High Potential Risk Research Articles

Spatial Distribution, Speciation, and Ecological Risk Assessment of Heavy Metals in Surface Sediments of Dongjiang Lake, Hunan Province

To understand the heavy metal pollution status of Dongjiang Lake, the contents and species of heavy metals in the surface sediments were investigated during September 2021, and the heavy metal pollution level and potential ecological risk were evaluated. The results showed that Cd, Pb, As, Cu, Zn, Ni, and Cr contents were in the range of 0.40-34.1, 14.8-1688, 6.99-1155, 6.89-280, 26.2-1739, 6.29-55.4, and 23.3-44.8 mg·kg-1, respectively, with extremely uneven spatial distributions. The highest contents of Cd, Pb, As, Zn, Cu, and Ni were found in the site adjacent to Yaogangxian tungsten ore. The proportion of metal species with bioavailability was high, in which Cd in acid-soluble species was 46.7%-71.5% and Pb in reducible species was 46.8%-67.0%. The bioavailable species of Cu, Zn, Ni, and Cr were 35%-68%, 42%-72%, 26%-51%, and 6%-30%, respectively, although they primarily existed in residual species. According to the geo-accumulation index (Igeo), there was a moderate or extreme pollution status of Cd in all sites, moderate or extreme pollution status of Pb in 90% of sites, and moderate pollution status of As, Cu, and Zn in 30% of sites. The ecological risk factor (Eri) of Cd showed high potential ecological risk in all sites with significantly high potential ecological risk in 80% of sites. Moreover, As and Pb had significantly high potential ecological risk, and Cu had moderate potential ecological risk in S7, which was adjacent to Yaogangxian tungsten ore. There was a high total potential ecological risk in all sites and significantly high potential ecological risk in 50% of sites. Therefore, the surface sediments of Dongjiang Lake were under the combined pollution of Cd, Pb, As, Zn, and Cu with high bioavailability and high total potential ecological risk.

P11.69.B INTRAVENOUS THROMBOLYSIS WITH OR WITHOUT ENDOVASCULAR TREATMENT FOR SUSPECTED ISCHEMIC STROKE IN PATIENTS WITH INTRACRANIAL TUMORS

Abstract BACKGROUND: AND OBJECTIVES Intravenous thrombolysis (IVT) for suspected ischemic stroke in patients with intracranial neoplasms is off-label. However, data on risks of intracranial hemorrhage (ICH) is scarce. METHODS In a multicenter registry-based analysis within the European Thrombolysis in Ischemic Stroke Patients (TRISP) collaboration, we assessed frequencies of symptomatic and fatal ICH after IVT for suspected ischemic stroke in patients with intracranial tumors by descriptive statistics and analyzed associations with clinical and imaging characteristics by binary logistic regression. Definition of symptomatic ICH was based on the clinical criteria of the European Cooperative Acute Stroke-II trial including hemorrhage at any site in cranial imaging and concurrent clinical deterioration. RESULTS Screening data of 21,289 patients from 14 centers, we identified 105 patients receiving IVT, among them 29 patients (28%) with additional endovascular treatment, with suspected, i.e. imaging-based, or histologically confirmed diagnosis of intracranial tumors. Among 104 patients with CT or MRI after IVT available, symptomatic and fatal ICH were observed in nine and four patients (9% and 4%). Among 82 patients with suspected or confirmed meningioma, symptomatic and fatal ICH occurred in six and three patients (7% and 4%). In 18 patients with intra-axial suspected or confirmed primary or secondary brain tumors, there was one symptomatic nonfatal ICH (6%). Out of four patients with tumors of the pituitary region, two patients (50%) had symptomatic ICH including one fatal ICH (25%). Tumor size was not associated with occurrence of symptomatic ICH (Odds ratio 2.8, 95% CI 0.3-24.8, p=0.34). CONCLUSION In our dataset from routine clinical care, we provide insights on the safety of IVT for suspected ischemic stroke in patients with intracranial tumors, a population that is commonly withheld thrombolysis in clinical practice and prospective trials. Except for a potential high risk of symptomatic ICH after IVT in patients with tumors of the pituitary region, frequencies of symptomatic ICH in patients with intracranial tumors in our cohort appear to be in the upper range of rates observed in previous studies within the TRISP cooperation. These results may guide individual treatment decisions in patients with acute stroke and intracranial tumors with potential benefit of IVT.

