Priority sources identification and risks assessment of heavy metal(loid)s in agricultural soils of a typical antimony mining watershed.

Heavy metal(loid) (HM) pollution in agricultural soils has become an environmental concern in antimony (Sb) mining areas. However, priority pollution sources identification and deep understanding of environmental risks of HMs face great challenges due to multiple and complex pollution sources coexist. Herein, an integrated approach was conducted to distinguish pollution sources and assess human health risk (HHR) and ecological risk (ER) in a typical Sb mining watershed in Southern China. This approach combines absolute principal component score-multiple linear regression (APCS-MLR) and positive matrix factorization (PMF) models with ER and HHR assessments. Four pollution sources were distinguished for both models, and APCS-MLR model was more accurate and plausible. Predominant HM concentration source was natural source (39.1%), followed by industrial and agricultural activities (23.0%), unknown sources (21.5%) and Sb mining and smelting activities (16.4%). Although natural source contributed the most to HM concentrations, it did not pose a significant ER. Industrial and agricultural activities predominantly contributed to ER, and attention should be paid to Cd and Sb. Sb mining and smelting activities were primary anthropogenic sources of HHR, particularly Sb and As contaminations. Considering ER and HHR assessments, Sb mining and smelting, and industrial and agricultural activities are critical sources, causing serious ecological and health threats. This study showed the advantages of multiple receptor model application in obtaining reliable source identification and providing better source-oriented risk assessments. HM pollution management, such as regulating mining and smelting and implementing soil remediation in polluted agricultural soils, is strongly recommended for protecting ecosystems and humans.

Bioaccessibility and health risk assessment of hydrophobic organic pollutants in soils from four typical industrial contaminated sites in China.

There have been reports of potential health risks for people from hydrophobic organic pollutants, such as polycyclic aromatic hydrocarbons (PAHs), polychlorinated hydrocarbons (PCHs), and organophosphate flame retardants (OPFRs). When a contaminated site is used for residential housing or public utility and recreation areas, the soil-bound organic pollutants might pose a threat to human health. In this study, we investigated the contamination profiles and potential risks to human health of 15 PAHs, 6 PCHs, and 12 OPFRs in soils from four contaminated sites in China. We used an in vitro method to determine the oral bioaccessibility of soil pollutants. Total PAHs were found at concentrations ranging from 26.4 ng/g to 987 ng/g. PCHs (0.27‒14.3 ng/g) and OPFRs (6.30‒310 ng/g) were detected, but at low levels compared to earlier reports. The levels of PAHs, PCHs, and OPFRs released from contaminated soils into simulated gastrointestinal fluids ranged from 1.74% to 91.0%, 2.51% to 39.6%, and 1.37% to 96.9%, respectively. Based on both spiked and unspiked samples, we found that the oral bioaccessibility of pollutants was correlated with their logKow and molecular weight, and the total organic carbon content and pH of soils. PAHs in 13 out of 38 contaminated soil samples posed potential high risks to children. When considering oral bioaccessibility, nine soils still posed potential risks, while the risks in the remaining soils became negligible. The contribution of this paper is that it corrects the health risk of soil-bound organic pollutants by detecting bioaccessibility in actual soils from different contaminated sites.

Unravelling the toxicity of carbon nanomaterials - From cellular interactions to mechanistic understanding.

The application of carbon nanomaterials in diverse fields has substantially increased their demand for commercial usage. Within the earliest decade, the development of functional materials has further increased the significance of this element. Despite the advancements recorded, the potential harmful impacts of embracing carbon nanomaterials for biological applications must be balanced against their advantages. Interestingly, many studies have neglected the intriguing and dynamic cellular interaction of carbon nanomaterials and the mechanistic understanding of their property-driven behaviour, even though common toxicity profiles have been reported. Reiterating the toxicity issue, several researchers conclude that these materials have minimal toxicity and may be safe for contact with biological systems at certain dosages. Here, we aim to provide a report on the significance of some of the properties that influence their toxicity. After that, a description of the implication of nanotoxicology in humans and living systems, revealing piece by piece their exposure routes and possible risks, will be provided. Then, an extensive discussion of the mechanistic puzzle modulating the interface between various human cellular systems and carbon nanomaterials such as carbon nanotubes, carbon dots, graphene, fullerenes, and nanodiamonds will follow. Finally, this review also sheds light on the organization that handles the risk associated with nanomaterials.

