Refining and psychometric evaluation of the falling risk assessment tool in ophthalmology inpatients.

AIMS: The aim of this study was to refine the Falling Risk Assessment Tool in Ophthalmology Inpatients (FRAT) and assess its psychometric properties. DESIGN: A cross-sectional design was used. METHODS: A convenience sample of 730 patients in the ophthalmology department was recruited in a level A tertiary hospital in Guangdong Province from July 2021 to January 2022. Data were analysed using item analysis, interrater reliability, content validation, internal consistency reliability and exploratory factor analysis. RESULTS: Five factors were extracted, accounting for 63.039% of the variance. The interrater reliability of the tool was 0.97. Cronbach's α was 0.658. The I-CVI was 0.75-1.00, the S-CVI/UA was 0.95 and the adjusted mean values of Kappa for indicators ranged from 0.72 to 1.00, as evaluated by the expert group. The FRAT showed satisfactory reliability and validity, and can be used to measure the fall risk assessment in ophthalmology inpatients. PATIENT OR PUBLIC CONTRIBUTION: After explaining the purpose, the patients received our fall risk assessment and answered the corresponding questionnaire questions.

Assessment of left ventricular energy loss in patients with mild coronary artery stenosis by using vector flow mapping combined with exercise stress echocardiography.

OBJECTIVES: To evaluate the left ventricular energy loss (EL), energy loss reserve (EL-r), and energy loss reserve rate in patients with mild coronary artery stenosis by using vector flow mapping (VFM) combined with exercise stress echocardiography. METHODS: A total of 34 patients (case group) with mild coronary artery stenosis and 36 sex and age matched patients (control group) without coronary artery stenosis according to coronary angiogram were prospectively enrolled. The total energy loss (ELt), basal segment energy loss (ELb), middle segment energy loss (ELm), apical segment energy loss (ELa), energy loss reserve (EL-r), and energy loss reserve rate were recorded in the isovolumic systolic period (S1), rapid ejection period (S2), slow ejection period (S3), isovolumic diastolic period (D1), rapid filling period (D2), slow filling period (D3), and atrial contraction period (D4). RESULTS: Compared with the control group, some of the EL in the resting case group were higher; some of the EL in the case group were lower after exercise, and those during D1 ELb and D3 ELb were higher. Compared with the resting state, the total EL and the EL within the time segment in the control group were higher after exercise, except during D2 ELb. In the case group, except for during D1 ELt, ELb and D2 ELb, the total and segmental EL of each phase was mostly higher after exercise (p < .05). Compared with the control group, most of the EL-r and EL reserve rates in the case group were lower (p < .05). CONCLUSION: The EL, EL-r, and energy loss reserve rate have a certain value in the evaluation of cardiac function in patients with mild coronary artery stenosis.

Developing a cross-validation tool for evaluating economic evidence in rapid literature reviews.

Background: Rapid economic reviews efficiently summarize economic evidence. However, reporting main findings without assessing quality and credibility can be misleading. The objective of this study was to develop a rapid cross-validation screening tool to evaluate economic evidence when conducting rapid economic literature reviews. Methods: This article outlines our reasoning and the theoretical concepts for developing the screening tool. Results: This cross-validation tool is a qualitative approach under a Bayesian framework that uses prior health economic evidence to gauge the credibility of the rapid economic review's findings. This article describes an application of this tool and highlights practical considerations for its development and deployment. Conclusion: This tool can provide a valuable screening instrument to evaluate the quality and credibility of the economic evidence.

Cost-effectiveness of noninvasive fetal RhD blood group genotyping in nonalloimmunized and alloimmunized pregnancies.

