Real-World Cost of Nasal Polyps Surgery and Risk of Major Complications in the United States: A Descriptive Retrospective Database Analysis.

Background: Endoscopic nasal polyp (NP) surgery is a treatment option for patients with chronic rhinosinusitis with nasal polyps (CRSwNP). Previous studies report NP surgery costs of $8000-13,000 and risk of major complications of NP surgery of ~0.1-1%. Limited contemporary data for costs and complications associated with NP surgery in US clinical practice are available. Methods: IQVIA PharMetrics Plus claims data were used to identify patients with NP surgery in 2019 with ≥3 years continuous baseline health-plan enrollment prior to index date (date of first eligible NP surgery) and ≥30 days continuous enrollment after index (follow-up). In this descriptive analysis, total costs of NP surgery were estimated as all medical costs on the index date (or during the entire hospital stay for patients who received surgery in the inpatient setting). Total medical costs (all-cause) were estimated for all medical services occurring from the index date to the index date +9 or +29 days (10-day and 30-day). Major complication was defined as cerebrospinal fluid (CSF) leak, orbital injury, or major hemorrhage within 30 days of index. Results: Of 6311 patients, median age was 46 years (interquartile range: 34-56); 59.7% were male; 88.2% had no NP surgery in the prior 3 years; 63.7% had allergic rhinitis, and 37.1% had asthma. Mean (SD) total medical cost of surgery was $14,697 (11,679) and mean (SD) 10-day total medical cost was $15,401 (11,968). Major complications occurred in 102 (1.7%) patients. Total medical costs and 10-day costs were higher in patients with major complications than those without ($23,605 [19,264] vs $15,251 [11,741]). Conclusion: In this descriptive analysis, NP surgery costs and rates of major surgical complications were updated using recent real-world data in the US. Results indicated that NP surgery complication rates were numerically higher than previously reported.

Incorporating in vitro bioaccessibility into human health risk assessment of heavy metals and metalloid (As) in soil and pak choi (Brassica chinensis L.) from greenhouse vegetable production fields in a megacity in Northwest China.

The rapid development of greenhouse vegetable production (GVP) in densely populated areas may cause the heavy metal/metalloid accumulation in soil and pose a threat to human health. In this study, 180 pairs of topsoil and pak choi (Brassica chinensis L.) samples were collected from GVP fields in Xi'an city in Northwest China to analyze health risks of Cd, Cr, Pb, and As in soil and pak choi combining in vitro bioaccessibility investigation. The results showed that Cd and Cr were common pollutants in both soil and pak choi. In the soil-pak choi system, the indexes of non-carcinogenic and carcinogenic risk for adults and children were 1.53, 2.68, and 1.37 × 10-4, 8.14 × 10-5, respectively, thereby indicating the presence of heavy metal/metalloid health risks for both groups. Based on the results, procedures to mitigate heavy metal/metalloid contamination risks should be discussed more during the development of GVP in the largest city in Northwest China.

Design, synthesis and biological assessment of novel CDK4 inhibitor with potent anticancer activity.

Efforts toward finding potent CDK4 inhibitor for cancer therapy, a series of fluorine substituted pyrrolo[2,3-d]pyrimidine derivatives were designed, synthesized, and evaluated. Among them, the optimal lead compound 18i was discovered with potent activity against CDK4 at the nanomolar level (IC50 = 2.5 nM) and exquisite selectivity which demonstrated only modest activity against 3 out of the 394 protein kinases. 18i exhibited a much greater in vitro antiproliferative activity against several human cancer cell lines than that of the approved drug ribociclib. Further mechanism studies revealed that 18i effectively stimulated cancer cell cycle arrest in G1 phase and induced tumor cell apoptosis. In the comparison of in vivo therapeutic effects in xenograft mouse models of breast cancer, oral administration of 18i showed a significantly better degree of inhibitory effect to ribociclib without obvious toxicity. All of the results indicated that 18i could be a promising CDK4 inhibitor for treating malignancies.

Cd, Cu, and Zn Accumulations Caused by Long-Term Fertilization in Greenhouse Soils and Their Potential Risk Assessment.