[Occurrence and environmental risks of antibiotics in surface water of China].

Antibiotics as emerging pollutants are frequently detected in surface water, raising concerns about the associated risk of antibiotic resistance genes (ARGs). Despite the widespread apprehension, there are still research gaps in the occurrence of antibiotic pollution in surface water and the associated ecological risks to aquatic organisms in China. Here, we established a dataset of antibiotic pollution in surface water in China during 2018-2022, which encompassed 3 368 concentration values of 128 antibiotics reported in 124 articles. Our analysis showed that antibiotic concentrations were predominantly in the ng/L-µg/L range, reaching up to 26 µg/L. Notably, sulfonamides (e.g., sulfamethoxazole) and quinolones (e.g., ciprofloxacin) were frequently reported at high concentrations. The pollution degree of antibiotics represented by sulfamethoxazole, ciprofloxacin, roxithromycin, and tetracycline exhibited no significant variation across different years but was lower in summer than that in spring and autumn. Additionally, distinct spatial distribution characteristics of the pollution were observed. According to calculation results of the aquatic ecological risk assessment model and the weighted frequency, we proposed a list of priority antibiotics including clarithromycin, erythromycin, sulfamethoxazole, ofloxacin, and oxytetracycline in surface water. Last but not least, this study points out the deficiencies in current research on the occurrence and ecological risks of antibiotics in surface water of China and provides viable screening strategies and monitoring recommendations in this context.

Prostate cancer risk assessment and avoidance of prostate biopsies using fully automatic deep learning in prostate MRI: comparison to PI-RADS and integration with clinical data in nomograms.

OBJECTIVES: Risk calculators (RCs) improve patient selection for prostate biopsy with clinical/demographic information, recently with prostate MRI using the prostate imaging reporting and data system (PI-RADS). Fully-automated deep learning (DL) analyzes MRI data independently, and has been shown to be on par with clinical radiologists, but has yet to be incorporated into RCs. The goal of this study is to re-assess the diagnostic quality of RCs, the impact of replacing PI-RADS with DL predictions, and potential performance gains by adding DL besides PI-RADS. MATERIAL AND METHODS: One thousand six hundred twenty-seven consecutive examinations from 2014 to 2021 were included in this retrospective single-center study, including 517 exams withheld for RC testing. Board-certified radiologists assessed PI-RADS during clinical routine, then systematic and MRI/Ultrasound-fusion biopsies provided histopathological ground truth for significant prostate cancer (sPC). nnUNet-based DL ensembles were trained on biparametric MRI predicting the presence of sPC lesions (UNet-probability) and a PI-RADS-analogous five-point scale (UNet-Likert). Previously published RCs were validated as is; with PI-RADS substituted by UNet-Likert (UNet-Likert-substituted RC); and with both UNet-probability and PI-RADS (UNet-probability-extended RC). Together with a newly fitted RC using clinical data, PI-RADS and UNet-probability, existing RCs were compared by receiver-operating characteristics, calibration, and decision-curve analysis. RESULTS: Diagnostic performance remained stable for UNet-Likert-substituted RCs. DL contained complementary diagnostic information to PI-RADS. The newly-fitted RC spared 49% [252/517] of biopsies while maintaining the negative predictive value (94%), compared to PI-RADS ≥ 4 cut-off which spared 37% [190/517] (p < 0.001). CONCLUSIONS: Incorporating DL as an independent diagnostic marker for RCs can improve patient stratification before biopsy, as there is complementary information in DL features and clinical PI-RADS assessment. CLINICAL RELEVANCE STATEMENT: For patients with positive prostate screening results, a comprehensive diagnostic workup, including prostate MRI, DL analysis, and individual classification using nomograms can identify patients with minimal prostate cancer risk, as they benefit less from the more invasive biopsy procedure. KEY POINTS: The current MRI-based nomograms result in many negative prostate biopsies. The addition of DL to nomograms with clinical data and PI-RADS improves patient stratification before biopsy. Fully automatic DL can be substituted for PI-RADS without sacrificing the quality of nomogram predictions. Prostate nomograms show cancer detection ability comparable to previous validation studies while being suitable for the addition of DL analysis.

Efficacy of communicating periodontal risk on psychological outcomes and supragingival plaque control in patients undergoing first periodontal consultation: A parallel-arm, randomized trial.

