Heavy Metal Assessments of Soil Samples from a High Natural Background Radiation Area, Indonesia

Mamuju, Indonesia, is an area with high natural background radiation. This study assesses heavy metal content in soil samples from this area to determine the level of public and environmental hazard it presents. This study analyzes natural radionuclide elements using high purity germanium (HPGe) gamma spectrometry and performs heavy metals analysis using a flame atomic absorption spectrometry (FAAS). Moreover, pollution indices and descriptive analyses were used to assess heavy metal contamination in the environment and the correlation between heavy metals and radionuclides. The results demonstrate that soil samples in several areas of Mamuju contain a high concentration of the natural radionuclides 226Ra and 232Th, and that heavy metal concentrations in the soil decrease in the sequence Zn > Pb > Cr > Cu > Ni > Cd. This study revealed that soil samples from Mamuju are moderately contaminated. There was a strong positive relationship between 226Ra, 232Th, ambient dose equivalent rate, and Pb. Ecological risk index (RI) and cumulative pollution index (IPI) values in Mamuju are 2.05 and 125, respectively, which are possible hazards to human health as a result. Pb concentration in the Mamuju soil samples ranged from 109 to 744 mg kg−1, exceeding the worldwide average of 27 mg kg−1.

Objective Assessment of Superiority of Enteral Feeding by Traditional Home Kitchen-Based Feed V/S Commercial Formula Feed in Patients of Esophagogastric Corrosive Injury

Background: Corrosive ingestion can cause severe chemical injury to upper gastrointestinal tract which leads to dysphagia, malnutrition and weight loss. Early nutritional assessment and support through feeding jejunostomy is important and it should be nutritionally optimum and economically balanced. The aim is to compare cost and nutritional status after nutritional support with traditional home kitchen made and commercial formula feed through feeding jejunostomy.Methods:A prospective study included patients on enteral nutrition based on traditional home kitchen feed (cohort-1) and on commercial formula feed (cohort-2). Patient’s body weight, BMI, haemoglobin, serum albumin, nutritional risk index, controlling nutritional status score were checked at the admission, 3rd and 6th month follow up.Results: In cohort 1 mean albumin and haemoglobin raised by 33.13% & 14.60% at 3rd month and 47.23% & 22.3% at 6th month respectively; In cohort 2 it was 9.12% & 2.69% at 3rd month and 17.62% & 6.53% at 6th month respectively. At 6th month in cohort 1 and 2 mean weight gain was 7.56% & 4.0%; mean increase in NRI was 34.78% & 11.5% respectively. Mean CONUT score at six months was better improved in cohort 1 which is 6 to 1 as compared to cohort 2 which was 6 to 3. Mean monthly cost of home-based feeds was significantly lower as compared to commercial feeds (62.14 Rs v/s 682-2354 Rs/day).Conclusions:In corrosive GI tract injury patient enteral nutrition with traditional home kitchen-based feeds is safe, cost effective and associated with better improvement in nutritional status objective parameters.

Study of trace metal contamination and ecological risk assessment in the sediments of a tropical river estuary, Southwestern India

The present study aims to assess the extent of trace metal pollution in the sediments of Sita-Swarna estuary, west coast of India, and investigate their possible ecological risk on the aquatic environment. The sediment cores were analyzed for sand, silt, clay, organic carbon, and trace metals (Al, Fe, Mn, As, Cd, Co, Zn, Pb, Ni, Cr, and Cu) at 2-cm intervals. The study revealed that sediments have deposited in relatively violent to very violent hydrodynamic energy conditions. Factor analysis indicated that the metal distribution is mainly controlled by Fe–Mn oxyhydroxides and organic carbon. Further, the geochemical approach, pollution indices, and statistical evaluation revealed moderate pollution in the catchment. From an ecotoxicological perspective, the estimated risk index (RI) value was found to less than 150, indicating low risk for aquatic life. Thus, this baseline study would help to adopt strategies in pollution control and protect the fragile marine environment.