BACKGROUND: We sought to determine the cost-effectiveness of noninvasive fetal RhD blood group genotyping in nonalloimmunized and alloimmunized pregnancies in Canada. STUDY DESIGN AND METHODS: We developed two probabilistic state-transition (Markov) microsimulation models to compare fetal genotyping followed by targeted management versus usual care (i.e., universal Rh immunoglobulin [RhIG] prophylaxis in nonalloimmunized RhD-negative pregnancies, or universal intensive monitoring in alloimmunized pregnancies). The reference case considered a healthcare payer perspective and a 10-year time horizon. Sensitivity analysis examined assumptions related to test cost, paternal screening, subsequent pregnancies, other alloantibodies (e.g., K, Rh c/C/E), societal perspective, and lifetime horizon. RESULTS: Fetal genotyping in nonalloimmunized pregnancies (at per-sample test cost of C$247/US$311) was associated with a slightly higher probability of maternal alloimmunization (22 vs. 21 per 10,000) and a reduced number of RhIG injections (1.427 vs. 1.795) than usual care. It was more expensive (C$154/US$194, 95% Credible Interval [CrI]: C$139/US$175-C$169/US$213) and had little impact on QALYs (0.0007, 95%CrI: -0.01-0.01). These results were sensitive to the test cost (threshold achieved at C$88/US$111), and inclusion of paternal screening. Fetal genotyping in alloimmunized pregnancies (at test cost of C$328/US$413) was less expensive (-C$6280/US$7903, 95% CrI: -C$6325/US$7959 to -C$6229/US$7838) and more effective (0.19 QALYs, 95% CrI 0.17-0.20) than usual care. These cost savings remained robust in sensitivity analyses. DISCUSSION: Noninvasive fetal RhD genotyping saves resources and represents good value for the management of alloimmunized pregnancies. If the cost of genotyping is substantially decreased, the targeted intervention can become a viable option for nonalloimmunized pregnancies.

Dual performance of environmental regulation on economic and environmental development: evidence from China.

Based on the comparative perspective of environmental regulation performance, this paper uses the threshold effect model to analyze the nonlinear characteristics of the impact of environmental regulation on economic development and environmental pollution and explore the dual performance of environmental regulation on economic and environmental development. The results are fourfold: Firstly, the intensity of fiscal expenditure on energy conservation and environmental protection has a restraining effect on environmental pollution, but it has a crowding-out effect on economic growth. Therefore, it is impossible to achieve a win-win situation between ecological protection and economic development by increasing the intensity of financial expenditure on energy conservation and environmental protection. Secondly, giving more financial rights to local governments in eastern China may help to reverse the non-win-win situation of the economy and the environment. Thirdly, increasing the environmental protection awareness of local governments will help to achieve a win-win situation. It is more effective to achieve a win-win situation of ecology and economy using constraint regulation than incentive regulation. Finally, the economic development level of the last period has different threshold effects on the current environmental pollution in the eastern and western China. Thus, the impact of environmental regulation lags. We conclude that we should give full play to the role of the environmental regulation, stimulate the endogenous power of environmental system, accurately implement the key differentiation strategy, and promote the win-win situation of ecological protection and economic development.

Dissipation and risk assessment of forchlorfenuron and its major metabolites in oriental melon under greenhouse cultivation.

Forchlorfenuron is a widely used plant growth regulator. The uptake of forchlorfenuron and its major metabolites poses a potential risk for human health. However, little is known about the dissipation of forchlorfenuron and its major metabolites in agricultural food. In this study, the metabolite 4-hydroxyphenyl-forchlorfenuron was first identified in oriental melon, which exhibited the highest level of residues of 4.42-5.12 µg/kg on the 4-7th days after application. Forchlorfenuron was found to be dissipated rapidly in melon at the recommended application rates, with half-lives ranging from 1.20 to 1.33 days. The rate of dissipation of 4-hydroxyphenyl-forchlorfenuron was greater than that of metabolism from forchlorfenuron in the oriental melon. However, the other metabolite, 3-hydroxyphenyl-forchlorfenuron, was not detected in oriental melon. The risk assessment showed that the acute and chronic dietary exposure risks of forchlorfenuron in oriental melon were 0.0011-0.0037% and 0.06-0.12%, respectively, suggesting little health risk to Chinese consumers.

Noninvasive Fetal RhD Blood Group Genotyping: A Systematic Review of Economic Evaluations.

