Regional impact assessment of air quality improvement: The air quality lifecourse assessment tool (AQ-LAT) for the West Midlands combined authority (WMCA) area.

Poor air quality is the largest environmental health risk in England. In the West Midlands, UK, ∼2.9 million people are affected by air pollution with an average loss in life expectancy of up to 6 months. The 2021 Environment Act established a legal framework for local authorities in England to develop regional air quality plans, generating a policy need for predictive environmental impact assessment tools. In this context, we developed a novel Air Quality Lifecourse Assessment Tool (AQ-LAT) to estimate electoral ward-level impacts of PM2.5 and NO2 exposure on outcomes of interest to local authorities, namely morbidity (asthma, coronary heart disease (CHD), stroke, lung cancer), mortality, and associated healthcare costs. We apply the Tool to assess the health economic burden of air pollutant exposure and estimate benefits that would be generated by meeting WHO 2021 Global Air Quality Guidelines (AQGs) (annual average concentrations) for NO2 (10 µg/m3) and PM2.5 (5 µg/m3) in the West Midlands Combined Authority Area. All West Midlands residents live in areas which exceed WHO AQGs, with 2070 deaths, 2070 asthma diagnoses, 770 CHD diagnoses, 170 lung cancers and 650 strokes attributable to air pollution exposure annually. Reducing PM2.5 and NO2 concentrations to WHO AQGs would save 10,700 lives reducing regional mortality by 1.8%, gaining 92,000 quality-adjusted life years (QALYs), and preventing 20,500 asthma, 7400 CHD, 1400 lung cancer, and 5700 stroke diagnoses, with economic benefits of £3.2 billion over 20 years. Significantly, we estimate 30% of QALY gains relate to reduced disease burden. The AQ-LAT has major potential to be replicated across local authorities in England and applied to inform regional investment decisions.

[Health Risk Assessment of Heavy Metals in Soils of a City in Guangdong Province Based on Source Oriented and Monte Carlo Models].

Taking a city in Guangdong Province as the research area, the concentration and spatial distribution characteristics of heavy metals in the surface soil were studied to clarify the situation of soil heavy metal pollution and priority control factors, providing basic data for the prevention and control of soil heavy metal pollution in the city. The content characteristics of heavy metals in 221 soil samples in the city were analyzed, and the potential health risk assessment and source analysis were carried out through the Monte Carlo model, the potential health risk assessment (HRA) model, and the PMF receptor model. It was found that heavy metals ω(As), ω(Hg), ω(Cd), ω(Pb), ω(Cr), ω(Cu), ω(Ni), and ω(Zn) in the soil of the city were 18.16, 0.43, 1.46, 68.57, 98.34, 64.19, 26.53, and 257.32 mg·kg-1, respectively, with a moderate to high degree of variation. Except for Ni concentration, the soil concentrations of other heavy metal elements exceeded the background values of soil in Guangdong Province to a certain extent, and the concentrations of Cd and Zn exceeded the national secondary standards, resulting in severe heavy metal pollution; the main sources of heavy metals were industrial sources, and natural parent materials, lead battery manufacturing, transportation, artificial cultivation, and pesticide and fertilizer inputs also had an undeniable impact on the accumulation of heavy metals in the soil. Heavy metals in the soil had a certain degree of tolerable carcinogenic health risk for both children and adults, whereas non-carcinogenic risks could be ignored. The potential health risk of children was greater than that of adults, and the main exposure route was through oral intake. The input sources of pesticides and fertilizers and As should be the main controlling factors for the health risks of heavy metals in the city's soil, followed by mixed sources and Cr. There were differences in the spatial distribution characteristics and relative pollution levels of heavy metals, and it is necessary to deepen zoning monitoring and control, strengthen soil pollution prevention and control, and reduce human input of heavy metals in soil.

[Pollution Characteristics and Risk Assessment of Polycyclic Aromatic Hydrocarbons in Soils of Guangzhou].

In order to comprehensively study the pollution characteristics of polycyclic aromatic hydrocarbons （PAHs） in soils of Guangzhou， 222 topsoil samples were collected and analyzed. The ecological risk of soil PAHs pollution was evaluated using the effect interval low/median method （ERL/ERM） and the （BaP） toxicity equivalent method， and the health risk of soil PAHs pollution was evaluated using the lifelong cancer risk increment model. The source of PAHs was analyzed using the characteristic compound ratio method and PMF model. The results indicated that： the content of surface soil （∑16PAHs） in Guangzhou was 38-11 115 µg·kg-1， with an average of 526 µg·kg-1， and 16 types of polycyclic aromatic hydrocarbon monomers showed strong variation. There was a certain degree of ecological risk of PAHs in Guangzhou， and there was already a significant ecological risk of PAHs pollution in individual sampling points， which were generally in a state of mild pollution. Based on the results of the health risk assessment， the contribution rates of total cancer risk in both adults and children were presented as follows： skin contact > ingestion of soil > respiratory intake. The health risk of children was greater than that of adults， and the overall health risk was within an acceptable range. Source analysis showed that the main sources of soil PAHs in Guangzhou were coal （37.1%）； diesel （32%）； coking （17.3%）； and mixed sources of traffic emissions， biomass combustion， and petrochemical product volatilization （13.6%）. The overall source of soil PAHs belonged to mixed sources. The research results have enriched our understanding of the pollution status of PAHs in the surface soil of Guangzhou and are helpful in promoting soil pollution prevention and control actions.

