Arsenite removal from groundwater by aerated electrocoagulation reactor with Al ball electrodes: Human health risk assessment.

The application of conventional electrocoagulation (EC) process for removal of As(III) from groundwater suffers from the need of external oxidation agent for oxidation of As(III) to As(V). To tackle this limitation, an aerated EC reactor for the removal of As(III) from groundwater was evaluated in this study. The effect of initial pHi, air flow rate, applied current, and electrode height in the EC reactor was examined. The experimental results showed that removal of arsenic mostly dependent on the applied current, electrode height in EC reactor, and air flow rate. The As(III) removal efficiency (99.2%) was maximum at pHi of 7.5, air flow rate of 6 L min-1, applied current of 0.30 A, and electrode height in EC reactor of 5 cm, with an total operating cost of 0.583 $ m-3. Furthermore, the carcinogenic risk (CR) and non-carcinogenic risk of arsenic (As) was in the range of tolerable limits at all operating conditions except applied current of 0.075 A at the end of the aerated EC process to remove As from groundwater. The present EC reactor process is able to remove As(III) from groundwater to below 10 µg L-1, which is maximum contaminant level of arsenic in drinking water according to the World Health Organization (WHO).

Low-dose daily aspirin reduces topical minoxidil efficacy in androgenetic alopecia patients.

Topical minoxidil is the only US FDA approved OTC drug for the treatment of androgenetic alopecia (AGA). Minoxidil is a pro-drug converted into its active form, minoxidil sulfate, by the sulfotransferase enzymes in the outer root sheath of hair follicles. Previously, we demonstrated that sulfotransferase activity in hair follicles predicts response to topical minoxidil in the treatment of AGA. In the human liver, sulfotransferase activity is significantly inhibited by salicylic acid. Low-dose OTC aspirin (75-81 mg), a derivative of salicylic acid, is used by millions of people daily for the prevention of coronary heart disease and cancer. It is not known whether oral aspirin inhibits sulfotransferase activity in hair follicles, potentially affecting minoxidil response in AGA patients. In the present study, we determined the follicular sulfotransferase enzymatic activity following 14 days of oral aspirin administration. In our cohort of 24 subjects, 50% were initially predicted to be responders to minoxidil. However, following 14 days of aspirin administration, only 27% of the subjects were predicted to respond to topical minoxidil. To the best of our knowledge, this is the first study to report the effect of low-dose daily aspirin use on the efficacy of topical minoxidil.

Mechanism of action of minoxidil in the treatment of androgenetic alopecia is likely mediated by mitochondrial adenosine triphosphate synthase-induced stem cell differentiation.

Topical minoxidil is the only topical drug approved by the US Food and Drug Administration (FDA) for the treatment of androgenetic alopecia. However, the exact mechanism by which minoxidil stimulates anagen phase and promotes hair growth is not fully understood. In the late telegen phase of the hair follicle growth cycle, stem cells located in the bulge region differentiate and re-enter anagen phase, a period of growth lasting 2-6 years. In androgenetic alopecia, the anagen phase is shortened and a progressive miniaturization of hair follicles occurs, eventually leading to hair loss. Several studies have demonstrated that minoxidil increases the amount of intracellular Ca2+, which has been shown to up-regulate the enzyme adenosine triphosphate (ATP) synthase. A recent study demonstrated that ATP synthase, independent of its role in ATP synthesis, promotes stem cell differentiation. As such, we propose that minoxidil induced Ca2+ influx can increase stem cell differentiation and may be a key factor in the mechanism by which minoxidil facilitates hair growth. Based on our theory, we provide a roadmap for the development of a new class of drugs for the treatment of androgenetic alopecia.

Burden of smoking among adults with COPD, chronic bronchitis, and emphysema in urban China.