Impacts of a lead smelter in East Java, Indonesia: degree of contamination, spatial distribution, ecological risk, and health risk assessment of potentially toxic elements in soils.

This study investigates the characteristics of potentially toxic elements in soils collected from the vicinity of a lead smelter in East Java, Indonesia. The objective is to assess the impact of the lead smelter on the surrounding soil. The study involves chemical composition analysis, spatial distribution mapping, and potential ecological and health risk assessments. Soil samples were collected from the surface area (0-10cm) and subsurface (15-30cm) within radii of 1.5km, 3km, and 5km from the lead smelter. The samples were analyzed for As, Cr, Cu, Ni, Pb, and Zn using energy-dispersive X-ray fluorescence. Principal component analysis (PCA) was performed to identify the sources of potentially toxic elements in the soil. The results indicate severe Pb contamination within a 1.5km radius of the smelter, with an average contamination factor (Cf) value of 22.0, posing a high potential health risk. The contamination factor indicated that the soils were heavily polluted by As and Pb and moderately polluted by Cu, Ni, and Zn. The results of PCA showed that smelter releases are the main source of potentially toxic element contamination in the soil, accounting for 66.2%. The health risk assessment suggested that the children and adults in the study region were exposed to non-carcinogenic risks caused by As and Pb. Oral ingestion was identified as the primary exposure route impacting health risks. The carcinogenic risk from potentially toxic elements in soil was found to exceed the acceptable level for children and adults in the study region. Therefore, it is necessary for the government to take effective measures, including designing regulations and interventions, and improving lead smelter management to mitigate potential contamination and minimize the impact of lead smelter releases on the surrounding environment, especially to protect human health, particularly that of children.

Technology For Screening Potency Risk Hamstring Strain Injury (HIS) Through Muscle Strength Test: Systematic Review

Athlete own risk more injuries many compared to common people. The hamstring muscle is part important body used for running, jumping, and kicking. Required a technology that can measure hamstring strength and help the rehabilitation process. Nordbord is one of the technology available measure strength maximal, average, hamstring asymmetry with accurate and objective. Purpose from use Nordbord as test hamstring muscles for measure, improve, train, and prevent potency risk hamstring injury. Study this use method Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA). Search the resources needed using an electronic site search program as Spingerlink, Emerald, Google Scholar, PubMed, and ScienceDirect with time rise with range 6 years time last (2016 – 2022). Criteria inclusion, study about screening potency risk injury ACLs and HIS with Nordbord. and criteria exclusion, only abstract, articles that do not published in a journal scientific. The result of this study is the Nordbord muscle strength test could be used to measure the power of the Nordic hamstring (eccentric) in a maximum manner with the formula (N) = 4 x BM (kg) + 26.1 and isometric, the more asymmetry results in a high potential injury risk. Keywords: Hamstring, asymmetry, muscle strength test, eccentric.

UCDM: A User-Centric Data Model in Power Blockchain

Background: As innovative information technology, blockchain has combined the advantages of decentralization, immutability, data provenance, and contract operation automatically, which can be used to solve the issues of single point failure, high trading cost, low effectiveness, and data potential risk in power trading. However, in the traditional power blockchain, the design of functional components in blockchain, such as the data structure of the block, does not take the actual features of power into account, thus leading to a performance bottleneck in practical application. Motivated by business characteristics of power trading, a user-centric data model UCDM in consortium blockchain is proposed to achieve efficient data storage and quick data retrieval. Methods: The proposed UCDM is designed by considering the requirements of transaction retrieval and analysis, thus supporting the requirements of concurrent data requests and mass data storage. The ID of each user will independently form its own chain over the blockchain. Results: Compared with the traditional data model, the extensive experimental results demonstrate that the proposed UCDM has shorter processing delay, higher throughput, and shorter response latency, thus having practical value. Conclusion: UCDM is an effective solution to the transaction retrieval and analysis in power blockchain. Furthermore, the participant of the blockchain network has a unique identity over the world, which ensures high security during trading.

