Performance of the Asia-Pacific Colorectal Screening score in stratifying the risk of advanced colorectal neoplasia: A meta-analysis and systematic review.

BACKGROUND AND AIM: This study systematically reviewed and meta-analyzed the performance of the Asia-Pacific Colorectal Screening (APCS) score and its incorporation with the fecal immunochemical test (FIT) in stratifying the risk of advanced colorectal neoplasia (ACN). METHODS: We systematically searched for relevant articles in 12 electronic databases and registers on October 20, 2021, and updated the search to September 1, 2023. Random-effect models were used to obtain the pooled performance statistics of the APCS score for ACN risk. RESULTS: From the 101 records screened, 13 eligible studies in the Asia-Pacific region involving 69 762 subjects who had undergone colonoscopy were enrolled. The pooled prevalences of ACN in the average-risk (AR) tier (APCS 0-1), moderate-risk (MR) tier (APCS 2-3), and high-risk (HR) tier (APCS ≥ 4) groups were 0.9%, 3.1%, and 8.1%, respectively. Compared with the combined AR-MR group, the HR group was significantly associated with a higher ACN risk (pooled diagnostic odds ratio: 2.84, 95% confidence interval [CI]: 2.35-3.45, P < 0.001). The APCS score showed a sensitivity of 0.42 (95% CI: 0.40-0.44) and a specificity of 0.86 (95% CI: 0.85-0.86) for predicting the ACN risk, with a weighted area under the curve of 0.642 (95% CI: 0.610-0.657). The combination of the APCS score and FIT substantially improved ACN risk identification, demonstrating pooled diagnostic odds ratios of 4.02 (95% CI: 2.50-6.49) in the AR-MR groups and 5.44 (95% CI: 1.89-15.63) in the MR-HR groups. CONCLUSIONS: The APCS score could effectively stratify the ACN risk in the Asia-Pacific population. Incorporating FIT further improves its performance in identifying high-risk subjects who should be prioritized for colonoscopy screenings.

Toxic element characterization against a typical high geology background: Pollution enrichment, source tracking, spatial distribution, and ecological risk assessment.

The geological environment determines the initial content of various elements in soil, while the late input of toxic elements produced through weathering and leaching is a persistent threat to food security and human health. In this study, we selected the Lou Shao Basin, a black rock system background, and combined geostatistical analysis and multivariate statistics to quantify the specific contribution of weathering of the black rock system, and to analyze the source traces, spatial distributions, and ecological risks of the soil toxicity of elements. The results show that the soils in the study area are acidic, which is related to the weathering of sulfides in the black rock system. The concentrations of most elements in the soil were determined to exceed the soil background values, and the Cd, Se and N contents, exceeded more than five times, especially Se, Mo nearly as high as 13 times. Strong positive correlation between Se, Cu, V and P, low correlation between N and Se, Cu, V, P, Ni and Cd.72.52%, 43%, 77.79%, 82%, 77%, and 44.1% of Cd, Se, Ni, Cu, B, and Mo came from the black rock system, respectively, which were greatly affected by geogenic weathering; V, Zn, Pb, and As are mainly from biomass burning sources; N and P are mainly from agricultural surface sources. Comparison found that the Cd and Se elements in the rocks in the study area were 16.78 times and 1.36 times higher than the world shale average, respectively, and need to pay attention to the weathering process of the two, and the spatial distribution of the 12 elements in soils showed a striped and centralized block distribution pattern, specifically around the distribution of carbonate and metamorphic rocks and other high-geology blocks. The ecological risk results showed that Cd was the main element causing high ecological risk, followed by Se and N, which were at moderate to high ecological risk levels, and Se and N showed similar ecological risk patterns, which may be related to the fact that selenium can promote the uptake and transformation of nitrogen. The present results add to the endogenous sources of toxic elements, quantify the source contributions of toxic elements in soils with high geologic backgrounds, fill this knowledge gap, and provide new insights for pollution control and ecological protection in areas with high geochemical backgrounds.

