Average Risk Research Articles

Determination of Fractionation Scheme Based on Repair Effect Using Equivalent Uniform Dose (EUD) Model

Radiotherapy treatment planning is required to obtain an optimal balance between delivering a high dose to target volume and a low dose to organ at risks. In this planning, it is also necessary to determine the appropriate fractionation scheme for each patient. One of the commonly used methods to determine the fractionation scheme is calculating the Normal Tissue Complication Probability (NTCP) and Tumor Control Probability (TCP) parameters. In this study, the Equivalent Uniform Dose (EUD) model is used to calculate NTCP and TCP. This model is based on a non-uniform dose distribution that is sensitive to the biological factors of cells. The biological factor examined in this research is the repair effect, which is the ability of cells to repair themselves after being radiated. Thus, the objective of this research is to determine the fractionation scheme based on NTCP calculations using the EUD model while taking into account the repair effect. The data used in this study were obtained from 10 patients with glioblastoma brain cancer in the form of cumulative DVH (dose-volume histogram) and total time of radiation. Based on the NTCP calculations, the average risk of organ complication for each patient appears to be close to zero, with a range of values from 2 x 10-6% to 1 x 10-1%. These results indicate that the treatment planning conducted is proven to be safe and there are no complications for the patients. Furthermore, based on the NTCP and TCP calculations, the best fractionation scheme is hypofractionation, which remains safe while considering the dose limit for each normal organ surrounding the target.

A cross-sectional study of the relationship between physical activity, diet quality, and high-sensitivity C-reactive protein in US adults

Background and aimsHigh-sensitivity C-reactive protein (hs-CRP) is associated with many diseases, especially cardiovascular disease (CVD). Research into the independent and integrated relationships of physical activity and diet quality with hs-CRP across sex-specific cohorts is lacking. Methods and resultsNational Health and Nutrition Examination Survey data (2015–2018) was used to examine the relationship between physical activity and diet quality with hs-CRP and hs-CRP classified CVD risk using multiple multinormal logistic regression adjusted for covariates including demographics. Physical activity was measured using a self-reported survey and further categorized to those who met (MPAR) or did not meet (NPAR) national recommendations. Diet quality was measured using the Healthy Eating Index-2015, and further categorized to higher (HDQ) and lower (LDQ) diet quality. hs-CRP was also categorized as low, average, and high CVD risk using established cut-points. Physical activity was inversely related to hs-CRP in males (p < 0.001) whereas diet quality was inversely related to hs-CRP in females (p = 0.031). Compared to those with NPAR and LDQ, the hs-CRP for males with NPAR and HDQ and females with MPAR and HDQ was 1.18 mg/L and 0.75 mg/L lower respectively. Although, diet quality was inversely associated with high CVD risk in both sexes (p < 0.05), the lowest proportion of high and average CVD risk was observed in males and females with MPAR and HDQ. ConclusionPhysical activity and diet-quality lowered CVD risk regardless of sex. However, the independent effects of physical activity and diet quality on hs-CPR differs between sexes.

Feasibility and acceptability of offering breast cancer risk assessment to general population women aged 30–39 years: a mixed-methods study protocol

IntroductionBreast cancer incidence starts to increase exponentially when women reach 30–39 years, hence before they are eligible for breast cancer screening. The introduction of breast cancer risk assessment for this...

Source identification and health risk assessment of particle phase organic compounds in urban and rural areas of Bangladesh

Particle phase organic compounds (PPOCs) constitute a significant portion of suspended organic compounds in the atmosphere, impacting human health. Limited research on sources, seasonal variations, and health effects in Bangladesh motivated this study, where particulate matter samples were collected in Dhaka, Rajshahi, Narayangonj, and Bhola from January 2015 to February 2019. Sixteen PPOCs concentrations were measured using a Gas Chromatography-Mass Spectrometry (GC-MS). Average PPOC concentrations were 11.60 ± 0.1 µgm-3 in Dhaka, 8.69 ± 0.3 µgm-3 in Rajshahi, 11.84 ± 0.4 µgm-3 in Narayangonj, and 7.22 ± 0.2 µgm-3 in Bhola, with 2 to 18 times higher concentrations in winter than monsoon season. Positive Matrix Factorization (PMF) identified major PPOCs sources as diesel exhaust, biomass burning, industrial emissions, and gasoline exhaust. Urban areas were dominated by industrial emissions, while rural regions had significant biomass burning contribution. Health risk assessment indicated a hazard index (HI) of 30.2, signifying severe non-carcinogenic effects, with Dimethoate contributing significantly (32%). The average lifetime cancer risk (2.94 × 10-3) exceeded USEPA guidelines, suggesting heightened cancer risk. Naphthalene posed the highest carcinogenic risk. Given anthropogenic sources and severe health impacts, public awareness and localized research are crucial.

