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1.
BMC Musculoskelet Disord ; 22(1): 529, 2021 Jun 09.
Artigo em Inglês | MEDLINE | ID: mdl-34107945

RESUMO

BACKGROUND: The prognosis of lung metastasis (LM) in patients with chondrosarcoma was poor. The aim of this study was to construct a prognostic nomogram to predict the risk of LM, which was imperative and helpful for clinical diagnosis and treatment. METHODS: Data of all chondrosarcoma patients diagnosed between 2010 and 2016 was queried from the Surveillance, Epidemiology, and End Results (SEER) database. In this retrospective study, a total of 944 patients were enrolled and randomly splitting into training sets (n = 644) and validation cohorts(n = 280) at a ratio of 7:3. Univariate and multivariable logistic regression analyses were performed to identify the prognostic nomogram. The predictive ability of the nomogram model was assessed by calibration plots and receiver operating characteristics (ROCs) curve, while decision curve analysis (DCA) and clinical impact curve (CIC) were applied to measure predictive accuracy and clinical practice. Moreover, the nomogram was validated by the internal cohort. RESULTS: Five independent risk factors including age, sex, marital, tumor size, and lymph node involvement were identified by univariate and multivariable logistic regression. Calibration plots indicated great discrimination power of nomogram, while DCA and CIC presented that the nomogram had great clinical utility. In addition, receiver operating characteristics (ROCs) curve provided a predictive ability in the training sets (AUC = 0.789, 95% confidence interval [CI] 0.789-0.808) and the validation cohorts (AUC = 0.796, 95% confidence interval [CI] 0.744-0.841). CONCLUSION: In our study, the nomogram accurately predicted risk factors of LM in patients with chondrosarcoma, which may guide surgeons and oncologists to optimize individual treatment and make a better clinical decisions. TRIAL REGISTRATION: JOSR-D-20-02045, 29 Dec 2020.


Assuntos
Neoplasias Ósseas , Condrossarcoma , Neoplasias Pulmonares , Neoplasias Ósseas/epidemiologia , Condrossarcoma/diagnóstico , Condrossarcoma/epidemiologia , Humanos , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/epidemiologia , Estudos Retrospectivos , Medição de Risco , Programa de SEER
2.
Nat Commun ; 12(1): 3270, 2021 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-34075035

RESUMO

Little is known about the long-term neurological development of children diagnosed with congenital Zika infection at birth. Here, we report the imaging and clinical outcomes up to three years of life of a cohort of 129 children exposed to Zika virus in utero. Eighteen of them (14%) had a laboratory confirmed congenital Zika infection at birth. Infected neonates have a higher risk of adverse neonatal and early infantile outcomes (death, structural brain anomalies or neurologic symptoms) than those who tested negative: 8/18 (44%) vs 4/111 (4%), aRR 10.1 [3.5-29.0]. Neurological impairment, neurosensory alterations or delays in motor acquisition are more common in infants with a congenital Zika infection at birth: 6/15 (40%) vs 5/96 (5%), aRR 6.7 [2.2-20.0]. Finally, infected children also have an increased risk of subspecialty referral for suspected neurodevelopmental delay by three years of life: 7/11 (64%) vs 7/51 (14%), aRR 4.4 [1.9-10.1]. Infected infants without structural brain anomalies also appear to have an increased risk, although to a lesser extent, of neurological abnormalities. It seems paramount to offer systematic testing for congenital ZIKV infection in cases of in utero exposure and adapt counseling based on these results.


Assuntos
Desenvolvimento Infantil , Malformações do Sistema Nervoso/epidemiologia , Complicações Infecciosas na Gravidez/virologia , Efeitos Tardios da Exposição Pré-Natal/epidemiologia , Infecção por Zika virus/complicações , Adolescente , Adulto , Pré-Escolar , Feminino , Guiana Francesa/epidemiologia , Humanos , Lactente , Recém-Nascido , Masculino , Idade Materna , Malformações do Sistema Nervoso/etiologia , Gravidez , Complicações Infecciosas na Gravidez/diagnóstico , Efeitos Tardios da Exposição Pré-Natal/etiologia , Medição de Risco/estatística & dados numéricos , Adulto Jovem , Zika virus/isolamento & purificação , Infecção por Zika virus/congênito , Infecção por Zika virus/diagnóstico , Infecção por Zika virus/virologia
3.
Artigo em Inglês | MEDLINE | ID: mdl-34072475

