-340. (2012 Background: Over 40% of children with cancer have reported that chemotherapy-induced nausea and vomiting (CINV) are the two most distressing side-effects of treatment even when antiemetic drugs have been used. Objectives: The purpose of this article is to report the findings from a feasibility and pilot study using auricular point acupressure point for CINV in a small group of children in Taiwan.Methods: This was a crossover randomized design study. CINV symptoms were assessed on 10 patients just prior to and for 7 days following each of three rounds of chemotherapy drugs (CTX). They received standard care (SC) and were not entered into a test treatment group until they completed the baseline assessment, which was conducted during their first round of chemotherapy after entering the study. Just prior to receiving the second round of CTX, patients were randomized into one of two treatment conditions: auricular acupressure intervention, in addition to standard care (AAP) or auricular acupressure using sham auricular points (SAP) in addition to standard care. For the third round of CTX, they were switched to the other treatment group. Results: The enrollment rate for this study was 77% of the children invited to participate and of those, 88% provided completed data sets for all three treatment conditions. Patients in the AAP group reported significantly lower occurrence and severity of nausea and vomiting than patients in the SC group ( p < 0.05). There were no significant differences of nausea and vomiting for patients between the AAP and SAP groups. All of the patients took antiemetic medication on the day they received CTX, and 80% of patients reported that the antiemetics did not help to treat CINV. Conclusions: These preliminary findings did show evidence that AAP is acceptable to the children and their parents to prevent/treat CINV. However, there were no statistically significant differences between the AAP and SAP groups in the prevention/treatment of CINV. There were clinical trend differences between the groups, which may due to the small sample size. In a larger study, it would be important to determine whether the effects of the AAP and SAP treatment are independent of any psychologic effects, such as the researcher's increased presence in both treatment groups.

This is the first study that used a statistical procedure to derive symptom clusters experienced by pediatric oncology patients. Knowledge from this study can provide a starting point to investigate the stability of symptom clusters with different states of disease, different populations, and over various periods of time.