Probabilistic risk assessment of dietary exposure to lead in residents of Guangzhou, China.

Lead and its compounds can have cumulative harmful effects on the nervous, cardiovascular, and other systems, and especially affect the brain development of children. We collected 4918 samples from 15 food categories in 11 districts of Guangzhou, China, from 2017 to 2022, to investigate the extent of lead contamination in commercial foods and assess the health risk from dietary lead intake of the residents. Lead was measured in the samples using inductively coupled plasma mass spectrometry. Dietary exposure to lead was calculated based on the food consumption survey of Guangzhou residents in 2011, and the health risk of the population was evaluated using the margin of exposure (MOE) method. Lead was detected in 76.5% of the overall samples, with an average lead content of 29.4 µg kg-1. The highest lead level was found in bivalves. The mean daily dietary lead intakes were as follows: 0.44, 0.34, 0.25, and 0.28 µg kg-1 body weight (bw) day-1 for groups aged 3-6, 7-17, 18-59, and ≥ 60 years, respectively. Rice and rice products, leafy vegetables, and wheat flour and wheat products were identified as the primary sources of dietary lead exposure, accounting for 73.1%. The MOE values demonstrated the following tendency: younger age groups had lower MOEs, and 95% confidence ranges for the groups aged 3-6 and 7-17 began at 0.6 and 0.7, respectively, indicating the potential health risk of children, while those for other age groups were all above 1.0. Continued efforts are needed to reduce dietary lead exposure in Guangzhou.

A data-driven combined prediction method for the demand for intensive care unit healthcare resources in public health emergencies.

BACKGROUND: Public health emergencies are characterized by uncertainty, rapid transmission, a large number of cases, a high rate of critical illness, and a high case fatality rate. The intensive care unit (ICU) is the "last line of defense" for saving lives. And ICU resources play a critical role in the treatment of critical illness and combating public health emergencies. OBJECTIVE: This study estimates the demand for ICU healthcare resources based on an accurate prediction of the surge in the number of critically ill patients in the short term. The aim is to provide hospitals with a basis for scientific decision-making, to improve rescue efficiency, and to avoid excessive costs due to overly large resource reserves. METHODS: A demand forecasting method for ICU healthcare resources is proposed based on the number of current confirmed cases. The number of current confirmed cases is estimated using a bilateral long-short-term memory and genetic algorithm support vector regression (BILSTM-GASVR) combined prediction model. Based on this, this paper constructs demand forecasting models for ICU healthcare workers and healthcare material resources to more accurately understand the patterns of changes in the demand for ICU healthcare resources and more precisely meet the treatment needs of critically ill patients. RESULTS: Data on the number of COVID-19-infected cases in Shanghai between January 20, 2020, and September 24, 2022, is used to perform a numerical example analysis. Compared to individual prediction models (GASVR, LSTM, BILSTM and Informer), the combined prediction model BILSTM-GASVR produced results that are closer to the real values. The demand forecasting results for ICU healthcare resources showed that the first (ICU human resources) and third (medical equipment resources) categories did not require replenishment during the early stages but experienced a lag in replenishment when shortages occurred during the peak period. The second category (drug resources) is consumed rapidly in the early stages and required earlier replenishment, but replenishment is timelier compared to the first and third categories. However, replenishment is needed throughout the course of the epidemic. CONCLUSION: The first category of resources (human resources) requires long-term planning and the deployment of emergency expansion measures. The second category of resources (drugs) is suitable for the combination of dynamic physical reserves in healthcare institutions with the production capacity reserves of corporations. The third category of resources (medical equipment) is more dependent on the physical reserves in healthcare institutions, but care must be taken to strike a balance between normalcy and emergencies.

Weight Loss Using an mHealth App Among Individuals With Obesity in Different Economic Regions of China: Cohort Study.