Bioinformatic Assessment and Expression Profiles of the AP2/ERF Superfamily in the Melastoma dodecandrum Genome.

AP2/ERF transcription factors play crucial roles in various biological activities, including plant growth, development, and responses to biotic and abiotic stressors. However, limited research has been conducted on the AP2/ERF genes of Melastoma dodecandrum for breeding of this potential fruit crop. Leveraging the recently published whole genome sequence, we conducted a comprehensive assessment of this superfamily and explored the expression patterns of AP2/ERF genes at a genome-wide level. A significant number of genes, totaling 218, were discovered to possess the AP2 domain sequence and displayed notable structural variations among five subfamilies. An uneven distribution of these genes was observed on 12 pseudochromosomes as the result of gene expansion facilitated by segmental duplications. Analysis of cis-acting elements within promoter sites and 87.6% miRNA splicing genes predicted their involvement in multiple hormone responses and abiotic stresses through transcriptional and post-transcriptional regulations. Transcriptome analysis combined with qRT-PCR results indicated that certain candidate genes are involved in tissue formation and the response to developmental changes induced by IAA hormones. Overall, our study provides valuable insights into the evolution of ERF genes in angiosperms and lays a solid foundation for future breeding investigations aimed at improving fruit quality and enhancing adaptation to barren land environments.

Impacts of net zero policies on air quality in a metropolitan area of the United Kingdom: Towards world health organization air quality guidelines.

Climate change and air pollution are closely interlinked since carbon dioxide and air pollutants are co-emitted from fossil fuel combustion. Net Zero (NZ) policies aiming to reduce carbon emissions will likely bring co-benefits in air quality and associated health. However, it is unknown whether regional NZ policies alone will be sufficient to reduce air pollutant levels to meet the latest 2021 World Health Organisation (WHO) guidelines. Here, we carried out high resolution air quality modelling for in the West Midlands region, a typical metropolitan area in the UK, to quantify the effects of different NZ policies on air quality. Results show that NZ policies will significantly improve air quality in the West Midlands, with up to 6 µg m-3 (21%) reduction in annual mean NO2 (mostly through the electrification of vehicle fleet, EV) and up to 1.4 µg m-3 (12%) reduction in annual mean PM2.5 projected for 2030 relative to levels under a "business as usual" (BAU) scenario. Under BAU, 2030 PM2.5 concentrations in most wards would be below 10 µg m-3 whilst under the Net Zero scenario, those in all wards would be below 10 µg m-3. This means that the ward averages in the West Midlands would meet the UK PM2.5 of 10 µg m-3target a decade early under the Net Zero scenario. However, no ward-level-averaged annual mean PM2.concentrations meet the 2021 WHO Air Quality guideline level of 5 µg m-3 under any scenario. Similarly for NO2 only 18 wards (8% of the region's population) are predicted to have NO2 concentrations below the 2021 WHO guideline level (10 µg m-3). Decarbonisation policies linked to Net Zero deliver substantial regional air quality benefits, but are not in isolation sufficient to deliver clean air with air pollutant levels low enough to meet the 2021 WHO guidelines.

Direct 1,1-Bisphosphonation of Isocyanides: Atom- and Step-Economical Access to Bisphosphinoylaminomethanes.

An atom- and step-economical strategy for the synthesis of bisphosphinoylaminomethanes is reported. This metal-free bisphosphinylation reaction proceeded smoothly through a base-mediated direct 1,1-bisphosphonation of phosphine oxides and isocyanides under mild conditions. The present method offers a facile, efficient, and general approach to a broad range of bisphosphinoylaminomethane derivatives in moderate to good yields.

A land-use decision approach integrating thermal regulation, stormwater management, and economic benefits based on urbanization stage identification.

