[Source Appointment and Assessment of Heavy Metal Pollution in Surface Dust in the Main District Bus Stops of Tianshui City].

In this study, a PMF model was used to identify the sources and pollution level of heavy metals in the surface dust of a bus station. On the basis of the traditional heavy metal pollution evaluation methods, the Hakanson toxicity response coefficient was used to modify the traditional weight. The matter-element extension theory was introduced to reflect the toxicological properties and hazard degree of the heavy metals, and the matter-element extension model was established to evaluate the pollution level of heavy metals in the surface dust of the study area. The results were compared with Igeo, PN, and RI. ① Except for Co and V, the other heavy metals were higher than the Gansu soil background values by 1.29-9.30 times. The points of Cu and Pb exceeded the rate by 100%, and Cr, Ni, and As exceeded the rate by 96.15%, 94.23%, and 96.15%, respectively. ② PMF showed that source 1 was a natural source, and its contribution rate to V was 32.12%. Source 2 was natural-traffic pollution sources, contributing 51.50% and 33.37% to Cu and Co, respectively. Source 3 was a construction waste pollution source, with contribution rates of 45.06% and 44.70% for Cr and Ni, respectively, and source 4 was a coal-traffic mixed source, with contribution rates of 49.89% and 75.25% for As and Pb, respectively. ③ The matter-element evaluation results showed that the surface dust of the bus stops was mainly class IV (moderately polluted), and 13% of sample points were still clean, 37% were moderately polluted, and 25% were slightly and heavily polluted. The results of this method were quite different from the PN results and were more consistent with the RI results, indicating that its evaluation results were more sensitive and can be used for heavy metal pollution assessment.

Landscape, Socioeconomic, and Meteorological Risk Factors for Canine Leptospirosis in Urban Sydney (2017-2023): A Spatial and Temporal Study.

Leptospirosis is a potentially fatal zoonotic disease caused by infection with pathogenic Leptospira spp. We described reported clinical cases of canine leptospirosis in the council areas of the Inner West and the City of Sydney, Australia, from December 2017 to January 2023 and tested the association with urban spatial (landscape and socioeconomic factors, community seroprevalence, and urban heat island effect) and temporal (precipitation and minimum and maximum temperature) factors and the cases using log-transformed Poisson models, spatially stratified population-adjusted conditional logistic models, General Additive Models (GAMs), and Autoregressive Integrated Moving Average (ARIMA) models. The results suggested that canine leptospirosis is now endemic in the study area. A longer distance to the nearest veterinary hospital (RR 0.118, 95% CI -4.205--0.065, p < 0.05) and a mildly compromised Index of Economic Resources (IER) (RR 0.202, 95% CI -3.124--0.079, p < 0.05) were significant protective factors against leptospirosis. In areas proximal to the clinical cases and seropositive samples, the presence of tree cover was a strong risk factor for higher odds of canine leptospirosis (OR 5.80, 95% CI 1.12-30.11, p < 0.05). As the first study exploring risk factors associated with canine leptospirosis in urban Sydney, our findings indicate a potential transmission from urban green spaces and the possibility of higher exposure to Leptospira-or increased case detection and reporting-in areas adjacent to veterinary hospitals.

A new point to correlate the multi-dimensional assessment for the aging process of microfibers.

Fiber, the most prevalent plastic type, can be weathered and eroded easily in the natural environment. Although a variety of techniques have been applied to characterize the aging characteristics of plastics, a comprehensive understanding was critically essential to correlate the multi-dimensional assessment of the weathering process of microfibers and their environmental behavior. Therefore, in this study, microfibers were prepared from the face masks and Pb2+ was selected as a typical metal pollutant. The weathering process was simulated by xenon aging and chemical aging, and then subjected to Pb2+adsorption to examine the effect of weathering processes. The changes in fiber property and structure were detected by using various characterization techniques, with the development of several aging indices to quantify the changes. The two-dimensional Fourier transform infrared correlation spectroscopy analysis (2D-FTIR-COS) and Raman mapping were also performed to understand the order of changes in the surface functional groups of the fiber. The results showed that both aging processes altered the surface morphology, physicochemical properties, and polypropylene chain conformations of the microfibers, with stronger effect after chemical aging. The aging process also enhanced the affinity of microfiber to Pb2+. Moreover, the changes and correlation of the aging indices were analyzed, showing that the maximum adsorption capacity (Qmax) was positively related to carbonyl index (CI), oxygen-to-carbon atom (O/C) ratio and intensity ratio of the Raman peaks (I841/808), but negatively related to contact angle and the temperature at the maximum weight loss rate (Tm). The O/C ratio was more suitable to quantify the surface changes with lower aging degree while the CI value explained the chemical aging process better. Overall, this study discussed the weathering processes of microfibers based on a multi-dimensional investigation, and attempted to correlate the aging characteristics of the microfibers and their environmental behavior.

