Urinary Metabolites of Polycyclic Aromatic Hydrocarbons of Rural Population in Northwestern China: Oxidative Stress and Health Risk Assessment.

Polycyclic aromatic hydrocarbon (PAH) exposure is suspected to be linked to oxidative damage. Herein, ten PAH human exposure biomarkers [hydroxylated PAH metabolites (OH-PAHs)] and five oxidative stress biomarkers (OSBs) were detected in urine samples collected from participants living in a rural area (n = 181) in Northwestern China. The median molar concentration of ΣOH-PAHs in urine was 47.0 pmol mL-1. The 2-hydroxynaphthalene (2-OHNap; median: 2.21 ng mL-1) was the dominant OH-PAH. The risk assessment of PAH exposure found that hazard index (HI) values were <1, indicating that the PAH exposure of rural people in Jingyuan would not generate significant cumulative risks. Smokers (median: 0.033) obtained higher HI values than nonsmokers (median: 0.015, p < 0.01), suggesting that smokers face a higher health risk from PAH exposure than nonsmokers. Pearson correlation and multivariate linear regression analysis revealed that ΣOH-PAH concentrations were significant factors in increasing the oxidative damage to deoxyribonucleic acid (DNA) (8-hydroxy-2'-deoxyguanosine, 8-OHdG), ribonucleic acid (RNA) (8-oxo-7,8-dihydroguanine, 8-oxoGua), and protein (o, o'-dityrosine, diY) (p < 0.05). Among all PAH metabolites, only 1-hydroxypyrene (1-OHPyr) could positively affect the expression of all five OSBs (p < 0.05), suggesting that urinary 1-OHPyr might be a reliable biomarker for PAH exposure and a useful indicator for assessing the impacts of PAH exposure on oxidative stress. This study is focused on the relation between PAH exposure and oxidative damage and lays a foundation for the study of the health effect mechanism of PAHs.

Assessment of nomogram model for the prediction of esophageal variceal hemorrhage in hepatitis B-induced hepatic cirrhosis.

BACKGROUND: Esophageal variceal (EV) hemorrhage is a life-threatening consequence of portal hypertension in hepatitis B virus (HBV) -induced cirrhotic patients. Screening upper endoscopy and endoscopic variceal ligation to find EVs for treatment have complications, contraindications, and high costs. We sought to identify the nomogram models (NMs) as alternative predictions for the risk of EV hemorrhage. METHODS: In this case-control study, we retrospectively analyzed 241 HBV-induced liver cirrhotic patients treated for EVs at the Second People's Hospital of Fuyang City, China from January 2021 to April 2023. We applied univariate analysis and multivariate logistic regression to assess the accuracy of various NMs in EV hemorrhage. The area under the curve (AUC) and calibration curves of the receiver's operating characteristics were used to evaluate the predictive accuracy of the nomogram. Decision curve analysis (DCA) was used to determine the clinically relevant of nomograms. RESULTS: In the prediction group, multivariate logistic regression analysis identified platelet distribution and spleen length as independent risk factors for EVs. We applied NMs as the independent risk factors to predict EVs risk. The NMs fit well with the calibration curve and have good discrimination ability. The AUC and DCA demonstrated that NMs with a good net benefit. The above results were validated in the validation cohort. CONCLUSION: Our non-invasive NMs based on the platelet distribution width and spleen length may be used to predict EV hemorrhage in HBV-induced cirrhotic patients. NMs can help clinicians to increase diagnostic performance leading to improved treatment measures.

Global, regional and national burden of alcohol cardiomyopathy from Global Burden of Disease Study 2019.

