Natural and anthropogenic origin of metallic contamination and health risk assessment: A hydro-geochemical study of Sehwan Sharif, Pakistan.

Heavy metal contamination in groundwater is a serious threat to the environment and therefore its proper monitoring is a matter of great concern these days. In the present research, groundwater samples from Sehwan Sharif district Jamshoro, Pakistan were collected to estimate the concentration of various elements including potentially hazardous metals. Statistical analysis of the collected data based on Pearson co-relation metal clustering and Principal Component Analysis (PCA) divides the elements into three groups; Group I contains As, Cu, Ni, and Cd, Group II contains Mn, Fe, B, and Cr and Group III contains Pb and Zn. The elements Cu, Ni, As, Pb, Cd, and Zn found with higher RSD values demonstrate their anthropogenic origin whereas the lower concentration of Mn, Fe, B, and Cr indicate their natural origin (Tepanosyan et al., 2016). The histograms and box-plots of Mn, Fe, B and Cr were found normally distributed while abnormal for Cu, Ni, Pb, As, Cd and Zn. The HQs of these elements indicate their non-carcinogenic risks. However, results of individual metallic behavior indicate the highest HQ measured for B followed by HQs for Cu, and As. The toxic effects of investigated metal (loid)s calculated using HI were found to be 1.58 for adults and 1.35 for the child which is considered the medium chromic risk and cancer risk. About the toxicity of these heavy metals, their cancer risk was assessed on the levels of Cd, As, and Cr in groundwater. The carcinogenic risk of As was found to be 2.78 × 10-4 and 1.62 × 10-3 for child and adult, respectively. Furthermore, the values of this carcinogenic risk are 2.64 × 10-6 and 1.54 × 10-5 for Cd while 4.24 × 10-3 and 2.48 × 10-2 for Cr in child and adult, respectively. Since cancer risk exceeded the target risk of 1 × 10-4 for As and Cr in adults and children, it can thus be considered 'non-acceptable'. The Geographic Information System (GIS) based maps were prepared using Inverse Distance Weighted (IDW) interpolation which showed the Spatial distribution of all elements throughout Sehwan Sharif from different sources of environment. Spatial maps of elements produced by ArcGIS show the hotspots of potentially hazardous elements such as the highest concentration of Pb, As, Zn, Cu, Ni, and Cd were found in urban areas of Sehwan Sharif district Jamshoro, Pakistan.

Equilibrium, kinetics and thermodynamic studies for the removal of arsenic from water using newly synthesized amino resin supported hydrous ferric oxide nano composite.

Arsenic (III) was treated by newly synthesized ferric oxide nano composite supported on amino resin (NXHFO). Amberlite XAD-4 was converted to amino derivative (NX) and HFO particles were prepared on its surface. Batch study was conducted to study the removal of arsenic from aqueous media. Uptake of ∼98.5% was recorded at pH 4 using 50 mg of NXHFO while the agitation time was 30 min. Monolayer sorption capacity of NXHFO resin calculated from Langmuir sorption isotherm for As(III) ions was 32.3 mg g-1. The sorption energy (E) calculated was 15 kJ mol-1, suggesting that the uptake of arsenite onto the NXHFO surface was due to ion-exchange.

Estimating the future cancer management costs attributable to modifiable risk factors in Canada.