Background: With the increasing prevalence of obesity, weight loss has become a critical issue in China. Self-managed weight loss through a mobile health (mHealth) app may be a prospective method. However, its practicability in different economic regions of China is unknown. Objective: This study aims to evaluate the effectiveness of self-managed weight loss through an mHealth app among individuals with obesity in different economic regions of China and to demonstrate the feasibility of online self-management for weight loss. Methods: A total of 165,635 Chinese adults who signed up for the mHealth app were included to analyze the body composition characteristics of individuals from different economic regions by χ2 analyses. Furthermore, 2 types of participants with obesity using mHealth monitoring, including 74,611 participants with a BMI ≥24.0 kg/m2 and 22,903 participants with a normal BMI but an excessive percentage of body fat (PBF), were followed for 6 months to explore the weight loss and fat loss effects in different economic regions of China and to find independent predictors associated with weight loss success by 2-tailed Student t test and multivariable logistic regression analysis. Results: There were 32,129 users from low-income regions and 133,506 users from high-income regions. The proportion of users with obesity in low-income regions was higher than in high-income regions, both based on BMI (15,378/32,129, 47.9% vs 59,233/133,506, 44.4%; P<.001) and PBF classification (19,146/32,129, 59.6% vs 72,033/133,506, 54%; P<.001). Follow-up analyses showed that the weight loss effect among participants with overweight or obesity in low-income regions was greater than in high-income regions (mean -4.93, SD 6.41 vs mean -4.71, SD 6.14 kg; P<.001), while there was no significant difference in fat loss (mean -2.06%, SD 3.14% vs mean -2.04%, SD 3.19%; P=.54). In the population with normal-weight obesity, the weight loss (mean -2.42, SD 4.07 vs mean -2.23, SD 4.21 kg; P=.004) and fat loss effects (mean -1.43%, SD 2.73% vs mean -1.27%, SD 2.63%; P<.001) were stronger in high-income regions than in low-income regions. In addition, multivariable logistic regression analyses showed that age, baseline PBF, skeletal muscle rate, and measurement frequency were related to weight loss, whereas gender and baseline body metabolic rate only showed a correlation with weight loss in the population in high-income regions. Conclusions: This study found a high proportion of mHealth app users with obesity in low-income regions. Individuals with overweight and obesity in different economic regions of China experienced significant weight loss and fat loss using an mHealth app. Moreover, individuals in high-income regions paid more attention to body fat and had better fat reduction effects. Therefore, promoting self-monitoring of weight and PBF through an mHealth app could be an important intervention that could be implemented across all regions of China.

Application of improved GalNAc conjugation in development of cost-effective siRNA therapies targeting cardiovascular diseases.

N-Acetylgalactosamine (GalNAc)-conjugated small interfering RNA (siRNA) therapies have received approval for treating both orphan and prevalent diseases. To improve in vivo efficacy and streamline the chemical synthesis process for efficient and cost-effective manufacturing, we conducted this study to identify better designs of GalNAc-siRNA conjugates for therapeutic development. Here, we present data on redesigned GalNAc-based ligands conjugated with siRNAs against angiopoietin-like 3 (ANGPTL3) and lipoprotein (a) (Lp(a)), two target molecules with the potential to address large unmet medical needs in atherosclerotic cardiovascular diseases. By attaching a novel pyran-derived scaffold to serial monovalent GalNAc units before solid-phase oligonucleotide synthesis, we achieved increased GalNAc-siRNA production efficiency with fewer synthesis steps compared to the standard triantennary GalNAc construct L96. The improved GalNAc-siRNA conjugates demonstrated equivalent or superior in vivo efficacy compared to triantennary GalNAc-conjugated siRNAs.

Clinical value assessment for serum hsa_tsr013526 in the diagnosis of gastric carcinoma.

Gastric carcinoma (GC) is a malignant tumor that is detrimental to human health. Transfer RNA-derived small RNAs are a newly identified class of noncoding small RNAs with specific biological functions that are aberrantly expressed in cancer. The aim of this study was to investigate the potential of hsa_tsr013526 as a biomarker for GC. Quantitative real-time fluorescence polymerase chain reaction was used to detect the expression level of hsa_tsr013526. The molecular characteristics of hsa_tsr013526 were verified by agarose gel electrophoresis, Sanger sequencing, and separation of nuclear and cytoplasmic RNA fractions. By testing the receiver operating characteristic (ROC) curves, the diagnostic efficiency of GC using hsa_tsr013526 was determined. Finally, we predicted the downstream of hsa_tsr013526 using functional assays and bioinformatics analysis. Serum expression of hsa_tsr013526 was higher in GC patients than in healthy donors. Serum expression showed differential changes in GC patients, gastritis patients, and healthy donors. Chi-squared tests showed that high expression of hsa_tsr013526 was significantly correlated with T stage, lymphatic metastasis, and tumor node metastasis stage. ROC curve analysis indicated that GC patients could be discriminated from healthy donors or gastritis patients based on their serum levels of hsa_tsr013526. Furthermore, hsa_tsr013526 expression was significantly reduced in postoperative GC patients (p = .0016). High expression of hsa_tsr013526 promotes gastric cancer cell proliferation, invasion, and migration. Serum hsa_tsr013526 was stable and specific, and could be used for dynamic monitoring of GC patients. Therefore, hsa_tsr013526 may be a new biomarker for the diagnosis and postoperative monitoring of GC patients.

