Supply chain in transition navigating economic growth and environmental sustainability through education.

The growing interest in the Management of Eco-Friendly Supply Chains warrants this study. Green supply chain management (GSCM) is an approach to supply chain management (SCM) that takes into account environmental factors. Therefore, GSCM is vital in shaping the cumulative environmental effect of businesses engaged in supply chain operations. In addition, GSCM may help improve the effectiveness of sustainability initiatives. Manufacturing companies, particularly in developing nations like India, are trying to adjust essential procedures and supply chains because of the rising need to be ecologically sustainable. However, such efforts must be deployed strategically to be ecologically sustainable and economically successful. As a result, this study focuses on the relationship between green supply chain management and education that affect environmental sustainability and economic performance. As a further step toward more sustainable development, the mediating function of education is sustainable economic growth and environmental health. The data was collected by distributing a well-crafted questionnaire to manufacturing facilities in India. We employed PLS-SEM to analyze and interpret the data test hypotheses based on data from 415 replies. The findings point to cost and profit as the primary metrics of corporate success. Disposal of trash, usage of resources, and release of greenhouse gases are alternative measures of environmental sustainability. Distributed online links and in-person interviews with employees at companies throughout India who use GSCM procedures provided the basis for the study's primary data set. The data was gathered with the use of an organized survey form. The findings of tests conducted on the hypotheses were considered. According to this research, cost, profit, waste, resource, and GHG emission impacts vary depending on which GSCM techniques are implemented. Green supply chain management strategies significantly affect price, trash disposal, resource utilization, and GHG emissions. There was no discernible trend between GSCM methods and financial success. In addition to discussing the unique elements of sustainable supply chains and the limits of current research, this article also discusses how a company's bottom line will benefit monetarily from establishing a sustainable supply chain. This should inspire more study in this area. Our investigation revealed patterns and voids, and we used that information to outline a thorough plan for future GSCM studies. The research helps manufacturing company management improve their sustainable policies while providing policymakers with pointers.

Using Explainable AI to Cross-Validate Socio-economic Disparities Among Covid-19 Patient Mortality.

This paper applies eXplainable Artificial Intelligence (XAI) methods to investigate the socioeconomic disparities in COVID-19 patient mortality. An Extreme Gradient Boosting (XGBoost) prediction model is built based on a de-identified Austin area hospital dataset to predict the mortality of COVID-19 patients. We apply two XAI methods, Shapley Additive exPlanations (SHAP) and Locally Interpretable Model Agnostic Explanations (LIME), to compare the global and local interpretation of feature importance. This paper demonstrates the advantages of using XAI which shows the feature importance and decisive capability. Furthermore, we use the XAI methods to cross-validate their interpretations for individual patients. The XAI models reveal that Medicare financial class, older age, and gender have high impact on the mortality prediction. We find that LIME's local interpretation does not show significant differences in feature importance comparing to SHAP, which suggests pattern confirmation. This paper demonstrates the importance of XAI methods in cross-validation of feature attributions.

[Effects of different long-term fertilization patterns on net carbon sink effect and economic benefits in double cropping rice paddy ecosystem in southern China]. / 长期不同施肥模式对南方双季稻田生态系统净碳汇效应和经济收益的影响.

