A Critical Review of Biomarkers Used for Monitoring Human Exposure to Lead: Advantages, Limitations, and Future Needs

Lead concentration in whole blood (BPb) is the primary biomarker used to monitor exposure to this metallic element. The U.S. Centers for Disease Control and Prevention and the World Health Organization define a BPb of 10 μg/dL (0.48 μmol/L) as the threshold of concern in young children. However, recent studies have reported the possibility of adverse health effects, including intellectual impairment in young children, at BPb levels < 10 μg/dL, suggesting that there is no safe level of exposure. It appears impossible to differentiate between low-level chronic Pb exposure and a high-level short Pb exposure based on a single BPb measurement; therefore, serial BPb measurements offer a better estimation of possible health outcomes. The difficulty in assessing the exact nature of Pb exposure is dependent not so much on problems with current analytical methodologies, but rather on the complex toxicokinetics of Pb within various body compartments (i.e., cycling of Pb between bone, blood, and soft tissues). If we are to differentiate more effectively between Pb stored in the body for years and Pb from recent exposure, information on other biomarkers of exposure may be needed. None of the current biomarkers of internal Pb dose have yet been accepted by the scientific community as a reliable substitute for a BPb measurement. This review focuses on the limitations of biomarkers of Pb exposure and the need to improve the accuracy of their measurement. We present here only the traditional analytical protocols in current use, and we attempt to assess the influence of confounding variables on BPb levels. Finally, we discuss the interpretation of BPb data with respect to both external and endogenous Pb exposure, past or recent exposure, as well as the significance of Pb determinations in human specimens including hair, nails, saliva, bone, blood (plasma, whole blood), urine, feces, and exfoliated teeth

Aripiprazole in the Maintenance Treatment of Bipolar Disorder: A Critical Review of the Evidence and Its Dissemination into the Scientific Literature

A systematic search of the literature reveals limited evidence to support use of aripiprazole, a second-generation antipsychotic medication, in maintenance therapy of bipolar disorder, despite widespread use

Snow farming: conserving snow over the summer season

Summer storage of snow for tourism has seen an increasing interest in the last years. Covering large snow piles with materials such as sawdust enables more than two-thirds of the initial snow volume to be conserved. We present detailed mass balance measurements of two sawdust-covered snow piles obtained by terrestrial laser scanning during summer 2015. Results indicate that 74 and 63 % of the snow volume remained over the summer for piles in Davos, Switzerland and Martell, Italy. If snow mass is considered instead of volume, the values increase to 83 and 72 %. The difference is attributed to settling and densification of the snow. Additionally, we adapted the one-dimensional, physically based snow cover model SNOWPACK to perform simulations of the sawdust-covered snow piles. Model results and measurements agreed extremely well at the point scale. Moreover, we analysed the contribution of the different terms of the surface energy balance to snow ablation for a pile covered with a 40 cm thick sawdust layer and a pile without insulation. Short-wave radiation was the dominant source of energy for both scenarios, but the moist sawdust caused strong cooling by long-wave emission and negative sensible and latent heat fluxes. This cooling effect reduces the energy available for melt by up to a factor of 12. As a result only 9 % of the net short-wave energy remained available for melt. Finally, sensitivity studies of the parameters thickness of the sawdust layer, air temperature, precipitation and wind speed were performed. We show that sawdust thickness has a tremendous effect on snow loss. Higher air temperatures and wind speeds increase snow ablation but less significantly. No significant effect of additional precipitation could be found as the sawdust remained wet during the entire summer with the measured quantity of rain. Setting precipitation amounts to zero, however, strongly increased melt. Overall, the 40 cm sawdust provides sufficient protection for mid-elevation (approx. 1500 m a.s.l.) Alpine climates and can be managed with reasonable effort