OBJECTIVE: Tobacco, widely used in China, poses a major risk for chronic obstructive pulmonary disease (COPD). This study assessed health outcomes of COPD-diagnosed smokers vs. never smokers and examined treatment patterns of patients attempting to quit smoking in urban China. METHODS: National Health and Wellness Survey (NHWS) 2010 and 2012 China data were analysed. Respondents self-reporting diagnosis with COPD, chronic bronchitis, or emphysema were categorised: quit attempters (current smokers 'trying to quit' or non-smokers 'in the process of quitting'), smokers (including quit attempters) and those who never smoked. Respondents reported smoking cessation treatment utilisation; health status: SF-36v2-based scores and SF-6D health utilities; Work Productivity and Activity Impairment questionnaire-based metrics; and resource utilisation. Regression modelling assessed health outcomes, controlling for covariates. RESULTS: Among 1421 (3.6%) diagnosed respondents, 51.6% never smoked and 35.5% smoked (of whom, 43.8% were attempting to quit). After adjustments, smokers vs. never smokers had significantly lower health utilities, lower mental/physical health status and greater absenteeism, presenteeism, overall work impairment, activity impairment, emergency room visits, hospitalisations and provider visits. Quit attempters were diagnosed an average 6.9 years (SD = 7.7) previously, with 25.3% reporting moderate/severe COPD. Most-reported main causes of COPD were: smoking (57.5%), illnesses/conditions (53.8%) and pollutants (44.3%). Among quit attempters, 82.8% smoked currently. Use of prescription cessation treatments was reported by 12.7%. CONCLUSIONS: Smokers experienced poorer health outcomes, reinforcing importance of prevention in mitigating disease burden. Among quit attempters, few reported using prescription cessation treatments. Given the high burden imposed by smoking in China, effective interventions may be beneficial.

Direct and indirect cost of urge urinary incontinence with and without pharmacotherapy.

OBJECTIVE: To evaluate the impact of treating urge urinary incontinence (UUI), including mixed urinary incontinence (MUI), on healthcare resource utilisation, productivity, activity impairment and associated costs. METHODS: The study used data from the 2011 U.S. National Health and Wellness Survey, an Internet-based questionnaire of a nationwide sample of adults. UUI or MUI respondents were identified via three Incontinence Questions. Respondents with stress urinary incontinence only, prostate cancer or (medication for) benign prostatic hyperplasia were excluded. UUI/MUI respondents were categorised as Rx users for overactive bladder (OAB) and non-Rx users (who never used Rx and whose condition reportedly interfered with life activities or was difficult to manage). Outcome measures included healthcare utilisation and Work Productivity and Activity Impairment questionnaire-based scores. Direct and indirect costs were estimated using 2010 labour and 2008 medical expenditure data sources. Generalised linear models predicted resource use and productivity as a function of treatment status, adjusting for covariates (e.g. sociodemographics, OAB severity, comorbid status) that may also predict impairment. RESULTS: Rx (vs. non-Rx) users were more likely to be female (80.7% vs. 70.0%), older (mean = 62.7 vs. 53.1) and reporting more moderate-to-severe OAB (70.9% vs. 52.6%; all p < 0.05). Adjusting for covariates, Rx (vs. non-Rx) users had significantly lower activity impairment (41.1% vs. 46.8%), more provider visits (7.42 vs. 5.60) and costs ($18,175 vs. $13,679), and higher total direct costs ($27,291 vs. $21,493), all p < 0.01. CONCLUSIONS: Urge urinary incontinence patients using, vs. never using, prescription medication reported lower activity impairment but higher direct costs. These findings may inform the degree to which UUI pharmacotherapy affects health outcomes.

Effect of leaded glasses and thyroid shielding on cone beam CT radiation dose in an adult female phantom.

