Eco-friendly revenues for healthcare: assessing the relationship between green taxation, public health expenditures, and life expectancy in China.

Introduction: The synergy of green taxation, public health expenditures, and life expectancy emerges as a compelling narrative in the intricate symphony of environmental responsibility and public well-being. Therefore, this study examine the impact of green taxation on life expectancy and the moderating role of public health expenditure on the said nexus, particularly in the context of China, an emerging economy. Methods: Statistical data is collected from the National Bureau of Statistics of China to empirically examine the proposed relationships. The dataset contains provincial data across years. Results: Using fixed-effect and system GMM regression models alongwith control variables, the results found a positive and statistically significant influence of green taxation on life expectancy. Moreover, public health expenditures have a positive and statistically significant partial moderating impact on the direct relationship. Discussion: These findings suggest that the higher cost of pollution encourages individuals and businesses to shift to less environmentally harmful alternatives, subsequently improving public health. Moreover, government investment in the health sector increases the availability and accessibility of health facilities; thus, the positive impact of green taxation on public health gets more pronounced. The findings significantly contribute to the fields of environmental and health economics and provide a new avenue of research for the academic community and policymakers.

Ultrasound-Based Deep Learning Radiomics Nomogram for the Assessment of Lymphovascular Invasion in Invasive Breast Cancer: A Multicenter Study.

RATIONALE AND OBJECTIVES: The aim of this study was to develop a deep learning radiomics nomogram (DLRN) based on B-mode ultrasound (BMUS) and color doppler flow imaging (CDFI) images for preoperative assessment of lymphovascular invasion (LVI) status in invasive breast cancer (IBC). MATERIALS AND METHODS: In this multicenter, retrospective study, 832 pathologically confirmed IBC patients were recruited from eight hospitals. The samples were divided into training, internal test, and external test sets. Deep learning and handcrafted radiomics features reflecting tumor phenotypes on BMUS and CDFI images were extracted. The BMUS score and CDFI score were calculated after radiomics feature selection. Subsequently, a DLRN was developed based on the scores and independent clinic-ultrasonic risk variables. The performance of the DLRN was evaluated for calibration, discrimination, and clinical usefulness. RESULTS: The DLRN predicted the LVI with accuracy, achieving an area under the receiver operating characteristic curve of 0.93 (95% CI 0.90-0.95), 0.91 (95% CI 0.87-0.95), and 0.91 (95% CI 0.86-0.94) in the training, internal test, and external test sets, respectively, with good calibration. The DLRN demonstrated superior performance compared to the clinical model and single scores across all three sets (p < 0.05). Decision curve analysis and clinical impact curve confirmed the clinical utility of the model. Furthermore, significant enhancements in net reclassification improvement (NRI) and integrated discrimination improvement (IDI) indicated that the two scores could serve as highly valuable biomarkers for assessing LVI. CONCLUSION: The DLRN exhibited strong predictive value for LVI in IBC, providing valuable information for individualized treatment decisions.

A framework for risk matrix design: A case of MASS navigation risk.

Risk matrix, a tool for visualizing risk assessment results, is essential to facilitate the risk communication and risk management in risk-based decision-making processes related to new and unexplored socio-technical systems. The use of an appropriate risk matrix is discussed in the literature, but it is overlooked for emerging technologies such as Maritime Autonomous Surface Ships (MASS). In this study, a comprehensive framework for developing a risk matrix based on fuzzy Analytic Hierarchy Process (AHP) is proposed. In this framework, a linear function is defined where the risk index is treated as a response variable, while the probability and consequence indices are explanatory variables, with weights of these two indices representing their importance on given risk level. This significance is assessed by experts and quantified using AHP in interval type 2 fuzzy environment. A continuous risk diagram is then created and converted into a risk matrix that can be improved. To verify the feasibility of the proposed framework, a risk matrix is designed in the context of MASS grounding. The results show that the proposed approach is feasible. Our discussion results can provide new insights for the design of risk matrices and promote the management of MASS navigational risks.