OBJECTIVES: An estimated 33-37% of incident cancers in Canada are attributable to modifiable risk factors. Interventions targeting these risk factors would minimize the substantial health and economic burdens Canadians face due to cancer. We estimate the future health and economic burden of cancer in Canada by incorporating data from the Canadian Population Attributable Risk of Cancer (ComPARe) study into OncoSim, a web-based microsimulation tool. METHODS: Using the integrated OncoSim population attributable risk and population impact measures, we evaluated risk factor-targeted intervention scenarios implemented in 2020, assuming the targeted risk factor prevalence reduction would be achieved by 2032 with a 12-year latency period. RESULTS: We estimate that smoking will be the largest contributor to cancer-related costs, with a cost of CAD $44.4 billion between 2032 and 2044. An estimated CAD $3.3 billion of the cost could be avoided with a 30% reduction in smoking prevalence by 2022. Following smoking, the next highest cancer management costs are associated with inadequate physical activity and excess body weight, accounting for CAD $10.7 billion ($2.7 billion avoidable) and CAD $9.8 billion ($3.2 billion avoidable), respectively. Avoidable costs for other risk factors range from CAD $90 million to CAD $2.5 billion. CONCLUSION: Interventions targeting modifiable cancer risk factors could prevent a substantial number of incident cancer cases and billions of dollars in cancer management costs. With limited budgets and rising costs in cancer care in Canada, these simulation models and results are valuable for researchers and policymakers to inform decisions and prioritize and evaluate intervention programs.

RéSUMé: OBJECTIFS: Il est estimé que de 33 % à 37 % des cancers incidents au Canada sont imputables à des facteurs de risque modifiables. Des interventions ciblant ces facteurs de risque réduiraient le fardeau sanitaire et économique considérable du cancer dans la population canadienne. Nous avons estimé le futur fardeau sanitaire et économique du cancer au Canada en intégrant les données de l'étude ComPARe (Canadian Population Attributable Risk of Cancer) dans l'outil de microsimulation en ligne OncoSim. MéTHODE: À l'aide des indicateurs d'impact dans la population et du risque attribuable dans la population intégrés dans OncoSim, nous avons évalué des scénarios d'intervention mis en œuvre en 2020 axés sur les facteurs de risque, en partant de l'hypothèse que la réduction de la prévalence des facteurs de risque ciblés serait atteinte d'ici 2032 avec une période de latence de 12 ans. RéSULTATS: Nous estimons que le tabagisme sera le facteur qui contribuera le plus aux coûts du cancer, avec un coût de 44,4 milliards $ CA entre 2032 et 2044. Il est estimé qu'une part de 3,3 milliards $ CA de ce coût pourrait être évitée en réduisant de 30 % la prévalence du tabagisme d'ici 2022. Après le tabagisme, les coûts de prise en charge du cancer les plus élevés sont associés à l'inactivité physique et au surpoids, qui représentent respectivement 10,7 milliard $ CA (dont 2,7 milliards $ évitables) et 9,8 milliards $ CA (dont 3,2 milliards $ évitables). Les coûts évitables pour d'autres facteurs de risque vont de 90 millions $ CA à 2,5 milliards $ CA. CONCLUSION: Des interventions ciblant les facteurs de risque de cancer modifiables pourraient prévenir un nombre considérable de cas de cancers incidents et épargner des milliards de dollars en coûts de prise en charge du cancer. Avec les budgets serrés et la hausse des coûts des soins du cancer au Canada, ces modèles de simulation et leurs résultats permettent aux chercheurs et aux responsables des politiques d'éclairer les décisions et de hiérarchiser et d'évaluer les programmes d'intervention.

Estimates of future cancer mortality attributable to modifiable risk factors in Canada.

OBJECTIVES: Modifiable lifestyle, environmental, and infectious risk factors associated with cancer impact both cancer incidence and mortality at the population level. Most studies estimating this burden focus on cancer incidence. However, because these risk factors are associated with cancers of disparate mortality rates, the burden associated with cancer incidence could differ from cancer mortality. Therefore, estimating the cancer mortality attributable to these risk factors provides additional insight into cancer prevention. Here, we estimated future cancer deaths and the number of avoidable deaths in Canada due to modifiable risk factors. METHODS: The projected cancer mortality data came from OncoSim, a web-based microsimulation tool. These data were applied to the methodological framework that we previously used to estimate the population attributable risks and the potential impact fractions of modifiable risk factors on Canadian cancer incidence. RESULTS: We estimated that most cancer deaths will be attributed to tobacco smoking with an average of 27,900 deaths annually from 2024 to 2047. If Canada's current trends in excess body weight continue, cancer deaths attributable to excess body weight would double from 2786 deaths in 2024 to 5604 deaths in 2047, becoming the second leading modifiable cause of cancer death. Applying targets to reduce these risk factors, up to 34,600 cancer deaths could be prevented from 2024 to 2047. CONCLUSION: Our simulated results complement our previous findings on the cancer incidence burden since decreasing the overall burden of cancer will be accelerated through a combination of decreasing cancer incidence and improving survival outcomes through improved treatments.

