RESUMO
Frozen-sectioned hematoxylin-eosin (H&E) image evaluation is the current method for intraoperative breast cancer metastasis assessment through ex vivo sentinel lymph nodes (SLNs). After frozen sectioning, the sliced fatty region of the frozen-sectioned specimen is easily dropped because of different freezing points for fatty tissues and other tissues. Optical-sectioned H&E images provide a nondestructive method for obtaining the insight en face image near the attached surface of the dissected specimen, preventing the freezing problem of fatty tissue. Specimens from 29 patients at Wanfang Hospital were collected after excision and were analyzed at the pathology laboratory, and a fluorescence-in-built optical coherence microscopic imaging system (OCMIS) was then used to visualize the pseudo-H&E (p-H&E) images of the SLNs for intraoperative breast cancer metastasis assessment, and the specificity, sensitivity, and accuracy were 100%, 88.9%, and 98.8% (n = 83), respectively. Compared with gold-standard paraffin-sectioned H&E images, the specificity, sensitivity, and accuracy obtained with the frozen-sectioned H&E images (n = 85) of the specimens were the same as those obtained with the p-H&E images (n = 95). Thus, OCMIS is a useful noninvasive image-assisted tool for breast cancer metastasis assessment based on SLN images.
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The antimicrobial residues of aquacultural production is a growing public concern, leading to reexamine the method for establishing robust withdrawal time and ensuring food safety. Our study aims to develop the optimizing population physiologically-based pharmacokinetic (PBPK) model for assessing florfenicol residues in the tilapia tissues, and for evaluating the robustness of the withdrawal time (WT). Fitting with published pharmacokinetic profiles that experimented under temperatures of 22 and 28 °C, a PBPK model was constructed by applying with the Bayesian Markov chain Monte Carol (MCMC) algorithm to estimate WTs under different physiological, environmental and dosing scenarios. Results show that the MCMC algorithm improves the estimates of uncertainty and variability of PBPK-related parameters, and optimizes the simulation of the PBPK model. It is noteworthy that posterior sets generated from temperature-associated datasets to be respectively used for simulating residues under corresponding temperature conditions. Simulating the residues under regulated regimen and overdosing scenarios for Taiwan, the estimated WTs were 12-16 days at 22 °C and 9-12 days at 28 °C, while for the USA, the estimated WTs were 14-18 and 11-14 days, respectively. Comparison with the regulated WT of 15 days, results indicate that the current WT has well robustness and resilience in the environment of higher temperatures. The optimal Bayesian population PBPK model provides effective analysis for determining WTs under scenario-specific conditions. It is a new insight into the increasing body of literature on developing the Bayesian-PBPK model and has practical implications for improving the regulation of food safety.
Assuntos
Antibacterianos/farmacocinética , Modelos Biológicos , Tianfenicol/análogos & derivados , Tilápia/metabolismo , Animais , Aquicultura , Teorema de Bayes , Cadeias de Markov , Método de Monte Carlo , Taiwan , Tianfenicol/farmacocinéticaRESUMO
The financial market is a nonlinear stochastic system with continuous Wiener and discontinuous Poisson random fluctuations. Most managers or investors hope their investment policies to be with the not only high profit but also low risk. Managers and investors involved pursue their own interests which are partly conflicting with others. Stochastic game theory has been widely applied to multiperson noncooperative decision making problem of financial market. However, for the nonlinear stochastic financial system with random fluctuations, it still lacks an analytical or computational scheme to effectively solve the complex noncooperative game strategy design problem. In this paper, the stochastic multiperson noncooperative game strategy in cyber-financial systems is transformed to a multituple Hamilton-Jacobi-Isacc inequalities (HJIIs)-constrained multiobjective optimization problem (MOP). This HJIIs-constrained MOP solution is also found to be the Nash equilibrium solution of multiperson noncooperative game strategy in nonlinear stochastic financial systems. In order to simplify design procedure by the global linearization theory, a set of local linear systems are interpolated to approximate the nonlinear stochastic financial system so that the m-tuple HJIIs-constrained MOP for noncooperative game strategy of cyber-financial system could be converted to a linear matrix inequalities (LMIs)-constrained MOP. Finally, an LMIs-constrained multiobjective evolution algorithm is explored for effectively solving the multiperson noncooperative game strategy in cyber-financial systems. Two design examples are also given for the illustration of the design procedure and the performance validation of the proposed stochastic noncooperative investment strategy in the nonlinear stochastic financial systems.
