Arsenic in groundwater and its health risk assessment in drinking water of Mailsi,Punjab, Pakistan

The present study was aimed at assessing drinking water quality regarding arsenic (As) and its impact on health from Mailsi (Punjab), Pakistan. Forty-four groundwater samples were collected from two sites, Sargana and Mailsi. Arsenic and other cations were determined by atomic absorption spectrophotometer, whereas the anions were determined either through titration or spectrophotometer. The results revealed that dominant anions were HCO₃^? and Cl^?, Ca⁺² was the dominant cation, and overall water chemistry of the area was CaMgHCO₃^? type. Arsenic concentrations were high, ranging from 11 to 828 µg/L that crossed the World Health Organization permissible limits. Likewise, higher SO₄^?2 concentrations ranging from 247 to 1053 mg/L were observed. The health risk index was higher in the Sargana site, which employed the differences in terms of higher Average Daily Dose, Hazard Quotient, and Carcinogenic Risk of arsenic, which is unsuitable for drinking purposes. The area seems to be at high risk due to arsenic pollution and wells have never been tested for arsenic concentrations earlier; therefore, necessary measures should be taken to test the wells with respect to arsenic.     

Human health risks associated with heavy metals in soil in different areas of San Luis Potosí, México

The aim of this study was to develop a health risk assessment in different areas of San Luis Potosí, México. Four heavy metals (arsenic, mercury, cadmium, and lead) were analyzed in soil from communities assessed. The mean arsenic concentration was significantly higher (p < .05) in the city of San Luis Potosí (51.85 mg/kg) compared to the other assessed areas (5.52–8.43 mg/kg). For cadmium, the mean concentration was significantly higher (p < .05) in Santa Maria Picula (7.46 mg/kg) than in the other areas (3.72–4.15 mg/kg). Regarding mercury levels, a significantly higher (p < .05) mean concentration was found in Mezquitic (1.54 mg/kg) compared to other areas (0.56–0.81 mg/kg). Lastly, when comparing the mean lead concentration in the city of San Luis Potosí (108 mg/kg), it was found to be significantly lower (p < .05) than in other areas (219–227 mg/kg). Subsequently, a probabilistic health risk assessment was performed, ingestion was the major exposure pathway for all four metals. Maximum cumulative hazard index (HI) values showed higher risk in all sampled locations (HIs > 1.0), suggesting that these sites can pose a non-carcinogenic risk to the populations (children) living in those areas. This study highlights the necessity of establishing a biomonitoring program for the surveillance of the child populations living in the assessed locations.     

Toxicological evaluation of multi-class pesticide residues in vegetables and associated human health risk study for adults and children

This article describes, for the first time in 10 years, the toxicological evaluation of pesticide residues in highly consumed vegetables (35 commodities) and health risk studies. Among 1075 vegetable samples consisting mainly of tuber, root, fruiting, and Brassica, 20% of samples contained 38 pesticides in the range of 0.005–18.7 mg/kg and 1% > maximum residue limits (MRLs). Organophosphates and chloronitrile were most frequently found (20%) in the pesticide class. The highest concentration of 18.7 mg/kg was noted for dichlofluanid. Fruiting vegetables (8%), especially tomatoes (5%), were the most contaminated, while multi-residues were determined in 5% of the samples. Risk assessment was performed by analytical results and consumption on the 97.5 percentile expressed as hazard index (HI) and hazard quotient (HQ). The highest chronic HI was calculated for diazinon in lettuce (32% Acceptable Daily Intake (ADI) adults and 36% children) and for forbidden dieldrin in carrots (26%, 62% ADI). The highest acute HI was estimated for dichlofluanid in lettuce (69% Acute Reference Dose (ARfD)) for adults, whereas for children it was above the acceptance values of ARfD (168%). Organophosphate insecticides with common mode of action showed the greatest HQ (108% ADI). Vegetables may not be a serious problem for consumers, but investigations on pesticide residues are necessary to ensure food safety and the protection of human health, especially toward children who are more highly exposed to pesticides than adults.     

