Delayed use of bioenergy crops might threaten climate and food security.

The potential of mitigation actions to limit global warming within 2 °C (ref. 1) might rely on the abundant supply of biomass for large-scale bioenergy with carbon capture and storage (BECCS) that is assumed to scale up markedly in the future2-5. However, the detrimental effects of climate change on crop yields may reduce the capacity of BECCS and threaten food security6-8, thus creating an unrecognized positive feedback loop on global warming. We quantified the strength of this feedback by implementing the responses of crop yields to increases in growing-season temperature, atmospheric CO2 concentration and intensity of nitrogen (N) fertilization in a compact Earth system model9. Exceeding a threshold of climate change would cause transformative changes in social-ecological systems by jeopardizing climate stability and threatening food security. If global mitigation alongside large-scale BECCS is delayed to 2060 when global warming exceeds about 2.5 °C, then the yields of agricultural residues for BECCS would be too low to meet the Paris goal of 2 °C by 2200. This risk of failure is amplified by the sustained demand for food, leading to an expansion of cropland or intensification of N fertilization to compensate for climate-induced yield losses. Our findings thereby reinforce the urgency of early mitigation, preferably by 2040, to avoid irreversible climate change and serious food crises unless other negative-emission technologies become available in the near future to compensate for the reduced capacity of BECCS.

A Simple Two-Step Cloud Point Extraction Process for Removing Fluorescent Whitening Agents VBL in Industrial Wastewater and Recycling of Surfactant.

With the enhancement of people's environmental consciousness, the treatment of wastewater was studied as the focus of this paper. Here we present a simple two-step extraction to realize efficient separation of fluorescent whitening agents VBL and cyclic utilization of surfactant to reduce the cost of wastewater treatment and environmental pollution. Firstly, the removal of VBL has been achieved by CPE using TX-114 as nonionic surfactant. The results showed that complete extraction was possible using 1% (w/w) TX-114 for VBL concentration not exceeding 17.5 mg/L, otherwise using a higher concentration of 1.5% (w/w) TX-114. Then the surfactant from the coacervate phase was recycled by changing the potential difference between phases. The morphology of micelles and solubilization mechanism of VBL were demonstrated through the observation of a fluorescent microscope. This method was successfully used to remove the VBL from wastewater sample and the surfactant could be reused several times.

[Tongjiang granule intervened non-erosive reflux disease patients of Gan-Wei incoordination syndrome: a curative effect observation].

OBJECTIVE: To assess the effectiveness of Tongjiang Granule (TJG) in treating non-erosive reflux disease (NERD) of Gan-Wei incoordination syndrome (GWIS). METHODS: Totally 128 NERD patients of GWIS were recruited from outpatients or inpatients at Department of Digestive Disease, Xiyuan Hospital, China Academy of Chinese Medical Sciences from February 2009 to November 2010. They were randomly assigned to two groups using the block group in the ratio of 1:1, 64 cases in each group. Patients in the experiment group were treated with TJG, 10 g each time, three times a day, while those in the control group were treated with Omeprazole Tablet, 20 mg each time, two times a day. The treatment course of both groups was 4 weeks. The symptoms questionnaires and SF-36 quality of life scale were observed. RESULTS: Finally 114 patients completed the trial. There was statistical difference in epigastric upset, pharyngeal foreign body sensation, abdominal swelling or abdominal pain, and integral of excrement between the two groups before treatment (P < 0.05). However, there was no statistical difference in the rest indices between the two groups (P > 0.05). Compared with before treatment in the same group, the scores of each symptom or the total symptoms were somewhat improved in the two groups (P < 0.01, P < 0.05). There was statistical difference in the rest scores (P > 0.05) except the score of mental health in the experiment group (P < 0.01, P < 0.05). There was statistical difference in the rest scores (P > 0.05) except the score of physical function in the control group (P < 0.01, P < 0.05). There was statistical difference in post-treatment acid reflux, irritability, depression, body pain, roles of emotions (P < 0.01, P < 0.05). The total effective rate was higher in the experimental group, showing no statistical difference when compared with that of the control group (P > 0.05). CONCLUSIONS: TJG had confirmative efficacy in treating NERD patients of GWIS. Meanwhile, it could improve their quality of life, with no obvious adverse reaction.