EVALUATION OF THE EFFECTS OF HEAVY METALS ON WATER FROM ILLEGAL CRUDE OIL REFINERIES: A CASE STUDY OF THREE SELECTED COMMUNITIES IN THE NIGER DELTA REGION, NIGERIA

In order to assess the levels of heavy metals and health concerns associated with the operations of illicit refineries in water, 15 surface water samples were taken from Okerenkoko, Peterou-Gbene, and Bille in the Niger Delta region of Nigeria. A number of heavy metal indices, including the Contamination Factor (Cf), Pollution Load Index (PLI), Modified Degree of Contamination (mCd), Ecological Risk Factor (Erf), and Geo Accumulation Index (Igeo), were successfully applied in the evaluation of heavy metal contamination in surface water using World Health Organization WHO (2011) and Nigerian Standard for Water Quality NSDWQ (2007) standards. Additional research from WHO and NSDWQ comparisons revealed that the majority of the investigated heavy metals were higher than permissble limits in comparison to the control site. Although the concentration of heavy metals in the aquatic habitats varies amongst the various communities in the area, according to the CV. Additionally, CV contends that there is a connection between the illicit refiners’ actions at the study site and the water chemistry changes that result in surface water contamination. According to data from the WHO and the NSDWQ, the majority of heavy metal concentration readings in the study sites exceeded the acceptable limits when compared to those in the control site. According to the results of heavy metals indices such as Cf and PLI, the surface water in the analyzed site ranges from very slightly contaminated to extremely contaminated. However, Erf and Igeo findings showed that human activities through illegal refiners increase heavy metal concentration, which results in a very high potential ecological risk associated with surface water. Additional mCd results demonstrated that in the studied sites, the surface water has a high degree of contamination. The findings suggest that surface water assessment is required to warn against a decline in water quality in the area.

Novel mechanism-based treatments for pediatric anxiety and depressive disorders.

Pediatric anxiety and depressive disorders are common, can be highly impairing, and can persist despite the best available treatments. Here, we review research into novel treatments for childhood anxiety and depressive disorders designed to target underlying cognitive, emotional, and neural circuit mechanisms. We highlight three novel treatments lying along a continuum relating to clinical impact of the disorder and the intensity of clinical management required. We review cognitive training, which involves the lowest risk and may be applicable for problems with mild to moderate impact; psychotherapy, which includes a higher level of clinical involvement and may be sufficient for problems with moderate impact; and brain stimulation, which has the highest potential risks and is therefore most appropriate for problems with high impact. For each treatment, we review the specific underlying cognitive, emotional, and brain circuit mechanisms that are being targeted, whether treatments modify those underlying mechanisms, and efficacy in reducing symptoms. We conclude by highlighting future directions, including the importance of work that leverages developmental windows of high brain plasticity to time interventions to the specific epochs in childhood that have the largest and most enduring life-long impact.

Synthesis and application of quaternary amine-functionalized core-shell-shell magnetic polymers for determination of metabolites of benzene, toluene and xylene in human urine samples and study of exposure assessment

As production processes have evolved, airborne concentrations of benzene, toluene and xylene in many workplaces are already well below the occupational exposure limits. However, studies have shown that low levels of exposure to benzene, toluene and xylene can still cause health effects in people exposed occupationally. However, there is no literature on health risk assessment of internal exposure. In view of this, an analytical method based on quaternary amine-functionalized core-shell-shell magnetic polymers (QA-CSS-MPs) was developed for the determination of seven metabolites in urine by MSPE-UPLC-DAD-HRMS. Furthermore, an improved QuEChERS method for the extraction of seven metabolites from human urine samples was introduced for the first time and satisfactory extraction rates were achieved. In addition, QA-CSS-MPs microspheres with core-shell-shell structure were designed and synthesized, and the morphology, composition and magnetic properties of the materials were fully characterized to verify the rationality of the synthetic route. Subsequently, QA-CSS-MPs microspheres were used as magnetic solid-phase extraction (MSPE) adsorbents for the purification of urine extracts, and UPLC-DAD-HRMS was used for the detection of seven metabolites. As a result, this method allows the accurate determination of seven metabolites in urine samples over an ultra-wide concentration range (0.001–100 mg/L). Under optimal experimental conditions, i.e., 2% hydrochloric acid in urine for the hydrolysis and 20 mg of QA-CSS-MPs for 5 min purification, the spiked recoveries of the seven target metabolites ranged from 81.5% to 117.7% with RSDs of 1.0%–9.4%. The limits of detection (LODs, S/N≥3) for the established method were in the range of 0.2–0.3 μg/L. The developed method was applied to 254 human urine samples for the determination of seven metabolites. The results showed that the concentration distributions of three xylene metabolites in urine, 2-MHA, 3-MHA, 4-MHA and total MHA, showed statistically significant differences for occupational exposure (p<0.001). In addition, the results of the internal exposure assessment showed that there is a high potential health risk associated with occupational exposure processes.