OBJECTIVES: This study aims to demonstrate the effectiveness of leaded glasses in reducing the lens of eye dose and of lead thyroid collars in reducing the dose to the thyroid gland of an adult female from dental cone beam CT (CBCT). The effect of collimation on the radiation dose in head organs is also examined. METHODS: Dose measurements were conducted by placing optically stimulated luminescent dosemeters in an anthropomorphic female phantom. Eye lens dose was measured by placing a dosemeter on the anterior surface of the phantom eye location. All exposures were performed on one commercially available dental CBCT machine, using selected collimation and exposure techniques. Each scan technique was performed without any lead shielding and then repeated with lead shielding in place. To calculate the percent reduction from lead shielding, the dose measured with lead shielding was divided by the dose measured without lead shielding. The percent reduction from collimation was calculated by comparing the dose measured with collimation to the dose measured without collimation. RESULTS: The dose to the internal eye for one of the scans without leaded glasses or thyroid shield was 0.450 cGy and with glasses and thyroid shield was 0.116 cGy (a 74% reduction). The reduction to the lens of the eye was from 0.396 cGy to 0.153 cGy (a 61% reduction). Without glasses or thyroid shield, the thyroid dose was 0.158 cGy; and when both glasses and shield were used, the thyroid dose was reduced to 0.091 cGy (a 42% reduction). CONCLUSIONS: Collimation alone reduced the dose to the brain by up to 91%, with a similar reduction in other organs. Based on these data, leaded glasses, thyroid collars and collimation minimize the dose to organs outside the field of view.

Significant reduction in dental cone beam computed tomography (CBCT) eye dose through the use of leaded glasses.

OBJECTIVE: In light of the increased recognition of the potential for lens opacification after low-dose radiation exposures, we investigated the effect of leaded eyeglasses worn during dental cone-beam computerized tomography (CBCT) procedures on the radiation absorbed dose to the eye and suggest simple methods to reduce risk of radiation cataract development. STUDY DESIGN: Dose measurements were conducted with the use of 3 anthropomorphic phantoms: male (Alderson radiation therapy phantom), female (CIRS), and juvenile male (CIRS). All exposures were performed on the same dental CBCT machine (Imtec, Ardmore, OK) using 2 different scanning techniques but with identical machine parameters (120 kVp, 3.8 mA, 7.8 s). Scans were performed with and without leaded glasses and repeated 3 times. All measurements were recorded using calibrated thermoluminescent dosimeters and optical luminescent dosimetry. RESULTS: Leaded glasses worn by adult and pediatric patients during CBCT scans may reduce radiation dose to the lens of the eye by as much as 67% (from 0.135 ± 0.004 mGy to 0.044 ± 0.002 mGy in pediatric patients). CONCLUSIONS: Leaded glasses do not appear to have a deleterious effect on the image quality in the area of clinical significance for dental imaging.

Doxycycline effects on serum bone biomarkers in post-menopausal women.

We previously demonstrated that subantimicrobial-dose-doxycycline (SDD) treatment of post-menopausal osteopenic women significantly reduced periodontal disease progression, and biomarkers of collagen destruction and bone resorption locally in periodontal pockets, in a double-blind placebo-controlled clinical trial. We now hypothesize that SDD may also improve biomarkers of bone loss systemically in the same women, consistent with previous studies on tetracyclines (e.g., doxycycline) in organ culture and animal models of bone-deficiency disease. 128 post-menopausal osteopenic women with chronic periodontitis randomly received SDD or placebo tablets daily for 2 years adjunctive to periodontal maintenance therapy every 3-4 months. Blood was collected at baseline and at one- and two-year appointments, and sera were analyzed for bone resorption and bone formation/turnover biomarkers. In subsets of the study population, adjunctive SDD significantly reduced serum biomarkers of bone resorption (biomarkers of bone formation were unaffected), consistent with reduced risk of future systemic bone loss in these post-menopausal women not yet on anti-osteoporotic drugs.

Radiation exposure with the NOMAD portable X-ray system.