RéSUMé: OBJECTIFS: Les facteurs de risque modifiables associés au cancer (liés au mode de vie, à l'environnement, aux maladies infectieuses) ont des effets à la fois sur l'incidence du cancer et sur la mortalité par cancer à l'échelle de la population. La plupart des études qui estiment ce fardeau portent sur l'incidence du cancer. Cependant, comme les facteurs de risque susmentionnés sont associés à des cancers dont les taux de mortalité sont disparates, le fardeau associé à l'incidence du cancer pourrait différer de la mortalité par cancer. En conséquence, l'estimation de la mortalité par cancer imputable à ces facteurs de risque pourrait éclairer la prévention du cancer. Nous estimons ici les décès futurs par cancer et le nombre de décès évitables au Canada dus à des facteurs de risque modifiables. MéTHODE: Les données projetées sur la mortalité par cancer proviennent d'OncoSim, un outil de microsimulation en ligne. Elles ont été appliquées au cadre méthodologique que nous avions déjà utilisé pour estimer les risques attribuables dans la population et les fractions de l'incidence potentielle des facteurs de risque modifiables sur l'incidence canadienne du cancer. RéSULTATS: Selon nos estimations, entre 2024 et 2047, la plupart des décès par cancer seront imputés au tabagisme, qui causera en moyenne 27 900 décès par année. Si les tendances actuelles au Canada en matière de surpoids se maintiennent, les décès par cancer attribuables au surpoids doubleraient, passant de 2 786 décès en 2024 à 5 604 en 2047, et le surpoids deviendrait la deuxième cause modifiable de décès par cancer. En appliquant des cibles de réduction de ces facteurs de risque, jusqu'à 34 600 décès par cancer pourraient être évités entre 2024 et 2047. CONCLUSION: Les résultats de notre simulation confirment nos constatations antérieures sur le fardeau de l'incidence du cancer, car la diminution du fardeau global du cancer sera accélérée par une combinaison de la diminution de l'incidence du cancer et de l'amélioration des résultats de survie grâce à l'amélioration des traitements.

Nonenzymatic Electrochemical Detection of 2,4,6-Trichlorophenol Using CuO/Nafion/GCE: A Practical Sensor for Environmental Toxicants.

2,4,6-Trichlorophenol (2,4,6 TCP) is one of the hazardous toxicants, which has severe impacts on the environment and human health. This study is designed to develop a highly sensitive and selective electrochemical sensor based on CuO nanostructures for the detection of 2,4,6 TCP. The CuO nanostructures were synthesized through an aqueous chemical growth method and characterized by versatile analytical techniques, for example, Fourier transform infrared spectroscopy, field emission scanning electron microscopy, atomic force microscopy, energy-dispersive spectrometry, and X-ray diffraction. The characterization tools revealed a high crystalline nature, exceptional phase purity, nanoball morphology with an average size of around 18.7 nm for the CuO nanostructures. The synthesized material was used to modify a glassy carbon electrode (GCE) with the help of Nafion as a binder to improve its efficiency and sensitivity. The CuO/Nafion/GCE was proven to be a potential sensor for the determination of 2,4,6 TCP under optimized conditions at a scan rate of 70 mV/s, potential range of 0.1-1.0 V, and phosphate buffer of neutral pH as the supporting electrolyte. The linear range for 2,4,6 TCP was set from (1 to 120 µM) with a low limit of detection value calculated to be 0.046 µM. The developed sensor was effectively applied for water samples with acceptable recovery values from 95.9 to 100.6%.

Clinical impact and cost-effectiveness of integrating smoking cessation into lung cancer screening: a microsimulation model.

