Predicting the death of patients with anti-melanoma differentiation-associated protein-5-positive dermatomyositis-associated interstitial lung disease: A systematic review and meta-analysis.

OBJECTIVES: To investigate the risk factors for death in anti-melanoma differentiation-associated protein-5-positive dermatomyositis-associated interstitial lung disease (ILD). METHODS: Studies were identified by searching PubMed, Embase, Web of Science, and Cochrane Library. We calculated pooled risk ratios (RRs) or standardized mean differences (SMDs) and 95% confidence intervals (CIs) using random-effects models. RESULTS: Twenty studies were selected. Factors that may increase death risk included older age (SMD: 0.62, 95% CI: 0.42-0.81), elevated Krebs von den Lungen-6 (SMD: 0.66, 95% CI: 0.47-0.86), lactate dehydrogenase (SMD: 0.87, 95% CI: 0.72-1.02), C-reactive protein (SMD: 0.62, 95% CI: 0.44-0.80), ferritin (SMD: 0.93, 95% CI: 0.71-1.15), creatine kinase (SMD: 0.28, 95% CI: 0.13-0.44), neutrophil (SMD: 0.34, 95% CI: 0.04-0.64), neutrophil-to-lymphocyte ratio (SMD: 0.52, 95% CI: 0.24-0.79), aspartate aminotransferase (SMD: 0.70, 95% CI: 0.45-0.94), shorter disease duration (SMD: -0.44, 95% CI: -0.67 to -0.21), rapidly progressive ILD (RR: 4.08, 95% CI: 3.01-5.54), fever (RR: 1.98, 95% CI: 1.46-2.69), dyspnoea (RR: 1.63, 95% CI: 1.32-2.02), and anti-Ro52 antibody positive (RR: 1.28, 95% CI: 1.11-1.49). Female (RR: 0.86, 95% CI: 0.78-0.94), increased albumin (SMD: -1.20, 95% CI: -1.76 to -0.64), lymphocyte (SMD: -0.49, 95% CI: -0.67 to -0.30), and arthralgia (RR: 0.53, 95% CI: 0.37-0.78) were protective factors. CONCLUSION: Older age, shorter disease duration, rapidly progressive ILD, fever, dyspnoea, anti-Ro52 antibody positive, and some inflammatory markers were risk factors for death in patients with anti-melanoma differentiation-associated protein-5-positive dermatomyositis-associated ILD.

Sedation and analgesia strategies for non-invasive mechanical ventilation: A systematic review and meta-analysis.

BACKGROUND: The use of sedative and analgesic drugs during non-invasive ventilation (NIV) in patients with acute respiratory failure (ARF) is controversial. OBJECTIVES: To assess the clinical effectiveness of sedative and analgesic medications used during NIV for patients with ARF to no sedation or analgesia. In addition, to investigate the characteristics of dexmedetomidine in comparison to other medications. METHODS: PubMed, Embase, Web of Science, Cochrane Library and China National Knowledge Infrastructure (CNKI) were searched. Mean differences (MDs) or pooled risk ratios (RRs) were computed using random-effects models. We applied the Cochrane risk-of-bias assessment tool 2.0 to assess the methodological quality of eligible studies and the GRADE approach to evaluate the evidence certainty. RESULTS: Twenty-one studies were selected. Whether in Group A (using sedative and analgesic drugs vs. nonuse) or Group B (using dexmedetomidine vs. other drugs), the rates of tracheal intubation and delirium, the length of NIV, and the length of stay in the intensive care unit (ICU LOS) all decreased in both experimental groups (P < 0.05). And there were no significant differences in all-cause mortality and the incidence of hypotension between the two groups (P > 0.05), while both Group A and Group B's experimental groups had greater incidences of bradycardia. CONCLUSIONS: Administering sedative and analgesic medications during NIV can reduce the risk of tracheal intubation and delirium. Additionally, dexmedetomidine outperformed other sedative medications in terms of these clinical outcomes, making it the better option when closely monitoring patients' vital signs.

Dietary exposure of radionuclides and heavy metals in adult residents in a high background natural radiation area using duplicate diet method.

