Research on leakage environmental risk assessment and risk prevention and control measures in the long-term landfill process of ultra-alkaline fly ash.

In this study, we simulated the actual landfill disposal process using accelerated carbonization experiments, based on the leaching characteristics of heavy metals from "alkaline" fly ash, and used the LandSim-HELP coupling model to assess the environmental risk of the leaching. The results showed that the leaching data of "alkaline" fly ash before carbonization showed the illusion of admission to landfill with only a small amount of chemical addition or even without curing/stabilization. The leached concentrations of Zn and Cd from "alkaline" fly ash after carbonation were significantly higher. The risk assessment of the leakage of heavy metals in the case of a single artificial composite liner system showed that the exposure concentrations of Pb, Zn, and Cd in samples exceeded Standard for groundwater quality (GB/T 14848-2017) the Class III permissible limits after carbonation; exposure risk for Cd was exceeded in all samples. However, although the use of a double-layer artificial composite liner to improve the level of impermeability effectively reduced the risk of Cd leaching, so that none of the non-carcinogenic risks exceeded the standard, the carcinogenic risk of Cd in the carbonized samples exceeded the factor of 1.1-4.5 of the acceptable hazard quotient, and the contamination characteristics of the alkaline fly ash still need to be kept in view.

Accuracy Assessment of Three-Dimensional Surface Imaging-Based Distance Measurements of the Face: Comparison of a Handheld Facial Scanner and a Stationary Whole-Body Surface Imaging Device.

Three-dimensional surface imaging (3DSI) has been shown to be a useful tool for plastic surgeons in the preoperative, intraoperative, and postoperative setting. The objective of this investigation was to compare the accuracy of facial surface distance measurements using both a handheld facial 3DSI device and a stationary whole-body 3DSI device. Users should be aware of deviations when obtaining 3DSI using the presented imaging devices but should not refrain from using them, as the absolute differences might be too small to play a role in both, clinical and research, settings.

Halogenated flame retardants in wild, prey-sized mud carp from an e-waste recycling site in South China, 2006-2016: Residue dynamics and ecological risk assessment.

The crude e-waste recycling has been regulated in China since the late 2000s; however, information on the recent levels and the ecological risks of e-waste derived contaminants such as halogenated flame retardants (HFRs) in the e-waste sites are limited. We therefore examined the concentrations of several HFRs in wild, prey-sized mud carps collected from a typical e-waste site in 2006, 2011 and 2016, to understand the exposure dynamics and ecological risk of these chemicals. Several ecological and biological parameters including δ15N, δ13C, body size and lipid content of the fish were also examined, to ensure an overall uniformity of the sample set among the sampling years. Among the HFRs measured, polybrominated diphenyl ethers (PBDEs) were detected at the highest concentrations (contributing >90% to ∑HFRs), followed by Dechlorane Plus (DPs), polybrominated biphenyls (PBBs), and alternative brominated flame retardants (ABFRs). The fish concentrations of ∑PBDEs, ∑PBBs and ∑DPs significantly dropped by 65%, 57% and 53% from 2006 to 2011, and 12%, 74% and 51% from 2011 to 2016, respectively; likely reflecting the positive impact of the environmental regulations on crude e-waste recycling. The ∑ABFRs concentrations were also decreased by 80% from 2006 to 2011, but increased by 127% from 2011 to 2016; suggesting possible fresh input of these novel HFRs in recent years. In addition to the changes in the HFR concentrations, contaminant profiles in the fish were also changed, possibly due to environmental degradation of the HFRs. Despite our conservative method of risk assessment, we found that PBDEs posed an important risk both for the mud carp and for piscivorous wildlife that inhabit the e-waste site.

Digital Leg Volume Quantification: Precision Assessment of a Novel Workflow Based on Single Capture Three-dimensional Whole-Body Surface Imaging.