Nutritional Risk Index Predicts Survival in Patients With Breast Cancer Treated With Neoadjuvant Chemotherapy

Nutritional risk index (NRI) is an index based on ideal body weight that aims to present body weight and serum albumin levels. It has been utilized to discriminate patients at risk of postoperative complications and predict the postoperative outcome of major surgeries. However, this index remains limited for breast cancer patients treated with neoadjuvant chemotherapy (NACT). The research explores the clinical and prognostic significance of NRI in breast cancer patients. This study included 785 breast cancer patients (477 cases received NACT and 308 cases did not) were enrolled in this retrospective study. The optimal NRI cutoff value was evaluated by receiver operating characteristic (ROC) curve, then reclassified as low NRI group (<112) and high NRI group (≥112). The results demonstrated that NRI independently predicted survival on disease-free survival (DFS) and overall survival (OS) by univariate and multivariate Cox regression survival analyses [P = 0.019, hazard ratio (HR): 1.521, 95% CI: 1.071–2.161 and P = 0.004, HR: 1.415, 95% CI: 1.119–1.789; and P = 0.026, HR:1.500, 95% CI: 1.051–2.143 and P < 0.001, HR: 1.547, 95% CI: 1.221–1.959]. According to the optimal cutoff value of NRI, the high NRI value patients had longer mean DFS and OS time in contrast to those with low NRI value patients (63.47 vs. 40.50 months; 71.50 vs. 56.39 months). Furthermore, the results demonstrated that the high NRI score patients had significantly longer mean DFS and OS time than those with low NRI score patients in early-stage breast cancer (χ2 = 9.0510, P = 0.0026 and χ2 = 9.2140, P = 0.0024) and advanced breast cancer (χ2 = 6.2500, P = 0.0124 and χ2 = 5.8880, P = 0.0152). The mean DFS and OS values in patients with high NRI scores were significantly longer in contrast to those with low NRI scores in different molecular subtypes. The common toxicities after NACT were hematologic and gastrointestinal reactions, and the NRI had no statistically significant effects on toxicities, except in nausea (χ2 = 9.2413, P = 0.0024), mouth ulcers (χ2 = 4.8133, P = 0.0282), anemia (χ2 = 8.5441, P = 0.0140), and leukopenia (χ2 = 11.0951, P = 0.0039). NRI serves as a minimally invasive, easily accessible and convenient prognostic tool for evaluating breast cancer prognoses and treatment efficacy, and may help doctors in terms of selecting measures of greater efficiency or appropriateness to better treat breast cancer.

Determining the Risk Level of Heavy Rain Damage by Region in South Korea

For risk assessment, two methods, quantitative risk assessment and qualitative risk assessment, are used. In this study, we identified the regional risk level for a disaster-prevention plan for an overall area at the national level using qualitative risk assessment. To overcome the limitations of previous studies, a heavy rain damage risk index (HDRI) was proposed by clarifying the framework and using the indicator selection principle. Using historical damage data, we also carried out hierarchical cluster analysis to identify the major damage types that were not considered in previous risk-assessment studies. The result of the risk-level analysis revealed that risk levels are relatively high in some cities in South Korea where heavy rain damage occurs frequently or is severe. Five causes of damage were derived from this study—A: landslides, B: river inundation, C: poor drainage in arable areas, D: rapid water velocity, and E: inundation in urban lowlands. Finally, a prevention project was proposed considering regional risk level and damage type in this study. Our results can be used when macroscopically planning mid- to long-term disaster prevention projects.

Interaction of obesity polygenic score with lifestyle risk factors in an electronic health record biobank