Driven by global climate change and urbanization, urban heat island (UHI) and urban storm flood (USF) have become the most frequent and influential hazards in recent decades. Land-use optimization can effectively cope with these hazards. However, the trade-offs between multi-hazard mitigation and economic development impose many limitations in practice. Furthermore, current region-based optimization methods no longer meet the precise management demand, and both subdivision and spatial heterogeneity identification have the potential for wider applicability. Hence, a systematic integration of climate adaptation and urban construction through land-use planning is urgently required. This paper proposes a new land-use decision approach for improving climate adaptability of urbanization. This approach involves multi-objective optimization, spatial subdivision, and urbanization stage identification, which enable the simultaneous achievement of environmental and economic benefits. Taking Xiamen as case study, the results showed that excessive pursuit of land economic output (LEO) limits the chance of mitigating UHI and USF. Improving the LEO per unit area of construction land could disrupt the link between land exploitation and the increasing side effects of climate hazards. Future urbanization hotspots in Xiamen will likely emerge at the urban fringe in Tong'an District and Xiang'an District. Within each developing unit, the upper limit of construction land was 81.06 hm2 and the green space was recommended to be 7.29-21.94 hm2. Construction land and bare land contributed most to UHI and USF, while forest and grassland were highly efficient in heat and runoff mitigation. The developed approach proved to be effective and practicable, especially for reducing the impacts of extreme UHI and USF.

Multi-b value diffusion-weighted magnetic resonance imaging and intravoxel incoherent motion modeling: Differentiation of aggressive lymphoma lesions on initial treatment and activity assessment after chemotherapy.

The diagnostic efficiency of diffusion-weighted magnetic resonance imaging with different b-values and application of an intravoxel incoherent motion (IVIM) model for differentiating disease states of lymphoma was investigated.Thirty-six patients at initial diagnosis and 69 after chemotherapy underwent diffusion-weighted magnetic resonance imaging (DW-MRI) with multiple b-values. Analysis parameters included the apparent diffusion coefficient (ADC) for each b-value. Standard ADC, D, D*, and f were calculated using an IVIM model.For patients at initial diagnosis, compared with aggressive lymphomas, the benign lymph nodes exhibited higher mean ADC (2.34 vs 0.66 × 10 mm/s, P < .01) for b = 200 s/mm. The AUC, sensitivity, specificity, and the cutoff value were 0.992, 96%, 100%, and 1.09 ×10 mm/s, respectively. For patients who had finished chemotherapy, the f-values of IVIM for those with partial remission (PR) were higher than those of complete remission (CR) (56.22 vs 21.81%, P < .01). The AUC, sensitivity, specificity, and the cutoff value were 0.937, 94%, 82%, 42.10%, respectively.For b = 200 s/mm, ADC values are most helpful for characterizing benign lymph nodes and malignant lymphomas. The f-value of the IVIM is most valuable in the identification of residual lesions of lymphomas after chemotherapy.

Blood loss and cost-effectiveness of oral vs intravenous tranexamic acid in primary total hip arthroplasty: A randomized clinical trial.

BACKGROUND: To assess the blood loss and cost-effectiveness of the oral and intravenous (IV) administration of tranexamic acid (TXA) for the treatment of primary total hip arthroplasty (THA). METHODS: From January 2017 to August 2017, 100 patients undergoing primary THA were enrolled and randomly divided into two groups. In the oral TXA group (N = 50), 1 g of TXA (2 tablets of 500 mg) was given 2 h before the incision, and the same dose was repeated 3 h and 6 h postoperatively. In the IV TXA group (N = 50), 1 g of TXA was administered 10 min before the incision, and the same dose was repeated 3 h and 6 h postoperatively. The total follow-up period was 6 months. RESULTS: There were no statistically significant differences in total blood loss (863.3 ±â€¯272.5 mL and 886.1 ±â€¯200.2 mL, P = 0.66), maximum Hb drop (2.9 ±â€¯0.6 g/dl and 3.1 ±â€¯0.8 g/dl, P = 0.17), maximum Hct drop (7.4 ±â€¯2.1% and 7.7 ±â€¯1.8%, P = 0.48), transfusion rates (1 and 2, P = 1.00) and transfusion units (1.5 u and 3 u, P = 0.56) between the two groups. However, the costs of TXA in the oral group were significantly lower than those in the IV TXA group (¥600 and ¥3150, P < 0.01). There was no difference in the Hb levels on postoperative days 1 and 3. No significant differences were found for operating time, hospital length of stay, DVT and/or PE, and wound complications in the postoperative follow-up. CONCLUSIONS: The study demonstrated that the oral and IV administration of TXA in patients undergoing THA was proved to be an equivalent and effective method in reducing blood loss and transfusion rates. However, oral TXA is more cost-effectiveness than IV TXA, and it may be an alternative to the IV form.

Efficacy of triclosan-coated sutures for reducing risk of surgical site infection in adults: a meta-analysis of randomized clinical trials.