The intense management practices in greenhouse production may lead to heavy metal (HM) accumulations in soils. To determine the accumulation characteristics of HM and to evaluate possible HM sources in greenhouse soils, thirty typical greenhouse soil samples were collected in Shouguang District, Shandong Province, China. The results indicate that the Cd, Cu, and Zn concentrations are, respectively, 164.8%, 78.6%, and 123.9% higher than their background values. In the study area, Cd exhibits certain characteristics, such as wide variations in the proportion of its exchangeable form and the highest mobility factor and geo-accumulation index, which are indicative of its high bioavailability and environmental risk. In addition, there is a significant positive correlation between pairs of Cd, P, soil organic carbon, and cultivation age. Combined with principal component analysis, the results indicate the clear effects that agricultural activities have on Cd, Cu, and Zn accumulation. However, Cr, Ni, and Pb have a significant correlation with soil Fe and Al (hydr)-oxides, which indicates that these metals mainly originate from parent materials. This research indicated that long-term intensive fertilization (especially the application of chemical fertilizers and livestock manure) leads to Cd, Cu, and Zn accumulation in greenhouse soils in Shouguang. And the time required to reach the maximum permeable limit in agricultural soils for Cd, Cu, and Zn is 23, 51, and 42 years, respectively, based on their current increasing rates.

Bioelectrochemical removal of tetracycline from four typical soils in China: A performance assessment.

Exposure to tetracycline in soil causes microbial mutations. Soil microbial fuel cells (MFCs) can promote the degradation efficiency of contaminants while generating bioelectricity under anaerobic conditions. MFC performance varies amongst different types of soils due to distinctive soil properties. This study assesses the performance of soil MFCs filled with four typical Chinese soils and explores key factors regulating bioelectricity generation and tetracycline degradation. Except for the MFCs filled with black soil, tetracycline degradation rates improved in soil MFCs, particularly in those filled with Chao soil, which enhanced the degradation rate by 39% relative to the corresponding control. Additionally, soil MFCs filled with Chao soil exhibited the highest charge output of 1347 ±â€¯357C, which was 100-499% higher than that of MFCs with other soils. According to redundancy analysis, soil particle size, pH, conductivity and dissolved organic carbon content showed positive association with tetracycline degradation and charge output, while the adsorption of tetracycline had a negative association with degradation rate. Thus, the adsorption of tetracycline restricted its removal efficiency in soil MFCs, and high soil conductivity and large particle size promoted electron transfer, enhancing biocurrent intensity, which increased tetracycline degradation efficiency.

Comparisons of heavy metal input inventory in agricultural soils in North and South China: A review.

A national-scale inventory of heavy metal inputs is essential to understand the current situation of contribution and spatial heterogeneity of heavy metal sources in China. Published literatures from 2008 to 2018 about heavy metal inputs from various pollution sources (atmospheric deposition, livestock manures, fertilizers, and sewage irrigation) to agricultural soils were collected. In the past ten years, atmospheric deposition was the main pollution source which was responsible for 50-93% of the total As, Cd, Cr, Hg, Ni, and Pb inputs, with livestock manures contributed to approximately 76% of total Cu inputs. However, due to industrial structure, geographical condition and the characteristics of economic development, the contribution of different sources to heavy metal pollution varies in different regions. For example, atmospheric deposition was the most important contributor in North China with its highly developed heavy industry and more coal combustion, while the contribution of livestock manures was obviously higher in South China due to its flourishing agricultural production and animal husbandry. Based on the analysis for clarifying the major pollution sources of five typical heavy metals (namely Cd, As, Hg, Cu and Pb), the controlling measures are suggested to make more effective and targeted strategies to protect agricultural soils in the future.

Single-step affinity and cost-effective purification of recombinant proteins using the Sepharose-binding lectin-tag from the mushroom Laetiporus sulphureus as fusion partner.

Previous research showed that a lectin from the mushroom Laetiporus sulphureus, designed LSL, bound to Sepharose and could be eluted by lactose. In this study, by taking advantage of the strong affinity of LSL-tag for Sepharose, we developed a single-step purification method for LSL-tagged fusion proteins. We utilized unmodified Sepharose-4B as a specific adsorbent and 0.2 M lactose solution as an elution buffer. Fusion proteins of LSL-tag and porcine circovirus capsid protein, designated LSL-Cap was recovered with purity of 90 ± 4%, and yield of 87 ± 3% from crude extract of recombinant Escherichia coli. To enable the remove of LSL-tag, tobacco etch virus (TEV) protease recognition sequence was placed downstream of LSL-tag in the expression vector, and LSL-tagged TEV protease, designated LSL-TEV, was also expressed in E. coli., and was recovered with purity of 82 ± 5%, and yield of 85 ± 2% from crude extract of recombinant E. coli. After digestion of LSL-tagged recombinant proteins with LSL-TEV, the LSL tag and LSL-TEV can be easily removed by passing the digested products through the Sepharose column. It is of worthy noting that the Sepharose can be reused after washing with PBS. The LSL affinity purification method enables rapid and inexpensive purification of LSL-tagged fusion proteins and scale-up production of native proteins.

