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Emerging aryl organophosphate esters (aryl-OPEs) have been employed as substitutes for organohalogen flame retardants in recent years; however, their environmental occurrence and associated impacts in urban estuarine sediments have not been adequately investigated, impeding regulatory decision-making. Herein, field-based investigations and modeling based on surface sediment and sediment core analysis were employed to uncover the historical pollution and current environmental impacts of aryl-OPEs in the Pearl River Estuary, South China. Our results revealed a substantial increase in aryl-OPE emission, particularly emerging aryl-OPEs, through sediment transport to the estuary since the 2000s. The emerging aryl-OPEs comprised 83% of the total annual input in the past decade, with an average annual input of 155,000 g. Additionally, the emerging-to-traditional aryl-OPE concentration ratios increased with decreasing distance from the shore, peaking in the highly urbanized riverine outlets. These findings indicate that inventories of emerging aryl-OPEs are likely increasing in estuarine sediments and their emissions are surpassing those of traditional aryl-OPEs. Our risk-based priority screening approach indicates that some emerging aryl-OPEs, particularly bisphenol A bis(diphenyl phosphate), can pose a higher environmental risk than traditional aryl-OPEs in estuarine sediments. Overall, our study highlights the importance of recognizing the environmental impacts of emerging aryl-OPEs.
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Due to their prevalence in urban contaminated water, the driving factors of organophosphate esters (OPEs) need to be well examined, and their related ecological impacts should include that of their transformation products (TPs). Additionally, a robust framework needs to be developed to integrate multiple variables related to ecological impacts for improving the ecological health assessment. Therefore, OPEs and TPs in urban stormwater and wastewater in Hong Kong were analyzed to fill these gaps. The results revealed that the total concentrations of OPEs in stormwater were positively correlated with the area of transportation land. Individual TP concentrations and the mass ratios of individual TPs/OPEs were somewhat higher in sewage effluents than that in stormwater. OPEs generally showed relatively higher risk quotients than TPs; however, the total risk quotients increased by approximately 38% when TPs were factored in. Moreover, the molecular docking results suggested that the investigated TPs might cause similar endocrine disruption in marine organisms as their parent OPEs. This study employed the Toxicological-Priority-Index scheme to successfully integrate the ecological risks and endocrine-disrupting effects to refine the ecological health assessment of the exposure to OPEs and their TPs, which can better inform the authority on the prioritization for regulating these contaminants of emerging concern in urban built environments.
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Retardadores de Chama , Poluentes Químicos da Água , Esgotos , Poluentes Químicos da Água/análise , Simulação de Acoplamento Molecular , Monitoramento Ambiental/métodos , Organofosfatos , Ésteres , China , Retardadores de Chama/análiseRESUMO
Heart failure (HF),a chronic progressive disease,is a global health problem and the leading cause of deaths in the global population.The pathophysiological abnormalities of HF mainly include abnormal cardiac structure (myocardium and valves),disturbance of electrophysiological activities,and weakened myocardial contractility.In addition to drug therapy and heart transplantation,interventional therapies can be employed for advanced-stage HF,including transcatheter interventions and mechanical circulatory assist devices.This article introduces the devices used for advanced HF that have been marketed or certified as innovative or breakthrough devices around the world and summarizes the research status and prospects the trend in this field.As diversified combinations of HF devices are used for the treatment of advanced HF,considerations regarding individualized HF therapy,risk-benefit evaluation on device design,medical insurance payment,post-market supervision system,and protection of intellectual property rights of high-end technology are needed,which will boost the development of the technology and industry and benefit the patients.
