Pelvic Organs Prolapse in Low-Resources Countries: Epidemiology, Risk Factors, Quality of Life. Narrative Review

Objective: Pelvic organ prolapse is an emerging public health problem affecting adult women of all ages with a negative impact on social, physical well-being, and psychological. Its presents several challenges in countries with low resources. This literature review aims to examine POP in its epidemiological aspects, risk factors, and staging by taking up the challenges associated with low-resource settings and identifying some avenues for future research. Methods: We searched the PubMed, Google Scholar, and Scopus databases. The other studies were identified by checking the secondary references in the original citation. We have collected studies on adult women published in English for the last 30 years. In total, 71 articles were read. We excluded studies from all newspaper articles, Studies presenting co-morbidities (fistulas, cervical cancer, pregnancy), those evaluating treatment, letters, comments, case reports, practice guidelines, news, historical articles, legal cases, published erratum, and congresses. Results: 16 studies examining the epidemiology have been identified with 11 in countries defined by the World Bank as limited or intermediate resources. 18 on risk factors whose 10 in countries with limited or intermediate resources, 10 on staging and 27 on physiopathology. Conclusion: POP affects the young more in low-resource settings. Its prevalence remains underestimated for several reasons. Several risk factors found are the same as those of women in countries with a high standard of living. However, there are some specific risk factors for these resource-limited settings.

Multidrug resistant organism infections in patients with COVID-19:risk factors and outcomes

Background:Coronavirus disease 2019(COVID-19)has now spread to most countries and regions of the world.Risk factors associated with multi-drug resistant organism(MDRO)infections in patients with COVID-19 have not been well studied yet.In the present study,we aimed to identify the risk factors associated with the MDRO infections and their impact on in-hospital mortality of COVID-19 patients.Methods:This retrospective cohort study was conducted between December 2019 and April 2020 at two tertiary hospitals in Wuhan,China.Data of cases were collected through electronic medical records system.This study was focused on cases with bacterial culture records.Risk factors and outcomes associated with MDRO infections were analyzed using logistic regression model.Results:Of the 2891 patients,370 patients have bacterial culture results,and MDROs were isolated in 38 patients.Respiratory tract infections(67.3%)were the most common hospital acquired infections.Variables independently associated with MDRO infections were dyspnea at admission(odds ratio(OR)4.74;95%confidence interval(CI)2.06-10.88;P<0.001),intensive care unit(ICU)admission(OR 5.02;95%CI 1.99-12.63;P<0.01),and invasive mechanical ventilation(OR 5.13;95%CI 2.15-12.27;P<0.001),adjusted for age and gender.MDROs infection was also a significant risk factor of death for the patients,adjusted for age,gender,severity of illness,ICU admission and mechanical ventilation(OR 1.12,95%CI:0.43-2.96,P=0.817).Conclusion:In our study,dyspnea at admission,ICU admission and invasive mechanical ventilation were associated with the presence of MDRO infections,and clinicians should be alert in MDRO infections in COVID-19 hospitalized patients.

Organochlorine compounds and polycyclic aromatic hydrocarbons in surface sediment from Baiyangdian Lake,North China:Concentrations,sources profiles and potential risk

Organochlorine pesticides （OCPs）, polychlorinated biphenyls （PCBs）, and polycyclic aromatic hydrocarbons （PAHs） were determined in nineteen surface sediment samples collected from Baiyangdian Lake and its inflowing river （Fuhe River） in North China. Total concentrations of OCPs, PCBs and PAHs in sediments ranged from 5.4 to 707.6 ng]g, 2.3 to 197.8 ng/g, and 101.3 to 6360.5 ng]g, respectively. The levels of contaminants in Fuhe River were significantly higher than those in Baiyandian Lake. For hexachlorocyclohexane （HCHs） and dichlorodiphenytrich/oroethanes （DDTs）, α-HCH and p,p＇-DDT were predominant isomers; while for PCBs, PCB 28/31, PCB 40/103, PCB 60, PCB 101, and PCB 118 were predominant congeners. Possible sources derived from historical usage for OCPs and incomplete combustion fuel, wood, and coal and exhaustion of boats or cars for PAHs. Risk assessment of sediment indicated that sediments in Fuhe River were likely to pose potential biological adverse impact.

