Threonine ADP-Ribosylation of Ubiquitin by a Bacterial Effector Family Blocks Host Ubiquitination.

Ubiquitination is essential for numerous eukaryotic cellular processes. Here, we show that the type III effector CteC from Chromobacterium violaceum functions as an adenosine diphosphate (ADP)-ribosyltransferase that specifically modifies ubiquitin via threonine ADP-ribosylation on residue T66. The covalent modification prevents the transfer of ubiquitin from ubiquitin-activating enzyme E1 to ubiquitin-conjugating enzyme E2, which inhibits subsequent ubiquitin activation by E2 and E3 enzymes in the ubiquitination cascade and leads to the shutdown of polyubiquitin synthesis in host cells. This unique modification also causes dysfunction of polyubiquitin chains in cells, thereby blocking host ubiquitin signaling. The disruption of host ubiquitination by CteC plays a crucial role in C. violaceum colonization in mice during infection. CteC represents a family of effector proteins in pathogens of hosts from different kingdoms. All the members of this family specifically ADP-ribosylate ubiquitin. The action of CteC reveals a new mechanism for interfering with host ubiquitination by pathogens.

Osteoporosis care after hip fracture: Observation from national health insurance database and fracture liaison services.

BACKGROUND: The objective of this research was to report the trend of osteoporosis care after hip fractures from usual care (UC) and to compare the quality of care with those who received fracture liaison services (FLSs). METHODS: Data on osteoporosis care for patients with hip fracture were acquired from the National Health Insurance claims (UC group), and surveys from FLS programs (FLS group). A total of 183,300 patients receiving UC and 3010 patients receiving FLS were studied. For the two groups, common osteoporosis care indicators, such as bone mineral density (BMD) testing rate, antiosteoporosis medication commencement rate, and adherence rate were described. RESULTS: There were 2488 participants (82.7%) in the FLS group who completed Dual-energy X-ray absorptiometry (DXA) in 8 weeks, 155 (5.1%) who finished it between 8 weeks and 1 year. Even in 2018, when the DXA completion rate was at its highest, the completion rate in the UC group was only 23.5%. In terms of medication commencement, 2372 FLS patients (78.8%) received treatment within 3 months. Only 24.9% of the UC patients received antiosteoporosis medication within 3 months. Furthermore, antiosteoporosis medication adherence rate was 92.2% after 1 year and 83.9% after 2 years in the FLS group, but these were only 66.5% and 42.7%, respectively, in the UC group. CONCLUSION: Patients who received FLS had more timely BMD exams, antiosteoporosis medication treatment, and higher adherence to antiosteoporosis therapy than those who received UC. The discrepancy in rates of continuing treatment became more significant over time between both groups.

Eleven years secular trend of the initiation of anti-osteoporosis medications and subsequent fractures in Taiwan: From 2008 to 2018.

BACKGROUND: Osteoporosis is a common metabolic bone disease that benefits from many newly developed anti-osteoporosis medications (AOMs). Reimbursement policies need to allocate medical budgets properly based on evidence-based data. This study aimed to investigate the 11-year secular trend, focusing on older age and males in this adjustment wave of the National Health Insurance reimbursement. METHODS: We adopted a nationwide cohort from Taiwan's National Health Insurance Research Database (NHIRD). Patients undergoing newly initiated AOMs from 2008 to 2018 were included. The AOMs in this study included denosumab, zoledronate, ibandronate, alendronate, raloxifene, and risedronate. Patients <50 years, pathological fractures, missing data, and two AOMs prescribed were excluded. The real-world trends related to subsequent fragility fracture and death within 1 and 3 years were used to evaluate the potential effects due to revision of reimbursement policies. RESULTS: Of 393,092 patients, among them, 336,229 patients met the criteria, whose mean age ranged from 73.3 to 74.4 years, and nearly 80% were female. Further analysis showed a steady increase of AOMs from 5567 (17.1%) and 8802 (27.0%) in 2008-6697 (18.3%) and 10,793 (29.5%) in 2018 for males and 80+ years respectively. The subsequent fragility fracture within one and three years post AOMs initiation was 5.81% and 11.80% in 2018. CONCLUSION: This study showed an immediate drop in AOMs prescription after the implementation of a new stricter reimbursement policy. It took 5 years to return the annual prescription number.

Refracture risk and all-cause mortality after vertebral fragility fractures: Anti-osteoporotic medications matter.