ONOO- Activatable Fluorescent Sulfur Dioxide Donor for a More Accurate Assessment of Cell Ferroptosis.

Ferroptosis is critical in the treatment of tumor therapies. Thus, monitoring reactive oxygen species (ROS) is of great significance for accurate assessment in ferroptosis without any interference. However, current probes for monitoring ROS during ferroptosis suffer from a drawback in that the probes consume ROS during detection, which inhibits the ferroptosis process and thus affects the accuracy and effectiveness of monitoring the process of ferroptosis. Herein, a new fluorescent donor probe, TFMU-SO2D, with the combination of the moiety of the SO2 donor is designed and synthesized by introducing the aryl boronate moieties that could give it the ability to effectively recognize ONOO-. The released SO2 could consume excess glutathione and regulate oxidative stress by elevating ROS levels, which would offset the ROS depletion by TFMU-SO2D and ensure accuracy in monitoring the ferroptosis process. The experimental results demonstrated that TFMU-SO2D possessed satisfactory performance for monitoring ONOO- as well as simultaneously releasing SO2 in oxidative stress stimulated by monensin and ferroptosis stimulated by erastin and RSL3. Additionally, the capability of SO2 synergized with ferroptosis to inhibit the viability of cancer cells was demonstrated by the CCK8 assay, which may be due to the fact that SO2 can potentiate ferroptosis cell death by increasing the ROS level. Overall, these combined results indicated that TFMU-SO2D possesses the excellent ability to precisely monitor ONOO- during ferroptosis without interference, which is significant for accurately accessing ferroptosis, cancer treatment, and drug development.

Quantitative Assessment Characteristics of Small Pulmonary Vessel Remodelling in Populations at High Risk for COPD and Smokers Using Low-Dose CT.

Purpose: To explore the morphological alterations in small pulmonary vessels in populations at high risk for chronic obstructive pulmonary disease (COPD) and smokers based on multiple computed tomography (CT) quantitative parameters. Patients and Methods: A total of 1969 Three Major Chest Diseases Screening Study participants with available demographic data and smoking history who underwent low-dose chest CT from 2018 to 2020 were included. All subjects were divided into normal, high risk for COPD, and COPD groups according to their pulmonary function test (PFT) results. Furthermore, the three groups were further subdivided into never-smokers, current smokers, and former smokers subgroups according to their smoking history. Quantitative parameters, such as the number, area at 6 mm~24 mm subpleura and volume of small pulmonary vessels, were extracted by computer software. Differences in small pulmonary vessel parameters among the groups were compared using two-way ANOVA. Results: The number, area at 6 mm~24 mm subpleura and volume of small pulmonary vessels in the group at high risk for COPD were lower than those in the normal group (P<0.05). The number, area at 6 mm~24 mm subpleura and volume of small pulmonary vessels in the COPD group were higher than those in the normal group (P<0.05). The number, area of small pulmonary vessels at 6 mm~12 mm subpleura in current smokers with high risk for COPD were higher than those in former smokers with high risk for COPD (P<0.05). Conclusion: The number, area, and volume of small pulmonary vessels in populations at high risk for COPD were decreased. Smoking cessation may impede structural changes in small pulmonary vessels in populations at high risk for COPD.

The assessment and forecasting of carbon emission for Gansu-Qinghai-Shaanxi of China.