Exploring evolution characteristics of eco-environment quality in the Yangtze River Basin based on remote sensing ecological index.

As an important ecological-economic development area in China, scientific understanding of the spatial and temporal changes in eco-environment quality (EEQ) and its drivers in the Yangtze River Basin (YRB) is crucial for the effective implementation of ecological protection projects in the YRB. To address the lack of large-scale EEQ assessment in the YRB, this paper uses the Google Earth Engine (GEE) platform and the Remote Sensing Ecological Index (RSEI) to investigate the spatial and temporal characteristics of EEQ in the YRB from 2000 to 2020, and to analyze the impact of various factors on the EEQ of the YRB. This study showed that: (1) The overall EEQ of YRB was at the 'good' grade over the past 20 years, showing an increasing trend, with the value changing from 0.70 to 0.77. (2) The YRB's EEQ has positive spatial aggregation characteristics, with the northern part of the Jialing River basin and the Han River basin exhibiting a high-high aggregation type and the upper reaches exhibiting a low-low aggregation type. (3) In the past 20 years, the human activities had a greater impact on the EEQ of the YRB; moreover, all factors had a greater impact on the EEQ than a single factor. The interaction between the biological abundance index and population density had the most effect, with a q-value of 0.737 in 2020.

Ultrasound Assessment of Entheseal Sites and Anterior Chest Wall in Ankylosing Spondylitis: A Cross-Sectional Study.

OBJECTIVES: The study was designed to evaluate entheseal sites and anterior chest wall (ACW) of patients with ankylosing spondylitis (AS) using ultrasound (US) and investigate the correlation between disease activity and US score. METHODS: This prospective cross-sectional study included 104 patients with AS and 50 control subjects. Each patient underwent US scanning of 23 entheses and 11 sites of the ACW. The US features, including hypoechogenicity, thickness, erosion, calcification, bursitis, and Doppler signal, were evaluated. Disease activity was assessed based on C reactive protein (CRP), erythrocyte sedimentation rate (ESR), disease activity score-C reactive protein (ASDAS-CRP), and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). RESULTS: The most commonly involved entheses on US were the Achilles tendon (AT) and quadriceps tendon (QT). The most involved site of ACW was the sternoclavicular joint (SCJ). Compared with the control group, significant differences were observed in the AS group in the rates of US enthesitis and ACW in AT (P = .01), SCJ (P = .00), and costochondral joint (CCJ) (P = .01). Patients with high or very high disease activity had a higher erosion score (P = .02). The erosion score was weakly positively associated with CRP, ESR, BASDAI, ASDAS-CRP, and ASDAS-ESR (correlation coefficient: 0.22-0.45). CONCLUSIONS: The most commonly involved entheseal sites on US were AT and QT, while the site of ACW was SCJ. The US assessment of AS should take the ACW into account. High disease activity might indicate erosion in AS.

Probabilistic risk assessment of dietary exposure to pentachlorophenol in Guangzhou, China.