Genotoxicity evaluation and a primary risk assessment of organic pollutants in the drinking water sources of Nanjing, China

An increasing number of industrial, agricultural, and commercial chemicals in the aquatic environment leads to various deleterious effects on organisms, which is becoming an increasingly serious problem in China. In this study, the comet assay was conducted to investigate the genotoxicity to human body caused by organic concentrates in the drinking water sources of Nanjing City from Yangtze River of China, and health and ecology risk due to expose to these organic pollutants were evaluated with the multimedia environmental assessment system （MEAS）. For all the water samples, they were collected from four different locations in the drinking water sourcr samples, es of Nanjing City. The results of the comet assay showed that all the organic concentrates from the water samples could induce different levels DNA damages on human peripheral blood lymphocytes, and a statistically significant difference （p〈0.01） was observed compared with the solvent control, which demonstrated the genotoxicity was in existence. According to the ambient severity （AS） of individual compound, we had sorted out the main organic pollutants in the drinking water source of the four waterworks, and the results showed that there was some potential hazard to human body for all the source water, namely the total ambient severity （TAS） of health for each water source was more than 1. However, the TAS of ecology for each water source was less than 1, which indicated that it was safe to ecology. The results of this investigation demonstrate the application of the comet assay and the MEAS in aquatic environmental monitoring studies, and the comet assay found to be fast, sensitive, and suitable for genotoxicity monitoring programs of drinking water source.

Human Health Risk Assessment Model of Organic Pollution in Groundwater:Shijiazhuang Industrial Zone

In this study, a risk-based management model is developed and applied to an industrial zone. The models proposed by the United States Environmental Protection Agency and Han Bing have been improved by adding a residual ratio of volatile organic compounds （VOC） after boiling and deleting the related parameters in half-life. Using this improved model, an integrated process was used to assess human health risk level in the study area. Compared with water quality analysis, the results highlight the importance of applying an integrated approach for decision making on risk levels and water protection. The results of this study demonstrated that： （1） Compared with these permissible level standards in China （GB 3838-2002） and National Primary Drinking Water Regulations of the United States, the residents＇ daily life had not been affected by the groundwater in this area （except for relative bad water quality of HB3-4 and HB3-6）; （2） The typical detected organic contaminants of all groundwater samples were chloroform, carbon tetrachloride, trichloroethylene and tetrachloroethene, and the pollution sources were mainly industrial sources by preliminary investigations; （3） As for groundwater, the non-carcinogenic risk values of all samples do not exceed the permissible level of 1.0 and the carcinogenic risk values are relatively lower than the permissible level of 1.00E-06 to 1.00E-04; （4） Drinking water pathway of trichloroethylene and tetrachloroethylene mainly contribute to increasing the health risk of residents＇ in study areas; （5） In terms of non-carcinogenic risk and carcinogenic risk, the health risk order for drinking water pathway and dermal contact pathway was： drinking water pathway 〉 dermal contact pathway.

Network analysis using organizational risk analyzer

The tool system of the organizational risk analyzer (ORA) to study the network of East Turkistan terrorists is selected. The model of the relationships among its personnel, knowledge, resources and task entities is represented by the meta-matrix in ORA, with which to analyze the risks and vulnerabilities of organizational structure quantitatively, and obtain the last vulnerabilities and risks of the organization. Case study in this system shows that it should be a shortcut to destroy effectively the network of terrorists by recognizing the caucus persons of the terrorism organization for the first and eliminating them when strikes the terror organization. It is vital to ensure effective use of the resources and control the risks of terrorist attacks.

Lower limit of thermal maturity for the carbonization of organic matter in marine shale and its exploration risk

Based on the drilling data of the Silurian Longmaxi Formation in the Sichuan Basin and periphery, SW China, the Ro lower limits and essential features of the carbonization of organic matter in over-high maturity marine shale were examined using laser Raman, electrical and physical property characterization techniques. Three preliminary conclusions are drawn:(1) The lower limit of Ro for the carbonization of Type I-II1 organic matter in marine shale is 3.5%; when the Ro is less than 3.4%, carbonization of organic matter won't happen in general; when the Ro ranges from 3.4% to 3.5%, non-carbonization and weak carbonization of organic matter may coexist; when the Ro is higher than 3.5%, the carbonization of organic matter is highly likely to take place.(2) Organic-rich shale entering carbonization phase have three basic characteristics: log resistivity curve showing a general "slender neck" with low-ultralow resistance response, Raman spectra showing a higher graphite peak, and poor physical property(with matrix porosity of only less than 1/2 of the normal level).(3) The quality damage of shale reservoir caused by the carbonization of organic matter is almost fatal, which primarily manifests in depletion of hydrocarbon generation capacity, reduction or disappearance of organic pores and intercrystalline pores of clay minerals, and drop of adsorption capacity to natural gas. Therefore, the lower limit of Ro for the carbonization of Type I-II1 organic matter should be regarded as the theoretically impassable red line of shale gas exploration in the ancient marine shale formations. The organic-rich shale with low-ultralow resistance should be evaluated effectively in area selection to exclude the high risk areas caused by the carbonization of organic matter. The target organic-rich shale layers with low-ultralow resistance drilled during exploration and development should be evaluated on carbonization level of organic matter, and the deployment plan should be adjusted according to the evaluation results in time.