For regional development, the assessment of regional low-carbon development level can fully reflect the current situation of low-carbon development, and the carbon emission forecasting can reveal the future trend of carbon emission and the pressure of emission reduction. It is significant to assess the low-carbon development level and forecast carbon emission. Therefore, this research constructs an index system to objectively reflect the low-carbon development level, and proposes IE-TOPSIS comprehensive assessment method to assess the regional low-carbon development level. For promoting the low-carbon development of the less developed areas in China, Gansu, Qinghai, and Shaanxi provinces are selected as the research objects. The results of comprehensive assessment show that low-carbon development level of the three provinces over past decade had an increasing trend. Furthermore, this research establishes a GM-GRA-DPC-PSOSVR combined forecasting model for carbon emission forecasting and it has higher forecasting accuracy than individual models. From 2021 to 2025, the forecasting results show that carbon emission of Shaanxi will continue to increase under the current development pattern, Gansu will increase slowly, while Qinghai will decrease.

Growth Control Strategy of Hydrogen-Containing Nanocrystalline Carbon Films during Plasma-Enhanced Chemical Vapor Deposition based on Molecular Dynamics-Monte Carlo Simulations.

Hydrogen-containing nanocrystalline carbon films (n-C:H) with amorphous-nanocrystalline hydrocarbon composite structures exhibit excellent properties in diverse applications. Plasma-enhanced chemical vapor deposition (PECVD) is commonly employed to prepare n-C:H films due to its ability to create an adjustable deposition environment and control film compositions. However, the atomic-scale growth mechanism of n-C:H remains poorly understood, obstructing the design of the appropriate deposition parameters and film compositions. This paper employs a state-of-the-art hybrid molecular dynamics-time-stamped force-biased Monte Carlo model (MD/tfMC) to simulate the plasma-assisted growth of n-C:H. Our results reveal that optimizing the energy of ion bombardments, deposition temperature, and precursor's H:C ratio is crucial for achieving the nucleation and growth of highly ordered n-C:H films. These findings are further validated through experimental observations and density functional theory calculations, which show that hydrogen atoms can promote the formation of nanocrystalline carbon through chemical catalytic processes. Additionally, we find that the crystallinity reaches its optimum when the H/C ratio is equal to 1. These theoretical insights provide an effective strategy for the controlled preparation of hydrogen-containing nanocrystalline carbon films.

Cylindrical granules in the development of mesalazine solid formulations (â ): Physical properties, compression behaviors, and tableting performances.

Cylindrical granules have been employed in the pharmaceutical industry. However, to our knowledge, the study on the compressibility and tabletability of cylindrical granules has not been reported. This study aimed to explore the effects of the physical properties of cylindrical granules on the compression behaviors and the tableting performances, with mesalazine (MSZ) as a model drug. First, the six formulations of MSZ cylindrical granules were extruded by changing the ethanol proportion in the binder. Then, the physical characteristics of MSZ cylindrical granules were systematically studied. Subsequently, the compressibility and tabletability were evaluated using different mathematic models. It was worth noting that highly porous cylindrical granules possessed favorable compressibility and good tabletability due to the increased pore volume, reduced density, and decreased fracture forces. Finally, dissolution tests were conducted and highly porous granules showed higher dissolution rates than the less porous ones, but an opposite trend was observed for the corresponding tablets. This study proved the importance of physical properties in the tableting process of cylindrical granules and provided strategies to improve their compressibility and tabletability.

Risk of Severe COVID-19 in Prevalent Users of Alpha-1 Adrenergic Receptor Antagonists: A National Case-Control Study of Medicare Beneficiaries.