Age-dependent annual effective dose and radiological health risk from salt and soil collected from Padag, Chaghi, Balochistan, Pakistan

ABSTRACT This study aimed to investigate the annual effective dose for different age groups and health hazards associated with natural radioactivity in salt and soil collected from Padag, Chaghi, Balochistan. All samples were analysed by using high-purity germanium (HPGe) and sodium iodide (NaI) detectors. The average values of concentration of 226Ra, 232Th and 40K in salt samples were found to be 10.49, 9.6 and 169.65 Bq.kg−1, respectively, using HPGe detector, while in case of NaI detector, these values were found to be 10.48, 9.89 and 161.73 Bq.kg−1, respectively. Similarly, the average values of concentration of 226Ra, 232Th and 40K in soil were found to be 24.59, 24.89 and 391.72 Bq.kg−1, respectively, using HPGe detector, while in case of NaI detector, these values were found to be 24.46, 24.71 and 358.31 Bq.kg−1, respectively. Significant correlations were found between the results obtained from HPGe and NaI detectors. The values of total annual effective dose due to ingestion of salt were found to be 2.46 × 10−5, 2.45 × 10−5, 3.55 × 10−5 and 1.13 × 10−5 μSv.y−1 using HPGe detector and 2.43 × 10−5, 2.44 × 10−5, 3.55 × 10−5 and 1.13 × 10−5 μSv.y−1 using NaI detector for the age groups (2–7 years), (7–12 years), (12–17 years) and (≥17 years), respectively. The highest value of annual effective dose was found in the age group 12–17 years and minimum was found in the age group ≥ 17 years. However, all values were found to be below the recommended value of 0.29 mSv. Total average radiological risk due to ingestion of salt for all age groups was found to be lower than the reported value.

Financial Performance of Accountable Care Organizations: A 5-Year National Empirical Analysis.

Of 513 accountable care organizations (ACOs) participating in the Medicare Shared Savings Program (MSSP) in 2020, 67% generated a positive shared savings of approximately $2.3 billion. This research aimed to examine their financial performance trends and drivers over time. The unit of analysis was the ACO in each year of the study period from 2016 to 2020. The dependent variable was the ACOs' total shared savings earned annually per beneficiary. The independent variables included ACO age, risk model, clinician staffing type, and provider type (hybrid, hospital-led, or physician-led). Covariates were the average risk score among beneficiaries, payer type, and calendar year. The Centers for Medicare & Medicaid Services (CMS) public use files (PUFs) and a commercial healthcare data aggregator were the data sources. ACOs' earned shared savings grew annually by 35%, while the proportions of ACOs with positive shared savings grew by 21%. For 1-year increase in ACO age, an additional $0.57 of shared savings per beneficiary was observed. ACOs with two-sided risk contracting were associated with an average marginal increase of $109 in shared savings per beneficiary compared to ACOs with one-sided risk contracting. Primary care physicians were associated with the greatest increase in earned shared savings per beneficiary. In contrast, nurse practitioners/physician assistants/clinical nurse specialists were associated with a reduction in earned shared savings. Under a one-sided risk model, hospital-led ACOs were associated with $18 higher average shared savings earning per beneficiary compared to hybrid ACOs, while physician-led ACOs were associated with lower average saved shared earnings per beneficiary at -$2 compared to hybrid ACOs. Provider-type results were not statistically significant at the 5% nominal level. No statistically significant differences were observed between provider types under a two-sided risk model. For all ACO provider types, building broader primary care provider networks was correlated with positive financial results. Future research should examine whether ACOs are conducting specific preventive screenings for cancer or monitoring conditions such as diabetes, hypertension, heart disease, obesity, mental disorders, and joint disorders. Such studies may answer health policy and strategy questions about the effects of incentives for improved ACO performance in serving a healthier population.