Intake of radionuclides and heavy metals through food consumption is one of the important pathways for long-term health considerations. In this paper, the dietary exposure to radionuclides (210Pb, 210Po, 226Ra, 228Ra, 40K, 137Cs and 129I) and heavy metals (As, Hg, Pb, Cd and U) of adult residents in the high background natural radiation area (HBNRA) in Yangjiang, China, was comprehensively assessed using duplicate diet method. The estimated effective dose received by the inhabitants in HBNRA from ingestion of radionuclides was 0.33 mSv/y, and the associated lifetime cancer risk was 1.1 × 10-3. Both the dose and cancer risk to humans were at the acceptable range, and showed no difference between the HBNRA and the control area. With respect to heavy metals, the estimated daily intake of heavy metals (DIM) values for As, Hg, Pb, Cd and U in HBNRA were 0.47, 0.03, 15.0, 0.26 and 0.04 µg/kg bw/d, respectively, and the corresponding target hazard quotient (THQ) were 1.58, 0.09, 3.7, 2.56, 0.18. The DIM and THQ of Cd and U in HBNRA were similar to the control area, but the DIM and THQ of Pb were much higher than the corresponding values of 0.39 and 0.03 in the control area. The hazard index (HI) value of heavy metals in HBNRA was almost twice that of the control area. This suggests that the inhabitants in the HBNRA may have a health risk associated with the heavy metals.

Experience and performance of In Vivo Monitoring Laboratory of NIRP in 2017 thyroid measurement intercomparison.

Determination of the 131I activity in the thyroid of exposed people or workers is one of the major concerns that needs to be addressed following a nuclear or radiological emergency. International intercomparison exercises on bioassay measurements are one of the effective methods to improve the capability and quality of internal dose assessment. In 2017, Working Group 1 (Internal Dosimetry) of the Asian Radiation Dosimetry Group (ARADOS) organized an intercomparison exercise on the thyroid measurement, aiming at enhancing and coordinating the radiation dosimetry capabilities of Asian countries. This paper describes the measurement experience and results of In Vivo Monitoring Laboratory of NIRP in the 2017 intercomparison exercise, which can provide technical reference for laboratories that have not yet participated in such thyroid measurement intercomparsion. It covers technical aspects such as calibration, measurement and data processing. The results presented in this intercomparison are within an acceptable range of performance criteria on the bioassay measurements. In addition, further research work considered in the field of thyroid measurement is described in the discussion section.

Measurement of Natural Radionuclides and Assessment of Radiation Hazard in Coal from Parts of China.

ABSTRACT: To study the content of radionuclides in coal and to assess its associated radiological impact on the environment for potential radiological risk assessment, a total of 40 coal samples were collected from various mining areas in eight provinces of China. The specific activities of 226Ra, 232Th, 40K, 210Pb, and 238U were measured in all samples using an HPGe gamma-ray spectrometer, and results were compared with available data from other similar studies. The results reveal that the radium equivalent activity was 74.20 Bq kg-1, external hazard index was 0.20, internal hazard index was 0.27, representative gamma index was 0.52, and indoor and outdoor annual effective dose rates were 0.16 nSv y-1 and 0.04 nSv y-1, respectively. Absorbed gamma dose rate in air was 32.87 nGy h-1. In general, these values are lower than the respective threshold limits recommended by UNSCEAR, and the radiation risk to the public is extremely small.

Identification method of EDXRD spectra for illicit substance detection.

The energy-dispersive X-ray diffraction technique can be more practical and accurate for security applications such as detecting drugs and explosives. Here, an accurate multivariate discriminant analysis (MDA) method is used to identify the energy-dispersive X-ray diffraction spectra of illicit contraband. MDA is a comprehensive algorithm based on the principal component analysis algorithm, spectral angle matching method, and correlation coefficient method. Experiments are performed to acquire the diffracted spectra of drugs and common daily necessities. The accurate identification of models for an unknown substance can indicate the substance type in an already established database. Even in the case of shielding, the concealed object can be correctly identified, and the identification accuracy improved much compared with other algorithms.

Effect of topsoil removal and selective countermeasures on radiocesium accumulation in rice plants in Fukushima paddy field.

