Per- and polyfluoralkyl substances (PFAS) in drinking water system: Target and non-target screening and removal assessment.

The massive use and the persistence of per- and polyfluoroalkyl substances (PFAS) have led to their frequent detection in aquatic environments, which may further threaten drinking water safety. So far, our knowledge about the occurrence of PFAS in drinking water system is still very limited. Here we investigated the occurrence and removal of PFAS in a drinking water system using non-target, suspect and target screening strategies. Sampling was performed in three seasons in the drinking water system including a water source, two drinking water treatment plants, and tap water in five households. The results showed detection of 17 homologous series with 51 homologues in non-target screening and 50 potential PFAS detected in suspect screening. Probable structures were proposed for 15 PFAS with high confidence levels (the first three of the five levels), with seven of them being reported for the first time in drinking water system. Semi-quantification was performed on seven homologous series based on target PFAS, the estimated total concentrations for non-target PFAS ranged between 4.10 and 17.6 ng/L. Nine out of 50 target PFAS were found and precisely quantified (

Sex Disparities in the Association of Serum Uric Acid With Kidney Stone: A Cross-Sectional Study in China.

BACKGROUND AND AIMS: Urolithiasis is characterized by high rates of prevalence and recurrence. Hyperuricemia is related to various diseases. We hope to determine the association between serum uric acid (UA) level and kidney stone (KS). METHODS: In this population-based cross-sectional study, a total of 82,017 Chinese individuals who underwent a comprehensive examination in 2017 were included. The KS was diagnosed based on ultrasonography examination outcomes. Fully adjusted odds ratio (OR) for KS, and mean difference between the two groups were applied to determine the association of UA level with KS. RESULTS: Among the 82,017 participants included in this study (aged 18~99 years), 9,435 participants (11.5%) are diagnosed with KS. A proportion of 56.3% of individuals is male. The mean UA level of overall participants is 341.77 µmol/L. The participants with KS report higher UA level than the participants without KS [mean UA level 369.91 vs. 338.11 µmol/L; mean difference (MD), 31.96 (95% CI, 29.61~34.28) µmol/L]. In men, the OR for KS significantly increases from 330 µmol/L UA level. Every 50 µmol/L elevation of UA level increases the risk of KS formation by about 10.7% above the UA level of 330 µmol/L in men. The subgroup analysis for male is consistent with the overall result except for the participants presenting underweight [adjusted OR, 1.035 (0.875~1.217); MD, -5.57 (-16.45~11.37)], low cholesterol [adjusted OR, 1.088 (0.938~1.261); MD, 8.18 (-7.93~24.68)] or high estimated glomerular filtration rate (eGFR) [adjusted OR, 1.044 (0.983~1.108); MD, 5.61 (-1.84~13.36)]. However, no significant association is observed in women between UA and KS either in all female participants or in female subgroups. CONCLUSION: Among Chinese adults, UA level is associated with KS in a dose-response manner in men but not in women. However, the association becomes considerably weak in male participants with malnutrition status.

Occurrence, fate and risk assessment of androgens in ten wastewater treatment plants and receiving rivers of South China.

Androgens are one class of steroids that could cause endocrine disrupting effects in aquatic organisms. However, little information is available about androgens in wastewater treatment plants (WWTPs) with different treatment technologies. Here we investigated the occurrence, removal, and fate of fourteen natural and synthetic androgens in ten WWTPs of Guangdong province, south China. The results showed detection of ten androgens in the influents of the ten WWTPs, with concentrations up to 4650 ng/L (androsta-1,4-diene-3,17-dione). But only three androgens androsta-1,4-diene-3,17-dione, 4-androstene-3,17-dione and 17ß-boldenone were detected in the final effluents of the ten WWTPs, while six androgens androsta-1,4-diene-3,17-dione (N.D. to 43.0 ng/g), 4-androstene-3,17-dione (2.06-42.7 ng/g), epi-androsterone (N.D. to 506 ng/g), testosterone (0.29-4.24 ng/g), 17ß-boldenone (N.D. to 2.05 ng/g) and methyl testosterone (N.D. to 0.70 ng/g) were found in activated sludge. The aqueous phase removal rates for most androgens in the WWTPs exceeded 95% except for 4-androstene-3,17-dione with its removal rates varying between 79.5% and 100%. The removal of androgens in the WWTPs could be attributed mainly to biodegradation while removal by precipitation, volatilization, sludge absorption and oxidation was very limited. Eight androgens were also found in five receiving rivers. The risk quotients of some androgens (androsta-1,4-diene-3,17-dione, 4-androstene-3,17-dione, methyl testosterone, 17α-trenbolone) exceeded 1 in the receiving rivers, showing high risks to aquatic organisms. Further studies are needed to understand the origin of these high risk androgens and ecological effects.

Biocides in the Yangtze River of China: spatiotemporal distribution, mass load and risk assessment.

Nineteen biocides were investigated in the Yangtze River to understand their spatiotemporal distribution, mass loads and ecological risks. Fourteen biocides were detected, with the highest concentrations up to 166 ng/L for DEET in surface water, and 54.3 ng/g dry weight (dw) for triclocarban in sediment. The dominant biocides were DEET and methylparaben, with their detection frequencies of 100% in both phases. An estimate of 152 t/y of 14 biocides was carried by the Yangtze River to the East China Sea. The distribution of biocides in the aquatic environments was significantly correlated to Gross Domestic Product (GDP), total phosphorus (TP) and total nitrogen (TN), suggesting dominant input sources from domestic wastewater of the cities along the river. Risk assessment showed high ecological risks posed by carbendazim in both phases and by triclosan in sediment. Therefore, proper measures should be taken to reduce the input of biocides into the river systems.

Cost-effectiveness of diagnostic approaches to vasovagal syncope.

BACKGROUND: Syncope is a common clinical problem with multiple causes. Vasovagal syncope (VVS) is by far the most frequent cause of syncope in children and adolescents. The traditional diagnostic approach to VVS of children and adolescents is based on a series of tests to exclude all other causes, which is complex and time and medical resource consuming. Attempts have been made to develop a new cost-effective diagnostic approach to avoid these problems. This study aimed to compare the economic effectiveness and diagnostic value of the traditional diagnostic approach to VVS of children with a new diagnostic approach. METHODS: One hundred and eighteen children diagnosed as VVS were divided into two groups according to the different diagnostic approaches. The diagnostic value of the two diagnostic approaches was then analyzed. Meanwhile, the costs of hospitalization, diagnostic testing and hospital stay were determined. Data were evaluated by the cost-minimization analysis. RESULTS: The diagnostic value of the new diagnostic approach was similar to that of the traditional diagnostic approach (56.57% vs. 53.91%, P = 0.697). However, the cost of hospitalization per patient by the new diagnostic approach was (1507.08 ± 144.63) Yuan (RMB) which was less than that of the traditional diagnostic approach (2603.64 ± 208.19) Yuan. The costs of diagnostic tests per patient by the new diagnostic approach was (1256.04 ± 109.14) Yuan and by the traditional approach (2175.22 ± 153.32) Yuan. CONCLUSION: Compared to the traditional diagnostic approach to diagnose VVS in children and adolescents, the new diagnostic approach is of a good economic value, and it should be popularized in clinical practice.

[Combination products: a new model of medical devices].

A combination product is a new model of the medical product that incorporates at least two of the regulated component categories of device, drug, or biological product into one product. It has become a new hot point within the development of devices and drugs, and has brought about a new opportunity for device and drug industries and a new challenge for administration too. In the paper, the properties of combination products are summed up and the impact on device and drug industries are discussed.