Osteosclerosis due to endemic fluorosis

Endemic water borne fluorosis is a public health problem in Isparta, a city located in southern Turkey. In order to investigate the association between osteosclerosis and fluorosis, we retrospectively screened the results of lumbar spine and femur neck bone mineral density (BMD) of 1500 patients who were examined before, for any reason in between 2001-2003. Sixty nine patients (67 females and 2 males, mean age 52.6+/-10.2) with vertebra T-scores>or=+2 were found only except a patient with osteoid osteoma in the femur neck (femur T-score+6.64). Thirty-four of the patients could be reexamined with lateral vertebra BMD and investigated for fluorosis and the other etiologic causes of osteosclerosis. Of 34 patients, 14 had either mottled tooth enamel or urine fluoride level greater than 1.5 mg/l. Other etiologic causes were hypothyroidism (2), hypoparathyroidism (1), history of lumbar fracture (1), use of retinoids (1), vitamin D (7), oral calcium preparations (9), and bisphosphanates (3). Lateral lumbar vertebral T-score was greater than+2 in 12 patients (35.3%). Femur T-score was greater than+2 in 7 patients (20.6%). Fourteen patients (41.2%) had lateral vertebral or femur T-score>or=+2. Five (35.7%) of these patients had signs of fluorosis, as discussed before. Mean body mass index of individuals with fluorosis was 36.4+/-7.9 and this result was significantly higher than other osteosclerotic subjects (31.6+/-4.4). In conclusion we believe that approximately one third of the osteosclerosis in our region was due to endemic skeletal fluorosis and obesity may enhance this osteosclerotic type bone changes in endemic fluorosis.     

Spatial dominance: a new approach to the estimation of interconnectedness in regional input-output tables

In the first, theoretical part, the paper gives an overview of possible measures of the impact of loops and feedbacks in an input-output structure. In the second part, the paper provides indicators that measure interregional connectedness. Applying the influence graphs theory, a distinction is proposed between partial interconnectedness (between two or three regions, sectors, ...) and global interconnectedness (between all regions, sectors, regional sectors ...). Lastly, this approach is illustrated by a comparison of two French tables (1982 and 1992), computed by a simple method of biproportion, and consisting of 6 large regions and 6 large sectors.Received: December 2000 / Accepted: May 2003     

Environmental exposure to lead in a population of adults living in northern France: lead burden levels and their determinants

As part of the assessment of a site in northern France polluted by metals from two smelters (in particular, lead, cadmium and mercury), a cross-sectional study was carried out which intended to estimate the levels of the lead burden of the adult population living on the site and the factors associated with these levels. The exposed zone included 10 municipalities in the Nord-Pas de Calais region, located in the vicinity of two non-ferrous metal smelters. The soils in these municipalities contained between 100 and 1700 ppm of lead. The non-polluted zone contained 20 municipalities from the same region, drawn randomly from those in the region of comparable size but free from any industrial lead exposure. The adult study population (301 men and 300 women) was stratified according to age, sex, employment status and exposure level. The inclusion criteria required subjects who were aged between 20 and 50 years and had been living in the exposed zone for at least 8 years; the exclusion criteria were pregnancy, cancer, kidney disease and diabetes. No more than 10% of the subjects participating could work at one of the two smelters. Data collection took place at home; visiting nurses interviewed subjects to complete a questionnaire and also took blood samples. The lead assay was performed by atomic absorption spectrometry. The geometric mean of the blood-lead levels was 74 microg/l, 95% CI = 69-80 among men and 49 microg/l, 95% CI = 46-53 among women. Blood-lead levels exceeding 100 microg/l were found among 30% of men and 12% of women. Several factors were associated with variation of the mean blood-lead level: the blood-lead level was significantly higher among the men for subjects living less than 1 km from the smelters (geometric mean x 1.3, 95% CI = 1.1-1.6), for those who drink alcoholic beverages (x 1.1, 95% CI = 1.0-1.2 for consumption of 30 g/day), those who smoke (x 1.2, 95% CI = 1.0-1.3 for 20 cigarettes/day), and for subjects with occupational exposure; among the women, for subjects living less than 1 km from the smelters (geometric mean x 1.5, 95% CI = 1.2-1.7), for those who drink alcohol (x 1.1, 95% CI = 1.1-1.2 for a daily consumption of 10 g), and for women living in a building constructed before 1948 (x 1.2, 95% CI = 1.0-1.4).     