RESUMO

Protecting worker and public health involves an understanding of multiple determinants, including exposures to biological, chemical, or physical agents or stressors in combination with other determinants including type of employment, health status, and individual behaviors. This has been illustrated during the COVID-19 pandemic by increased exposure and health risks for essential workers and those with pre-existing conditions, and mask-wearing behavior. Health risk assessment practices for environmental and occupational health typically do not incorporate multiple stressors in combination with personal risk factors. While conceptual developments in cumulative risk assessment to inform a more holistic approach to these real-life conditions have progressed, gaps remain, and practical methods and applications are rare. This scoping review characterizes existing evidence of combined stressor exposures and personal factors and risk to foster methods for occupational cumulative risk assessment. The review found examples from many workplaces, such as manufacturing, offices, and health care; exposures to chemical, physical, and psychosocial stressors combined with modifiable and unmodifiable determinants of health; and outcomes including respiratory function and disease, cancers, cardio-metabolic diseases, and hearing loss, as well as increased fertility, menstrual dysfunction and worsened mental health. To protect workers, workplace exposures and modifiable and unmodifiable characteristics should be considered in risk assessment and management. Data on combination exposures can improve assessments and risk estimates and inform protective exposure limits and management strategies.


Assuntos
COVID-19 , Exposição Ocupacional , Saúde do Trabalhador , Humanos , Pandemias , Medição de Risco , Fatores de Risco , SARS-CoV-2 , Local de Trabalho
4.
MMWR Morb Mortal Wkly Rep ; 70(22): 825-829, 2021 Jun 04.
Artigo em Inglês | MEDLINE | ID: mdl-34081687

RESUMO

End-stage renal disease (ESRD) is a condition in which kidney function has permanently declined such that renal replacement therapy* is required to sustain life (1). The mortality rate for patients with ESRD in the United States has been declining since 2001 (2). However, during the COVID-19 pandemic, ESRD patients are at high risk for COVID-19-associated morbidity and mortality, which is due, in part, to weakened immune systems and presence of multiple comorbidities (3-5). The ESRD National Coordinating Center (ESRD NCC) supports the Centers for Medicare & Medicaid Services (CMS) and the ESRD Networks†,§ through analysis of data, dissemination of best practices, and creation of educational materials. ESRD NCC analyzed deaths reported to the Consolidated Renal Operations in a Web-Enabled Network (CROWNWeb), a system that facilitates the collection of data and maintenance of information about ESRD patients on chronic dialysis or receiving a kidney transplant who are treated in Medicare-certified dialysis facilities and kidney transplant centers in the United States. Excess death estimates were obtained by comparing observed and predicted monthly numbers of deaths during February 1-August 31, 2020; predicted deaths were modeled based on data from January 1, 2016, through December 31, 2019. The analysis estimated 8.7-12.9 excess deaths per 1,000 ESRD patients, or a total of 6,953-10,316 excess deaths in a population of 798,611 ESRD patients during February 1-August 31, 2020. These findings suggest that deaths among ESRD patients during the early phase of the pandemic exceeded those that would have been expected based on previous years' data. Geographic and temporal patterns of excess mortality, including those among persons with ESRD, should be considered during planning and implementation of interventions, such as COVID-19 vaccination, infection control guidance, and patient education. These findings underscore the importance of data-driven technical assistance and further analyses of the causes and patterns of excess deaths in ESRD patients.


