Environmental hazard assessment and metal contamination in coastal sediments.

In order to reduce contamination levels from diverse sources, it is important to understand the factors affecting the natural ecosystems that are impacted by coastal and marine pollution. In this study, we used GIS and remote sensing techniques to investigate and evaluate the distribution of heavy metals (Fe, Mn, Zn, Cr, Pb, Co, and Cu) in surface sediments along Tamil Nadu's East Coast (from Besant Nagar to Sathurangapattinam). The CF and Igeo of metals indicate that sediments contain no evidence of Fe, Mn, or Zn metal pollution in the sediments, with only mild contamination from Co, Cu, and Pb. In contrast, the sediment samples were found to be significantly contaminated with Cr. Heavy metal contamination occurs in the following order, according to our research: Cr > Pb > Cu > Co > Mn > Zn > Fe. Except for sites 8, 10, 11, and 13, where PLI>1 implies that there is no pollution in this area, the PLI values show that most of the locations are contaminated. The ecological risk index (ERI) values for five metals in the study areas are as follows: Cr > Pb > Cu > Mn > Zn. The sediment samples fall into the low-risk and highly polluted to dangerous sediment categories for SPI, according to the Risk index (RI). Based on the Mean Effect Range-Median Quotient (M-ERM-Q), Cu, Pb, Zn, and Cr metals in the research region have a 9-21% probability of being harmful. Statistical approaches show that the majority of heavy metals in sediments are of natural origin. The spatial distribution of heavy metals in surface sediments provides the conceptual framework for practical strategies to protect coastal areas. Many shreds of evidence indicate that anthropogenic inputs from the surrounding land area are primarily responsible for the deposition of these heavy metals in the coastal zone.

Pollution, sources, and human health risk assessment of heavy metals in urban areas around industrialization and urbanization-Northwest China.

Heavy metal pollution in urban soils and dust is mostly caused by extensive anthropogenic activity during urbanization and industrialization. In this research study, the pollution characteristics, sources, ecological and human health risks of heavy metals in urban soil, and dust have been thoroughly evaluated. The research findings demonstrate that dust has a higher level of contamination than urban soil, such as Pb, Cu, and Zn metals are more contaminated in both urban soil and dust throughout the city, and Hg and As are also found in locations with a high concentration of heavy industrial companies. This implies that traffic emissions are still a significant source of metals in urban areas, though industrial companies also contribute. The health risk assessment model used to calculate human exposure revealed that the non-carcinogenic and carcinogenic risks of selected metals in soil and dust were generally in the low range, except for the carcinogenic risk from Cr in children. Statistical analysis revealed that Cr and Ni concentrations were mainly of natural origin, Cu and Zn have been sourced from traffic, whereas Pb, Hg, and As have been sourced from industrial activities. The overall recommendation is that the road traffic environment and municipal construction facilities need to be improved to ensure the sustainable development of the city's environment, while pollution from industrial waste is strongly controlled.

Potential Value of Presepsin Guidance in Shortening Antibiotic Therapy in Septic Patients: a Multicenter, Prospective Cohort Trial.

INTRODUCTION: Long-term use of antibiotics for septic patients leads to bacterial resistance, increased mortality, and hospital stay. In this study, we investigated an emerging biomarker presepsin-guided strategy, which can be used to evaluate the shortening of antibiotic treatment in patients with sepsis without risking a worse outcome. METHODS: In this multicenter prospective cohort trial, patients were assigned to the presepsin or control groups. In the presepsin group, antibiotics were ceased based on predefined cut-off ranges of presepsin concentrations. The control group stopped antibiotics according to international guidelines. The primary endpoints were the number of days without antibiotics within 28 days and mortality at 28 and 90 days. Secondary endpoints were the percentage of patients with a recurrent infection, length of stay in ICU and hospital, hospitalization costs, days of first episode of antibiotic treatment, percentage of antibiotic administration and multidrug-resistant bacteria, and SOFA score. RESULTS: Overall, 656 out of an initial 708 patients were eligible and assigned to the presepsin group (n = 327) or the control group (n = 329). Patients in the presepsin group had significantly more days without antibiotics than those in the control group (14.54 days [SD 9.01] vs. 11.01 days [SD 7.73]; P < 0.001). Mortality in the presepsin group showed no difference to that in the control group at days 28 (17.7% vs. 18.2%; P = 0.868) and 90 (19.9% vs. 19.5%; P = 0.891). Patients in the presepsin group had a significantly shorter mean length of stay in the hospital and lower hospitalization costs than control subjects. There were no differences in the rate of recurrent infection and multidrug-resistant bacteria and the SOFA score tendency between the two groups. CONCLUSIONS: Presepsin guidance has potential to shorten the duration of antibiotic treatment in patients with sepsis without risking worse outcomes of death, recurrent infection, and aggravation of organ failure. TRIAL REGISTRATION: ChiCTR, ChiCTR1900024391. Registered 9 July 2019-Retrospectively registered, http://www.chictr.org.cn.

