Development of chemical emission scenarios using the Shared Socio-economic Pathways

The widespread use of chemicals has led to significant water quality concerns, and their use is still increasing. Hence, there is an urgent need to understand the possible future trends in chemical emissions to water systems. This paper proposes a general framework for developing emission scenarios for chemicals to water using the Shared Socio-economic Pathways (SSPs) based on an emission-factor approach. The proposed approach involves three steps: (i) identification of the main drivers of emissions, (ii) quantification of emission factors based on analysis of publicly available data, and (iii) projection of emissions based on projected changes in the drivers and emission factors. The approach was tested in Europe for five chemical groups and on a national scale for five specific chemicals representing pharmaceuticals, pesticides, and industrial chemicals. The resulting emission scenarios show widely diverging trends of increased emissions by 240% for ibuprofen in SSP3 (regional rivalry) to a 68% decrease for diclofenac in SSP1 (sustainable development) by 2050. While emissions typically decrease in SSP1, they follow the historical trend in SSP2 (middle-of-the-road scenario) and show an increase in the regional rivalry scenario SSP3 for most selected chemicals. Overall, the framework allows understanding of future chemical emissions trends as a function of the socio-economic trends as captured in the SSPs. Our scenarios for chemical emissions can thus be used to model future aqueous emissions to support risk assessment. While the framework can be easily extended to other pharmaceuticals and pesticides, it heavily leans on the availability and quality of historical emission data and a detailed understanding of emission sources for industrial chemicals

Children’s first experience of taking anabolic-androgenic steroids can occur before their 10th birthday: a systematic review identifying 9 factors that predict doping among young people

Taking performance-enhancing drugs (PEDs) can cause serious and irreversible health consequences, which can ultimately lead to premature death. Some young people may take PEDs without fully understanding the ramifications of their actions or based on the advice from others. The purpose of this systematic review was to identify the main factors that predicted doping among young people. The literature was systematically reviewed using search engines, manually searching specialist journals, and pearl growing. Fifty-two studies, which included 187,288 young people aged between 10 and 21 years of age, 883 parents of adolescent athletes, and 11 adult coaches, who were interviewed regarding young athletes, were included in this review. Nine factors predicted doping among young people: gender; age; sports participation; sport type; psychological variables; entourage; ethnicity; nutritional supplements’ and health harming behaviors. In regards to psychological variables, 22 different constructs were associated with doping among young people. Some psychological constructs were negatively associated with doping (e.g., self-esteem, resisting social pressure, and perfectionist strivings), whereas other were positively associated with doping (e.g., suicide risk, anticipated regret, and aggression). Policy makers and National Anti-Doping Organisations could use these findings to help identify athletes who are more at risk of doping and then expose these individuals to anti-doping education. Based on the current findings, it also appears that education programs should commence at the onset of adolescence or even late childhood, due to the young age in which some individuals start doping

COVID-19 symptoms at hospital admission vary with age and sex: results from the ISARIC prospective multinational observational study

Background: The ISARIC prospective multinational observational study is the largest cohort of hospitalized patients with COVID-19. We present relationships of age, sex, and nationality to presenting symptoms. Methods: International, prospective observational study of 60 109 hospitalized symptomatic patients with laboratory-confirmed COVID-19 recruited from 43 countries between 30 January and 3 August 2020. Logistic regression was performed to evaluate relationships of age and sex to published COVID-19 case definitions and the most commonly reported symptoms. Results: ‘Typical’ symptoms of fever (69%), cough (68%) and shortness of breath (66%) were the most commonly reported. 92% of patients experienced at least one of these. Prevalence of typical symptoms was greatest in 30- to 60-year-olds (respectively 80, 79, 69%; at least one 95%). They were reported less frequently in children (≤ 18 years: 69, 48, 23; 85%), older adults (≥ 70 years: 61, 62, 65; 90%), and women (66, 66, 64; 90%; vs. men 71, 70, 67; 93%, each P < 0.001). The most common atypical presentations under 60 years of age were nausea and vomiting and abdominal pain, and over 60 years was confusion. Regression models showed significant differences in symptoms with sex, age and country. Interpretation: This international collaboration has allowed us to report reliable symptom data from the largest cohort of patients admitted to hospital with COVID-19. Adults over 60 and children admitted to hospital with COVID-19 are less likely to present with typical symptoms. Nausea and vomiting are common atypical presentations under 30 years. Confusion is a frequent atypical presentation of COVID-19 in adults over 60 years. Women are less likely to experience typical symptoms than men

Investigations of alkaline rare earth orthophosphates M3RE(PO4)2\mathrm{M_3RE(PO_4)_2}

A preparation route to synthesize rubidium and/or potassium rare earth double phosphate powders of the type M3RE(PO4)2 (RE=La, Ce, Eu, Gd, Tb) as pure phases in a solid state reaction is described. The essential fact of the reaction is to make use of the low particle size of freshly precipitated rare earth phosphate REPO4.nH2O as a starting material. Properties of the materials are described

Development of chemical emission scenarios using the Shared Socio-economic Pathways