A Monte Carlo simulation-based health risk assessment of heavy metals in soils of the tropical region in southern China.

The disturbance of ecological stability may take place in tropical regions due to the elevated biomass density resulting from heavy metal and other contaminant pollution. In this study, 62 valid soil samples were collected from Sanya. Source analysis of heavy metals in the area was carried out using absolute principal component-multiple linear regression receptor modelling (APCS-MLR); the comprehensive ecological risk of the study area was assessed based on pollution sources; the Monte-Carlo model was used to accurately predict the health risk of pollution sources in the study area. The results showed that: The average contents of soil heavy metals Cu, Ni and Cd in Sanya were 5.53, 6.56 and 11.66 times higher than the background values of heavy metals. The results of soil geo-accumulation index (Igeo) showed that Cr, Mo, Mn and Zn were unpolluted to moderately polluted, Cu and Ni were moderately polluted, and Cd was moderately polluted to strongly polluted. The main sources of heavy metal pollution were natural sources (57.99%), agricultural sources (38.44%) and traffic sources (3.57%). Natural and agricultural sources were jointly identified as priority control pollution sources and Cd was the priority control pollution element for soil ecological risk. Heavy metal content in Sanya did not pose a non-carcinogenic risk to the population, but there was a carcinogenic risk to children. The element Zn had a high carcinogenic risk to children, and was a priority controlling pollutant element for the risk of human health, with agricultural sources as the priority controlling pollutant source.

Chemical characteristics, morphology and source apportionment of PM10 over National Capital Region (NCR) of India.

The present study frames the physico-chemical characteristics and the source apportionment of PM10 over National Capital Region (NCR) of India using the receptor model's Positive Matrix Factorization (PMF) and Principal Momponent Mnalysis/Absolute Principal Component Score-Multilinear Regression (PCA/APCS-MLR). The annual average mass concentration of PM10 over the urban site of Faridabad, IGDTUW-Delhi and CSIR-NPL of NCR-Delhi were observed to be 195 ± 121, 275 ± 141 and 209 ± 81 µg m-3, respectively. Carbonaceous species (organic carbon (OC), elemental carbon (EC) and water-soluble organic carbon (WSOC)), elemental constituents (Al, Ti, Na, Mg, Cr, Mn, Fe, Cu, Zn, Br, Ba, Mo Pb) and water-soluble ionic components (F-, Cl-, SO42-, NO3-, NH4+, Na+, K+, Mg2+, Ca2+) of PM10 were entrenched to the receptor models to comprehend the possible sources of PM10. The PMF assorted sources over Faridabad were soil dust (SD 15%), industrial emission (IE 14%), vehicular emission (VE 19%), secondary aerosol (SA 23%) and sodium magnesium salt (SMS 17%). For IGDTUW-Delhi, the sources were SD (16%), VE (19%), SMS (18%), IE (11%), SA (27%) and VE + IE (9%). Emission sources like SD (24%), IE (8%), SMS (20%), VE + IE (12%), VE (15%) and SA + BB (21%) were extracted over CSIR-NPL, New Delhi, which are quite obvious towards the sites. PCA/APCS-MLR quantified the similar sources with varied percentage contribution. Additionally, catalogue the Conditional Bivariate Probability Function (CBPF) for directionality of the local source regions and morphology as spherical, flocculent and irregular were imaged using a Field Emission-Scanning Electron Microscope (FE-SEM).

Asia-Pacific Colorectal Screening Score Combined With Stool DNA Test Improves the Detection Rate for Colorectal Advanced Neoplasms.