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Growing evidence indicates that ocean acidification has a significant impact on calcifying marine organisms. However, there is a lack of exposure risk assessments for aquatic organisms under future environmentally relevant ocean acidification scenarios. The objective of this study was to investigate the probabilistic effects of acidified seawater on the life-stage response dynamics of fertilization, larvae growth, and larvae mortality of the green sea urchin (Strongylocentrotus droebachiensis). We incorporated the regulation of primary body cavity (PBC) pH in response to seawater pH into the assessment by constructing an explicit model to assess effective life-stage response dynamics to seawater or PBC pH levels. The likelihood of exposure to ocean acidification was also evaluated by addressing the uncertainties of the risk characterization. For unsuccessful fertilization, the estimated 50% effect level of seawater acidification (EC50 SW ) was 0.55 ± 0.014 (mean ± SE) pH units. This life stage was more sensitive than growth inhibition and mortality, for which the EC50 values were 1.13 and 1.03 pH units, respectively. The estimated 50% effect levels of PBC pH (EC50 PBC ) were 0.99 ± 0.05 and 0.88 ± 0.006 pH units for growth inhibition and mortality, respectively. We also predicted the probability distributions for seawater and PBC pH levels in 2100. The level of unsuccessful fertilization had 50 and 90% probability risks of 5.07-24.51 (95% CI) and 0-6.95%, respectively. We conclude that this probabilistic risk analysis model is parsimonious enough to quantify the multiple vulnerabilities of the green sea urchin while addressing the systemic effects of ocean acidification. This study found a high potential risk of acidification affecting the fertilization of the green sea urchin, whereas there was no evidence for adverse effects on growth and mortality resulting from exposure to the predicted acidified environment.
Assuntos
Fertilização/fisiologia , Larva/crescimento & desenvolvimento , Modelos Teóricos , Água do Mar/química , Strongylocentrotus/crescimento & desenvolvimento , Animais , Concentração de Íons de Hidrogênio , Medição de RiscoRESUMO
Exposure to several specific pesticides has led to an increase of Parkinson's disease (PD) risk. However, it is difficult to quantify the PD population risk related to certain pesticides in regions where environmental exposure data are scarce. Furthermore, the time trend of the prevalence and incidence of PD embedded in the background relationship between PD risk and pesticide exposures has not been well characterized. It has been convincingly identified that a key pesticide associated significantly with an increased risk trend of PD is paraquat (PQ). Here, we present a novel, probabilistic population-based exposure-response approach to quantify the contribution from PQ exposure to prevalence risk of PD. We found that the largest PQ exposure contributions occurred in its positive trend during 2004-2011, with the PQ contributing nearly 21 and 24%, respectively, to the PD prevalence rates among the age groups of 70-79 and ≥ 80 years in Taiwan. We also employed the present population risk model to predict the PQ-induced PD prevalence based on the projected rates of increase in PQ exposure associated with age-specific population. The predicted outcome can be used as an early warning signal for public health authorities. We suggest that a mechanistic understanding of the contribution of a specific pesticide exposure to PD risk trends is crucial to enhance our insights into the perspective on the impacts of environmental exposure on the neurodegenerative diseases.