Automatic delineation of organs at risk in non-small cell lung cancer radiotherapy based on deep learning networks

Objective To introduce an end-to-end automatic segmentation method for organs at risk(OARs)in chest computed tomography(CT)images based on dense connection deep learning and to provide an accurate auto-segmentation model to reduce the workload on radiation oncologists.Methods CT images of 36 lung cancer cases were included in this study.Of these,27 cases were randomly selected as the training set,six cases as the validation set,and nine cases as the testing set.The left and right lungs,cord,and heart were auto-segmented,and the training time was set to approximately 5 h.The testing set was evaluated using geometric metrics including the Dice similarity coefficient(DSC),95%Hausdorff distance(HD95),and average surface distance(ASD).Thereafter,two sets of treatment plans were optimized based on manually contoured OARs and automatically contoured OARs,respectively.Dosimetric parameters including Dmax and Vx of the OARs were obtained and compared.Results The proposed model was superior to U-Net in terms of the DSC,HD95,and ASD,although there was no significant difference in the segmentation results yielded by both networks(P>0.05).Compared to manual segmentation,auto-segmentation significantly reduced the segmentation time by nearly 40.7%(P<0.05).Moreover,the differences in dose-volume parameters between the two sets of plans were not statistically significant(P>0.05).Conclusion The bilateral lung,cord,and heart could be accurately delineated using the DenseNet-based deep learning method.Thus,feature map reuse can be a novel approach to medical image auto-segmentation.

Dosimetric benefit to organs at risk following margin reductions in nasopharyngeal carcinoma treated with intensity-modulated radiation therapy

Introduction:It is important to decrease the radiation exposure of normal tissue in intensity-modulated radiation therapy(IMRT).Minimizing planning target volume(PTV) margins with more precise target localization techniques can achieve this goal.This study aimed to quantify the extent to which organs at risk(OARs) are spared when using reduced margins in the treatment of nasopharyngeal carcinoma(NPC).Methods:Two IMRT plans were regenerated for 40 patients with NPC based on two PTV margins,which were reduced or unchanged following cone beam computed tomography online correction.The reduced-margin plan was optimized based on maximal dose reduction to OARs without compromising target coverage.Dosimetric comparisons were evaluated in terms of target coverage and OAR sparing.Results:Improvements in target coverage occurred with margin reduction,and significant improvements in dosimetric parameters were observed for all OARs(P<0.05) except for the right optic nerve,chiasm,and lens.Doses to OARs decreased at a rate of 1.5%to 7.7%.Sparing of the left parotid and right parotid,where the mean dose(D_(mean)) decreased at a rate of 7.1%and 7.7%,respectively,was greater than the sparing of other OARs.Conclusions:Significant improvements in OAR sparing were observed with margin reduction,in addition to improvement in target coverage.The parotids benefited most from the online imaging-guided approach.

Organ at Risk Doses during High Dose Rate Intracavitary Brachytherapy for Cervical Cancer: A Dosimetric Study

Background: Treatment of Cervical cancer includes a combination of external beam radiotherapy (EBRT) with intracavitary brachytherapy (ICBT). ICBT helps to boost radiation dose to primary disease. Organs like rectum, bladder, sigmoid and small bowel lie close to the cervix region and these organs receive dose from EBRT as well as ICBT and we want to know the dose to these organ at risk (OAR). Materials & Methods: Dosimetric details of 174 ICBT applications done in 58 patients were retrospectively analysed. All patients received EBRT dose of 50.4 Gy in 28 fractions. All patients had ICBT, three sessions with 7 Gy prescribed to point A. Dosimetric data including dose to right and left point A and dose to OARs were recorded from Oncentra Planning System. Results: Mean dose to point A on right side was 6.89 Gy and left side was 6.91 Gy. Mean D2cc dose to rectum, bladder, sigmoid and small bowel was 3.5 Gy, 5.25 Gy, 4.75 Gy and 4.2 Gy respectively. Mean EQD2 dose combining EBRT and ICBT in point A was 78.7 Gy on right side and 79 Gy on left side. Mean EQD2 doses to D2cc of rectum, bladder, sigmoid and small bowel was 62 Gy, 74.4 Gy, 70.5 Gy and 66.5 Gy respectively. Conclusion: From the results of this dosimetric study it is evident that OARs like rectum, sigmoid, bladder & bowel are receiving only acceptable doses of radiation using point A prescribed CT based ICBT planning. Hence with regards to OAR doses, CT based ICBT planning with dose prescribed to point A is a feasible option.