There is close relationship between fertilizer managements and net carbon (C) sink effect, economic benefits in rice paddy ecosystem. Based on a long-term (35-year) field experiment, we analyzed the effects of different fertilization patterns on soil C sequestration rate, C density of topsoil, annual C balance, and economic benefits in the double cropping rice paddy in southern China. There were four fertilization treatments, chemical fertilizer alone (MF), rice straw and chemical fertilizer (RF), 30% organic manure and 70% chemical fertilizer (OM), and without any fertilizer input as a control (CK). The results showed that soil C pool in the double cropping rice paddy field under different fertilization treatments changed from 216.02 to 866.74 kg·hm-2·a-1, and soil C pool under OM treatment were significantly higher than that of MF, RF and CK. The soil C sequestration rates in the double cropping rice paddy field under different fertilization treatments ranged from 51.5 to 650.7 kg·hm-2·a-1, and that of C density of topsoil was from 55.64 to 78.42 t·hm-2. The order of soil C sequestration rates and C density of topsoil was OM>RF>MF>CK. The change range of C adsorption in the double cropping rice paddy field ecosystem was from 4.42 to 9.32 t C·hm-2·a-1, with an order of OM>RF>MF>CK. Compared with the MF treatment, soil net C sink under OM and RF treatments increased by 27.6% and 13.6%, respectively. The change range of C cost material input ranged from 1.49 to 2.17 t C·hm-2·a-1, and that of annual economic benefits was from 1.30×103 to 7.83×103 yuan·hm-2·a-1 with an order of RF>OM>MF>CK. The net income of economic benefits of OM, RF and MF treatments were significantly higher than that of CK. Generally, soil C sequestration rate, C sink effect and annual economic benefits were increased by the long-term application of organic manure and rice straw returning together with chemical fertilizer, which could increase soil organic carbon storage in the double cropping rice paddy field of southern China.

Methylparaben as a preservative in the development of a multi-dose HPV-2 vaccine.

The human papillomavirus (HPV) vaccine is the simplest, most economical, convenient, and effective method of preventing cervical cancer. However, the current HPV vaccine is supplied as a single-dose vial with a relatively high cost per dose, which hinders its supply to low- and middle-income countries (LMICs), where the demand for HPV vaccine is highest. Therefore, it is necessary to develop a multi-dose HPV vaccine to promote large-scale affordable vaccination in LMICs. Moreover, the addition of preservatives is required to reduce the risk of microbial contamination in multi-dose vaccines within a single vial. In this study, we investigated the effects of six preservatives on HPV 16L1 and 18L1 virus-like particles in solution, as well as the aluminum adsorption status, under normal and high-temperature conditions. Multiple methods were employed, including dynamic light scattering, differential scanning calorimetry, an in vitro relative potency assay, and an in vivo potency assay in mice. Based on the above results, four types of selected preservatives were further studied, and an antimicrobial effectiveness test was performed on the HPV-2 vaccine, which was employed as a model HPV vaccine. Finally, three preservatives were selected based on their performance to evaluate the long-term stability of the HPV-2 vaccine. The results indicated that 0.12% methylparaben is the most suitable preservative for the multi-dose HPV-2 vaccine, guaranteeing the shelf life for at least three years and meeting "B" standards for antimicrobial effectiveness. The formula developed in this study can contribute toward combating cervical cancer in LMICs.

Immunological Risk Assessment of Xenogeneic Dural Patch by Comparing with Raw Material via GTKO Mice.

OBJECTIVE: In this study, α-Gal epitope-deficient (GGTA1 knockout (GTKO)) mice were used to assess the immunological risks of xenogeneic dural patch by comparing with raw material. METHODS: The xenogeneic dural patch (T2) was prepared from bovine pericardium (T1, raw material) through decellularization and carboxymethyl chitosan (CMCS) coating. Transmission electron microscopy (TEM) and scanning electron microscopy (SEM) were used to characterize the collagen fibers and surface microstructural changes in the T1 and T2 samples. The remnant α-Gal epitopes and DNA of implants were detected by standardized method. T1 and T2 were implanted subcutaneously into GTKO mice for 4 and 12 weeks, respectively, and the negative control group (Con) was only performed sham operation. The total serum antibody, anti-Gal antibody, and splenic lymphocyte subtypes were analyzed by ELISA or flow cytometry, and histological analysis of implant-tissue was performed by H&E and Masson stain. RESULTS: TEM and Sirius red staining showed that the collagen fibers in the dural patch were closely arranged, and SEM showed that a loose three-dimensional structure was successfully constructed on the surface of the dural patch after CMCS coating. The remnant DNA in T2 was 24.64 ± 8.73 ng/mg (dry weight), and clearance of α-Gal epitope was up to 99.83% compared to T1. The significant increases in serum total IgM, anti-Gal IgG, and anti-Gal IgM at 4 weeks and the significant changes in anti-Gal IgG and spleen lymphocyte at 12 weeks were observed in the T1 group, but no significant change was observed in the T2 group, compared to the control group. Histological semiquantitative analysis showed severe cell and tissue responses at 4 weeks and a moderate response at 12 weeks in the T1 group, while a moderate response at 4 weeks and a slight response at 12 weeks in the T2 group. CONCLUSIONS: The results demonstrated that the xenogeneic dural patch has a lower and acceptable immunological risk compared to the raw material and control, respectively. On the other hand, it was suggested that GTKO mice are useful experimental model for immunological risk assessment of animal tissue-derived biomaterials.

