Conductive materials enhance microbial salt-tolerance in anaerobic digestion of food waste: Microbial response and metagenomics analysis.

Previous studies have shown that high salinity environments can inhibit anaerobic digestion (AD) of food waste (FW). Finding ways to alleviate salt inhibition is important for the disposal of the growing amount of FW. We selected three common conductive materials (powdered activated carbon, magnetite, and graphite) to understand their performance and individual mechanisms that relieve salinity inhibition. Digester performances and related enzyme parameters were compared. Our data revealed that under normal and low salinity stress conditions, the anaerobic digester ran steady without significant inhibitions. Further, the presence of conductive materials promoted conversion rate of methanogenesis. This promotion effect was highest from magnetite > powdered activated carbon (PAC) > graphite. At 1.5% salinity, PAC and magnetite are beneficial in maintaining high methane production efficiency while control and the graphite added digester acidified and failed rapidly. Additionally, metagenomics and binning were used to analyze the metabolic capacity of the microorganisms. Some species enriched by PAC and magnetite possessed higher cation transport capacities and were to accumulate compatible solutes. PAC and magnetite promoted direct interspecies electron transference (DIET) and syntrophic oxidation of butyrate and propionate. Also, the microorganisms had more energy available to cope with salt inhibition in the PAC and magnetite added digesters. Our data imply that the promotion of Na+/H+ antiporter, K+ uptake, and osmoprotectant synthesis or transport by conductive materials may be crucial for their proliferation in highly stressful environments. These findings will help to understand the mechanisms of alleviate salt inhibition by conductive materials and help to recover methane from high-salinity FW.

Evaluation of the star family doctors training program: an observational cohort study of a novel continuing medical education program for general practitioners within a compact medical consortium: a quantitative analysis.

INTRODUCTION: To determine the effectiveness of the Star Family Doctors Training Program, a comprehensive Continuing professional development (CPD) program for general practitioners (GPs) in a compact medical consortium. PATIENTS AND METHODS: Observational cohort study with a quantitative analyses in primary health care institutions in Sichuan Province. The interventions were as following: (1) The Star Family Doctors Training Program is a full-time, local government allocation program certified by the Health Department of Sichuan Province, emphasizing small group learning and practice, and using standard patients and medical patient simulators; 30 participants were selected by their institutions. (2) The control group underwent a self-financed after-work CPD program using conventional lectures; 50 participants were self-selected. Short-term effectiveness assessed using immediate post-training tests and self-evaluations; long-term (1 year) effectiveness evaluated using self-reported surveys. RESULTS: The study involved 80 GPs (28.75% men; mean age: 38.2 ± 9.2 years). The average post-training total score was higher in the STAR group than in the control group (72.83 ± 5.73 vs. 68.18 ± 7.64; p = 0.005). Compared to the controls, STAR participants reported seeing more patients (all p < 0.05), and had more patients who signed family-doctor contracts (p = 0.001) as well as increased patient satisfaction (p = 0.03), respectively. STAR-group trainees appraised the program higher and were more willing to recommend it to colleagues (90% vs. 64%, p = 0.011). CONCLUSION: The Star Family Doctors Training Program achieved good responses and provides a reference for future CPD programs.

[The lipid-regulating effect and safety of combined statin and bezafibrate therapy in acute coronary syndrome patients complicating with dyslipidemia].