A bio-inspired versatile free-standing membrane for oral cavity microenvironmental monitoring and remineralization to prevent dental caries.

The fast monitoring of oral bacterial infection, bacterial clearance and repairing of enamel damage caused by dental caries relies on an effective way of monitoring, killing and repairing in situ, but presents a major challenge in oral healthcare. Herein, we developed a bio-inspired versatile free-standing membrane by filling TiO2 nanotube arrays with ß-sheet-rich silk fibroin and cleaving them from Ti foil, as inspired by nacre or enamel-like structures. The robust transparent membrane exhibited good mechanical properties, and could indicate acid-base microenvironment variation and the infection of S. mutans in a 5 min test by loading cyanidin cations in the membrane. Meanwhile, it can be used for photocatalysis and nanoreservoirs ascribed to TiO2 nanotubes, to kill and remove 99% of S. mutans bacteria under interval UV irradiation with low-power density, and load functional peptide to induce the remineralization on the etched-enamel for long-term treatment, tested in vitro and in vivo. The mechanical property of repaired enamel is improved in comparison. This bio-inspired constructed membrane would be applied in the prevention and treatment of oral cavity related diseases, such as enamel demineralization and dental caries, etc.

Compositions, sources, and potential health risks of volatile organic compounds in the heavily polluted rural North China Plain during the heating season.

Severe volatile organic compound (VOC) pollution has become an urgent problem during the heating season in the North China Plain (NCP), as exposure to hazardous VOCs can lead to chronic or acute diseases. A campaign with online VOC measurements was conducted at a rural site in Wangdu, NCP during the 2018 heating season to characterize the compositions and associated sources of VOCs and to assess their potential health risks. The total concentration of VOCs with 94 identified species was 77.21 ± 54.39 ppb. Seven source factors were identified by non-negative matrix factorization, including coal combustion (36.1%), LPG usage (21.1%), solvent usage (13.9%), biomass burning and secondary formation (14.2%), background (7.0%), industrial emissions (4.5%), and vehicle emissions (3.3%). The point estimate approach and Monte Carlo simulation were used to estimate the carcinogenic and non-carcinogenic risks of harzadous VOCs. The results showed that the cumulative health risk of VOCs was above the safety level. Acrolein, 1.2-dichloroethane, 1,2-dichloropropane, chloroform, 1,3-butadiene, and benzene were identified as the key hazardous VOCs in Wangdu. Benzene had the highest average carcinogenic risk. Solvent usage and secondary formation were the dominant sources of adverse health effects. During the Spring Festival, most sources were sharply reduced; and VOC concentration declined by 49%. However, coal and biomass consumptions remained relatively large, probably due to heating demand. This study provides important references for the control strategies of VOCs during the heating season in heavily polluted rural areas in the NCP.

Intrathecal morphine versus femoral nerve block for pain control after total knee arthroplasty: a meta-analysis.

BACKGROUND: This meta-analysis aims to illustrate the efficacy and safety of intrathecal morphine (ITM) versus femoral nerve block (FNB) for pain control after total knee arthroplasty (TKA). METHODS: In April 2017, a systematic computer-based search was conducted in PubMed, EMBASE, Web of Science, Cochrane Database of Systematic Reviews, Cami Info. Inc., Casalini databases, EBSCO databases, Verlag database and Google database. Data on patients prepared for TKA surgery in studies that compared ITM versus FNB for pain control after TKA were collected. The main outcomes were the visual analogue scale (VAS) at 6, 12, 24, 48 and 72 and total morphine consumption at 12, 24 and 48 h. The secondary outcomes were complications that included postoperative nausea and vomiting (PONV) and itching. Stata 12.0 was used for pooling the data. RESULTS: Five clinical studies with a total of 225 patients (ITM group = 114, FNB group = 111) were ultimately included in the meta-analysis. The results revealed that the ITM group was associated with a reduction of VAS at 6, 12, 24, 48 and 72 h and total morphine consumption at 12, 24 and 48 h. There was no significant difference between the occurrences of PONV. However, the ITM group was associated with an increased occurrence of itching after TKA. CONCLUSIONS: Some immediate analgesic efficacy and opioid-sparing effects were obtained with the administration of ITM when compared with FNB. The complications of itching in the ITM group were greater than in the FNB group. The sample size and the quality of the included studies were limited. A multi-centre RCT is needed to identify the optimal method for reaching maximum pain control after TKA.