Toward a less natural gas dependent energy mix in Spain: Crowding-out effects of shifting to biomass power generation

This paper estimates the impact of a hypothetical change in Spain's energy mix on a number of productive sectors. The change would be brought about by substituting power generation from natural gas with generation from biomass. The total amount of electricity supplied has been calculated to remain constant so that a crowding-out effect would be derived from the displacement of one technology with another. An input–output (IO) framework has been used to estimate the overall economic impact on 26 productive sectors included on Spain's 2007 IO Table. Based on the available literature, the consideration of net impact improves the analysis. The results show that the overall net impact across all productive sectors of this change in the energy mix would be positive and equal to about 0.5% for the period. Higher impacts were measured for the ‘Electricity power and Electricity Supply’ sector (15.4%) followed by the ‘Agriculture, Hunting, Forestry’ sector (7.1%). Only the ‘Gas generation and Gas supply’ sector showed a negative impact (–2.5%), which is consistent with the reduced use of natural gas. The overall calculated total impact for Spain's productive sector was equal to € 8074.95 million at the 2007-equivalent value.     

Territory contamination with the radionuclides representing the fuel component of Chernobyl fallout

The data obtained through a series of experiments were used to specify the correlation of activities of the fuel component radionuclides of Chernobyl fallout and to create the maps of the 30-km Chernobyl zone terrestrial density of contamination with 154Eu, 238Pu, 239+240Pu and 241Am (on 01.01.2000). In the year 2000, total inventories of the fuel component radionuclides in the upper 30-cm soil layer of the 30-km Chernobyl zone in Ukraine (outside the ChNPP industrial site, excluding the activity located in the radioactive waste storages and in the cooling pond) were estimated as: 90Sr--7.7 x 10(14) Bq; 137Cs--2.8 x 10(15) Bq; 154Eu--1.4 x 10(13) Bq; 238Pu--7.2 x 10(12) Bq; 239+240Pu--1.5 x 10(13) Bq; 241Am--1.8 x 10(13) Bq. These values correspond to 0.4-0.5% of their amounts in the ChNPP unit 4 at the moment of the accident. The current estimate is 3 times lower than the previous widely-cited estimates. Inventories of the fuel component radionuclides were also estimated in other objects within the 30-km zone and outside it. This allowed more accurate data to be obtained on the magnitude of a relative release of radionuclides in the fuel particles (FP) matrix during the Chernobyl accident outside the ChNPP industrial site. It amounts to 1.5+/-0.5% of these radionuclides in the reactor, which is 2 times lower than the previous estimates. Two-thirds of the radionuclides release in the FP was deposited on the territory of Ukraine.     

Mapping indoor radon-222 in Denmark: design and test of the statistical model used in the second nationwide survey

In Denmark, a new survey of indoor radon-222 has been carried out, 1-year alpha track measurements (CR-39) have been made in 3019 single-family houses. There are from 3 to 23 house measurements in each of the 275 municipalities. Within each municipality, houses have been selected randomly. One important outcome of the survey is the prediction of the fraction of houses in each municipality with an annual average radon concentration above 200 Bq m(-3). To obtain the most accurate estimate and to assess the associated uncertainties, a statistical model has been developed. The purpose of this paper is to describe the design of this model, and to report results of model tests. The model is based on a transformation of the data to normality and on analytical (conditionally) unbiased estimators of the quantities of interest. Bayesian statistics are used to minimize the effect of small sample size. In each municipality, the correction is dependent on the fraction of area where sand and gravel is a dominating surface geology. The uncertainty analysis is done with a Monte-Carlo technique. It is demonstrated that the weighted sum of all municipality model estimates of fractions above 200 Bq m(-3) (3.9% with 95%-confidence interval = [3.4,4.5]) is consistent with the weighted sum of the observations for Denmark taken as a whole (4.6% with 95%-confidence interval = [3.8,5.6]). The total number of single-family houses within each municipality is used as weight. Model estimates are also found to be consistent with observations at the level of individual counties. These typically include a few hundred house measurements. These tests indicate that the model is well suited for its purpose.     