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Insuficiência Cardíaca , Transplante de Coração , Coração Auxiliar , Humanos , Insuficiência Cardíaca/terapia , Miocárdio , Doença CrônicaRESUMO
Organic anion transporting polypeptides (OATPs) are key players of drug absorption, distribution and excretion due to their broad substrate specificity, wide tissue distribution and the involvement in drug-drug interaction. OATP1B1 is specifically localized at the basolateral membrane of human hepatocytes and serves a crucial role in the drug clearance from the body. Previous studies have shown that transmembrane domains (TMs) are essential for proper functions of OATPs. In the present study, site-directed mutagenesis was performed to study the TM1 and amino-terminus of OATP1B1. Two positively charged residues, K41 and K49, as well as a hydrophobic residue I46, in TM1 were identified to be important for the proper function of the transporter. K41A and K49A exhibited altered Km value at the high and low affinity binding sites of estrone-3- sulfate (ES), respectively; while alanine substitution of I46 showed altered Km and Vmax values for both binding components of ES. Additional replacement of K41 revealed that the positively charged property at this position is important for maintaining OATP1B1 protein level and function; while the specific side-group structure of lysine at position 49 is irreplaceable for the transporter activity. Conservative replacement of I46 with leucine also recovered the function of the transporter. In addition, studies of the amino-terminus of OATP1B1 revealed that residues ranging from 19 to 27 are essential for protein stability and substrate interaction. Therefore, the amino-terminal region, which includes TM1 and the amino-terminus of OATP1B1, is important for proper function of the membrane protein.
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Transportador 1 de Ânion Orgânico Específico do Fígado/metabolismo , Especificidade por Substrato/fisiologia , Sequência de Aminoácidos , Sítios de Ligação/fisiologia , Transporte Biológico/fisiologia , Linhagem Celular , Membrana Celular/metabolismo , Estrona/análogos & derivados , Estrona/metabolismo , Células HEK293 , Humanos , Cinética , Mutagênese Sítio-Dirigida/métodos , Peptídeos/metabolismo , Domínios Proteicos/fisiologiaRESUMO
Organic anion transporting polypeptides (OATPs, gene symbol SLCO) are important membrane transporter proteins that mediate the uptake of wide ranges of endogenous and exogenous compounds. OATP2B1 has been found in multiple organs and tissues, including the liver, small intestine, kidney, brain, placenta, heart, skin, as well as skeletal muscle, and is proposed to be involved in the uptake of orally administered drugs. Quite a few reports have demonstrated that transmembrane domains (TMs) are crucial for proper functions of OATP family members. Comparative modeling proposed that TM1, along with TM2, 4, and 5 of the N-terminal half of OATP2B1, may be localized within the substrate interaction pocket and are important for uptake function of the transporter. Alanine scanning of the putative transmembrane domain 1 of OATP2B1 revealed that substitution of L58 with alanine dramatically altered the Km value, and mutation of V52, H55, Q59, and L69 resulted in significantly reduced substrate turnover number, whereas A61V, Q62A, and S66A exhibited significant change in both Km and Vmax values. In addition, phenylalanine at position 51 seems to play an important role in maintaining proper folding of OATP2B1 because alanine replacement of F51 caused accelerated degradation of the transporter protein. Although proteasome and lysosome inhibitors could partially recover protein level, the mutant transporter remained nonfunctional. Taken together, the identification of nine essential amino acid residues within TM1 of OATP2B1 suggested that the transmembrane domain is important for maintaining proper function of the transporter.
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Substituição de Aminoácidos , Transportadores de Ânions Orgânicos/química , Transportadores de Ânions Orgânicos/metabolismo , Motivos de Aminoácidos , Sítios de Ligação , Transporte Biológico , Células HEK293 , Humanos , Modelos Moleculares , Transportadores de Ânions Orgânicos/genética , Domínios Proteicos , Dobramento de Proteína , Estrutura Terciária de ProteínaRESUMO
Hypertension is a risk factor in many cardiovascular or cerebrovascular diseases. Adolescent hypertension may develop into adult hypertension. Examining the aetiologic factors of adolescent hypertension is crucial in its prevention and in managing its possible complications. The predominant view of aetiologic factors includes heredity, overweight/obesity, insulin resistance, gestational hypertension, diet, and intrauterine growth retardation. This article reported that children's academic grades in schools were positively correlated with adolescent blood pressure.
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Pressão Sanguínea , Escolaridade , Estresse Psicológico/fisiopatologia , Adolescente , Feminino , Humanos , MasculinoRESUMO
The effects of moisture and drying shrinkage can lead to uneven settlement, cracking, and other diseases in loess subgrade. The objective of this study was to investigate the effects of amide polymer (AP) on the permeability, mechanical properties and crack resistance of loess by orthogonal experiments. The basic properties of AP and the permeability, mechanical properties, and dry-wet variation properties of polymer-modified loess were tested, and a scale model verification and simulation analysis were conducted. In this paper, water migration in subgrade is regulated by improving the water sensitivity of loess. By reducing the variation range of subgrade water content, the stress accumulation in subgrade caused by water is weakened. The results show that the curing time and mechanical properties of AP are directly affected by the oxidant and reducing agent, and the mechanical properties of AP are compatible with the characteristics of loess. AP filled the grain gap and reduced the permeability of loess by 34.05-280.83%. The ductility of polymer-modified loess is significantly increased, and the strain of peak strength is increased by 17.21-126.36%. AP can regulate moisture change, reduce the surface tension between particles, and reduce stress concentration. The strength loss rate was reduced by 19.98-51.21% by enhancing the cracking resistance and weakening the strength loss caused by dry and wet cycling. The increase of upper layer moisture content in the scale model of polymer-modified loess subgrade is reduced by 31.38-36.11%.