BACKGROUND: Alpha-1 adrenergic receptor antagonists prevent cytokine storm in mouse sepsis models. This led to the hypothesis that alpha-1 blockers may prevent severe coronavirus disease 2019 (COVID-19), which is characterized by hypercytokinemia and progressive respiratory failure. METHODS: We performed an observational case-control study in male Medicare beneficiaries aged 65 years or older, with or without benign prostatic hyperplasia (BPH), and treated with alpha-1 receptor blockers or 5-alpha reductase inhibitors. Adjusted odds ratios (aOR) and 95% confidence intervals (CI) were estimated for outcomes of uncomplicated and severe COVID-19 hospitalization (intensive care unit admission, invasive mechanical ventilation, or death). RESULTS: There were 20,963 cases of hospitalized COVID-19 matched to 101,161 controls on calendar date and neighborhood of residence. In the primary analysis (males with BPH), there was no difference in risk of uncomplicated COVID-19 hospitalization (aOR 1.08, 95% CI 0.996-1.17) or hospitalization with severe complications (aOR 0.97, 95% CI 0.88-1.08). In the secondary analysis (males with or without BPH), the corresponding aORs were 1.02 (95% CI, 0.96-1.09) (uncomplicated) and 0.99 (95% CI, 0.91-1.07) (complicated), respectively. Subgroup and sensitivity analyses yielded similar results. Of note, there was no difference in risk of severe COVID-19 hospitalization when comparing non-selective vs selective alpha-1 blocker use (aOR 0.98, 95% CI 0.86-1.10), higher- vs lower-dose alpha-1 blocker use (aOR 0.96, 95% CI 0.86-1.08), or current vs remote alpha-1 blocker use (aOR 1.04, 95% CI 0.91-1.18). CONCLUSIONS: Prevalent use of alpha-1 receptor blockers was not associated with a protective or harmful effect on risk of uncomplicated or severe hospitalized COVID-19.

Cost-effective In Vivo and In Vitro Mouse Models for Evaluating Anticryptosporidial Drug Efficacy: Assessing Vorinostat, Docetaxel, and Baicalein.

BACKGROUND: Cryptosporidiosis is a significant diarrheal disease in humans and animals. Immunodeficient mice are the primary small animal models, but their high costs and specialized breeding/housing requirements limit in vivo drug testing. Numerous anticryptosporidial lead compounds identified in vitro remain untested in vivo. METHODS: Cryptosporidium tyzzeri, a natural mouse parasite closely related to Cryptosporidium parvum and Cryptosporidium hominis, was isolated to establish an infection model in immunocompetent mice. The model was validated using classic anticryptosporidial drugs (paromomycin and nitazoxanide) and then employed to assess the efficacy of 3 new leads (vorinostat, docetaxel, and baicalein). An in vitro culture of C. tyzzeri was also developed to complement the animal model. RESULTS: Chronic C. tyzzeri infection was established in chemically immunosuppressed wild-type mice. Paromomycin (1000 mg/kg/d) and nitazoxanide (100 mg/kg/d) demonstrated efficacy against C. tyzzeri. Vorinostat (30 mg/kg/d), docetaxel (25 mg/kg/d), and baicalein (50 mg/kg/d) were highly effective against C. tyzzeri infection. In vitro, nitazoxanide, vorinostat, docetaxel, and baicalein exhibited low to submicromolar efficacy against C. tyzzeri. CONCLUSIONS: Novel in vivo and in vitro models have been developed for cost-effective anticryptosporidial drug testing. Vorinostat, docetaxel, and baicalein show potential for repurposing and/or optimization for developing new anticryptosporidial drugs.

From the Perspectives of Pollution Governance and Public Health: A Research of China's Fiscal Expenditure on Energy Conservation and Environmental Protection.

Improving the scale and effectiveness of China's energy conservation and environmental protection fiscal expenditure is crucial to enhancing the capacity of ecological and environmental governance of China, considering the dual perspectives of pollution governance and public health. This article first explains the mechanism by which national energy conservation and environmental protection fiscal expenditure can improve pollution control and promote public health. Secondly, this article scrutinizes the current status and limitations of China's fiscal expenditure, highlighting the contribution of fiscal expenditure in the construction of ecological civilization from the standpoints of environmental governance and public health. Additionally, this study empirically uses DEA to measure the efficiency of the government's fiscal expenditure. Conclusions found that: First, environmental protection fiscal expenditure is mainly focused on technological transformation and pollution control, while relatively little is spent on public health protection. Second, the efficiency of environmental protection fiscal funds is relatively low. These suggestions aim to optimize the positive impact of energy conservation and environmental protection fiscal expenditure for improving pollution governance and promoting public health.