OBJECTIVES: A new hand-held battery-operated portable X-ray system was tested for possible leakage radiation through the existing heavy metal compounds surrounding the X-ray tube, backscatter radiation through the lead-filled acrylic shield attached at the end of the exit tube and patient exposure. METHODS: Dose measurements were conducted using a DXTRR phantom and a water phantom. All measurements were recorded using calibrated thermoluminescent dosimetry (TLD), calibrated Unfors Model 583L dosemeter, and a calibrated Radcal MDH model 1015 dosemeter. The settings for all exposure were 60 kVp, 2.3 mA and 0.25 s using Kodak Insight (Class F) film. RESULTS: All backscatter measurements, in front of the shield, behind the shield, at the finger of the operator, the operator's chest, eyes and gonads were significantly below the maximum permissible radiation leakage as per the United States Food and Drug Administration regulations (100 mR h(-1)). Our measurements indicate that the exposure would be well within the occupational maximum permissible dose for an occupationally exposed person. Film dose was consistent with the manufacturer's recommendations. As a result of our measurements, the State of New York Bureau of Environmental Radiation Protection granted us a variance to use the NOMAD on a case-by-case basis. CONCLUSIONS: Our data have shown that the NOMAD presents risks that are no greater than with standard dental radiographic units to the patient or operator and the measured doses are well below recommended levels.

Adjustment to illness of cancer patients treated by complementary therapy along with conventional therapy.

This pilot study compares the adjustment to illness, i.e. psychosocial and psychological distress, of 29 cancer patients being treated by complementary therapy along with conventional therapy, with a control group of 29 patients being treated by conventional therapy only. The findings indicate statistical differences in the brief symptom inventory scale (BSI), namely, the psychological distress of patients who received conventional therapy only was more severe than those being treated by complementary therapy with conventional therapy. No statistical differences, however, were found between the two groups in terms of psychosocial adjustment to the illness (PAIS). The findings lead to a recommendation that complementary therapy should be offered by public medical facilities as part of the standard treatment for cancer patients in order to ease psychological distress.

Triterpenoids of the roots of Lavandula stoechas ssp. stoechas.

The roots of Lavandula stoechas ssp. stoechas afforded eleven known triterpenes, two steroids and two aromatics, in addition to two new triterpenes, 18-hydroxy-27-norolean-12,14-dien-30-al-28-oic acid and 3 beta-hydroxy-1-oxo-olean-12-ene-30-al-28-oic acid. Their structures were determined by spectroscopic analyses. The chloroform extract and some isolated compounds were evaluated for their growth inhibitory activity against several mammalian cell lines.

Exposure to benzene in fuel distribution installations: monitoring and prevention.

The authors used a mixed-effects model on a cohort of 258 randomly chosen workers in 7 fuel-distribution facilities to examine the association between airborne benzene exposure and task and timing factors. During an 8-y period, 692 repeated personal measurements were performed. Filler task, warm month, Tuesday, credit day, and time period (1992-1996) were associated significantly with higher exposures to benzene. The authors controlled for the time period, and task type strongly affected the between-worker variance; therefore, two exposure groups (i.e., fillers and nonfillers) were adequate for purposes of exposure grouping strategy. Timing factors (after controlling for task and period effects) strongly affected the high within-worker variance (> 2 than between-worker variance). Long-term exposure would be better represented if the sample was stratified by warm/nonwarm months and if measurement days were selected randomly.

Updated quality assurance self-assessment exercise in intraoral and panoramic radiography. American Academy of Oral and Maxillofacial Radiology, Radiology Practice Committee.

This updated self-assessment exercise for the dental team by the Radiology Practice Committee of the American Academy of Oral and Maxillofacial Radiology is intended to produce the highest quality diagnostic radiographs while keeping patient exposure as low as is reasonably achievable. To continue to provide the best radiographic services to patients, those involved in dental radiography need to be aware of the latest changes and advances in dental radiography and need to use them in their practice.

Respiratory problems associated with exposure to airborne particles in the community.