This study aimed to provide up-to-date and comprehensive estimates on the global alcohol cardiomyopathy (ACM) from 1990 to 2019. Detailed data on the prevalence, disability-adjusted life-years (DALYs), deaths,percentage change in the number of cases and estimated annual percentage change (EAPC) of ACM worldwide from 1990 to 2019 were obtained or calculated from the Global Burden of Disease Study (GBD) 2019. Globally, the estimated prevalent cases of ACM in 2019 were 707,652 [95% uncertainty interval (UI): 545,182-924,392], with a 35.4% (28.2-44.2) increase from 522,616 (95% UI: 394,118-683,206) in 1990, while the age-standardized prevalence rate (ASPR) was slightly decreased with an overall EAPC of - 1.30 (- 1.38 - - 1.22). Similar to ASPR, the global age-standardized DALYs rate and age-standardized death rate (ASDR) also declined, with an EAPC of - 1.12(- 2.09 - - 0.14) and - 1.53(- 2.36 - - 0.70) from 1990 to 2019, respectively. Conversely, the number of ACM-related DALYs cases in 2019 was 2,441,108 (95% UI: 2,046,734-2,782,542), with an increase of 38.8%(2.8-59.9) over the past 30 years, and the number of ACM-related deaths in 2019 was 71,723 (95% UI: 60,167-81,995), with an increase of 33.1% (0.5- 51.9) compared with 1990. A significant variation in the burden of ACM was observed between different regions and countries. Although the ASPR, age-standardized DALYs rate and ASDR slightly decreased from 1990 to 2019, the absolute number of prevalent cases, DALYs cases and deaths significantly increased. This showed that the burden of ACM remains an important global public health concern. Public health policy and decision-makers should develop and implement more effective strategies specific to geographical location to combat and reduce the burden of ACM in the future.

rFGF4 alleviates lipopolysaccharide-induced acute lung injury by inhibiting the TLR4/NF-κB signaling pathway.

Acute lung injury (ALI) is a serious and common clinical disease. Despite significant progress in ALI treatment, the morbidity and mortality rates remain high. However, no effective drug has been discovered for ALI. FGF4, a member of the FGF family, plays an important role in the regulation of various physiological and pathological processes. Therefore, in the present study, we aimed to study the protective effects of FGF4 against LPS-induced lung injury in vivo and in vitro. We found that rFGF4 treatment improved the lung W/D weight ratio, the survival rate, immune cell infiltration and protein concentrations in mice with LPS-induced ALI. Histological analysis revealed that rFGF4 significantly attenuated lung tissue injury and cell apoptosis. Furthermore, rFGF4 inhibited the activation of the TLR4/NF-κB signaling pathway and the production of pro-inflammatory mediators in LPS-injured lung tissues, murine alveolar macrophages (MH-S) and murine pulmonary epithelial (MLE-12) cells. The results of cell experiments further verified that rFGF4 inhibited the production of inflammatory mediators in MH-S cells and MLE-12 cells by regulating the TLR4/NF-κB signaling pathway. These results revealed that rFGF4 protected lung tissues and inhibited inflammatory mediators in mice with LPS-induced ALI by inhibiting the TLR4/NF-κB signaling pathway in MH-S and MLE-12 cells.

Global burden of atrial fibrillation/atrial flutter and its attributable risk factors from 1990 to 2019.

AIMS: The aim of this study was to estimate the global burden of atrial fibrillation (AF)/atrial flutter (AFL) and its attributable risk factors from 1990 to 2019. METHODS AND RESULTS: The data on AF/AFL were retrieved from the Global Burden of Disease Study (GBD) 2019. Incidence, disability-adjusted life years (DALYs), and deaths were metrics used to measure AF/AFL burden. The population attributable fractions (PAFs) were used to calculate the percentage contributions of major potential risk factors to age-standardized AF/AFL death. The analysis was performed between 1990 and 2019. Globally, in 2019, there were 4.7 million [95% uncertainty interval (UI): 3.6 to 6.0] incident cases, 8.4 million (95% UI: 6.7 to 10.5) DALYs cases, and 0.32 million (95% UI: 0.27 to 0.36) deaths of AF/AFL. The burden of AF/AFL in 2019 and their temporal trends from 1990 to 2019 varied widely due to gender, Socio-Demographic Index (SDI) quintile, and geographical location. Among all potential risk factors, age-standardized AF/AFL death worldwide in 2019 were primarily attributable to high systolic blood pressure [34.0% (95% UI: 27.3 to 41.0)], followed by high body mass index [20.2% (95% UI: 11.2 to 31.2)], alcohol use [7.4% (95% UI: 5.8 to 9.0)], smoking [4.3% (95% UI: 2.9 to 5.9)], diet high in sodium [4.2% (95% UI: 0.8 to 10.5)], and lead exposure [2.3% (95% UI: 1.3 to 3.4)]. CONCLUSION: Our study showed that AF/AFL is still a major public health concern. Despite the advancements in the prevention and treatment of AF/AFL, especially in regions in the relatively SDI quintile, the burden of AF/AFL in regions in lower SDI quintile is increasing. Since AF/AFL is largely preventable and treatable, there is an urgent need to implement more cost-effective strategies and interventions to address modifiable risk factors, especially in regions with high or increased AF/AFL burden.