Study on the fundraising of horizontal ecological compensation under efficiency and fairness: a case study of the Yellow River Basin in China.

How to raise the ecological compensation fund for the Yellow River Basin is one of the key difficulties for executing the ecological compensation mechanism and ensuring the high-quality development of the entire basin. This paper, which is based on systems theory, analyzes the social-economic-ecological compound system of the Yellow River Basin. It makes the point that the goals of human-water harmony, ecological compensation efficiency improvement, and coordinated regional development should be achieved in raising ecological compensation funds. Guided by the raising targets, a two-layer fundraising model based on efficiency and fairness is constructed for ecological compensation. The upper-level model is built to calculate the ecological compensation efficiency of each compensation subject from an input-output perspective. The initial fundraising scheme was further determined to implement the efficiency principle. Within the framework of sustainable development theory, the lower-level model adheres to the fairness principle based on efficiency. The social-economic development level of the compensation subject is considered to discriminate and optimize the initial scheme. Additionally, the two-layer model was utilized to conduct an empirical analysis with the data of the Yellow River Basin from 2013 to 2020. The results show that the optimized fundraising scheme is in line with the actual development level of the Yellow River Basin. This study can provide a reference for the fundraising of horizontal ecological compensation and promote the sustainable development of the whole basin.

Prognostic Assessment and Risk Stratification in Patients With Postoperative Major Salivary Acinar Cell Carcinoma.

OBJECTIVE: To investigate the clinicopathological features and prognosis of postoperative major salivary acinar cell carcinoma (MSACC) and develop a prognostic model. STUDY DESIGN: Retrospective cohort analysis of a public database. SETTING: Patients with MSACC were identified from the Surveillance, Epidemiology, and End Results database (1975-2019). METHODS: Overall survival (OS) was evaluated using Kaplan-Meier curves and a log-rank test. Univariate and multivariate Cox analyses were performed to explore independent prognostic factors. The prognostic model was constructed using screened variables and further visualized with a nomogram and web calculator, and assessed by concordance index, the area under the curve, calibration curve, and decision-making curve analysis. RESULTS: An upward trend in the incidence of MSACC was observed throughout the study period. A total of 1398 patients were enrolled (training cohort: 978; validation cohort: 420), and the 5- and 10-year OS rates were 97.7% and 81.6%, respectively. Age, marital status, sex, histological grade, T stage, and lymph node status were identified as prognostic factors for OS. A novel nomogram was developed and showed excellent discrimination and clinical applicability. Additionally, a web calculator was designed to dynamically predict patient survival. Based on the nomogram-based score, a risk stratification system was constructed to distinguish patients with different risks. The OS of high-risk patients was significantly lower than that of the low-risk subgroup. CONCLUSION: Long-term survival in postoperative MSACC was influenced by 6 prognostic factors. The proposed model enables individualized survival prediction and risk stratification, prompting us to be vigilant in high-risk subgroups and consider timely adjustment of subsequent treatment.

Evaluation of an innovative mHealth-based integrated modality for smoking cessation in Chinese smokers: protocol for a randomized controlled trial.

