Spatial cluster mapping and environmental modeling in pediatric inflammatory bowel disease

BACKGROUND Geographical(geospatial)clusters have been observed in inflammatory bowel disease(IBD)incidence and linked to environmental determinants of disease,but pediatric spatial patterns in North America are unknown.We hypothesized that we would identify geospatial clusters in the pediatric IBD(PIBD)population of British Columbia(BC),Canada and associate incidence with ethnicity and environmental exposures.AIM To identify PIBD clusters and model how spatial patterns are associated with population ethnicity and environmental exposures.METHODS One thousand one hundred eighty-three patients were included from a BC Children’s Hospital clinical registry who met the criteria of diagnosis with IBD≤age 16.9 from 2001–2016 with a valid postal code on file.A spatial cluster detection routine was used to identify areas with similar incidence.An ecological analysis employed Poisson rate models of IBD,Crohn’s disease(CD),and ulcerative colitis(UC)cases as functions of areal population ethnicity,rurality,average family size and income,average population exposure to green space,air pollution,and vitamin-D weighted ultraviolet light from the Canadian Environmental Health Research Consortium,and pesticide applications.RESULTS Hot spots(high incidence)were identified in Metro Vancouver(IBD,CD,UC),southern Okanagan regions(IBD,CD),and Vancouver Island(CD).Cold spots(low incidence)were identified in Southeastern BC(IBD,CD,UC),Northern BC(IBD,CD),and on BC’s coast(UC).No high incidence hot spots were detected in the densest urban areas.Modeling results were represented as incidence rate ratios(IRR)with 95%CI.Novel risk factors for PIBD included fine particulate matter(PM2.5)pollution(IRR=1.294,CI=1.113-1.507,P<0.001)and agricultural application of petroleum oil to orchards and grapes(IRR=1.135,CI=1.007-1.270,P=0.033).South Asian population(IRR=1.020,CI=1.011-1.028,P<0.001)was a risk factor and Indigenous population(IRR=0.956,CI=0.941-0.971,P<0.001),family size(IRR=0.467,CI=0.268-0.816,P=0.007),and summer ultraviolet(IBD=0.9993,CI=0.9990–0.9996,P<0.001)were protective factors as previously established.Novel risk factors for CD,as for PIBD,included:PM2.5 air pollution(IRR=1.230,CI=1.056-1.435,P=0.008)and agricultural petroleum oil(IRR=1.159,CI=1.002-1.326,P=0.038).Indigenous population(IRR=0.923,CI=0.895–0.951,P<0.001),as previously established,was a protective factor.For UC,rural population(UC IRR=0.990,CI=0.983-0.996,P=0.004)was a protective factor and South Asian population(IRR=1.054,CI=1.030–1.079,P<0.001)a risk factor as previously established.CONCLUSION PIBD spatial clusters were identified and associated with known and novel environmental determinants.The identification of agricultural pesticides and PM2.5 air pollution needs further study to validate these observations.

Correlation between Combined Urinary Metal Exposure and Grip Strength under Three Statistical Models:A Cross-sectional Study in Rural Guangxi

Objective This study aimed to investigate the potential relationship between urinary metals copper(Cu),arsenic(As),strontium(Sr),barium(Ba),iron(Fe),lead(Pb)and manganese(Mn)and grip strength.Methods We used linear regression models,quantile g-computation and Bayesian kernel machine regression(BKMR)to assess the relationship between metals and grip strength.Results In the multimetal linear regression,Cu(β=−2.119),As(β=−1.318),Sr(β=−2.480),Ba(β=0.781),Fe(β=1.130)and Mn(β=−0.404)were significantly correlated with grip strength(P<0.05).The results of the quantile g-computation showed that the risk of occurrence of grip strength reduction was−1.007(95%confidence interval:−1.362,−0.652;P<0.001)when each quartile of the mixture of the seven metals was increased.Bayesian kernel function regression model analysis showed that mixtures of the seven metals had a negative overall effect on grip strength,with Cu,As and Sr being negatively associated with grip strength levels.In the total population,potential interactions were observed between As and Mn and between Cu and Mn(P_(interactions) of 0.003 and 0.018,respectively).Conclusion In summary,this study suggests that combined exposure to metal mixtures is negatively associated with grip strength.Cu,Sr and As were negatively correlated with grip strength levels,and there were potential interactions between As and Mn and between Cu and Mn.