BACKGROUND & AIMS: The Asia-Pacific Colorectal Screening (APCS) scoring system was developed to stratify the risk of colorectal advanced neoplasm (AN). We aimed to evaluate the performance of the APCS score combined with a stool DNA test used for colorectal cancer screening. METHODS: A total of 2842 subjects who visited outpatient clinics or cancer screening centers were enrolled. Age, sex, smoking status, and family history were recorded and APCS scores were calculated in 2439 participants. A stool DNA test (SDC2 and SFRP2 tests) and fecal immunochemical test (FIT) were performed and colonoscopy was used as the gold standard among 2240 subjects who completed all study procedures. We used a threshold of 4.4 µg/g for the FIT, in addition to the manufacturer's recommended threshold of 20 µg/g to match the specificity of a stool DNA test. RESULTS: Based on the APCS score, 38.8% (946 of 2439) of the subjects were categorized as high risk, and they had a 1.8-fold increase in risk for AN (95% CI, 1.4-2.3) compared with low and moderate risk. The APCS combined with the stool DNA test detected 95.2% of invasive cancers (40 of 42) and 73.5% of ANs (253 of 344), while the colonoscopy workload was only 47.1% (1056 of 2240). The sensitivity for AN of APCS combined with stool DNA test was significantly higher than that of APCS combined with FIT (73.5% vs 62.8% with FIT cut-off value of 20 µg/g, and 73.5% vs 68.0% with FIT cut-off value of 4.4 µg/g; both P < .01). CONCLUSIONS: The APCS score combined with a stool DNA test significantly improved the detection of colorectal ANs, while limiting colonoscopy resource utilization (Chictr.org.cn, ChiCTR-DDD-17011169).

Flow cytometry-based high-throughput RNAi screening for miRNAs regulating MHC class II HLA-DR surface expression.

HLA-DR isotype is a MHC-II cell-surface receptor found on APCs and plays a key role in initiating immune responses. In severely immunocompromised patients with conditions like sepsis, the number of HLA-DR molecules expressed on leukocytes is considered to correlate with infectious complications and patients' probability of survival. The underlying regulatory mechanisms of HLA-DR expression remain largely unknown. One probable path to regulation is through microRNAs (miRNAs), which have been implicated as regulatory elements of both innate and adaptive immune system development and function. In our study, flow cytometry-based high-throughput miRNA screening was performed in a stable HLA-DR-expressing human melanoma cell line, MelJuSo, for either up- or downregulating miRNAs of the surface HLA-DR expression. By the end of the screening, the top ten upregulators and top five downregulators were identified, and both the HLA-DR protein and mRNA regulations were further verified and validated. In-silico approaches were applied for functional miRNA-mRNA interaction prediction. The potential underlying gene regulations of different miRNAs were proposed. Our results promote the study of miRNA-mediated HLA-DR regulation under both physiological and pathological conditions, and may pave the way for potential clinical applications.

Do autologous platelet concentrates (APCs) have a role in intra-oral bone regeneration? A critical review of clinical guidelines on decision-making process.

In the past decades, personalized regenerative medicine has gained increased attention. Autologous platelet concentrates (APCs) such as PRP, PRGF, and L-PRF, all serving as a source of a large variety of cells and growth factors that participate in hard and soft tissue healing and regeneration, could play a significant role in regenerative periodontal procedures. This narrative review evaluated the relative impact of APCs in alveolar ridge preservation, sinus floor augmentation, and the regeneration of bony craters around teeth, both as a single substitute or in combination with a xenograft. L-PRF has a significant beneficial effect on alveolar ridge preservation (bone quality). The data for PRGF are less convincing, and PRP is controversial. L-PRF can successfully be used as a single substitute during transcrestal (≥3.5 mm bone gain) as well as 1-stage lateral window sinus floor elevation (>5 mm bone gain). For PRGF and especially PRP the data are very scarce. In the treatment of bony craters around teeth, during open flap debridement, L-PRF as a single substitute showed significant adjunctive benefits (e.g., >PPD reduction, >CAL gain, >crater depth reduction). The data for PRP and PRGF were non-conclusive. Adding PRP or L-PRF to a xenograft during OFD resulted in additional improvements (>PPD reduction, >CAL gain, >bone fill), for PRGF no data were found. Autologous platelet concentrates demonstrated to enhance bone and soft tissue healing in periodontal regenerative procedures. The data for L-PRF were most convincing. L-PRF also has the advantage of a greater simplicity of production, and its 100% autologous character.