Analisis Risiko Kandungan Timbal (Pb) pada Air Sumur Kawasan Pertanian di Kenagarian Simpang Tanjung Nan IV Kabupaten Solok

Farmers in the Nagari Simpang Tanjung Nan IV, Solok Regency, are using synthetic pesticides to achieve good agricultural results. Inappropriate pesticide application practices, such as mixing multiple types of pesticides simultaneously, using incorrect dosages, and spraying more than three times a day, have become commonplace. Residents living next to their farmlands have wells as their primary source of clean drinking water, which are located within the agricultural area. This situation poses a contamination risk to the community. The objective of this research is to analyze the risk of lead (Pb) content in well water within the agricultural area of Kenagarian Simpang Tanjung Nan IV. The research design employs the Environmental Health Risk Analysis (ARKL) method. The research findings indicate that Pb concentrations in the water range from 6,735 mg/L to 53,492 mg/L, exceeding the quality standards set by the Ministry of Health Regulation No. 32 of 2017. A significant portion of the population frequently experiences health issues, with an intensity of 66.7%. The average lifetime Risk Quotient (RQ) is 1.11, indicating a risk of pesticide poisoning in the community. Therefore, it is recommended that the community limits the use of pesticides and uses boiled water for daily consumption in an effort to minimize the danger of exposure to heavy metal Pb entering the body through water.

The pollution characteristics and risk assessment of microplastics in mollusks collected from the Bohai Sea

Microplastics (MPs) pollution in the marine environment has become a global problem. In this study, a number of 21 mollusk species (n = 2006) with different feeding habits were collected from 11 sites along the Bohai Sea for MPs uptake analysis. The MPs in mollusk samples were isolated and identified by micro-Fourier Transform Infrared Spectroscopy (μ-FTIR), and an assessment of the health risks of MPs ingested by mollusk consumption is also conducted. Approximately 91.9 % of the individuals among all the collected species inhaled MPs, and there was an average abundance of 3.30 ± 2.04 items·individual−1 or 1.04 ± 0.74 items·g−1 of wet weight. The shape of MPs was mainly fiber, and a total number of 8 polymers were detected, of which rayon had the highest detection rate (58.3 %). The highest abundance, uptake rate and polymer composition of MPs was observed in creeping types, suggesting that they might ingest these MPs from their food. The gastropod Siphonalia subdilatata contains the highest levels of MPs, which may increase the risk of human exposure if consumed whole without removing the digestive gland. The polymer risk level of MPs in these mollusks was Level III (H = 299), presenting harmful MPs such as polyvinyl chloride. In terms of human exposure risk, the average risk of human exposure to MPs through consumption of Bohai mollusks is estimated to be 3399 items·(capita·year)−1 (424–9349 items·(capita·year)−1). Overall, this study provides a basis for the ecological and health Risk assessment of MPs in mollusks collected from the coastline of China.

An Exploratory Analysis of the Cost-Effectiveness of a Multi-cancer Early Detection Blood Test Compared with Standard of Care Screening in Ontario, Canada.

Determining whether multi-cancer early detection (MCED) tests are cost effective is important in deciding whether they should be included in the clinical path of cancer care, especially for cancers where screening tools do not exist. The main objective of this study is to determine the cost effectiveness of including a MCED screening regimen together with existing provincial screening protocols for selected cancers that are prevalent in Ontario, Canada, among average risk persons aged 50-75 years. The selected cancers include breast, colorectal, lung, esophageal, liver, pancreatic, stomach, and ovarian. Cost effectiveness was estimated from a provincial Ministry of Health perspective. A state-transition Markov model representing the decision path of both the proposed and existing screening strategies along the natural history of the selected types of cancers was implemented. The incremental cost-effectiveness ratio (ICER) was calculated using data from available literature and the guidelines published by the Canadian Agency for Drugs and Technologies in Health (CADTH) for conducting a cost-effectiveness analysis, which included a discount rate of 1.5% applied to all costs and outcomes. Costs were also converted to 2022 Canadian dollars. To test the robustness of the model, both univariate and probabilistic sensitivity analyses were conducted. MCED screening resulted in more diagnosed cases of each type of cancer, even at an earlier stage of disease. This was also associated with fewer related deaths compared with standard of care. Notwithstanding, the analysis revealed that the MCED intervention was not cost effective [ICER: CAD$143,369 per quality-adjusted life year (QALY)], given a willingness to pay (WTP) threshold of $100,000 per QALY. The probabilistic sensitivity analyses revealed that the MCED intervention strategy was preferred to standard of care no more than 2% of the time at this WTP for both males and females. The model was most sensitive to the cost of MCED screening, and the levels of specificity of the MCED and colorectal cancer screening tests. The main contribution of the study is to present and execute a methodological approach that can be adopted to test the cost effectiveness of an MCED tool in the Canadian setting. The model is also sufficiently generic that it could be adapted to other jurisdictions, and with consideration for increasing the WTP threshold beyond the common $100,000 per QALY limit, given the life-threatening nature of cancer, to ensure that MCED interventions are cost-effective.