Assuntos
Falência Renal Crônica/mortalidade , Falência Renal Crônica/terapia , Mortalidade/tendências , COVID-19/epidemiologia , COVID-19/mortalidade , Humanos , Medição de Risco , Estados Unidos/epidemiologia
5.
PLoS Pathog ; 17(6): e1009583, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-34081744

RESUMO

The Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) pandemic reveals a major gap in global biosecurity infrastructure: a lack of publicly available biological samples representative across space, time, and taxonomic diversity. The shortfall, in this case for vertebrates, prevents accurate and rapid identification and monitoring of emerging pathogens and their reservoir host(s) and precludes extended investigation of ecological, evolutionary, and environmental associations that lead to human infection or spillover. Natural history museum biorepositories form the backbone of a critically needed, decentralized, global network for zoonotic pathogen surveillance, yet this infrastructure remains marginally developed, underutilized, underfunded, and disconnected from public health initiatives. Proactive detection and mitigation for emerging infectious diseases (EIDs) requires expanded biodiversity infrastructure and training (particularly in biodiverse and lower income countries) and new communication pipelines that connect biorepositories and biomedical communities. To this end, we highlight a novel adaptation of Project ECHO's virtual community of practice model: Museums and Emerging Pathogens in the Americas (MEPA). MEPA is a virtual network aimed at fostering communication, coordination, and collaborative problem-solving among pathogen researchers, public health officials, and biorepositories in the Americas. MEPA now acts as a model of effective international, interdisciplinary collaboration that can and should be replicated in other biodiversity hotspots. We encourage deposition of wildlife specimens and associated data with public biorepositories, regardless of original collection purpose, and urge biorepositories to embrace new specimen sources, types, and uses to maximize strategic growth and utility for EID research. Taxonomically, geographically, and temporally deep biorepository archives serve as the foundation of a proactive and increasingly predictive approach to zoonotic spillover, risk assessment, and threat mitigation.


Assuntos
Bancos de Espécimes Biológicos/organização & administração , Controle de Doenças Transmissíveis , Doenças Transmissíveis Emergentes/prevenção & controle , Redes Comunitárias/organização & administração , Vigilância em Saúde Pública/métodos , Animais , Animais Selvagens , Biodiversidade , Bancos de Espécimes Biológicos/normas , Bancos de Espécimes Biológicos/provisão & distribuição , Bancos de Espécimes Biológicos/tendências , COVID-19/epidemiologia , Controle de Doenças Transmissíveis/métodos , Controle de Doenças Transmissíveis/organização & administração , Controle de Doenças Transmissíveis/normas , Doenças Transmissíveis Emergentes/epidemiologia , Doenças Transmissíveis Emergentes/microbiologia , Doenças Transmissíveis Emergentes/virologia , Redes Comunitárias/normas , Redes Comunitárias/provisão & distribuição , Redes Comunitárias/tendências , Planejamento em Desastres/métodos , Planejamento em Desastres/organização & administração , Planejamento em Desastres/normas , Geografia , Saúde Global/normas , Saúde Global/tendências , Humanos , Contramedidas Médicas , Pandemias/prevenção & controle , Saúde Pública , Medição de Risco , SARS-CoV-2/fisiologia , Zoonoses/epidemiologia , Zoonoses/prevenção & controle
6.
Sensors (Basel) ; 21(9)2021 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-34062827

RESUMO

The reproduction and simulation of workplaces, and the analysis of body postures during work processes, are parts of ergonomic risk assessments. A commercial virtual reality (VR) system offers the possibility to model complex work scenarios as virtual mock-ups and to evaluate their ergonomic designs by analyzing motion behavior while performing work processes. In this study a VR tracking sensor system (HTC Vive tracker) combined with an inverse kinematic model (Final IK) was compared with a marker-based optical motion capture system (Qualisys). Marker-based optical motion capture systems are considered the gold standard for motion analysis. Therefore, Qualisys was used as the ground truth in this study. The research question to be answered was how accurately the HTC Vive System combined with Final IK can measure joint angles used for ergonomic evaluation. Twenty-six subjects were observed simultaneously with both tracking systems while performing 20 defined movements. Sixteen joint angles were analyzed. Joint angle deviations between ±6∘ and ±42∘ were identified. These high deviations must be considered in ergonomic risk assessments when using a VR system. The results show that commercial low-budget tracking systems have the potential to map joint angles. Nevertheless, substantial weaknesses and inaccuracies in some body regions must be taken into account. Recommendations are provided to improve tracking accuracy and avoid systematic errors.