Assessment of Children's Metal Exposure via Hand Wipe, Outdoor Soil and Indoor Dust and Their Associations with Blood Biomarkers.

The soil environment contributes considerably to human exposure to metals. This study aimed to comprehensively compare children's exposure to soil metals using different sampling approaches (i.e., hand wipe, indoor dust and outdoor soil) and assessment strategies, combing the method of external exposure evaluation and the correlation with internal biomarkers. Environmental exposure samples (hand wipe, outdoor soil and indoor dust), blood samples and child-specific exposure factors were simultaneously collected for 60 children aged 3 to 12 years from an area of northwestern China. Eight typical toxic metals were analyzed. Results showed that metal levels in hand wipes were associated with children's age, years of residency and the ground types of the play areas. Hand-to-mouth contact was an important pathway for children's metal exposure, with the corresponding oral exposure cancer risk to Cr already exceeding the maximum acceptable level. In comparison, metal concentrations in hand wipes were one to seven times higher than those in outdoor soil and indoor dust. Even greater discrepancies were found for the estimated exposure dose, which could lead to differences of several to dozens of times. In addition, Pb, Mn and Cr in hand wipes were significantly correlated with those in blood, whereas no relationships were found with soil and dust. This study indicates that the selection of different sampling and assessing strategies could lead to great differences in children metal exposure outcomes. It also suggests that hand wipe, which could reflect the true and integrated exposure level and the individual difference, serves as a better matrix to assess children's metal exposure compared to soil and dust. Further studies should standardize the sampling method for hand wipes and verify its applicability for other age groups.

Health Risk Assessment of Metals via Multi-Source Oral Exposure for Children Living in Areas with Intense Electronic Manufacturing Activities.

Oral ingestion is the predominant pathway of metal(loid)s exposure. In this study, the health risks of typical metal(loid)s (including Mn, As, Cr, Cd, and Pb) via multi-source, oral pathways for children aged 3-12 years, living in an area of China dominated by the electronic manufacturing industry, were studied based on the field sampling of duplicated diet, soil, and drinking water. Child-specific ingestion parameters were measured (except the soil ingestion rates, which were from a previous study of the same population), and a Monte Carlo method was applied to determine the uncertainty of the risk assessment. It was observed that children living in such environments were at risk of metal(loid)s exposure, with the accumulative carcinogenic risk exceeding the maximum acceptable level. Food intake was identified to be the primary exposure pathway. Moreover, Pb and Cr were the major risk elements to local children's health. Compared with primary school students, kindergarten children experienced a higher risk. This study highlights that high attention should be paid to children living in suburban areas dominated by the electronic manufacturing industry, and that priority should be given to studies on metal(loid)s exposure deriving from different types of food and their corresponding bioavailability, in order to further discern the precise risk sources to protect children's health.

[Probabilistic Risk Assessment of Arsenic Exposure Through Drinking Water Intake in Chinese Residents].