AIM: To evaluate the efficacy of the PerioRisk prognostic tool in implementing the effect of motivational interviewing (MI) on psychological outcomes and supragingival plaque control. MATERIALS AND METHODS: Participants underwent MI immediately after their first periodontal visit. According to a parallel-arm, randomized study design, MI was performed with (RISK group) or without (CTR group) information on PerioRisk level and treatment goals based on PerioRisk output. Psychological outcomes were assessed using the Positive Affect Negative Affect Scale (PANAS) and Protection Motivation Theory (PMT). Plaque index (PI) was re-evaluated after 8-12 weeks. RESULTS: Significant improvements in PMT overall score and PI were observed in CTR and RISK groups, without inter-group difference in PANAS and PMT overall scores and PI. A sub-analysis showed that the overall PMT scores recorded immediately after MI in both CTR and RISK groups for subjects with no tooth loss due to periodontitis were higher than those recorded before MI in subjects with tooth loss due to periodontitis. CONCLUSIONS: At first periodontal visit, MI (implemented with without PerioRisk) has tangible effects on psychological outcomes and supragingival plaque control and seems to anticipate the awareness that is commonly generated by periodontitis-related tooth loss (ClinicalTrials.gov protocol registration ID: NCT05078411).

[Risk appraisal of dietary intake of per- and polyfluoroalkyl substances by the Veneto population living in the area with water contamination. Update based on EFSA 2020 limits. Food surveillance campaign 2016-2017]. / Valutazione del rischio legato all'assunzione di sostanze per- e polifluoroalchiliche per via alimentare da parte della popolazione veneta residente nella zona con contaminazione delle acque. Aggiornamento sulla base dei limiti EFSA 2020. Campagna di so.

The Veneto Region (Northern Italy) conducted a monitoring campaign in the years 2016-2017 in order to evaluate the concentration of per- and polyfluoroalkyl substances (PFASs) in foods in the area affected by the water contamination discovered in 2013. The risk assessment for the resident population was conducted by the Italian National Institute of Health (ISS) in 2018 and updated in 2021. The European Food Safety Agency (EFSA) updated the limits used by ISS, in particular adding a limit for the sum of four PFAS molecules in 2020. In this work, the risk assessment conducted by ISS is reviewed in light of the new limit of 4.4 ng/kg body weight for the sum of perfluorooctanoic acid (PFOA), perfluorooctanesulfonic acid (PFOS), perfluorononanoic acid (PFNA), and perfluorohexanesulfonate (PFHxS). In the adult population (18-65 years), total weekly intakes, calculated for the years preceding 2013, resulted more than ten times the EFSA 2020 limit, more than five times in the intermediate period 2013-2017 - preceding the implementation of mitigation actions through double filtration of the water of the aqueduct -, by more than three times in the period after 2018, and yet by almost seven times for those who supply contaminated groundwater through private wells. The food contribution for those who use filtered water from the aqueduct is equal to 20% of the total weekly income.

Accuracy of the COMPASS-CAT thrombosis risk assessment scale in predicting venous thromboembolism in cancer patients: a meta-analysis.

OBJECTIVE: This systematic review aims to assess the accuracy of the COMPASS-CAT tool in predicting venous thromboembolism (VTE) among cancer patients. METHODS: Relevant studies were searched in PubMed, Web of Science, The Cochrane Library, Embase, CINAHL, OVID, CBM, CNKI, WanFang Data, and VIP database from their inception up to April 19, 2023. The quality of studies was appraised using the diagnostic test accuracy study bias assessment tool (QUADAS-2). Quantitative analysis was performed using Stata MP 17.0. RESULTS: Thirteen studies involving 8,665 patients were included. Meta-analysis indicated that the COMPASS-CAT score had a pooled sensitivity of 0.76 [95%CI (0.61, 0.86)], specificity of 0.67 [95%CI (0.52, 0.79)], positive likelihood ratio of 2.3 [95%CI (1.7, 3.1)], negative likelihood ratio of 0.36 [95%CI (0.23, 0.54)], diagnostic odds ratio of 6 [95%CI (4, 10)], and an area under the Summary Receiver Operating Characteristic (SROC) curve (AUC) of 0.77 [95%CI (0.74, 0.81)]. Funnel plots indicated no publication bias. Meta-regression and subgroup analysis suggested that country and diagnostic setting might be potential sources of heterogeneity. The sensitivity of the COMPASS-CAT assessment tool in international outpatient settings was 0.94 with an AUC of 0.86, while in domestic inpatient settings, the sensitivity was 0.65 with an AUC of 0.78. CONCLUSION: The COMPASS-CAT score had a certain diagnostic value for VTE in cancer patients and can effectively identify patients at risk of VTE. Most studies focus on patients with lung cancer. Future research should investigate more tumor types, and high-quality, large-sample, multi-center prospective studies on larger populations with cancers are warranted.