The Effect of Absorbed Dose to Organs at Risk Following Craniospinal Irradiation Using Different Radiotherapy Techniques

Introduction: In medulloblastoma patients craniospinal irradiation is an important element the treatment. Our study aimed to evaluate the effect of absorbed dose to organs at risk using the hybrid intensity-modulated radiation therapy (IMRT) versus three-dimensional conformal radiotherapy (3DCRT) for craniospinal irradiation (CSI) in average risk medulloblastoma patients. Materials and Methods: In this study, thirteen medulloblastoma patients were included. The prescribed total dose to the planning target volume (PTV) was 23, 40 Gy in 13 fractions. Two radiotherapy techniques, three dimensional conformal radiotherapy (3DCRT) and hybrid intensity modulated radiotherapy (IMRT) were used to treat these patients. The coverage of the Target was evaluated using the D mean, D95%, D2%, D98% and V95%. Other parameters were also compared such as Integral dose (ID), Homogeneity index (HI) and doses to the organs at risk (OARs). Results: There was no significant difference in the mean dose received by the PTV-Brain or the dose received by 95% and 98% of PTV volume using the two techniques. For PTV-Spine, the percentage volume receiving 95% of the total dose increased significantly in the hybrid IMRT technique compared to the conformal technique. So, hybrid IMRT plan achieved the best coverage for PTV spine. Lower dose for OAR was delivered by 3DCRT, except the heart and thyroid, hybrid IMRT achieved better sparing. All plans resulted in the same dose homogeneity index (DHI) for PTV-Brain. For PTV-Spine, hybrid IMRT technique achieved better dose homogeneity compared to 3DCRT technique (1.09 vs. 1.12;p > 0.05). Conclusions: hybrid IMRT technique can be realized on conformal technique because it achieved better dose coverage for the (PTV) and organ at risk (OAR). 3DCRT reduced mean dose to most OARS, except the heart and thyroid. Therefore, the hybrid IMRT technique may be a CSI treatment alternative to 3DCRT.

Waterlogging risk assessment based on self-organizing map(SOM)artificial neural networks:a case study of an urban storm in Beijing

Due to rapid urbanization, waterlogging induced by torrential rainfall has become a global concern and a potential risk affecting urban habitant's safety. Widespread waterlogging disasters haveoccurred almost annuallyinthe urban area of Beijing, the capital of China. Based on a selforganizing map(SOM) artificial neural network(ANN), a graded waterlogging risk assessment was conducted on 56 low-lying points in Beijing, China. Social risk factors, such as Gross domestic product(GDP), population density, and traffic congestion, were utilized as input datasets in this study. The results indicate that SOM-ANNis suitable for automatically and quantitatively assessing risks associated with waterlogging. The greatest advantage of SOM-ANN in the assessment of waterlogging risk is that a priori knowledge about classification categories and assessment indicator weights is not needed. As a result, SOM-ANN can effectively overcome interference from subjective factors,producing classification results that are more objective and accurate. In this paper, the risk level of waterlogging in Beijing was divided into five grades. The points that were assigned risk grades of IV or Vwere located mainly in the districts of Chaoyang, Haidian, Xicheng, and Dongcheng.