[Accuracy of sequential organ failure assessment score in emergency department physicians in Beijing: a multicenter investigation study].

OBJECTIVE: To investigate the accuracy of sequential organ failure assessment (SOFA) scoring in emergency physicians in Beijing. METHODS: Emergency physicians from 8 hospitals in Beijing in January 2018 were demanded to complete a SOFA questionnaire which was developed on "wenjuanxing" website and submit via cell phone. All participants were divided into urban center group (UC group) and no-urban center group (NUC group) based on the hospital's location. The accuracy rate of components and total score of SOFA along with the mistakes were evaluated, and the results of the two groups were compared. RESULTS: (1) The questionnaire was sent to 217 emergency physicians of the 8 hospitals, and 197 qualified questionnaires were received with 109 of NUC group and 88 of UC group, respectively, the total response rate was 90.8%. Compared with those from NUC group, UC physicians had older ages [years: 37 (32, 42) vs. 34 (29, 40), Z = -2.554, P = 0.011] and higher education level [postgraduate degree 76.1% (67/88) vs. 40.4% (44/109), χ2 = 25.327, P < 0.001], and more of them experienced SOFA scoring [62.5% (55/88) vs. 45.9% (50/109), χ2 = 5.409, P = 0.020]. Other baseline characteristics such as gender, working years, professional title and training experience were not different between the two groups. (2) The accuracy rate of total SOFA score was 62.4% (123/197) in the whole cohort, and UC group was lower than that of NUC group, but the difference was not significant [56.8% (50/88) vs. 67.0% (73/109), χ2 = 2.141, P = 0.143]. While comparing the accuracy of individual variable/system of SOFA, the accuracy rate of norepinephrine of UC group was much higher than NUC group [80.7% (71/88) vs. 66.1% (72/109), χ2 = 5.235, P = 0.022], but the accuracy of Glasgow coma scale (GCS) was much lower in NUC group [38.6% (27/70) vs. 81.6% (71/87), χ2 = 30.629, P < 0.001]. Other variables of SOFA were not different between the two groups. Based upon the results of all submitted questionnaires, 566 mistakes were identified. It was indicated that the mistakes per capital was 2.9 in the whole cohort and in the two groups. The first type mistakes which caused by carelessness (including calculating error, filling error, choosing error) were 233 times. The calculating error in norepinephrine from NUC physicians was higher than the UC group [33.9% (37/109) vs. 19.3% (17/88), χ2 = 5.235, P = 0.022], there was no significant difference in any other first type mistakes between the two groups. The total second type mistakes caused by misunderstanding of SOFA (including using wrong variables, not using the worst value within 24 hours, and incorrect GCS score) were 333 times in the whole cohort. GCS error [61.8% (42/88) vs. 16.9% (14/109), χ2 = 32.292, P < 0.001], and using urine output per hour instead of urine output per 24 hours [15.9% (14/88) vs. 4.6% (5/109), χ2 = 7.162, P = 0.007] were much higher in UC group than NUC group. CONCLUSIONS: The total accuracy of SOFA scoring in the investigated emergency physicians of 8 hospitals in Beijing was not good. Mistakes causing by carelessness or misunderstanding of score rules were similar. It is necessary to apply strict training in SOFA scoring.