Content, Distribution, Source Analysis, and Risk Assessment of PAHs in Arable Soils of Taiyuan

PAHs (polycyclic aromatic hydrocarbons) accumulated in arable soils have significant impacts on farmland quality and human health, which has attracted wide attention from scientists and the public. A total of 22 arable soil samples were collected from Taiyuan, an old industrial city, including three districts (industrial zones, hilly areas, and sewage irrigation area), and the contents of 21 PAHs were detected using the GC-MS method. The sources of PAHs in soils were analyzed using the diagnostic ratios (DRs) method and positive matrix factorization (PMF) model, and the soil health risks were analyzed using the incremental lifetime cancer risk (ILCR) model. The results indicated that the average concentrations of Σ21PAHs and Σ16PAHs in arable soils of Taiyuan were 934.6 ng·g-1 and 787.7 ng·g-1, respectively, which were lower than the soil pollution risk screening value of agricultural land stipulated in GB 15168-2018. 3-5 rings PAHs were the dominant components, accounting for~90% of the Σ21PAHs. Approximately 60% of sites in industrial zones, 13% in hilly areas, and 33% in the sewage irrigation area had high PAHs contents larger than 1000 ng·g-1. The spatial distribution of PAHs showed that more severe PAHs pollution in the soil occurred in industrial areas than that in the other two districts. The DRs suggested that the combustion of coals, bio-masses, and traffic emissions were the dominant sources for PAHs pollution in arable soils in Taiyuan. The simulation results of the PMF model indicated that the sources and contribution rates of PAHs in cultivated soils were coal and biomass burning sources (59%), traffic sources (22%), and coking sources (19%). The risk assessment confirmed that the arable soils in Taiyuan had high potential carcinogenic risks; thus, more attention should be paid to the PAHs pollutions in arable soils.

Dietary exposure to cadmium from six common foods in the United States.

Recently, the United States (US) Food and Drug Administration (FDA) launched a Closer to Zero Action Plan to assess the risks of and develop action levels for certain heavy metals in food including cadmium (Cd). The problem of foodborne metal contamination has taken on new urgency, thanks in part to a 2021 US Congressional Report detailing high levels of metals found in infant food. Our risk assessment aids this FDA Action Plan by estimating the American population's Cd exposures in food, by age group and consumption patterns of certain high-risk foods; and by determining circumstances in which exposures exceed tolerable daily intakes developed by policymaking groups in the US and worldwide. We found that the age groups 6-24 months and 24-60 month old are the most highly exposed to Cd in common foodstuffs. American infants and young children of these age groups who regularly consumed rice, spinach, oats, barley, potatoes, and wheat had mean Cd exposures exceeding maximum tolerable intake level was set by the Agency for Toxic Substances and Disease Registry (ATSDR). We have identified age groups at highest potential risk, and therefore of interest for developing food safety policies to improve safety of commercial food for children.

