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.

Pharmaceuticals in avian scavengers and other birds of prey: A toxicological perspective to improve risk assessments.

Pharmaceuticals are emerging contaminants given their increasing use worldwide due to intensive food production and population growth. These compounds reach the environment through different pathways with potential negative consequences for wildlife. One dramatic example occurred in Asia, where three native vulture populations collapsed almost to extinction due to acute intoxication with diclofenac, a veterinary use non-steroidal anti-inflammatory drug (NSAID). As seen with diclofenac, avian scavengers are useful sentinels to monitor for the presence of pharmaceuticals in the environment given their position at the top of the trophic chain, and in the case of obligate avian scavengers (vultures), their intimate link to domestic animal carcasses. Unfortunately, little is known about the wider exposure and potential health and population risks of pharmaceuticals to birds of prey. Here we compile literature data regarding relevant toxicological aspects of the most important pharmaceutical groups for birds of prey in terms of toxicity: NSAIDs, antibiotics, external antiparasitics and barbiturates. This work also includes critical information for future risk assessments, including concentrations of drug residues that can remain in animal tissues after treatment, or specific pharmaceutical features that might influence their toxicity in avian scavengers and other birds of prey. We also consider future research needs in this field and provide management recommendations to prevent potential intoxication events with pharmaceuticals in these species. This review highlights the need to consider specific risk assessments regarding exposure to pharmaceuticals, especially those used in veterinary medicine, for birds of prey.

Evaluation of ecological and health risks of trace elements in soils of olive orchards and apportionment of their sources using the APCS-MLR receptor model.

Izmir, Turkey's third most populous city, is in an important position in terms of both agriculture and industry. The province, which contributes 9.3% to the country's industrial production, also has an important potential in terms of olive cultivation. However, until now, no research has been undertaken to analyze the content of trace elements (TEs) in the soil of olive orchards in Izmir. This study was carried out to determine the pollution level and ecological risks of TEs in the olive orchards soils of Izmir province, to reveal their potential sources and to evaluate their health risks. Among the TEs, the average content of only Ni (37.9 mg/kg) exceeded the world soil average content (29 mg/kg), while the average content of only Cd (0.176 mg/kg) exceeded the upper continental crust content (0.09 mg/kg). Enrichment factor revealed that there was significant enrichment for Cd in 73.6%, Ni in 11.6% and Cr in 5.4% of olive orchards, respectively, due to polluted irrigation water and agrochemicals. Similarly, ecological risk factor indicated that there were moderate and considerable ecological risks for Cd in 48.8% and 23.3% of olive orchards, respectively. Absolute principal component scores-multiple linear regression (APCS-MLR) model showed that Ni and Cr in the study area are affected by agricultural sources, Al, Co, Cu, Fe, Mn, Pb and Zn originate from lithogenic sources, and Cd originates from mixed sources. Based on health risk evaluation methods, non-carcinogenic and carcinogenic effects would not be expected for residents. This study provides significant knowledge for evaluating soil TE pollution in olive orchards and serves a model for source apportionment and human health risk evaluation of TEs in other agricultural regions.

Potential risks of accumulated microplastics in shells and soft tissues of cultured hard clams (Meretrix taiwanica) and associated metals.

Microplastics (MPs) pose risks to both aquatic ecosystems and human health. This study investigated MPs in the shells and soft tissues of hard clams (Meretrix taiwanica) cultured in the inland waters of Taiwan. This study further developed two novel risk indices for assessing the potential ecological and health consequences of MPs. Moreover, the metal concentrations in the clam's soft tissues and the associated consumption health risks were investigated. Clamshells contained significant amounts of MPs with an average abundance of 16.6 ± 6.9 MPs/ind., which was higher than in the soft tissues (2.7 ± 1.7 MPs/ind.). The distribution and sizes of MPs in shells and soft tissues were similar, primarily small-sized (<2 mm, >99 %), blue (>65 %), and fibrous (>99 %). Dominant MP polymer types included rayon (83.5 %), polyethylene terephthalate (11.8 %), and polyacrylonitrile (3.6 %). The proposed MP potential ecological risk index indicates a higher potential ecological MP risk in soft tissues (302-423) than in shells (270-278) of the clams. The MP potential hazard risk index showed that the risk of exposure to MP through shellfish consumption decreased with age. The total hazard index (THI) value suggested negligible health hazards from metal exposure through shellfish consumption. Moreover, there was no significant correlation between MPs and metal concentrations in soft tissues, suggesting that metals bound to MPs contribute minimally to the total accumulated metals in clam's soft tissues. This study confirms the presence of MPs in clam shells and provides a novel tool to assess the potential ecological and health risks associated with MPs in shellfish.