Risk of infectious diseases and cutaneous tumours in solid organ recipients: A meta-analysis of literature

AIM: To compare the risk of cutaneous infections and tumours in kidney transplant recipients with data recently published about this topic.METHODS: In the present work, we evaluated the incidence of bacterial, fungal and viral cutaneous infectious diseases and the development of skin cancers in a cohort of 436 patients who underwent a renal transplantation. The median age at transplantation of our patients was 50 years and the median duration of the immunosuppression was of 7.2 years. Data obtainedfrom our cohort were compared with those obtained by a systematic review of the literature of the last 20 years about the same topic.RESULTS: Infectious diseases were the most frequent dermatological disorders that were diagnosed after transplantation, affecting about the 16.5% of patients. Herpes virus reactivation occurs in about the 35% of patients and is more common within 6 mo from transplantation, whereas when the immunosuppression is reduced, skin infections are mainly represented by Human Papilloma Virus infections and localized mycosis, such as pityriasis versicolor and superficial candidiasis. Bacterial infections were relatively rare and occur mainly in the first months after transplantation. The cumulative risk to develop skin cancer enhance significantly over the time, as consequence of longterm immunosuppressive regiments. Endogenous and exogenous risk factors, as well as the schedule of immunosuppression can play a role and justify the different incidence of skin cancer in the various series. CONCLUSION: Skin infections and cancer, commonly diagnosed in transplanted patients, impact on survival and life-quality, justifying the realization of follow-up programs for the early diagnosis and treatment.

Risk factors for infection with multidrug-resistant organisms in diabetic foot ulcer patients:A systematic review and meta-analysis

Objective:To systematically evaluate the risk factors for multidrug-resistant organisms(MDROs)infection in patients with diabetic foot ulcer(DFU).Methods:The quality assessment of outcome measures was performed by searching the Web of Science,Embase library,PubMed,Cochrane Library databases and screening the literature on the risk factors of MDROs infection in DFU patients according to the inclusion and exclusion criteria,and meta-analysis was performed using revman5.3 analysis software.Results:13 literature was retrieved,involving in 1715 patients.A total of 15 risk factors were included in the analysis and the meta-analysis showed that Previous hospitalization(OR=2.61,95%CI[1.51,4.52],P=0.0006),Previous antibiotic use(OR=2.17,95%CI[1.24-3.78],P<0.01),Type of diabetes(OR=2.44,95%CI[1.29-4.63],P<0.01),Nature of ulcer(OR=2.16,95%CI[1.06-4.40],P=0.03),Size of ulcer(OR=2.56,95%CI[1.53-4.28],P<0.01),Osteomyelitis(OR=3.50,95%CI[2.37-5.17],P<0.01),Peripheral vascular disease(OR=2.37,95%CI[1.41-3.99],P<0.01),and Surgical treatment(OR=4.81,95%CI[2.95-7.84],P<0.01)were closely associated with MDROs infection in DFU patients.Conclusions:The risk factors of MDROs infection in patients with DFU were previous hospitalization,previous antibiotic use,type of diabetes,nature of ulcer,size of ulcer,osteomyelitis,peripheral vascular disease,and surgical treatment.This study is conducive to early detection of MDROs infection in high-risk groups and timely comprehensive treatment to delay the development of the disease.

The Impact of Variation in Bladder Volume on the Doses of Target and Organ-at-Risk in Intensity-Modulated Radiation Therapy for Localized Prostate Cancer

Intensity-modulated radiation therapy (IMRT) has become the mainstay of treatment for localized prostate cancer. In IMRT, minimizing differences between the conditions used during planning CT and daily treatment is important to prevent adverse events in normal tissues. In the present study, we evaluated the impact of variation in bladder volume on the doses to various organs. A total of 35 patients underwent definitive radiotherapy at Saitama Medical Center. A Light Speed RT16 (GE Healthcare) was used for planning and to obtain examination CT images. Such images were acquired after 4 - 6 days of planning CT image acquisition. The IMRT plans were optimized using the planning CT data to satisfy the dose constraints set by our in-house protocols for the PTV and the OARs. The dose distributions were then re-calculated using the same IMRT beams, and checked on examination CT images. It was clear that bladder volume affected the doses to certain organs. We focused on the prostate, bladder, rectum, small bowel, and large bowel. Regression coefficients were calculated for variables that correlated strongly with bladder volume (p < 0.05). We found that variation in bladder volume [cm3] predicted deviations in the bladder V70Gy, V50Gy, and V30Gy [%];the maximum dose to the small bowel [cGy];and the maximum dose to the large bowel [cGy]. The regression coefficients were -0.065, -0.125, -0.180, -10.22, and -9.831, respectively. We evaluated the impacts of such variation on organ doses. These may be helpful when checking a patient’s bladder volume before daily IMRT for localized prostate cancer.