Characteristics and pollution risks of potentially toxic elements and nematode community structure on farm soil near coal mines.

As one of the most important coal-producing provinces of China, Shanxi Province has been concerned about soil potentially toxic elements (PTEs) contamination in recent years. The study aimed to determine the status and sources of PTEs contamination and evaluate the quality of the soil ecology. This study investigated the degree of 13 PTEs contamination. The sources and contributions of PTEs were traced by the absolute principal component score followed by a multiple linear regression model (APCS-MLR). And the status of the soil ecosystem was verified by evaluating the soil nematode community around the coal mining areas in Jinzhong. The results showed that the mean PTEs concentration of 5 trace elements were higher than the background values of Shanxi, and safe to considerable was indicated by the pollution and ecological risk values. Soil Hg was the most contaminated element, followed by Cd. The distribution of PTEs was determined by coal mining activities (44.72%) followed by agricultural practice (32.37%) and coal transportation (21.37%). The nematode genera Acrobeloides (4.01%), Aphelenchus (20.30%), Meloidogyne (11.95%) and Aporcelaimus (2.74%) could be regarded as bioindicators of soil PTEs contamination by their tolerance. Concentrations of soil Cr, Mn, Ti and Cd showed remarkable influences on the total nematode abundance, maturity index, enrichment index, structural index, Shannon-Wiener diversity index and Pielou index of soil nematode. It is an appropriate method to evaluate the status of soil PTEs contamination combining the response of a single nematode genus and the nematode community evaluation index.

Receptor model-based source-specific health risks of toxic metal(loid)s in coal basin-induced agricultural soil in northwest Bangladesh.

Toxic metal(loid)s (TMLs) in agricultural soils cause detrimental effects on ecosystem and human health. Therefore, source-specific health risk apportionment is very crucial for the prevention and control of TMLs in agricultural soils. In this study, 149 surface soil samples were taken from a coal mining region in northwest Bangladesh and analyzed for 12 TMLs (Pb, Cd, Ni, Cr, Mn, Fe, Co, Zn, Cu, As, Se, and Hg). Positive matrix factorization (PMF) and absolute principal component score-multiple linear regression (APCS-MLR) receptor models were employed to quantify the pollution sources of soil TMLs. Both models identified five possible sources of pollution: agrochemical practice, industrial emissions, coal-power-plant, geogenic source, and atmospheric deposition, while the contribution rates of each source were calculated as 28.2%, 17.2%, 19.3%, 19% and 16.3% in APCS-MLR, 22.2%, 13.4%, 24.3%, 15.1% and 25.1% in PMF, respectively. Agrochemical practice was the major source of non-carcinogenic risk (NCR) (adults: 32.37%, children: 31.54%), while atmospheric deposition was the highest source of carcinogenic risk (CR) (adults: 48.83%, children: 50.11%). NCR and CR values for adults were slightly higher than for children. However, the trends in NCR and CR between children and adults were similar. As a result, among the sources of pollution, agrochemical practices and atmospheric deposition have been identified as the primary sources of soil TMLs, so prevention and control strategies should be applied primarily for these pollution sources in order to protect human health.

Water quality assessment and pollution source apportionment using multivariate statistical techniques: a case study of the Laixi River Basin, China.