Are pharmaceutical residues in crops a threat to human health?

The application of biosolids, manure, and slurry onto agricultural soils and the growing use of treated wastewater in agriculture result in the introduction of human and veterinary pharmaceuticals to the environment. Once in the soil environment, pharmaceuticals may be taken up by crops, resulting in consequent human exposure to pharmaceutical residues. The potential side effects of pharmaceuticals administered in human medicine are widely documented; however, far less is known regarding the risks that arise from incidental dietary exposure. The aim of this study was to evaluate human exposure to pharmaceutical residues in crops and assess the associated risk to health for a range of pharmaceuticals frequently detected in soils. Estimated concentrations of carbamazepine, oxytetracycline, sulfamethoxazole, trimethoprim, and tetracycline in soil were used in conjunction with plant uptake and crop consumption data to estimate daily exposures to each compound. Exposure concentrations were compared to Acceptable Daily Intakes (ADIs) to determine the level of risk. Generally, exposure concentrations were lower than ADIs. The exceptions were carbamazepine, and trimethoprim and sulfamethoxazole under conservative, worst-case scenarios, where a potential risk to human health was predicted. Future research therefore needs to prioritize investigation into the health effects following exposure to these compounds from consumption of contaminated crops.

Fluorinated liquid-crystal monomers in infant formulas and implication for health risk.

Fluorinated liquid-crystal monomers (FLCMs), a new class of potential persistent, bioaccumulative and toxic (PBT) emerging pollutants, are extensively utilized in the display panel of various electronic devices. These compounds have been found in various environmental matrixes and dietary. Our previous studies have documented their ubiquitous occurrence in high fat foodstuffs. Infants, a vulnerable group, are more susceptible to the impacts of these pollutants compared to adults. Herein, we provided an assessment of the health risks posed by FLCMs to infants, focusing on their exposure through infant formula. The presence of FLCMs was detected in all infant formulas, with median concentration of 16.5 ng/g dry weight (dw) and the 95th percentile concentration of 65.7 ng/g dw. The most prevalent pollutant in these formulas was 2-fluoro-4-[4'-propyl-1,1'-bi(cyclohexyl)-4-yl] phenyl trifluoromethyl ether (FPrBP), with median and a 95th percentile concentration of 12.2 ng/g dw and 23.8 ng/g dw, accounting for 55.2% to the total FLCMs. Infants aged 0-6 months had the highest estimated daily intakes (EDIs) of FLCMs, with the EDImedian of 267 ng/kg bw/day. FPrBP and 4-[trans-4-(trans-4-Propylcyclohexyl) cyclohexyl]-1-trifluoromethoxybenzene (PCTB) together made up 83.3% of the total EDIs in median exposure scenario of 0-6 months infant. The highest EDI value was 1.30 × 103 ng/kg bw/day, 77.1% of which was attributed to a combination of FPrBP, 4″-ethyl-2'-fluoro-4-propyl-1,1':4',1″-terphenyl (EFPT), 2-[4'-[difluoro(3,4,5-trifluoro-2-methyl-phenoxy)methyl]-3',5'-difluoro-[1,1'-biphenyl]-4-yl]-5-ethyl-tetrahydro-pyran (DTMPMDP), 4-[Difluoro-(3,4,5-trifluoro-2-methyl-phenoxy)-methyl]-3,5-difluoro-4'-propyl-1,1-biphenyl (DTMPMDB), 2,3-difluoro-1-methyl-4-[(trans, trans)-4'-pentyl[1,1'-bicyclohexyl]-4-yl]benzene (DMPBB) and PCTB. It's worth noting that FLCMs have higher exposure risk. Based on the threshold of toxicological concern (TTC) method, the EDImedian of FPrBP (183 ng/kg bw/day) and FPCB (3.27 ng/kg bw/day) were beyond their TTC values (2.5 ng/kg bw/day) in 0-6 months infant, implying their prospective health risk.