Occurrence, evaluation, and human health risk assessment of ochratoxin a in infant formula and cereal-based baby food: a global literature systematic review.

This study reviews global levels of ochratoxin A (OTA) in infant formula and cereal-based foods, using Monte Carlo simulation to assess risks. The review found 24 studies on global OTA levels in infant food and cereal-based products, using databases including PubMed, Scopus, Web of Science and Embase until March 2024. We estimated OTA exposure in infant food based on concentration, intake and body weight. The exposure and hazard quotient margin were calculated using BMDL10 and TDI values. Monte Carlo simulation evaluated human health risks from OTA in infant formula and cereal-based foods. A global study from 14 countries shows varying levels, surpassing EU limits in Tunisia, Ecuador, the USA, and generally in Africa, notably in infant cereals, which had higher levels than formula. Globally, OTA was present in 29.3% of the 3348 samples analyzed, with Lebanon at 95.2% and Brazil at 0%. Analysis indicates only non-carcinogenic risk for infants. While health risks for infants are mostly low, ongoing research and monitoring are vital to minimize OTA exposure in infant food.

Consistency between the ACGIH TLV for hand activity and proposed action levels for wrist velocity and forearm muscular load based on objective measurements: an example from the assembly industry.

Objectives. This study aimed to investigate the consistency between results of the American Conference for Governmental Occupational Hygienists (ACGIH) threshold limit value (TLV) for hand activity and proposed action levels of objective measurements in risk assessments of work-related musculoskeletal disorders. Methods. Wrist velocities and forearm muscular load were measured for 11 assemblers during one working day. Simultaneously, each assembler's hand activity level (HAL) during three sub-cycles was rated twice on two separate occasions by two experts, using a HAL scale. Arm/hand exertion was also rated by the assemblers themselves using a Borg scale. In total, 66 sub-cycles were assessed and assigned to three exposure categories: A) below ACGIH action limit (AL) (green); B) between AL and TLV (yellow); and C) above TLV (red). The median wrist velocity and the 90th percentile of forearm muscular load obtained from the objective measurements corresponding to the sub-cycles were calculated and assigned to two exposure categories: A) below or C) above the proposed action level. Results. The agreement between ACGIH TLV for hand activity and the proposed action level for wrist velocity was 87%. Conclusions. The proposed action level for wrist velocity is highly consistent with the TLV. Additional studies are needed to confirm the results.

Risk assessment of Phlyctinus callosus for the EU.

Following a request from the European Commission, the EFSA Panel on Plant Health performed a quantitative risk assessment for the EU of Phlyctinus callosus (Coleoptera: Curculionidae), a polyphagous pest occurring in Australia, New Zealand and South Africa. The current risk assessment focused on potential pathways for entry, the climatic conditions allowing establishment, the expected spread capacity and the impact considering a time horizon of 10 years (2023-2032). The Panel identified the import of apples, cut flowers and table grapes as the most relevant entry pathways. Over the next 10 years, an annual median estimate of approximately 49.5 (90% certainty range, CR, ranging from 4.0 to 881.2) potential P. callosus founder populations are expected. When the probability of establishment is considered and climatic indicators are used to define the areas in the EU where establishment is possible, the model estimated a median of 1 founder population every 1.3 years (90% CR: 1 every 30.8 years to 23.3 per year) in the scenario where the areas are defined by the union of all the climatic indicators and 1 founder population every 11.9 years (90% CR: 1 every 256.6 years to 2.5 per year) in the scenario where establishment is possible only in the areas defined by the climatic indicator of minimum soil temperature. The estimated number of founder populations per year is mostly driven by the probability of establishment in the rural areas, infestation rate in table grapes and the probability of transfer to a suitable host in the rural area. The risk of entry for cut flowers and apples is substantially lower than the risk from the table grapes. If such founder populations were to establish, P. callosus is estimated to spread by natural dispersal and common agricultural practices at a rate of 15.5 m/year (90% CR 5.1-46.8 m/year) after a lag phase of 4.0 years (90% CR 1.3-8.7 years). The impact, expressed as percentage loss of the production directly attributable to P. callosus in the areas where establishment is possible and assuming farmers do not apply specific control measures was estimated at 0.5% (90% CR 0.01%-2.8%) for cut flowers/foliage, 5.2% (90% CR 2.2%-11.7%) for apples and 2% (90% CR 1.3%-5.2%) for table grapes. Options for risk reduction are discussed, but their effectiveness is not quantified.