Primary Care Physicians' and Patients' Perspectives on Equity and Health Security of Infectious Disease Digital Surveillance.

PURPOSE: The coronavirus disease 2019 (COVID-19) pandemic facilitated the rapid development of digital detection surveillance (DDS) for outbreaks. This qualitative study examined how DDS for infectious diseases (ID) was perceived and experienced by primary care physicians and patients in order to highlight ethical considerations for promoting patients' autonomy and health care rights. METHODS: In-depth interviews were conducted with a purposefully selected group of 16 primary care physicians and 24 of their patients. The group was reflective of a range of ages, educational attainment, and clinical experiences from urban areas in northern and southern China. Interviews were audio recorded, transcribed, and translated. Two researchers coded data and organized it into themes. A third researcher reviewed 15% of the data and discussed findings with the other researchers to assure accuracy. RESULTS: Five themes were identified: ambiguity around the need for informed consent with usage of DDS; importance of autonomous decision making; potential for discrimination against vulnerable users of DDS for ID; risk of social inequity and disparate care outcomes; and authoritarian institutions' responsibility for maintaining health data security. The adoption of DDS meant some patients would be reluctant to go to the hospital for fear of either being discriminated against or forced into quarantine. Certain groups (older people and children) were thought to be vulnerable to DDS misappropriation. CONCLUSIONS: These findings indicate the paramount importance of establishing national and international ethical frameworks for DDS implementation. Frameworks should guide all aspects of ID surveillance, addressing privacy protection and health security, and underscored by principles of social equity and accountability.Annals "Online First" article.

Prediction and risk assessment of sepsis-associated encephalopathy in ICU based on interpretable machine learning.

Sepsis-associated encephalopathy (SAE) is a major complication of sepsis and is associated with high mortality and poor long-term prognosis. The purpose of this study is to develop interpretable machine learning models to predict the occurrence of SAE after ICU admission and implement the individual prediction and analysis. Patients with sepsis admitted to ICU were included. SAE was diagnosed as glasgow coma score (GCS) less than 15. Statistical analysis at baseline was performed between SAE and non-SAE. Six machine learning classifiers were employed to predict the occurrence of SAE, and the adjustment of model super parameters was performed by using Bayesian optimization method. Finally, the optimal algorithm was selected according to the prediction efficiency. In addition, professional physicians were invited to evaluate our model prediction results for further quantitative assessment of the model interpretability. The preliminary analysis of variance showed significant differences in the incidence of SAE among patients with pathogen infection. There were significant differences in physical indicators like respiratory rate, temperature, SpO2 and mean arterial pressure (P < 0.001). In addition, the laboratory results were also significantly different. The optimal classification model (XGBoost) indicated that the best risk factors (cut-off points) were creatinine (1.1 mg/dl), mean respiratory rate (18), pH (7.38), age (72), chlorine (101 mmol/L), sodium (138.5 k/ul), SAPSII score (23), platelet count (160), and phosphorus (2.4 and 5.0 mg/dL). The ranked features derived from the best model (AUC is 0.8837) were mechanical ventilation, duration of mechanical ventilation, phosphorus, SOFA score, and vasopressin usage. The SAE risk prediction model based on XGBoost created here can make very accurate predictions using simple indicators and support the visual explanation. The interpretable model was effectively evaluated by professional physicians and can help them predict the occurrence of SAE more intuitively.