Assuntos
Realidade Virtual , Ergonomia , Humanos , Movimento (Física) , Medição de Risco , Tecnologia
7.
Medicina (Kaunas) ; 57(5)2021 May 11.
Artigo em Inglês | MEDLINE | ID: mdl-34065022

RESUMO

Background and Objectives: Risk management is considered an integral part of laboratory medicine to assure laboratory quality and patient safety. However, the concept of risk management is philosophical, so actually performing risk management in a clinical laboratory can be challenging. Therefore, we would like to develop a sustainable, practical system for continuous total laboratory risk management. Materials and Methods: This study was composed of two phases: the development phase in 2019 and the application phase in 2020. A concept flow diagram for the computerized risk registry and management tool (RRMT) was designed using the failure mode and effects analysis (FMEA) and the failure reporting, analysis, and corrective action system (FRACAS) methods. The failure stage was divided into six according to the testing sequence. We applied laboratory errors to this system over one year in 2020. The risk priority number (RPN) score was calculated by multiplying the severity of the failure mode, frequency (or probability) of occurrence, and detection difficulty. Results: 103 cases were reported to RRMT during one year. Among them, 32 cases (31.1%) were summarized using the FMEA method, and the remaining 71 cases (68.9%) were evaluated using the FRACAS method. There was no failure in the patient registration phase. Chemistry units accounted for the highest proportion of failure with 18 cases (17.5%), while urine test units accounted for the lowest portion of failure with two cases (1.9%). Conclusion: We developed and applied a practical computerized risk-management tool based on FMEA and FRACAS methods for the entire testing process. RRMT was useful to detect, evaluate, and report failures. This system might be a great example of a risk management system optimized for clinical laboratories.


Assuntos
Segurança do Paciente , Gestão de Riscos , Humanos , Sistema de Registros , Medição de Risco
8.
Sensors (Basel) ; 21(10)2021 May 17.
Artigo em Inglês | MEDLINE | ID: mdl-34067644

RESUMO

Falls among the elderly population cause detrimental physical, mental, financial problems and, in the worst case, death. The increasing number of people entering the higher risk age-range has increased clinicians' attention to intervene. Clinical tools, e.g., the Timed Up and Go (TUG) test, have been created for aiding clinicians in fall-risk assessment. Often simple to evaluate, these assessments are subject to a clinician's judgment. Wearable sensor data with machine learning algorithms were introduced as an alternative to precisely quantify ambulatory kinematics and predict prospective falls. However, they require a long-term evaluation of large samples of subjects' locomotion and complex feature engineering of sensor kinematics. Therefore, it is critical to build an objective fall-risk detection model that can efficiently measure biometric risk factors with minimal costs. We built and studied a sensor data-driven convolutional neural network model to predict older adults' fall-risk status with relatively high sensitivity to geriatrician's expert assessment. The sample in this study is representative of older patients with multiple co-morbidity seen in daily medical practice. Three non-intrusive wearable sensors were used to measure participants' gait kinematics during the TUG test. This data collection ensured convenient capture of various gait impairment aspects at different body locations.


Assuntos
Acidentes por Quedas , Equilíbrio Postural , Acidentes por Quedas/prevenção & controle , Idoso , Fenômenos Biomecânicos , Humanos , Aprendizado de Máquina , Estudos Prospectivos , Medição de Risco , Estudos de Tempo e Movimento
9.
Artigo em Inglês | MEDLINE | ID: mdl-34069419

RESUMO

Due to airborne transmission of the coronavirus, the question arose as to how high the risk of spreading infectious particles can be while playing a wind instrument. To examine this question and to help clarify the possible risk, we analyzed 14 wind instruments, first qualitatively by making airflows visible while playing, and second quantitatively by measuring air velocity at three distances (1, 1.5, 2 m) in the direction of the instruments' bells. Measurements took place with wind instrumentalists of the Bamberg Symphony in their concert hall. Our findings highlight that while playing, no airflows escaping from any of the wind instruments-from the bell with brass instruments or from the mouthpiece, keyholes or bell with woodwinds-were measurable beyond a distance of 1.5 m, regardless of volume, pitch or what was played. With that, air velocity while playing corresponded to the usual value of 1 m/s in hall-like rooms. For air-jet woodwinds, alto flute and piccolo, significant air movements were seen close to the mouthpiece, which escaped directly into the room.