Peer review of the pesticide risk assessment of the active substance lenacil.

The conclusions of the European Food Safety Authority (EFSA) following the peer review of the initial risk assessments carried out by the competent authorities of the rapporteur Member State, Belgium, and co-rapporteur Member State, Austria, for the pesticide active substance lenacil are reported. The context of the peer review was that required by Commission Implementing Regulation (EU) No 844/2012, as amended by Commission Implementing Regulation (EU) No 2018/1659. The conclusions were reached on the basis of the evaluation of the representative uses of lenacil as a herbicide on sugar and fodder beet (field use). The reliable end points, appropriate for use in regulatory risk assessment, are presented. Missing information identified as being required by the regulatory framework is listed. Concerns are reported where identified.

Scientific Committee guidance on appraising and integrating evidence from epidemiological studies for use in EFSA's scientific assessments.

EFSA requested its Scientific Committee to prepare a guidance document on appraising and integrating evidence from epidemiological studies for use in EFSA's scientific assessments. The guidance document provides an introduction to epidemiological studies and illustrates the typical biases, which may be present in different epidemiological study designs. It then describes key epidemiological concepts relevant for evidence appraisal. This includes brief explanations for measures of association, exposure assessment, statistical inference, systematic error and effect modification. The guidance then describes the concept of external validity and the principles of appraising epidemiological studies. The customisation of the study appraisal process is explained including tailoring of tools for assessing the risk of bias (RoB). Several examples of appraising experimental and observational studies using a RoB tool are annexed to the document to illustrate the application of the approach. The latter part of this guidance focuses on different steps of evidence integration, first within and then across different streams of evidence. With respect to risk characterisation, the guidance considers how evidence from human epidemiological studies can be used in dose-response modelling with several different options being presented. Finally, the guidance addresses the application of uncertainty factors in risk characterisation when using evidence from human epidemiological studies.

Extended thromboprophylaxis in heart failure patients; the unmet need.

Heart failure (HF) is considered one of a leading cause of cardiovascular morbidity and mortality worldwide. The association between HF and venous thromboembolism (VTE) has been reported in several studies owing to many physiological and thromboembolic risk factors. Thus, the need for extended thromboprophylaxis during the post-discharge period in HF patients has been evaluated. Most guidelines do not recommend extended thromboprophylaxis because of its uncertain benefits and increased risk of bleeding. However, recent evidence in HF patients revealed no increased risk of bleeding with extended thromboprophylaxis, which highlights the importance of identifying ideal candidates who might benefit from extended thromboprophylaxis. Several risk assessment models (RAMs) have been developed to identify patients at a high risk of VTE who would benefit from in-hospital and post-discharge prophylactic anticoagulation therapy based on the risk-benefit principle. However, their accuracy in predicting VTE is questionable, and none have a standardized approach for evaluating the risk of VTE in HF patients. In this review, we provided an overview of the incidence and pathophysiology of VTE in HF patients, a summary of guideline recommendations for VTE prevention, and a summary of studies evaluating the use of extended thromboprophylaxis, with a focus on subgroup or post-hoc analyses of HF patients. We also discussed the need to design an ideal RAM that can identify candidate patients for extended thromboprophylaxis by stratifying the risk of VTE and identifying the key risk factors for bleeding in medically ill patients, including those with HF.

Mapping and assessment of groundwater pollution risks in the main aquifer of the Mostaganem plateau (Northwest Algeria): utilizing the novel vulnerability index and decision tree model.

