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Environmental Geochemistry and Health Feb 2024An evaluation of the pollution, distribution, and mobility of arsenic and heavy metals in spoil heaps and soils surrounding the abandoned Carmina lead-zinc mine...
An evaluation of the pollution, distribution, and mobility of arsenic and heavy metals in spoil heaps and soils surrounding the abandoned Carmina lead-zinc mine (Asturias, northern Spain) was carried out. Fractionation of arsenic was performed by an arsenic-specific sequential extraction method; while, heavy metal fractionations was carried out using the protocol of the Bureau Community of Reference (BCR) (now renamed Standards, Measurements and Testing Programme). Arsenic appeared predominantly associated with amorphous iron oxyhydroxides. Among the heavy metals, lead and zinc showed high availability since significant amounts were extracted in the nonresidual fractions; whereas, chromium, copper and nickel showed very low availability, indicating their lithogenic origins. The results showed that the extractability of heavy metals in soils is influenced mainly by the presence of iron and manganese oxides as well as by pH and Eh. Multiple pollution indices, including the enrichment factor (EF), geoaccumulation index (Igeo), ecological risk index (Er) and potential ecological risk index (PERI), were used to assess the degree of soil pollution in the mine area. All results showed that lead was the key factor causing the pollution and ecological risk in the studied area, and copper, zinc and arsenic also had significant contributions. Notably, the sites at higher risk coincided with those with high availability of arsenic and heavy metals. This study provides an integrative approach that serves as a powerful tool to evaluate the metal pollution status and potential threats to the local environment of abandoned mining areas, and the results are useful for making management decisions in these areas.
Topics: Arsenic; Soil; Copper; Spain; Soil Pollutants; Metals, Heavy; Zinc; Environmental Monitoring; Iron; Risk Assessment
PubMed: 38367139
DOI: 10.1007/s10653-023-01848-6 -
Annales Pharmaceutiques Francaises May 2024In a context of heparin shortage, we studied the wasted quantities in three intensive care units (ICU) of a university hospital where two electric syringe pump (ESP)... (Observational Study)
Observational Study
OBJECTIVES
In a context of heparin shortage, we studied the wasted quantities in three intensive care units (ICU) of a university hospital where two electric syringe pump (ESP) heparin protocols coexist (20,000UI/48mL used in the cardiology ICU and 25,000UI/50mL use in the medical and surgical ICUs).
METHOD
We performed a prospective observational study of patients treated with heparin ESP. We collected the information recorded in the prescription software connected to the ESP (dosage, start time, infusion rate, interruption times, date and time of end of treatment). We observed the ESPs, noted the time of start written on the label and the quantity remaining, and questioned nurses about the constraints that lead for changing the ESPs.
RESULTS
Between 23/03/23 and 19/05/23, 164 vials of 25,000UI/5mL were used. The wasted quantity was equivalent 42 vials: 18 vials (43%) of treatment stopped, nurses practices such as changing the ESP in advance 6 vials (14%), application of the rule "discard the ESP 24hours after preparation" 9 vials (21.5%) and 9 vials (21.5%) corresponding to the 45mL discarded for the 45 ESP prepared in the cardiology ICU.
CONCLUSION
More than a quarter of the heparin purchased is wasted. The results should lead to policy decisions concerning the medications supply chain, i.e. abandoning the 20,000UI/48mL protocol, supply of ready to use heparin syringes by industry or by the pharmacy. It is essential that these data be fed back to nurses' teams, in order to gather their suggestions before considering any changes of their practices.
Topics: Humans; Heparin; Hospitals, University; Intensive Care Units; Pharmacy; Prospective Studies
PubMed: 38340805
DOI: 10.1016/j.pharma.2024.02.002 -
Journal of Clinical Medicine Jan 2024VDD (atrial sensing, ventricular sensing/pacing) leads are relatively rarely implanted; therefore, experience in their extraction is very limited. We aimed to...
VDD (atrial sensing, ventricular sensing/pacing) leads are relatively rarely implanted; therefore, experience in their extraction is very limited. We aimed to investigate whether VDD lead removal may be a risk factor for the increased complexity of transvenous lead extraction (TLE) or major complications. We retrospectively analyzed 3808 TLE procedures (including 103 patients with VDD leads). If TLE included VDD lead removal, procedure duration (lead dilation time) was prolonged, complicated extractions were slightly more common, and more advanced tools were required. This is partly due to longer implant duration (in patients with VDD systems-135.2 months; systems without VDD leads-109.3 months; < 0.001), more frequent presence of abandoned leads (all systems containing VDD leads-22.33% and all systems without VDD leads-10.77%), and partly to the younger age of patients with VDD leads (51.74 vs. 57.72 years; < 0.001, in the remaining patients) at the time of system implantation. VDD lead extraction does not increase the risk of major complications (1.94 vs. 2.34%; = 0.905). The extraction of VDD leads may be considered a risk factor for increased procedure complexity, but not for major complications. However, this is not a direct result of VDD lead extraction but specific characteristics of the patients with VDD leads. Operator skill and team experience combined with special custom maneuvers can enable favorable results to be achieved despite the specific design of VDD leads, even with older VDD lead models.