Identifying potential sources of pollution in tributaries and determining their contribution rates are critical to the treatment of water pollution in main streams. In this paper, we conducted a multivariate statistical analysis on the water quality data of 12 parameters for 3 years (2018-2020) at six sampling sites in the Laixi River to qualitatively identify potential pollution sources and quantitatively calculate the contribution rates to reveal the tributaries' pollution status. Spatio-temporal cluster analysis (CA) divided 12 months into two parts, corresponding to the lightly polluted season (LPS) and highly polluted season (HPS), and six sampling sites were divided into two regions, corresponding to the lightly polluted region (LPR) and highly polluted region (HPR). Principal component analysis (PCA) was used to determine the potential sources of contamination, identifying four and three potential factors in the LPS and HPS, respectively. The absolute principal component score-multiple linear regression (APCS-MLR) receptor model quantitatively analyzed the contribution rates of identified pollution sources, and the importance of the different pollution sources in LPS can be ranked as domestic sewage and industrial wastewater and breeding pollution (33.80%) > soil weathering (29.02%) > agricultural activities (20.95%) > natural influence (13.03%). HPS can be classified as agricultural cultivation (41.23%), domestic sewage and industrial wastewater and animal waste (33.19%), and natural variations (21.43%). Four potential sources were identified in LPR ranked as rural domestic sewage (31.01%) > agricultural pollution (26.82%) > industrial effluents and free-range livestock and poultry pollution (25.13%) > natural influence (14.82%). Three identified latent pollution sources in HPR were municipal sewage and industrial effluents (37.96%) > agricultural nonpoint sources and livestock and poultry wastewater (33.55%) > natural sources (25.23%). Using multivariate statistical tools to identify and quantify potential pollution sources, managers may be able to enhance water quality in tributary watersheds and develop future management plans.

Pollution source identification of nitrogen and phosphorus in the lower West Main Canal, the Ganfu Plain irrigation district (South China).

The degradation of surface water quality has been a widespread concern around the world. However, irrigation canal water does not attract much attention although it is important to agriculture and population. In this study, a 5-year water quality monitoring of surface water was conducted in the lower West Main Canal of the Ganfu Plain irrigation district to identify the levels and pollution sources of nitrogen and phosphorus.Over 75% of samples had total phosphorus (TP) concentrations of > 0.02 mg/L, and all samples had total nitrogen (TN) concentrations of > 0.2 mg/L, indicating a risk of eutrophication. The concentrations of NO3--N and NH4+-N averagely occupied 57% and 18% of TN, respectively. PCA analysis showed that phosphorus and nitrogen in canal water were associated with meteorological factors, urban life and surface runoff, agricultural cultivation, livestock-poultry breeding, and water-sediment interaction in the wet season, whereas they were affected by meteorological factors, industrial effluent, urban domestic sewage, and livestock-poultry breeding in the dry season. Absolute principal component score-multiple linear regression (APCS-MLR) model results revealed that (1) agricultural cultivation plus livestock-poultry breeding contributed 43.2% of TP in canal water in the wet season, while livestock-poultry breeding contributed 52.9% in the dry season, and (2) domestic sewage plus surface runoff contributed 29.4% of TN in the wet season, while livestock-poultry breeding contributed 45.9% in the dry season. The unidentified sources had significant contributions of > 20% for almost all variables. So further investigations are required for determining unidentified sources, and anthropogenic pollution control is imperative for canal water quality protection.

Spatial distribution characteristics, influencing factors, and source distribution of soil cadmium in Shantou City, Guangdong Province.

A total of 511 topsoils and 139 deep soil samples were collected to analyze the distribution characteristics, regional differentiation factors, and contamination sources of Cd in Shantou City, and to assess its environmental, ecological, and human health risks. We used a combination of multivariate statistics and geostatistics to quantify the distribution and level of Cd contamination in the study area, and an absolute principal component scores-multiple linear regression model to resolve the sources of contamination and their contribution values, combined with the health risk model to assess the human health risk from each source. The result exhibited that the average value of soil Cd content was 0.100 mg/kg, which was lower than the threshold value of soil environmental quality standard, but higher than the 0.070 mg/kg background value of soil. The high-value areas of surface Cd content in the study area were distributed in the western, northern, and northeastern parts of Shantou, and the source of Cd in the soil was a mix of anthropogenic and natural contamination. The non-carcinogenic and carcinogenic risks of heavy metal Cd exposure pathways are: oral ingestion > dermal contact > inhalation. The human health risk posed by Cd is below the reference threshold, indicating that the Cd contents in the soil have no unacceptable health risk to the residents. Among industrial sources, natural sources, and unknown sources with potential carcinogenic and non-carcinogenic risks, natural sources were the main source of contamination for adults and children. Among the different soil types, paddy, and red soils had relatively high Cd content, and among the different soil-forming parent materials, the Cd content in soils developed on Quaternary sediments was significantly higher than that other parent materials. Among the different land use types, the Cd content of soil for construction land was the highest. This study provides a scientific foundation and reference for the prevention of soil Cd contamination in Shantou City and the analysis of soil contamination sources in areas with similar contamination patterns.