BACKGROUND: Surgical site infection (SSI) is the third most frequent type of nosocomial infections. Triclosan-coated sutures are often used to reduce the risk of SSI, but studies examining this have given conflicting results. Therefore, this meta-analysis was performed to assess the efficacy of triclosan-coated sutures for reducing risk of SSI in adults. METHODS: PubMed, EMBASE, Google Scholar, and ClinicalTrials.gov were searched to identify randomized clinical trials evaluating triclosan-coated sutures for preventing SSI on patients 18 y or older. RESULTS: Thirteen randomized clinical trials involving 5256 participants were included. Triclosan-coated sutures were associated with lower risk of SSI than uncoated sutures across all surgeries (risk ratio [RR] 0.76, 95% confidence interval [CI] 0.65-0.88, P < 0.001). Similar proportions of patients experienced wound dehiscence with either type of suture (RR 0.97, 95% CI 0.49-1.89, P = 0.92). Subgroup analysis showed lower risk of SSI with triclosan-coated sutures in abdominal surgeries (RR 0.70, 95% CI 0.50-0.99, P = 0.04) and group with prophylactic antibiotic (RR 0.79, 95% CI 0.63-0.99, P = 0.04). However, such risk reduction was not observed in cardiac surgeries, breast surgeries, or group without prophylactic antibiotic. CONCLUSIONS: Triclosan-coated sutures can decrease the incidence of SSI in abdominal surgeries and might not interfere with wound healing process. Nevertheless, further studies are needed to examine whether triclosan-coated sutures are effective at preventing SSI in non-abdominal surgeries and to further study the interaction of antibiotic prophylaxis with triclosan-coated sutures.

Health-related quality of life and health service utilization in Chinese rural-to-urban migrant workers.

OBJECTIVES: The number of rural-to-urban migrant workers has been increasing rapidly in China over recent decades, but there is a scarcity of data on health-related quality of life (HRQOL) and health service utilization among Chinese rural-to-urban migrant workers in comparison to local urban residents. We aimed to address this question. METHODS: This was a cross-sectional study of 2315 rural-to-urban migrant workers and 2347 local urban residents in the Shenzhen-Dongguan economic zone (China) in 2013. Outcomes included HRQOL (measured by Health Survey Short Form 36) and health service utilization (self-reported). RESULTS: Compared to local urban residents, rural-to-urban migrant workers had lower scores in all domains of HRQOL, and were more likely to report chronic illnesses (9.2% vs. 6.0%, adjusted OR = 1.62, 95% CI 1.28-2.04) and recent two-week morbidity (21.3% vs. 5.0%, adjusted OR = 5.41, 95% CI 4.26-6.88). Among individuals who reported sickness in the recent two weeks, migrant workers were much less likely to see a doctor (32.7% vs. 66.7%, adjusted OR = 0.21, 95% CI 0.13-0.36). CONCLUSIONS: Chinese rural-to-urban migrant workers have lower HRQOL, much more frequent morbidity, but are also much less likely to see a doctor in times of sickness as compared to local urban residents, indicating the existence of significant unmet medical care needs in this population.

Feasibility of a remote monitoring system for home-based non-invasive positive pressure ventilation of children and infants.

OBJECTIVE: We examined the safety, efficacy, and caregiver satisfaction of a remote monitoring system for home-based non-invasive positive pressure ventilation of children and infants with upper airway obstruction. METHODS: Fourteen pediatric patients (age 50 days to 12 years) treated in our ENT unit from March 2009 to July 2011 and requiring home-based non-invasive positive pressure ventilation were enrolled in this feasibility study; one patient underwent CPAP and the other 13 patients underwent Bi-PAP. User satisfaction with the monitoring system was assessed by questionnaires given at regular intervals to parents and attending physicians. Compliance was determined by the number of days that parents uploaded data to the central server. In addition, the feasibility of the system was analyzed by comparing costs and time expenditures with traditional clinic visits. RESULTS: The patients' parents (primary caregivers) uploaded data via the system on 93.3% of trial days, indicating good compliance. No system or device failures occurred. Both parents and physicians considered the system convenient and ease to use according to >80% of the returned questionnaires, indicating high user satisfaction. The mean distance between the patients' homes and the hospital was 113 ± 71 km, and parents required 371 ± 182 min to reach the hospital for a follow-up visit. In contrast, it took only 5.7 ± 3.1 min per day to transmit data (P<0.05 compared to hospital travel time). As of August 2011, average cost per patient was 632 Chinese yuan (¥), which was ¥924 (59.4%) lower than the cost of clinic visits (¥1556). CONCLUSIONS: The remote monitoring system was safe, reliable, easy to use, cost effective, and widely acceptable to both parents and physicians. This system may allow for safe and effective home-based non-invasive positive pressure ventilation for children with upper airway obstructions in developing countries with limited health care budgets or for patients from remote regions.