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OBJECTIVE: We aimed to investigate the correlation between long-term blood pressure variability (BPV) and the risk of cardiovascular diseases (CVDs) among population with different blood pressure statuses (normotension, well-controlled hypertension, and uncontrolled hypertension). METHODS: In this ambispective cohort study, CVD-free residents aged over 50 years were consecutively enrolled from two community health service centers (CHCs) in Tianjin, China from April 2017 to May 2017. Information on blood pressure was retrospectively extracted from electronic medical records of CHCs between January 2010 and May 2017, and the occurrence of new-onset CVDs was prospectively observed during follow-up until September 2019. Long-term variation of SBP and DBP was assessed using four indicators: SD, coefficient of variation (CV), average successive variability (ASV), and average real variability (ARV). Cox proportional hazards regression model was developed to identify the potential impact of BPV on the incidence of CVDs. The receiver operating characteristic curve (ROC) was utilized to evaluate the predictive value of BPV indicators for the occurrence of CVDs. RESULTS: Of 1275 participants included, 412 (32.3%) experienced new CVD events during the median 7.7 years of follow-up, with an incidence density of 499/10 000 person-year in the whole cohort. Cox regression analysis revealed that almost all SBP and DBP variability indicators (except for SBP-SD) were significantly related to the risk of CVDs, especially among individuals with well-controlled hypertension. A trend toward an increased risk of CVDs across BPV quartiles was also observed. Moderate predictive abilities of BPV were observed, with the area under ROC curves ranging between 0.649 and 0.736. For SBP variability, SD had the lowest predictive ability, whereas for DBP variability, ARV had the lowest predictive ability. No significant association of CVDs with SBP-SD was found in all analyses, no matter as a continuous or categorical variable. CONCLUSION: Elevated long-term BPV is associated with an increased risk of CVDs, especially among individuals with well-controlled hypertension. CV and ASV had higher predictive values than SD and ARV.
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Pharmaceuticals are receiving increasing attention as emerging contaminants in the aquatic environment. Herein, we investigated the occurrence of 11 antidepressants, 6 antihistamines and 4 metabolites in treated wastewater effluents, rivers, stormwater, and seawater in Hong Kong, with special focus on chirality. The average levels of ∑pharmaceuticals ranged from 0.525 to 1070 ng/L in all samples and the total annual mass load of target pharmaceuticals in the marine environment of Hong Kong was 756 kg/y. Antihistamines accounted for >80 % of ∑pharmaceuticals, with diphenhydramine and fexofenadine being predominant. The occurrence and enantiomeric profiles of brompheniramine and promethazine sulfoxide were reported in global natural waters for the first time. Among chiral pharmaceuticals, mirtazapine and fexofenadine exhibited R-preference, while others mostly exhibited S-preference, implying that the ecological risks derived from achiral data for chiral pharmaceuticals may be biased. The joint probabilistic risk assessment of fluoxetine revealed that R-fluoxetine and rac-fluoxetine presented different ecological risks from that of S-fluoxetine; Such assessment also revealed that target pharmaceuticals posed only minimal to low risks, except that diphenhydramine posed an intermediate risk. As estimated, 10 % aquatic species will be affected when the environmental level of diphenhydramine exceeds 7.40 ng/L, which was seen in 46.9 % samples. Collectively, this study highlights further investigations on the enantioselectivity of chiral pharmaceuticals, particularly on environmental behavior and ecotoxicity using local aquatic species as target organisms.