Long-term Di-(2-ethylhexyl) phthalate Exposure Disturbs the Lipid Metabolism Profiles and Hepatic Enzymes in Male Rats:A UPLC-MS-based Serum Metabolomics Analysis

In recent years,many investigations have indicated that environmental endocrine disruptors(EEDs)may accelerate the development of obesity[1].One kind of EEDs,di-(2-ethylhexyl)phthalate(DEHP),is ubiquitous in natural environments due to its role in the manufacture and use of plastic products[2].

Epidemiology of esophageal cancer

Esophageal cancer(EsC)is one of the least studied and deadliest cancers worldwide because of its extremely aggressive nature and poor survival rate.It ranks sixth among all cancers in mortality.In retrospective studies of EsC,smoking,hot tea drinking,red meat consumption,poor oral health,low intake of fresh fruit and vegetables,and low socioeconomic status have been associated with a higher risk of esophageal squamous cell carcinoma.Barrett’s esophagus is clearly recognized as a risk factor for EsC,and dysplasia remains the only factor useful for identifying patients at increased risk,for the development of esophageal adenocarcinoma in clinical practice.Here,we investigated the epidemiologic patterns and causes of EsC.Using population based cancer data from the Surveillance,Epidemiology and End Results Program of the United States;we generated the most up-to-date stage distribution and 5-year relative survival by stage at diagnosis for 1998-2009.Special note should be given to the fact that esophageal cancer,mainly adenocarcinoma,is one of the very few cancers that is contributing to increasing death rates(20%)among males in the United States.To further explore the mechanism of development of EsC will hopefully decrease the incidence of EsC and improve outcomes.

Urine Metabonomic Analysis of Interventions Effect of Soy Isoflavones on Rats Exposed to Di-(2-ethylhexyl) Phthalate

Objective Di-(2-ethylhexyl) phthalate(DEHP) is a ubiquitous environmental contaminant.As an endocrine disruptor,it seriously threatens human health and ecological environmental safety.This study examines the impact of intervention with soybean isoflavones(SIF) on DEHP-induced toxicity using a metabonomics approach.Methods Rats were randomly divided into control(H),SIF-treated(A,86 mg/kg body weight),DEHP-treated(B,68 mg/kg),and SIF plus DEHP-treated(D) groups.Rats were given SIF and DEHP daily through diet and gavage,respectively.After 30 d of treatment,rat urine was tested using UPLC/MS with multivariate analysis.Metabolic changes were also evaluated using biochemical assays.Results Metabolomics analyses revealed that p-cresol glucuronide,methyl hippuric acid,N1-methyl-2-pyridone-5-carboxamide,lysophosphatidycholine [18:2(9 Z,12 Z)] {lyso PC [18:2(9 Z,12 Z)]},lyso PC(16:0),xanthosine,undecanedioic acid,and N6-acetyl-l-lysine were present at significantly different levels in control and treatment groups.Conclusion SIF supplementation partially protects rats from DEHP-induced metabolic abnormalities by regulating fatty acid metabolism,antioxidant defense system,amino acid metabolism,and is also involved in the protection of mitochondria.

Contamination of Prohibited Substances in Various Food Products in Guangzhou, China

The use of antibiotics to maintain animal health has widely been practiced,for both therapeutic and prophylactic purposes.Along with the identification of serious adverse effects of some antibiotics on human and domestic animals[1],chloramphenicol.

