China Initiative for Multi-Domain Intervention (CHINA-IN-MUDI) to Prevent Cognitive Decline: Study Design and Progress.

BACKGROUND: Alzheimer's disease (AD), the most common type of irreversible dementia, is predicted to affect 152 million people by 2050. Evidence from large-scale preventive randomized controlled trials (RCTs) on modifiable risk variables in Europe has shown that multi-domain lifestyle treatments for older persons at high risk of dementia may be practical and effective. Given the substantial differences between the Chinese and European populations in terms of demographics and living conditions, direct adoption of the European program in China remains unfeasible. Although a RCT has been conducted in China previously, its participants were mainly from rural areas in northern China and, thus, are not representative of the entire nation.There is an urgent need to establish cohorts that represent different economic, cultural, and geographical situations in order to explore implementation strategies and evaluate the effects of early multi-domain interventions more comprehensively and accurately. MEDTODS: We developed an integrated intervention procedure implemented in urban neighborhood settings, namely China Initiative for Multi-Domain Intervention (CHINA-IN-MUDI). CHINA-IN-MUDI is a 2-year multicenter open-label cluster-randomised controlled trial centered around a Chinese-style multi-domain intervention to prevent cognitive decline. Participants aged 60-80 years were recruited from a nationally representative study, i.e. China Healthy Aging and Dementia Study cohort. An external harmonization process was carried out to preserve the original FINGER design. Subsequently, we standardized a series of Chinese-style intervention programs to align with cultural and socioeconomic status. Additionally, we expanded the secondary outcome list to include genomic and proteomic analyses. To enhance adherence and facilitate implementation, we leveraged an e-health application. RESULTS: Screening commenced in July 2022. Currently, 1,965 participants have been randomized into lifestyle intervention (n = 772) and control groups (n = 1,193). Both the intervention and control groups exhibited similar baseline characteristics. Several lifestyle and vascular risk factors were present, indicating a potential window of opportunity for intervention. The intervention will be completed by 2025. CONCLUSIONS: This project will contribute to the evaluation of the effectiveness and safety of intervention strategies in controlling AD risk and reducing clinical events, providing a basis for public health decision-making in China.

Development of soil-covered SBR process for small scale sewage treatment.

Nitrogen and phosphorus compounds, mainly from the households in residential areas are responsible for eutrophication occurring in lakes or estuaries. In Korea, there is a growing trend for villages in the countryside, rest areas of express ways, military unit bases, etc. to use small scale sewage treatment plants (SSTPs). However, the technological developments have mainly focused on medium or large scale sewage treatment plants, leaving a gap in the development of technologies for SSTPs without a residing operator. In this study, a soil-covered sequencing batch reactor (SBR) process for SSTPs in combination with a natural purification technology is developed to remove nitrogen and phosphorus as well as organic contamination (BOD), and the results are as follows: (1) the removal rates of BOD, total nitrogen (T-N), total phosphorus (T-P) and suspended solids (SS) are 93%, 74%, 80% and 95%, respectively, (2) the soil-covered SBR process without the decanter used for effluent discharge is similar to other SBR processes in suspended solids removal rate, and (3) the performance of the field pilot plant was monitored by remote sensing system in real time, and the results show that this system can be applied to SSTPs with no residing operators.

Application of sequential expanded granular sludge bed reactors for biodegradation of acetate, benzoate, terephtalate and p-toluate in purified terephtalic acid production wastewater.

The anaerobic degradation of four major constituents from purified terephtalic acid production wastewater in sequential two expanded granular sludge bed (EGSB) reactors was studied. The performance of the system was evaluated in terms of chemical oxygen demand (COD) removal efficiencies, methane production, stability, granular sludge adaptability as well as reversion of bacterial inhibition. With volumetric loading rates of 1.9-25 kg-COD m(-3) d(-1) and terephtalate and p-toluate of 584-821 mg L(-1), average removal efficiencies of 97.6% and 75.2% were achieved in the EGSB reactors, respectively. In these conditions, gas production reached a total methane production rate of 0.33 L g-COD(-1) in the two-stage EGSB reactor system. The disturbance of the EGSB reactors was observed at a feed concentration above around 6.9 g-COD L(-1) because of higher influent COD concentration compared to other experiments.

Feasibility study of nitrogen removal with the mecellulose wasted liquor as an external carbon source in the two-stage denitrification process.

The utilization of mecellulose wasted liquor (MWL) as an external carbon source was investigated to find an alternative for methanol in the two-stage denitrification pilot process. The pilot plant was supplied with the raw water from the J-Municipal Sewage Treatment Plant (J-MSTP) in Korea. The raw water of J-Municipal Sewage Treatment Plant contains low and high concentration of biodegradable organics and nitrogen source, respectively, due to the inflow of industrial wastewater and landfill leachate. Methanol was fed to provide external carbon source for high concentration of nitrogen source removal by denitrification in this J-Municipal Sewage Treatment Plant, and thus this study was performed to test effects to the effluent quality and efficiencies of nitrogen source removal with an alternative carbon source for the cost reduction. The 6.5mg 1(-1) and 5.7mg l(-1) of total nitrogen (TN) concentration in the effluent were achieved with mecellulose and methanol, whereas mecellulose and methanol were fed to give the same ratio of gCODgNO,-N(-1), respectively. The 60% of COD in mecellulose wasted liquor was used as a carbon source for denitrification and the stable denitrification rate was earned when one half of the required total carbon source for denitrification was fed to pre-anoxic tank in the pilot plant. The required gCODgNO,-N(-1) ratio with mecellulose wasted liquor was 1.4 times higher than with methanol. Mecellulose wasted liquor is feasible to be used as external carbon source for organic loading, nitrogen and phosphorus removal. If mecellulose wasted liquor is considered as an alternative external carbon source to substitute methanol 26-28m3 mecellulose wasted liquor per 1 m3 methanol will be required. However, to meet with the effluent standard (10 mg BOD l(-1)) for J-Municipal Sewage Treatment Plant, the feed concentration of mecellulose wasted liquor should be recommended to be lower than 200 mgl(-1).