An in-depth analysis of head-on crash severity and fatalities in Ghana

Head-on collisions are often linked to more serious injuries compared to other types of crashes, due to the intense impact they cause. In low- and middle-income countries, these collisions frequently involve high occupancy public transportation vehicles, leading to higher fatality rates per crash. Given the high risk of injury and potential for multiple casualties, this study delves into the factors influencing the outcomes of head-on crashes and the number of fatalities in Ghana. The study analyzed six years of historical head-on collision data from Ghana and developed two models to address the issue. The injury-severity analysis was performed using a random parameter multinomial logit with heterogeneity in means and variances approach and aimed to identify the factors that have a significant impact on the severity of injuries sustained in head-on collisions, while the random parameters negative binomial fatality count model was designed to examine the factors that contribute to the number of fatalities in these crashes in the country. Results showed that head-on collisions with drivers over 65, buses, motorcycles, and those between 25 and 65 years of age were more likely to result in fatalities. Speeding and vehicle malfunctions were also found to be significant contributing factors to fatal head-on collisions. Head-on crashes involving minibuses and incidents where the driver was attempting to overtake another vehicle were found to be more likely to result in a higher number of fatalities. The results of this study uncover an intriguing interaction between human-related elements and socioeconomic factors, which pose obstacles to the Government's endeavor to upgrade the major highways in the country. Additionally, the increasing need for transportation has led to the presence of vehicles on the roads that may not meet safety standards. Consequently, it is no surprise that several of the study's findings align with expectations. Nevertheless, within the specific context of Ghana, these findings furnish compelling data-driven evidence supporting the adoption and implementation of the safe systems approach as a means to tackle fatal head-on collisions in the country.

Difficulties in diagnostics of urea synthesis cycle disturbance

Introduction. Hereditary metabolic diseases include a large group of diseases caused by genetic mutations with a high potential risk of transmitting this disorder to future offspring. Manifesting at any age and accompanied by recurrent and progressive clinical symptoms, some of these mutations become incompatible with life, while most lead to gross violations of the normal physiological process of child development. The paper presents a clinical case of hereditary urea synthesis disorder caused by deficiency of ornithine transcarbamylase of mitochondrial matrix in liver (hyperammonemia type 2) as a result of mutation of the OTC gene (MIM 300461). The disease recessive, linked with the X-chromosome and is associated with a high risk of mortality due to accumulation of toxic concentrations of ammonia. Materials and methods. The boy E., born in 2015. Introduction of protein-based complimentary foods and increase in its portion volume is associated with decrease in appetite, regurgitation, nausea, vomiting, flatulence, dyspepsia appear, and sharp weakness progresses. There is a significant increase in the blood concentration of intracellular liver enzymes. Physical development is slowed due to poor weight gain, and neuropsychiatric development lags significantly. Repeatedly examined in the hospital at the place of residence. Results obtained. A total of 47 genes with mutations causing hereditary diseases with predominant liver damage were studied by mass parallel sequencing. Substitution of c.523G&gt;A (p.Asn175Asp) in the OTC gene in hemizygous state was detected. Clinical diagnosis was established: urea cycle metabolism disorder, hyperammonemia, ornithine transcarbamylase deficiency, E 72.2. Dietary recommendations were given. Carbaglu, Recordati, France at the rate of 100 mg/kg/24 h was prescribed on vital signs. Against the background of the therapy and dietary recommendations the condition of the child had a pronounced positive trend. Conclusions. Since the true incidence of this pathology in Russia has not been established (many cases of metabolic disorders of the urea cycle remain undiagnosed), the presented clinical case will allow clinicians, using modern possibilities of structural and functional analysis of the human genome, to make a timely diagnosis and prescribe adequate therapy, thereby not only prolonging the life of a young patient but also significantly improving its quality.

Accumulation Pattern and Risk Assessment of Potentially Toxic Elements in Permafrost-Affected Agricultural Soils in Northeast China.

The accumulation of potentially toxic elements (PTEs) in agricultural soils is of particular concern in China, while its status, ecological risks, and human health hazards have been little studied in the permafrost areas of Northeast China. In this study, 75 agricultural soil samples (0-20 cm) were collected from the Arctic Village, Mo'he City, in the northernmost part of China. The average concentration (mean ± standard deviation) of As, Cd, Cr, Cu, Hg, Ni, Pb, and Zn were 12.11 ± 3.66 mg/kg, 0.11 ± 0.08 mg/kg, 52.50 ± 8.83 mg/kg, 12.08 ± 5.12 mg/kg, 0.05 ± 0.02 mg/kg, 14.90 ± 5.35 mg/kg, 22.38 ± 3.04 mg/kg, and 68.07 ± 22.71 mg/kg, respectively. Correlation analysis, cluster analysis, and principal component analysis indicated that As, Cu, Ni, and Zn likely originated from geogenic processes, Hg and Pb from long-range atmospheric transport, Cd from planting activities, and Cr from Holocene alluvium. The geo-accumulation index and enrichment factor showed that As, Cd, Hg, and Zn are enriched in soils. The Nemerow pollution index showed that 66.67%, 24%, and 1.33% of soil samples were in slight, moderate, and heavy pollution levels, respectively, with Hg being the most important element affecting the comprehensive pollution index. The potential ecological risk index showed that 48.00% and 1.33% of soil samples were in the moderate ecological risk and high potential ecological risk levels, respectively. The non-carcinogenic and carcinogenic human health risk index for adults and children were both less than 1, which was within the acceptable range. This study revealed the accumulation pattern of PTEs in agricultural soils of permafrost regions and provided a scientific basis for research on ecological security and human health.