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Fluoxetina , Terfenadina/análogos & derivados , Poluentes Químicos da Água , Fluoxetina/toxicidade , Poluentes Químicos da Água/análise , Monitoramento Ambiental , Antidepressivos , Antagonistas dos Receptores Histamínicos , Difenidramina , Medição de Risco , Rios , Preparações FarmacêuticasRESUMO
This study provided a systematic investigation of microplastics in Hong Kong's surface marine waters during the pandemic from 2019 to 2021. Microplastics (2.07 ± 4.00 particles/m3) exhibited significant temporal variations with higher abundance in the wet season, without a consistent trend after the mandatory mask-wearing requirement was announced. The impact of pandemic restrictions on microplastic distribution was found to be relatively minor. However, significant correlations between microplastic abundances and rainfall highlighted the substantial contribution of local emissions through surface runoff. Notably, sites in closer proximity to the Pearl River Delta exhibited higher microplastic abundances, indicating their association with emission sources. The influence of rainfall and adverse weather on marine microplastic loads demonstrated different sensitivities among various locations but can generally last for one month. These results revealed the impact of seasonal rainfall on coastal microplastics and emphasized the need for efforts to reduce microplastic discharge from land-based sources.
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Monitoramento Ambiental , Microplásticos , Chuva , Rios , Poluentes Químicos da Água , Hong Kong , Poluentes Químicos da Água/análise , Microplásticos/análise , Rios/química , Água do Mar/química , Estações do AnoRESUMO
RATIONAL: Paragangliomas are rare and can occur in many places throughout the body, but mediastinal paragangliomas are even rarer, accounting for less than 0.3% of mediastinal masses. Extremely susceptible to misdiagnosis and mistreatment, which may lead to the death of the patient. PATIENT CONCERNS: We report a case of a giant paraganglioma of the middle mediastinum. A 40-year-old woman was admitted to the hospital with a rib fracture and a chest computed tomography suggesting a giant occupying tumor in the middle mediastinum. DIAGNOSIS: Immunohistochemistry revealed positive for S100 fraction and Syn, focally positive for CgA, while negative for CKp and succinate dehydrogenase complex iron sulfur subunit B gene, and Ki67indexâ ≈â 5%. The imaging and immunohistochemical features suggested a final diagnosis of Paragangliomas. INTERVENTIONS: This patient underwent lateral open heart surgery to remove a mediastinal mass. OUTCOMES: One month after being discharged, the patient was contacted by phone for a follow-up visit and reported feeling OK. Unfortunately, as of the date of submission, the patient did not come to our hospital for review. LESSONS: Mediastinal paraganglioma as a rare and potentially malignant tumor susceptible to misdiagnosis and mistreatment. Organ pathology examination is the gold standard for diagnosis, and surgery is an important treatment method. A clear diagnosis and thorough preoperative examination are important guarantees for the success of surgery.
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Neoplasias do Mediastino , Paraganglioma Extrassuprarrenal , Paraganglioma , Feminino , Humanos , Adulto , Mediastino/patologia , Paraganglioma/diagnóstico , Paraganglioma/cirurgia , Paraganglioma/patologia , Paraganglioma Extrassuprarrenal/patologia , Neoplasias do Mediastino/diagnóstico , Neoplasias do Mediastino/cirurgia , Neoplasias do Mediastino/patologia , Tomografia Computadorizada por Raios XRESUMO
Estuaries are unique transition zones connecting terrestrial and coastal environments and are recognized as primary conveyors for land-derived plastics to open oceans. Riverine microplastics (MPs) have been commonly investigated using sequential sampling which might not effectively reflect the actual load. In this study, sampling at eight outlets was performed during a complete tidal cycle to estimate the MP flux to the Pearl River Estuarine (PRE) using a concurrent sampling strategy. The MP abundances ranged from 2.90 ± 0.57-5.9 ± 2.27 particles/L. A remarkable difference between tides in MP abundances suggests tidal effect should not be overlooked in assessment. The MP load through the eight outlets was estimated at 304 trillion particles or 1102 tons into the PRE annually. Additionally, similar potential ecological risk assessment among eight rivers implied that environmental threats posed by less urbanized and populated rural areas on the western side have been under-evaluating for decades.