Disposable and low-cost pen-like sensor incorporating nucleic-acid amplification based lateral-flow assay for at-home tests of communicable pathogens.

Rapid at-home test is a good alternative to the gold standard quantitative polymerase chain reaction (qPCR) for early identification and management of infected individuals in pandemic. However, the currently available at-home rapid antigen kits and nucleic acid tests (NATs) are prone to false results. Although some CRISPR-mediated NATs enhanced accuracy, long turnaround time (ca. 1 h) and aerosol contamination due to additional open-lid reaction hinder its applicability for self-tests. Moreover, the accuracy of at-home NATs is also impacted by interference of sample matrix due to lack of sample purification. Here we report a Fast, Low-cost, Aerosol contamination-free and Sensitive molecular assay for at-Home tests of communicable pathogens (FLASH) incorporating oLAMP, a recently reported isothermal and target-specific NATs by our group, and a visible lateral-flow readout. The integrated platform enabled sample-to-result SARS-CoV-2 RNA detection in 20-30 min achieving a sensitivity of 0.5 copies/µL in a blinded experiment with a high accuracy comparable with the qPCR. Its prototype consists of two disposable pen-like instruments for single-step sample preparation and contamination-free NATs, respectively. The simplified workflow of the FLASH enabled detection to be readily conducted by untrained users for at-home tests. All in all, the FLASH prototype demonstrates itself to be a promising home-use assay platform for effective mitigation of the pandemic.

[Pollution Characteristics and Risk Assessment of Polycyclic Aromatic Hydrocarbons in a Suburban Farmland Soil].

In order to assess the pollution of polycyclic aromatic hydrocarbons(PAHs) in a suburban farmland soil, 29 sampling sites were collected around Nanjing according to the grid method, and the contents of 15 different PAHs were determined. Acenaphthene(Ace) was not detected in any of the samples. The total content of PAHs in farmland soil ranged from 24.49 to 750.04 µg·kg-1, with an average of 226.64 µg·kg-1. The spatial distribution of high-ring PAHs, the main PAHs in the farmland soil, was similar to that of total PAHs. There was no significant correlation between PAHs and soil organic matter(SOM), pH, cation exchange capacity(CEC), and total nitrogen(TN), whereas bulk density and low ring PAHs were significantly correlated. The results of source apportionment show that the main source of PAHs in the farmland soil is a mixture of combustion and petroleum. The contamination severity index(CSI) index shows that the PAHs does not pose an ecological risk. The results of the health risk assessment show that there is no potential carcinogenic risk to children or adults, and the main sequence of exposure is skin contact>ingestion>inhalation.

[Geochemical Characteristics and Driving Factors of NO3-Type Groundwater in the Rapidly Urbanizing Pearl River Delta].

In response to rapid economic development, nitrate pollution of groundwater is becoming a serious issue in many parts of China. Urbanization and industrialization are the main drivers of NO3-type groundwater expansion. Focusing on the Pearl River Delta, the occurrence and driving factors of shallow nitrate groundwater are discussed. Overall, groundwater nitrate concentrations are generally high in this region. Of 1538 groundwater samples, 5.7% had nitrate concentrations higher than the groundwater quality standard(88.6 mg·L-1) and 18.5% were classified as NO3-type waters, which are mainly distributed in the hilly and piedmont areas. Guangzhou, Dongguan, Foshan, Zhuhai and other areas show high total dissolved solid(TDS)-concentration NO3-type waters, which are affected by urbanization and industrialization. In comparison, low-TDS NO3-type waters are distributed in the hilly and valley areas. In the Xijiang and Dongjiang plains, the TDS concentrations on groundwater increased significantly due to inputs of industrial wastewater and saline seawater. The NO3- concentration in the groundwater in this area exceeded the class III water standard but did not change the hydrochemical type classification. However, industrialization has led to the frequent appearance of SO4-type water in this area. The NO3-type water occurs in acidic or weakly acidic environments, typically characterized by low TDS and total hardness concentrations, and high Cl-, SO42-, and K+ concentrations. The formation of NO3-type water is mainly affected by domestic sewage, industrial wastewater, agricultural nitrogen fertilizer, septic tank outflows, and landfill leachate leakage. Generally, the pollution loads of high-TDS NO3-type waters are higher than low-TDS NO3-type waters. The delineation of NO3-type waters, especially the low-TDS type, is helpful for identifying groundwaters posing greater risks for human activities, and those with low nitrate concentrations but potential pollution risk, which is of great significance in the prevention and control of groundwater pollution.