The total arsenic concentrations of the three main drinking water types in China were determined through a systematic literature review. The distribution models of drinking water exposure parameters for different age groups were obtained using the regression method. The carcinogenic and non-carcinogenic risks of different population groups caused by arsenic exposure through different drinking water types were evaluated by a probabilistic risk assessment. The results showed that the geometric mean of total arsenic content in all the drinking water samples in China was (13.0±38.1) µg·L-1. The highest arsenic content was found in the Inner Mongolia Autonomous Region, followed by Guangxi and Shanxi. Based on the relevant standards for drinking water quality, the probability exceeding the threshold value of groundwater and source water is 23.2% and 18.4%, respectively. According to the results of non-carcinogenic risk assessment, the probability of the residents drinking well water and surface water from the water source area exceeding the daily average exposure dose threshold was 24.0% and 19.5%, respectively. According to the carcinogenic risk assessment, the median of carcinogenic risk caused by arsenic in drinking water in China was 3.22×10-5, which is acceptable. The population group of 18-45 years old had the highest risk, and the median LCR was 1.37×10-5. There was still a certain probability that the LCR of drinking well water and surface water would exceed the acceptable risk level recommended by the US EPA. In conclusion, the potential health risks caused by arsenic exposure through drinking water intake exist among Chinese residents. Further control of the arsenic concentration in drinking water is required to reduce the health risk and improve the safety of drinking water. Meanwhile, it is suggested to strengthen the research on risk threshold to provide a scientific basis for the residents' health protection.

Patterns and sociodemographic determinants of water intake by children in China: results from the first national population-based survey.

PURPOSE: Accurate data on water and beverage intakes are essential for assessing hydration adequacy and setting proper guidelines. The objective of this study is to identify the patterns and sociodemographic determinants of water intake and to assess the intake adequacy for children in China. METHODS: The study team recruited 41,439 children aged 6-17 years using a multi-stage cluster random sampling method. Daily water and beverage intakes were investigated with the standard questionnaires and measuring containers in face-to-face interviews. Each participant was assigned an adjustment weight to obtain a nationally representative sample. Sociodemographic factors influencing water intake were identified using multi-variable regressions. Water intake adequacy was evaluated by comparing with the recommended water intake (RWI). RESULTS: The mean ± standard deviation of total water intake (TWI) was 1603 ± 731 mL/day for boys and 1487 ± 661 mL/day for girls. Plain water, food moisture, and other beverages contributed 51%, 20%, and 29% of the TWI. Multi-variable analyses showed that TWI of children increased with age, in urban areas and day schools, and with parents' economic and educational levels. The majority (82%) of children had TWI not meeting the corresponding RWI, and the percentage increased with age except for 14-17-year-old boys. CONCLUSIONS: Plain water is still the major source of daily water intake by children in China. Unfortunately, the majority of children do not have sufficient water intake, which warrants future actions and guidelines targeting adequate hydration.

The Chinese version of Instrument of Professional Attitude for Student Nurses (IPASN): Assessment of reliability and validity.

BACKGROUND: Professional attitude is of great importance for nursing talents in the modern society. To develop an effective educational program for student nurses in China, an appropriate instrument is required for the assessment of their professional attitude. OBJECTIVE: To assess the validity and reliability of the Instrument of Professional Attitude for Student Nurses (IPASN) in Chinese version. METHODS: The original version of IPASN was translated through Brislin model (translation, back translation, culture adaption and pilot study) with the authorization from the developer. A total of 681 nursing students were chosen by stratified convenience sampling to assess construct validity using exploratory factor analysis (EFA). Besides, item analysis, Cronbach's alpha coefficients, test-retest reliability were conducted to test the psychometric properties in this part. A total of 204 nursing undergraduate trainees were selected by cluster convenience sampling to confirm the structure using confirmatory factor analysis (CFA) in another time. RESULTS: Corrected item-total correlations, alpha if item deleted were between 0.33 and 0.69, 0.906 and 0.913, respectively, indicating no item should be deleted. Cronbach alpha value was 0.91 for the total scale and Cronbach alpha coefficient for subscales ranged from 0.67 to 0.89. Test-retest reliability estimated from intraclass correlation coefficient (ICC) was 0.74 (P<0.05). Differences in item scores between the high-score group (the first 27%) and low-score group (the last 27%) were significant (P<0.001), indicating that the item discrimination ability was good. Seven subscales (contribution to increase of scientific information load, autonomy, community service, continuous education, to promote professional development, cooperation and theory guiding practice) were identified in EFA and confirmed in CFA, and explained 65.5% of the total variance. CONCLUSION: It indicated that the Chinese version of IPASN was valid and reliable for the evaluation of nursing students' professional attitude.