Whole-body three-dimensional surface imaging (3DSI) offers the ability to monitor morphologic changes in multiple areas without the need to individually scan every anatomical region of interest. One area of application is the digital quantification of leg volume. Certain types of morphology do not permit complete circumferential scan of the leg surface. A workflow capable of precisely estimating the missing data is therefore required. We thus aimed to describe and apply a novel workflow to collect bilateral leg volume measurements from whole-body 3D surface scans regardless of leg morphology and to assess workflow precision. For each study participant, whole-body 3DSI was conducted twice successively in a single session with subject repositioning between scans. Paired samples of bilateral leg volume were calculated from the 3D surface data, with workflow variations for complete and limited leg surface visibility. Workflow precision was assessed by calculating the relative percent differences between repeated leg volumes. A total of 82 subjects were included in this study. The mean relative differences between paired left and right leg volumes were 0.73 ± 0.62% and 0.82 ± 0.65%. The workflow variations for completely and partially visible leg surfaces yielded similarly low values. The workflow examined in this study provides a precise method to digitally monitor leg volume regardless of leg morphology. It could aid in objectively comparing medical treatment options of the leg in a clinical setting. Whole-body scans acquired using the described 3DSI routine may allow simultaneous assessment of other changes in body morphology after further validation.

Estimating the health burden of aflatoxin attributable stunting among children in low income countries of Africa.

Numerous population-based studies have documented high prevalence of aflatoxin associated childhood stunting in low income countries. We provide an estimate of the disease burden of aflatoxin related stunting using data from the four African countries. For this empirical analysis, we obtained blood aflatoxin albumin adduct biomarker based exposure data as measured using ELISA technique and anthropometric measurement data from surveys done over a 12-year period from 2001 to 2012 in four low income countries in Africa. We used these data to calculate population attributable risk (PAR), life time disease burden for children under five by comparing two groups of stunted children using both prevalence and incidence-based approaches. We combined prevalence estimates with a disability weight, measuring childhood stunting and co-occurrence of stunting-underweight to produce years lived with disability. Using a previously reported mortality, years of life lost were estimated. We used probabilistic analysis to model these associations to estimate the disability-adjusted life-years (DALYs), and compared these with those given by the Institute for Health Metrics and Evaluation's Global Burden of Disease (GBD) 2016 study. The PAR increased from 3 to 36% for aflatoxin-related stunting and 14-50% for co-occurrence of stunting and underweight. Using prevalence-based approach, children with aflatoxin related stunting resulted in 48,965.20 (95% uncertainty interval (UI): 45,868.75-52,207.53) DALYs per 100,000 individuals. Children with co-occurrence of stunting and underweight due to exposure to aflatoxin resulted in 40,703.41 (95% UI: 38,041.57-43,517.89) DALYs per 100,000 individuals. Uncertainty analysis revealed that reducing aflatoxin exposure in high exposure areas upto non-detectable levels could save the stunting DALYs up to 50%. The burden of childhood all causes stunting is greater in countries with higher aflatoxin exposure such as Benin. In high exposure areas, these results might help guide research protocols and prioritisation efforts and focus aflatoxin exposure reduction. HEFCE Global Challenge Research Fund Aflatoxin project.

A Novel External Quality Assessment of Chromosomal Karyotype Analysis Based on Chimera Image Assembly.

OBJECTIVE: This study aimed to establish a new external quality assessment (EQA) of chromosomal karyotype analysis. METHODS: Chimeric assembly A1 was established by collecting chimeric chromosome images prepared artificially from chromosomally abnormal amniocytes remaining after prenatal diagnosis. Chimeric assembly B1 and nonchimeric assembly C1 were constructed through the collection of chimeric and nonchimeric chromosome images from prenatal diagnosis, respectively. Then, chromosome images were selected randomly from assemblies A1, B1, or C1 to send to 20 technicians via email to verify the validity of a new EQA of chromosomal karyotype analysis. RESULTS: According to the EQA of 20 technicians, 47,XX,+mar from assembly A was easily misdiagnosed as 47,XX,+19 or 47,XXY, and 45,XX,t(13;22) (q10;q10) was misdiagnosed as 45,XX,13S+,-22. The total misdiagnosis rate was 3.8%. For assembly B, 46,X,+mar and 46,X,idic(Y) were easily misdiagnosed as 46,XY and 46,X,+mar, respectively. In addition, some testers missed 47,XXX in 47,XXX[2]/46,XX[48], as well as 47,XX,+18 in 46,XX [47]/47,XX,+18[3], and 45,X and 47,XXX in 46,XX[47]/45,X[2]/47,XXX[1]. The total misdiagnosis rate was 4.2%. All karyo-types from assembly C were correctly diagnosed, although incorrect descriptions used for 4% of cases. CONCLUSION: The quality of chromosome karyotype analysis can be comprehensively evaluated by a new EQA based on assembly A1 or B1.