OBJECTIVE: To investigate the lipid-regulating effect and safety of combined statin and bezafibrate therapy in acute coronary syndrome(ACS) patients complicating with dyslipedemia. METHODS: One hundred and four hospitalized patients with established ACS and increased serum triglycerides (TG) levels and/or low serum levels of high density lipoprotein cholesterol (HDL-C) were selected. Except for conventional therapy, the patients were randomly divided into 2 groups: control group (n = 52), treated with atorvastatin 20 mg qn or other statin equivalent to 20 mg atorvastatin; treatment group (n = 52), treated with the same dose statin plus bezafibrate 200 mg bid. The serum levels of total cholesterol (TC), TG, low-density lipoprotein cholesterol (LDL-C) and HDL-C were assessed before and after 6 and 12 weeks treatment, side effects and adverse events were recorded. RESULTS: After 6 weeks treatment, the serum levels of TC, TG and LDL-C in two groups were significantly reduced compared to baseline (all P < 0.05), which were further declined after 12 weeks treatment, and the reduction was more significant in treatment group(29.8%, 38.0% and 36.1%, respectively) than in control group(14.7%, 9.8% and 26.7%, respectively) (all P < 0.05). After treatment, the serum levels of HDL-C in the two groups were significantly higher than the baseline levels, especially after 12 weeks treatment (all P < 0.05), and the elevations of HDL-C levels in control group and in treatment group were 19.3% and 24.2%, respectively, but there were no significant difference between the two groups (P > 0.05). After 12 weeks, the rates reaching to target goals of LDL-C, TG, HDL-C, and non-HDL-C levels in the treatment group (69.2%, 88.5%, 92.3%, 46.2% and 65.4%, respectively) were significantly higher than those in the control group (34.6%, 65.4%, 46.2%, 7.7% and 42.3%, respectively, all P < 0.05). No serious side effects were observed in the two groups during the treatment period. CONCLUSION: The combined statin and bezafibrate treatment is safe and could increase the ratios of reaching target lipid levels in ACS patients complicating with increased TG and (or) decreased HDL-C.

Expectancy-Value Motivation and Physical Activity- and Health-Related Outcomes among At-Risk Children and Adolescents.

Despite a large amount of research having been done to examine and promote physical activity and health among adolescents and children, relatively little attention has been paid attention to underrepresented populations. In this study, we investigated the relationships between expectancy-value motivation and physical activity- and health-related outcomes among a group of at-risk boys at a summer sports camp. The total participants included 107 boys (Mage = 11.78 years, SD = 1.20). The boys' perceived expectancy beliefs (EXP), importance (IMP), interest (INT), usefulness (USE), effort (EFT), and intention for future participation (IFP) were assessed using established questions on a five-point Likert scale, and a PACER test was performed to estimate their cardiovascular fitness (CVF). Through a path analysis, we found that EXP positively predicted CVF (ß = 0.19, p < 0.01), IMP positively predicted EFT (ß = 0.26, p < 0.01), and INT positively predicted both EFT (ß = 0.34, p < 0.01) and IFP (ß = 0.28, p < 0.01), while USE had no statistically significant effect on either EFT, IFP, or CVF. We discussed the limitations and implications of the present study. We recommend including a diverse sample and employing the expectancy-value model in future research, and advocating expectancy beliefs and task values, especially importance and interest, among participants during physical activity promotion.

Management of male erectile dysfunction: From the past to the future.

Erectile dysfunction is a common disease of the male reproductive system, which seriously affects the life quality of patients and their partners. At present, erectile dysfunction is considered as a social-psychological-physiological disease with complex etiology and various treatment methods. Oral PDE5I is the first-line treatment for erectile dysfunction with the advantages of high safety, good effect and non-invasiveness. But intracavernosal injection, hormonal replacement therapy, vacuum erection device, penile prosthesis implantation can also be alternative treatments for patients have organic erectile dysfunction or tolerance to PDE5I. With the rapid development of technologies, some new methods, such as low-intensity extracorporeal shock wave and stem cell injection therapy can even repair the organic damage of the corpora cavernosa. These are important directions for the treatment of male erectile dysfunction in the future. In this mini-review, we will introduce these therapies in detail.

Effect of Obstetric Fine Nursing on Pain during Natural Childbirth and Postpartum Recovery.

BACKGROUND: This study aimed to observe the effect of fine nursing on pain and postpartum recovery during natural delivery of pregnant women. METHODS: The clinical data of 192 primiparas who were expecting labor in Nanfang Hospital, Southern Medical University, Guangzhou, China from 2015-2016 were retrospectively analyzed. Among them, 100 cases were treated with fine nursing before and after delivery, and 92 cases were treated with routine nursing. The pain rate, the second stage of labor, the amount of bleeding 2 hours postpartum, and postpartum recovery were compared between the two groups. RESULTS: The number of cases of grade 0 and 1 pain and the good rate of pain were significantly higher in the observation group than in the control group, the number of cases with grade 2 pain in the observation group was significantly lower than that of the control group (P<0.01). The second stage of labor and the 2h postpartum hemorrhage in the observation group were significantly lower than those in the control group (P<0.001). The number of maternal cases with good postpartum sleep, good lactation and good mental health in the observation group was significantly higher than that in the control group (P<0.05). CONCLUSION: Fine nursing before and after delivery can reduce maternal pain rate, shorten the second stage of labor, reduce the amount of bleeding after 2 hours postpartum, promote good sleep, lactation, psychological conditions, reduce postpartum infection rate, which is conducive to maternal body recovery, worthy of clinical promotion.