The burden of disease on HIV-infected orphaned and non-orphaned children accessing primary health facilities in a rural district with poor resources in South Africa: a cross-sectional survey of primary caregivers of HIV-infected children aged 5–18 years

Background:Provider-initiated HIV testing and counseling(PITC)is offered as part of the normal standard of care to increase access to treatment for HIV-infected children.In practice,HIV diagnosis occurs in late childhood following recurrent and chronic infections.We investigated primary caregivers’reported reasons for seeking HIV testing for children aged 5–18 years,determined the orphan status of the children,and compared the clinical profile and disease burden of orphans and non-orphans.Methods:This was a cross-sectional survey of primary caregivers of HIV-infected children accessing antiretroviral treatment(ART)from two community hospitals and 34 primary healthcare facilities in a rural district in Mpumalanga province,South Africa.Results:The sample consisted of 406 primary caregivers:319(78.6%)brought the child to the health facility for HIV testing because of chronic and recurrent infections.Almost half(n=183,45.1%)of the children were maternal orphans,128(31.5%)were paternal orphans,and 73(39.9%)were double orphans.A univariate analysis showed that maternal orphans were significantly more likely to be older(OR=2.57,p=0.000,CI:1.71–3.84),diagnosed late(OR=2.48,p=0.009,CI:1.26–4.88),and to start ART later(OR=2.5,p=0.007,CI:1.28–4.89)than non-orphans.There was a high burden of infection among the children prior to HIV diagnosis;274(69.4%)presented with multiple infections.Multiple logistic regression showed that ART start age(aOR=1.19,p=0.000,CI:1.10–1.29)and time on ART(aOR=2.30,p=0.000,CI:1.45–3.64)were significantly associated with orphanhood status.Half(n=203,(50.2%)of the children were admitted to hospital prior to start of ART,and hospitalization was associated with multiple infections(OR=1.27,p=0.004,CI:1.07–1.51).Conclusions:The study found late presentation with undiagnosed perinatal HIV infection and high prevalence of orphanhood among the children.The health of maternal orphans was more compromised than non-orphans.Routine PICT should be strengthened to increase community awareness about undiagnosed HIV among older children and to encourage primary caregivers to accept HIV testing for children.

Disclosure, Multiple Sex Partners, and Consistent Condom Use among HIV Positive Adults on Antiretroviral Therapy in Johannesburg, South Africa

Inconsistent condom use among persons on antiretroviral treatment (ART) is a major public health concern because of the risk of HIV transmission. This study examined the association between socio-demographic variables and knowing partners’ HIV status, multiple sex partners, and consistent condom use among 400 HIV-infected adults who had received ART for at least six months in Johannesburg, South Africa. The study used a cross-sectional survey and a structured interviewer administered questionnaire. Over half (n = 225, 56.3%) of participants were on ART for more than two years. Two thirds (n = 234, 63.2%) were aware of partner’s HIV status. Over a third (n = 136, 34.0%) reported having more than one sex partners. Three quarters (n = 279, 75.8%) reported consistent condom use with regular partner. Discussing HIV testing (aOR = 2.28, CI: 1.31 -3.95), awareness of partner’s HIV status (aOR = 2.59, CI: 1.50 -4.46), level of education (aOR = 0.64, CI: 0.42 -0.98), and duration on ART (aOR = 0.71, CI: 1.31 -3.95) were predictors for consistent condom use. Awareness of partner’s HIV status was associated with multiple partnership (aOR = 0.38, CI: 0.21 -0.66), living with partner (aOR = 4.75, CI: 2.86 -7.91), discussing HIV testing (aOR = 2.43, CI: 1.48 -3.99), and duration on ART (aOR = 2.04, CI: 1.43 -2.92). While gender (aOR = 5.68, CI: 3.46 -9.34), marital status (aOR = 0.44, CI: 0.25 -0.77), and awareness of partner’s HIV status (aOR = 0.52, CI: 0.30 -0.89) were associated with multiple partnerships. Risky sexual behaviours occurred in all types of partners and knowing partner’s HIV status was a predictor for consistent condom use with all types of partners. It is essential that HIV prevention strategies create an enabling environment for disclosure and reductions of risky sexual behaviours by HIV-infected persons on ART.

