The Value of Routine Biopsy during Percutaneous Kyphoplasty for Vertebral Compression Fractures

<div><p>Objective</p><p>Percutaneous kyphoplasty (PKP) is now widely performed to treat VCF, which is usually caused by osteoporosis. Previous researches have reported unsuspected malignancies found by biopsy. However, the safety and cost-effective profiles of routine biopsy during PKP are unclear. The purpose of this study was to evaluate the feasibility of routine biopsy during PKP in treatment of VCF.</p><p>Methods</p><p>Ninety-three patients (September 2007–November 2010) undergoing PKP without biopsy were reviewed as the control group. One hundred and three consecutive patients (November 2010–September 2013) undergoing PKP with biopsy of every operated vertebral level were prospectively enrolled as the biopsy group. The rate of unsuspected lesions was reported, and the severe adverse events, surgical duration, cement leakage rate and pain control were compared between the two groups.</p><p>Results</p><p>No statistically significant differences were found between the two groups, regarding the severe adverse events, surgical duration, cement leakage rate and pain control. Four unsuspected lesions were found in the biopsy group, three of which were malignancies with a 2.9% (3/103) unsuspected malignancy rate. The economic analysis showed that routine biopsy was cost-effective in finding new malignancies comparing with a routine cancer screening campaign.</p><p>Conclusions</p><p>Routine biopsy during PKP was safe and cost-effective in finding unsuspected malignancies. We advocate routine biopsy in every operated vertebral level during PKP for VCF patients.</p></div

Comparison of demographics, surgical duration, cement leakage rate and pain control between the biopsy and control groups.

<p>Comparison of demographics, surgical duration, cement leakage rate and pain control between the biopsy and control groups.</p

Gaseous Ammonia Emissions from Coal and Biomass Combustion in Household Stoves with Different Combustion Efficiencies

This study reports on the emission characteristics of NH₃ from coal and biomass combustion in the household stoves. The average NH₃ emission factors (EFs) for burning 13 coal and four biomass briquette samples in a traditional heating stove were 1.01 and 0.95 mg/g, respectively, whereas the biomass EF in a traditional cooking stove was 0.96 mg/g. These NH₃ EFs did not present significant differences and were not well-correlated with the tested fuel properties. However, the modified combustion efficiency (MCE) appeared to be well-correlated with the NH₃ EFs measured from various fuel–stove combinations. For the same fuel samples, the advanced heating stove with a high MCE had a much lower average NH₃ EF of 0.13 mg/g. Our findings indicate that household combustion may be a significant NH₃ emission source in developing countries such as China, and demonstrate that utilizing improved combustion technologies is an effective method for reducing these emissions

Anthropogenic Emissions of Hydrogen Chloride and Fine Particulate Chloride in China

Particulate chloride (Cl^–) can be transformed to nitryl chloride (ClNO₂) via heterogeneous reaction with nitrogen pentoxide (N₂O₅) at night. Photolysis of ClNO₂ and subsequent reactions of chlorine radical with other gases can significantly affect the atmospheric photochemistry. In China, the only available integrated anthropogenic chloride emission inventory was compiled in the 1990s with low spatial resolution, which hinders assessment of impact of ClNO₂ on current air quality. In this study, we developed an up-to-date and high-resolution anthropogenic inventory of hydrogen chloride (HCl) and fine particulate Cl^– emissions in China for 2014 with 0.1° × 0.1° resolution. Detailed local data and county-level activity data were collected and complied. The anthropogenic emissions of HCl and fine particulate Cl^– in 2014 were estimated to be 458 and 486 Gg, respectively. Biomass burning was the largest contributor, accounting for 75% of fine particulate Cl^– emission and 32% of HCl emission. Northeast China and North China Plain were the largest chloride emitters. The monthly distribution varied in different regions, due to different agricultural activities and climate conditions. This work updates the chloride emission information and improves its spatial and temporal resolution, which enables better quantification of the ClNO₂ production and its impact over China

Environmental Justice Aspects of Exposure to PM_2.5 Emissions from Electric Vehicle Use in China

Plug-in electric vehicles (EVs) in China aim to improve sustainability and reduce environmental health impacts of transport emissions. Urban use of EVs rather than conventional vehicles shifts transportation’s air pollutant emissions from urban areas (tailpipes) to predominantly rural areas (power plants), changing the geographic distribution of health impacts. We model PM_2.5-related health impacts attributable to urban EV use for 34 major cities. Our investigation focuses on environmental justice (EJ) by comparing pollutant inhalation versus income among impacted counties. We find that EVs could increase EJ challenge in China: most (∼77%, range: 41–96%) emission inhalation attributable to urban EVs use is distributed to predominately rural communities whose incomes are on average lower than the cities where EVs are used. Results vary dramatically across cities depending on urban income and geography. Discriminant analysis reveals that counties with low income and high inhalation of urban EV emissions have comparatively higher agricultural employment rates, higher mortality rates, more children in the population, and lower education levels. We find that low-emission electricity sources such as renewable energy can help mitigate EJ issues raised here. Findings here are not unique to EVs, but instead are relevant for nearly all electricity-consuming technologies in urban areas

Temporal Trend and Spatial Distribution of Speciated Atmospheric Mercury Emissions in China During 1978–2014

Mercury pollution control has become a global goal. The accurate estimate of long-term mercury emissions in China is critical to evaluate the global mercury budget and the emission reduction potentials. In this study, we used a technology-based approach to compile a consistent series of China’s atmospheric mercury emissions at provincial level from 1978 to 2014. China totally emitted 13 294 t of anthropogenic mercury to air during 1978–2014, in which gaseous elemental mercury, gaseous oxidized mercury, and particulate-bound mercury accounted for 58.2%, 37.1%, and 4.7%, respectively. The mercury removed during this period were 2085 t in coal-fired power plants (counting 49% of mercury input), 7259 t in Zn smelting (79%), 771 t in coal-fired industrial boilers (25%), and 658 t in cement production plants (27%), respectively. Annual mercury emissions increased from 147 t in 1978 to 530 t in 2014. Both sectoral and spatial emissions of atmospheric mercury experienced significant changes. The largest mercury emission source evolved from coal-fired industrial boilers before 1998, to zinc smelting during 1999–2004, coal-fired power plants during 2005–2008, finally to cement production after 2009. Coal-fired industrial boilers and cement production have become critical hotpots for China’s mercury pollution control

Residential Coal Combustion as a Source of Levoglucosan in China

Levoglucosan (LG) has been widely identified as a specific marker for biomass burning (BB) sources and frequently utilized in estimating the BB contribution to atmospheric fine particles all over the world. However, this study provides direct evidence to show that coal combustion (CC) is also a source of LG, especially in the wintertime in Northern China, based on both source testing and ambient measurement. Our results show that low-temperature residential CC could emit LG with emission factors (EF) ranging from 0.3 to 15.9 mg kg^–1. Ratios of LG to its isomers, mannosan and galactosan, differ between CC and BB emissions, and the wintertime ratios in Beijing ambient PM_2.5 and source-specific tracers including carbon isotopic signatures all indicated a significant contribution from CC to ambient levoglucosan in winter in Beijing. The results suggest that LG cannot be used as a distinct source marker for biomass burning in special cases such as some cities in the northern China, where coal is still widely used in the residential and industrial sectors. Biomass burning sources could be overestimated, although such an over-estimation could vary spatially and temporally