[Pollution Characteristics and Health Risk Assessment of Hazardous Air Pollutants in the Surroundings of Three Petrochemical Industries in Northwest China].

The samples in the surroundings of three representative petrochemical industries in Northwest China were collected by summa canister/adsorption using activated carbon/glass fiber filter, and then they were analyzed for 13 hazardous air pollutants by gas chromatography-mass spectrometry/gas chromatograph/high performance liquid chromatography. The pollution characteristics and human health risk of hazardous air pollutants were discussed. The results showed that 8 hazardous air pollutants existed in the surroundings of all petrochemical industries. The detection frequency for 8 hazardous air pollutants exceeded 80%. The ranges of the average concentrations of benzene series(BTEX), 1,3-butadiene, 1,4-dichlorobenzene, benzo[a]pyrene were 48.01-182.75 µg·m-3, 6.28-7.95 µg·m-3, 5.53-12.62 µg·m-3 and 7.03-36.08 ng·m-3. Daily average concentration of benzo[a]pyrene was 1.8-13.4 times higher than the limit of national standard level-Ⅱ, and those of benzene, toluene and xylene were also over their limits of standard to different degrees. The non-carcinogenic risks of benzo[a]pyrene and 1,3-butadiene were beyond acceptable levels around the three petrochemical industries in Northwest China. Meanwhile, the non-carcinogenic health impact of benzene was appreciable on the exposed population of Lanzhou petrochemical industrial area. The carcinogenic risks of benzene, ethylbenzene, styrene, 1,3-butadiene, 1,4-dichlorobenzene and benzo[a]pyrene were beyond acceptable levels. At the same time, the carcinogenic risks of benzene, 1,3-butadiene and 1,4-dichlorobenzene were significantly higher than their acceptable ranges recommended by US EPA.

Liver failure after hepatectomy: A risk assessment using the pre-hepatectomy shear wave elastography technique.

OBJECTIVE: To determine the efficacy of liver stiffness (LS) measurements utilizing the Shear Wave Elastography (SWE) technique for predicting post-hepatectomy liver failure (PHLF) among patients with hepatocellular carcinoma (HCC). METHODS: Data from eighty consecutive patients who were undergoing hepatectomy for HCC were prospectively identified and evaluated with preoperative SWE. The SWE was measured with advanced ultrasound equipment (Philips EPIQ7; Philips Healthcare, Seattle, WA, USA). PHLF classification was defined according to the International Study Group of Liver Surgery Recommendations (ISGLS). RESULTS: SWE was successfully performed in 77 patients. According to the ISGLS criteria, PHLF occurred in 35.1% of patients (27 patients), including 2/25 patients with Grade A/B, respectively. Elevated SWE values (P=0.002) and histological cirrhosis (P=0.003) were independent predictors of PHLF according to the multivariate analysis. Patients with SWE values higher than or equal to 6.9kPa were identified at higher risk of PHLF (area under the curve: 0.843, sensitivity: 77.8% and specificity: 78.0%). Postoperative dynamic course of the median the Model For End-stage Liver Disease (MELD) score showed irregular changes among patients with an SWE >6.9kPa. Patients with an SWE <6.9kPa, postoperative dynamic course of the median MELD score gradually decreased. CONCLUSION: LS measured with SWE is a valid and reliable method for the prediction of PHLF grade A/B among patients with HCC. SWE could become a routine examination for the preoperative evaluation of PHLF.

[Impact of Phosphogypsum Wastes on the Wheat Growth and CO2 Emissions and Evaluation of Economic-environmental Benefit].