Pentachlorophenol (PCP) is a ubiquitous environmental contaminant commonly existing as its sodium salt (NaPCP), which enters the human body primarily through long term but low-level dietary exposure. PCP contributes to chemical carcinogenesis and teratogenesis. In this study, the probabilistic risk of dietary exposure to PCP in Guangzhou citizens was investigated. In total, 923 food samples in the categories of pork, livestock (beef and lamb), poultry, offal, eggs, and freshwater fish (considered to be relatively susceptible to PCP contamination) were collected from various markets in Guangzhou and tested for PCP. Probabilistic risk assessment model calculations for PCP dietary exposure and margin of exposure (MOE) values were performed using @RISK software, based on a Monte Carlo simulation with 10,000 iterations. The overall detection rate of PCP (above 1 µg kg-1, the detection limit) was 19.9% (184/923), with an average of 7.9 µg kg-1. The highest rate of PCP detection, 28.2%, was in livestock (beef and lamb). The MOE value for dietary PCP exposure in general Guangzhou residents averaged 400, which was far below 5,000 (the borderline for judging a health risk). The lowest MOE value, 190, was observed in the 3- to-6-year old population and indicates a significant risk. In conclusion, this study suggests that PCP exposure in Guangzhou residents is of considerable health risk, especially for the pre-school young children.

Would Financial Development Help China Achieve Carbon Peak Emissions?

China has committed to reaching carbon peak before 2030. To realize the carbon peak goal, financial development plays an essential role in developing a green economy. Based on the panel data of 30 provinces in China from 2006 to 2019, this paper explores the impact of financial development on carbon intensity both theoretically and empirically. A financial development index system is constructed and computed using the entropy method. A spatial lag panel data model is employed to empirically test the interaction effect of financial development on carbon intensity. Moreover, the mediating effects of industrial upgrading and technological innovation are further investigated. The results show that: first, carbon intensity generates strong spatial spillover effects between provinces in China. Second, financial development significantly reduces carbon intensity, and is most pronounced in central China, followed by western and eastern China. Third, industrial upgrading and technological innovation are important channels to assist financial development in cutting down carbon intensity, and both produce positive spatial spillover effects. These findings suggest that inter-regional cooperation and coordination on financial development, industrial upgrading, and technological innovation are conducive to achieving low-carbon development targets. This research not only has practical significance to China, but also provides global reference value to other countries.

Quantitative assessment of the risk of human activities on landscape fragmentation: A case study of Northeast China Tiger and Leopard National Park.

Risk assessment of human activities on landscape fragmentation in nature reserves can effectively balance the conflict between wildlife conservation and human development. However, previous studies had been unable to quantitatively assess the risk of human activities on landscape fragmentation. Thus, we constructed a risk assessment methodology to quantitatively assess the risk of different human activities on the Landscape Fragmentation Composite Index (LFCI) in the Northeast China Tiger and Leopard National Park (NCTLNP). First, we fitted the relationship curve between LFCI and different human activity factors based on the Generalized Additive Model (GAM) to determine the impact patterns of each factor on LFCI. Secondly, we identified impact risk areas of each human activity factor on LFCI by the location of threshold points in the curve and analyzed their spatiotemporal variation characteristics from 2015 to 2020. The results show that the relationship between LFCI and Land Use Intensity (LUI) showed an inverted "U" shape, the relationship with Population Density (POPD) showed a "rising-flat-rising" trend, and the relationship with Traffic Accessibility (TA) and Industrial and Mining Activity (IMA) showed a positive correlation after a flat interval. In addition, we found that the LUI and IMA impact risk areas were widely distributed and remained stable for five years. But the POPD impact risk area was mainly distributed around settlements and expanded by 6.6 % from 2015 to 2020. The TA impact risk area was distributed in strips and expanded by 16.38 % from 2015 to 2017 due to the construction of the G331 national road. And the joint impact risk area of these four factors expanded by 1.55 times in five years. Our research can provide a reference for ecological risk assessment under the impact of human activities on other nature reserves in the world.

Comprehensive assessment of miniature CRISPR-Cas12f nucleases for gene disruption.