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Estuários , Poluentes Químicos da Água , Microplásticos , Plásticos , Rios , Poluentes Químicos da Água/análise , Monitoramento Ambiental , China , Medição de RiscoRESUMO
The aim of this study was to investigate the influence of statin on glycemic control in different age groups. Patients admitted for suspected or confirmed coronary artery disease between January 2005 and December 2013 in Seoul, Korea were initially enrolled. After propensity score matching, 2654 patients (1:1 statin users and non-users) were selected out of total 5041 patients, including 1477 "young" patients (≤60 y) and 1177 elderly patients (>60 y). HbA1c was decreased by 0.04% (±0.86%) in statin non-users. On the contrary, a slight increment of 0.05% (±0.71%) was found in statin users (p < 0.001). The change patterns of HbA1c were constant in both young and elderly patient groups. Furthermore, elderly statin users demonstrated significantly worse glycemic control in serum insulin and homeostatic model assessmentinsulin resistance (HOMA-IR) index. In elderly patients, statin users were found to have a 2.61 ± 8.34 µU/mL increment in serum insulin, whereas it was 2.35 ± 6.72 µU/mL for non-users (p = 0.012). Statin users had a 0.78 ± 3.28 increment in HOMA-IR, in contrast to the 0.67 ± 2.51 increment in statin non-users (p = 0.008). In conclusion, statin treatment was associated with adverse glycemic control in the elderly population.
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Phthalate esters (PAEs) are predominant additives in plastics, their widespread contamination in aquatic environments has raised global concern. Here, twelve plastic products were prepared as microplastics to investigate their release behaviors of PAEs. Six out of 15 PAEs were quantified after 14 days of incubation in water. The leaching potentials were plastic type-specific, where the pencil case (polyvinyl chloride, PVC) represented the highest migrations with total ∑15 PAEs concentration of 6660 ± 513 ng/g, followed by the cleaning brush-1 (polyamide, PA, ~1830 ng/g) and rubber glove (1390 ± 57.5 ng/g). Conversely, the straw (polypropylene, PP), cleaning brush-2 (polyethylene terephthalate, PET) and shampoo bottle (PET) released the lowest amounts of PAEs, with 50.3 ± 8.21, 93.9 ± 91.8 and 104.35 ng/g, respectively. The release patterns of PAE congeners were polymer type-related, where di-n-butyl phthalate (DBP) dominated the leaching from PA, PP and PET microplastics (47-84%), diethyl phthalate leached the most from PVC and rubber microplastics (45-92%), while diisobutyl phthalate and DBP dominated the leaching from PE microplastics (68-94%). Water chemical properties could affect PAEs migration and the kinetic leaching process was well fitted with the pseudo-first-order model. Approximately 57.8-16,100 kg/year of PAEs were estimated to be released into oceans from microplastics.
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Microplásticos , Ácidos Ftálicos , China , Dibutilftalato , Ésteres , Plásticos , Cloreto de Polivinila , Borracha , ÁguaRESUMO
Microplastics (MPs) have become a great concern owing to their persistence and ecotoxicity in various environmental compartments. MPs can be transported from land to oceans via the aquatic system, and the oceans are believed to be the final sink for MPs. To resolve the lack of data concerning MP contamination in the northern South China Sea (NSCS), coastal seawater and sediments were investigated. The sample sites included the coastal area from Hong Kong to western Guangdong Province, which provided a representative coverage of variable distance to the shore. MP particles were observed in all samples, suggesting a widespread MP pollution in NSCS. The average MP abundance was relatively high in South China Sea, but it was lower than that in other Chinese coastal areas. In all samples, the dominant MP polymer was polyethylene terephthalate fibers. No statistically significant correlation was found between the abundances of MPs in seawater and sediment. The MP distribution in surface water affected by the monsoon exhibited high abundance in the east and low in the west, and MPs were more abundant near the shore than away from it. The tropical cyclone had no obvious effect on the overall MP abundance except in the Hong Kong west marine water (R4), which may attribute to proximity to Hong Kong and other islands.