Assuntos
Poluentes Atmosféricos/toxicidade , Exposição Ambiental/análise , Paraquat/toxicidade , Doença de Parkinson/etiologia , Praguicidas/toxicidade , Idoso , Idoso de 80 Anos ou mais , Humanos , Pessoa de Meia-Idade , Doença de Parkinson/epidemiologia , Prevalência , Fatores de Risco , Taiwan/epidemiologiaRESUMO
BACKGROUND: The interaction between influenza and pneumococcus is important for understanding how coinfection may exacerbate pneumonia. Secondary pneumococcal pneumonia associated with influenza infection is more likely to increase respiratory morbidity and mortality. This study aimed to assess exacerbated inflammatory effects posed by secondary pneumococcal pneumonia, given prior influenza infection. MATERIALS AND METHODS: A well-derived mathematical within-host dynamic model of coinfection with influenza A virus and Streptococcus pneumoniae (SP) integrated with dose-response relationships composed of previously published mouse experimental data and clinical studies was implemented to study potentially exacerbated inflammatory responses in pneumonia based on a probabilistic approach. RESULTS: We found that TNFα is likely to be the most sensitive biomarker reflecting inflammatory response during coinfection among three explored cytokines. We showed that the worst inflammatory effects would occur at day 7 SP coinfection, with risk probability of 50% (likely) to develop severe inflammatory responses. Our model also showed that the day of secondary SP infection had much more impact on the severity of inflammatory responses in pneumonia compared to the effects caused by initial virus titers and bacteria loads. CONCLUSION: People and health care workers should be wary of secondary SP infection on day 7 post-influenza infection for prompt and proper control-measure implementation. Our quantitative risk-assessment framework can provide new insights into improvements in respiratory health especially, predominantly due to chronic obstructive pulmonary disease (COPD).
Assuntos
Coinfecção , Vírus da Influenza A/patogenicidade , Influenza Humana/virologia , Modelos Teóricos , Infecções Pneumocócicas/microbiologia , Pneumonia/microbiologia , Pneumonia/virologia , Doença Pulmonar Obstrutiva Crônica/microbiologia , Doença Pulmonar Obstrutiva Crônica/virologia , Streptococcus pneumoniae/patogenicidade , Animais , Simulação por Computador , Modelos Animais de Doenças , Humanos , Influenza Humana/diagnóstico , Influenza Humana/transmissão , Camundongos , Método de Monte Carlo , Infecções Pneumocócicas/diagnóstico , Infecções Pneumocócicas/transmissão , Pneumonia/diagnóstico , Doença Pulmonar Obstrutiva Crônica/diagnóstico , Medição de Risco , Fatores de Risco , Fatores de TempoRESUMO
Human health risks associated with the consumption of metal-contaminated fish over extended periods have become a concern particularly in Taiwan, where fish is consumed on a large scale. This study applied the interaction-based hazard index (HI) to assess the mixture health risks for fishers and non-fishers who consume the arsenic (As), copper (Cu), and zinc (Zn) contaminated milkfish from As-contaminated coastal areas in Taiwan, taking into account joint toxic actions and potential toxic interactions. We showed that the interactions of As-Zn and Cu-Zn were antagonistic, whereas As-Cu interaction was additive. We found that HI estimates without interactions considered were 1.3-1.6 times higher than interactive HIs. Probability distributions of HI estimates for non-fishers were less than 1, whereas all 97.5%-tile HI estimates for fishers were >1. Analytical results revealed that the level of inorganic As in milkfish was the main contributor to HIs, indicating a health risk posed to consumers of fish farmed in As-contaminated areas. However, we found that Zn supplementation could significantly decrease As-induced risk of hematological effect by activating a Zn-dependent enzyme. In order to improve the accuracy of health risk due to exposure to multiple metals, further toxicological data, regular environmental monitoring, dietary survey, and refinement approaches for interactive risk assessment are warranted.