[Ultrasound assessment of gastric insufflation in obese patients receiving transnasal humidified rapid-insufflation ventilatory exchange during general anesthesia induction].

OBJECTIVE: To assess the effect of transnasal humidified rapid-insufflation ventilatory exchange (THRIVE) on gastric insufflation during general anesthesia induction in obese patients. METHODS: Ninety obese patients (BMI 30-39.9 kg/m2) undergoing laparoscopic cholecystectomy under general anesthesia were randomized into 3 groups (n=30) to receive facemask pre- oxygenation followed by face mask ventilation (FMV) after administration of anesthetics (Group M), oxygenation with THRIVE (Group T), or pre-oxygenation with facemask combined with THRIVE followed continuous oxygenation with both FMV and THRIVE after administration of anesthetics (Group M+T). The patients in the latter two groups received continuous oxygen via THRIVE during tracheal intubation. All the patients received real-time ultrasound monitoring of the gastric antrum, and positive gastric insufflation (GI+) was defined by the presence of comet-tail artifacts. The cross-sectional area of the gastic antrum (CSA-GA) was measured by ultrasound before and after pre-oxygenation and after intubation. The patients' SpO2, PaO2, and PaCO2 at admission (T1), 5 min after pre-oxygenation (T2), 5 min after medication (T3), and immediately after intubation (T4) were recorded, and the incidence of postoperative adverse events was assessed. RESULTS: The incidence of gastric insufflation was significantly higher in Group M and Group M+T than in Group T (P < 0.05). The CSA-GA was significantly greater at T4 than at T1 in Group M and Group M+T and in their GI+s ubgroups. The GI+ subgroups in Group M and Group M+ T had significantly larger CSA-GA at T4 than the GI- subgroups (P < 0.05). CSA-GA did not vary significantly during anesthesia induction in Group T (P>0.05). The incidence of grade Ⅰ gastric distension was lower but grade Ⅱ gastric distention was higher in Group M and Group M+T than in Group T (P < 0.05). Group M showed significantly greater variations of PaO2 at T3 and T4 than Group T and Group M+T (P < 0.05). CONCLUSIONS: Ultrasound monitoring of the comet tail sign and the changes of CSA-GA in the gastric antrum is feasible and reliable for detecting gastrointestinal airflow, and in obese patients, the application of THRIVE for induction of anesthesia can ensure the oxygenation level without further increasing gastric insufflation.

An Ovarian Reserve Assessment Model Based on Anti-Müllerian Hormone Levels, Follicle-Stimulating Hormone Levels, and Age: Retrospective Cohort Study.