Estimation of reproduction numbers of COVID-19 in typical countries and epidemic trends under different prevention and control scenarios

The coronavirus disease 2019(COVID-19)has become a life-threatening pandemic.The epidemic trends in different countries vary considerably due to different policy-making and resources mobilization.We calculated basic reproduction number(R0)and the time-varying estimate of the effective reproductive number(Rt)of COVID-19 by using the maximum likelihood method and the sequential Bayesian method,respectively.European and North American countries possessed higher (R0)and unsteady Rt fluctuations,whereas some heavily affected Asian countries showed relatively low (R0)and declining Rt now.The numbers of patients in Africa and Latin America are still low,but the potential risk of huge outbreaks cannot be ignored.Three scenarios were then simulated,generating distinct outcomes by using SEIR(susceptible,exposed,infectious,and removed)model.First,evidence-based prompt responses yield lower transmission rate followed by decreasing Rt.Second,implementation of effective control policies at a relatively late stage,in spite of huge casualties at early phase,can still achieve containment and mitigation.Third,wisely taking advantage of the time-window for developing countries in Africa and Latin America to adopt adequate measures can save more people’s life.Our mathematical modeling provides evidence for international communities to develop sound design of containment and mitigation policies for COVID-19.

Elimination of antibiotic resistance genes and control of horizontal transfer risk by UV-based treatment of drinking water: A mini review

Antibiotic-resistant bacteria (ARB) and antibiotic resistance genes (ARGs) have been recognized as one of the biggest public health issues of the 21 st century. Both ARB and ARGs have been determined in water after treatment with conventional disinfectants. Ultraviolet (UV) technology has been seen growth in application to disinfect the water. However, UV method alone is not adequate to degrade ARGs in water. Researchers are investigating the combination of UV with other oxidants (chlorine, hydrogen peroxide (H2O2), peroxymonosulfate (PMS), and photocatalysts) to harness the high reactivity of produced reactive species (C1-, C1O -, Cl2-,-OH, and SO4-_) in such processes with constituents of cell (e.g., deoxyribonucleic acid (DNA) and its components) in order to increase the degradation efficiency of ARGs. This paper briefly reviews the current status of different UV-based treatments (UV/chlorination, UV/H2O2, UV/PMS, and UV-photocatalysis) to degrade ARGs and to control horizontal gene transfer (HGT) in water. The review also provides discussion on the mechanism of degradation of ARGs and application of q-PCR and gel electrophoresis to obtain insights of the fate of ARGs during UV-based treatment processes.

Phase-and epidemic region-adjusted estimation of the number of coronavirus disease 2019 cases in China

The outbreak of the coronavirus disease 2019 in China was first reported in Wuhan in December 2019 and gradually spread to other areas in China.After implementation of prevention and control measures,the estimation of the epidemic trend is needed.A phase-and region-adjusted SEIR model was applied for modeling and predicting the number of cases in Wuhan,Hubei Province and regions outside Hubei Province in China.The estimated number of infections could reach its peak in late February 2020 in Wuhan and Hubei Province,which is 55303–84520 and 83944–129312,respectively,while the epidemic peaks in regions outside Hubei Province in China could appear on February 13,2020 with the estimated 13035–19108 cases.According to the estimation,the outbreak would abate in March and April all over China.Current estimation provided evidence for planned work resumption under stringent prevention and control in China to further support the fight against the epidemic.Nevertheless,there is still possibility of the second outbreak brought by the work resumption and population migration,especially from Hubei Province and high intensity cities outside Hubei Province.Strict prevention and control measures still need to be considered in the regions with high intensity of epidemic and densely-populated cities.

Decreased bioavailability of aminomethylphosphonic acid(AMPA)in genetically modified corn with activated carbon or calcium montmorillonite clay inclusion in soil