Assuntos
COVID-19 , Movimentos do Ar , Humanos , Medição de Risco , SARS-CoV-2
10.
Rev Med Liege ; 76(5-6): 502-506, 2021 May.
Artigo em Francês | MEDLINE | ID: mdl-34080387

RESUMO

Breast cancer is the leading cause of neoplastic death in women around the world. In the era of personalized medicine, legitimately awaited by our patients, the future of breast cancer screening will depend on an individual-based risk assessment, making it possible to better adapt the age of onset, frequency and the type of examinations useful for this screening. This article reviews the three broad categories of highest risk factors available to establish a risk score appropriate for each patient.


Assuntos
Neoplasias da Mama , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/epidemiologia , Detecção Precoce de Câncer , Feminino , Humanos , Medicina de Precisão , Medição de Risco , Fatores de Risco
11.
Chemosphere ; 278: 130438, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34126682

RESUMO

Arsenic is frequently found in poultry waste, most of which is transformed from feed additive organoarsenicals, resulting in arsenic pollution of soils and water around poultry farms. The North China Plain, an important area for livestock breeding of China, was chosen to investigate the pollution characteristics and assess the health risk of arsenic around chicken farms. Among the 138 chicken farms sampled, almost no roxarsone, a common organoarsenical, was detected in chicken feeds, manure, and surface soils, while the detectable rate of other arsenic species was high. Because of long-term enrichment, the concentrations of arsenic species in manure were generally higher than that in feed. As(III) was the main inorganic arsenic species in the manure, where is reducing environment. In surface soils beneath the accumulated manure, As(V) was the predominant arsenic species with 100% detectable rate. The detectable rate and average concentrations at 0 cm were generally higher than those at 25 cm depth, indicating that arsenic accumulated in the surface soils. In addition, a typical conceptual diagram of arsenic was developed to clarify the pollution process from feed to soil. Through health risk assessment of inorganic arsenic, the carcinogenic risk (CR) and non-carcinogenic risk (non-CR) were both negligible. The city of Jiaozuo had the highest CR and non-CR, which was 11 times higher than that of the city with the lowest risks. This study presents a clear picture and evaluation of arsenic pollution on chicken farms, inspiring future studies assessing arsenic pollution after the ban of organoarsenicals.


Assuntos
Arsênio , Poluentes do Solo , Animais , Arsênio/análise , Galinhas , China , Fazendas , Esterco , Medição de Risco , Solo , Poluentes do Solo/análise
12.
Chemosphere ; 278: 130453, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34126685

RESUMO

A method quantifying 16 polycyclic aromatic hydrocarbons (PAHs) in wood vinegars (WVs) obtained from slow pyrolysis of biomass with ultrasonic-assisted liquid-liquid extraction/gas chromatography-mass spectrometry (USALLE/GC-MS) was established. The recovery range was 83-128%, and the relative standard deviations (RSD%) were less than 15% except naphthalene, acenaphthylene and acenaphthene. Acenaphthylene, acenaphthene, fluorene, anthracene, phenanthrene, fluoranthene, and pyrene were observed in all samples and the other 9 compounds, including benzopyrene (B[a]P), were not detected. The concentration of ∑PAHs referred to the sum total of 7 PAHs mentioned above was 22.0-498.3 µg L-1. The PAHs concentration increased with the increasing pyrolysis temperature in bamboo willow WV, pinus sylvestris WV, and corncob WV, while it increased initially, and then decreased with a maximum at 550 °C in rice husk WV. The ∑PAHs concentration increased with a higher heating rate in the white pine WV, while rice husk WV and cornstalk WV showed the opposite trend. The varied condensed aromatic ring number showed that 3-ring PAHs relatively were the main component in all kind WVs. 3-ring PAHs increased with increasing temperatures, while 4-ring PAHs showed an opposite trend in sawdust WV and corncob WVs. A higher cellulose content in sawdust enhanced the reaction of lignin leading to a higher concentration of PAHs than that in straws and leaves. Calculations of the toxicity equivalents of PAHs in WVs indicated that anthracene was the most toxic among the PAHs, and the pinus sylvestris WV had the highest risk of ∑PAHs toxicity in all WVs.