BACKGROUND: Previously, we reported a model for assessing ovarian reserves using 4 predictors: anti-Müllerian hormone (AMH) level, antral follicle count (AFC), follicle-stimulating hormone (FSH) level, and female age. This model is referred as the AAFA (anti-Müllerian hormone level-antral follicle count-follicle-stimulating hormone level-age) model. OBJECTIVE: This study aims to explore the possibility of establishing a model for predicting ovarian reserves using only 3 factors: AMH level, FSH level, and age. The proposed model is referred to as the AFA (anti-Müllerian hormone level-follicle-stimulating hormone level-age) model. METHODS: Oocytes from ovarian cycles stimulated by gonadotropin-releasing hormone antagonist were collected retrospectively at our reproductive center. Poor ovarian response (<5 oocytes retrieved) was defined as an outcome variable. The AFA model was built using a multivariable logistic regression analysis on data from 2017; data from 2018 were used to validate the performance of AFA model. Measurements of the area under the curve (AUC), sensitivity, specificity, positive predictive value, and negative predicative value were used to evaluate the performance of the model. To rank the ovarian reserves of the whole population, we ranked the subgroups according to the predicted probability of poor ovarian response and further divided the 60 subgroups into 4 clusters, A-D, according to cut-off values consistent with the AAFA model. RESULTS: The AUCs of the AFA and AAFA models were similar for the same validation set, with values of 0.853 (95% CI 0.841-0.865) and 0.850 (95% CI 0.838-0.862), respectively. We further ranked the ovarian reserves according to their predicted probability of poor ovarian response, which was calculated using our AFA model. The actual incidences of poor ovarian response in groups from A-D in the AFA model were 0.037 (95% CI 0.029-0.046), 0.128 (95% CI 0.099-0.165), 0.294 (95% CI 0.250-0.341), and 0.624 (95% CI 0.577-0.669), respectively. The order of ovarian reserve from adequate to poor followed the order from A to D. The clinical pregnancy rate, live-birth rate, and specific differences in groups A-D were similar when predicted using the AFA and AAFA models. CONCLUSIONS: This AFA model for assessing the true ovarian reserve was more convenient, cost-effective, and objective than our original AAFA model.

A novel mathematical model of true ovarian reserve assessment based on predicted probability of poor ovarian response: a retrospective cohort study.

PURPOSE: To establish a mathematical model for assessing the true ovarian reserve based on the predicted probability of poor ovarian response (POR). METHODS: In this retrospective cohort study, a total of 1523 GnRH-antagonist cycles in 2017 were firstly analyzed. The ovarian responses were calculated based on the number of retrieved oocytes. The continuous variables were converted into categorical variables according to cutoff values generated by the decision tree method. The optimal model was identified using forward stepwise multiple logistic regression with 5-fold cross-validation and further verified its performances using outer validation data. RESULTS: The predictors in our model were anti-Müllerian hormone (AMH), antral follicle counts (AFC), basal follicle-stimulating hormone (FSH), and age, in order of their significance, named AAFA model. The AUC, sensitivity, specificity, positive predictive value, and negative predictive value of AAFA model in inner validation and outer validation data were 0.861 and 0.850, 0.603 and 0.519, 0.917 and 0.930, 0.655 and 0.570, and 0.899 and 0.915. Ovarian reserve of 16 subgroups was further ranked according to the predicted probability of POR and further divided into 4 groups of A-D using clustering analysis. The incidence of POR in the four groups was 0.038 (0.030-0.046), 0.139 (0.101-0.177), 0.362 (0.308-0.415), and 0.571 (0.525-0.616), respectively. The order of ovarian reserve from adequate to poor followed the order of A to D. CONCLUSION: We have established an easy applicable AAFA model for assessing true ovarian reserve and may have important implications in both infertile women and general reproductive women in Chinese or Asian population.

Integrated fate assessment of aromatic amines in aerobic sewage treatment plants.