Because of their small size, the recently developed CRISPR-Cas12f nucleases can be effectively packaged into adeno-associated viruses for gene therapy. However, a systematic evaluation of the editing outcomes of CRISPR-Cas12f is lacking. In this study, we apply a high-throughput sequencing method to comprehensively assess the editing efficiency, specificity, and safety of four Cas12f proteins in parallel with that of Cas9 and two Cas12a proteins at multiple genomic sites. Cas12f nucleases achieve robust cleavage at most of the tested sites and mainly produce deletional fragments. In contrast, Cas9 and Cas12a show relatively higher editing efficiency at the vast majority of the tested sites. However, the off-target hotspots identified in the Cas9- and Cas12a-edited cells are negligibly detected in the Cas12f-edited cells. Moreover, compared to Cas9 and Cas12a nucleases, Cas12f nucleases reduce the levels of chromosomal translocations, large deletions, and integrated vectors by 2- to 3-fold. Therefore, our findings confirm the editing capacity of Cas12f and reveal the ability of this nuclease family to preserve genome integrity during genome editing.

Object-Oriented Technology Model of Regional Industrial Economic Innovation Project Management System.

Managers have a deeper understanding of computer technology, network technology, and communication technology, which is also a necessary condition for the implementation of project management information. It plays an important role in improving the performance of regional resource-based industry and high-tech service industry. By analyzing the current situation of the company's project management, the project management and management processes are standardized and the management of project quality, progress, contract, and cost through the design system is completed, so that the various resources of the project can be effectively and rationally allocated and utilized. Information communication inside and outside the project is more convenient, smooth, and fast, and more standardized operating procedures can be carried out. This paper also improves the level of local government governance, shapes the cultural connotation of innovation, openness, and cooperation, and strengthens the cultivation and flow of social elements. A series of policy suggestions are put forward in building the capacity system of both sides of industrial integration, thus greatly improving the overall project management level and the company's decision-making and analysis ability, so as to achieve fine and precise management objectives.

Probabilistic Risk Assessment of Dietary Exposure to Cadmium in Residents of Guangzhou, China-Young Children Potentially at a Health Risk.

Cadmium (Cd) and its compounds are hazardous environmental pollutants with renal toxicity and human carcinogenicity, with ingestion of contaminated foods representing the major mode of exposure. There have been a number of reports evaluating the Cd content in various foods; however, regarding the actual risk posed by dietary cadmium exposure, only a few reports are available in which single point evaluation (less accurate than multiple point evaluation) was employed. In this study, we used a margin of exposure (MOE) model and @RISK software (for multiple evaluation) to evaluate Cd-related health risk in the local Guangzhou residents at varying ages, through a comparison between the estimated monthly exposures and the provisional tolerable monthly intake (0.025 mg/kg body weight (b.w.)), based on the Cd contents in various food categories available locally (a total of 3964 food samples were collected from each of the 13 districts of Guangzhou between 2015 and 2019), which were determined by using inductively coupled plasma mass spectrometry. In this study, Cd was detected in 69.6% of the samples (averaged 0.120 mg/kg), and rice and its products, leafy vegetables, bivalves, and shrimp and crabs contributed most to Cd exposure (8.63, 3.18, 2.79, and 1.48 ng/kg b.w./day, respectively). The MOE values demonstrated the following tendency: the younger age group, the lower MOE, and its 95% confidence range for the (youngest) 3~6 year old group started from 0.92, indicating a health risk of young children, while that for the other age groups were all above 1.0. Our preliminary findings warrant further clarification using biomarker assays in the relevant population.

Understanding Individual Differences in Metacognitive Strategy Use, Task Demand, and Performance in Integrated L2 Speaking Assessment Tasks.

This study investigated the concept of individual differences (IDs) in the use of metacognitive strategies (planning, problem-solving, monitoring, and evaluating) and its relationship with task demand and learner performance within Kormos' Bilingual Speech Production Model from the lens of Chinese English-as-foreign-language (EFL) learners in the context of integrated L2 speaking assessment. To measure metacognitive strategies, we administered an inventory on 134 Chinese EFL learners after they completed four integrated L2 speaking assessment tasks. Descriptive analysis and multiple linear regression were adopted for data analysis, and results show that: (a) IDs displayed variance in Chinese EFL learners' metacognitive strategy use; (b) among the four metacognitive strategies under investigation, problem-solving was reported to be used the most frequently in sharp contrast to monitoring, which had the lowest frequency; (c) metacognitive strategies worked interactively, responding to task demands involved in the four integrated L2 speaking assessment tasks; and (d) Chinese EFL learners' use of metacognitive strategies, in individual and interactive working modes, had no relationship with their speaking performance. These results are expected to present some insights into the role of IDs in metacognitive strategy use during L2 speech production under assessment conditions, which will add robust evidence to the existing literature on L2 speaking, in particular on metacognitive strategy use in L2 speaking assessment. In the meantime, the findings will provide some empirical validation support for Kormos' model, which will further provide some implications for L2 speaking instruction and L2 assessment.