Assuntos
Hidrocarbonetos Policíclicos Aromáticos , Ácido Acético , Biomassa , Metanol , Pirólise , Medição de Risco
13.
Chemosphere ; 278: 130479, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34126691

RESUMO

Polybrominated diphenyl ethers (PBDEs) are widespread, persistent in the environment, and classified as global pollutants. Their presence has been confirmed in various types of food which adversely affect human health when consumed in sufficient amounts. Although milk has advantageous nutritional qualities and there are health benefits associated with its consumption, it could also contain toxic PBDEs. The aim of the study was the determination of the concentrations of ten congeners (BDE -28, -47, -49, -99, -100, -138, -153, -154, -183, and 209) in cow's, sheep's, and goat's milk obtained from Polish farms and their determination in infant formula. A total of 103 samples of raw milk and infant formula were tested using an accredited high-resolution gas chromatography-high-resolution mass spectrometry method. PBDEs were detected in all analyzed samples, the highest concentration being found in sheep's milk (11.9 ng g-1 fat), and cow's milk containing the least contamination. BDE-209 makes the predominant contribution to the sum of the ten congeners, constituting at least 38%. The profiles of PBDEs were dependent on the milk type and the differences between its varieties are discussed. The highest median concentration of the sum of ten PBDEs (0.473 ng g-1 fat) was determined in infant formula, which was identified as an important source of infants' exposure (5.48 ng kg-1 b.w. day-1 calculated based on P95 concentration). Milk is a source of PBDE in the diet; however, considered in isolation its consumption does not pose a risk to either adults' or children's health.


Assuntos
Poluentes Ambientais , Éteres Difenil Halogenados , Animais , Bovinos , Monitoramento Ambiental , Poluentes Ambientais/análise , Éteres Difenil Halogenados/análise , Fórmulas Infantis , Leite Humano/química , Medição de Risco
14.
Environ Monit Assess ; 193(7): 421, 2021 Jun 14.
Artigo em Inglês | MEDLINE | ID: mdl-34128113

RESUMO

Ice cream is a popular frozen dairy product and a possible source of dietary minerals. However, ice cream may also contain toxic metals, which may cause several health implications. The current study aimed to determine the content of toxic elements in ice cream samples using inductively coupled plasma-optical emission spectrometry (ICP-OES) and to assess the health risks of consumers based on target cancer risk (TCR), target hazard quotient (THQ), and hazardous index (HI). The determined concentration (median, range) of all studied elements had shown a descending order of Al (9.36, 5.37-14.26) > Zn (5.94, 1.95-10.22) > Cu (1.73, 1.02-3.77) > Ni (0.95, 0.67-1.80) > Fe (0.79, 0.10-1.64) > Cr (0.43, 0.28-0.73) > Mn (0.42, 0.11-1.03) > Pb (0.34, 0.09-0.79) > Cd (0.08, 0.04-0.14) mg/kg (fresh weight). The values of THQ and HI (except 16% for children) were lower than the maximum threshold risk limit (TRL = 1.0), indicating no potential non-carcinogenic health effects might occur. Similarly, the TCR of Cr and Pb for both adults and children was within the permissible limit of 10-4-10-6, which suggested that the consumer would not experience potential lifetime carcinogenic health risks. However, the overall analyses revealed that the consumption of ice cream is almost safe for people, but the combined impact of all metals (HI) in some samples is a matter of health concern. Henceforth, regular monitoring of toxic metals in ice creams should be done to assure food safety and hygiene.