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Tempestades Ciclônicas , Poluentes Químicos da Água , China , Monitoramento Ambiental , Microplásticos , Plásticos , Água/análise , Poluentes Químicos da Água/análiseRESUMO
Urban stormwater is an important pathway for transporting anthropogenic pollutants to water bodies. Phthalate esters (PAEs) are endocrine disruptors owing to their estrogenic activity and potential carcinogenicity and their ubiquitous presence has garnered global interest. However, their transportation by urban stormwater has been largely overlooked. This study, for the first time, investigated 15 PAEs in stormwater from six major stormwater drains in the highly urbanized Hong Kong, a major metropolitan city in China. The results showed that PAEs were ubiquitous in the stormwater of Hong Kong, with total concentrations (∑15PAEs) spanning from 195 to 80,500 ng/L. Bis(2-n-butoxyethyl) phthalate (DBEP), diisopentyl phthalate (DiPP), dicyclohexyl phthalate (DCHP) and di-n-pentyl phthalate (DnPP) were detected in stormwater for the first time. Spatial variations in PAEs were observed among different stormwater drains, possibly due to the different land use patterns and intensities of human activities in their respective catchments. The highest and lowest levels of ∑15PAEs were found in Kwai Chung (3860 ± 1960 ng/L) and the Ng Tung River (672 ± 557 ng/L), respectively. Additionally, significantly higher concentrations of ∑15PAEs in stormwater were found in the wet season (2520 ± 2050 ng/L) than in the dry season (947 ± 904 ng/L). Principal component analysis classified domestic and industrial origins as two important sources of PAEs in the stormwater of Hong Kong. Stormwater played a crucial role in transporting PAEs, with an estimated annual flux of 0.705-29.4 kg. Thus, possible stormwater management measures were proposed to protect the receiving environment and local ecosystems from stormwater.
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Ácidos Ftálicos , Poluentes Químicos da Água , China , Dibutilftalato/análise , Ecossistema , Ésteres/análise , Hong Kong , Humanos , Ácidos Ftálicos/análise , Poluentes Químicos da Água/análiseRESUMO
Phthalate esters (PAEs) are representative additives used extensively in plastics. In this study, 15 PAEs were investigated at the eight riverine outlets of the Pearl River Delta (PRD). The total concentrations of Σ15PAEs, including both the dissolved and particulate phases, ranged from 562 to 1460 ng/L and 679 ng/L-2830 ng/L in the surface and bottom layers, respectively. Dibutyl phthalate (DBP) and di(2-ethylhexyl) phthalate (DEHP) dominated in the dissolved and suspended particulate matter (SPM) phases, respectively, accounting for >50 % and > 80 % of Σ15PAEs. Riverine input of wastewater from the PRD was possibly the primary source of the contamination. Higher levels of PAEs occurred at the eastern outlets than at the western ones. The dissolved and particulate PAEs varied seasonally, with significantly higher concentrations observed in the dry season than in the wet season. However, no significant differences of PAE levels in both phases were observed among low, medium, and high tides. The partitioning results demonstrated that SPM is important in the transportation of pollutants in estuaries, where more hydrophobic DEHP was predominantly transported by the SPM phase, while those more hydrophilic ones were regularly transported by the dissolved phase. The total annual flux of Σ15PAEs through the eight outlets to the SCS reached 1390 tons.
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Dietilexilftalato , Poluentes Ambientais , Ácidos Ftálicos , China , Dibutilftalato/análise , Dietilexilftalato/análise , Ésteres/análise , Material Particulado/análise , Ácidos Ftálicos/análise , Plásticos , Rios/química , Águas ResiduáriasRESUMO
Metabolic syndrome (MetS) is a risk factor for various diseases with a high prevalence globally. We aimed to investigate the association of serum vitamin D levels with MetS, and we hypothesized that the beneficial cutoffs of vitamin D for MetS might vary by sex among urban people aged ≥60 years in Tianjin, China. This community-based cross-sectional study was conducted in 2 community health centers. We collected lifestyle and anthropometric information and measured serum 25(OH)D3 concentrations by high-performance liquid chromatography. MetS was diagnosed based on the 2009 International Diabetes Federation/American Heart Association/National Heart, Lung, and Blood Institute criterion. Binary logistic regression and stratification analysis were performed to determine the association between MetS and 25(OH)D3 levels. Among 840 eligible participants (347 males and 493 females), 439 (52.3%) were diagnosed with MetS. The prevalence rates of MetS in men and women were 52.7% and 51.9%, respectively (P = .82). In the whole population, no significant association was found between 25(OH)D3 and MetS, regardless of which 25(OH)D3 cutoff was used. After stratification by sex, men with serum 25(OH)D3 ≥40 ng/mL had a significantly lower risk of MetS before and after adjustment, with odds ratios (ORs) and 95% confidence intervals (CIs) of 0.55 (0.31-0.98) and 0.53 (0.29-0.96), respectively. For women, serum 25(OH)D3 ≥20 ng/mL was associated with a lower MetS risk, with unadjusted and adjusted ORs (95% CI) of 0.64 (0.43-0.95) and 0.61 (0.41-0.91), respectively. This association was more significant among females with respect to diastolic pressure and triglycerides. The beneficial cutoffs of serum 25(OH)D3 levels for MetS among men and women might be different.