OBJECTIVE: Noninvasive fetal rhesus D (RhD) blood group genotyping may prevent unnecessary use of anti-D immunoglobulin (RhIG) in non-alloimmunized RhD-negative pregnancies and can guide management of alloimmunized pregnancies. We conducted a systematic review of the economic literature to determine the cost-effectiveness of this intervention over usual care. DATA SOURCES: Systematic literature searches of bibliographic databases (Ovid MEDLINE, Embase, and Cochrane) until February 26, 2019, and auto-alerts until October 30, 2020, and of grey literature sources were performed to retrieve all English-language studies. STUDY SELECTION: We included studies done in serologically confirmed non-alloimmunized or alloimmunized RhD-negative pregnancies, comparing costs and effectiveness of the intervention versus usual care. DATA EXTRACTION AND SYNTHESIS: Two reviewers extracted data from the eligible studies and assessed their methodological quality (risk of bias) using the Quality of Health Economic Studies (QHES) and Drummond tools. We narratively synthesized findings. Our review included 8 economic studies that evaluated non-invasive fetal RhD genotyping followed by targeted RhIG prophylaxis in non-alloimmunized pregnancies. Five studies further considered a subsequent alloimmunized pregnancy. The cost-effectiveness of the intervention versus usual care (e.g., universal RhIG or prophylaxis conditional on results of paternal testing) for non-alloiummunized pregnancies was inconsistent. Two studies indicated greater benefits and lower costs for the intervention, and another 2 suggested a trade-off. In 4 studies, the intervention was less effective and costlier than alternatives. Three studies were determined to be of high quality by both tools. Two of these studies favoured the intervention, and one assessed benefits in quality-adjusted life-years. No study clearly examined the cost-effectiveness of repetitive use of fetal genotyping in multiple non-alloimmunized or alloimmunized pregnancies. The cost of genotyping was the most influential parameter. CONCLUSION: The cost-effectiveness of noninvasive fetal RhD genotyping for non-alloimmunized pregnancies varies between studies. Potential savings from targeted management of alloimmunized pregnancies requires further research.

Space-time evolution of the ecological security of regional urban tourism: the case of Hubei Province, China.

While increased tourist demand has brought economic benefits to tourist destinations, it has also put tremendous pressure on tourism-related ecological environments. Therefore, the relationship between regional urban tourism's economic benefits and tourism ecologies must be considered by increasing the ecological security levels of regional urban tourism and promoting sustainable tourism development. This paper defines the ecological security of regional urban tourism, constructs an indicator system of said ecological security based on a pressure-state-response social-economic-environment (PSR-SEE) model, uses the entropy method to objectively assign weights to the indicator system, constructs a dynamic multi-scenario simulation model to assess ecological security under continuous, economic priority and various ecological protection scenarios, employs ArcGIS software to analyze the spatial distribution patterns of the ecological security of regional urban tourism, and uses a standard deviation ellipse method to analyze the space-time evolutionary track of the ecological security of regional urban tourism. The index system is applied to 16 cities in Hubei Province to measure the ecological security levels and test the viability of the system. The present research focuses on the space-time evolution of the ecological security of regional urban tourism, addresses the contradictions between socioeconomic development and the ecological security of regional urban tourism, provides an important reference for tourism destination planning, and can assist in improving the levels of the ecological security of regional urban tourism to promote sustainable tourism development.

Assessment of the toxicity and toxicokinetics of the novel potent tropomyosin receptor kinase (Trk) inhibitor LPM4870108 in rhesus monkeys.

LPM4870108 is a tropomyosin receptor kinase (Trk) inhibitor that is currently under consideration for human clinical trials. We characterized the toxicity and toxicokinetic properties of LPM4870108 following its oral administration to rhesus monkeys (5, 10, or 20 mg/kg/day for 4 weeks with a 4-week recovery period). No evidence of LPM4870108 toxicity was observed over this study as reflected by an absence of difference in body weight, ophthalmoscopy, urinalysis, gross, or histopathology findings. No significant differences in toxicity-related outcomes were detected when comparing LPM4870108 and control groups, and no significant treatment-related changes in food consumption, electrocardiogram results, blood pressure, hematological parameters, biochemical values, organ weight, or bone marrow parameters were observed. Treatment caused dose-dependent effects of gait disturbance, impaired balance, poor coordination, and decreased grip strength in all LPM4870108-treated animals, with these effects being attributable to excessive on-target Trk receptor inhibition. After the 4-week recovery period, all these abnormal treatment-related findings had fully or partially resolved. The toxicokinetic study of monkeys revealed that the LPM4870108 exposure increased with dose. Overall, LPM4870108 exhibited a safety profile in treated monkeys, indicating that the Highest Non-Severely Toxic Dose (HNSTD) for LPM4870108 in monkeys was 20 mg/kg/day.

Dissipation and dietary risk assessment of tristyrylphenol ethoxylate homologues in cucumber after field application.

