康复运动对冠脉支架植入术后患者相关因素的影响

目的：研究心脏康复运动对冠脉支架植入术后患者血脂、血糖、体重指数及生活质量的影响。方法：对实施冠脉支架植入术的 146例患者进行比较分析，根据随机原则分为试验组76 例及对照组70 例。对照组患者给予常规的健康教育及冠心病二级预防指 导，给予定期随访。试验组患者在此基础上给予规律的康复运动指导。经过6 个月随访，比较两组患者血脂、HbA1C、体重指数及 生活质量情况。结果：试验组患者通过为期6 个月的规律的心脏康复运动指导，其血脂、HbA1C等冠心病危险因素控制情况优于 对照组，差异有统计学意义(P<0.05)。同时，6个月后，试验组康复运动六月后sF 量表各项评分与对照组同期比较，差异均有统计 学意义(P<0.05)。结论：规范的心脏康复运动指导能够有效改善冠脉支架植入术后患者血脂、血糖情况，提高患者生活质量。     

Analysis and assessment of heavy metals pollution in soils around a Pb and Zn smelter in Baoji City,Northwest China

Soil heavy metal pollution from mining activities is potentially harmful to human health through the food chain. In this study, a total of 43 soil samples were collected from a depth of 0–20 cm from fields close to a Pb and Zn smelter. The samples were used to: 1) analyze the pollution level of heavy metals (Pb, Zn, Cr, and Cu) and spatial distribution pattern; 2) evaluate the degree of accumulation and enrichment, potential ecological risk, and human health risk; and 3) perform source apportionment in Fengxiang County, Shaanxi Province of China. The results showed that the concentration ranged from 43.67 to 189.55, 131.43 to 239.53, 74.77 to 112.25, and 24.69 to 37.71 mg·kg^?1 for Pb, Zn, Cr, and Cu, respectively, and the mean concentration for Pb, Zn, Cr, and Cu was 129.46, 192.85, 91.98 and 31.67 mg·kg^?1, respectively. The concentrations were greater than the Shaanxi Province background values, while they were lower than the second-level limits of Environmental Quality Standard for Soils of China (EQSS). The spatial distribution of heavy metal contents showed a banded in soil except Cu. The spatial distribution pattern and pollution assessment indexes (I_geo, EF) indicated that the investigated metals had been accumulated in the study areas, and implied significant influences from anthropogenic activities, local meteorological situation, and soil properties. The ecological risk assessment showed that the risks were relatively low (RI<150). Compared with the exposure risk for adults, that for children was significantly greater. The ingestion of heavy metals in the soils by humans was the main exposure pathway compared with the dermal exposure. There may be a risk of noncarcinogenic adverse health effects (HQ < 1, 0.377 ≤ HI≤1.553) on children, but the adults were unlikely to experience obvious adverse health effects (HQ < 1, HI < 1). The carcinogenic risk of Cr for adults and children was at an unacceptable level. The carcinogenic and noncarcinogenic risks were in the order of children > adults. The correlation analysis showed that Pb, Cr, and Cu have identical anthropogenic and natural sources, while Zn has another identical source. This study could provide a basis for the sustainable management of this region by reducing metal inputs and to protect soils from long-term heavy metal accumulation.     

Concomitant Information in Competing Risk Analysis

A competing risk model, accommodating both Type I censoring and random withdrawals, is expanded to incorporate concomitant information by allowing the parameters of the underlying distributions to be a linear function of two covariates. The model is developed for two competing risks, one following a Weibull distribution and the other a Rayleigh distribution, and random withdrawals following a Weibull distribution. A method is developed for testing the equality of the coefficients for a given covariate for each of the competing risks using MLE'.     

Health risk assessment via consumption of Pb and Cd contaminated vegetables collected from fresh markets in the lower north of Thailand

This study aimed to investigate the Pb and Cd contamination and health risk assessment for population via consumption of vegetables sold in fresh markets around the lower north of Thailand. The concentrations of Pb and Cd in various vegetables such as root/tuber, stem, inflorescence, fruit, and leaf vegetables were analyzed using an atomic absorption spec-trophotometer. Human health risks of these metals in vegetables were assessed based on target hazard quotient (THQ). The results indicated that more than 80% of the Pb and Cd in almost all vegetable samples exceeded the maximum allowable concentration by National Food Institute criteria with an average range of 0.96–3.39 and 0.48–1.40 mg/kg, respectively. The estimated daily intakes (EDI) of Pb and Cd via dietary consumption of vegetables were between 0.001–0.010 and 0.002–0.008 mg/kg/d, respectively. All EDIs of Pb contaminated vegetables were higher than the reference dose recommended by the USEPA except for leaf edible vegetables, while all EDIs of Cd contaminated vegetables were higher than the reference dose recommended by the USEPA. THQ indicated that the consumption of Pb contaminated root/tuber, stem, inflorescence, and fruit edible vegetables and Cd contaminated leaf vegetable for the local population in the lower north of Thailand could be a severe health risk problem.     