Assuntos
Arsênio/toxicidade , Contaminação de Alimentos , Medição de Risco , Zinco/toxicidade , Animais , Cobre , Monitoramento Ambiental , Pesqueiros , Peixes , Humanos , Alimentos Marinhos , TaiwanRESUMO
Cadmium (Cd) is of great concern in the soil environment and it can damage terrestrial organisms. The purpose of this study was to employ a toxicokinetic/toxicodynamic (TK/TD) approach to investigate the effects of toxicologically relevant Cd accumulation on the life cycle growth of earthworms (Lumbricus rubellus and Eisenia fetida) and to assess potential terrestrial ecosystem risk. We reanalyzed growth toxicity and whole body and pellet accumulation data linked with TK/TD and life cycle growth models to estimate key rate constants. The growth risk of earthworms exposed to Cd was also assessed. This study found that the estimated whole body killing rate constant (0.114 g d µg-1) was much lower than that of pellet (0.248 g d µg-1). The recovery rate constant for whole body (6.02 d-1) was much higher than that of pellet (2.91 d-1). We also employed a life cycle-based probabilistic risk assessment model to estimate the growth inhibition risk for earthworms in response to environmentally relevant concentrations of Cd in Taiwan. Results showed that earthworms had a 90% growth inhibition probability risk of body weight, which was lower than 872.33 mg based on assessment of toxicologically relevant Cd accumulation. This study suggests that toxicologically relevant Cd accumulation could accurately reflect the capacity of Cd toxicity to earthworms. The integrated life cycle toxicity of earthworms exposed to Cd in this study provides a robust and applicable tool for the management of ecological risk assessment of Cd-contaminated soil.
Assuntos
Cádmio/toxicidade , Estágios do Ciclo de Vida/efeitos dos fármacos , Oligoquetos/fisiologia , Poluentes do Solo/toxicidade , Animais , Modelos Teóricos , Solo , Taiwan , Testes de ToxicidadeRESUMO
The ablative fractional laser is a new modality used for surgical resurfacing. It is expected that laser treatment can generally deliver drugs into and across the skin, which is toxicologically relevant. The aim of this study was to establish skin absorption characteristics of antibiotics, sunscreens, and macromolecules via laser-treated skin and during postoperative periods. Nude mice were employed as the animal model. The skin received a single irradiation of a fractional CO2 laser, using fluences of 4-10 mJ with spot densities of 100-400 spots/cm(2). In vitro skin permeation using Franz cells was performed. Levels of skin water loss and erythema were evaluated, and histological examinations with staining by hematoxylin and eosin, cyclooxygenase-2, and claudin-1 were carried out. Significant signs of erythema, edema, and scaling of the skin treated with the fractional laser were evident. Inflammatory infiltration and a reduction in tight junctions were also observed. Laser treatment at 6 mJ increased tetracycline and tretinoin fluxes by 70- and 9-fold, respectively. A higher fluence resulted in a greater tetracycline flux, but lower skin deposition. On the other hand, tretinoin skin deposition increased following an increase in the laser fluence. The fractional laser exhibited a negligible effect on modulating oxybenzone absorption. Dextrans with molecular weights of 4 and 10 kDa showed increased fluxes from 0.05 to 11.05 and 38.54 µg/cm(2)/h, respectively. The optimized drug dose for skin treated with the fractional laser was 1/70-1/60 of the regular dose. The skin histology and drug absorption had recovered to a normal status within 2-3 days. Our findings provide the first report on risk assessment of excessive skin absorption after fractional laser resurfacing.
Assuntos
Procedimentos Cirúrgicos Dermatológicos/efeitos adversos , Terapia a Laser/efeitos adversos , Lasers de Gás/efeitos adversos , Pele/metabolismo , Protetores Solares/farmacocinética , Animais , Procedimentos Cirúrgicos Dermatológicos/métodos , Feminino , Terapia a Laser/métodos , Lasers de Gás/uso terapêutico , Camundongos , Camundongos Endogâmicos ICR , Camundongos Nus , Modelos Animais , Permeabilidade , Medição de Risco , Pele/efeitos dos fármacos , Pele/patologia , Protetores Solares/administração & dosagem , Tetraciclina/administração & dosagem , Tetraciclina/farmacocinéticaRESUMO
The impact of environmentally pulsed metal exposure on population dynamics of aquatic organisms remains poorly understood and highly unpredictable. The purpose of our study was to link a dynamic energy budget model to a toxicokinetic/toxicodynamic (TK/TD). We used the model to investigate tilapia population dynamics in response to pulsed waterborne copper (Cu) assessed with available empirical data. We mechanistically linked the acute and chronic bioassays of pulsed waterborne Cu at the scale of individuals to tilapia populations to capture the interaction between environment and population growth and reproduction. A three-stage matrix population model of larva-juvenile-adult was used to project offspring production through two generations. The estimated median population growth rate (λ) decreased from 1.0419 to 0.9991 under pulsed Cu activities ranging from 1.6 to 2.0 µg L(-1). Our results revealed that the influence on λ was predominately due to changes in the adult survival and larval survival and growth functions. We found that pulsed timing has potential impacts on physiological responses and population abundance. Our study indicated that increasing time intervals between first and second pulses decreased mortality and growth inhibition of tilapia populations, indicating that during long pulsed intervals tilapia may have enough time to recover. Our study concluded that the bioenergetics-based matrix population methodology could be employed in a life-cycle toxicity assessment framework to explore the effect of stage-specific mode-of-actions in population response to pulsed contaminants.