The potential for tristyrylphenol ethoxylates (TSPEOs) residues to contaminate crops or be released into the environment is of increasing concern, as they are toxic to living organisms. This study determined the dissipation of TSPEO homologues in cucumber under field conditions. TSPEOn (n = 6-29) dissipated more rapidly in cucumber than in soil samples, with half-lives of 1.80-4.30 d and 3.73-6.52 d, respectively. Short-chain TSPEOn (n = 6-11) persisted for longer than other oligomers in soil. Concentrations of the final residues (∑TSPEOs) in cucumber and soil were 24.3-1349 µg/kg and 47.3-1337 µg/kg, respectively. TSP15EO or TSP16EO was the dominant oligomer, with concentrations of 2.30-150 µg/kg. The risk assessment showed that the acute and chronic dietary exposure risks of ∑TSPEOs in cucumber were 0.03-0.57% and 0.05-0.39%, respectively, suggesting little or no health risk to Chinese consumers.

Cost-effectiveness of genome-wide sequencing for unexplained developmental disabilities and multiple congenital anomalies.

PURPOSE: Genetic testing is routine practice for individuals with unexplained developmental disabilities and multiple congenital anomalies. However, current testing pathways can be costly and time consuming, and the diagnostic yield low. Genome-wide sequencing, including exome sequencing (ES) and genome sequencing (GS), can improve diagnosis, but at a higher cost. This study aimed to assess the cost-effectiveness of genome-wide sequencing in Ontario, Canada. METHODS: A cost-effectiveness analysis was conducted using a discrete event simulation from a public payer perspective. Six strategies involving ES or GS were compared. Outcomes reported were direct medical costs, number of molecular diagnoses, number of positive findings, and number of active treatment changes. RESULTS: If ES was used as a second-tier test (after the current first-tier, chromosomal microarray, fails to provide a diagnosis), it would be less costly and more effective than standard testing (CAN$6357 [95% CI: 6179-6520] vs. CAN$8783 per patient [95% CI: 2309-31,123]). If ES was used after standard testing, it would cost an additional CAN$15,228 to identify the genetic diagnosis for one additional patient compared with standard testing. The results remained robust when parameters and assumptions were varied. CONCLUSION: ES would likely be cost-saving if used earlier in the diagnostic pathway.

Comparative Study of Monoexponential, Intravoxel Incoherent Motion, Kurtosis, and IVIM-Kurtosis Models for the Diagnosis and Aggressiveness Assessment of Prostate Cancer.

Objective: This study aimed to compare the potential of monoexponential model (MEM), intravoxel incoherent motion (IVIM) model, kurtosis model, and IVIM-kurtosis model in the diagnosis and aggressiveness assessment of prostate cancer (PCa). Materials and Methods: Thirty-six patients were recruited. Diffusion-weighted images were acquired on a 3.0-T magnetic resonance imaging (MRI) system using 0 b values up to 2,000 s/mm2 and analyzed using four models: MEM (ADCMEM), IVIM (D IVIM, D*IVIM, f IVIM), kurtosis (D kurtosis, K kurtosis), and IVIM-kurtosis (D IVIM-kurtosis, D * IVIM-kurtosis, f IVIM-kurtosis, D IVIM-kurtosis) models. The values of these parameters were calculated and compared between PCa, benign prostatic hyperplasia (BPH), and prostatitis. Correlations between these parameters and the Gleason score (GS) of PCa were evaluated using the Pearson test. Results: Forty-five lesions were studied, including 18 PCa, 12 prostatitis, and 15 BPH lesions. The ADCMEM, D IVIM, f IVIM, D kurtosis, and D IVIM-kurtosis values were significantly lower and K kurtosis and K IVIM-kurtosis values were significantly higher in PCa compared with prostatitis and BPH. The area under the curve (AUC) of ADCMEM showed significantly higher values than that of f IVIM and K IVIM-kurtosis, but no statistical differences were found between the other parameters. The D * IVIM-kurtosis value correlated negatively and f IVIM-kurtosis and K IVIM-kurtosis values correlated positively with the GS. Conclusion: The MEM, IVIM, kurtosis, and IVIM-kurtosis models were all useful for the diagnosis of PCa, and the diagnostic efficacy seemed to be similar. The IVIM-kurtosis model may be superior to the MEM, IVIM, and kurtosis models in the grading of PCa.

Retrospective Study of the Epidemiology, Pathology, and Therapeutic Management in Patients With Mucinous Ovarian Tumors.