BACKGROUND: Low-dose computed tomography (CT) screening can reduce lung cancer mortality in people at high risk; adding a smoking cessation intervention to screening could further improve screening program outcomes. This study aimed to assess the impact of adding a smoking cessation intervention to lung cancer screening on clinical outcomes, costs and cost-effectiveness. METHODS: Using the OncoSim-Lung mathematical microsimulation model, we compared the projected lifetime impact of a smoking cessation intervention (nicotine replacement therapy, varenicline and 12 wk of counselling) in the context of annual low-dose CT screening for lung cancer in people at high risk to lung cancer screening without a cessation intervention in Canada. The simulated population consisted of Canadians born in 1940-1974; lung cancer screening was offered to eligible people in 2020. In the base-case scenario, we assumed that the intervention would be offered to smokers up to 10 times; each intervention would achieve a 2.5% permanent quit rate. Sensitivity analyses varied key model inputs. We calculated incremental cost-effectiveness ratios with a lifetime horizon from the health system's perspective, discounted at 1.5% per year. Costs are in 2019 Canadian dollars. RESULTS: Offering a smoking cessation intervention in the context of lung cancer screening could lead to an additional 13% of smokers quitting smoking. It could potentially prevent 12 more lung cancers and save 200 more life-years for every 1000 smokers screened, at a cost of $22 000 per quality-adjusted life-year (QALY) gained. The results were most sensitive to quit rate. The intervention would cost over $50 000 per QALY gained with a permanent quit rate of less than 1.25% per attempt. INTERPRETATION: Adding a smoking cessation intervention to lung cancer screening is likely cost-effective. To optimize the benefits of lung cancer screening, health care providers should encourage participants who still smoke to quit smoking.

Environmental Friendly Synthetic Modification of Amberlite XAD-2 Resin for the Removal of Highly Toxic Hexavalent Chromium from Water.

Amberlite XAD-2 functionalized by coupling through -C=N- spacer with isatin via an environmental friendly protocol. The modified resin was used for the evaluation of its sorption capacity towards toxic Cr (VI) ions using spectrophotometer. pH, volume, sorbent amount, initial concentration of Cr(VI) ions, and agitation time were optimized. The Freundlich and Dubinin- Radushkevich models gave better fit to isotherm data than Langmuir model. The evaluation of kinetic data indicated pseudo-first-order kinetics followed by sorption process. Thermodynamic parameters were also evaluated. Maximum recovery was obtained at 10 mL of 0.1M NaOH. Spiking methodology was used to confirm the validity of proposed method. The results revealed that developed method can be used for the removal of Cr(VI) ions efficiently from water, as well as reused for three cycles.

Equilibrium, kinetic and thermodynamic studies of removal of phenol from aqueous solution using surface engineered chemistry.

Iron impregnated activated carbon has been used as a new adsorbent for the adsorptive removal of phenol from waste water. Impregnation of iron was confirmed by Fourier transform infrared spectroscopy and scanning electron microscope and energy dispersive spectroscopy. Different parameters affecting the adsorption capacity of Iron impregnated activated carbon such as Iron impregnated activated carbon dosage, contact time, pH of solution, initial concentration of phenol and agitation speed were optimized. The residual concentration of phenol was determined by UV-Vis spectroscopy. Maximum adsorption efficiency was calculated 98.5% at optimized parameters: concentration of phenol 25 mg L-1, Iron impregnated activated carbon dose 75 mg, pH 7.0 and agitation time 90 min. The experimental data was fitted to different adsorption isotherms and adsorption capacities obtained were 20 and 15 mg g-1, respectively. Adsorption energy was found to be 1.54 kJ mol-1 which predicts that phenol was adsorbed onto the Iron impregnated activated carbon through physisorption.

Correction to: Evaluation of hydrochar efficiency for simultaneous removal of diclofenac and ibuprofen from aqueous system using surface response methodology.

The original publication of this paper contain typographical mistakes.

Evaluation of hydrochar efficiency for simultaneous removal of diclofenac and ibuprofen from aqueous system using surface response methodology.