Assuntos
Cobre/farmacocinética , Cobre/toxicidade , Monitoramento Ambiental/métodos , Tilápia/fisiologia , Poluentes Químicos da Água/farmacocinética , Poluentes Químicos da Água/toxicidade , Animais , Peso Corporal , Ingestão de Energia , Feminino , Modelos Biológicos , Crescimento Demográfico , Reprodução , Medição de Risco , Sensibilidade e Especificidade , Tilápia/crescimento & desenvolvimento , Fatores de TempoRESUMO
Long-term metal exposure risk assessment for aquatic organism is a challenge because the chronic toxicity of chemical is not only determined by the amount of accumulated chemical but also affected by the ability of biological regulation or detoxification of biota. We quantified the arsenic (As) detoxification ability of tilapia and developed a biologically based growth toxicity modeling algorithm by integrating the process of detoxification and active regulations (i.e., the balance between accumulated dose, tissue damage and recovery, and the extent of induced toxic effect) for a life span ecological risk prediction. Results showed that detoxification rate (k (dex)) increased with increasing of waterborne As when the accumulated metal exceeded the internal threshold level of 19.1 µg g( - 1). The k (dex) values were comparable to or even higher than the rates of physiological loss and growth dilution in higher exposure conditions. Model predictions obtained from the proposed growth toxicity model were consistent with the measured growth data. The growth toxicity model was also used to illustrate the health condition and growth trajectories of tilapia from birth to natural death under different exposure scenarios. Results showed that temporal trends of health rates and growth trajectories of exposed fish in different treatments decreased with increasing time and waterborne As, revealing concentration-specific patterns. We suggested that the detoxification rate is critical and should be involved in the risk assessments framework. Our proposed modeling algorithm well characterizes the internal regulation activities and biological response of tilapia under long-term metal stresses.
Assuntos
Arsênio/toxicidade , Doenças dos Peixes/induzido quimicamente , Poluentes Químicos da Água/toxicidade , Água/química , Algoritmos , Animais , Arsênio/química , Relação Dose-Resposta a Droga , Masculino , Medição de Risco , Tilápia , Fatores de Tempo , Poluentes Químicos da Água/químicaRESUMO
The Tigecycline In Vitro Surveillance in Taiwan (TIST) study, initiated in 2006, is a nationwide surveillance program designed to longitudinally monitor the in vitro activity of tigecycline against commonly encountered drug-resistant bacteria. This study compared the in vitro activity of tigecycline against 3,014 isolates of clinically important drug-resistant bacteria using the standard broth microdilution and disk diffusion methods. Species studied included methicillin-resistant Staphylococcus aureus (MRSA; n = 759), vancomycin-resistant Enterococcus faecium (VRE; n = 191), extended-spectrum ß-lactamase (ESBL)-producing Escherichia coli (n = 602), ESBL-producing Klebsiella pneumoniae (n = 736), and Acinetobacter baumannii (n = 726) that had been collected from patients treated between 2008 and 2010 at 20 hospitals in Taiwan. MICs and inhibition zone diameters were interpreted according to the currently recommended U.S. Food and Drug Administration (FDA) criteria and the European Committee on Antimicrobial Susceptibility Testing (EUCAST) criteria. The MIC(90) values of tigecycline against MRSA, VRE, ESBL-producing E. coli, ESBL-producing K. pneumoniae, and A. baumannii were 0.5, 0.125, 0.5, 2, and 8 µg/ml, respectively. The total error rates between the two methods using the FDA criteria were high: 38.4% for ESBL-producing K. pneumoniae and 33.8% for A. baumannii. Using the EUCAST criteria, the total error rate was also high (54.6%) for A. baumannii isolates. The total error rates between these two methods were <5% for MRSA, VRE, and ESBL-producing E. coli. For routine susceptibility testing of ESBL-producing K. pneumoniae and A. baumannii against tigecycline, the broth microdilution method should be used because of the poor correlation of results between these two methods.