Investigating the Relationship between Internet Addiction and Dietary Behavior among Students: an analytical cross-sectional study

Background: Internet addiction can affect students' general health. Regarding to the importance of healthy eating and the impact on health and academic achievement of students. This research was conducted to aim the assessment of relationship between internet addiction and dietary behavior among students.&#x0D; Methods: In this an analytical cross-sectional study, 373 nursing and midwifery students of Tehran University of Medical Sciences participated in 2020. Data were collected by Young's Internet Addiction Scale, demographic data and Dietary Behavior questionnaire. Data analyzed by SPSS V.21 and descriptive indicators including percentage, frequency, mean and standard deviation and inferential tests including Spearman’s test, T-test and Kruskal-Wallis. A significance level of less than 0.05 was considered&#x0D; Results: The majority of the student population had no internet addiction by 91.4%. Also, 8.3% and 0.3% from student population were potential risk and high risk respectively. There was a statistical significant correlation between levels of internet addiction and dietary behavior in high-fat diets (r = 0.483, P = 0.004), snacking (r = 0.455, P &lt; 0.001), emotional eating behavior (r = 0.543, P &lt; 0.001) and poor dietary pattern (r = 0.632; P &lt; 0.001).&#x0D; Conclusions: It is suggested to improve students' beneficial use of the internet with training and improve their dietary behavior.

Source apportionment of heavy metal(loid)s in sediments of a typical karst mountain drinking-water reservoir and the associated risk assessment based on chemical speciations.

As important place for water storage and supply, drinking-water reservoirs in karst mountain areas play a key role in ensuring human well-being, and its water quality safety has attracted much attention. Source apportionment and ecological risks of heavy metal(loid)s in sediments of drinking-water reservoir are important for water security, public health, and regional water resources management, especially in karst mountain areas where water resources are scarce. To expound the accumulation, potential ecological risks, and sources of heavy metal(loid)s in a drinking-water reservoir in Northwest Guizhou, China, the surface sediments were collected and analyzed based on the combined use of the geo-accumulation index (Igeo), sequential extraction (BCR), ratios of secondary phase and primary phase (RSP), risk assessment code (RAC), modified potential ecological risk index (MRI), as well as the positive matrix factorization methods. The results indicated that the accumulation of Cd in sediments was obvious, with approximately 61.9% of the samples showing moderate to high accumulation levels, followed by Pb, Cu, Ni, and Zn, whereas the As and Cr were at low levels. A large proportion of BCR-extracted acid extractable and reducible fraction were found in Cd (72.5%) and Pb (40.3%), suggesting high bioavailability. The combined results of RSP, RAC, and MRI showed that Cd was the major pollutant in sediments with high potential ecological risk, while the risk of other elements was low. Source apportionment results of heavy metal(loid)s indicated that Cd (75.76%) and Zn (23.1%) mainly originated from agricultural activities; As (69.82%), Cr (50.05%), Cu (33.47%), and Ni (31.87%) were associated with domestic sources related to residents' lives; Cu (52.36%), Ni (44.57%), Cr (34.33%), As (26.51%), Pb (24.77%), and Zn (23.80%) primarily came from natural geological sources; and Pb (47.56%), Zn (22.46%) and Cr (13.92%) might be introduced by mixed sources of traffic and domestic. The contribution ratios of the four sources were 18.41%, 36.67%, 29.48%, and 15.44%, respectively. Overall, priority control factors for pollution in relation to agricultural sources included Cd, while domestic sources are primarily associated with As. It is crucial to place special emphasis on the impacts of human activities when formulating pollution prevention and control measures. The results of this study can provide valuable reference and insights for water resources management and pollution prevention and control strategies in karst mountainous areas.