BACKGROUND AND AIMS: Developing accessible, affordable, and effective approaches to smoking cessation is crucial for tobacco control. Mobile health (mHealth) based interventions have the potential to aid smokers in quitting, and integrating treatments from multiple sources may further enhance their accessibility and effectiveness. As part of our efforts in smoking cessation, we developed a novel behavioral intervention delivery modality for smoking cessation that integrated three interventions using the WeChat app, called the "Way to Quit" modality (WQ modality). It is presented here the protocol for a randomized controlled trial evaluating the effectiveness, feasibility, and cost-effectiveness of the WQ modality in Chinese smokers. METHODS: Eligible participants (n = 460) will be recruited via online advertisement in Beijing, China. They will be randomly assigned to receive either quitline-based treatment (QT, n = 230) or WQ modality-based treatment (WQ, n = 230) using a block randomization method. Participants in the QT group will receive telephone-assisted treatment over a four-week period (multi-call quitline protocol), while those in the WQ group will receive integrated interventions based on the WQ modality for four weeks. A four-week supply of nicotine replacement therapy (gums) will be provided to all participants. Participants will be asked to complete phone or online follow-up at 1, 3, 6, and 12-months. At 1-month follow-up, individuals with self-reported smoking abstinence for more than 7 days will be invited to receive an exhaled carbon monoxide (CO) test for biochemical validation. The primary aim is to determine whether the WQ modality is effective in assisting smokers in quitting smoking. The secondary aims are to evaluate the acceptability, satisfaction, and cost-effectiveness of the WQ modality. DISCUSSION: If the WQ modality is determined to be effective, acceptable, and affordable, it will be relatively easy to reach and provide professional cessation treatments to the communities, thus helping to reduce the disparities in smoking cessation services between different regions and socioeconomic groups. TRIAL REGISTRATION: Chinese Clinical Trial Registry: ChiCTR2200066427, Registered December 5, 2022.

Assessment of the spatiotemporal water quality variations in the Middle Route of China's South-to-North Water Diversion Project by multivariate analysis.

As an important drinking water source for North China, the Middle Route of China's South-to-North Water Diversion Project (MRP) must provide high-quality water to maintain the health and safety of more than 60 million people. However, different water transfer operation modes may affect the water quality status, and the spatiotemporal characteristics of water quality in the MRP, with high water transfer volumes, remain poorly understood. In this study, the differences in water quality in the MRP between the initial stage (Nov. 2015 to Oct. 2017, low transfer volumes) and the current stage (Nov. 2017 to Oct. 2020, high transfer volumes) were compared, and the spatiotemporal water quality variations in the current stage were evaluated using multivariate statistical methods. For this purpose, approximately 12,528 observations, including the datasets of 12 water quality parameters collected from 29 monitoring sites, were used. The results showed that the water quality status improved significantly during the current stage. Based on principal component analysis (PCA), physical parameters (natural), nutrients, organic matter and microbes (anthropogenic), and heavy metals (natural and anthropogenic) were the key factors influencing water quality variations. Based on hierarchical cluster analysis, 12 months were classified into two groups: the high-flow period (HFP, Jun.-Oct.) and the low-flow period (LFP, Nov.-May). Additionally, 29 sampling sites were grouped into three sections: the Henan section (HN; S1-S16), Hebei section (HB; S17-S24), and Tianjin-Beijing section (TB; S25-S29). From the perspective of water quality regulation, the total nitrogen concentration and permanganate index in the HB and TB sections of the MRP should be considered throughout the year, and the faecal coliform concentrations in these two sections should also be considered during the HFP. The results of this study could be helpful for local administrations to understand and control pollution and better protect the quality of water in the MRP.

Disinfection byproducts in indoor swimming pool water: Detection and human lifetime health risk assessment.

Quantification of regulated and emerging disinfection byproducts (DBPs) in swimming pool water, as well as the assessment of their lifetime health risk are limited in China. In this study, the occurrence of regulated DBPs (e.g., trihalomethanes, haloacetic acids) and emerging DBPs (e.g., haloacetonitriles, haloacetaldehydes) in indoor swimming pool water and the corresponding source water at a city in Eastern China were determined. The concentrations of DBPs in swimming pool water were 1-2 orders of magnitude higher than that in source water. Lifetime cancer and non-cancer risks of DBPs stemming from swimming pool water were also estimated. Inhalation and dermal exposure were the most significant exposure routes related to swimming pool DBP cancer and non-cancer risks. For the first time, buccal and aural exposure were considered, and were proven to be important routes of DBP exposure (accounting for 17.9%-38.9% of total risk). The cancer risks of DBPs for all swimmers were higher than 10-6 of lifetime exposure risk recommended by United States Environmental Protection Agency, and the competitive adult swimmers experienced the highest cancer risk (7.82 × 10-5). These findings provide important information and perspectives for future efforts to lower the health risks associated with exposure to DBPs in swimming pool water.