Background Genetic and lifestyle factors have considerable effects on obesity and related diseases, yet their effects in a clinical cohort are unknown. This study in a patient biobank examined associations of a BMI polygenic risk score (PRS), and its interactions with lifestyle risk factors, with clinically measured BMI and clinical phenotypes. Methods The Mass General Brigham (MGB) Biobank is a hospital-based cohort with electronic health record, genetic, and lifestyle data. A PRS for obesity was generated using 97 genetic variants for BMI. An obesity lifestyle risk index using survey responses to obesogenic lifestyle risk factors (alcohol, education, exercise, sleep, smoking, and shift work) was used to dichotomize the cohort into high and low obesogenic index based on the population median. Height and weight were measured at a clinical visit. Multivariable linear cross-sectional associations of the PRS with BMI and interactions with the obesity lifestyle risk index were conducted. In phenome-wide association analyses (PheWAS), similar logistic models were conducted for 675 disease outcomes derived from billing codes. Results Thirty-three thousand five hundred eleven patients were analyzed (53.1% female; age 60.0 years; BMI 28.3 kg/m2), of which 17,040 completed the lifestyle survey (57.5% female; age: 60.2; BMI: 28.1 (6.2) kg/m2). Each standard deviation increment in the PRS was associated with 0.83 kg/m2 unit increase in BMI (95% confidence interval (CI) =0.76, 0.90). There was an interaction between the obesity PRS and obesity lifestyle risk index on BMI. The difference in BMI between those with a high and low obesogenic index was 3.18 kg/m2 in patients in the highest decile of PRS, whereas that difference was only 1.55 kg/m2 in patients in the lowest decile of PRS. In PheWAS, the obesity PRS was associated with 40 diseases spanning endocrine/metabolic, circulatory, and 8 other disease groups. No interactions were evident between the PRS and the index on disease outcomes. Conclusions In this hospital-based clinical biobank, obesity risk conferred by common genetic variants was associated with elevated BMI and this risk was attenuated by a healthier patient lifestyle. Continued consideration of the role of lifestyle in the context of genetic predisposition in healthcare settings is necessary to quantify the extent to which modifiable lifestyle risk factors may moderate genetic predisposition and inform clinical action to achieve personalized medicine.

Unplanned Hemodialysis Initiation and Low Geriatric Nutritional Risk Index Scores are Associated with End-Stage Renal Disease Outcomes

Background Patients with end-stage renal disease (ESRD) have low nutritional status, presenting a high mortality risk. The geriatric nutritional risk index (GNRI) is a predictive marker of malnutrition. However, it is unclear whether the association between unplanned hemodialysis (HD) and GNRI scores is related to mortality. Methods The 180 patients who underwent HD at our hospital were divided into two groups: unplanned initiation with a central venous catheter (CVC; n=73) or planned initiation with prepared vascular access (n=107). Results There were no significant differences in sex, age, malignant tumor, hypertension, and vascular disease, while there were significant differences in time from the first visit to HD initiation (0 vs. 7 times, p=0.012) and days between the first visit and HD (12 vs. 186 days, p<0.001). The CVC insertion group had significantly lower GNRI scores at initiation (85.5 vs. 98.8, p<0.001). The adjusted hazard ratios were 4.115 and 3.077 for the GNRI scores and frequency, respectively. Three-year survival was significantly lower in the CVC + low GNRI group (p<0.0001). GNRI after 1 month was significantly inferior in the CVC insertion group. Conclusions Inadequate general management due to late referral to the nephrology department is a risk factor for patients with ESRD.

Assessment of the Ecological Risk from Heavy Metals in the Surface Sediment of River Surma, Bangladesh: Coupled Approach of Monte Carlo Simulation and Multi-Component Statistical Analysis

River sediment can be used to measure the pollution level in natural water, as it serves as one of the vital environmental indicators. This study aims to assess heavy metal pollution namely Copper (Cu), Iron (Fe), Manganese (Mn), Zinc (Zn), Nickel (Ni), Lead (Pb), and Cadmium (Cd) in Surma River. Further, it compares potential ecological risk index values using Hakanson Risk Index (RI) and Monte Carlo Simulation (MCS) approach to evaluate the environmental risks caused by these heavy metals. in the study area. With obtained results, enrichment of individual heavy metals in the study area was found in the order of Ni > Pb > Cd > Mn > Cu > Zn. Also, variance in MCS index contributed by studied metals was in the order of Cd > Pb > Ni > Zn > Cu. None of the heavy metals, except Ni, showed moderate contamination of the sediment. Risk index values from RI and MCS provide valuable insights in the contamination profile of the river, indicating the studied river is currently under low ecological risk for the studied heavy metals. This study can be utilized to assess the susceptibility of the river sediment to heavy metal pollution near an urban core, and to have a better understanding of the contamination profile of a river.