Risk assessment when consuming drinking water treated with chlorine dioxide and risk management in EU countries and Ukraine to protect public health

The purpose of the work was to conduct a comparative scientific analysis of the main approaches to risk assessment and risk management to prevent the negative impact of drinking water on public health when treating it with chlorine dioxide in EU countries and Ukraine. The main risk to the population's health arising when consuming drinking water, is the risk of its microbiologicall contamination. Microbiological contamination of drinking water corresponds to a high risk, while the formation of disinfection byproducts in drinking water is an average risk. The regulatory documents of all EU countries take into account the requirements of Directive 2020/2184/EU regarding the content of chlorites and chlorates in drinking water when treating it with chlorine dioxide, while in Denmark, Slovakia, Hungary, Spain, and France, a risk-oriented approach to the safety of drinking water forced to introduce stricter standards to these indicators (as mandatory, recommended or those, which can be temporarily raised).The scientific analysis of the regulation of drinking water quality in the EU countries and Ukraine, as well as field studies on the safety and quality of drinking water at the Dnipro water station in the city of Kyiv, allowed to assess the risks of drinking water hazards and became the basis for raising the issue of revising or canceling the unscientific standard for chlorine dioxide in drinking water of the distribution network (≥0.1 mg/l), revising the strict standard for chlorites (≤0.2 mg/l), as well as control of drinking water quality by the content of chlorates following the requirements of European legislation. When appointing the organizers, executors, and decision-makers regarding risk assessment, similar approaches were implemented in various EU countries; in the documents of many countries, there are references to the relevant scientific institutions and the functions assigned to them. Under such conditions, the working programs of production control over drinking water quality and modernization plans can be adapted to the relevant water supply system and modern realities.

VARIATIONS ACROSS 11 DEPARTMENT OF VETERANS AFFAIRS HOSPITAL-IN-HOME PROGRAMS IN 2021–2022

Abstract The Department of Veterans Affairs’ (VA) Hospital-In-Home (HIH) program provides Veterans with the option to receive acute level services in the comforts of their own homes. A total of 11 HIH programs operated between fiscal years 2021 and 2022. We examined the volume of the programs and average risk of one-year mortality (using the Care Assessment of Needs measure) among each program’s participants and characteristics of HIH stays (length-of-stay [LOS] and discharge destination) across program sites and program types (complementary- admissions from hospital and substitutive- other admissions) using VA administrative data linked with Medicare claims. The number of patients served in a year varied between 36 and 680 with 6 programs having &amp;lt;200 patients. Substitutive HIH was the dominant HIH type in 8 programs (&amp;gt;50% of patients) while only one program had clearly more complementary HIH (87%) and only 9 programs had complementary HIH. Average length-of-stay (los) in HIH was 20.5 days (SD=24.4 days, median=13 days), with averages across programs ranging between 3 - 36 days, 6 programs with average los&amp;lt;13 days and 5 programs with average los &amp;gt;19 days. Predicted risk of death within one-year varied: among substitutive HIH, 7 programs’ average risk was &amp;gt; 20% and 4 programs’ average risk was &amp;lt;15%. Among complementary HIH only one program’s risk was &amp;lt;15% and the rest was &amp;gt;20%. Substitutive HIH programs discharged 2-10% of Veterans to hospital, while complementary programs discharged 11-23% to hospital. Interviews with program staff will help elucidate reasons for differences and inform expected outcomes.