Assuntos
Antibacterianos/farmacologia , Farmacorresistência Bacteriana , Bactérias Gram-Negativas/efeitos dos fármacos , Bactérias Gram-Positivas/efeitos dos fármacos , Minociclina/análogos & derivados , Acinetobacter baumannii/efeitos dos fármacos , Acinetobacter baumannii/crescimento & desenvolvimento , Carbapenêmicos/farmacologia , Enterococcus faecium/efeitos dos fármacos , Enterococcus faecium/crescimento & desenvolvimento , Enterococcus faecium/isolamento & purificação , Escherichia coli/efeitos dos fármacos , Escherichia coli/crescimento & desenvolvimento , Escherichia coli/isolamento & purificação , Bactérias Gram-Negativas/crescimento & desenvolvimento , Bactérias Gram-Negativas/isolamento & purificação , Bactérias Gram-Positivas/crescimento & desenvolvimento , Bactérias Gram-Positivas/isolamento & purificação , Humanos , Klebsiella pneumoniae/efeitos dos fármacos , Klebsiella pneumoniae/crescimento & desenvolvimento , Klebsiella pneumoniae/isolamento & purificação , Estudos Longitudinais , Staphylococcus aureus Resistente à Meticilina/efeitos dos fármacos , Staphylococcus aureus Resistente à Meticilina/crescimento & desenvolvimento , Staphylococcus aureus Resistente à Meticilina/isolamento & purificação , Testes de Sensibilidade Microbiana , Minociclina/farmacologia , Taiwan , Tigeciclina , Vancomicina/farmacologia , beta-Lactamases/biossínteseRESUMO
It has been proposed that irreversible responses of organisms exposed to contaminants are due to a systems-level feedback. Here we tested this hypothesis by reanalyzing the published data on toxicokinetics and survival probability based on a systems-level threshold damage model (TDM) incorporating with a positive damage feedback to explore the steady-state response and dynamic behavior of damage for tilapia and freshwater clam exposed to waterborne arsenic (As). We found that ultrasensitivity appeared in As-tilapia and freshwater clam systems with Hill coefficient n ≥ 4, indicating that the positive damage feedback mechanism has been triggered. We confirmed that damage can trigger a positive feedback loop that together with As stressor increases irreversibility. This study also showed that TDM with positive feedback gave a much better predictability than that of TDM at As concentrations ranging from 100 to 500 mg l(-1) for freshwater clam, whereas for tilapia, two models had nearly same performance on predictability. We suggested that mortality-time profile derived Hill coefficient could be used as a new risk indicator to assess the survival probability for species exposed to waterborne metals. We anticipated that the proposed toxicokinetics/toxicodynamics with a positive damage feedback may facilitate our understanding and manipulation of complex mechanisms of metal susceptibility among species and improve current risk assessment strategies.