PubMed: 38337494
DOI: 10.3390/jcm13030800 -
Long-term monitoring of mammal communities in the Peneda-Gerês National Park using camera-trap data.Biodiversity Data Journal 2023In the past decades, agricultural land abandonment and declining land-use intensity became common, especially in the Mediterranean countries of southern Europe. In some...
BACKGROUND
In the past decades, agricultural land abandonment and declining land-use intensity became common, especially in the Mediterranean countries of southern Europe. In some areas, this development opened up possibilities for rewilding and the recolonisation or expansion of large mammal populations. Yet, in some instances, co-occurrence of wild mammals and free-ranging domestic herbivores might lead to potential conflicts. It is, therefore, necessary to study the ecological interactions between wild and domestic mammal species to understand the effects of land abandonment and rewilding on biodiversity and ecosystem services. Camera traps are an effective tool for studying species interactions and occupancy dynamics as they allow for long-term monitoring with minimal interference. We conducted a long-term monitoring programme with camera traps in the Peneda-Gerês National Park in northern Portugal. The area has undergone substantial land-use changes following the abandonment of agricultural areas in the past 60 years. While agro-pastoral activities, especially the breeding of free-ranging horses and cattle, are still common in the area, the intensity of these activities has decreased significantly, promoting natural succession and an increase or return of several large mammal species in recent years. Overall, our project aims at: (1) assessing the population trends of the medium and large sized mammals in the area over time; (2) analysing the effects of passive rewilding on occurrence, abundance and behaviour; and (3) understanding potential interactions or conflicts between wild and domestic herbivores. In this publication, we present results of a primary occupancy analysis between 2015 and 2020, as well as a comparison between occupancy and density estimates for 2019.
NEW INFORMATION
Our publication provides a dataset from long-term camera-trap monitoring in the Peneda-Gerês National Park between 2015 and 2021. We established a 16 km² grid of 64 cameras deployed yearly during the summer months. Together with this publication, we publish the data and images collected between 2015 and 2021, using both the Camtrap DP standard and the GBIF Darwin Event Core. We obtained a total of 934,810 pictures on 41,234 trap nights. The pictures were automatically grouped into sequences with each sequence representing a distinct occurrence event, resulting in 80,191 occurrences. Out of those, 14,442 contained observations of a species, while the remaining were either blank or the species was not identifiable. We only obtained the information whether a species was present or absent on a picture, disregarding the number of individuals. Most observations were of domestic cattle () and horses (), followed by European roe deer () and wild boar ). Further observations include red fox (), gray wolf (), Eurasian badger (), stone marten (), common genet (), Iberian ibex () and red deer (). We estimated occupancy and densities for the most common species. The project is on-going and additional data will be included in the future. The dataset is freely available for ecological analysis, but also for training machine-learning systems in automated image classification as all pictures have been manually classified.
PubMed: 38327315
DOI: 10.3897/BDJ.11.e99588 -
Diabetes & Metabolic Syndrome Feb 2024Prior authorization (PA) is a utilization management strategy used by health plans to ensure affordable, cost-effective care; however, PA may lead to therapy... (Observational Study)
Observational Study
BACKGROUND
Prior authorization (PA) is a utilization management strategy used by health plans to ensure affordable, cost-effective care; however, PA may lead to therapy delay/abandonment and exacerbate health disparities. The purpose of this observational study was to assess the clinical outcomes and any health disparities associated with PA for diabetes mellitus (DM) medications.
MATERIALS AND METHODS
This was a cohort study of US adult patients from health plans with integrated and non-integrated system providers who were prescribed a DM medication that required a PA. Patients were categorized into three groups: received the requested DM medication (PA Med) or a new, alternative DM medication (DM Med), or did not receive the requested or new DM medication (No Med). The primary outcome was change in hemoglobin A1c (HbA1c). Adjusted and unadjusted analyses were performed. Patient characteristics associated with the No Med group were identified, also, with multivariable logistic regression modeling.