AIM: We sought to determine the epidemiology of mucinous ovarian tumors, the correlation between serum biomarkers and tumor status, and the outcomes of the management in different subtypes of mucinous ovarian tumors in a Chinese surgical cohort. METHODS: A total of 513 patients were enrolled from January 2009 to May 2017. The number of patients who had benign mucinous ovarian tumor, borderline mucinous ovarian tumor, or malignant mucinous ovarian tumor was pathologically quantified. All patients underwent surgery with or without postoperative adjuvant therapy. Prognosis was analyzed based on clinicopathological characteristics and the type of treatment received. Hyperthermic intraperitoneal chemotherapy efficacy and adverse effects in patients were also explored. RESULTS: In all, 383 (75%) patients were diagnosed as having benign mucinous ovarian tumor, 76 (14%) patients with borderline mucinous ovarian tumor, and 54 (5%) patients with malignant mucinous ovarian tumor. Levels of serum biomarkers increased as the tumors became more malignant. Patients with stage IA and IC (unilateral) malignant mucinous ovarian tumor who underwent fertility conserving surgery did not experience poorer prognoses when compared to those who received non-fertility conserving surgery. Hyperthermic intraperitoneal chemotherapy followed by chemotherapy significantly influenced survival rates in patients with a ruptured malignant mucinous ovarian tumor. CONCLUSIONS: Levels of serum tumor markers, carbohydrate antigen 125, carbohydrate antigen 199, carbohydrate antigen 242, and carcinoembryonic antigen may be useful in monitoring for malignant transformation. Fertility conserving surgery might be a preferable surgical procedure for patients with malignant mucinous ovarian tumor at early stage (IA and IC [unilateral]). Hyperthermic intraperitoneal chemotherapy appears to be a well-tolerated and promising postoperative adjuvant.

Cereal production in the presence of climate change in China.

This study sought to investigate the impacts of climate change on cereal production in China over the period 1990Q1-2013Q4. Using the Autoregressive Distributed Lag (ARDL) approach, the results showed that CO2 emissions, average temperature, and temperature variability have a significant negative impact on cereal production in the long run. However, energy consumption, average rainfall, labor force, and cultivated area significantly and positively influenced the production of cereal crops in the long run. Meanwhile, the study observed that rainfall variability has no significant effect on cereal production in the long run. The study again found that in the short run, CO2 emissions, average temperature, and temperature variability have a significant negative relationship with cereal production. Besides, energy consumption, average rainfall, rainfall variability, labor force, and the cultivated area had a significant positive association with cereal production in the short run. The results of the Granger causality test showed that there exists a unidirectional causality running from CO2 emissions, energy consumption, and labor force to the production of cereal crops in China. On the contrary, the study found no causality between cultivated area and cereal production. The study suggests that improved cereal crop varieties ought to be developed and introduced to cope with the adverse impacts of climate change in China. This will help to circumvent Huang et al.'s (2017) prediction of a decline in the total food self-sufficiency of China from 94.5% in 2015 to about 91% by 2025.

Cost-Effectiveness of Magnetic Resonance-Guided Focused Ultrasound for Essential Tremor.

BACKGROUND: Radiofrequency thalamotomy and deep brain stimulation are current treatments for moderate to severe medication-refractory essential tremor. However, they are invasive and thus carry risks. Magnetic resonance-guided focused ultrasound is a new, less invasive surgical option. The objective of the present study was to determine the cost-effectiveness of magnetic resonance-guided focused ultrasound compared with standard treatments in Canada. METHODS: We conducted a cost-utility analysis using a Markov cohort model. We compared magnetic resonance-guided focused ultrasound with no surgery in people ineligible for invasive neurosurgery and with radiofrequency thalamotomy and deep brain stimulation in people eligible for invasive neurosurgery. In the reference case analysis, we used a 5-year time horizon and a public payer perspective and discounted costs and benefits at 1.5% per year. RESULTS: Compared with no surgery in people ineligible for invasive neurosurgery, magnetic resonance-guided focused ultrasound cost $21,438 more but yielded 0.47 additional quality-adjusted life years, producing an incremental cost-effectiveness ratio of $45,817 per quality-adjusted life year gained. In people eligible for invasive neurosurgery, magnetic resonance-guided focused ultrasound was slightly less effective but much less expensive compared with the current standard of care, deep brain stimulation. The results were sensitive to assumptions regarding the time horizon, cost of magnetic resonance-guided focused ultrasound, and probability of recurrence. CONCLUSIONS: In people ineligible for invasive neurosurgery, the incremental cost-effectiveness ratio of magnetic resonance-guided focused ultrasound versus no surgery is comparable to many other tests and treatments that are widely adopted in high-income countries. In people eligible for invasive neurosurgery, magnetic resonance-guided focused ultrasound is also a reasonable option. © 2018 International Parkinson and Movement Disorder Society.