GILT Expression in Human Melanoma Cells Enhances Generation of Antigenic Peptides for HLA Class II-Mediated Immune Recognition.

Melanoma is an aggressive skin cancer that has become increasingly prevalent in western populations. Current treatments such as surgery, chemotherapy, and high-dose radiation have had limited success, often failing to treat late stage, metastatic melanoma. Alternative strategies such as immunotherapies have been successful in treating a small percentage of patients with metastatic disease, although these treatments to date have not been proven to enhance overall survival. Several melanoma antigens (Ags) proposed as targets for immunotherapeutics include tyrosinase, NY-ESO-1, gp-100, and Mart-1, all of which contain both human leukocyte antigen (HLA) class I and class II-restricted epitopes necessary for immune recognition. We have previously shown that an enzyme, gamma-IFN-inducible lysosomal thiol-reductase (GILT), is abundantly expressed in professional Ag presenting cells (APCs), but absent or expressed at greatly reduced levels in many human melanomas. In the current study, we report that increased GILT expression generates a greater pool of antigenic peptides in melanoma cells for enhanced CD4+ T cell recognition. Our results suggest that the induction of GILT in human melanoma cells could aid in the development of a novel whole-cell vaccine for the enhancement of immune recognition of metastatic melanoma.

Risk assessment, spatial distribution, and source identification of heavy metals in surface soils in Zhijin County, Guizhou Province, China.

Zhijin County is a typical mineral resource-based city in Southwest China. The problem of heavy metals (HM) in the soil in Zhijin County must be considered during regional economic and ecological development. A total of 2436 soil samples (0‒20 cm depth) were collected to analyze the soil pH, organic matter content, and HM spatial distribution and sources. The HM concentrations in the surface soil were found to be higher than the national surface soil background values. Absolute principal component sore-multivariate linear regression (APCS-MLR) showed that the HM sources in the surface soil of Zhijin County were industrial and agricultural activities (48.09%), natural sources (34.47%), and atmospheric deposition (17.43%); 65.53% of HM were produced by anthropogenic activities, which were mainly associated with the mineral industry. The impact of anthropogenic pollution decreased in the following order: paddy field (66.45%) > rainfed cropland (65.91%) > barren land (61.98%) > garden land (61.82%) > forest land (59.11%) > grassland (53.31%). The potential ecological risk of surface soil is moderate, while low-risk areas were mainly distributed in mountainous regions in the north, southwest, and east. The study emphasizes the source and risk assessment of HM in the surface soil of Zhijin County. The results can be used for environmental management planning, decision-making, and risk assessment.

A guide to oral vaccination: Highlighting electrospraying as a promising manufacturing technique toward a successful oral vaccine development.