RESULTS
6305 patients were included: 2434, 1323, and 2548 in the PA Med, DM Med, and No Med groups, respectively. Patients in the PA Med (-0.9 %) and DM Med (-1.0 %) groups had statistically significantly greater reductions in HbA1c compared to the No Med group (-0.4 %) in both unadjusted and adjusted analyses (all p < 0.05). Patients who were Hispanic/Latino, had a non-integrated system prescriber, and had a higher burden of chronic disease were statistically significantly associated with the No Med group.
CONCLUSIONS
Receiving a new DM medication following PA was associated with better clinical outcomes but health disparities were present in the PA process.
Topics: Adult; Humans; Cohort Studies; Prior Authorization; Glycated Hemoglobin; Diabetes Mellitus; Health Inequities
PubMed: 38310735
DOI: 10.1016/j.dsx.2024.102954 -
The Science of the Total Environment Mar 2024Heavy metal composite pollution is widespread in the surrounding environment of tailings ponds in arid and semi-arid regions, leading to the abandonment of substantial...
Evaluation of heavy metal speciation distribution in soil and the accumulation characteristics in wild plants: A study on naturally aged abandoned farmland adjacent to tailings.
Heavy metal composite pollution is widespread in the surrounding environment of tailings ponds in arid and semi-arid regions, leading to the abandonment of substantial agricultural land. This study investigates the speciation distribution and plant accumulation characteristics of heavy metals in abandoned farmland with different durations of natural aging. The aim is to comprehend the local heavy metal behavior pattern in the soil-plant system and offer insights for environmental remediation. Our findings reveal that Cd stands out as the primary heavy metal pollutant in this area. The mobility ranking of heavy metals is Cd > Pb > Zn > Cu, with Cd and Pb mobility decreasing along the basin. Notably, active Pb exhibits a higher affinity for soil binding compared to other metals. The predominant plant species in the region are primarily small shrubs, herbaceous plants, and semi-shrubs that demonstrate tolerance to drought and salt. Most plant samples showed elevated levels of Cd, Pb, and Zn, surpassing the maximum tolerance levels for dietary minerals in livestock. This elevated metal content poses potential threats to the health of local livestock and wildlife, yet it is also considered a potential for phytoremediation. Selected dominant plant species from the current study include Kalidium foliatum & gracile which shows potential as a Cd accumulator and indicator. Neotrinia splendens and Reaumuria songarica demonstrate potential as Cd excluders, with the latter exhibiting higher tolerance to Cd (62.9 mg/kg). Additionally, our observations indicate that different plant parts exhibit distinct responses to heavy metals, and Zn synergistically influences the aerial part accumulation of Cd. This study holds significant importance in understanding the complex behavior patterns of multi-metal pollutants in the natural environment. The identification of native plants with remediation potential is valuable for phytoremediation of environment pollution in mining area.
Topics: Soil; Cadmium; Farms; Lead; Soil Pollutants; Metals, Heavy; Plants; Environmental Pollutants; China; Environmental Monitoring
PubMed: 38309366
DOI: 10.1016/j.scitotenv.2024.170594 -
JACC. Case Reports Jan 2024Transvenous lead extraction has been increasingly recognized as a safe and effective method of lead extraction, but there are only few references for extracting leads...
Transvenous lead extraction has been increasingly recognized as a safe and effective method of lead extraction, but there are only few references for extracting leads migrating outside the heart. We present a successful extraction of a fractured pacemaker lead from the spermatic vein using several approaches and multiple tools.
PubMed: 38264307
DOI: 10.1016/j.jaccas.2023.102160 -
Social Science & Medicine (1982) Feb 2024Understanding the shifting nature of structural racism historically and across institutions is vital for effective action towards racial health equity. While public...
Understanding the shifting nature of structural racism historically and across institutions is vital for effective action towards racial health equity. While public health research on structural racism is rapidly increasing, most studies are missing the interdependence of policies and institutional practices over time that shape power imbalances and lead to entrenched health inequities. Here, we discuss Ruth Wilson Gilmore's concept of organized abandonment - the intentional disinvestment in communities which, in turn, creates opportunities for extraction, revenue generation, and carceral enforcement to fill the cracks of a compromised social infrastructure - to encourage action-oriented public health research that is grounded in history and an understanding of racial capitalism. We present a case example using publicly-available data on redlining, gentrification and policing in Seattle, Washington. We mapped the intersections of redlining and gentrification and estimated their neighborhood-level association with police activity using Bayesian spatial Poisson regression models. We found that histories of racist housing policies like redlining and processes of gentrification are interdependent and shape contemporary neighborhood racial and economic segregation and police activity. Compared to structurally advantaged neighborhoods, police stops were higher in neighborhoods that were 1) historically disinvested (i.e. redlined) and remain low-income and structurally disadvantaged and 2) formerly industrial and business districts that were not redlined and are now gentrified. Notably, we found that policing practices were significantly more intensive in neighborhoods that were both high redlined and gentrified. Together, these findings illustrate how the place-based racialized processes of dispossession, displacement and policing are deeply intertwined to maintain racial capitalism. Our findings also highlight the importance of examining multiple racialized processes simultaneously to fill critical gaps in the existing literature that are necessary for sustainable solutions to address structural racism.