Assuntos
Arsenicais/efeitos adversos , Arsenicais/farmacocinética , Bivalves/efeitos dos fármacos , Retroalimentação Fisiológica , Tilápia/fisiologia , Animais , Aquicultura , Bivalves/fisiologia , Limiar Diferencial , Água Doce , Longevidade/efeitos dos fármacos , Valor Preditivo dos Testes , Medição de RiscoRESUMO
BACKGROUND: Heavy caregiving burdens can harm the physical and mental health of primary caregivers and reduce patient care quality. Understanding caregiving burden and its associated factors among primary caregivers of terminally ill patients with gastrointestinal cancer can help improve holistic terminal healthcare quality. PURPOSE: The authors explore in this paper the relationship between caregiving burden and terminally ill gastrointestinal cancer patient disease characteristics, demographic backgrounds, level of social support, self-care efficacy, fear of death and self-perceived symptom distress in both patients and primary caregivers. METHODS: This was a cross-sectional, descriptive, and correlational study that used convenience sampling and structured questionnaires. Data were collected from 178 family caregivers of terminally ill patients with gastrointestinal cancer in the Tainan and Chiayi areas of Southern Taiwan. RESULTS: The caregiving burden of caregivers of terminally ill gastrointestinal cancer patients in hospice homecare was significantly higher than that of those recruited from outpatient departments. Caregiving burden for liver and pancreatic cancer patients was significantly higher than for colorectal cancer patients. The caregiving burden of spousal caregivers was significantly higher than that of lineal blood relatives. The caregiving burden of caregivers with worse self-perceived health status was significantly higher than that of those with better self-perceived health status. The most important explanatory factors of caregiving burden among primary caregivers terminally ill gastrointestinal cancer patients were (in descending order) social support, self-perceived symptom distress in patient, self-perceived health status, location of study subject recruitment, fear of death, and relationship with patient; these factors explained 63.8% of the total variation. Social support was the most important explanatory factor, explaining 37.2% of total variance. CONCLUSIONS: We recommend that terminal health care teams better assess the social support given primary caregivers of terminally ill gastrointestinal cancer patients, that assistance be provided to caregivers with less social support, that caregiver life-and-death education be improved, and that primary caregivers be taught how to accept and positively handle the death of the loved one in their care. More attention should be paid to controlling symptoms of terminal stage cancer patients in order to reduce caregiver self-perceived symptom distress. Evaluation of caregiving burden is especially important for those primary caregivers who are hospice homecare workers, spouses, and of lower self-perceived health status.
Assuntos
Cuidadores/psicologia , Neoplasias Gastrointestinais/psicologia , Doente Terminal , Adulto , Idoso , Idoso de 80 Anos ou mais , Efeitos Psicossociais da Doença , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Autocuidado , Apoio SocialRESUMO
The purpose of this study is to conduct a long-term site-specific risk assessment for zinc (Zn) susceptibility of bivalves, green mussel Perna viridis and hard clam Ruditapes philippinarum, based on published experimental data by linking the biologically-based damage assessment model with the subcellular partitioning concept. A comprehensive risk modeling framework was developed to predict susceptibility probability of two bivalve species exposed to waterborne Zn. The results indicated that P. viridis accumulates more Zn toxicity, whereas both toxic potency and the recovery rate of Zn are higher for R. philippinarum. We found that negative linear correlations exist in elimination-recovery and elimination-detoxification relationships, whereas a positive linear correlation was observed in recovery-detoxification relationships for bivalves exposed to waterborne Zn. Simulation results showed that the spatial differences of susceptibility primarily resulted from the variation of waterborne Zn concentration under field conditions. We found that R. philippinarum is more susceptible of Zn than P. viridis under the same exposure condition. Results also suggested that Zn posed no significant susceptibility risk to two bivalve species in Taiwan. We suggested that these two species can be used to biomonitor the water quality on Taiwan coastal areas.