Pharmaceutically active compounds like diclofenac (DFS), ibuprofen (IBP), and other drugs that persist in the environment are listed as emerging contaminants. These escape from normal wastewater treatment plants and find their way to water streams; therefore, alternate treatment processes are needed. Herein, a sorbent material is reported that is prepared through hydrotermal carbonization from dried fruit powder of Zizipus mauritiana L. (HTC-ZM) and applied for simultaneous removal of DFS and IBP. Carbonized material (HTC-ZM) was found as agglomerates of approximately 1 µm particle size with surface area of 1160 m2/g having oxygen functional groups (e.g., COO, O, C=O) on surface. Simultaneous removal of IBP and DFS onto HTC-ZM was studied using response surface methodology with a set of 18 experiments using factors such as pH, amount of sorbent, contact time, and sorbate concentration. Maximum removal efficiency was obtained 88% and 97% for DFS and for IBP, respectively, with adsorption capacity of 2.03 mmol g-1 for DFS and 2.54 mmol g-1 for IBP. Kinetics modeling and "mean free energy" values predicted that sorption is mainly governed by physical interactions followed by "pore filling" mechanism for uptake of DFS and IBP.

Quantitative separation of hesperidin, chrysin, epicatechin, epigallocatechin gallate, and morin using ionic liquid as a buffer additive in capillary electrophoresis.

Recently, an increasing interest has been observed in ionic liquids (ILs) due to their potentialities in various chemical processes. ILs have some unique properties making them excellent additives in CE. In this work a simple, rapid, and reliable CZE method has been developed and validated using 1-butyl-3-methyl imidazolium hexafluorophosphate (BMIM-PF6 ) ionic liquid as a buffer additive for the determination/separation of five flavonoids including hesperedin, epicatechin (EC), epigallocatechin gallate (EGCG), and morin using photodiode array (PDA) detector. The effect of several parameters such as concentration and pH of the running buffer, applied voltage, and concentration of ionic liquid were optimized. CZE at 25°C with 25 mM borate buffer of pH 9.0 at an applied voltage of 17 kV by adding 17.5 mM of IL was found to be suitable for the separation/determination of all five analytes within 08 min. Validation of the method was performed in terms of linearity, accuracy, precision, and limit of detection and quantification. The calibration curves were plotted in the concentration range of 1-200 µg/mL for all five analytes. The response was linear with R2  = 0.990 for EC, chrysin, and hesperidin, 0.992 for morin, and 0.988 for EGCG. LOD and LOQ were obtained within the range of 0.4-0.5 and 1.4-1.7 µg/mL, respectively. The proposed method showed good reproducibility with RSD of less than 3% for both migration time and peak height. The method was successfully applied for the determination of flavonoids from citrus fruits and tea samples.

Biennial lung cancer screening in Canada with smoking cessation-outcomes and cost-effectiveness.

BACKGROUND: Guidelines recommend low-dose CT (LDCT) screening to detect lung cancer among eligible at-risk individuals. We used the OncoSim model (formerly Cancer Risk Management Model) to compare outcomes and costs between annual and biennial LDCT screening. METHODS: OncoSim incorporates vital statistics, cancer registry data, health survey and utility data, cost, and other data, and simulates individual lives, aggregating outcomes over millions of individuals. Using OncoSim and National Lung Screening Trial eligibility criteria (age 55-74, minimum 30 pack-year smoking history, smoking cessation less than 15 years from time of first screen) and data, we have modeled screening parameters, cancer stage distribution, and mortality shifts for screen diagnosed cancer. Costs (in 2008 Canadian dollars) and quality of life years gained are discounted at 3% annually. RESULTS: Compared with annual LDCT screening, biennial screening used fewer resources, gained fewer life-years (61,000 vs. 77,000), but resulted in very similar quality-adjusted life-years (QALYs) (24,000 vs. 23,000) over 20 years. The incremental cost-effectiveness ratio (ICER) of annual compared with biennial screening was $54,000-$4.8 million/QALY gained. Average incremental CT scan use in biennial screening was 52% of that in annual screening. A smoking cessation intervention decreased the average cost-effectiveness ratio in most scenarios by half. CONCLUSIONS: Over 20 years, biennial LDCT screening for lung cancer appears to provide similar benefit in terms of QALYs gained to annual screening and is more cost-effective. Further study of biennial screening should be undertaken in population screening programs. A smoking cessation program should be integrated into either screening strategy.