Selection of appropriate organic additives for enhancing Zn and Cd phytoextraction by hyperaccumulators

Chelant-enhanced phytoextraction is one of the most promising technologies to remove heavy metals from soil. The key of the technology is to choose suitable additives in combination with a suitable plant. In the present study, laboratory batch experiment of metal solubilization, cress seeds germination were undertaken to investigate the metal-mobilizing capability and the phytotoxicity of organic additives, including ethylene diamine triacetic acid （EDTA）, citric acid, acetic acid, oxalic acid, glutamine and monosodium glutamate waste liquid （MGWL） from food industry. Experiments in pots were carried out to study the effects of the additives on Zn and Cd phytoextraction. Furthermore, a leaching experiment with lysimeter was performed to evaluate the environmental risks of additive-induced leaching to underground water. The results showed that EDTA had a strong mobilizing ability for Zn and Cd, followed by mixed reagent （MR） and MGWL. MGWL and acetic acid at 5 mmol equivalent per liter resulted in seed germination index less than 2%. Experiments in pots verified the phytotoxicity of acetic acid and MGWL. Addition of the mixed reagent at 6--10 mmol/kg significantly increased Zn phytoextraction by Thlaspi caerulescens. The same for EDTA and the mixed reagent at 10 mmol/kg by Sedum dfredii. But only mixed reagents could significantly increase Cd phytoextraction by the studied hyperaccumulators. This suggested that the strong chelant was not always the good agent to enhance phytoextraction. S. alfredii combined with 2--10 mmol/kg soil MR was preferred for phytoremediation of Cd/Zn contaminated soils in southern China, this could result in high phytoextraction of Cd/Zn and reduce the leaching risk to underground water than EDTA assisted phytoextration.

Potential risks of organic contaminated soil after persulfate remediation:Harmful gaseous sulfur release

Persulfate is considered a convenient and efficient remediation agent for organic contaminated soil.However,the potential risk of sulfur into the soil remediation by persulfate remains ignored.In this study,glass bottles with different persulfate dosages and groundwater tables were set up to simulate persulfate remediation of organic pollutants(aniline).The results found sulfate to be the main end-product(83.0%–99.5%)of persulfate remediation after10 days.Moreover,H_(2)S accounted for 93.4%–99.4%of sulfur reduction end-products,suggesting that H_(2)S was the final fate of sulfur.H_(2)S was released rapidly after one to three days at a maximum concentration of 33.0 ppm,which is sufficient to make a person uncomfortable.According to the fitted curve results,H_(2)S concentration decreased to a safe concentration(0.15 ppm)after 20–85 days.Meanwhile,the maximum concentration of methanethiol reached 0.6 ppm.These results indicated that secondary pollution from persulfate remediation could release harmful gases over a long time.Therefore,persulfate should be used more carefully as a remediation agent for soil contamination.

Emerging Organic Contaminants in Chinese Surface Water:Identification of Priority Pollutants

The occurrence and impacts of emerging organic contaminants(EOCs)in the aquatic environment have gained widespread attention over the past two decades.Due to large number of potential contaminants,monitoring campaigns,treatment plants,and proposed regulations should preferentially focus on specific pollutants with the highest potential for ecological and human health effects.In the present study,a multi-criteria screening approach based on hazard and exposure potentials was developed for prioritization of 405 unregulated EOCs already present in Chinese surface water.Hazard potential,exposure potential,and risk quotients for ecological and human health effects were quantitatively analyzed and used to screen contaminants.The hazard potential was defined by contaminant persistence,bioaccumulation,ecotoxicity,and human health effects;similarly,the exposure potential was a function of contaminant concentration and detection frequency.In total,123 compounds passed the preselection process,which involved a priority index equal to the normalized hazard potential multiplied by the normalized exposure potential.Based on the prioritization scheme,11 compounds were identified as top-priority,and 37 chemicals were defined as high-priority.The results obtained by the priority index were compared with four other prioritization schemes based on exposure potential,hazard potential,or risk quotients for ecological effects or human health.The priority index effectively captured and integrated the results from the more simplistic prioritization schemes.Based on identified data gaps,four uncertainty categories were classified to recommend:①regular monitoring,derivation of environmental quality standards,and development of control strategies;②increased monitoring;③fortified hazard assessment;and④increased efforts to collect occurrence and toxicity data.Overall,20 pollutants were recommended as priority EOCs.The prioritized list of contaminants provides the necessary information for authoritative regulations to monitor,control,evaluate,and manage the risks of environmentally-relevant EOCs in Chinese surface water.