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BACKGROUND Water quality security and human health are important to ensure rural revitalization of old liberated areas. The continuous development and utilization of ion-adsorption type REE deposits in northern Ganzhou aggravate trace elements from ores and tailings to the water cycle, thereby endangering the sanitation and safety of drinking water. OBJECTIVES To investigate and evaluate health risk and water quality on the watershed scale of rare earth ore concentration area in the Huangpi River Basin. METHODS The contents of manganese, cadmium and other elements were determined by inductively coupled plasma-optical emission spectrometry/mass spectrometry(ICP-OES/MS). By choosing "standards for drinking water quality" (GB 5749—2006) as the evaluation basis, the water quality index (WQI), hazard quotient (HQ), and cancer risk (CR)were adopted to evaluate water quality and human health risks through analyzing 9 indices including Pb and Mn. RESULTS NH3-N and Mn were anomaly indices whether in surface water or groundwater. The average values of NH3-N were 750μg/L and 4533μg/L in surface water and groundwater, respectively. Index values of Mn were 207μg/L and 4009μg/L in surface water and groundwater, respectively. Arsenic, class I carcinogen published by the World Health Organization, had no abnormality in surface water and groundwater. Moreover, 85.7% of surface water and groundwater was found to be suitable for drinking upon analyzing the WQI values. The HQ average value of NH3-N was less than 1 in surface water and groundwater so it had no harmful effects on human health. However, the HQ average value of Mn was more than 1, which may be harmful to human health. CR values of As varying from 10-6 to 10-4 were also calculated, and the risk of cancer was acceptable. CONCLUSIONS It is suggested that relevant departments should pay attention to the status of NH3-N and heavy metal elements in water during the reclamation evaluation of rare earth mines. The research detailed in this paper confirms that the groundwater monitoring system of manganese should be improved.

Background: This study aimed to evaluate the clinical significance of baseline Epstein–Barr virus (EBV) DNA in recurrent or metastatic primary pulmonary lymphoepithelioma-like carcinoma (PLELC). Methods: 75 patients with baseline EBV DNA were included. The relationships between baseline EBV DNA and clinical characteristics, survival and objective response rate were analyzed. Results: The baseline EBV DNA levels were related to the liver, chest wall, distant lymph node(s) or multiple sites of distant metastasis. The high baseline EBV DNA group (≥41,900 copies/ml) was related to shorter progression-free and overall survival in univariate analysis and remained significant for progression-free survival in multivariate analysis. Conclusion: The baseline EBV DNA is a valuable biomarker for predicting prognosis and reflecting tumor burden in recurrent or metastatic PLELC. In this study, the baseline plasma EBV DNA level was related to tumor burden, and it was an independent prognostic indicator for PFS in recurrent or metastatic primary pulmonary lymphoepithelioma-like carcinoma. [ABSTRACT FROM AUTHOR]

Background: Afatinib is a potent, irreversible second-generation epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor which has demonstrated efficacy in advanced non-small cell lung cancer (NSCLC) patients harboring either common or uncommon EGFR mutations. However, data on its activity against brain metastases are limited. This study aimed to retrospectively evaluate the efficacy and safety of afatinib as first-line treatment for EGFR-mutant NSCLC patients with brain metastases., Methods: Treatment-naive advanced NSCLC patients harboring EGFR mutations and brain metastases treated with afatinib were retrospectively reviewed to assess the central nervous system (CNS) efficacy and also the systematic benefits., Results: Totally 43 patients with measurable or non-measurable brain metastases were enrolled in the CNS full analysis (cFAS) set. Among them, 23 patients with measurable brain metastases were included in the CNS evaluable for response (cEFR) set. The CNS ORR was 48.8% (95% CI, 33.3 - 64.5%) in the cFAS set and 82.6% (95% CI, 61.2 - 95.0%) in the cEFR set, respectively. CNS mDoR was 8.9 months (95% CI, 4.7 - 13.1 months) and CNS mPFS was 12.7 months (95% CI, 6.9 - 18.5 months) in the cFAS set. In the subgroup analysis stratified by EGFR mutation types, CNS ORR of cEFR set in the common mutation cohort was 100% (95% CI, 75.3 - 100%) and 60% (95% CI, 26.2 - 87.8%) in the uncommon mutation cohort ( p = 0.024); CNS ORR of cFAS set was 57.7% (95% CI, 36.9 - 76.6%) and 35.3% (95% CI, 14.2 - 61.7%), respectively ( p = 0.151). CNS mPFS was 14.4 months in patients with common mutations and 6.1 months in patients with uncommon mutations (hazard ratio, 0.47; 95% CI, 0.22 - 1.00; p = 0.045). Patients with common mutations showed a significantly lower cumulative incidence of CNS failure than uncommon mutation cohort ( p = 0.0026). Most of patients experienced grade 1/2 treatment-related adverse events., Conclusions: First-line afatinib demonstrated encouraging efficacy on brain metastases in NSCLC patients harboring either common or major uncommon EGFR mutations in a real-world setting, with manageable toxicities. Patients with common mutations showed better CNS outcomes than those with uncommon mutations., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Kang, Mai, Liang, Zou, Huang, Lin and Liang.)

Background: Myringotomy with tube insertion can be challenging for junior Otolaryngology residents as it is one of the first microscopic procedures they encounter. The Western myringotomy simulator was developed to allow trainees to practice microscope positioning, myringotomy, and tube placement. This virtual-reality simulator is viewed in stereoscopic 3D, and a haptic device is used to manipulate the digital ear model and surgical tools., Objective: To assess the face and content validity of the Western myringotomy simulator., Methods: The myringotomy simulator was integrated with new modules to allow speculum placement, manipulation of an operative microscope, and insertion of the ventilation tube through a deformable tympanic membrane. A questionnaire was developed in consultation with instructing surgeons. Fourteen face validity questions focused on the anatomy of the ear, simulation of the operative microscope, appearance and movement of the surgical instruments, deformation and cutting of the eardrum, and myringotomy tube insertion. Six content validity questions focused on training potential on surgical tasks such as speculum placement, microscope positioning, tool navigation, ear anatomy, myringotomy creation and tube insertion. A total of 12 participants from the Department of Otolaryngology-Head and Neck Surgery were recruited for the study. Prior to completing the questionnaire, participants were oriented to the simulator and given unlimited time to practice until they were comfortable with all of its aspects., Results: Responses to 12 of the 14 questions on face validity were predominantly positive. One issue of concern was with contact modeling related to tube insertion into the eardrum, and the second was with the movement of the blade and forceps. The former could be resolved by using a higher resolution digital model for the eardrum to improve contact localization. The latter could be resolved by using a higher fidelity haptic device. With regard to content validity, 64% of the responses were positive, 21% were neutral, and 15% were negative., Conclusions: The Western myringotomy simulator appears to have sufficient face and content validity. Further development with automated metrics and skills transference testing is planned.