Bioaccessibility and health risk assessment of arsenic in soil and indoor dust in rural and urban areas of Hubei province, China.

Incidental oral ingestion is the main exposure pathway by which human intake contaminants in both soil and indoor dust, and this is especially true for children as they frequently exhibit hand-to-mouth behaviour. Research on comprehensive health risk caused by incidental ingestion of both soil and indoor dust is limited. The aims of this study were to investigate the arsenic concentration and to characterize the health risks due to arsenic (As) exposure via soil and indoor dust in rural and urban areas of Hubei province within central China. Soil and indoor dust samples were collected from schools and residential locations and bioaccessibility of arsenic in these samples was determined by a simplified bioaccessibility extraction test (SBET). The total arsenic content in indoor dust samples was 1.78-2.60 times that measured in soil samples. The mean As bioaccessibility ranged from 75.4% to 83.2% in indoor dust samples and from 13.8% to 20.2% in soil samples. A Pearson's analysis showed that As bioaccessibility was significantly correlated with Fe and Al in soil and indoor dust, respectively, and activity patterns of children were utilised in the assessment of health risk via incidental ingestion of soil and indoor dust. The results suggest no non-carcinogenic health risks (HQ<1) or acceptable carcinogenic health risks (1×10(-6)

Health risk assessment of various metal(loid)s via multiple exposure pathways on children living near a typical lead-acid battery plant, China.

Manufacture of lead-acid batteries is of widespread interest because of its emissions of heavy metals and metalloids into environment, harming environmental quality and consequently causing detrimental effects on human health. In this study, exposure pathways and health risks of children to heavy metal(loid)s (Pb, Cd, As, etc) were investigated based on field sampling and questionnaire. Pb was one of the most abundant elements in children's blood, with an elevated blood lead level of 12.45 µg dL(-1). Soil/dust and food were heavily polluted by targeted metal(loid)s. Food ingestion accounted for more than 80% of the total exposure for most metal(loid)s. The non-cancer risks to children were 3-10 times higher than the acceptable level of 1, while the cancer risks were 5-200 times higher than the maximum acceptable level of 1.0 × 10(-4). The study emphasized the significance of effective environmental management, particularly to ensure food security near battery facilities.

Health risk assessment of dietary exposure to polycyclic aromatic hydrocarbons in Taiyuan, China.

Sixteen polycyclic aromatic hydrocarbons (PAHs) were determined in 24 duplicate-diet samples from people in Taiyuan during summer and winter in 2009. Dietary intake of PAHs for 2862 participants was subsequently estimated by a survey in Taiyuan. Results from these 24 samples were compared with a raw food study in Taiyuan in 2008. Three main sources of dietary PAHs are vegetables, wheat flour and fruits, the sum of which contributes 75.95% of PAHs in dietary food. Compared to the estimated value in raw food, much more B[a]P(eq) (benzo[a]pyrene equivalents) were detected in food samples collected in the duplicate-diet study in Taiyuan (60.75 ng/day). The cooking process may introduce more B[a]P(eq) into food, and the relative contribution of 16 PAHs in the diet would be changed during the cooking procedure.

[Source and health risk assessment of heavy metals in ambient air PM10 from one coking plant].

