Assisted by framework of multimedia total exposure model for hazard waste sites(CalTOX),potential influences of scenario-uncertainty on multimedia health risk assessment(MHRA) and decision-making were quantitatively a...Assisted by framework of multimedia total exposure model for hazard waste sites(CalTOX),potential influences of scenario-uncertainty on multimedia health risk assessment(MHRA) and decision-making were quantitatively analyzed in a primary extent under the Chinese scenario case by deliberately varying the two key scenario-elements,namely conceptual exposure pathways combination and aim receptor cohorts choice.Results show that the independent change of one exposure pathway or receptor cohort could lead variation of MHRA results in the range of 3.6×10-6-1.4×10-5 or 6.7×10-6-2.3×10-5.And randomly simultaneous change of those two elements could lead variation of MHRA results at the range of 7.7×10-8-2.3×10-5.On the basis of the corresponding sensitivity analysis,pathways which made a valid contribution to the final modeling risk value occupied only 16.7% of all considered pathways.Afterwards,comparative analysis between influence of parameter-uncertainty and influence of scenario-uncertainty was made.In consideration of interrelationship among all types of uncertainties and financial reasonability during MHRA procedures,the integrated method how to optimize the entire procedures of MHRA was presented innovatively based on sensitivity analysis,scenario-discussion and nest Monte Carlo simulation or fuzzy mathematics.展开更多
目的基于FAERS对胺碘酮相关失明药物不良事件(adverse drug event,ADE)进行信号挖掘,探索相关失明ADE的发生特点以及胺碘酮与相关失明ADE的相关性。方法提取FAERS 2016年第1季度—2021年第4季度共24个季度的胺碘酮相关失明ADE报告数据,...目的基于FAERS对胺碘酮相关失明药物不良事件(adverse drug event,ADE)进行信号挖掘,探索相关失明ADE的发生特点以及胺碘酮与相关失明ADE的相关性。方法提取FAERS 2016年第1季度—2021年第4季度共24个季度的胺碘酮相关失明ADE报告数据,利用报告比值比法和综合标准法进行数据挖掘。得到有效信号后,再利用MedDRA规范进行汉化及系统归类。结果获得胺碘酮报告数39166个,胺碘酮相关失明ADE报告503个,其中失明、单侧盲、黑朦、一过性黑朦4个首选语运用2种方法均提示生成可疑信号。在503份患者报告中,男性所占比例(64.41%)高于女性(31.22%),在已知年龄的患者中,年龄主要集中在≥65岁(6.16%)。报告人员以律师和消费者为主90.46%,医务人员占比较低;除给药途径未知的患者,其余所有患者给药途径为口服(66.80%)。胺碘酮相关失明ADE的中位发病时间为692 d(四分位间距422.5~1045.75 d);占比最高的患者结局为其他严重的医疗事件,报告病例279例(55.47%),患者结局为死亡的报告病例73例(14.51%),居第3位。结论需重视胺碘酮的失明风险,重点关注男性、>65岁老人、给药途径为口服的患者,加强用药前的眼科评估及用药中、用药后的眼部监测,及时诊断和治疗可防止相关失明ADE的发生。展开更多
基金Projects(50978088,51039001,51178172,51009063) supported by the National Natural Science Foundation of ChinaProject(NCET-08- 180) supported by the Program for New Century Excellent Talents in University from the Ministry of Education of China
文摘Assisted by framework of multimedia total exposure model for hazard waste sites(CalTOX),potential influences of scenario-uncertainty on multimedia health risk assessment(MHRA) and decision-making were quantitatively analyzed in a primary extent under the Chinese scenario case by deliberately varying the two key scenario-elements,namely conceptual exposure pathways combination and aim receptor cohorts choice.Results show that the independent change of one exposure pathway or receptor cohort could lead variation of MHRA results in the range of 3.6×10-6-1.4×10-5 or 6.7×10-6-2.3×10-5.And randomly simultaneous change of those two elements could lead variation of MHRA results at the range of 7.7×10-8-2.3×10-5.On the basis of the corresponding sensitivity analysis,pathways which made a valid contribution to the final modeling risk value occupied only 16.7% of all considered pathways.Afterwards,comparative analysis between influence of parameter-uncertainty and influence of scenario-uncertainty was made.In consideration of interrelationship among all types of uncertainties and financial reasonability during MHRA procedures,the integrated method how to optimize the entire procedures of MHRA was presented innovatively based on sensitivity analysis,scenario-discussion and nest Monte Carlo simulation or fuzzy mathematics.