PERSONALIZED AND TYPICAL CONCURRENT RISK: JOINT MODELS OF RECURRENT OUTCOMES AND MORTALITY BY RACE/ETHNICITY

Abstract The growing burden of multiple chronic conditions documented by a U.S. Department of Health and Human Services initiative noted the importance of studies that 1) “Develop tools to identify and target population subgroups of individuals with multiple chronic conditions who are at high risk for poor health outcomes”, and 2) “Improve knowledge about patient trajectories temporally in relation to changes in health status, functional status, and health services use”. Expanding upon our methods for jointly modeling multiple outcomes, where each person’s shared influence on concurrent outcomes can be captured by using a random intercept term, we demonstrate how to model additional heterogeneity. Based on the estimates from the joint model, the typical concurrent risk (TCR) of each outcome (i.e., probability) can be estimated at the cohort level, providing a method for identifying average longitudinal effects of risk factors useful for healthcare system policies. In contrast, a person-specific effect reflects the probability of each outcome within a defined interval of time, while currently at risk for another non-mutually exclusive outcome (i.e., personalized concurrent risk [PCR]). Chronic conditions and sociodemographic risk factors may partially account for the heterogeneity of a cohort. However, differences in the occurrences and associations among these may differ for minoritized groups. These methods identify persons above (or below) average risk. We expanded these joint models to address truncation of measurement due to death and the interdependence of outcomes at the person-level, while maintaining the Type I error rate. We have made the code publicly available.

Screening for Colorectal Cancer in Individuals Younger Than 50 Years

What Is the Issue?&#x0D; &#x0D; Incidence of colorectal cancer in individuals younger than 50 years in Canada is rising, despite existing recommendations in Canada advising that colorectal cancer screening be initiated at 50 years.&#x0D; In response to the also increasing incidence of colorectal cancer observed in other jurisdictions, screening for colorectal cancer in individuals of average risk younger than 50 years has been recommended.&#x0D; These factors have prompted reconsideration of current Canadian guidelines regarding the age at which colorectal cancer screening should be initiated.&#x0D; &#x0D; What Did We Do?&#x0D; &#x0D; To inform considerations about the age at which colorectal cancer screening should best be initiated, CADTH identified and summarized studies comparing colorectal cancer screening in individuals of average risk younger than 50 years with either no screening or screening in individuals of average risk aged 50 years and older.&#x0D; An information specialist conducted a search of peer-reviewed and grey literature sources. Recommendations from evidence-based guidelines for screening individuals of average risk younger than 50 years were also sought and summarized.&#x0D; &#x0D; What Did We Find?&#x0D; &#x0D; Data from 1 retrospective cohort study in the US conducted in a large sample across 13 years suggested there is higher incidence of colorectal cancer among individuals between the ages of 45 and 49 years who underwent screening colonoscopy than in those between the ages of 50 and 54 years.&#x0D; Data from a retrospective cohort study conducted in Greece with a limited sample size across 1 year of observation demonstrated no difference in the cumulative incidence of colorectal cancer in individuals of average risk younger than 50 years or 50 years and older.&#x0D; Estimates from 4 modelling studies (1 of which was Canadian) that investigated screening in individuals younger than 50 years indicate that life-years may be gained, colorectal cancer cases and deaths may be reduced, but that numbers of lifetime colonoscopies and complications from screening would likely increase.&#x0D; One economic evaluation conducted in Portugal concluded that there is no cost-utility for colorectal cancer screening in individuals of average risk younger than 50 years at a willingness-to-pay threshold of €39,760, given current estimates of incidence in this age cohort.&#x0D; Seven evidence-based guidelines identified recommend that colorectal cancer screening be initiated in individuals of average risk at age 45 years, whereas 1 guideline recommends against screening in individuals of average risk beginning at 45 years and 1 guideline recommends against screening beginning at age 40 years. Most evidence-based guidelines highlight the lack of empirical evidence describing clinical effectiveness and cost-effectiveness as limitations when developing recommendations.&#x0D; &#x0D; What Does It Mean?&#x0D; &#x0D; Empirical data describing the effectiveness of colorectal cancer screening in individuals of average risk younger than 50 years remain limited, although a preponderance of evidence-based guidelines identified by this review recommend in favour of doing so.&#x0D; Modelled data estimate that colorectal cancer screening in individuals younger than 50 years may produce benefits, although these estimates are vulnerable to model inputs and assumptions (perfect adherence to screening protocols, for instance), and may not adequately account for the potential harms of screening.&#x0D; Additional opportunities for maximizing the benefits of colorectal cancer screening may include targeting increased uptake among disadvantaged and high-risk groups, including those 50 years and older.&#x0D; Broader considerations that address societal benefit and costs — including health equity and implementation — are essential to inform decision-making concerning colorectal cancer screening in individuals of average risk younger than 50 years.&#x0D;