Fabrication of a label-free electrochemical cell-based biosensor for toxicity assessment of thiram.

Thiram has been widely used in agriculture and may invades the food chain, posing a threat to human health. In this research, a label-free electrochemical cell-based biosensor was presented for in vitro toxicity assessment of thiram. HepG2 cells were cultured on poly-l-lysine@gold nano-flowers functionalized indium tin oxide coated glass electrode (PLL@AuNFs/ITO) to serve as biorecognition elements. AuNFs were electrodeposited on ITO to provide an enlarged specific surface area and benefited the output signal amplification. PLL was selected as an effective biocompatible coating material to facilitate cell adhesion and proliferation, thereby realizing one-step recording of electrochemical signals from thiram-treated cells. With the aid of the differential pulse voltammetry method, the fabricated biosensor was applied to assess the cytotoxicity of thiram. Results showed that the cytotoxicity measured by the fabricated biosensor exhibited a linear relationship related to thiram concentration ranging from 5 to 50 µM with a detection limit of 2.23 µM. The IC50 of thiram obtained by the biosensor was 29.5 µM, which was close to that of conventional MTT assay (30.8 µM). The effects of thiram on HepG2 cells were also investigated via SEM and flow cytometry. Meanwhile, the proposed biosensor was used to evaluate the toxicity of thiram in fruit samples. Results indicated that the toxicity of thiram cannot be ignored even at a low residual concentration in food (≤5 mg/kg). In conclusion, the developed sensor showed excellent sensitivity, stability, and reliability, which provided a great capacity for the convenient toxicity evaluation of thiram residue in food.

Seasonal variation of quantitative microbial risk assessment for three airborne enteric bacteria from wastewater treatment plant emissions.

Airborne E. coli, fecal coliform, and Enterococcus are all related to sewage worker's syndrome and therefore used as target enteric bioaerosols about researches in wastewater treatment plants (WWTPs). However, most of the studies are often inadequately carried out because they lack systematic studies reports bioaerosols emission characteristics and health risk assessments for these three enteric bacteria during seasonal variation. Therefore, quantitative microbial risk assessment based on Monte Carlo simulation was utilized in this research to assess the seasonal variations of health risks of the three enteric bioaerosols among exposure populations (academic visitors, field engineers, and office staffs) in a WWTP equipped with rotating-disc and microporous aeration modes. The results show that the concentrations of the three airborne bacteria from the rotating-disc aeration mode were 2-7 times higher than the microporous aeration mode. Field engineers had health risks 1.5 times higher than academic visitors due to higher exposure frequency. Health risks of airborne Enterococcus in summer were up to 3 times higher than those in spring and winter. Similarly, health risks associated to E. coli aerosol exposure were 0.3 times higher in summer compared to spring. In contrast, health risks associated with fecal coliform aerosol were between 2 and 19 times lower in summer compared to spring and winter seasons. Data further suggest that wearing of N95 mask could minimize health risks by 1-2 orders of magnitude. This research shed light on seasonal variation of health risks associated with bioaerosol emission from wastewater utilities.

Use of Mobile Apps for Visual Acuity Assessment: Systematic Review and Meta-analysis.