Topics: Humans; Bayes Theorem; Capitalism; Public Health; Racism; Systemic Racism
PubMed: 38237286
DOI: 10.1016/j.socscimed.2024.116576 -
PLoS Computational Biology Jan 2024The 2022 FIFA World Cup was the first major multi-continental sporting Mass Gathering Event (MGE) of the post COVID-19 era to allow foreign spectators. Such large-scale...
The 2022 FIFA World Cup was the first major multi-continental sporting Mass Gathering Event (MGE) of the post COVID-19 era to allow foreign spectators. Such large-scale MGEs can potentially lead to outbreaks of infectious disease and contribute to the global dissemination of such pathogens. Here we adapt previous work and create a generalisable model framework for assessing the use of disease control strategies at such events, in terms of reducing infections and hospitalisations. This framework utilises a combination of meta-populations based on clusters of people and their vaccination status, Ordinary Differential Equation integration between fixed time events, and Latin Hypercube sampling. We use the FIFA 2022 World Cup as a case study for this framework (modelling each match as independent 7 day MGEs). Pre-travel screenings of visitors were found to have little effect in reducing COVID-19 infections and hospitalisations. With pre-match screenings of spectators and match staff being more effective. Rapid Antigen (RA) screenings 0.5 days before match day performed similarly to RT-PCR screenings 1.5 days before match day. Combinations of pre-travel and pre-match testing led to improvements. However, a policy of ensuring that all visitors had a COVID-19 vaccination (second or booster dose) within a few months before departure proved to be much more efficacious. The State of Qatar abandoned all COVID-19 related travel testing and vaccination requirements over the period of the World Cup. Our work suggests that the State of Qatar may have been correct in abandoning the pre-travel testing of visitors. However, there was a spike in COVID-19 cases and hospitalisations within Qatar over the World Cup. Given our findings and the spike in cases, we suggest a policy requiring visitors to have had a recent COVID-19 vaccination should have been in place to reduce cases and hospitalisations.
Topics: Humans; Mass Gatherings; COVID-19 Vaccines; COVID-19; Soccer; Sports
PubMed: 38236838
DOI: 10.1371/journal.pcbi.1011018 -
Sensors (Basel, Switzerland) Dec 2023Lower limb exoskeletons and orthoses have been increasingly used to assist the user during gait rehabilitation through torque transmission and motor stability. However,...
Lower limb exoskeletons and orthoses have been increasingly used to assist the user during gait rehabilitation through torque transmission and motor stability. However, the physical human-robot interface (HRi) has not been properly addressed. Current orthoses lead to spurious forces at the HRi that cause adverse effects and high abandonment rates. This study aims to assess and compare, in a holistic approach, human-robot joint misalignment and gait kinematics in three fixation designs of ankle-foot orthoses (AFOs). These are AFOs with a frontal shin guard (F-AFO), lateral shin guard (L-AFO), and the ankle modulus of the H2 exoskeleton (H2-AFO). An experimental protocol was implemented to assess misalignment, fixation displacement, pressure interactions, user-perceived comfort, and gait kinematics during walking with the three AFOs. The F-AFO showed reduced vertical misalignment (peak of 1.37 ± 0.90 cm, -value < 0.05), interactions (median pressures of 0.39-3.12 kPa), and higher user-perceived comfort (-value < 0.05) when compared to H2-AFO (peak misalignment of 2.95 ± 0.64 and pressures ranging from 3.19 to 19.78 kPa). F-AFO also improves the L-AFO in pressure (median pressures ranging from 8.64 to 10.83 kPa) and comfort (-value < 0.05). All AFOs significantly modified hip joint angle regarding control gait (-value < 0.01), while the H2-AFO also affected knee joint angle (-value < 0.01) and gait spatiotemporal parameters (-value < 0.05). Overall, findings indicate that an AFO with a frontal shin guard and a sports shoe is effective at reducing misalignment and pressure at the HRI, increasing comfort with slight changes in gait kinematics.
Topics: Humans; Biomechanical Phenomena; Ankle; Foot Orthoses; Robotics; Gait
PubMed: 38203110
DOI: 10.3390/s24010246