Analysis of the seismic performance of isolated buildings according to life-cycle cost.

This paper proposes an indicator of seismic performance based on life-cycle cost of a building. It is expressed as a ratio of lifetime damage loss to life-cycle cost and determines the seismic performance of isolated buildings. Major factors are considered, including uncertainty in hazard demand and structural capacity, initial costs, and expected loss during earthquakes. Thus, a high indicator value indicates poor building seismic performance. Moreover, random vibration analysis is conducted to measure structural reliability and evaluate the expected loss and life-cycle cost of isolated buildings. The expected loss of an actual, seven-story isolated hospital building is only 37% of that of a fixed-base building. Furthermore, the indicator of the structural seismic performance of the isolated building is much lower in value than that of the structural seismic performance of the fixed-base building. Therefore, isolated buildings are safer and less risky than fixed-base buildings. The indicator based on life-cycle cost assists owners and engineers in making investment decisions in consideration of structural design, construction, and expected loss. It also helps optimize the balance between building reliability and building investment.

Assessment of organochlorine pesticide contamination in relation to soil properties in the Pearl River Delta, China.

High levels of organochlorine pesticides (OCPs) such as hexachlorocyclohexanes (HCHs) and dichlorodiphenyltrichloroethanes (DDTs) have been found in soil of the Pearl River Delta (PRD), attributable to high pesticide application in this area. Consequently, the occurrence and environmental effect of HCHs and DDTs in the PRD have attracted considerable attention. However, study focusing on the influence of potential factors such as soil property on the environmental fate of HCHs and DDTs in the PRD has been rare. The present study aimed to investigate the impact of soil physiochemical properties on the distribution patterns and fate of soil HCHs and DDTs on a large spatial scale. Levels of HCHs (sum of α-, ß-, γ- and δ-HCH) and DDTs (sum of 1,1,1-trichloro-2,2-bis-(p-chlorophenyl)ethane (p,p'-DDT), 1,1-dichloro-2,2-bis-(p-chlorophenyl)ethane (p,p'-DDD), and 1,1-dichloro-2,2-bis-(p-chlorophenyl)ethylene (p,p'-DDE)) in 151 soil samples covering all areas of the PRD and physiochemical parameters related to soil properties including pH, total organic carbon (TOC), total Fe (TFe), DCB-Fe (DFe), amorphous-Fe (AFe), complexed-Fe (CFe), total Mn (TMn), DCB-Mn (DMn), amorphous-Mn (AMn), complexed-Mn (CMn) and cation exchange capacity (CEC) were determined. The residual levels of HCHs and DDTs in soils of the present study, which are mainly controlled by soil TOC and CFe content and varying spatially with land use types, may potentially pose ecological risk to plants and animals. On the other hand, transformation of soil HCHs may be affected by pH and DDT transformation correlated significantly with AFe and CFe. Currently, soil has become an important secondary source of OCPs and the re-emission potential of OCPs in soil was mainly affected by soil OCP concentrations and land use types.

Pollution assessment, distribution and sources of PAHs in agricultural soils of Pearl River Delta--the biggest manufacturing Base in China.

A large scale of soil survey was performed to determine the contents, distributions and sources of 16 polycyclic aromatic hydrocarbons (PAHs) in 231 agricultural soils under 3 land-use types from 5 regions of the subtropical Pearl River Delta (PRD). The average sum of 16 PAHs in all soil samples is 316.5 micro g.kg(-1), with range from ND to 4079 micro g.kg(-1). Three- and 4-ring PAHs are the most abundant PAHs that contribute to 73.0% of total contents. The most abundant components are phenanthrene, benzo(b)fluoranthene and fluoranthene. ANOVA and principal component analyses (PCA) indicate that soil samples from Dongguan and Zhongshan contain greater PAHs than other regions. More abundant carcinogenic and higher molecular weight PAHs accumulated in soils from Dongguan and Zhongshan, while higher low molecular weight PAHs were in soils from Guanghzou, Huizhou and Shunde. Soil PAHs from 3 land uses are not statistically different. Additionally, 5 PAH compound ratios suggest that soil PAHs in PRD derived from mixture of pyrogenic and petrogenic sources, but the majorities are pyrogenic sources. PAHs were further identified as mixture of petroleum combustion and grass, wood, and coal combustion. Some soil PAHs were revealed vehicle emission, coal soot and petroleum sources. The 5 regions showed different PAHs sources according to some compound ratios, but no marked distinction between regions from 2 banks of the Pearl River because of major wind direction, distribution of riverway and industry.