Assessing the Relationship between Resource Misallocation and Total Factor Productivity Based on Artificial Neural Network.

For interpretation of China's economy, total factor productivity is considered as one of the crucial aspects which is generally dependent on innovation in technologies especially those driven by both scientific research and efficiency of the methodology or process which is dedicated for the allocation of numerous resources available, among enterprises. It is important to note that various factors, which are either directly or indirectly involved, to cause misallocation of the resources to the enterprises, are overly complex. Therefore, an affective mechanism is needed to be realized which is capable of resolving these issues with the available resources and infrastructures. In this paper, we have focused on the construction or development of an artificial neutral network (ANN) based evaluation model to study the impact of resource misallocation on total factor productivity. Likewise, we have conducted a counterfactual experiment, i.e., simulation only, to thoroughly examine the relationship between two very important factors, that is, (i) resource misallocation and (ii) total factor productivity. To do this, we are aiming at investigating the growth potential of total factor productivity when there is no resource misallocation. After comparing 8 industries in different regions, we conclude that the contribution of capital and labor distortion to total factor productivity is the highest in the eastern region of China with -0.036 and 0.065, respectively, followed by the northeast, central, and western regions. In the experiment, China's total factor productivity growth potential could reach 1.1296, if there is no resource misallocation. The results in this paper would shed some lights on the paths to improve resource allocation efficiency and total factor productivity.

Carbon footprint, yield and economic performance assessment of different mulching strategies in a semi-arid spring maize system.

Crop productivity maximization while minimizing carbon emissions is of critical importance for achieving sustainable agriculture. Socio-economic and ecological benefits should be taken together under the circumstance of stagnant farming profitability and climatic variability. The effectiveness of various mulching strategies in rain-fed semiarid areas has been confirmed, but scarce the comprehensive evaluations of the conventional and new mulching strategies in terms of yield, economic benefit, and carbon footprint based on life cycle assessment (LCA) have been conducted. Hence, a two-year field experiment was conducted on maize (Zea mays L.) crop to explore the effects of four mulching strategies (PM: plastic-film mulching, SM: maize straw mulching, BM: biodegradable-film mulching, and NM: no mulching) on the yield, net return, greenhouse gas (GHG) emissions, and carbon footprint (CF). The results revealed that PM and BM significantly increased maize yield by 11.3-13.3% and 9.4-10.6%. PM marginally raised the net return by 2.0-2.4% whereas BM slightly reduced it by 4.6-8.8% relative to NM. Unexpectedly, the yield and net return were the lowest under SM, and intensified N2O emissions, GWPdirect, and yield-scaled GWPdirect were observed. When the GHGs using LCA concept and SOC sequestration rate were considered, the lowest net GWP (1804.1-1836.4 kg CO2-eq ha-1) and CF (148.9-119.9kg CO2-eq t-1) were observed in the SM treatment due to the boost of soil organic carbon (SOC) sequestration. Conversely, PM and BM significantly increased the net GWP and CF compared to NM. When the tradeoffs between the high production, high net return and low net GWP were assessed by an integrated evaluation framework, the NM was recommended as an efficient low-carbon agricultural practice in the rain-fed semiarid areas.

[Lead contamination status and assessment of potential risk to human health of commercial foods in Guangzhou City in 2017-2019].