BACKGROUND: Vision impairments (VIs) and blindness are major global public health issues. A visual acuity (VA) test is one of the most crucial standard psychophysical tests of visual function and has been widely used in a broad range of health care domains, especially in many clinical settings. In recent years, there has been increasing research on mobile app-based VA assessment designed to allow people to test their VA at any time and any location. OBJECTIVE: The goal of the review was to assess the accuracy and reliability of using mobile VA measurement apps. METHODS: We searched PubMed, Embase, Cochrane Library, and Google Scholar for relevant articles on mobile apps for VA assessment published between January 1, 2008, and July 1, 2020. Two researchers independently inspected and selected relevant studies. Eventually, we included 22 studies that assessed tablet or smartphone apps for VA measurement. We then analyzed sensitivity, specificity, and accuracy in the 6 papers we found through a meta-analysis. RESULTS: Most of the 22 selected studies can be considered of high quality based on the Quality Assessment of Diagnostic Accuracy Studies-2. In a meta-analysis of 6 studies involving 24,284 participants, we categorized the studies based on the age groups of the study participants (ie, aged 3-5 years, aged 6-22 years, and aged 55 years and older), examiner (ie, professional and nonprofessional examiners), and the type of mobile devices (ie, smartphone, iPad). In the group aged 3 to 5 years, the pooled sensitivity for VA app tests versus clinical VA tests was 0.87 (95% CI 0.79-0.93; P=.39), and the pooled specificity was 0.78 (95% CI 0.70-0.85; P=.37). In the group aged 6 to 22 years, the pooled sensitivity for VA app tests versus clinical VA tests was 0.86 (95% CI 0.84-0.87; P<.001), and the pooled specificity for VA app tests versus clinical VA tests was 0.91 (95% CI 0.90-0.91; P=.27). In the group aged 55 years and older, the pooled sensitivity for VA app tests versus clinical VA tests was 0.85 (95% CI 0.55-0.98), and the pooled specificity for VA app tests versus clinical VA tests was 0.98 (95% CI 0.95-0.99). We found that the nonprofessional examiner group (AUC 0.93) had higher accuracy than the professional examiner group (AUC 0.87). In the iPad-based group, the pooled sensitivity for VA app tests versus clinical VA tests was 0.86, and the pooled specificity was 0.79. In the smartphone-based group, the pooled sensitivity for VA app tests versus clinical VA tests was 0.86 (P<.001), and the pooled specificity for VA app tests versus clinical VA tests was 0.91 (P<.001). CONCLUSIONS: In this study, we conducted a comprehensive review of the research on existing mobile apps for VA tests to investigate their diagnostic value and limitations. Evidence gained from this study suggests that mobile app-based VA tests can be useful for on-demand VI detection.

[Health Risk Assessment of Soil Heavy Metals in a Small Watershed of a Mining Area in Yunnan].

The purpose of this study was to explore the pollution of soil heavy metals and the health risk of the contaminated soil to residents, which was affected by the copper mine in a small basin of a mining area in Yunnan Province. Soil (39 samples), sediment (six samples), water, and corresponding suspended particle (six samples) and dust (one sample) samples were collected. The contents of Cd, Pb, Hg, As, Zn, Cu, Ni, and Cr in the samples and the soil pH were determined. The spatial distribution of heavy metals was analyzed, and the source of soil heavy metals was innovatively traced by the relative proportion of heavy metals in various media. The geo-accumulation index, Nemerow comprehensive pollution index, and potential ecological risk index were used to evaluate and analyze the pollution status and the potential ecological risk of soil heavy metals in the watershed, whereas the health risk model recommended by USEPA was applied to evaluate the health risk. The results showed that the heavy metals in the soil of the upstream area might be derived from the synergistic input of irrigation, atmospheric deposition, and soil erosion. In the middle reaches and lower reaches, the irrigation and the soil erosion of sloping land mainly contributed the heavy metal input, respectively. It was also found that the pollution degree in the upstream area was higher than that in the downstream area. The farmland soil was seriously polluted by Cd, Zn, Pb, and Cu, and Cd, Zn, and Pb had high potential ecological risks. Although residents did not face the risk of non-cancer diseases, the carcinogenic risk had exceeded the acceptable level, and children were at higher risk of cancer. In addition, although the content of As in the soil was lower than that of Cd, Zn, and Pb, it had a higher carcinogenic risk.