[Efficacy and safety of extended-release niacin alone or with atorvastatin for lipid profile modification].

OBJECTIVE: To evaluate the efficacy and safety of extended-release niacin (niacin ER) either alone or in combination with atorvastatin for the lipid profile modification in the patients with coronary heart disease (CHD) and its equivalents. METHODS: One hundred and ten patients with CHD and its equivalents with serum total cholesterol (TC) > or = 3.5 mmol/L were randomly assigned into three treatment groups: (1) atorvastatin group (n = 38), receiving atorvastatin 10 mg/d for 8 weeks; (2) niacin ER group (n = 38), given niacin ER 500 mg/d for 4 weeks and then 1000 mg/d for 4 weeks; (3) combination treatment group (n = 34), treated with atorvastatin (10 mg/d) plus niacin ER, with the dose initiating from 500 mg/d, and increasing to 1000 mg/d after 4 weeks, for 8 weeks. The serums lipid profiles and adverse effects were assessed in all the patients before treatment, and 4 and 8 weeks after treatment. RESULTS: (1) After 8 weeks of treatment, the serum level of triglyceride (TG) and high-density lipoprotein cholesterol (HDL-C) were reduced by 30% and 16% respectively in the niacin ER group compared with the baseline values (both P < 0.05). After 8 weeks, the TC, low-density lipoprotein cholesterol (LDL-C), and TG in the atorvastatin group decreased by 19%, 26%, and 17% respectively compared with the baseline values (all P < 0.05). Combination treatment decreased the TC, LDL-C, and TG levels by 28%, 38%, and 39% respectively, and increased the HDL-C level by 23% (all P < 0.05). The improvement in TC and LDL-C achieved by combination treatment was superior to treatment of atorvastatin alone and treatment of niacin ER alone (all P < 0.05). (2) The rate of achieving the LDL-C goal of The National Cholesterol Education Program (NCEP) in Adult Treatment Panel III (ATP III) in the combination therapy group was 73.5%, significantly higher than those of the atorvastatin and niacin groups (47.7% and 42.1% respectively, both P < 0.05). (3) Adverse effect, such as flushing (15.8%) and gastrointestinal symptoms (23.7%) were found in the niacin ER group, however, no more adverse effects were found in the combination therapy group. There were no serious adverse events in all groups. CONCLUSION: Niacin ER has a favorable effect in modulating the blood lipid profile, especially in reducing TG and elevating HDL-C. Combined statin with niacin may produce a more global and effective improvement in lipid blood levels than monotherapy and is generally safe and well tolerable.

[Prevention and therapy of cerebrospinal fluid leakage after translabyrinthine acoustic neuroma removal].

OBJECTIVE: To evaluate the modified wound closure technique and other methods for preventing and treating the cerebrospinal fluid (CSF) leakage after removal of acoustic neuroma by translabyrinthine approach. METHODS: In a series of 85 cases of acoustic neuroma surgery, two kinds of technique of wound closure, the traditional (as first group) and the modified (as second group), have been subsequently used to prevent CSF leakage. The incidences of CSF leak were analyzed respectively. Conservative and surgical treatments were applied to treatment the CSF leak. RESULTS: In the first group, the CSF leak was 19.5% (8/41), and that of second group was 2.3% (1/44). There was significant difference between them (P = 0.013). The CSF leak mainly occurred in large acoustic neuromas surgery with traditional wound closure technique. Among 9 cases of CSF leaks, 3 were controlled by conservative method, 5 by one single revision surgery and one by two revisions. CONCLUSIONS: The revision technique of wound closure could significantly reduce the incidence of CSF leakage after acoustic neuroma removal by translabyrinthine approach. The revision surgery is an effective method for stopping the CSF leak.