OBJECTIVE: To investigate lead contamination in commercial foods in Guangzhou City, and to assess the health risk of dietary lead exposure in the residents. METHODS: Food samples were collected in 11 districts in Guangzhou City from 2017 to 2019.The samples were tested for lead by using inductively coupled plasma mass spectrometry. The dietary exposure to lead of residents of different age groups in Guangzhou was calculated in combination with the intake of foods from the food consumption survey of Guangzhou residents in 2011, and the margin of exposure(MOE) method was used to evaluate the health risk of the population. RESULTS: A todal of 3130 food samples of 15 categories were collected. The overall lead detection rate was 82.11%, the exceeding rate was 0.13%, and the average lead content was 0.031 mg/kg. The highest lead levels were found in bivalve, edible fungi and flour and flour products. Excessive levels of lead were found in bivalve, eggs and egg products, and flour and flour products. The average daily dietary intake of lead in people aged 3-6, 7-17, 18-59 and over 60 in Guangzhou were 0.368, 0.377, 0.326 and 0.337 µg/kg, respectively. Daily lead exposure of population with high consumption(P95) in various age groups through foods were 1.091, 1.079, 0.906 and 0.925 µg/kg, respectively. Brassica and leafy vegetables, rice and its products and meat were the main sources of dietary lead exposure, accounting for 53.28% of the total dietary lead exposure. The average MOE of lead in all age groups were greater than 1, but the P95 of MOE value of people aged 3-6 and 7-17 were 0.55 and 0.56, respectively, which presented certain health risks. CONCLUSION: There was a certain amount of lead exceeding the standard in commercial foods in Guangzhou. The average level of dietary lead exposure for residents of all ages posed a low risk to population health, but the dietary lead exposure risk of high-food consumers aged 3-6 and 7-17 posed certain health risks that deserve significant attention.

Probabilistic Risk Assessment of Dietary Exposure to Chloramphenicol in Guangzhou, China.

Chloramphenicol has been used in veterinary medicine, where its residues can remain in food of animal origin, thus potentially causing adverse health effects. This facilitated the ban for its use in food-producing animals globally, but its residues have remained ubiquitous. In this study, food commodities possibly contaminated with chloramphenicol, including livestock meat, poultry, edible viscera, fish, shrimp and crab, molluscs, milk, and eggs, were collected from domestic retail shops in all the 11 districts of Guangzhou and tested for its residue. Probabilistic risk assessment model calculations for its dietary exposure, and the margin of exposure (displayed as mean values and 5th percentile to 95th percentile ranges) were performed by using @RISK software based on a Monte Carlo simulation with 10,000 iterations. The results indicated the detection of chloramphenicol in 248 out of 1454 samples (17.1%), which averaged to a level of 29.1 µg/kg. The highest average value was observed in molluscs (148.2 µg/kg, with the top value as 8196 µg/kg); meanwhile, based on the dietary structure of a typical Cantonese, pond fish, pork, and poultry meat contributed most (about 80%) to the residents' dietary exposure to chloramphenicol. The margin of exposure for dietary chloramphenicol exposure in Guangzhou residents was 2489, which was apparently below 5000 (the borderline for judging a health risk), particularly low in preschool children (2094, suggesting an increased risk). In conclusion, the study suggests that chloramphenicol exposure in Guangzhou residents is considerable, and its relevant health hazard, especially for preschool children, is worthy of further investigation.

Effect of Cost-Related Medication Non-adherence Among Older Adults With Medication Therapy Management.

Background: Medication therapy management (MTM) was established by the Center for Medicare and Medicaid Services (CMS) with the aim to improve medication adherence. However, the national prevalence of cost-related medication non-adherence (CRN) is still unknown and there is a literature gap in the association between MTM services and CRN. Methods: A cross-sectional study was conducted. A nationally representative study sample from Medicare Current Beneficiary Surveys (MCBS) was used. Survey sampling weights were applied for national estimates of CRN. Weighted multivariable logistic regressions controlling for covariates were conducted to investigate the effect of the MTM on the CRN. Results: The study identified 1,549 MTM-eligible beneficiaries. The prevalence of CRN was higher in MTM-eligible individuals than in non-MTM eligible individuals (24.14 vs. 13.44%; P < 0.001). According to the results of multivariable logistic regressions, we found that MTM eligibility was significantly associated with a higher prevalence of CRN (OR: 1.59; 95% CI: 1.28-1.96). Additionally, some other variables such as health status, with or without low-income subsidy are also associated with CRN. Conclusions: Our findings suggest that the prevalence of CRN in MTM-eligible beneficiaries was higher than in non-MTM eligible beneficiaries. Further studies with the longitudinal design are warranted to clarify the relationship between MTM and CRN. Alternative strategies to improve CRN should be considered in future Medicare Part D Enhanced MTM Models.