Cost-effectiveness of Lung Cancer Screening in Canada.

IMPORTANCE: The US National Lung Screening Trial supports screening for lung cancer among smokers using low-dose computed tomographic (LDCT) scans. The cost-effectiveness of screening in a publically funded health care system remains a concern. OBJECTIVE: To assess the cost-effectiveness of LDCT scan screening for lung cancer within the Canadian health care system. DESIGN, SETTING, AND PARTICIPANTS: The Cancer Risk Management Model (CRMM) simulated individual lives within the Canadian population from 2014 to 2034, incorporating cancer risk, disease management, outcome, and cost data. Smokers and former smokers eligible for lung cancer screening (30 pack-year smoking history, ages 55-74 years, for the reference scenario) were modeled, and performance parameters were calibrated to the National Lung Screening Trial (NLST). The reference screening scenario assumes annual scans to age 75 years, 60% participation by 10 years, 70% adherence to screening, and unchanged smoking rates. The CRMM outputs are aggregated, and costs (2008 Canadian dollars) and life-years are discounted 3% annually. MAIN OUTCOMES AND MEASURES: The incremental cost-effectiveness ratio. RESULTS: Compared with no screening, the reference scenario saved 51,000 quality-adjusted life-years (QALY) and had an incremental cost-effectiveness ratio of CaD $52,000/QALY. If smoking history is modeled for 20 or 40 pack-years, incremental cost-effectiveness ratios of CaD $62,000 and CaD $43,000/QALY, respectively, were generated. Changes in participation rates altered life years saved but not the incremental cost-effectiveness ratio, while the incremental cost-effectiveness ratio is sensitive to changes in adherence. An adjunct smoking cessation program improving the quit rate by 22.5% improves the incremental cost-effectiveness ratio to CaD $24,000/QALY. CONCLUSIONS AND RELEVANCE: Lung cancer screening with LDCT appears cost-effective in the publicly funded Canadian health care system. An adjunct smoking cessation program has the potential to improve outcomes.

Spectrofluorimetric analysis of famotidine in pharmaceutical preparations and biological fluids by derivatization with benzoin.

A sensitive and simple spectrofluorimetric method has been developed for the analysis of famotidine, from pharmaceutical preparations and biological fluids after derivatization with benzoin. The reaction was carried out in alkaline medium with measurement of fluorescence intensity at 446 nm with excitation wavelength at 286 nm. Linear calibration was obtained with 0.5-15 µg/ml with coefficient of determination (r(2)) 0.997. The factors affecting the fluorescence intensity were optimized. The pharmaceutical additives and amino acid did not interfere in the determination. The mean percentage recovery (n=4) calculated by standard addition from pharmaceutical preparation was 94.8-98.2% with relative standard deviation (RSD) 1.56-3.34% and recovery from deproteinized spiked serum and urine of healthy volunteers was 98.6-98.9% and 98.0-98.4% with RSD 0.34-0.84% and 0.29-0.87% respectively.

LC/UV determination of cefradine, cefuroxime, and cefotaxime in dairy milk, human serum and wastewater samples.