Water plays a pivotal role in socio-economic development in Algeria. However, the overexploitations of groundwater resources, water scarcity, and the proliferation of pollution sources (including industrial and urban effluents, untreated landfills, and chemical fertilizers, etc.) have resulted in substantial groundwater contamination. Preserving water irrigation quality has thus become a primary priority, capturing the attention of both scientists and local authorities. The current study introduces an innovative method to mapping contamination risks, integrating vulnerability assessments, land use patterns (as a sources of pollution), and groundwater overexploitation (represented by the waterhole density) through the implementation of a decision tree model. The resulting risk map illustrates the probability of contamination occurrence in the substantial aquifer on the plateau of Mostaganem. An agricultural region characterized by the intensive nutrients and pesticides use, the significant presence of septic tanks, widespread illegal dumping, and a technical landfill not compliant with environmental standards. The critical situation in the region is exacerbated by excessive groundwater pumping surpassing the aquifer's natural replenishment capacity (with 115 boreholes and 6345 operational wells), especially in a semi-arid climate featuring limited water resources and frequent drought. Vulnerability was evaluated using the DRFTID method, a derivative of the DRASTIC model, considering parameters such as depth to groundwater, recharge, fracture density, slope, nature of the unsaturated zone, and the drainage density. All these parameters are combined with analyses of inter-parameter relationship effects. The results show a spatial distribution into three risk levels (low, medium, and high), with 31.5% designated as high risk, and 56% as medium risk. The validation of this mapping relies on the assessment of physicochemical analyses in samples collected between 2010 and 2020. The results indicate elevated groundwater contamination levels in samples. Chloride exceeded acceptable levels by 100%, nitrate by 71%, calcium by 50%, and sodium by 42%. These elevated concentrations impact electrical conductivity, resulting in highly mineralized water attributed to anthropogenic agricultural pollution and septic tank discharges. High-risk zones align with areas exhibiting elevated nitrate and chloride concentrations. This model, deemed satisfactory, significantly enhances the sustainable management of water resources and irrigated land across various areas. In the long term, it would be beneficial to refine "vulnerability and risk" models by integrating detailed data on land use, groundwater exploitation, and hydrogeological and hydrochemical characteristics. This approach could improve vulnerability accuracy and pollution risk maps, particularly through detailed local data availability. It is also crucial that public authorities support these initiatives by adapting them to local geographical and climatic specificities on a regional and national scale. Finally, these studies have the potential to foster sustainable development at different geographical levels.

Trends and hotspots in gastrointestinal neoplasms risk assessment: A bibliometric analysis from 1984 to 2022.

BACKGROUND: Gastrointestinal neoplasm (GN) significantly impact the global cancer burden and mortality, necessitating early detection and treatment. Understanding the evolution and current state of research in this field is vital. AIM: To conducts a comprehensive bibliometric analysis of publications from 1984 to 2022 to elucidate the trends and hotspots in the GN risk assessment research, focusing on key contributors, institutions, and thematic evolution. METHODS: This study conducted a bibliometric analysis of data from the Web of Science Core Collection database using the "bibliometrix" R package, VOSviewer, and CiteSpace. The analysis focused on the distribution of publications, contributions by institutions and countries, and trends in keywords. The methods included data synthesis, network analysis, and visualization of international collaboration networks. RESULTS: This analysis of 1371 articles on GN risk assessment revealed a notable evolution in terms of research focus and collaboration. It highlights the United States' critical role in advancing this field, with significant contributions from institutions such as Brigham and Women's Hospital and the National Cancer Institute. The last five years, substantial advancements have been made, representing nearly 45% of the examined literature. Publication rates have dramatically increased, from 20 articles in 2002 to 112 in 2022, reflecting intensified research efforts. This study underscores a growing trend toward interdisciplinary and international collaboration, with the Journal of Clinical Oncology standing out as a key publication outlet. This shift toward more comprehensive and collaborative research methods marks a significant step in addressing GN risks. CONCLUSION: This study underscores advancements in GN risk assessment through genetic analyses and machine learning and reveals significant geographical disparities in research emphasis. This calls for enhanced global collaboration and integration of artificial intelligence to improve cancer prevention and treatment accuracy, ultimately enhancing worldwide patient care.

Assessment of spatiotemporal risks for nationwide groundwater nitrate contamination.