Assuntos
Sorvetes , Metais Pesados , Adulto , Bangladesh , Criança , Monitoramento Ambiental , Humanos , Metais Pesados/análise , Medição de Risco
15.
Br J Community Nurs ; 26(6): 278-282, 2021 Jun 02.
Artigo em Inglês | MEDLINE | ID: mdl-34105372

RESUMO

Vaccination is an important public health intervention, but its effectiveness depends upon the uptake of vaccination reaching sufficient levels to yield 'herd' immunity. While the majority of the UK hold positive attitudes about vaccination, some people, including health professionals, decline vaccinations. This article reviews the evidence relating to vaccine hesitancy, its underlying factors and the sociodemographic variations. A second article will review the evidence relating to strategies to address vaccine hesitancy and promote vaccination acceptance.


Assuntos
Vacinas contra COVID-19 , COVID-19/prevenção & controle , Conhecimentos, Atitudes e Prática em Saúde , Vacinação em Massa/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Atitude do Pessoal de Saúde , Saúde Global , Pessoal de Saúde/psicologia , Humanos , Medição de Risco , Reino Unido
17.
Arq Bras Cir Dig ; 34(1): e1576, 2021.
Artigo em Inglês, Português | MEDLINE | ID: mdl-34133523

RESUMO

BACKGROUND: Liver transplantation is the treatment of choice for patients with terminal liver disease. The Balance of Risk Score (BAR), Survival Outcomes Following Liver Transplantation (SOFT) and Donor Risk Index (DRI) scores are predictive systems for post-transplant survival. AIM: To evaluate the most accurate score and the best cutoff point for each predictor in the brazilian population. METHOD: Retrospective cross-sectional study of 177 patients. Data on the recipient, donor and transplant were analyzed and the prognostic scores BAR, SOFT and DRI were calculated for each transplant. To determine the BAR and SOFT cutoff points associated with death in three months, ROC curves were adjusted. Results : The best cutoff point for BAR was 9 points with an area under the ROC curve=0.69 and for SOFT it was 12 points with an area under the ROC curve=0.73. The DRI score did not discriminate survival (p = 0.139). CONCLUSION: The SOFT score proved to be better than BAR for survival analysis post-hepatic transplantation and the DRI was not effective.


Assuntos
Transplante de Fígado , Brasil , Estudos Transversais , Humanos , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Análise de Sobrevida
18.
Chemosphere ; 279: 130902, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34134438

RESUMO

Various veterinary antibiotics (VAs) are used in large quantities as an essential component for intensive livestock farming, and can flow into the environment from various pollution sources. In this study, VAs in surface water and groundwater in the Gwangcheon stream watershed, an intensive livestock farming area in Korea, were analyzed using ultra-high-performance liquid chromatograph-quadrupole orbitrap high-resolution mass spectrometer with online solid phase extraction. Although the selected VAs are relatively mobile and have low KOW values it is significant to assess their fates and ecological risks in the environment. The concentration of VAs in the surface water was higher than that in groundwater by approximately 23-fold, indicating that the former were directly introduced from pollution sources such as livestock manure. An analysis of the correlation between livestock manure production and the residuals of VAs in the stream showed a high linearity (R2 > 0.70), confirming that livestock excreta significantly contributed to the VAs in the watershed. A combined evaluation of environmental behaviors and ecological risks of VAs was performed for the first time using persistence, bioaccumulation potential, and toxicity properties and risk quotient values of VAs. Trimethoprim showed persistence and a potential impact on the ecosystem. The cumulative risk quotient values at one sampling point exceeded 1 indicating that several VAs can cumulatively cause local risk. The risk assessment method considering pollution sources, different locations, and correlation analysis applied in this study will be useful in evaluating the impacts of trace pollutants in watersheds.