Assuntos
Bivalves/efeitos dos fármacos , Poluentes Químicos da Água/análise , Zinco/análise , Animais , Bivalves/metabolismo , Monitoramento Ambiental , Perna (Organismo)/efeitos dos fármacos , Perna (Organismo)/metabolismo , Medição de Risco , Poluentes Químicos da Água/metabolismo , Poluentes Químicos da Água/toxicidade , Zinco/metabolismo , Zinco/toxicidadeRESUMO
Exposures to carcinogenic polycyclic aromatic hydrocarbons (PAHs) have been linked to human lung cancer. The purpose of this study was to assess lung cancer risk caused by inhalation exposure to nano/ultrafine particle-bound PAHs at the population level in Taiwan appraised with recent published data. A human respiratory tract model was linked with a physiologically based pharmacokinetic model to estimate deposition fraction and internal organic-specific PAHs doses. A probabilistic risk assessment framework was developed to estimate potential lung cancer risk. We reanalyzed particle size distribution, total-PAHs, particle-bound benzo(a)pyrene (B[a]P) and PM concentrations. A dose-response profile describing the relationships between external B[a]P concentration and lung cancer risk response was constructed based on population attributable fraction (PAF). We found that 90% probability lung cancer risks ranged from 10(-5) to 10(-4) for traffic-related nano and ultrafine particle-bound PAHs, indicating a potential lung cancer risk. The particle size-specific PAF-based excess annual lung cancer incidence rate due to PAHs exposure was estimated to be less than 1 per 100,000 population, indicating a mild risk factor for lung cancer. We concluded that probabilistic risk assessment linked PAF for limiting cumulative PAHs emissions to reduce lung cancer risk plays a prominent role in future government risk assessment program.
Assuntos
Exposição Ambiental , Neoplasias Pulmonares/etiologia , Nanopartículas/toxicidade , Hidrocarbonetos Policíclicos Aromáticos/toxicidade , Emissões de Veículos/toxicidade , Humanos , Incidência , Neoplasias Pulmonares/epidemiologia , Modelos Teóricos , Risco , Medição de RiscoRESUMO
The objective of this paper was to develop a mechanistic-based framework to explicitly incorporate the factors controlling the bioavailability, toxicodynamics and mode of action to enhance predictive ability of arsenic (As) toxicity to protect the health of farmed tilapia Oreochromis mossambicus. We linked the biotic ligand model and damage assessment model to develop a toxicokinetic model for elucidating the site-specific temporal changes of As bioavailability and to characterize how the fish regulate the metal toxicity. We built a bioavailability-mode of action-based growth toxicity model by linking a bioenergetic growth model and damage assessment model to predict how the As affects on the tilapia growth in the entire life span in site-specific field ecosystems. Here we show that the proposed model well describes the water-chemistry-dependent toxicokinetics and toxicodynamics variations of As to tilapia. We selected two local tilapia farms with different water chemistries located at southwestern Taiwan coast region to implement the proposed algorithm to predict the risk of As exposure. Results indicate that the growth toxicity of O. mossambicus in Taihsi is more sensitive than that in Peimen. We found that the effect of ion competition on the As bioavailability and their ecotoxicological effects on tilapia are more obvious in Taihsi comparing with that in Peimen. We suggested that the proposed bioavailability- and mode of action-based framework can be used to capture the biological response and regulation of tilapia to As exposures. It is applicable for a site-specific and long-term ecotoxicological risk assessment.
Assuntos
Arsênio/farmacocinética , Arsênio/toxicidade , Medição de Risco/métodos , Tilápia/fisiologia , Algoritmos , Animais , Disponibilidade Biológica , Modelos Teóricos , TaiwanRESUMO
Farming of tilapia Oreochromis mossambicus is an important aquacultural activity in Taiwan. Due to the elevated arsenic (As) concentration in pond water, it is important to assess the bioavailability and toxicity of As to tilapia for protection of aquatic life and human health. In the present study, we developed a biotic ligand model (BLM)-based toxicodynamic approach to dynamically predict both acute and chronic effective concentrations of As to tilapia in two tilapia farms located at Pudai and Chiangchun counties in southwestern Taiwan. Parameters revealed in the mechanistic model were obtained by fitting this model to the toxicokinetic and toxicodynamic data from our previous laboratory experiments. Based on our extended BLM concepts, the site-specific water effect ratios and ambient water quality criteria can be determined with known water chemistry. The proposed methodology was capable of bridging the gap between laboratory toxicity bioassays and field investigations. With respect to risk assessments, our research may also provide an useful means of generating and adjusting the site-specific ambient water quality criteria.