RISK OF HRIDROGA (CARDIOVASCULAR DISORDER) IN AMAVATA PA-TIENTS (RHEUMATOID ARTHRITIS) AMONG COASTAL POPULATION: A HEALTHCARE CHALLENGE

Amavata (RA), which is a systemic disease affecting mainly Koshta (gastrointestinal tract) and Sandhi (marmas-thisandhigat vyadhi), is a prevalent condition encountered in our day-to-day practice. In modern science, Aamvat can be correlated with Rheumatoid Arthritis. The association between RA and heart disease has been studied extensively, and the results are concerning. Patients with RA have an average risk of heart disease that is almost 50 percent higher than the general population. Changes in the occurrence/ outcome of Amavata due to Geo-graphical differences must be considered. According to our observation, Aamvat prevalence in the coastal popu-lation was exceptionally higher than in any other region. Inadequate access to healthcare services and limited health knowledge in remote coastal locations are associated with a higher burden of such chronic diseases. This Review article focuses on the need to understand and assess the risk of Hridroga (CVD) in Amavata vyadhi (RA) among the Coastal population so that we can help them lower the incidences of this vyadhi and its Updra-vas (complications).

Cardiometabolic and renal phenotypes and transitions in the United States population

Cardiovascular and renal conditions have both shared and distinct determinants. In this study, we applied unsupervised clustering to multiple rounds of the National Health and Nutrition Examination Survey from 1988 to 2018, and identified 10 cardiometabolic and renal phenotypes. These included a ‘low risk’ phenotype; two groups with average risk factor levels but different heights; one group with low body-mass index and high levels of high-density lipoprotein cholesterol; five phenotypes with high levels of one or two related risk factors (‘high heart rate’, ‘high cholesterol’, ‘high blood pressure’, ‘severe obesity’ and ‘severe hyperglycemia’); and one phenotype with low diastolic blood pressure (DBP) and low estimated glomerular filtration rate (eGFR). Prevalence of the ‘high blood pressure’ and ‘high cholesterol’ phenotypes decreased over time, contrasted by a rise in the ‘severe obesity’ and ‘low DBP, low eGFR’ phenotypes. The cardiometabolic and renal traits of the US population have shifted from phenotypes with high blood pressure and cholesterol toward poor kidney function, hyperglycemia and severe obesity.

Polygenic Risk Score Modifies Prostate Cancer Risk of Pathogenic Variants in Men of African Ancestry.

These findings highlight the importance of considering rare and common variants to comprehensively assess prostate cancer risk in men of African ancestry.

Polygenic risk alters the penetrance of monogenic kidney disease

Chronic kidney disease (CKD) is determined by an interplay of monogenic, polygenic, and environmental risks. Autosomal dominant polycystic kidney disease (ADPKD) and COL4A-associated nephropathy (COL4A-AN) represent the most common forms of monogenic kidney diseases. These disorders have incomplete penetrance and variable expressivity, and we hypothesize that polygenic factors explain some of this variability. By combining SNP array, exome/genome sequence, and electronic health record data from the UK Biobank and All-of-Us cohorts, we demonstrate that the genome-wide polygenic score (GPS) significantly predicts CKD among ADPKD monogenic variant carriers. Compared to the middle tertile of the GPS for noncarriers, ADPKD variant carriers in the top tertile have a 54-fold increased risk of CKD, while ADPKD variant carriers in the bottom tertile have only a 3-fold increased risk of CKD. Similarly, the GPS significantly predicts CKD in COL4A-AN carriers. The carriers in the top tertile of the GPS have a 2.5-fold higher risk of CKD, while the risk for carriers in the bottom tertile is not different from the average population risk. These results suggest that accounting for polygenic risk improves risk stratification in monogenic kidney disease.