A wide area of paddy fields was contaminated by radiocesium derived from the Fukushima nuclear accident. Implement of agricultural countermeasures is one of the principle methods to reduce the contamination of rice plants. In this study, the effect of topsoil removal measure and fertilizer application on radiocesium uptake by rice plants was investigated over a four-year period. Some other available countermeasures carried out after the Fukushima nuclear accident were also summarized. The results indicate that the effect of topsoil removal measure on the accumulation of radiocesium in rice plants was effective, but the concentration ratio of radiocesium activity concentration between rice plant and soil increased. This may be correlated with the radiocesium imported from irrigation water and relatively high exchangeable radiocesium proportion of plowing soil in the topsoil removal paddy. We summarized four year's data to further confirm that potassium and nitrogen fertilizers had an opposite effect on the accumulation of radiocesium in rice plants. Increasing potassium and reducing nitrogen fertilizer conditions tended to inhibit the radiocesium uptake by rice plants. Moreover, of all the available countermeasures applied in the paddy fields, the most effective countermeasure was the application of phlogopite. However, further analyses are required to confirm the effectiveness of application of phlogopite considering the limited available information.

Temporal changes of radiocesium in irrigated paddy fields and its accumulation in rice plants in Fukushima.

About half of the total paddy field area, which is the dominant agricultural land in Fukushima Prefecture, was contaminated by radiocesium released by the Fukushima Daiichi Nuclear Power Plant accident. In this study, we investigated the temporal changes of radiocesium in soil, irrigation water, and rice plant in two adjacent rice paddies, with and without surface-soil-removal, in Fukushima Prefecture for over three years (2012-2014) after the nuclear accident. Our results showed that radiocesium migrated into 24-28 cm soil layers and that the activity concentration of radiocesium in paddy soils showed a significant reduction in 2014. The newly added radiocesium to paddies through irrigation water contributed only a maximum value of 0.15% and 0.75% of the total amount present in control and decontaminated paddies, respectively, throughout the study period. The radiocesium activity concentration in suspended sediment in irrigation water exponentially decreased, and the effective half-lives (Teff) for (137)Cs and (134)Cs were 1.3 and 0.9 years, respectively. Additionally, the average suspended sediment concentration in irrigation water increased between 2012 and 2014, suggesting that enhanced soil erosion had occurred in the surrounding environment. Radiocesium accumulation in rice plant also decreased with time in both paddies. However, the concentration ratio of radiocesium for rice plant in the decontaminated paddy increased compared with control paddy, despite approximately 96% of fallout radiocesium removed in paddy soil. Further analysis is required to clarify the reasons of high concentration ratio of radiocesium for rice plant in the decontaminated paddy.

Assessment of radiological risk for marine biota and human consumers of seafood in the coast of Qingdao, China.

This paper reports the levels of (226)Ra, (232)Th, (40)K and (137)Cs in the edible parts of 11 different marine species collected from the Qingdao coast of China. The activities of (226)Ra, (232)Th and (40)K ranged from 0.08±0.03 to 1.65±0.60 Bq kg(-1) w.w., 0.09±0.02 to 1.44±0.10 Bq kg(-1) w.w., 26.89±1.25 to 219.25±5.61 Bq kg(-1) w.w., respectively. Artificial (137)Cs was undetectable or close to the detection limit in the biota sampled. To link radioactivity to possible impact on health, we calculated radiation doses to both the marine biota and human beings. We showed that doses in all cases were dominated by naturally occurring (40)K and that (137)Cs doses were negligible compared with (40)K-derived doses. The total doses to marine biota ranged between 16.55 and 62.41 nGy h(-1) among different biota species, which were below the benchmark level of aquatic organism. The committed effective dose to humans through seafood consumption varied from 10.55 to 36.17 µSv y(-1), and the associated lifetime cancer risks ranged from 5.93E-05 to 9.49E-05 for different age and gender groups. Both the dose and cancer risk to humans were at the acceptable range. Despite the significant amount of radionuclides released as a result of the Fukushima accident, their impact on the seafood in Qingdao coast appears to be negligible based on our measurements of concentrations of radionuclide activity and internal dose estimates.