The spatial overlay effect of urban waterlogging risk and land use value.

Urban waterlogging poses a severe threat to lives and property globally, making it crucial to identify the distribution of urban value and waterlogging risk. Previous research has overlooked the heterogeneity of value and risk in spatial distribution. To identify the overlay effect of urban land value and risk, this study employs the Entropy Weighting Method (EM) to assess urban value, Principal Component Analysis (PCA) to determine waterlogging risk and key areas (RK), local Moran's I (SC) to identify key areas (HK), and finally Bivariate local Moran's I (DC) to comprehensively evaluate urban value and waterlogging risk to delineate key areas (BH). The results indicate that waterlogging risk is primarily influenced by proximity to water systems (PCA coefficient: 0.567), population density (0.550), and rainfall (0.445). There is a positive correlation between urban value and waterlogging risk, with a global Moran's I of 0.536, indicating that areas with higher urban value also face greater waterlogging risk. The DC method improved identification precision, reducing the BH area by 6.42 and 3.51 km2 compared to RK and HK, accounting for 25.50 % and 15.76 % of the RK and HK identified areas, respectively. At present, rescue resources can access less than one-third of the area within 5 min, but with the DC method, during the centennial rainfall scenario, the accessibility rate within 5 min for the BH area reaches 63 %, and all BH key areas can be covered within 15 min. This study provides a new methodology for identifying key areas of waterlogging disasters and can be used to enhance urban rescue efficiency and the precision management of flood disasters.

Prevalence of interarm blood pressure difference is notably higher in women; the Viborg population-based screening program (VISP).

BACKGROUND: Bilateral blood pressure (BP) measurement is important in cardiovascular prevention for identifying systolic interarm BP difference (IAD) and hypertension. We investigated sex-stratified IAD prevalence and its associations and coexistence with screen-detected peripheral atherosclerosis and hypertension. Furthermore, we determined the proportion misclassified as non-hypertensive when using the lower versus the higher reading arm. METHODS: This sub-study formed part of the Viborg Screening Program (VISP), a cross-sectorial population-based cardiovascular screening programme targeting 67-year-old Danes. VISP includes screening for peripheral atherosclerosis (lower extremity arterial disease and carotid plaque), abdominal aortic aneurysm, hypertension, diabetes mellitus, and cardiac disease. Self-reported comorbidities, risk factors, and medication use were also collected. Among 4,602 attendees, 4,517 (82.1%) had eligible bilateral and repeated BP measurements. IAD was defined as a systolic BP difference ≥ 10 mmHg. IAD-associated factors (screening results and risk factors) were estimated by logistic regression; proportional coexistence was displayed by Venn diagrams (screening results). RESULTS: We included 2,220 women (49.2%) and 2,297 men (50.8%). IAD was more predominant in women (26.8%) than men (21.0%) (p < 0.001). This disparity persisted after adjustment [odds ratio (OR) 1.53; 95% confidence interval (CI) 1.32-1.77]. No other association was recorded with the conditions screened for, barring potential hypertension: BP 140-159/90-99 mmHg (OR 1.68, 95% CI 1.44-1.97) and BP ≥ 160/100 mmHg (OR 1.82, 95% CI 1.49-2.23). Overall, IAD and BP ≥ 160/100 mmHg coexistence was 4% in women and 5% in men; for BP ≥ 140/90 mmHg, 13% and 14%, respectively. Among those recording a mean BP ≥ 140/90 mmHg in the higher reading arm, 14.5% of women and 15.3% of men would be misclassified as non-hypertensive compared with the lowest reading arm. CONCLUSION: Female sex was an independent factor of IAD prevalence but not associated with other arterial lesions. Approximately 15% needed reclassification according to BP ≥ 140/90 mmHg when the lower rather than the higher reading arm was used; verifying bilateral BP measurements improved detection of potential hypertension. In future, the predictive value of sex-stratified IAD should be assessed for cardiovascular events and death to verify its potential as a screening tool in population-based cardiovascular screening. TRIAL REGISTRATION FOR VISP: NCT03395509:10/12/2018.

The occurrence and human health risk assessment of total and aflatoxin B1 in selected food commodities in Bhutan.