Phosphogypsum is a phosphorus chemical waste which has not been managed and reused well, resultantly, causing environmental pollution and land-occupation. Phosphogypsum wastes were used as a soil amendment to assess the effect on wheat growth, yield and CO2 emissions from winter wheat fields. Its economic and environmental benefits were analyzed at the same time. The results showed that wheat yield was increased by 37.71% in the treatment of phosphogypsum of 2 100 kg x hm(-2). Compared with the control treatment, throughout the wheat growing season, CO2 emission was accumulatively reduced by 3% in the treatment of phosphogypsum waste of 1050 kg x hm(-2), while reduced by 8% , 10% , and 6% during the jointing stage, heading date and filling period of wheat, respectively; while CO2 emission was accumulatively reduced by 7% in the treatment of phosphogypsum waste of 2 100 kg x hm(-2) throughout the wheat growing season, as reduced by 11% , 4% , and 12% during the reviving wintering stage, heading date and filling period of wheat, respectively. It was better for CO2 emission reduction in the treatment of a larger amount of phosphogypsum waste. In the case of application of phosphogypsum waste residue within a certain range, the emission intensity of CO2 ( CO2 emissions of per unit of fresh weight or CO2 emissions of per unit of yield) , spike length, fresh weight and yield showed a significantly negative correlation--the longer the ear length, the greater fresh weight and yield and the lower the CO2 emissions intensity. As to the carbon trading, phosphogypsum utilization was of high economic and environmental benefits. Compared with the control, the ratio of input to output changed from 1: 8.3 to 1: 10.7, which in the same situation of investment the output could be increased by 28.92% ; phosphogypsum as a greenhouse gas reducing agent in the wheat field, it could decrease the cost and increase the environmental benefit totally about 290 yuan per unit of ton. The results demonstrated phosphogypsum wastes could obviously decrease the CO2 emission from field soil and had a great potential to control agricultural greenhouse gases. Hopefully it has an important application perspective for the low-carbon, ecological and sustainable agricultural development.

Status and determinants of health literacy among adolescents in Guangdong, China.

BACKGROUND: Previous studies for non-communicable disease cotrol, including cancer, have mostly relied on health literacy in adults. However, limited studies are available for adolescents. This study aimed to assess the status and determinants of health literacy in in-school adolescents in Guangdong, China. MATERIALS AND METHODS: A total of 3,821 students aged 13-25 years were selected by multi-stage cluster sampling. After the questionnaire of health literacy was answered, the total scores for health knowledge (18 questions), skills (5 questions) and behaviors (14 questions) were determined. The total scores for health literacy and each subscale were recoded into adequate and inadequate subgroups, and logistic regression models were used to identify factors associated with each outcome variable. RESULTS: The prevalence of adequate health literacy was 14.4%, and the prevalences for adequate knowledge, skills and behavior were 22.4%, 64.7% and 6.6%, respectively. Students coming from prestigious schools and having parents with higher education had higher odds of having adequate knowledge, skills and behaviors. Female students had higher odds of having adequate knowledge and behaviors. Students in grade 7-8 had higher odds of having adequate knowledge and skills. The health knowledge was positive associated with health skills (odds ratio [OR]=2.1, 95% confidence interval [CI] 1.7-2.5) and behaviors (OR=3.0, 95% CI 2.3-4.0), and health skills were positive associated with health behaviors (OR=2.6, 95% CI 1.8-3.8). CONCLUSIONS: Further efforts should be made to increase adolescents' health knowledge and behaviors, especially for low grade and male students in non-prestigious schools.

The origin of novel avian influenza A (H7N9) and mutation dynamics for its human-to-human transmissible capacity.

In February 2013, H7N9 (A/H7N9/2013_China), a novel avian influenza virus, broke out in eastern China and caused human death. It is a global priority to discover its origin and the point in time at which it will become transmittable between humans. We present here an interdisciplinary method to track the origin of H7N9 virus in China and to establish an evolutionary dynamics model for its human-to-human transmission via mutations. After comparing influenza viruses from China since 1983, we established an A/H7N9/2013_China virus evolutionary phylogenetic tree and found that the human instances of virus infection were of avian origin and clustered into an independent line. Comparing hemagglutinin (HA) and neuraminidase (NA) gene sequences of A/H7N9/2013_China viruses with all human-to-human, avian, and swine influenza viruses in China in the past 30 years, we found that A/H7N9/2013_China viruses originated from Baer's Pochard H7N1 virus of Hu Nan Province 2010 (HA gene, EPI: 370846, similarity with H7N9 is 95.5%) and duck influenza viruses of Nanchang city 2000 (NA gene, EPI: 387555, similarity with H7N9 is 97%) through genetic re-assortment. HA and NA gene sequence comparison indicated that A/H7N9/2013_China virus was not similar to human-to-human transmittable influenza viruses. To simulate the evolution dynamics required for human-to-human transmission mutations of H7N9 virus, we employed the Markov model. The result of this calculation indicated that the virus would acquire properties for human-to-human transmission in 11.3 years (95% confidence interval (CI): 11.2-11.3, HA gene).