Clinical assessment of prophylactic chemotherapy in treating with hydatidiform mole: A protocol for systematic review and meta-analysis.

BACKGROUND: Hydatidiform mole (HM) is more common as molar pregnancy. It is a disease classified under the category of gestational trophoblastic diseases, which could metastasize after originating in the placenta. A majority of females suffering from molar pregnancies are curable by evacuating retained products of conception and the patient's fertility is preserved. In some cases, the growth perseveres and leads to gestational trophoblastic neoplasia, which is an extremely malicious condition that needs chemo-based treatment. There is a possibility to lessen the risk of gestational trophoblastic disease in females with HM through the administration of prophylactic chemo. Yet, there is controversy regarding prophylactic chemotherapy administered pre-or-post removal of HM to curtail the malignant sequelae. Therefore, we will conduct this research to assess both the efficacy as well as security of using prophylactic chemotherapy to treat HM. METHODS: In the preliminary review, the authors will search for randomized controlled trials involving prophylactic chemotherapy to treat HM. The literature search is carried out in the following electronic databases from their inception to May 2021: Chinese National Knowledge Infrastructure, Chinese BioMedical Literature, and WanFang database are the three Chinese language databases. Web of Science, PubMed, Cochrane Library, and EMBASE are the four English language databases. The authors will also perform a manual search through the bibliographies in related literature to find extra articles and ongoing studies. Two independent authors will assess the literature according to an inclusion criteria, use a specialized data collection table to extract data, and use the Cochrane 'Risk of bias' tool for evaluating any possible bias risk in the selected articles. Data synthesis and statistical operations are completed with the RevMan software (v. 5.3). RESULTS: The present systematic analysis provides a rationalized synthesis of existing evidence related to the use of prophylactic chemotherapy in the treatment of HM. CONCLUSION: Our findings will summarize the current evidences for prophylactic chemotherapy in the treatment of HM. ETHICS AND DISSEMINATION: An ethics approval is nonrequired because pre published results will be used. REGISTRATION NUMBER: DOI 10.17605/OSF.IO/6QV52 (https://osf.io/6qv52/).

Quantitative assessment and determinants of the papillary microvasculature in healthy subjects.

BACKGROUND: It is critical to monitor the optic disc's vessel density using Optical coherence tomography angiography (OCTA) and evaluate its determinants. In the current study, we investigate the superficial vessel density (VD) of the papillary microvasculature and its determinants in healthy subjects of Southern China. METHODS: This was a prospective, cross-sectional study. Superficial VD in healthy individuals' optic disc region was measured by OCTA. The factors associated with ocular and systemic parameters were analyzed using a generalized estimation equation (GEE) model. RESULTS: A total of 510 eyes of 260 healthy subjects were analyzed in the study. The total VD in the optic disc area was 17.21 ± 2.15 mm- 1 (95% CI, 17.02-17.40 mm- 1). The VD in the inner ring and the outer ring of the optic disc were significantly higher compared with the central ring, while the VD of the superior quadrant and inferior quadrant was significantly higher compared with the temporal and nasal quadrant. After adjusting for the ocular factors and systemic factors, AL (ß = - 0.4917, P = 0.0003), disc area (ß = - 0.3748, P = 0.0143), CMT (ß = - 0.0183, P = 0.0003) and SSI (ß = 1.0588, P < 0.001) were significantly associated with total VD of the optic disc. CONCLUSION: The mean total VD in the optic disc area was 17.21 ± 2.15 mm- 1 in healthy subjects, and the superior and inferior VD was significantly higher than the temporal and nasal VD. AL, disc area, CMT, and SSI may affect the total VD in the optic disc area and should be considered in clinical practice.