Development of an inventory and temporal allocation profiles of emissions from power plants and industrial facilities in Thailand

An emission inventory (EI) of power plants and industrial (i.e., non-power plant) facilities in Thailand was developed. Emissions considered are those from fuel consumption (i.e., combustion) for power plants and those from both fuel consumption and industrial processes (i.e., non-combustion) for industrial facilities. For power plants, total annual emissions due to fuel consumption are 107.9 x 10(3) ton NOx (as NO2), 146.2 x 10(3) ton SO2, 6.1 x 10(3) ton NMVOC (non-methane volatile organic compounds), 47.0 x 10(3) ton CO, 1.8 x 10(3) ton NH3, 1.5 x 10(3) ton OC (organic carbon), and 1.5 x 10(3) ton BC (black carbon). For industrial facilities, total annual emissions due to fuel consumption are 111.4 x 10(3) ton NOx (as NO2), 476.9 x 10(3) ton SO2, 33.4 x 10(3) ton NMVOC, 193.1 x 10(3) ton CO, 1.6 x 10(3) ton NH3, 8.5 x 10(3) ton OC, and 8.0 x 10(3) ton BC. Among various industrial types, Food and Beverage, Chemical, and Non-Metal industries are dominant emitters. Total annual emissions due to industrial processes are 79.2 x 10(3) ton SO2, 76.0 x 10(3) ton NMVOC, and 4.8 x 10(3) ton CO. The Central and Eastern regions combined contribute considerably to total emissions for most emission species. Emission estimates found here show fair agreement with those in some selected past studies. A crude estimation of potential fugitive NMVOC emissions specifically from petroleum industry was also made, and the estimates found could be considered significant (nearly half of NMVOC emissions from industrial processes). Several temporal allocation profiles of emissions were also developed and suggested for power plants and industrial facilities, including monthly, daily, and hourly profiles.     

Pesticide use related to cancer incidence as studied in a rural district of Hungary

General mortality analysis showed an increasing tendency of circulatory diseases in two villages examined. Respiratory diseases and suicide were more frequent in the village with greater pesticide use (village I). The relative risk (RR) of gastric cancer for men is significantly higher in village I (high rate of pesticide use) than in the county as a whole (RR, 1.65; 95% confidence interval (CI), 0.96-2.83) and also in relation to the national data (RR, 3.20; 95% CI, 1.91-5.36). Since the nitrate concentration in the drinking water, the drug consumption, smoking and eating habits are similar in the two villages, and since alcohol consumption is higher in village II (moderate rate of pesticide use), it seems that nitrosable pesticides may play a role in the etiology of stomach cancer. This is supported by the fact that a higher number of gastric cancer cases was found where larger quantities of nitrosable pesticides had been used.     

The association of noise sensitivity with coronary heart and cardiovascular mortality among Finnish adults

The association of coronary heart and cardiovascular mortality with noise sensitivity was studied. We also investigated how this association is affected by self-reported lifetime noise exposure. In 1988 a case-control study, based on the Finnish Twin Cohort, was carried out to investigate the relationship between noise and hypertension (n=1495). Potential confounders were obtained from questionnaire in 1981 for the same individuals. Data on deaths and causes of death were obtained from record linkage to the nationwide register of death certificates. All deaths that occurred among the study population during the 15 years of follow-up were classified as being due to all causes (n=382), to cardiovascular diseases (n=193), including the number of deaths due to coronary heart diseases (n=111) and to other causes than cardiovascular diseases (n=189). Cardiovascular mortality (Hazard ratio 1.80, 95% CI 1.07-3.04) was significantly increased among noise-sensitive women. Among men, there were no statistically significant effects. Noise sensitivity may be a risk factor for cardiovascular mortality in women.     