The Burden and Risk Factors of Reproductive Tract Infections among Married Women Aged 15-49 Years in Urban Slum of Agra Uttar Pradesh

Introduction: In developing countries, reproductive tract infection among women commonly goes undiagnosed and their sequel causes various complications. Objectives: To find out the prevalence of RTI/STI through a syndromic case approach and its correlates among women of reproductive age group. Material and Methods: A community-based cross-sectional study was carried out among 500 eligible married women residing in urban slums of Agra by using WHO Syndromic case approch for diagnosis of RTIs/STIs. Results: The overall prevalence of RTI/STD was found to be 32.80% where vaginal discharge (22.60%) and lower abdominal pain (8.20%) were the most common syndromes. On multivariate analysis, religion, caste, type of absorbent used during menses, and history of IUD use were found to be significantly significant. Conclusion: The result of this study highlights the high prevalence and potential risk factors that contribute to the occurrence of RTI. It also emphasizes the need of training and education session of the participants to identify the early symptoms of RTI.

Relationship analysis of protection strategy and the number of containers with the existence of Aedes aegypti larvae at Tebing Tinggi city in 2022

Background: Dengue hemorrhagic fever (DHF) is an endemic disease in Tebing Tinggi, the number of DHF cases in 2022 reached 175. Protection strategy and the number of landfills are risk factors for the presence of Aedes aegypti mosquito larvae. This study aimed to analyze the relationship between protection strategy and the number of containers in the presence of Aedes aegypti. Methods: This type of research was an analytic survey with a cross-sectional research design. The study population was all families living in 5 sub-districts in Tebing Tinggi city with 500 houses selected using a cluster sampling technique. Primary data collection used a questionnaire containing questions on protection strategy and location points, also observation sheets containing the type of landfills, and the number and presence of larvae. Data were analyzed by Chi-Square test. Results: The results showed that Aedes aegypti larvae were found in 144 houses and 14% of families had made protection strategies, 41% of houses had more than 4 containers. Protection strategies against the presence of grass bushes within a radius of 100 meters from the house and the number of landfills had a relationship with the presence of Aedes aegypti mosquito larvae (p&lt;0.05). Conclusions: Tebing Tinggi city is an area that has a high potential risk of DHF. Suggestions for increasing DHF protection strategy and eliminating resting places and breeding places are important for empowering jumantik at the family level as well as providing ongoing assistance and education.

EFEFKTIFITAS PENERAPAN SISTEM MANAJEMEN DALAM MELAKSANAKAN KOORDINASI DAN PEMELIHARAAN SISTEM MANAJEMEN KESEHATAN DAN KESELAMATAN KERJA (SMK-3) PADA SUATU PERUSAHAAN

The method used in this article is a literature review, which is a review and discussion of literature in a particular research area, by peeling, comparing, summarizing and collecting literature and then drawing a conclusion. Implementation of SMK-3 requires commitment from companies as providers of vacancies. Management as directors and employees as resources that maintain the continuity of the company. The application often raises questions from both company management and employees. Companies are required to implement SMK-3 in the workplace by integrating the system with SMK-3. This obligation applies to companies with a workforce of at least 100 (one hundred) or less than 100 people, but which are classified as a high potential risk company. Iimplementing this Health and Safety Management System (SMK-3)it is hoped that it can increase workforce productivity.