Aflatoxins are mycotoxins that contaminate staple foods globally and pose a significant health risk. To the best of our knowledge, information on the occurrence of aflatoxins in Bhutanese diets is scarce. This study aimed to estimate the aflatoxin levels in selected foodstuffs in Bhutan and determine the health risk associated with aflatoxin exposure. Ten different types of food commodities were randomly collected from farmers' markets, shelves of supermarkets, and wholesale and retail shops from 20 districts of the country. The samples were subjected to analysis by an enzyme-linked immunosorbent assay for both total aflatoxins (B1, B2, G1 and G2) and aflatoxin B1. Among the 315 samples included, 48.81% and 79.35% were positive for total aflatoxins and aflatoxin B1, respectively. The overall mean total aflatoxin concentration was 11.49 ± 12.83 µg/kg, and that for B1 was 17.62 ± 23.99 µg/kg. The most prevalent food commodity with the highest aflatoxin contamination was chili products. In addition, the estimated daily intake and margin of exposure to aflatoxin B1 via the consumption of chili products ranged from 0.98 to 5.34 ng kg-1 bw day-1 and from 74.90 to 408.10, indicating a risk for public health. The liver cancer risk was estimated to be 0.01 and 0.007 cancers per year per 100,000 population resulting from the consumption of chili products. The present findings revealed the presence of total aflatoxins and aflatoxin B1 in the selected samples. The margin of exposure values was exorbitant, demanding a stringent public health measure. Notably, these results suggest the need for routine monitoring of aflatoxin contamination in the region and stress rigorous safety management strategies to reduce exposure.

[Occurrence and Risk Assessment of Microplastics in the Coastal Seawater of Guangdong Province].

Microplastics （MPs） are ubiquitous in the marine environment and have become an emerging pollutant that is attracting great attention. To reveal the pollution characteristics of MPs in surface seawater of coastal waters in Guangdong Province, nine bays （estuaries） were selected from Jiangmen to Shantou. The distribution and compositional characteristics of MPs were investigated through field sampling, oxidation digestion, and visual and compositional identification, and their potential sources were analyzed. The ecological risks were assessed by combining the pollution load index and the polymer risk index. The results showed that MPs were detected in all 30 surface seawater samples from the coastal waters of Guangdong Province, with an abundance range of 70-920 n·m-3 and an average abundance of （295.3 ±175.3） n·m-3. The highest MPs abundance was found in the Pearl River estuary, and the lowest abundance was found in Shenquan bay. The distribution patterns were mainly influenced by human activities and ocean currents. The dominant polymer types included polypropylene （31.2%）, phenol resin （16.0%）, polyethylene terephthalate （15.3%）, and polyethylene （10.9%）. The main shape, color, and size categories of MPs were fiber （57.5%）, transparent （72.0%）, and 0.5-1 mm （32.8%）, respectively. The possible sources of MPs mainly included aquaculture, fishing, navigation, tourism, municipal sewage discharge, and ocean current transportation. The model assessment results showed that the pollution load risk of MPs was relatively low, but the polymer risk was at a medium-high level. This study provides a data basis for the action plan of plastic pollution control in Guangdong Province and supports the prevention and control of marine MPs pollution.

[Distribution Characteristics and Risk Assessment of Organophosphates in Water and Sediment in Dongting Lake].

Organophosphates （OPEs） are widely used as flame retardants and additives and thus are commonly detected in the environment. In order to explore their environmental behavior, the concentrations of 13 OPEs in the surface water and sediment of Dongting Lake were analyzed using UPLC-MS/MS. The results showed that 11 OPEs were detected, with detection frequencies of 5.26%-100% and 58.3%-100%, and the concentrations of OPEs were 2.06-2 028 ng·L-1 and 19.6-2 232 ng·g-1 in water and sediment, respectively. Overall, contamination concentrations were ranked in descending order as follows： inflowing rivers, lake area, and outlet, whereas the spatial distribution of concentrations in sediment was inversely proportional to hydrodynamics. The concentration of OPEs in Dongting Lake was at a high level compared with that of domestic and foreign lakes. Among the detected 11 OPEs, tri-iso-butyl phosphate （TnBP） and （TiBP） were dominant in water, accounting for 52.3% and 22.4% of ∑OPEs, respectively. TPhP was the dominant OPEs in sediment, accounting for 31.2% of ∑OPEs. The correlation and principal component analysis indicated that OPEs pollution in Dongting Lake was mainly affected by industrial production emissions, fishery aquaculture, and atmospheric deposition. The assessment results of the risk entropy showed that most of the detected OPEs in water had relatively low ecological risks, whereas the ecological risk of 2-ethylhexyl diphenyl phosphate （EHDPP） at some sampling points requires further attention.