The widespread use of pesticides has resulted in detectable residues throughout the environment,sometimes at concentrations well above regulatory limits.Therefore,the development of safe,effective,field-practical,and economically feasible strategies to mitigate the effects of pesticides is warranted.Glyphosate is an organophosphorus herbicide that is degraded to aminomethylphosphonic acid(AMPA),a toxic and persistent metabolite that can accumulate in soil and sediment and translocate to plants.In this study,we investigated the binding efficacy of activated carbon(AC)and calcium montmorillonite(CM)clay to decrease AMPA bioavailability from soil and AMPA translocation to plants.Adsorption isotherms and thermodynamic studies on AC and CM were conducted and showed tight binding(enthalpy values>-20 k J/mol)for AMPA with high capacities(0.25 mol/kg and 0.38 mol/kg,respectively),based on derivations from the Langmuir model.A hydra assay was utilized to indicate toxicity of AMPA and the inclusion of 1%AC and CM both resulted in 90%protection of the hydra(**p≤0.01).Further studies in glyphosate-contaminated soil showed that AC and CM significantly reduced AMPA bioavailability by 53%and 44%,respectively.Results in genetically modified(GM)corn showed a conversion of glyphosate to AMPA in roots and sprouts over a 10-day exposure duration.Inclusion of AC and CM reduced AMPA residues in roots and sprouts by 47%-61%.These studies collectively indicate that AC and CM are effective sorbents for AMPA and could be used to reduce AMPA bioavailability from soil and AMPA residues in GM corn plants.

Improved estimation of PM_(2.5) brown carbon contributions to filter light attenuation

Multiwavelength light attenuation measurements have been acquired as part of thermal/optical carbon analysis in the U.S.Chemical Speciation Network(CSN)and the Interagency Monitoring of PROtected Visual Environments(IMPROVE)network beginning in 2016.These are used to estimate PM_(2.5)brown carbon(BrC)contributions to light absorption at various wavelengths,a useful method for separating biomass burning contributions from other sources.Attenuation of light transmitted through the filter deviates from Beers Law as the mass of light absorbing materials increase.This study estimates the effects of these deviations with empirical adjustment factors applied to samples for CSN from 2016 to 2017 and for IMPROVE from 2016 to 2019.Accounting for the filter loading effect results in an annual average increase of∼6-7%BrC contribution to light attenuation:from 3.6%to 10.7%for the urban,more heavily loaded CSN samples;and from 23.7%to 29.5%for the non-urban IMPROVE samples.An alternative method is examined for BrC and black carbon(BC)adjustments by calculating the AbsorptionÅngström Exponent(AAE)for BC(i.e.,AAE_(BC))based on the ratios of 635 nm/780 nm light attenuation rather than assuming AAE_(BC)of unity.These paired-wavelength calculations result in a median AAE_(BC)of 0.76 for CSN and 0.8 for IMPROVE,with the majority of samples(i.e.,91%of CSN and 70%of IMPROVE)showing AAE_(BC)<1.By assuming negligible contributions from BrC to AAE at longer wavelengths,the amount of light attenuation at shorter wavelengths(e.g.,405 nm)where BrC is dominant can be calculated.The paired-wavelength method applied to the filter loading adjusted data has a greater effect on urban(fresh)than on non-urban(aged)aerosols,resulting in a factor of two increase in annual averaged BrC light attenuation(from 10.7%to 21.6%)for CSN and by a factor of 1.11(from 29.5%to 32.7%)for IMPROVE samples.This result demonstrates the importance of particle loading and AAE correction on quantifying BrC light attenuation from multi-wavelength thermal/optical analysis.

Risk Factors for Adverse Pregnancy Outcomes among Zhuang Ethnic Pregnant Women:A Cohort Study in Guangxi,China

Risk factors for adverse pregnancy outcomes among Zhuang ethnic pregnant women are unclear.This study analyzed the incidence and risk factors related to preterm birth(PB),low birth weight(LBW)and macrosomia in Zhuang population.We conducted a prospective cohort study of 9965 Zhuang pregnancy women in Guangxi,China.Information on mothers and newborns was obtained by using questionnaires and referring to medical records.Multivariate logistic regression analyses were used to evaluate the association between related factors and adverse pregnancy outcomes.Our results showed that the incidence of PB,LBW and macrosomia in Zhuang people was 5.55%,5.64%and 2.19%,respectively.Maternal age≥36 years(OR=2.22,95%CI:1.51-3.27)was related to a higher incidence of PB.Those with pre-pregnancy body mass index(BMI)<18.5 kg/㎡(OR-1.91,95%CI:1.45--2.51),and had a female fetus(OR=1.74,95%CI:1.36-2.23)were more likely to have LBW infants.Maternal age between 31 and 35 years(OR=1.76,95%CI:1.03-2.99)and pre-pregnancy overweight or obesity(OR=1.79,95% CI:1.15-2.80)were associated with a higher risk of macrosomia.The protective factors of macrosomia were maternal pre-pregnancy BMI<18.5 kg/㎡(OR=0.30,95% CI:0.15-0.60)and female fetus(OR=0.41,95% CI:0.28-0.59).Our study provided a reference for maternal and childcare administration among Zhuang population.