中国罕见病领域新进展（2020—2021）

2020—2021年,我国罕见病领域取得突出进展。罕见病相关政策方面,国家层面已建立罕见病国家重点实验室,并筹建国家罕见病质控中心,对罕见病药物实行零关税;地方层面不断扩大纳入医保的罕见病范围。罕见病用药方面,共14种罕见病药物被纳入医保,13种罕见病药物在国内获批上市,并有多种罕见病用药被纳入优先审评或临床试验默示许可。罕见病患者登记与流行病学研究方面,我国已启用国家罕见病注册系统,并建立罕见病患者登记制度;首个重症肌无力流行病学调查结果公布,溶酶体贮积症筛查项目启动,首个软骨发育不全队列研究正式启动。在官方政策和渠道之外,罕见病患者组织和信息平台均发挥重要补充作用。     

国际工程承包市场行业结构及其发展趋势比较分析

根据美国《工程新闻纪录》(ENR)周刊2000-2006年国际市场225家最大承包商的统计数据,整理和分析了国际工程承包市场行业结构状况,提出了行业结构集中度的概念,分析了国际工程承包市场行业结构集中度及变化趋势。分析结果显示,国际工程承包主要集中在房屋建筑、工业/石化及交通等三大行业,但三大行业集中度均呈现明显下降趋势。按三大行业集中度年均值从高到低排列,依次是:工业/石化(20.74%)、交通(15.54%)和房屋建筑(14.72%)。     

Mechanical Ventilation in Office Buildings and the Sick Building Syndrome. An Experimental and Epidemiological Study

The effects of mechanical ventilation on the sick building syndrome (SBS) were studied in an office building with 2150 employees, where the mechanical ventilation and indoor air quality were commonly blamed for causing symptoms typical of the SBS (nasal, eye, and mucous membrane symptoms, lethargy, skin symptoms and headache). The mechanical ventilation rates in the building were high (mean 26 l/s/person). To test the hypothesis that mechanical ventilation causes the SBS, a controlled experimental study was carried out by shutting off the ventilation in one part of the building and reducing the ventilation rate by 75% and 60% in two areas while leaving one part unaltered as a control. The experimental reduction of the ventilation rate did not alleviate the symptoms. On the contrary, the reduction of the ventilation rate caused a slight but statistically significant relative increase in symptoms (p < 0.05). In the cross-sectional analysis of the baseline data the SBS symptoms did not associate significantly with the ventilation rate (range 7–70 l/s/person). In the linear regression model, a positive correlation was found between temperatures above 22°C and the occurrence of symptoms (p < 0.05). Subjects exposed to environmental tobacco smoke had more symptoms than those not exposed (p < 0.01). Women reported more symptoms than men (p < 0.001). In addition, any prior history of allergic diseases (p < 0.001) and a negative attitude towards the social atmosphere at work (p < 0.001) were significant determinants of the SBS.     

Selective moving behaviour in ethnic neighbourhoods: white flight,white avoidance,ethnic attraction or ethnic retention?

Spatial concentrations of ethnic minorities might in principle be created and maintained by four different kinds of moving behaviour stemming from special housing preferences and options among either ethnic minorities or the native population. Inclination among natives to move away from neighbourhoods dominated by ethnic minorities has been called ‘White Flight’ in the literature, and disposition to avoid them ‘White Avoidance’. Preferences among ethnic minorities for living together with kinsmen or countrymen might create an inclination to move into multi-ethnic neighbourhoods, in this paper called ‘Ethnic Attraction’, or to remain there, called ‘Ethnic Retention’. This paper estimates the importance and size of these four kinds of behaviour based on an extensive database from Denmark using new statistical methods. It is concluded that white avoidance is the strongest reason for spatial concentrations of Non-Western ethnic minorities followed by ethnic attraction. White flight has a smaller impact and ethnic retention is without importance.     

Are shocks to electricity consumption transitory or permanent? Sub-national evidence from Turkey

This is the first study that aims to investigate policy shocks to energy consumption in terms of unit root properties by sector. More precisely, we analyze the stationarity of electricity consumption for 12 regions of Turkey by four sectors in addition to total electricity consumption by region (for a total of 60 cases). We find that 48 cases are non-stationary and 12 cases are stationary. Thus, policies to decrease or stimulate the use of electricity have permanent effects on electricity consumption in 80% of the cases and transitory effects in the rest. Findings and policy implications are further discussed.     