Echocardiographic assessment of right ventricular function and right ventriculoarterial coupling in tricuspid regurgitation

Abstract Funding Acknowledgements Type of funding sources: None. Background Echocardiographic evaluation of the cardiopulmonary unit may be difficult in the presence of tricuspid regurgitation (TR) and combined echocardiographic parameters could therefore be useful in such patients. Purpose To assess the variation of simple and combined echocardiographic parameters analysing the cardiopulmonary unit according to the severity of TR. Methods Echocardiographic images were reviewed in 179 patients to assess TR grade according to Hahn’s 5 grades classification. Classical morphological (right ventricle (RV) end diastolic (ED) length and area), function (tricuspid annular plane systolic excursion (TAPSE), RV fractional area change (RVFAC), S’ wave, RV free wall longitudinal strain (RVFWS)) and load (TR Time-velocity integral (TR TVI), pulmonary artery systolic pressure (PASP)) parameters analysing RV were assessed. Combined parameters of function and load (TAPSE/PASP, TR TVI x RVFWS), morphology and load (load adaptation index (LAI) = TR TVI x RVED length/area) and morphology, load, and function (myomechanical index (MMI = RV-RA mean pressure gradient x RVFWS/indexed RAED area x 10–2 ) and morphology-load-function index (MLF = RVED length/area x TR TVI x RVFWS)) were calculated. We used receiver operating characteristic (ROC) curve analysis to analyze the diagnostic value of echocardiographic parameters to predict potential high (&amp;gt;3) or low (&amp;lt;6) surgical risk of mortality according to TRISCORE. Results Simple parameters were significatively different among groups with a nonlinear progression between the 5 levels of severity of TR. Combined parameters were also significatively different among groups. Among them, MMI and MLF had a linear progression between the 5 groups (MMI: grade 1: 0.20±0.09; grade 2: 0.15±0.08; grade 3: 0.10±0.05, grade 4: 0.09±0.08; grade 5: 0.05±0.04 p = 0.000; MLF: grade 1: 7.56±2.06; grade 2: 6.57±2.14; grade 3: 4.85±2.29, grade 4: 4.79±3.17; grade 5: 3.06±1.82 p = 0.000) and had the best predictive value for TRISCORE high and low risk (MMI: AUC =0.889 p = 0.000 for low risk, 0.855 p = 0.000 for high risk; MLF: AUC =0.873 p = 0.000 for low risk, 0.822 p = 0.000 for high risk). Conclusion Combined parameters are relevant to evaluate cardiopulmonary unit in a population presenting with TR, especially when combining morphology, function and load parameters. Their good predictive value for TRISCORE risk suggests a potential role of such parameters in the prognostic assessment of TR patients and in the selection for new percutaneous repair techniques.

Stability of the ecosystem gross primary productivity increasing in Chinese forestry ecological engineering area

Gross Primary Production (GPP) is an important component of global carbon cycle. In the context of ecosystem construction, ecosystem GPP is significantly increasing, however, the stability of the increasing remains unclear. In this study, the nonlinearity of GPP increasing and its stability were studied with Ensemble Empirical Mode Decomposition method in Chinese forestry ecological engineering (FEE) areas during 1982–2018. The results showed that (1) although linearly increasing trend of GPP occupied 50.83% of the area, it implied different nonlinear trends as monotonic increasing, decreasing to increasing, and increasing to decreasing, accounting for 25.30%, 9.03% and 7.76%, respectively. Meanwhile, for insignificantly linear changes of GPP (41.19%), among them, 5.99% and 5.41% showed trend reversal from increasing to decreasing and from decreasing to increasing, respectively. (2) the trends in all FEE areas were dominated by monotonic increasing, especially for shelterbelt programs of Middle Yellow River (YR). Meanwhile, the trend from decreasing to increasing also has high area percentage (15.75%), especially for YR and coast shelterbelt program (CS), indicating early degradation and later recovery. However, there are large areas (>10%) of the trend shifts from increasing to decreasing in most FEE areas, especially in the shelterbelt programs of Huaihe River and Taihu Lake (HT), Taihang Mountain(TH) and upper and middle reaches of Yangtze River (YZ), indicating high risk of future degradation. (3) Although GPP changes are mainly dominated by interannual variations except YR, contribution of trends to GPP changes are high in HT and TH; For monotonic increasing and decreasing to increasing, the trend contributions to whole GPP changes were > 33%, especially in YR and TH, indicating high stability of ecosystem improvement. For monotonic decreasing, increasing to decreasing and insignificant changes, the contributions were low, indicating low stability but high recovery potential or degradation risk;(4) Both agriculture reclamation and ecological engineering not only favored GPP increasing, but also enhanced its stability. Our results highlight the importance of the nonlinearity of trend and its stability, which provides scientific implications for evaluating the effectiveness of ecological engineering.