The fate and exposure of chemicals in sewage treatment plants (STPs) are major considerations in risk assessment and environmental regulation. The biodegradability and removal of seven aromatic amines were systematically evaluated using a three-tiered integrated method: a standard ready biodegradability test, an aerobic sewage treatment simulation method, and model prediction. In tier 1, the seven aromatic amines were not readily biodegraded after 28 days. In adapted aerobic active sludge, 4-isopropyl aniline, 2,4-diaminotoluene, and 4-nitroaniline among them exhibited the degradation half-life time less than 20 h, the other four aromatic amines exhibited persistent with degradation half-life of > 60 h. In tier 2 of the aerobic sewage treatment simulation testing, 2,4-diaminotoluene, 4-nitroaniline, and 4-isopropylaniline demonstrated moderately to high overall removal. Hydraulic retention time (HRT) affects the removal with the optimum HRT was determined to be 12 h to 24. 2,6-Dimethyl aniline, 2-chloro-4-nitroaniline, 2,6-diethylaniline, and 3,4-dichloroaniline were not removed during the test, indicting these four aromatic amines will enter surface water and hence pose a potential risk to aquatic ecology. Considering the lack of an STP model in China for regulation purposes, in tier 3, we developed a Chinese STP (aerobic) (abbreviated as C-STP(O)) model that reflects a universal scenario for China to predict the fate. The predicted degradation, volatilization, and absorption showed a close relationship to the physicochemical properties of the chemicals, and had same tendency with tier 2 simulation test. The prediction showed that biodegradation rather than absorption or volatilization was the main removal process of aromatic amines in aerobic STP. With the combination of modified kinetics test with C-STP (O) model, the chemical fate can be more accurately predicted than using only the readily biodegradation result.

[Psychometric Evaluation of the Union Physio-Psycho-Social Assessment Questionnaire].

Objective To validate the Union Physio-Psycho-Social Assessment Questionnaire(UPPSAQ-70)and test its validity and reliability.Methods From April,2013 to July,2018,patients were asked to finish the computer evaluation of UPPSAQ-70 and Symptom Checklist 90(SCL-90)in Peking Union Medical College Hospital(PUMCH).Confirmatory factor analysis(CFA)was conducted on the SPSS 17.0,and the number of fixed factors was 8 factors and 3 factors.Amos 23.0 was used to verify the original 8-factor model,8-factor revision model,3-factor model,3-factor revision model,and single-factor model.Each factor of SCL-90 was used as the calibration standard to calculate the correlation coefficient between factors.The retest reliability was tested by the outpatients in PUMCH in July,2018.Results Exploratory factor analysis indicated that the 8-factor revised model included:depression,anxiety and fatigue,sleep,physical discomfort,sexual function,happiness and satisfaction,hypochondria,and social anxiety.The 3 factors revised model included that:psychological,physiological and social dimension.Confirmatory factor analysis indicated that the 8-factor modified model was superior to the 3-factor model and the single-factor model: χ 2=10 410.4,df=1862,RMSEA=0.07,CFI=0.753,and NFI=0.715.With SCL-90 as the standard criteria,except the low correlation coefficient between emotional scale and depression(r=0.600)and anxiety(r=0.520),the correlation coefficients of other symptoms were below 0.5.The chronbach's α between each factor and total score of UPPSAQ-70 was between 0.823 and 0.904,and the Chronbach's α coefficient of the whole scale was between 0.954 and 0.956 after each item was deleted.The retest reliability of the scale of 32 participants Chronbach's α was 0.847.Each item of the scale measured between one week was significantly correlated(P<0.05). Conclusion UPPSAQ-70 is a good scale for evaluating overall health status and is especially feasible in general hospitals.

The Effects of a New Public Medicine Procurement Policy on Medicine Price in Shaanxi Province, Western China: An Interrupted Time Series Analysis.

Objectives: To assess the effects on medicine price, a new public medicine procurement policy (NPMPP) undertaken in western China in 2015. Methods: An interrupted time series analysis was used to evaluate the impact of NPMPP on the prices of emergency medicines, gynaecological medicines, and paediatric medicines in Shaanxi Province, western China. Based on the procurement records in all the public health institutions in Shaanxi Province, we built three regression models. The monthly average price growth rate of the three categories of medicines was analysed covering the period 2015 to 2017. Findings: Before the intervention, there was an increasing trend in the monthly average growth rate of the three categories of medicines, but significant only in emergency medicines and paediatric medicines. After the introduction of NPMPP, the increasing trend was accelerated for both the emergency medicines (coefficient = 0.114, P < 0.001) and gynaecological medicines (coefficient = 0.078, P < 0.05), whereas the increasing trend for paediatric medicines was slowed down after the intervention (coefficient = -0.024, P < 0.05). Conclusion: Using interrupted time series analysis, we identified a statistically significant increase in the price growth rate of emergency medicines and gynaecological medicines, but a statistically significant decrease in the price growth rate of paediatrics, following the introduction of NPMPP. The impact of NPMPP on emergency medicines was greater than that on gynaecological medicines. To inhibit the growth trend of drug price, effective policies need to be introduced.