Occurrence, fate and ecotoxicological assessment of pharmaceutically active compounds in wastewater and sludge from wastewater treatment plants in Chongqing, the Three Gorges Reservoir Area.

The occurrence, removal and ecotoxicological assessment of 21 pharmaceutically active compounds (PhACs) including antibiotics, analgesics, antiepileptics, antilipidemics and antihypersensitives, were studied at four municipal wastewater treatment plants (WWTP) in Chongqing, the Three Gorges Reservoir Area. Individual treatment unit effluents, as well as primary and secondary sludge, were sampled and analyzed for the selected PhACs to evaluate their biodegradation, persistence and partitioning behaviors. PhACs were identified and quantified using high performance liquid chromatography/tandem mass spectrometry after solid-phase extraction. All the 21 analyzed PhACs were detected in wastewater and the target PhACs except acetaminophen, ibuprofen and gemfibrozil, were also found in sludge. The concentrations of the antibiotics and SVT were comparable to or even higher than those reported in developed countries, while the case of other target PhACs was opposite. The elimination of PhACs except acetaminophen was incomplete and a wide range of elimination efficiencies during the treatment were observed, i.e. from "negative removal" to 99.5%. The removal of PhACs was insignificant in primary and disinfection processes, and was mainly achieved during the biological treatment. Based on the mass balance analysis, biodegradation is believed to be the primary removal mechanism, whereas only about 1.5% of the total mass load of the target PhACs was removed by sorption. Experimentally estimated distribution coefficients (<500 L/kg, with a few exceptions) also indicate that biodegradation/transformation was responsible for the removal of the target PhACs. Ecotoxicological assessment indicated that the environment concentrations of single compounds (including sulfadiazine, sulfamethoxazole, ofloxacin, azithromycin and erythromycin-H2O) in effluent and sludge, as well as the mixture of the 21 detected PhACs in effluent, sludge and receiving water had a significant ecotoxicological risk to algae. Therefore, further control of PhACs in effluent and sludge is required before their discharge and application to prevent their introduction into the environment.

[Variation characteristics and potential ecological risk assessment of heavy metals in the surface sediments of Bohai Bay].

The geochemical characteristics of eight heavy metals (Cd, Co, Cr, Cu, Ni, Pb, V and Zn) in two sediment cores from Bohai Bay, North China, were studied. Sediment samples were collected from 27 stations in spring 2008. A sequential extractions, procedure was used to gain their fractionation information. Five operationally defined fractions were obtained by this protocol, i. e. exchangeable (L1), bound to carbonates (L2), bound to Fe/Mn-oxides (L3), bound to organic matter and sulphides (LA), and residual fraction (R5). Combined with ecological risk in total contents and fraction, a series of results and viewpoints with regard to distribution characteristics of heavy metals were presented, as well as ecological risk and controlling factors. Heavy metals in sediments were mainly concentrated in the middle region with fine particle. The distributions of V, Ni, Cu, Pb, Co, Cd were mainly controlled by nature source, while Zn and Cr can be easily impacted by environment or human input. Coming from atmospheric deposition and riverine, Pb was different with other heavy metals. Sequential extractions suggested that V, Zn, Cr were mainly composed with residual fractions, while Co, Ni, Cu were dominated by labile fractions. The percentage of labile Co increased from inner to outside, labile Ni reached maximum at station A3, labile Cu and Pb concentrated in the middle of Bohai Bay, while Cu achieved maximum at station D1 near Yellow River. Labile heavy metals were enriched near the estuary of Haihe River. The order of enrichment factors (EF) of heavy metals was Pb > Cd > Zn > Cr > V > Co > Cu > Ni. And the EF of Pb, Cd and Zn were above 1, suggesting that they could be polluted by exterior input, while the sediment quality was relatively good in general. The ratios of labile and residual fraction showed that V and Cr were clean, Zn was partly in slightly polluted, Co was mostly slightly polluted, Cu was from clean to moderately polluted, Ni was polluted from slightly to heavy, and Pb was polluted heaviest in all heavy metal. In conclusion, V, Cr and Co were clean, Cu and Zn may be polluted, while Pb was polluted heaviest.