Cephalosporins type antibiotics are widely used to treat infectious diseases. Their determination is not only important in blood/serum of patients under treatment but also in diverse matrices like wastewaters, milk etc. as contaminant. Keeping in view the need, a new high performance liquid chromatographic method for the determination of three cephalosporins (cefradine, cefuroxime and cefotaxime) has been developed. Separation was performed on an ODS column with binary solvent elution of aqueous formic acid (0.05%) and methanol in the ratio of 45: 55 (v/v) at a flow rate of 1 mL min(-1) and UV detection at 260 nm. Under optimised conditions, all three cephalosporins were baseline separated within 5 min. Linear responses for cefradine 5-20 µg mL(-1), cefuroxime 0.5-15 µg mL(-1) and cefotaxime 1.0-20 µg mL(-1) were established. LOD of 0.05-0.25 µg mL(-1) after preconcentration was achieved. The method was applied to serum samples of patients under treatment with these antibiotics and to screen the selected cephalosporins from hospital wastewater and milk samples. Moreover, method was applied to study stability of aqueous solutions and acid/base induced degradation of all three drugs.

Single-channel flow injection spectrophotometric determination of nickel using furildioxime in micellar solution.

A very simple, selective, and fast flow injection spectrophotometeric method is developed for determination of nickel using furildioxime as complexing agent. Micellar solution of brij-35 is employed to solubilize the sparingly soluble complex of Ni-furildioxime in buffered aqueous system (pH-9.00). Under optimized conditions, absorbance is linear from 0.02 to 10 µg mL(-1) using 500 µL sample volume and from 10 to 30 µg mL(-1) using 50 µL sample volume of nickel at 480 nm, with R(2) = 0.9971 and 0.9916, respectively. The molar absorption coefficient and Sandell's sensitivity were 6.0 × 10(3) L mol(-1) cm(-1) and 0.01 ng cm(-2), respectively. The sample throughput of the method is 120 samples per hour with RSD of 0.01-0.2% for 0.02 to 10 µg mL(-1) nickel (n = 5), indicating that the method is highly precise and reproducible. Interference from cobalt is removed by Nitroso R-salt-modified XAD-16. The developed method is validated by analysing certified reference materials and is applied to assess nickel content of commercially available cigarettes.

A novel micellar electrokinetic chromatographic method for separation of metal-DDTC complexes.

Micellar electrokinetic chromatography (MEKC) was examined for the separation and determination of Mo(VI), Cr(VI), Ni(II), Pd(II), and Co(III) as diethyl dithiocarbamate (DDTC) chelates. The separation was achieved from fused silica capillary (52 cm × 75 µm id) with effective length 40 cm, background electrolyte (BGE) borate buffer pH 9.1 (25 mM), CTAB 30% (100 mM), and 1% butanol in methanol (70 : 30 : 5 v/v/v) with applied voltage of -10 kV using reverse polarity. The photodiode array detection was achieved at 225 nm. The linear calibration for each of the element was obtained within 0.16-10 µg/mL with a limit of detection (LOD) 0.005-0.0167 µg/mL. The separation and determination was repeatable with relative standard deviation (RSD) within 2.4-3.3% (n = 4) in terms of migration time and peak height/peak area. The method was applied for the determination of Mo(VI) from potatoes and almond, Ni(II) from hydrogenated vegetable oil, and Co(III) from pharmaceutical preparations with RSD within 3.9%. The results obtained were checked by standard addition and rechecked by atomic absorption spectrometry.

Teaching aseptic technique for central venous access under ultrasound guidance: a randomized trial comparing didactic training alone to didactic plus simulation-based training.