Excellent adsorption performance of dibenzothiophene on functionalized low-cost activated carbons with different oxidation methods.

Low-cost activated carbon (KAC) was functionalized by HNO3, (NH4)2S2O8 and air oxidation, respectively, to remove dibenzothiophene (DBT) from model fuel. The changes in physical and chemical properties of these activated carbons were characterized by thermal analysis, elemental analysis, nitrogen adsorption apparatus, Raman spectra, scanning electron microscope and Boehm's titration method. HNO3 and (NH4)2S2O8 oxidation result in a significant decrease in pore structure, while air oxidation only causes slight pore reduction due to the re-activation by O2. The oxygen-containing functional groups (OFGs) increase markedly after oxidative modification, in which (NH4)2S2O8 oxidation is considered as the most efficient method with respect to the introduction of OFGs. HNO3 and (NH4)2S2O8 oxidation are more selective to generate carboxyls and lactones, whereas air oxidation creates more phenols, carbonyls and ethers. The DBT adsorption capacity follows the order: NAC (HNO3-oxidized KAC) > OAC (air-oxidized KAC) > KAC > SAC ((NH4)2S2O8-oxidized KAC), implying the introduction of OFGs is beneficial for the DBT adsorption process, especially for selectivity, but excessive OFGs have a negative effect on the removal of DBT. Thus, to achieve high DBT adsorption performance, there should be a trade-off between the micropore volume and the OFGs amount.

Degradation dynamics, residues and risk assessment of Dufulin enantiomers in corn plants and corn by LC/MS/MS.

The degradation dynamics and terminal residues of dufulin enantiomers were investigated in two typical corn plants. A convenient and precise chiral method by high-performance liquid chromatography coupled with tandem triple quadrupole mass spectrometry (HPLC/MS/MS) using a Chiralpak IC column was developed and validated for measuring dufulin enantiomers in corn plants and corn. The two enantiomers of dufulin quickly dissipated in the corn plant, and no noticeable stereoselectivity was observed during degradation or in the final residues. After 30% rac-dufulin wettable powder with a 1- to 1.5-fold dose of the recommended value was sprayed two to three times on corn plants, the residue levels of S-(+)-dufulin and R-(-)-dufulin in corn from both sites were lower than or equal to 0.0520 mg kg-1 on days 7, 14 and 21 after the last application. The dietary risk assessment indicated that dufulin did not exhibit obvious dietary health risks in corn samples when good agricultural practices were implemented. The findings from this study may be used to better understand the chiral profiles of dufulin in the environment and the effect of dufulin residues in corn on health.

Ultrasonic/CT image fusion guidance facilitating percutaneous catheter drainage in treatment of acute pancreatitis complicated with infected walled-off necrosis.

BACKGROUND: As the firs-line treatment for acute pancreatitis (AP) related infectious walled-off necrosis (WON), percutaneous catheter drainage (PCD) are usually accomplished under CT or US guidance, either of which has certain disadvantages. It is necessary to verify the clinical effects of using US and CT images fusion as guidance of PCD. METHODS: The total 94 consecutive AP patients with infected WON from January of 2013 to January of 2017 were included. Among these patients with infected WON, 48 received PCD under simple US guidance (US-PCD) and 46 under US/CT images fusion guidance (US/CT-PCD). The clinical data consisting of puncture data, drainage effectiveness indicators, intervention complications were collected. RESULTS: The demographic characteristics and disease related characteristics of two groups were comparable. After 48 h of PCD treatment, the US/CT-PCD group achieved a significantly higher imaging effective rate, and significantly lower inflammatory response indexes and severity score, than the US-PCD group (P < 0.05). The US/CT-PCD group required fewer puncture times and drainage tubes and lower rate of advanced treatment, showing higher operational success rate than the US-PCD group (P < 0.05). Moreover, the US/CT-PCD group exhibited significantly fewer puncture related complications, lower hospital stay, intubation time, and hospitalization expenses than the US-PCD group (P < 0.05). CONCLUSION: PCD treatment under the US/CT images fusion guidance is a reliable intervention with definite clinical effects for AP complicated with infected WON.

