[Spatial Characteristics, Risk Assessment, and Source Analysis of Elements in Surface Sediments from the Baiyangdian Lake].

In this paper, nutrient elements (N and P), heavy metals (Pb, Cu, Zn, Cd, Cr, Co, Ni, and Sn), and grain size in surface sediments of Baiyangdian Lake, northern China, are studied. We also analyze the spatial variation in elemental characteristics and undertaken a pollution risk assessment. By combining data with information on the river sediment characteristics, we use multivariate statistical methods to reveal the sources and variation of elements in sediments. The results showed that the average contents of heavy metals in surface sediments from the lake and associated rivers were higher than background values. Within the area of the lake, nutrient elements are relatively high in the northwest region but low in the southeast region, and heavy metals are relatively high in the middle of the lake but low in the southern and northern areas. The sequence of comprehensive pollution index (I) in sediments was Cd > Pb > Cr > Cu=Zn > Ni > Sn > Co, with Cd being assessed as severe pollution and other elements as moderate pollution, although severe pollution of Cr was found in the Zaolinzhuang area. The order of potential ecological risk coefficients (Eri) was determined as Cd > Pb > Cu > Cr > Ni > Zn, whereby Cd was associated with a strong potential ecological risk (except in the Caiputai area) and other elements were associated with a slight potential ecological risk. Differences in the lake sediment texture were found to be slight. Non-point source pollution after rivers flow into the lake was determined as the main reason for the spatial variation of elements in the surface sediments of Baiyangdian Lake, although point source pollution in the villages surrounding the lake should not be ignored, especially with respect to N, P, Pb, and Cr.

Trends of CT utilisation in an emergency department in Taiwan: a 5-year retrospective study.

OBJECTIVES: To investigate the association between the trends of CT utilisation in an emergency department (ED) and changes in clinical imaging practice and patients' disposition. SETTING: A hospital-based retrospective observational study of a public 1520-bed referral medical centre in Taiwan. PARTICIPANTS: Adult ED visits (aged ≥18 years) during 2009-2013, with or without receiving CT, were enrolled as the study participants. MAIN OUTCOME MEASURES: For all enrolled ED visits, we retrospectively analysed: (1) demographic characteristics, (2) triage categories, (3) whether CT was performed and the type of CT scan, (4) further ED disposition, (5) ED cost and (6) ED length of stay. RESULTS: In all, 269 239 adult ED visits (148 613 male patients and 120 626 female patients) were collected during the 5-year study period, comprising 38 609 CT scans. CT utilisation increased from 11.10% in 2009 to 17.70% in 2013 (trend test, p<0.001). Four in 5 types of CT scan (head, chest, abdomen and miscellaneous) were increasingly utilised during the study period. Also, CT was increasingly ordered annually in all age groups. Although ED CT utilisation rates increased markedly, the annual ED visits did not actually increase. Moreover, the subsequent admission rate, after receiving ED CT, declined (59.9% in 2009 to 48.2% in 2013). CONCLUSIONS: ED CT utilisation rates increased significantly during 2009-2013. Emergency physicians may be using CT for non-emergent studies in the ED. Further investigation is needed to determine whether increasing CT utilisation is efficient and cost-effective.