To investigate the sources and health risk of heavy metals in ambient air PM10 from the coking plant, the PM10 in the air around one coking plant was collected in June 2012. Then the heavy metals concentrations in PM10 were tested by the microwave-ICP-MS method. Furthermore, the USEPA's human exposure assessment model was applied to preliminarily evaluate the human health risks of the heavy metals in air particulate matter. The results show that the concentrations of 10 kinds of heavy metals in PM10 from the coking plant vary significantly, ranging from 3.06 x 10(-5) mg x m(-3) to 1.77 x 10(-2) mg x m(-3), of which the concentration of Cr is the highest, while the concentration of Co is the lowest, and the concentration of the carcinogenic substances is higher than that of the non-carcinogenic substances. The coking plant is identified to be the major source of the heavy metals in ambient air PM10, and Ni is the main polluting heavy metal. Moreover, the heavy risk assessment results reveal that the carcinogenic risks for adults are higher than children, while the carcinogenic risks in industrial areas and school relatively large. The non-carcinogenic risks for children are the highest in all the population, and the non-carcinogenic risks in residential area can not be ignored. Among the carcinogenic substances, the potential carcinogenic risks of Cd, Cr and As are comparatively large, Ni and Co have certain potential risks. Whereas, among the non-carcinogenic substances, the non-carcinogenic risks of Mn is great. Consequently, relevant departments should pay close attention to this situation.

[Health risk assessment of heavy metals in drinking water based on field measurement of exposure factors of Chinese people].

This study was carried out in Biyang County, located in the junction of Yangtze river and Huaihe river. Drinking water samples of 20 sites in urban and rural areas in this county were collected to measure 14 heavy metals by ICP/MS. About 2 500 subjects with different age and sex were selected to measure exposure factors. Time-activity of drinking water by ingestion and dermal contact of each individual subject during the last three days were kept in dairy in detail by questionnaires. Intake of drinking water from direct and indirect consumption of water and time duration of dermal contact to water in each individual subject were kept in record based on real time measurements. Human health risks were assessed and sensitivity of exposure factors and uncertainty of risks were also analyzed. The results showed that the average drinking water intake rate of male and female are 2276 mL/d, 2265 mL/d in urban adults and 2464 mL/d, 2170 mL/d in rural adults respectively. Body surface area of male and female are 1.806 m2, 1.641 m2 in urban adults and 1.747 m2, 1.617 m2 in rural adults respectively. The contents of 14 heavy metals in this study area are all below the national drinking water standards. Cancer risks from exposure to As are ranged from 2.5 x 10(-6) to 5.2 x 10(-6) through ingestion and 1.1 x 10(-7) to 2.3 x 10(-7) through dermal exposure. Non-cancer risks are ranged from 2.1 x 10(-7) to 1.7 x 10(-6) through ingestion and 1.0 x 10(-8) to 6.0 x 10(-8) through dermal exposure. Non-cancer risks in rural population are 2.1 times to 5.6 times to the risks in urban populations. However all the risks are below the acceptable level. The sensitivity of various exposure factors including drinking water intake rate, dermal exposure time and body surface area are 71.5%. This indicates that exposure factors play a very important role in health risk assessment. Health risks in this research based on real measurement of exposure factors are about 0.94 time to 6.33 times higher than the risks based on the references of the data from the exposure factors handbooks in other countries. This study showed that the accuracy of health risk assessment could be improved a lot by the real measurements of exposure factors. Attentions should be attached to exposure factor investigation to decrease uncertainty of health risk assessment.

[Evaluation of resource exploitation value and ecosystem service loss in Mentougou District of Beijing City].

By using the evaluation approach of ecosystem services (including market value, opportunity cost, restoration cost, and shadow project approaches), and combining with situation investigation, the ecosystem service loss in Mentougou District of Beijing City caused by coal resource exploitation in 1949-2006 was systematically evaluated. In the study area, coal mining mainly induced the cost increase of solid waste disposal and sink reclamation, and the losses in food production, water self-preserving, residents moving, and water and soil resources. The ecosystem service loss caused by the coal mining in 1949-2006 was about 54.3 billion Yuan RMB, approximately 9 times high of its market economic benefit (5.9 billion Yuan RMB). It was very difficult or needed a long time to restore the damaged ecosystem.