Assuntos
Gado , Esterco , Agricultura , Animais , Antibacterianos/análise , Antibacterianos/toxicidade , Ecossistema , Monitoramento Ambiental , Esterco/análise , República da Coreia , Medição de Risco
19.
Environ Monit Assess ; 193(7): 416, 2021 Jun 12.
Artigo em Inglês | MEDLINE | ID: mdl-34120239

RESUMO

Spatial variations and mobility of mercury (Hg) and Hg associations with other potentially toxic elements (PTEs) were studied in soil samples from Alaba, the largest e-waste recycling site in Nigeria and West Africa. Total Hg concentration was determined in surface soil samples from various locations using cold vapour atomic absorption spectrometry (CVAAS) following microwave-assisted acid extraction, while sequential extraction was used to determine operationally defined mobility. The concentrations of the PTEs arsenic (As), cadmium (Cd), chromium (Cr), copper (Cu), manganese (Mn), mercury (Hg), nickel (Ni), lead (Pb) and zinc (Zn) metals were determined using inductively coupled plasma mass spectrometry (ICP-MS) following microwave-assisted digestion with aqua regia. Total Hg concentration ranged from < 0.07 to 624 mg/kg and was largely dependent on the nature and intensity of e-waste recycling activities carried out. Mobile forms of Hg, which may be HgO (a known component of some forms of e-waste), accounted for between 3.2 and 23% of the total Hg concentration, and were observed to decrease with increasing organic matter (OM). Non-mobile forms accounted for >74% of the total Hg content. In the main recycling area, soil concentrations of Cd, Cd, Cu, Hg, Mn, Ni, Pb and Zn were above soil guideline values (Environment Agency in Science Report, 2009; Kamunda et al., 2016). Strong associations were observed between Hg and other PTEs (except for Fe and Zn) with the correlational coefficient ranging from 0.731 with Cr to 0.990 with As in April, but these correlations decreased in June except for Fe. Hazard quotient values > 1 at two locations suggest that Hg may pose health threats to people working at the e-waste recycling site. It is therefore recommended that workers should be investigated for symptoms of Hg exposure.


Assuntos
Resíduo Eletrônico , Mercúrio , Metais Pesados , Poluentes do Solo , África Ocidental , Monitoramento Ambiental , Humanos , Mercúrio/análise , Metais Pesados/análise , Nigéria , Medição de Risco , Solo , Poluentes do Solo/análise
20.
Environ Monit Assess ; 193(7): 417, 2021 Jun 13.
Artigo em Inglês | MEDLINE | ID: mdl-34120244

RESUMO

The need to generate internal revenue by most individuals and government in Nigeria has led to the establishment of quarries in different parts of Ebonyi state of Nigeria. This study was aimed at determining the risk associated with the heavy metal burden in the state. Soil samples from the quarrying environments designated as MS1, MS2, and MS3 were analyzed for the metal profile using inductively coupled plasma optical emission spectrometry (ICP-OES). The result showed that the mean concentration of metals which is a representation of the whole sites showed a higher concentration of Ca (40.065 ± 1.011 ppm), Mg (12.450 ± 8.815 ppm), K (16.631 ± 14.670 ppm), and Mn (19.539 ± 3.225 ppm) while Na (1.326 ± 0.117 ppm) was low. The heavy metal profile showed Pb (0.120 ± 0.027 ppm), Fe (27.718 ± 1.523 ppm), Zn (2.227 ± 0.570 ppm), Cu (6.267 ± 1.402 ppm), Ni (1.856 ± 0.472 ppm), Mo (1.758 ± 0.258 ppm), Cd (0.023 ± 0.006 ppm), Cr (0.037 ± 0.011 ppm), etc. Hg was found to be below detectable limit while the Cs was not radioactive. The mean values were found to be lower than the permissible limit of each metal. The pollution index (PI) was calculated for the different sites, and the result reveals that MS3 (0.0426) had a higher PI when compared to MS1 (0.0341) and MS2 (0.0317). Therefore, the PI of the sites showed MS3 > MS1 > MS2. These results showed that the environment is still as safe as PI < 1. The geoaccumulation index also showed a safe environment since its values were less than 0 which means that the environment is practically uncontaminated. Other risk determining parameters showed that the three locations were still within a safe level. Although the results of the study have shown a safe environment, it is still necessary to keep close monitoring of the heavy metal profile of the environment, since these metals can bioaccumulate in living tissues with time.


Assuntos
Metais Pesados , Poluentes do Solo , Monitoramento Ambiental , Humanos , Metais Pesados/análise , Nigéria , Medição de Risco , Solo , Poluentes do Solo/análise
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