[Characteristics of Pollution and Microbial Community Structure in the Antimony Mining Area of Longnan, Gansu Province].

Antimony （Sb） is a major pollutant that poses a serious threat to the environment in the mining and processing of nonferrous metals, coexisting with sulfide and oxide of arsenic （As）. Microorganisms play an important role in the migration, transformation, and repair of metals in soil. The ecological effects of bioavailable Sb and As on the microbial community in antimony mining areas（mining and smelting areas）are still poorly understood. The Wenzel method and high-throughput 16S rDNA amplicon were used to characterize soil pollution characteristics in different functional areas, and the relationship between the bacterial community and bioavailable concentrations have been investigated comprehensively. The results showed that： Chemical speciation of Sb and As were amorphous, and poorly crystalline hydrous oxides of Fe and Al （F3） > well-crystallized hydrous oxides of Fe and Al （F4） > residual phases （F5） > specifically adsorbed （F2） > non-specifically adsorbed （F1）. According to the estimation of the potential ecological risk index （RI） and geo-accumulation index （Igeo）, the Sb pollution degree was： smelting area > mining area > contrast area, in which the smelting area showed serious pollution, and the mining area showed moderate to severe pollution. The As pollution degree was： mining area > smelting area > contrast area, in which the mining area and smelting area showed moderate to severe pollution. High-throughput 16S rDNA amplicon showed that Proteobacteria was the most abundant phylum in mining and smelting areas； Kaistobacter, Pseudomonas, Sphingomonas, and Lysobacter were the most abundant microbial genera； Geobacter and Luteolibacter had a high LDA score in mining areas； and Thiobacillus had a high LDA score in antimony-contaminated areas. Spearman correlation analysis, variation partitioning analysis （VPA）, and random forest （RF） analysis showed that Sb, As, bioavailable antimony [Sb （Bio）], and bioavailable arsenic [As （Bio）]were the main factors affecting the microbial community structure in different functional areas of antimony ore. Redundancy analysis （RDA） indicated that Sb and its bioavailable concentrations showed uniformly negative associations with the relative abundance of bacteria Nitrospirae and showed a significant positive correlation with Thiobacillus （P<0.05）. The in-depth research on the ecological effects of bioavailable Sb and As on the bacterial community provides references and new perspectives for environmental monitoring and management.

[Antibiotic Contamination Characteristics and Ecological Risk Assessment in Soils of Large-scaled Culturing Farms].

The soils of different land use types in large-scaled culturing farms were collected for detecting the contents of antibiotics in these soils by applying high-performance liquid chromatography, analyzing the relationship between antibiotics and physicochemical properties of soils, as well as performing the ecological risk assessment of antibiotics in the soils of culturing farms by using the risk quotient method. The results showed that the surrounding soils of the culturing farm were contaminated by antibiotics to varying degrees, in which tetracycline had the highest detection rate and average content. Among the soils of different land use types, the average contents of antibiotics were ranked as corn field （1.48 µg·kg-1）>0.5 meters outside the farm fence （1.27 µg·kg-1）>yam field （1.03 µg·kg-1）>pasture （0.69 µg·kg-1）>woodland （0.18 µg·kg-1）. According to the redundancy analysis results, the total nitrogen, total phosphorus, and cellulase had a great impact on the antibiotic content in soil samples. It can be concluded from the ecological risk assessment that oxytetracycline （OTC）, chlortetracycline （CTC）, doxycycline （DOC）, ciprofloxacin （CIP）, and tetracycline （TC） were categorized in the low risk level. Sulfadiazine （SM） and sulfadimidine （SM2） were categorized in the medium and high risk levels. It is of the upmost importance to control the antibiotic contamination in surrounding soils of culturing farms and to strengthen the management of veterinary antibiotics.