Clinical assessment of awake endotracheal intubation using the lightwand technique alone in patients with difficult airways.

BACKGROUND: There is few study to determine whether the use of the lightwand technique alone could achieve effective, safe and successful awake endotracheal intubation (ETI), therefore we designed a prospective clinical study to systematically evaluate the feasibility, safety and efficacy of awake ETI using the lightwand alone in patients with difficult airways. METHODS: Seventy adult patients with difficult airways were enrolled in this study. After the desired sedation with fentanyl and midazolam, airway topical anesthesia was performed with 9 ml of 2% lidocaine, which were in order sprayed in three aliquots at 5 minutes intervals into the supraglottic (two doses) and laryngotracheal areas (one dose) using a combined unit of the lightwand and MADgic atomizer. After airway topical anesthesia, awake ETI was performed using a Lightwand. Subjective assessments by patients and operators using the visual analogue scores (VAS), and objective assessments by an independent investigator using patients' tolerance and reaction scores, coughing severity, intubating conditions and cardiovascular variables were taken as the observed parameters. RESULTS: Of 210 airway sprays, 197 (93.8%) were successfully completed on the first attempt. The total time for airway spray was (14.6 +/- 1.5) minutes. During airway topical anesthesia, the average patients' tolerance scores were 1.7 - 2.3. After airway topical anesthesia, the mean VAS for discomfort levels that the patients reported was 6.5. Also airway topical anesthesia procedure was rated as acceptable and no discomfort by 94.3% of patients. The lightwand-guided awake ETI was successfully completed on first attempt within 29 seconds in all patients. During awake ETI, patients' reaction and coughing scores were 1.9 and 1.6, respectively. All patients exhibited excellent or acceptable intubating conditions. Cardiovascular monitoring revealed that changes of systolic blood pressure and heart rate at each stage of airway manipulations were less than 20% of baseline values. The postoperative follow-up showed that 95.7% of patients had no recall or slight memories of all airway instrumentation. The incidence of postoperative mild airway complications was 38.6%. CONCLUSION: Alone use of the lightwand technique can achieve effective, safe and successful awake ETI in patients with difficult airways.

Assessment of small-dose fentanyl and sufentanil blunting the cardiovascular responses to laryngoscopy and intubation in children.

BACKGROUND: The authors found no study assessing the efficacy of small-dose narcotics on the cardiovascular response from intubation in children, so they observed the effects of fentanyl 2 microg x kg(-1) and sufentanil 0.2 microg x kg(-1) on the cardiovascular changes during laryngoscopy and intubation in children. METHODS: Ninety-three children aged 3-9 years were randomized to one of three groups to receive the following treatments in a double-blind manner: normal saline (group C), fentanyl 2 microg x kg(-1) (group F) and sufentanil 0.2 microg x kg(-1) (group S) 2 min before induction. Noninvasive blood pressure (BP) and heart rate (HR) were recorded before anesthesia induction (baseline value), immediately before intubation (postinduction values), at intubation and 5 min after intubation at 1-min interval. RESULTS: Tracheal intubation caused significant increases in BP and HR in the three groups compared with baseline values. BP and HR at intubation and after intubation and their maximum values during observation were significantly lower in groups F and S than in group C (P < 0.05). The mean percent increases of systolic blood pressure (SBP) and HR at intubation were significantly lower in group S, 7% and 10%, than in group F, 17% and 25% (P < 0.05). The increases in SBP and HR of more than 30% of baseline values during the observation period were significantly higher in group F, 27% and 43%, than in group S, 0% and 3% (P < 0.05). CONCLUSIONS: When used as part of anesthesia induction with propofol in children, sufentanil 0.2 microg x kg(-1) 2 min before induction is more effective in attenuating the cardiovascular intubation response than fentanyl 2 microg x kg(-1).