Most vaccines approved by regulatory bodies are administered via intramuscular or subcutaneous injections and have shortcomings, such as the risk of needle-associated blood infections, pain and swelling at the injection site. Orally administered vaccines are of interest, as they elicit both systemic and mucosal immunities, in which mucosal immunity would neutralize the mucosa invading pathogen before the onset of an infection. Hence, oral vaccination can eliminate the injection associated adverse effects and enhance the person's compliance. Conventional approaches to manufacturing oral vaccines, such as coacervation, spray drying, and membrane emulsification, tend to alter the structural proteins in vaccines that result from high temperature, organic and toxic solvents during production. Electrohydrodynamic processes, specifically electrospraying, could solve these challenges, as it also modulates antigen release and has a high loading efficiency. This review will highlight the mucosal immunity and biological basis of the gastrointestinal immune system, different oral vaccine delivery approaches, and the application of electrospraying in vaccines development.

T-cell immunoglobulin and ITIM domain, as a potential immune checkpoint target for immunotherapy of colorectal cancer.

The importance of the tumor microenvironment in cancer progression has been well studied for many years. Immune checkpoint inhibitors (ICIs) are regarded as potential strategies in enhancing the immune responses in patients with cancer, particularly colorectal cancer (CRC). Notably, CRCs are extraordinarily heterogeneous and mostly are microsatellite-stable (MSS) or cold tumors, which means that the immune response is not usually as strong as that of foreign cells. T-cell immunoglobulin and ITIM domain (TIGIT) is a new immune checkpoint receptor overexpressed inside the CRC tumor-immune microenvironments. Moreover, several studies have shown that TIGIT in combination with other ICIs and/or conventional treatments, can lead to a robust anti-tumor response in CRC. This review looks deep inside TIGIT expression patterns, their various functions, and possible immunotherapy strategies to increase survival rates and decrease immune-related adverse events.

Deep anterior lamellar keratoplasty with cross-linked acellular porcine corneal stroma to manage fungal keratitis.

PURPOSE: To evaluate the effects of deep anterior lamellar keratoplasty (DALK) with cross-linked acellular porcine corneal stroma (APCS) and post-operative topical tacrolimus treatment in patients with fungal keratitis. METHODS: This multicenter prospective study involved 25 cases of fungal keratitis that were treated by DALK with cross-linked APCSs and post-operative topical tacrolimus from December 2013 to November 2014 at the Wenzhou Eye Hospital and the Henan provincial Eye Hospital. Signs of post-operative inflammation, corneal reepithelialization, corneal neovascularization, and graft rejection were assessed, and best corrected visual acuity (BCVA), intraocular pressure (IOP), and APCS graft transparency were monitored for the 12-month follow-up period. RESULTS: All 25 patients underwent DALK without Descemet's membrane perforation. Corneal epithelium recovered completely in 17 patients in the first week, and APCS grafts maintained transparency in 18 patients at 1-year follow-up. The mean BCVA significantly improved from 2.16 ± 0.32 (LogMAR) at baseline to 1.56 ± 0.70 at 1-week (P < .001), 0.95 ± 0.57 at 1-month (P < .001), and 0.70 ± 0.51 at 3-month follow-ups (P < .001). The BCVA kept stable at 6-month and 12-month follow-ups. Post-operative topical tacrolimus alleviated the ciliary injection, except in one case which acute stromal rejection occurred. One patient developed fungal reinfection and underwent penetrating keratoplasty. Graft rejection occurred in three patients. No case was noted with graft splitting, elevated IOP or tacrolimus intolerance. CONCLUSIONS: DALK using cross-linked APCS combining topical tacrolimus treatment is safe and effective in managing fungal keratitis. It may ameliorate the shortage of corneal donation globally.

Incorporating bioaccessibility and source apportionment into human health risk assessment of heavy metals in urban dust of Xiamen, China.