Apparent diffusion coefficient values are superior to transrectal ultrasound-guided prostate biopsy for the assessment of prostate cancer aggressiveness.

Background Few studies have focused on comparing the utility of diffusion-weighted imaging (DWI) and transrectal ultrasound (TRUS)-guided biopsy in predicting prostate cancer aggressiveness. Whether apparent diffusion coefficient (ADC) values can provide more information than TRUS-guided biopsy should be confirmed. Purpose To retrospectively assess the utility of ADC values in predicting prostate cancer aggressiveness, compared to the TRUS-guided prostate biopsy Gleason score (GS). Material and Methods The DW images of 54 patients with biopsy-proven prostate cancer were obtained using 1.5-T magnetic resonance (MR). The mean ADC values of cancerous areas and biopsy GS were correlated with prostatectomy GS and D'Amico clinical risk scores, respectively. Meanwhile, the utility of ADC values in identifying high-grade prostate cancer (with Gleason 4 and/or 5 components in prostatectomy) in patients with a biopsy GS ≤ 3 + 3 = 6 was also evaluated. Results A significant negative correlation was found between mean ADC values of cancerous areas and the prostatectomy GS ( P < 0.001) and D'Amico clinical risk scores ( P < 0.001). No significant correlation was found between biopsy GS and prostatectomy GS ( P = 0.140) and D'Amico clinical risk scores ( P = 0.342). Patients harboring Gleason 4 and/or 5 components in prostatectomy had significantly lower ADC values than those harboring no Gleason 4 and/or 5 components ( P = 0.004). Conclusion The ADC values of cancerous areas in the prostate are a better indicator than the biopsy GS in predicting prostate cancer aggressiveness. Moreover, the use of ADC values can help identify the presence of high-grade tumor in patients with a Gleason score ≤ 3 + 3 = 6 during biopsy.

Assessment of Multipotent Mesenchymal Stromal Cells in Bone Marrow Aspirate From Human Calcaneus.

Bone marrow aspirates (BMAs), owing to their innate osteogenic potential, are well-documented supplements to osteoconductive and/or osteoinductive materials. The calcaneal body provides foot and ankle surgeons a convenient harvest site with low morbidity and minimal cost. In the present study, we sought to identify and characterize multipotent mesenchymal stromal cells (MSCs) in BMAs harvested from the human calcaneal body. Ten healthy patients aged 18 to 65 years were enrolled in the present study. BMAs were harvested from the patients without any reported postoperative complications related to the harvest. Cells isolated from all the aspirates were adherent to culture plates and expressed positive MSC surface markers (CD105, CD90, and CD73) and a low level of negative MSC markers (CD34 and CD45). The cells maintained the ability to proliferate and differentiate into cells of mesenchymal lineages. The BMAs from the human calcaneal body offer a healthy source of multipotent MSCs.

Identifying unknown by-products in drinking water using comprehensive two-dimensional gas chromatography-quadrupole mass spectrometry and in silico toxicity assessment.

Improvements in extraction and detection technologies have increased our abilities to identify new disinfection by-products (DBPs) over the last 40 years. However, most previous studies combined DBP identification and measurement efforts with toxicology to address concerns on a few expected DBPs, making it difficult to better define the health risk from the individual DBPs. In this study, a nontargeted screening method involving comprehensive two-dimensional gas chromatography-quadrupole mass spectrometry (GC × GC-qMS) combined with OECD QSAR Toolbox Ver. 3.2 was developed for identifying and prioritizing of volatile and semi-volatile DBPs in drinking water. The method was successfully applied to analyze DBPs formed during chlorination, chloramination or ozonation of the raw water. Over 500 compounds were tentatively identified in each sample, showing the superior performance of this analytical technique. A total of 170 volatile and semi-volatile DBPs representing fourteen chemical classes were then identified, according to the criteria that the DBP was presented in the duplicate treated samples. The genotoxicity and carcinogenicity of the DBPs were evaluated using Toolbox, and 58 DBPs were found to be actual or potential genotoxicants. The accuracy of the compound identification was determined by comparing 47 identified compounds with commercially available standards. About 90% (41 of the 47) of the compounds that were automatically identified using the library were correct. The results show that GC×GC-qMS coupled with a quantitative structure-activity relationship model is a powerful and fast nontargeted screening technique for compounds. The method and results provide us a new idea for identification and prioritization of DBPs.