During the spring of 1995, schoolchildren aged 7-13 y who lived in a rural area in Israel were studied. These children lived in two communities: in one community, the population was exposed to pollution from a cement factory and quarries; the population of the second community was not exposed to pollution from these sources. The children from participating schools performed forced vital capacity, forced expiratory volume in 1 s, peak expiratory flow, forced expiratory flow at 50%, and forced expiratory flow at 25%. Parents completed an American Thoracic Society-National Heart and Lung Institute health questionnaire, which included information about respiratory symptoms and diseases of the children and information about background variables. A trend of higher prevalence of most respiratory symptoms occurred in 638 children who were growing up in the community that bordered the industrial zone, compared with 338 children from the unexposed community. Cough without cold, sputum without cold, and cough accompanied by sputum were the most prevalent symptoms. Asthma diagnosed by a physician was reported more frequently for children who lived near the polluting sources. No consistent trend of reduced pulmonary function tests was observed among children who lived in the polluted community; however, peak expiratory flow was significantly lower among these children. Odds ratio values, calculated from logistic regressions in which we controlled for respiratory problems among parents, mothers who smoked, crowding index, education of mothers, and residential heating, were 3.6 (p value for model = .244) for cough without cold, 4.0 (p value for model = .333) for asthma, and 2.2 (p value for model = .753) for asthma and/or bronchitis in the polluted area, compared with 1.0 in the low-pollution community. Total suspended particulate matter and levels of airborne particles less than 10 microns, measured in the community bordering the industrial zone, very often violated the relevant 24-h Israeli standards of 200 microg/m3 and 150 microg/m3, respectively.

Causes of excessive bitewing exposure: results of a survey regarding radiographic equipment in New York.

OBJECTIVE: The purpose of this study was to identify the causes of excessive exposure in those dental practices that were found to use exceptionably high levels of radiation in bitewing radiography. STUDY DESIGN: Using the parameters of the Dental Exposure Normalization Technique survey, certified radiation equipment safety officers conducted on-site inspections of 186 intraoral x-ray machines in 77 dental facilities. RESULTS: In 23 facilities, the safety officers identified 43 units (23.1%) that delivered entrance exposures greater than 10% in excess of the upper limit of recommended exposures. For each of 27 (63%) of these units, the cause of the elevated exposure was clearly identifiable. CONCLUSIONS: The factors contributing to increased exposure, listed from most frequent to least frequent, were as follows: improper processing, kilovoltage miscalibration, use of D-speed techniques with E-speed film, use of newly installed units with default timer settings that were too high, exposure timer failure, and insufficient half-value layer. Only 18% of the facilities surveyed reported using E-speed film.

Respiratory conditions among schoolchildren and their relationship to environmental tobacco smoke and other combustion products.

The purpose of this study was to examine possible links between respiratory conditions among schoolchildren and exposure to environmental tobacco smoke and other home and community exposures. More than 8,000 second- and fifth-grade schoolchildren who lived in three towns along the Israeli coast were administered pulmonary function tests, and their parents completed standardized health questionnaires. The prevalence of the most reported respiratory conditions was found to be higher, some of them significantly so, among children whose fathers or mothers were smokers, compared with children of non-smoking parents. Most respiratory conditions were reported significantly more often for children who were growing up in medium- and highly polluted communities than for children from low-polluted areas. House heating with kerosene or gas was seldom associated with higher prevalence of respiratory conditions among children. No consistent r trend of reduced pulmonary function tests was associated with exposure to environmental tobacco smoke, with community pollution, or with house heating pollution. In conclusion, exposure of schoolchildren to their parents' cigarette smoke and to community air pollution is associated with higher prevalence of respiratory conditions, whereas house heating does not appear to be a public health problem in Israel.

Outpatient management with oral corticosteroid therapy for obstructive conditions in chronic granulomatous disease.

We report the outpatient management of three patients with X-linked chronic granulomatous disease, two of whom had episodes of gastric outlet obstruction and another, urinary bladder obstruction. These obstructive conditions were successfully treated with 2-week courses of orally administered corticosteroids with or without the addition of orally administered clindamycin. There were no infectious or other adverse reactions.