[Pollution Level, Distribution Characteristics and Risk Assessment of 32 PPCPs in Surface Water of Luomahu Lake].

A total of 22 water samples collected from Luomahu Lake were determined using high performance liquid chromatography tandem mass spectrometry (HPLC-MS/MS) to evaluate the pollution level,spatial distribution and ecological risk of 32 PPCPs.23 PPCPs were detected in surface water of Luomahu Lake and the total concentrations of 22 samples were 892-1536 ng·L-1.The concentration of norfloxacin (256-707 ng·L-1) was the highest among the detected PPCPs,followed by ketoprofen (85-438 ng·L-1),acesulfame (101-290 ng·L-1) and naproxen (1.9-112 ng·L-1).Spatial differences were found in concentrations of PPCPs in various sampling sites.Concentrations of PPCPs in northeast of Luomahu Lake were higher than those of southwest.Concentration of PPCPs in Fangtinghe River was high and that of Zhangshanzha River was relatively low.The risk assessment of 13 pharmaceutical PPCPs showed that risk quotients (RQs) of norfloxacin were 0.26-0.72,posing medial risk to aquatic ecosystem.Gemifibrozil posed low ecological risks with RQs>0.01 in most sampling sites.RQs of other 11 PPCPs were less than 0.01,posing no ecological risks.The combined risk quotients of 12 PPCPs in water of Luomahu Lake were 0.29-0.75,indicating that those compounds posed an medial risk to aquatic ecosystem.Human health risk assessment showed that the RQs were less than one for 6 selected PPCPs,indicating that these compounds did not appear to pose an appreciable risk to human health by potential environmental exposure from drinking water.

Assessment of HCV genotypes in Yunnan Province of Southwest China.

Recently, we reported that the frequency of hepatitis C virus (HCV) genotypes and subtypes has rapidly changed among intravenous drug users (IDUs) in Yunnan Province over the last 5 years; this is especially true for subtype 6a which has increased in frequency from 5 to 15%. Here, we assessed 120 HCV-positive plasma samples from the general population (GP). HCV NS5B fragments were amplified and sequenced by PCR. We identified four HCV genotypes (1, 2, 3 and 6) and seven HCV subtypes (1b, 2a, 3a, 3b, 6a, 6n, and 6k) in this population. Genotype 3 was predominant, with a distribution frequency of 0.484, followed by genotype 1 (0.283), genotype 6 (0.133) and genotype 2 (0.100). HCV subtypes 3b (frequency 0.292) and 1b (frequency 0.283) were the most common subtypes. A comparison of the current data with previous results reported for IDUs showed that the distribution frequencies of genotypes 1, 2 and 6 were significantly different between patients in the GP and IDUs (P < 0.05). Among the HCV subtypes, the distribution frequencies of 1b, 2a, 6a, and 6n were significantly different between patients in the GP and IDU groups (P < 0.05). Moreover, Phylogenetic analyses showed that HCV subtype 6a strains isolated from IDUs and the GP were intermixed and not separately clustered. HCV subtype 6a was predominant not only among IDUs but also among those in the GP in the Guangdong Province and Vietnam. However, HCV subtype 6a was predominant only among IDUs and not among those in the GP in the Yunnan and Guangxi Provinces. Our results indicate that the HCV subtype 6a could rapidly spread across China.

Analysis of In-hospital Neonatal Death in the Tertiary Neonatal Intensive Care Unit in China: A Multicenter Retrospective Study.