2011—2013年北京协和医院外籍和中国港台地区住院患者人口及疾病特征

目的　探讨北京协和医院外籍和中国香港、台湾地区住院患者人口统计学特征、疾病构成和临床特点。方法　通过检索医院信息系统和复习住院病历，回顾性收集、整理、分析2011年1月至2013年12月在北京协和医院国际医疗部住院的外籍和中国港台地区患者一般资料及临床资料。结果　共纳入557例患者，其中男性216例，女性341例；平均年龄45.5岁，其中30⁵9岁患者居多，共379例（68.0%）。患者来自于76个国家及中国香港和台湾地区，来源前3位分别为美国（123例，22.1%）、加拿大（66例，11.8%）和澳大利亚（45例，8.1%）。557例患者罹患247种疾病，前3位疾病分别为妊娠、分娩和产褥期疾病（124例，22.3%）、肿瘤（78例，14.0%）、消化系统疾病（65例，11.7%）；187例（33.6%）急诊入院。疑难及急重症患者103例（18.5%），29例（5.2%)曾转入转出重症监护病房。557例患者平均住院时间7.1 d。281例（50.5%）经治疗后痊愈，273例（49.0%）好转，3例（0.5%）死亡。结论　北京协和医院国际医疗部外籍及中国港台地区住院患者年龄跨度大、地域来源广泛、病种丰富、疑难急重症患者多，除需要提供良好的就医环境、人性化的医疗服务和人文关怀外，更需要医务人员具有流利的外语水平、全面丰富的临床经验、迅速识别危重患者的能力，充分发挥多学科协作的优势，提供高效、优质的涉外医疗服务。     

Mexico’s regional output convergence after NAFTA: a dynamic panel data analysis

This paper examines Mexico’s output convergence across its 32 states for 1993–2006, a period including the start of NAFTA. Employing dynamic panel data methods, our estimates provide interesting new results. First, we find positive rates of output absolute convergence across Mexican regions: varying from 1.5% for the years 1993–2006 to 9.4% for the years 1996–2006. Second, trade, capital inflows and international migration exert positive effects on output per capita growth. Third, rolling panels suggest the Border-North region faces increasing output convergence speed (from 8.9 to 11.2%), while the South-Center experiences a declining trend (from 12 to 7.6%) more recently.     

Blood mercury concentration in an urban population

Mercury concentrations in whole blood of 210 patients admitted to two urban hospitals ranged from 0 to 298 ppb with a mean of 14.2 ppb. When corrected by omission of nine values over 50 ppb the mean was 8.1 ppb. Although mean values for men were slightly higher than those for women, this difference was not significant. Results of a 12-test blood chemistry screening profile were available for 186 subjects, but no correlation between mercury concentrations in blood and those chemistry measurements could be detected. Simultaneous determinations of mercury in whole blood and plasma were performed for 65 subjects; the mean for plasma was 5.0 ppb, somewhat below the mean of 6.3 ppb for whole blood in the same group. Other surveys have shown corrected values of 13.3 and 6.7 ppb for normal populations. These values are very much higher than current estimates of 0 to 2 ppb for normals. Levels are higher in urban residents than in rural probably because of increased exposure to combined industrial and environmental sources. The mean level appears to be 8 ppb with a range of 0 to 30 ppb.     

妇女在千年目标中应得到的优先考虑

根据发展中国家提供的信息，由妇女当家的家庭普遍比男子当家的家庭贫困。     

Perceptions in the U.S. building industry of the benefits and costs of improving indoor air quality

How building stakeholders (e.g. owners, tenants, operators, and designers) understand impacts of Indoor Air Quality (IAQ) and associated energy costs is unknown. We surveyed 112 stakeholders across the United States to ascertain their perceptions of their current IAQ and estimates of benefits and costs of, as well as willingness to pay for, IAQ improvements. Respondents' perceived IAQ scores correlated with the use of high‐efficiency filters but not with any other IAQ‐improving technologies. We elicited their estimates of the impacts of a ventilation–filtration upgrade (VFU), that is, doubling the ventilation rate from 20 to 40 cfm/person (9.5 to 19 l/s/person) and upgrading from a minimum efficiency reporting value 6 to 11 filter, and compared responses to estimates derived from IAQ literature and energy modeling. Minorities of respondents thought the VFU would positively impact productivity (45%), absenteeism (23%), or health (39%). Respondents' annual VFU cost estimates (mean = $257, s.d. = $496, median = $75 per person) were much higher than ours (always <$32 per person), and the only yearly cost a plurality of respondents said they would pay for the VFU was $15 per person. Respondents holding green building credentials were not more likely to affirm the IAQ benefits of the VFU and were less likely to be willing to pay for it.