Prognostic value of CT body composition analysis for 1-year mortality after transcatheter aortic valve replacement.

OBJECTIVES: To investigate the value of body composition indices derived from pre-procedural computed tomography (CT) in predicting 1-year mortality among patients who underwent transcatheter aortic valve replacement (TAVR). MATERIALS AND METHODS: We assessed consecutive patients who underwent TAVR between June 2016 and December 2021 at a single academic medical center. Skeletal muscle and subcutaneous fat area at the T4, T12, and L3 levels on pre-procedural CT were measured. The association between body composition and 1-year mortality was evaluated using Cox proportional hazard regression analysis. RESULTS: Finally, 408 patients were included (185 men and 223 women; mean age, 81.7 ± 5.1 years; range, 62-98 years). Post-procedural death occurred in 13.2% of patients. The muscle-height index and fat-height index at the L3 level were more strongly correlated with those at the T12 level (r = 0.765, p < 0.001 and r = 0.932, p < 0.001, respectively) than with those at the T4 level (r = 0.535, p < 0.001 and r = 0.895, p < 0.001, respectively). The cumulative 1-year mortality rate was highest for patients with both sarcopenia and adipopenia (26%), followed by those with adipopenia only (17%), those with sarcopenia only (12%), and those with neither sarcopenia nor adipopenia (8%, p = 0.002). Multivariable analysis revealed that body composition at the T12 level was an independent risk factor for 1-year mortality (hazard ratio: 4.09, 95% confidence interval: 2.01-8.35) in patients with both sarcopenia and adipopenia (p < 0.001). CONCLUSION: Sarcopenia or adipopenia assessed with CT at the thoracic level may be valuable for stratifying 1-year all-cause mortality in patients who undergo TAVR. CLINICAL RELEVANCE STATEMENT: Skeletal muscle and subcutaneous fat mass indices at the level of T12, measured on pre-procedural CT, have value for risk stratification of 1-year all-cause mortality in patients who undergo transcatheter aortic valve replacement. KEY POINTS: Sarcopenia and adipopenia are associated with the prognosis of patients undergoing transcatheter aortic valve replacement. Body composition at the T12 level was an independent risk factor for 1-year all-cause mortality. Sarcopenia or adipopenia assessed at T12 with pre-procedural CT is valuable for risk stratification.

A comprehensive perspective on potentially hazardous elements (PHEs) bound with particulate matters in ambient air of landfill sites: a systematic review and probabilistic risk assessment.

Air pollution from Potentially Hazardous Elements bound with particulate matter (PHEs bound PM) in landfill air is a significant concern for human health. To date, no comprehensive research has focused on the health risks of PHEs bound to PM in landfill air. This systematic review aimed to examine PHEs, including Lead (Pb), Cadmium (Cd), Chromium (Cr), Arsenic (As), Nickel (Ni), and Zinc (Zn) bound with PM in landfill air and assess the health risk for workers and waste management personnel. The systematically search was made in different electronic databases. After the screening, 18 most relevant studied focused on PHEs bound PM in landfill air were selected. The data extraction analysis indicated that mean concentrations of Pb, Cd, Cr, As, Ni, and Zn in landfill air were 0.3037, 0.0941, 0.4093, 0.0221, 0.2768, and 0.7622 µg/m3, respectively. Except for Pb, the concentrations of other PHEs bound to PM exceeded USEPA air quality standards. In addition, Non-carcinogenic risks from Cd, Cr, and Ni exposure exceeded permissible limits (HQ > 1), while As had an HQ value of 0.401. Carcinogenic risks from As, Cd, Ni, and Pb exposure were 1.31 × 10-5, 5.10 × 10-4, 3.51 × 10-5, and 2.03 × 10-6, respectively. Notably, the lifetime carcinogenic risk for workers exposed to Cr in polluted air (6.17 × 10-3) exceeded permissible limits (10-4 to 10-6). In conclusion, given the high carcinogenic and non-carcinogenic risks of some PHEs bound PM in landfills, it is necessary to conduct more research on the health effects of interaction with these PHEs bound PM on communities and the environment in different countries. Also, it is necessary to evaluate the role of different landfill operational activities on atmospheric dispersion of PHEs bound PM) in landfill air.

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.