Health risk assessment of uranium intake from private residential drinking groundwater facilities based on geological characteristics across the Republic of Korea

Groundwater contributes to an average of 8 % of the total water source capacity in the Republic of Korea. Hence, private residential households in rural areas in Korea are still using groundwater for drinking without any regular water quality inspection. This can increase the risk of exposure to natural radionuclides like uranium through drinking groundwater. This study investigated the uranium level in drinking groundwater all over the country by analyzing 11,451 samples from private residential drinking groundwater facilities and compared the exposure amount and its associated carcinogenic and non-carcinogenic risk based on the geological characteristics of the aquifer. Results yield that although the average hazard quotient (HQ) and excess cancer risk (ECR) of exposure to natural uranium through drinking groundwater were respectively below 1 and 1 × 10−6 and do not indicate a potential health hazard, significantly high HQ and ECR up to respectively 70 and 4 × 10−4 in samples where the aquifer is the Jurassic granite observed. Accordingly, regular water quality investigation and onsite treatment methods are required to provide healthy drinking water in such areas.

Risk-oriented approach in the problems of modeling of metrological support of the measuring instrument fleet

The methods of management of metrological support of the measuring instrument fleet are considered. The modern situation is described, when the fleet of measuring instruments is heterogeneous and includes both obsolete samples of measuring instruments with a long service life and significant operating time, and the newest, high-tech samples of measuring instruments. At the same time the proportions between the mentioned groups of measuring instruments change over time, as the ageing of measuring instruments and their transition from one group to another takes place. Also the measurement instrument park is renewed as a result of purchases of new and modernization of existing samples. The heterogeneity of the measuring instrument park leads to the necessity of development and application of new methods of management of metrological support of the measuring instrument park, including the use of mathematical modeling. One of the promising methods of metrological management of the measuring instrument fleet based on the risk-oriented approach is proposed. The probability of finding a randomly selected sample of measuring instruments from the measurement instrument park at an arbitrary moment of time in the state of unreadiness for intended use is used as a risk indicator for the measuring instrument park. In accordance with the risk-oriented approach the measuring instrument park is divided into risk classes. The algorithm of assigning measuring instruments to different risk classes is developed, based on solving a series of optimization problems of the fleet operation taking into account the processes of aging and renewal of the fleet of measuring instruments. The results of application of the risk-oriented approach in the problem of modeling of metrological support of heterogeneous fleet of measuring instruments including both modern and obsolete samples with different metrological characteristics, MTBF and lifetime are presented. It is shown that by dividing all samples of measuring instruments into risk classes and carrying out verifications with their close to optimal periodicity and with their tolerance for controlled parameters in each risk class it is possible to minimize the total average risk for the fleet of measuring instruments and at the same time to achieve resource saving.

Assessment of mortality risks due to a strong cold spell in 2022 in China.

With the intensification of global climate warming, extreme low temperature events such as cold spells have become an increasingly significant threat to public health. Few studies have examined the relationship between cold spells and mortality in multiple Chinese provinces. We employed health impact functions for temperature and mortality to quantify the health risks of the first winter cold spell in China on November 26th, 2022, and analyzed the reasons for the stronger development of the cold spell in terms of the circulation field. This cold spell was a result of the continuous reinforcement of the blocking high-pressure system in the Ural Mountains, leading to the deepening of the cold vortex in front of it. Temperature changes associated with the movement of cold fronts produced additional mortality risks and mortality burdens. In general, the average excess risk (ER) of death during the cold spell in China was 2.75%, with a total cumulative excess of 369,056 deaths. The health risks associated with temperatures were unevenly distributed spatially in China, with the ER values ranging from a minimum of 0.14% to a maximum of 5.72%, and temperature drops disproportionately affect southern regions of China more than northern regions. The cumulative excess deaths exibited the highest in eastern and central China, with 87,655 and 80,230 respectively, and the lowest in northwest China with 27,474 deaths. Among the provinces, excess deaths pronounced the highest in Shandong with 29,492 and the lowest in Tibet with only 196. The study can provide some insight into the mortality burden of cold spells in China, while emphasising the importance of understanding the complex relationship between extreme low temperature events and human health. The outcomes could provide valuable revelations for informing pertinent public health policies.