Health impacts from cyanobacteria harmful algae blooms: Implications for the North American Great Lakes

Harmful cyanobacterial blooms (cHABs) have significant socioeconomic and ecological costs, which impact drinking water, fisheries, agriculture, tourism, real estate, water quality, food web resilience and habitats, and contribute to anoxia and fish kills. Many of these costs are well described, but in fact are largely unmeasured. Worldwide cHABs can produce toxins (cyanotoxins), which cause acute or chronic health effects in mammals (including humans) and other organisms. There are few attempts to characterize the full health-related effects other than acute incidences, which may go unrecorded. At present these are difficult to access and evaluate and may be ascribed to other causes. Such information is fundamental to measure the full costs of cHABs and inform the need for often-costly management and remediation. This paper synthesizes information on cHABs occurrence, toxicology and health effects, and relates this to past and current conditions in the Great Lakes, a major global resource which supplies 84% of the surface water in North America. This geographic region has seen a significant resurgence of cHABs since the 1980s. In particular we focus on Lake Erie, where increased reporting of cHABs has occurred from the early 1990's. We evaluate available information and case reports of cHAB-related illness and death and show that cHABs occur throughout the basin, with reports of animal illness and death, especially dogs and livestock. Lake Erie has consistently experienced cHABs and cyanotoxins in the last decade with probable cases of human illness, while the other Great Lakes show intermittent cHABs and toxins, but no confirmed reports on illness or toxicity. The dominant toxigenic cyanobacterium is the genus Microcystis known to produce microcystins. The presence of other cyanotoxins (anatoxin-a, paralytic shellfish toxins) implicates other toxigenic cyanobacteria such as Anabaena (Dolichospermum) and Lyngbya.     

First investigations to refine video-based IR thermography as a non-invasive tool to monitor the body temperature of calves

In this study, a video-based infrared camera (IRC) was investigated as a tool to monitor the body temperature of calves. Body surface temperatures were measured contactless using videos from an IRC fixed at a certain location in the calf feeder. The body surface temperatures were analysed retrospectively at three larger areas: the head area (in front of the forehead), the body area (behind forehead) and the area of the entire animal. The rectal temperature served as a reference temperature and was measured with a digital thermometer at the corresponding time point. A total of nine calves (Holstein-Friesians, 8 to 35 weeks old) were examined. The average maximum temperatures of the area of the entire animal (mean±SD: 37.66±0.90°C) and the head area (37.64±0.86°C) were always higher than that of the body area (36.75±1.06°C). The temperatures of the head area and of the entire animal were very similar. However, the maximum temperatures as measured using IRC increased with an increase in calf rectal temperature. The maximum temperatures of each video picture for the entire visible body area of the calves appeared to be sufficient to measure the superficial body temperature. The advantage of the video-based IRC over conventional IR single-picture cameras is that more than one picture per animal can be analysed in a short period of time. This technique provides more data for analysis. Thus, this system shows potential as an indicator for continuous temperature measurements in calves.     

The impact of a knowledge translation intervention employing educational outreach and a point-of-care reminder tool vs standard lay health worker training on tuberculosis treatment completion rates: study protocol for a cluster randomized controlled trial

BackgroundDespite availability of effective treatment, tuberculosis (TB) remains an important cause of morbidity and mortality globally, with low- and middle-income countries most affected. In many such settings, including Malawi, the high burden of disease and severe shortage of skilled healthcare workers has led to task-shifting of outpatient TB care to lay health workers (LHWs). LHWs improve access to healthcare and some outcomes, including TB completion rates, but lack of training and supervision limit their impact. The goals of this study are to improve TB care provided by LHWs in Malawi by refining, implementing, and evaluating a knowledge translation strategy designed to address a recognized gap in LHWs’ TB and job-specific knowledge and, through this, to improve patient outcomes.Methods/designWe are employing a mixed-methods design that includes a pragmatic cluster randomized controlled trial and a process evaluation using qualitative methods. Trial participants will include all health centers providing TB care in four districts in the South East Zone of Malawi. The intervention employs educational outreach, a point-of-care reminder tool, and a peer support network. The primary outcome is proportion of treatment successes, defined as the total of TB patients cured or completing treatment, with outcomes taken from Ministry of Health treatment records. With an alpha of 0.05, power of 0.80, a baseline treatment success of 0.80, intraclass correlation coefficient of 0.1 based on our pilot study, and an estimated 100 clusters (health centers providing TB care), a minimum of 6 patients per cluster is required to detect a clinically significant 0.10 increase in the proportion of treatment successes. Our process evaluation will include interviews with LHWs and patients, and a document analysis of LHW training logs, quarterly peer trainer meetings, and mentorship meeting notes. An estimated 10–15 LHWs and 10–15 patients will be required to reach saturation in each of 2 planned interview periods, for a total of 40–60 interview participants.DiscussionThis study will directly inform the efforts of knowledge users within TB care and, through extension of the approach, other areas of care provided by LHWs in Malawi and other low- and middle-income countries.