Planktonic indices in the evaluation of the ecological status and the trophic state of the longest lake in Poland

Due to the intensive mixing polymictic lakes should be homogenous. However, morphometric diversity and high water dynamics contribute to the differentiation of many parameters in various areas of the lakes. This study analyzes both phytoplankton and zooplankton to assess differences in water quality along the north–south axis of the longest lake in Poland. New phytoplankton indicators were applied for determining the lake's ecological status: the Q index based on functional groups and the PMPL (Phytoplankton Metric for Polish Lakes) index based on phytoplankton biomass. TSI_ROT index (Rotifer Trophic State Index), which comprises the percentage of species indicating a high trophic state in the indicatory group and the percentage of bacteriovorus in the Rotifera population, was used for zooplankton analysis.TP content was different at different sites – we observed its gradual increase from the south to the north. Spatial variation of phosphorus did not considerably affect plankton diversity. The phytoplankton was dominated by Oscillatoriales, typical of shallow, well-mixed eutrophic lakes. The ecological status of the lake based on the EQR (Ecological Quality Ratio) was poor or moderate. The zooplankton was dominated by rotifers (at almost all sites), which indicates a eutrophic state of the lake. The values of phytoplankton indices at the studied sites did not differ considerably; the differences resulted more from local conditions such as the contaminant inflow and the macrophyte development than water dynamics.We have demonstrated that in the lake dominated by filamentous Cyanobacteria the ecological status should be determined according to the PMPL index or other indices dependent on the dominant Cyanobacteria species. Since the Q index does not include the functional group S1, the results can lead to the false conclusion that water quality improves with an increased amount of phytoplankton. The high abundance of Cyanobacteria in the lake may have contributed to the poor growth of rotifers.     

What Are the Health Risks of Eating Red Meat,and How Should We Assess Them?

This paper discusses possible mechanisms that might lead to misinterpretations of collected data and makes new evidence-based medicine (EBM) recommendations to oppose the previously accepted preventive measures, or treatment options. It is focused on the danger of the “red meat” consumption, and the question whether eating pungent food is good or bad for our health and finally whether the “bad luck” concept of getting several cancer types is valid or not. These three topics got and still have significant media attention. Several mechanisms are proposed as possible causes of these apparent conflicts. Some of them have already been recognized but sadly remained less known to medical readers and also to the general population. Also see the video abstract here https://youtu.be/owjoRXrNShA .     

The use of ecological integrity indicators within the natural capital index framework: The ecological and economic value of the remnant natural capital of México

In this paper, the ecological integrity hierarchy framework (EIHF) and the natural capital index framework (NCI) are integrated as decision-making tools for evaluating the natural capital of Mexico. Two hierarchy-levels of ecological integrity indicators are used to estimate the quality and quantity of the natural capital, the amount of ecological degradation and ecological sustainability. After human transformation, the extent still considered as “natural” in the country is ∼67%; while the amount of human transformed areas is ∼33%, which gives a total estimate of NCI = 0.334; i.e., only ∼33.4% of the national capital remains available, while ∼33% is ecologically degraded. Furthermore, the critical natural capital; i.e., the legacy for future generations that remains in the country is only ∼12%. The total estimated value of the current natural capital in Mexico is ∼$457.1 billion/yr, which is ∼435 times greater than the national GDP ($1.051 billion in 2010). The cost of maintaining the degradation of the natural capital is ∼$144.6 billion/yr (∼138 times greater than national GDP in 2010). The potential value of the natural capital after restoration would be ∼$602 billion/yr. Valuing the natural capital can be helpful for strategic environmental evaluations and useful for spatial decision support systems that evaluate natural capital as a decision-making tool.     

Bisphenol A and Risk Management Ethics

It is widely recognized that endocrine disrupting compounds, such as Bisphenol A, pose challenges for traditional paradigms in toxicology, insofar as these substances appear to have a wider range of low‐dose effects than previously recognized. These compounds also pose challenges for ethics and policymaking. When a chemical does not have significant low‐dose effects, regulators can allow it to be introduced into commerce or the environment, provided that procedures and rules are in place to keep exposures below an acceptable level. This option allows society to maximize the benefits from the use of the chemical while minimizing risks to human health or the environment, and it represents a compromise between competing values. When it is not possible to establish acceptable exposure levels for chemicals that pose significant health or environmental risks, the most reasonable options for risk management may be to enact either partial or complete bans on their use. These options create greater moral conflict than other risk management strategies, leaving policymakers difficult choices between competing values.