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Síndrome Metabólica , Deficiência de Vitamina D , Idoso , Índice de Massa Corporal , China/epidemiologia , Estudos Transversais , Feminino , Humanos , Masculino , Fatores de Risco , Vitamina D , Deficiência de Vitamina D/complicações , Deficiência de Vitamina D/epidemiologia , VitaminasRESUMO
AIMS: Information regarding ß-blocker use and bleeding risk in patients on antithrombotic therapy in contemporary practice is limited. We examined the association between early (within the first 24 hours) oral ß-blocker therapy and major in-hospital bleeds among acute coronary syndrome (ACS) patients treated with percutaneous coronary intervention (PCI). METHODS AND RESULTS: In the Improving Care for Cardiovascular Disease in China-ACS project, among patients without contraindications to ß-blocker, we examined the association between early oral ß-blocker exposure [users/non-users, dosing, and type (metoprolol vs. bisoprolol)] and major in-hospital bleeds. Of the 43,640 eligible patients, 36.0% patients received early oral ß-blocker and 637 major bleeds were recorded. Compared with non-users, early oral ß-blocker was associated reduced risks for major bleeds [odds ratio (OR): 0.48; 95% confidence interval (CI): 0.38-0.61] and in-hospital mortality (OR: 0.47; 95%CI: 0.34-0.64) in multivariable-adjusted logistic regression models. Early oral ß-blocker use associated reduction in major bleeding was evident both in high-dose (defined by metoprolol-equivalent dose ≥50 mg/day) users (OR: 0.47; 95%CI: 0.33-0.68) and in low-dose users (metoprolol-equivalent dose <50 mg/day; OR: 0.61; 95%CI: 0.47-0.79). No significant difference was observed between metoprolol and bisoprolol in terms of reductions in major bleeding and mortality. Analyses based on inverse-probability-of-treatment-weighted regression adjustment and propensity-score matching yielded consistent findings. CONCLUSION: In this retrospective study based on the nationwide ACS registry, among patients treated by PCI, in addition to a reduction in in-hospital mortality, oral ß-blocker therapy initiated within the first 24 hours was associated with a reduced risk for major in-hospital bleeds. Clinical Trial Registration: URL: https://www.clinicaltrials.gov. Unique identifier: NCT02306616.
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The release of microplastics from sewage treatment works (STWs) into the oceans around coastal cities is well documented. However, there are fewer studies on the microplastic abundance in stormwater drains and their emissions into the coastal marine environment via sewage and stormwater drainage networks. Here, we comprehensively investigated microplastic abundance in 66 sewage and 18 sludge samples collected from different process stages at three typical STWs and 36 water samples taken from six major stormwater drains during the dry and wet seasons in Hong Kong, which is a metropolitan city in south China. The results showed that microplastics were detected in all the sewage and stormwater samples, with the abundance ranging from 0.07 to 91.9 and from 0.4 to 36.48 particles/L, respectively, and in all the sludge samples with the abundance ranging from 167 to 936 particles/g (d. w.). There were no significant seasonal variations in the microplastic abundance across all samples of sewage, sludge, and stormwater. For both waterborne sample types, a smaller size (0.02-0.3 mm) and fiber shape were the dominant characteristics of the microplastics. Polyethylene terephthalate (PET) and polypropylene (PP) were the most abundant polymer types in the sewage samples, while polyethylene (PE), PET, PP, and PE-PP copolymer were the most abundant polymer types in the stormwater samples. The estimated range of total daily microplastic loads in the effluent from STWs in Hong Kong is estimated to be 4.48 × 109 - 2.68 × 1010 particles/day, demonstrating that STWs are major pathways of microplastics in coastal environments despite the high removal percentage of microplastics in sewage treatment processes examined. This is the first comprehensive study on microplastics in the urban waters of a coastal metropolis. However, further studies on other coastal cities will enable an accurate estimation of the microplastic contribution of stormwater drains to the world's oceans.