A Multimorbidity Analysis of Hospitalized Patients With COVID-19 in Northwest Italy: Longitudinal Study Using Evolutionary Machine Learning and Health Administrative Data.

BACKGROUND: Multimorbidity is a significant public health concern, characterized by the coexistence and interaction of multiple preexisting medical conditions. This complex condition has been associated with an increased risk of COVID-19. Individuals with multimorbidity who contract COVID-19 often face a significant reduction in life expectancy. The postpandemic period has also highlighted an increase in frailty, emphasizing the importance of integrating existing multimorbidity details into epidemiological risk assessments. Managing clinical data that include medical histories presents significant challenges, particularly due to the sparsity of data arising from the rarity of multimorbidity conditions. Also, the complex enumeration of combinatorial multimorbidity features introduces challenges associated with combinatorial explosions. OBJECTIVE: This study aims to assess the severity of COVID-19 in individuals with multiple medical conditions, considering their demographic characteristics such as age and sex. We propose an evolutionary machine learning model designed to handle sparsity, analyzing preexisting multimorbidity profiles of patients hospitalized with COVID-19 based on their medical history. Our objective is to identify the optimal set of multimorbidity feature combinations strongly associated with COVID-19 severity. We also apply the Apriori algorithm to these evolutionarily derived predictive feature combinations to identify those with high support. METHODS: We used data from 3 administrative sources in Piedmont, Italy, involving 12,793 individuals aged 45-74 years who tested positive for COVID-19 between February and May 2020. From their 5-year pre-COVID-19 medical histories, we extracted multimorbidity features, including drug prescriptions, disease diagnoses, sex, and age. Focusing on COVID-19 hospitalization, we segmented the data into 4 cohorts based on age and sex. Addressing data imbalance through random resampling, we compared various machine learning algorithms to identify the optimal classification model for our evolutionary approach. Using 5-fold cross-validation, we evaluated each model's performance. Our evolutionary algorithm, utilizing a deep learning classifier, generated prediction-based fitness scores to pinpoint multimorbidity combinations associated with COVID-19 hospitalization risk. Eventually, the Apriori algorithm was applied to identify frequent combinations with high support. RESULTS: We identified multimorbidity predictors associated with COVID-19 hospitalization, indicating more severe COVID-19 outcomes. Frequently occurring morbidity features in the final evolved combinations were age>53, R03BA (glucocorticoid inhalants), and N03AX (other antiepileptics) in cohort 1; A10BA (biguanide or metformin) and N02BE (anilides) in cohort 2; N02AX (other opioids) and M04AA (preparations inhibiting uric acid production) in cohort 3; and G04CA (Alpha-adrenoreceptor antagonists) in cohort 4. CONCLUSIONS: When combined with other multimorbidity features, even less prevalent medical conditions show associations with the outcome. This study provides insights beyond COVID-19, demonstrating how repurposed administrative data can be adapted and contribute to enhanced risk assessment for vulnerable populations.

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.

Polybrominated diphenyl ethers in indoor dust from Brazil: assessing demographic differences and human health exposure.

Indoor house dust is considered an important human exposure route to polybrominated diphenyl ethers (PBDEs), which has raised concern about their environmental persistence and toxicity properties. In this study, eight PBDEs (BDE-28, -47, -99, -100, -153, -154, -183, and -209) were determined in house dust from two cities with different socio-demographic characteristics from Brazil, examining possible relationships with factors that potentially influence contamination (population density, economic activities, presence of electronic equipment, and so on) and also estimating the risk of human exposure through oral ingestion and dermal contact. The Σ8PBDE concentration in Sorocaba city ranged between 380 and 4269 ng/g dw, while in Itapetininga city ranged from 106 to 1000 ng/g dw. In both regions, BDE-209 was the most abundantly found congener, followed by BDE-99. House dust from Sorocaba presented significantly greater concentrations of BDE-183 and BDE-209 than Itapetininga. Regarding risk exposure assessment, the estimated daily intake (EDI) of PBDEs was much lower than their respective reference doses (RfDs) in all pathways estimated (non-dietary ingestion and dermal contact). This study provided valuable data to improve the knowledge about the presence and exposure to PBDEs in Brazilian house dust in comparison to other developing countries and the need to control environmental pollution and protect human health.