The widespread use of chemicals has led to significant water quality concerns, and their use is still increasing. Hence, there is an urgent need to understand the possible future trends in chemical emissions to water systems. This paper proposes a general framework for developing emission scenarios for chemicals to water using the Shared Socio-economic Pathways (SSPs) based on an emission-factor approach. The proposed approach involves three steps: (i) identification of the main drivers of emissions, (ii) quantification of emission factors based on analysis of publicly available data, and (iii) projection of emissions based on projected changes in the drivers and emission factors. The approach was tested in Europe for five chemical groups and on a national scale for five specific chemicals representing pharmaceuticals, pesticides, and industrial chemicals. The resulting emission scenarios show widely diverging trends of increased emissions by 240% for ibuprofen in SSP3 (regional rivalry) to a 68% decrease for diclofenac in SSP1 (sustainable development) by 2050. While emissions typically decrease in SSP1, they follow the historical trend in SSP2 (middle-of-the-road scenario) and show an increase in the regional rivalry scenario SSP3 for most selected chemicals. Overall, the framework allows understanding of future chemical emissions trends as a function of the socio-economic trends as captured in the SSPs. Our scenarios for chemical emissions can thus be used to model future aqueous emissions to support risk assessment. While the framework can be easily extended to other pharmaceuticals and pesticides, it heavily leans on the availability and quality of historical emission data and a detailed understanding of emission sources for industrial chemicals

A key role of GARP in the immune suppressive tumor microenvironment

In melanoma patients, one of the main reasons for tumor immune escape and therapy failure is the immunosuppressive tumor microenvironment. Herein, suppressive immune cells and inhibitory factors secreted by the tumor itself play a central role. In the present study we show that the Treg activation marker GARP (glycoprotein A repetitions predominant), known to induce peripheral tolerance in a TGF-β dependent way, is also expressed on human primary melanoma. Interestingly, membrane bound GARP is shed from the surface of both, activated Treg and melanoma cells, and, in its soluble form (sGARP), not only induces peripheral Treg but also a tumor associated (M2) macrophage phenotype. Notably, proliferation of cytotoxic T cells and their effector function is inhibited in the presence of sGARP. GARP expression on Treg and melanoma cells is significantly decreased in the presence of agents such as IFN-α, thus explaining at least in part a novel mechanism of action of this adjuvant therapy. In conclusion, GARP in its soluble and membrane bound form contributes to peripheral tolerance in a multipronged way, potentiates the immunosuppressive tumor microenvironment and thus acts as a negative regulator in melanoma patients. Therefore, it may qualify as a promising target and a new checkpoint for cancer immunotherapy

Children's First Experience of Taking Anabolic-Androgenic Steroids can Occur before Their 10th Birthday: A Systematic Review Identifying 9 Factors That Predicted Doping among Young People

Taking performance-enhancing drugs (PEDs) can cause serious and irreversible health consequences, which can ultimately lead to premature death. Some young people may take PEDs without fully understanding the ramifications of their actions or based on the advice from others. The purpose of this systematic review was to identify the main factors that predicted doping among young people. The literature was systematically reviewed using search engines, manually searching specialist journals, and pearl growing. Fifty-two studies, which included 187,288 young people aged between 10 and 21 years of age, 883 parents of adolescent athletes, and 11 adult coaches, who were interviewed regarding young athletes, were included in this review. Nine factors predicted doping among young people: gender; age; sports participation; sport type; psychological variables; entourage; ethnicity; nutritional supplements; and health harming behaviors. In regards to psychological variables, 22 different constructs were associated with doping among young people. Some psychological constructs were negatively associated with doping (e.g., self-esteem, resisting social pressure, and perfectionist strivings), whereas other were positively associated with doping (e.g., suicide risk, anticipated regret, and aggression). Policy makers and National Anti-Doping Organizations could use these findings to help identify athletes who are more at risk of doping and then expose these individuals to anti-doping education. Based on the current findings, it also appears that education programs should commence at the onset of adolescence or even late childhood, due to the young age in which some individuals start doping

Supported high-risk percutaneous coronary intervention with the impella 2.5 device the europella registry

OBJECTIVES: This retrospective multicenter registry evaluated the safety and feasibility of left ventricular (LV) support with the Impella 2.5 (Abiomed Europe GmbH, Aachen, Germany) during high-risk percutaneous coronary intervention (PCI). BACKGROUND: Patients with complex or high-risk coronary lesions, such as last remaining vessel or left main lesions, are increasingly being treated with PCI. Because periprocedural hemodynamic compromise and complications might occur rapidly, many of these high-risk procedures are being performed with mechanical cardiac assistance, particularly in patients with poor LV function. The Impella 2.5, a percutaneous implantable LV assist device, might be a superior alternative to the traditionally used intra-aortic balloon pump. METHODS: The Europella registry included 144 consecutive patients who underwent a high-risk PCI. Safety and feasibility end points included incidence of 30-day adverse events and successful device function. RESULTS: Patients were older (62% >70 years of age), 54% had an LV ejection fraction </=30%, and the prevalence of comorbid conditions was high. Mean European System for Cardiac Operative Risk Evaluation score was 8.2 (SD 3.4), and 43% of the patients were refused for coronary artery bypass grafting. A PCI was considered high-risk due to left main disease, last remaining vessel disease, multivessel coronary artery disease, and low LV function in 53%, 17%, 81%, and 35% of the cases, respectively. Mortality at 30 days was 5.5%. Rates of myocardial infarction, stroke, bleeding requiring transfusion/surgery, and vascular complications at 30 days were 0%, 0.7%, 6.2%, and 4.0%, respectively. CONCLUSIONS: This large multicenter registry supports the safety, feasibility, and potential usefulness of hemodynamic support with Impella 2.5 in high-risk PC