BACKGROUND: Globally, the proportion of child deaths that occur in the neonatal period remains a high level of 37-41%. Differences of cause in neonate death exist in different regions as well as in different economic development countries. The specific aim of this study was to investigate the causes, characteristics, and differences of death in neonates during hospitalization in the tertiary Neonatal Intensive Care Unit (NICU) of China. METHODS: All the dead neonates admitted to 26 NICUs were included between January l, 2011, and December 31, 2011. All the data were collected retrospectively from clinical records by a designed questionnaire. Data collected from each NICU were delivered to the leading institution where the results were analyzed. RESULTS: A total of 744 newborns died during the 1-year survey, accounting for 1.2% of all the neonates admitted to 26 NICUs and 37.6% of all the deaths in children under 5 years of age in these hospitals. Preterm neonate death accounted for 59.3% of all the death. The leading causes of death in preterm and term infants were pulmonary disease and infection, respectively. In early neonate period, pulmonary diseases (56.5%) occupied the largest proportion of preterm deaths while infection (27%) and neurologic diseases (22%) were the two main causes of term deaths. In late neonate period, infection was the leading cause of both preterm and term neonate deaths. About two-thirds of neonate death occurred after medical care withdrawal. Of the cases who might survive if receiving continuing treatment, parents' concern about the long-term outcomes was the main reason of medical care withdrawal. CONCLUSIONS: Neonate death still accounts for a high proportion of all the deaths in children under 5 years of age. Our study showed the majority of neonate death occurred in preterm infants. Cause of death varied with the age of death and gestational age. Accurate and prompt evaluation of the long-term outcomes should be carried out to guide the critical decision.

An exploration of spatial human health risk assessment of soil toxic metals under different land uses using sequential indicator simulation.

A modified method was proposed which integrates the spatial patterns of toxic metals simulated by sequential indicator simulation, different exposure models and local current land uses extracted by remote-sensing software into a dose-response model for human health risk assessment of toxic metals. A total of 156 soil samples with a various land uses containing farm land (F1-F25), forest land (W1-W12) and residential land (U1-U15) were collected in a grid pattern throughout Xiandao District (XDD), Hunan Province, China. The total Cr and Pb in topsoil were analyzed. Compared with Hunan soil background values, the elevated concentrations of Cr were mainly located in the east of XDD, and the elevated concentrations of Pb were scattered in the areas around F1, F6, F8, F13, F14, U5, U14, W2 and W11. For non-carcinogenic effects, the hazard index (HI) of Cr and Pb overall the XDD did not exceed the accepted level to adults. While to children, Cr and Pb exhibited HI higher than the accepted level around some areas. The assessment results indicated Cr and Pb should be regarded as the priority pollutants of concern in XDD. The first priority areas of concern were identified in region A with a high probability (>0.95) of risk in excess of the accepted level for Cr and Pb. The areas with probability of risk between 0.85 and 0.95 in region A were identified to be the secondary priority areas for Cr and Pb. The modified method was proved useful due to its improvement on previous studies and calculating a more realistic human health risk, thus reducing the probability of excessive environmental management.

Assessment of environmental risk for red mud storage facility in China: a case study in Shandong Province.

Red mud storage facility (RM-SF) pollution remains a serious problem in China mainly due to the RM's huge quantity, little recyclability, and high alkalinity. And, there is also a risk of dam failure because almost all RM-SFs are processed by damming. In order to address this challenge and improve the level of risk management, it is necessary to evaluate the environmental risk of RM-SFs systematically. So, this paper firstly designs a comprehensive evaluation index system with a three-level evaluation index in the terms of RM characteristics, RM-SF characteristics, ambient environment of RM-SF, the management of RM-SF, and the application aspect of RM by the analytic hierarchy process (AHP) method. Then, a case of RM-SF from a typical alumina production enterprise is studied according to this system, as is assisted by several experts from different fields when determining the weights of all indicators. The results show that the risk of selected RM-SF primarily depends on the former factors, that is, RM and RM-SF characteristics, while the contributions of the other factors are quite smaller.