Development and Initial Validation of the Novel Scale for Assessing Quality of Life of Prostate Cancer Patients Receiving Androgen Deprivation Therapy.

BACKGROUND: There has been no a specific scale to measure quality of life (QOL) for prostate cancer patients receiving androgen deprivation therapy (ADT) to date. This study aimed to develop and initially validate the scale to evaluate QOL for prostate cancer patients receiving ADT. METHODS: The scale was developed following international recommendations. Moreover, the items were all generated through literature review and referenced questionnaires. After being reviewed by expert panelists, the revised scale was formed and then completed by a convenience sample of 200 prostate cancer patients from our hospital. Explore factor analysis (EFA) was applied to test the construct validity, then split-half reliability, Cronbach's alpha, and test-retest reliability were applied to assess the reliability and stability of the scale. RESULTS: The revised scale contained 22 items and a total of 200 participants had completed the scale. One hundred participants were randomly selected from the total 200 participants to perform EFA with varimax rotation on the revised scale, and "hot flashes" item was deleted for low factor loading. We selected only 3 items from each factor, then, the final scale was formed with 18-items. We selected another 100 participants to perform the EFA again on the final scale. It was demonstrated that the structure with 6 factors explained 72.5% of total variance and factor loading value was above 0.40 in all items of the factors. Moreover, the split-half reliability coefficient, Cronbach's alpha, and test-retest reliability coefficient were calculated to be 0.74, 0.63, and 0.89, respectively, exhibiting good reliability on the whole. CONCLUSIONS: The scale was identified to be a valid and reliable instrument to measure QOL for prostate cancer patients receiving ADT. Moreover, further research is needed to overcome the potential drawbacks.

[Application of internal fixation for injuries of pelvic anterior ring through minimally invasive ilioinguinal approach].

OBJECTIVE: To evaluate the reliability of limited open reduction and minimally invasive plate osteosynthesis (MIPO) for injuries of pelvic anterior ring and to explore its operative techniques and therapeutic efficacy. METHODS: From March 2009 to March 2012,20 patients with injuries of pelvic anterior ring were surgically fixed with reconstructive plates through minimally invasive ilioinguinal approach. There were 13 males and 7 females with an average age of 41.6 years ranging from 25 to 61 years. According to classification of Tile, there were 5 cases of type A2, 2 cases of type B1, 9 cases of type B2, 1 case of type B3, 3 cases of type C1. Including 15 cases with anterior ring fracture, 2 cases with anterior ring fracture combined with pubic symphysis separation, and 3 cases with anterior and posterior fractures. Operation time, intra-operative blood losing, injuries of femoral nerve and iliac blood vessels, condition of fracture reduction were observed. RESULTS: All wounds healed at one stage. No complications such as infection or deep venous thrombosis occurred. According to Matta criterion of fracture reduction, 12 cases got excellent results, 7 good, 1 fair. Eighteen patients were followed up from 6 to 32 months with a mean of 16.3 months. According to functional score of Majeed, 15 cases obtained excellent results and 3 good,with an average score of 94.3 +/- 6.0. CONCLUSION: The modified ilioinguinal approach has advantage of short operation time, less blood losing,minimally invasive in treating injuries of pelvic anterior ring and can obtain satisfactory outcomes.

[Efficacy observation on the needling depth recorded in Lingshu (Miraculous Pivot) for irritable bowel syndrome of diarrhea].