National assessments of groundwater contamination risks are crucial for sustaining high-quality groundwater supplies. However, traditional methods often treat groundwater contamination risk as a steady-state indicator without considering spatiotemporal variation in risk, both geographically and over time, caused by anthropogenic and climatic factors. In this work, XGBoost, a tree-based algorithm, was applied to comprehensively analyze the drivers of groundwater contamination from nitrate, using data on 13 physical features (as used by the index-based ranking method DRASTIC) and 30 anthropogenic features from 1985 to 2010 in the contiguous United States (CONUS). The results indicate that physical features controlling the transport processes, particularly those affecting contaminant travel time from land surface to groundwater (depth to water table and transmissivity), were the dominant factors for nitrate contamination in groundwater. This was followed by features representing the potential nitrogen loading. Positive correlations between most features and the nitrogen loading time (year) were found, suggesting their growing influence on contamination risk. Based on the drivers identified for nitrate concentrations exceeding 10 mg/L in groundwater and their varying temporal contributions, this study proposes a reformulated index-based method for contamination risk assessment. With this method, an overall accuracy of around 70 % was achieved based on the validation data set. The predicted high-risk areas are mainly intensive irrigation regions, such as the High Plains, northern Midwest, and Central Valley. This new approach contributes to a more accurate and effective assessment of the contamination risks of groundwater on a regional and national scale under temporally varying environmental conditions.

POBS-Card, a new score of severe bleeding after cardiac surgery: Construction and external validation.

Objective: Bleeding after cardiac surgery leads to poor outcomes. The objective of the study was to build the PeriOperative Bleeding Score in Cardiac surgery (POBS-Card) to predict bleeding after cardiac surgery. Methods: We conducted a retrospective cohort study in 2 academic hospitals (2016-2019). Inclusion criteria were adult patients after cardiac surgery under cardiopulmonary bypass. Exclusion criteria were heart transplantation, assistance, aortic dissection, and preoperative hemostasis diseases. Bleeding was defined by the universal definition for perioperative bleeding score ≥2. POBS-Card score was built using multivariate regression (derivation cohort, one center). The performance diagnosis was assessed using the area under the curve in a validation cohort (2 centers) and compared with other scores. Results: In total, 1704 patients were included in the derivation cohort, 344 (20%) with bleeding. Preoperative factors were body mass index <25 kg/m2 (odds ratio [OR], 1.48 [1.14-1.93]), type of surgery (redo: OR, 1.76 [1.07-2.82]; combined: OR, 1.81 [1.19-2.74]; ascendant aorta: OR, 1.56 [1.02-2.38]), ongoing antiplatelet therapy (single: OR, 1.50 [1.09-2.05]; double: OR, 2.00 [1.15-3.37]), activated thromboplastin time ratio >1.2 (OR, 1.44 [1.03-1.99]), prothrombin ratio <60% (OR, 1.91 [1.21-2.97]), platelet count <150 g/L (OR, 1.74 [1.17-2.57]), and fibrinogen <3 g/L (OR, 1.33 [1.02-1.73]). In the validation cohort of 597 patients, the area under the curve was 0.645 [0.605-0.683] and was superior to other scores (WILL-BLEED, Papworth, TRUST, TRACK). A threshold >14 predicted bleeding with a sensitivity of 50% and a specificity of 73%. Conclusions: POBS-Card score was superior to other scores in predicting severe bleeding after cardiac surgery. Performances remained modest, questioning the place of these scores in the perioperative strategy of bleeding-sparing.

Dietary exposure to polycyclic aromatic hydrocarbons-contaminated Talinum Triangulare grown along polluted river.

The research aims to evaluate the source, dispersion, and human health risk assessment of PAH-contaminated Talinum Triangulare grown along the polluted Ikpoba River. The freeze-dried vegetables were sonicated with dichloromethane for an hour and then concentrated using a rotary evaporator. The extract was purified using a glass column with anhydrous Na2SO4 and silica gel and analyzed using gas chromatography-mass spectrometry (GC-MS). The distribution of the contaminants showed that Pyrene < Benzo(a)anthracene ≤ Fluorene < Phenathrene ≤ Naphthalene ≤ Acenaphthene < Anthracene ≤ Acenaphthylene, while Pyrene < Benzo(a)anthracene < Fluorene < Phenathrene < Acenaphthalene ≤ Naphthalene < Anthracene < Acenaphthylene in wet and dry periods, respectively. The average ∑8 PAHs was 0.85 mg/kg and 0.75 mg/kg in wet and dry periods, respectively, and showed a decrease of 17.64% from wet to dry periods. The daily average dose revealed that the infant male and the adult female consumed the least and highest doses of T. Triangulare (TT), respectively. Furthermore, the hazard quotient and hazard index were < 1 for all the target groups, with adult females having higher values in both seasons. However, the incremental life cancer risk of the target group was between potential and high-potential cancer risk, with adolescent males and adult females more prone to low and high cancer risk, respectively. The isomer ratio and multivariate statistics revealed the sources of the PAH-contaminated TT to be more from pyrolysis.