BACKGROUND: Our goal was to determine whether simulation combined with didactic training improves sterile technique during ultrasound (US)-guided central venous catheter (CVC) insertion compared with didactic training alone among novices. We hypothesized that novices who receive combined didactic and simulation-based training would perform similarly to experienced residents in aseptic technique, knowledge, and perception of comfort during US-guided CVC insertion on a simulator. METHODS: Seventy-two subjects were enrolled in a randomized, controlled trial of an educational intervention. Fifty-four novices were randomized into either the didactic group or the simulation combined with didactic group. Both groups received didactic training but the simulation combined with didactic group also received simulation-based CVC insertion training. Both groups were tested by demonstrating US-guided CVC insertion on a simulator. Aseptic technique was scored on 8 steps as "yes/no" and also using a 7-point Likert scale with 7 being "excellent technique" by a rater blinded to subject randomization. After initial testing, the didactic group was offered simulation-based training and retesting. Both groups also took a pre- and posttraining test of knowledge and rated their comfort with US and CVC insertion pre- and posttraining on a 5-point Likert scale. Subsequently, 18 experienced residents also took the test of knowledge, rated their comfort level, and were scored while performing aseptic US-guided CVC insertion using a simulator. RESULTS: The simulation combined with didactic group achieved a 167% (95% confidence interval [CI] 133%-167%) incremental increase in yes/no scores and 115% (CI 112%-127%) incremental increase in Likert scale ratings on aseptic technique compared with novices in the didactic group. Compared with experienced residents, simulation combined with didactic trained novices achieved an increase in aseptic scores with a 33.3% (CI 16.7%-50%) increase in yes/no ratings and a 20% (CI 13.3%-40%) increase in Likert scaled ratings, and scored 2.5-fold higher on the test of knowledge. There was a 3-fold increase in knowledge and 2-fold increase in comfort level among all novices (P < 0.001) after combined didactic and simulation-based training. CONCLUSION: Simulation combined with didactic training is superior to didactic training alone for acquisition of clinical skills such as US-guided CVC insertion. After combined didactic and simulation-based training, novices can outperform experienced residents in aseptic technique as well as in measurements of knowledge.

Development and implication of a capillary electrophoresis methodology for ciprofloxacin, paracetamol and diclofenac sodium in pharmaceutical formulations and simultaneously in human urine samples.

This work studies the development of a simple and fairly rapid methodology for simultaneous determination/separation of three frequently co-administered drugs; ciprofloxacin (CIP), paracetamol (PCT) and diclofenac sodium (DIC) using capillary electrophoresis (CE) with UV detection at 260 nm. Separation was achieved in only 6.5 min with a simple buffer of sodium tetraborate (50 mM) at pH 9.0. The Parameters affecting the separation and detection were optimized. The calibration curves were linear in the range of 5-500 µg/mL for CIP, 5-250 µg/mL for PCT and 1-125 µg/mL for DIC sodium under the optimized conditions. The lower limit of detection (LOD) was found to be 1 µg/mL for CIP & PCT and 0.5 µg/mL for DIC. The method was successfully used for the analysis of drugs in commercial pharmaceutical formulations and simultaneously from patient's urine sample with RSD 0.5-2.4%. Results obtained with CE method are compared with standard HPLC procedure and were found in good agreement.

The status of water and sanitation among Pacific Rim nations.

Analysis of relationships among national wealth, access to improved water supply and sanitation facilities, and population health indices suggests that the adequacy of water resources at the national level is a poor predictor of economic development--namely, that low water stress is neither necessary nor sufficient for economic development at the present state of water stress among Pacific Rim nations. Although nations differ dramatically in terms of priority provided to improved water and sanitation, there is some level of wealth (per capita GNP) at which all nations promote the development of essential environmental services. Among the Pacific Rim countries for which there are data, no nation with a per capita GNP > US$18,000 per year has failed to provide near universal access to improved water supply and sanitation. Below US$18,000/person-year, however, there are decided differences in the provision of sanitary services (improved water supply and sanitation) among nations with similar economic success. There is a fairly strong relationship between child mortality/life expectancy and access to improved sanitation, as expected from the experiences of developed nations. Here no attempt is made to produce causal relationships among these data. Failure to meet Millennium Development Goals for the extension of improved sanitation is frequently evident in nations with large rural populations. Under those circumstances, capital intensive water and sanitation facilities are infeasible, and process selection for water/wastewater treatment requires an adaptation to local conditions, the use of appropriate materials, etc., constraints that are mostly absent in the developed world. Exceptions to these general ideas exist in water-stressed parts of developed countries, where water supplies are frequently augmented by water harvesting, water reclamation/reuse, and the desalination of brackish water resources. Each of these processes involves public acceptance of water resources that are at least initially of inferior quality. Despite predictions of looming increases in water stress throughout the world, adaptation and resourcefulness generally allow us to meet water demand while pursuing rational economic development, even in the most water-stressed areas of the Pacific Rim.