OBJECTIVE: To observe the clinical efficacy of the needling depth recorded in Lingshu (Miraculous Pivot) for irritable bowel syndrome of diarrhea (IBS-D) in Germany. METHODS: With the needling technique recorded in Lingshu: Jingshui (Miraculous Pivot: Meridian Water), 21 cases of IBSD were treated with acupuncture at Zhangmen(lR 13), Zhongwan(CV 12), Tianshu (ST 25), Guanyuan(CV 4), Qimen (LR 14), Quchi (LI 11), Hegu (LI 4), Yinlingquan(SP 9), Zusanli (ST 36) and Taichong (LR 3), 0. 1-0. 6 cun (2-12 mm) in depth. Even needling technique was applied. The treatment was given 2-3 times each week, and 8 treatments made one session. The efficacy and the scale for the severity degree of symptom (IBS-SSS) were observed in 1-2 sessions of treatment. RESULTS: The total effective rate was 52.4% (11/21) in the 1st session and was 90.5% (19/21) in the 2nd session. The efficacy in the 2nd session was superior to that in the 1st session (P < 0.05). IBS-SSS was 143.58 +/- 70.15 in the 1st session and was 115.98 +/- 72.68 in the 2nd session, all reduced obviously as compared with those before treatment (all P < 0.01). The reducing degree in the 2nd session was much remarkable than that in the 1st session (P < 0.05). CONCLUSION: The better clinical efficacy has been achieved for IBS-D treated with needling depth recorded in Lingshu (Miraculous Pivot) in Germany. The longer session of treatment is, the better efficacy is obtained.

[Dual steel plate for the surgical management of intercondylar fractures of the humerus through approach of osteotomy of olecranon].

OBJECTIVE: To explore the surgical management and its results of intercondylar fractures of the humerus through approach of osteotomy of olecranon (AOO) with dual steel plate. METHODS: From June 2001 to March 2007, 38 patients of intercondylar fractures of humerus were treated surgically through AOO, and the fracture was reduced and fixed with dual steel plate. There were 24 males and 14 females with a mean age of 37 years (range 19 to 48 years). All cases were closed fractures. The fractures were classified according AO included 12 cases of C1, 20 cases of C2 and 6 cases of C3. The time from injured to operation was 6 hours to 14 days (means 7 days). RESULTS: These 38 patients were followed up from 5 months to 2 years (average 12 months). The wound healing of one patient was below the mark. After the treatment of change dressings, the wound healed. Of these 38 patients, no loosening or breakage of internal fixation occurred. All the osteotomies healed in 15 weeks averagely (range 12 to 22 weeks). According to Cassebaum scoring system, the results were excellent in 15 cases, good in 17 cases, fair in 5 cases and poor in 1 case. CONCLUSION: The technique of dual steel plate for the treatment intercondylar fractures of the humerus through approach of osteotomy of olecranon (AOO) offers many advantages, such as sufficient exposure easy, stable fixation and earlier exercise. Functional exercise in the early period is the crucial factor of enhancing the therapeutic effect.

[Maxillomandibular advancement for obstructive sleep apnea/hypopnea syndrome].

OBJECTIVE: To explore effectiveness of maxillomandibular advancement (MMA) in the treatment of obstructive sleep apnea/hypopnea syndrome (OSAHS). METHODS: MMA was performed in 10 OSAHS patients with mandibular dysplasia diagnosed by mandibular protrusion angle (SNB) < 75 degrees and a posterior airway space (PAS) < 11 mm. Six patients had uvulopalatopharyngoplasty (UPPP) also. Six patients had over 6 months postoperative follow up. RESULTS: The blood loss was about 250-600 ml in the operation, and the serious complications didn't happen. The patients were satisfied with the postoperative facial change. Based on success criteria of 2009, of 5 patients showed highly responsive result and 1 patient was responsive (valid). rate was 83% and the responsive rate 100%. The snoring loudness score and Epworth sleepy score were reduced from preoperative 8 (6-10) and 15 (11-24) to postoperative 2 (0-4) and 5 (1-8). AHI was reduced from preoperative 52.2 (23.7-83.8) to postoperative 12.6 (7.6-31.8), lowest mean oxygen saturation increased from 0.64 (0.57-0.83) to 0.82 (0.78-0.93). Percentage of time with oxyhemoglobin saturation below 0.90 (CT90) reduced from 21.0% (12.0%-37.2%) to 2.0% (0%-8.0%). CONCLUSIONS: MMA is effective for the OSAHS patients with mandibular dysplasia.