Diesel engine exhaust exposures in two underground mines

Exposure to diesel engine exhaust(DE) is a major concern in underground mines. It has been linked to cardiopulmonary diseases and is classified as a human carcinogen. The goal of this study is to assess DE exposures in workers at two underground gold mines, to compare exposure levels within and between the mines, and to compare different methods of measuring DE exposures, namely respirable combustible dust(RCD), elemental carbon(EC) and total carbon(TC). Ambient and personal breathing zone(PBZ) measurements were taken. Side-by-side monitoring of RCD and of the respirable fraction of EC and TC(EC_Rand TC_R) was carried out in the workers' breathing zone during full-shift work.Regarding ambient measurements, in addition to EC_R, TC_Rand RCD, a submicron aerosol fraction(less than 1 mm) of EC and TC was also sampled(EC_1and TC_1). Average ambient results of 240 mg/m^3 in RCD, 150 mg/m^3 in EC_Rand 210 mg/m^3 in TC_Rare obtained. Average PBZ results of 190 mg/m^3 in RCD,84 mg/m^3 in EC3Rand 150 mg/min TC_Rare obtained. Very good correlation is found between EC_Rand EC_1 with a Pearson correlation coefficient of 0.99(p < 0.01) calculated between the two logtransformed concentrations. No differences are reported between EC_Rand EC_1, nor between TC_Rand TC_1, since ratios are equal to 1.04, close to 1, in both cases. Highest exposures are reported for loadhaul-dump(LHD) and jumbo drill operators and conventional miners. Significant exposure differences are reported between mines for truck and LHD operators(p < 0.01). The average TC_R/EC_Rratio is 1.6 for PBZ results, and 1.3 for ambient results. The variability observed in the TC_R/EC_Rratio shows that interferences from non-diesel related organic carbon can skew the interpretation of results when relying only on TC data.

Concentrations of disinfection by-products in swimming pool following modifications of the water treatment process:An exploratory study

The formation and concentration of disinfection by-products（DBPs） in pool water and the ambient air vary according to the type of water treatment process used. This exploratory study was aimed at investigating the short-term impact of modifications of the water treatment process on traditional DBP levels（e.g., trihalomethanes（THMs）, chloramines） and emerging DBPs（e.g., Halonitromethanes, Haloketones, NDMA） in swimming pool water and/or air. A sampling program was carried to understand the impact of the following changes made successively to the standard water treatment process： activation of ultraviolet（UV）photoreactor, halt of air stripping with continuation of air extraction from the buffer tank,halt of air stripping and suppression of air extraction from the buffer tank, suppression of the polyaluminium silicate sulfate（PASS） coagulant. UV caused a high increase of Halonitromethanes（8.4 fold）, Haloketones（2.1 fold）, and THMs in the water（1.7 fold） and, of THMs in the air（1.6 fold） and contributed to reducing the level of chloramines in the air（1.6fold） and NDMA in the water（2.1 fold）. The results highlight the positive impact of air stripping in reducing volatile contaminants. The PASS did not change the presence of DBPs, except for the THMs, which decrease slightly with the use of this coagulant. This study shows that modifications affecting the water treatment process can rapidly produce important and variable impacts on DBP levels in water and air and suggests that implementation of any water treatment process to reduce DBP levels should take into account the specific context of each swimming pool.

COVID-19 containment: China provides important lessons for global response

The world must act fast to contain wider international spread of the epidemic of COVID-19 now.The unprecedented public health efforts in China have contained the spread of this new virus.Measures taken in China are currently proven to reduce human-to-human transmission successfully.We summarized the effective intervention and prevention measures in the fields of public health response,clinical management,and research development in China,which may provide vital lessons for the global response.It is really important to take collaborative actions now to save more lives from the pandemic of COVID-19.