Heavy metals in urban dust could pose noticeable human health risks, but there are few studies focusing on comprehensive human health risk assessment with the incorporation of both bioaccessibility and source apportionment in urban dust. Thus, fifty-eight urban dust samples were collected from kindergartens in Xiamen to analyze the bioaccessibility-based, source-specific health risk of heavy metals (V, Co, Ni, As, Mo, Cr, Mn, Cu, Zn, and Pb). Most heavy metals, except for V and Mn, were significantly enriched in urban dust based on their values of geoaccumulation index (Igeo) and may be influenced by human activities. The oral bioaccessibility values of heavy metals, which were estimated by the Solubility/Bioaccessibility Research Consortium (SBRC) in vitro model, ranged from 1.563% to 76.51%. The source apportionment determined by applying the absolute principal component analysis-multiple linear regression (APCS-MLR) model indicated five main potential sources, coal combustion, traffic and industrial, natural, construction and furniture sources, and unidentified sources, with contributions of 34.09%, 20.72%, 18.72%, 7.597% and 18.87%, respectively, to the accumulation of heavy metals in urban dust. After incorporating bioaccessibility adjustments, lower non-carcinogenic and carcinogenic risks of heavy metals were observed than those based on total metal content, with the mean hazard index (HI) values being less than the threshold value (1) and the mean total carcinogenic risk (TCR) values exceeding the precautionary criterion (10-6) for both adults and children. By combining bioaccessibility-based health risk assessment and source apportionment, traffic and industrial emissions and coal combustion dominated the noncarcinogenic and carcinogenic risks induced by heavy metals in urban dust, respectively. This study is expected to promote the systematic integration of source apportionment and bioaccessibility into health risk estimation for heavy metal contamination in urban dust, thus providing useful implications for better human health protection.

Contamination characteristics, source analysis and health risk assessment of heavy metals in the soil in Shi River Basin in China based on high density sampling.

To explore the contamination of heavy metals in the Shi River Basin soil in China, a high density sampling of surface soil was conducted. In this study, an absolute principal component scores multiple linear regression model (APCS-MLR) was used to identify the sources of heavy metals in the soil and quantify their amounts. The methods to assess the heavy metals included a fuzzy synthetic evaluation, index and health risk assessment. The results show that heavy metals are relatively rich southwest of the study area. Their levels may be affected by natural sources, such as parent materials. The pollution caused by human factors cannot be ignored, and it is primarily influenced by traffic emissions and processing sources, which contribute 62.6%, followed by agricultural sources, such as pesticides and fertilizers, that contribute 21.1%. The risk assessment indicated that the study area was slightly to moderately polluted. All heavy metals pose higher carcinogenic and other health risks to children than adults, and ingestion is the main way that these pollutants enter the body. The carcinogenic risk of children owing to Cr from natural sources merits further study, while the carcinogenic risk to adults and the non-carcinogenic risk to both adults and children are at acceptable levels. Transportation and industrial processing sources are the main cause of the non-carcinogenic risk. The results could provide reference for reducing heavy metal pollution in the soil.

Integrated ecological risk assessment of heavy metals in an oil shale mining area after restoration.

Although the mining area has been restored, the environmental problems caused by years of large-scale oil shale mining are still continuing, coupled with the intensive distribution of the surrounding petrochemical industry, posing a serious threat to the local ecological environment. In this study, we investigated eight heavy metals (Cu, Ni, Pb, Cd, As, Cr, Mn and Zn) contamination and distribution around mining area, evaluated the potential risks of environment, identified the main sources of metal pollution and performed source apportionment. The results showed that the original north and south dumps were seriously polluted, and the CF values were significantly higher than other sampling sites. Ni, Zn and Mn have high coefficients of variation, which may be greatly affected by human factors and especially the waste slag piled up. The concentration of heavy metals in the water was lower than in the soil; soil particles, pH, Eh and acid mine drainage influence the variation of heavy metal concentrations. As and Cd have very high RAC values, and accordingly they were mainly present in the exchangeable and reduced fractions. Mn was exposed to higher ecological risks, followed by Pb, although there were high loads on carbonate bound and oxidizable fractions. APCS-MLL receptor model was used to identify and apportionment three main sources of contamination. The mean contribution rates of industrial activity, atmospheric deposition and mixed sources accounted for 39.77%, 22.24% and 37.99%, respectively. Cluster analysis further classified the metal pollution sources according to the spatial distance of sampling points.