Trial registration

ClinicalTrials.gov {"type":"clinical-trial","attrs":{"text":"NCT02533089","term_id":"NCT02533089"}}NCT02533089. Registered 20 August 2015. Protocol Date/Version 29 May 2016/Version 2.

Electronic supplementary material

The online version of this article (doi:10.1186/s13063-016-1563-2) contains supplementary material, which is available to authorized users.     

Lithium vs. valproate vs. olanzapine vs. quetiapine as maintenance monotherapy for bipolar disorder: a population‐based UK cohort study using electronic health records

It is unclear which maintenance treatment for bipolar disorder is superior in clinical practice. Randomized controlled head‐to‐head trials of available drugs either do not exist or are inconclusive. We aimed to compare rates of monotherapy treatment failure in individuals prescribed lithium, valproate, olanzapine or quetiapine by a population‐based cohort study using electronic health records. 5,089 patients with bipolar disorder were prescribed lithium (N=1,505), valproate (N=1,173) olanzapine (N=1,366) or quetiapine (N=1,075) as monotherapy. Treatment failure was defined as time to stopping medication or add‐on of another mood stabilizer, antipsychotic, antidepressant or benzodiazepine. In unadjusted analyses, the duration of successful monotherapy was longest in individuals treated with lithium. Treatment failure had occurred in 75% of those prescribed lithium by 2.05 years (95% CI: 1.63‐2.51), compared to 0.76 years (95% CI: 0.64‐0.84) for those prescribed quetiapine, 0.98 years (95% CI: 0.84‐1.18) for those prescribed valproate, and 1.13 years for those prescribed olanzapine (95% CI: 1.00‐1.31). Lithium's superiority remained in a propensity score matched analysis; when treatment failure was defined as stopping medication or add‐on of a mood stabilizer or antipsychotic; and when treatment failure was restricted to more than three months after commencing the study drug. Lithium appears to be more successful as monotherapy maintenance treatment than valproate, olanzapine or quetiapine. Lithium is often avoided because of its side effect profile, but alternative treatments may reduce the time to being prescribed more than one drug, with potential additive side effects of these treatments.     

Cloning of a chromosomal fragment from Lactococcus lactis subsp. lactis partially complementing Escherichia coli recA functions

A recA-like gene was isolated from a gene library of Lactococcus lactis subsp. lactis by intergeneric complementation of an E. coli recA mutant. A plasmid was obtained which fully complemented the RecA response to DNA damaging agents and UV inducibility of prophage, but not P1 plating efficiency in an E. coli recA mutant. The cloned DNA fragment also partially complemented the rec mutation in Lc. lactis MMS36. Hybridization studies showed that there was no detectable sequence homology between the recA gene of E. coli and Lc. lactis subsp. lactis chromosomal DNA.     

Origin of hydrogen required for fatty acid synthesis in isolated rat adipocytes.

Beef liver and beef spinal cord d-glycerate dehydrogenases have been shown to be extremely similar. No differences between the two enzymes could be shown by polyacrylamide electrophoresis, sodium dodecyl sulfate polyacrylamide electrophoresis, immunodiffusion, immunoelectrophoresis, or their response to certain inhibitors. Differences could be obtained, however, between the beef spinal cord enzyme and the hog spinal cord enzyme by immunodiffusion and immunoelectrophoresis.Only by the very sensitive technique of microcomplement fixation could a small but significant difference be shown between the beef liver and beef spinal cord enzymes. Like the beef liver and hog spinal cord enzymes, the beef spinal cord enzyme was not inhibited by high concentrations of serine or glycine. The enzyme was inhibited however by low concentrations of phosphohydroxypyruvate and by other phosphorylated compounds.