BACKGROUND: Osteoporotic vertebral fractures may predict the future occurrence of fractures and increase mortality. Treating underlying osteoporosis may prevent second fractures. However, whether anti-osteoporotic treatment can reduce the mortality rate is not clear. The aim of this population study was to identify the degree of decreased mortality following the use of anti-osteoporotic medication after vertebral fractures. METHODS: We identified patients who had newly diagnosed osteoporosis and vertebral fractures from 2009 to 2019 using the Taiwan National Health Insurance Research Database (NHIRD). We used national death registration data to determine the overall mortality rate. RESULTS: There were 59,926 patients with osteoporotic vertebral fractures included in this study. After excluding patients with short-term mortality, patients who had previously received anti-osteoporotic medications had a lower refracture rate as well as a lower mortality risk (hazard ratio (HR): 0.84, 95% confidence interval (CI): 0.81-0.88). Patients receiving treatment for more than 3 years had a much lower mortality risk (HR: 0.53, 95% CI: 0.50-0.57). Patients who used oral bisphosphonates (alendronate and risedronate, HR: 0.95, 95% CI: 0.90-1.00), intravenous zoledronic acid (HR: 0.83, 95% CI: 0.74-0.93), and subcutaneous denosumab injections (HR: 0.71, 95% CI: 0.65-0.77) had lower mortality rates than patients without further treatment after vertebral fractures. CONCLUSION: In addition to fracture prevention, anti-osteoporotic treatments for patients with vertebral fractures were associated with a reduction in mortality. A longer duration of treatment and the use of long-acting drugs was also associated with lower mortality.

Clinical practice guidelines for the prevention and treatment of osteoporosis in Taiwan: 2022 update.

Osteoporosis greatly increases the risk of fractures. Osteoporotic fractures negatively impact quality of life, increase the burden of care, and increase mortality. Taiwan is an area with a high prevalence of osteoporosis. This updated summary of guidelines has been developed by experts of the Taiwan Osteoporosis Association with the intention of reducing the risks of osteoporotic fractures and improving the quality of care for patients with osteoporosis. The updated guidelines compile the latest evidence to provide clinicians and other healthcare professionals with practical recommendations for the prevention, diagnosis, and management of osteoporosis under clinical settings in Taiwan.

Asia-pacific consensus on osteoporotic fracture prevention in postmenopausal women with low bone mass or osteoporosis but no fragility fractures.

Postmenopausal women are at significant risk for osteoporotic fractures due to their rapid bone loss. Half of all postmenopausal women will get an osteoporosis-related fracture over their lifetime, with 25% developing a spine deformity and 15% developing a hip fracture. By 2050, more than half of all osteoporotic fractures will occur in Asia, with postmenopausal women being the most susceptible. Early management can halt or even reverse the progression of osteoporosis. Consequently, on October 31, 2020, the Taiwanese Osteoporosis Association hosted the Asia-Pacific (AP) Postmenopausal Osteoporotic Fracture Prevention (POFP) consensus meeting, which was supported by the Asian Federation of Osteoporosis Societies (AFOS) and the Asia Pacific Osteoporosis Foundation (APOF). International and domestic experts developed ten applicable statements for the prevention of osteoporotic fractures in postmenopausal women with low bone mass or osteoporosis but no fragility fractures in the AP region. The experts advocated, for example, that postmenopausal women with a high fracture risk be reimbursed for pharmaceutical therapy to prevent osteoporotic fractures. More clinical experience and data are required to modify intervention tactics.

Influence of power generation period on the oily sludge bio-electrical system.

The single-chamber bio-electrical systems can degrade oily sludge in sediments while generating electricity from the microbial fuel cells (MFCs) and their characteristics in energy and environmental effects have attracted wide international attention in recent years. To explore the influence of the power generation period on the oily sludge bio-electrical system, an oily sludge bio-electrical system was constructed. The output voltage, polarization curve, power density curve, crude oil removal rate and microflora were detected during different power generation periods, respectively. The results of this study showed that under the stable power generation period, the power generation and oily sludge degradation performance of MFC are higher than the voltage rise period and voltage attenuation period. Besides, the oily sludge bio-electrical system during the stable period contained more electricity-producing bacteria than the other two periods. The voltage in the stable period of oily sludge bio-electrical system is about 280 mV, the electromotive force is 493.1 mV and the power density is 134.93 mW·m-3. It lays a foundation for the improvement of degradation of crude oil and power generation performance in oily sludge bio-electrical system.

Simple quantum key distribution using a stable transmitter-receiver scheme.

Quantum key distribution (QKD) is a technology that allows secure key exchange between two distant users. A widespread adoption of QKD requires the development of simple, low-cost, and stable systems. However, implementation of the current QKD requires a complex self-alignment process during the initial stage and an additional hardware to compensate the environmental disturbances. In this study, we present the implementation of a simple QKD with the help of a stable transmitter-receiver scheme, which simplifies the self-alignment and is robust enough to withstand environmental disturbances. In case of the stability test, the implementation system is able to remain stable for 48 h and exhibits an average quantum bit error rate of less than 1% without any feedback control. The scheme is also tested over a fiber spool, obtaining a stable and secure finite key rate of 7.32k bits per second over a fiber spool extending up to 75 km. The demonstrated long-term stability and obtained secure key rate prove that our method of implementation is a promising alternative for practical QKD systems, in particular, for CubeSat platform and satellite applications.

First insights on value-based healthcare of elders using ICHOM older person standard set reporting.

BACKGROUND: Clinical guidelines for specific conditions fragment care provision for elders. The International Consortium for Health Outcomes Measurement (ICHOM) has developed a global standard set of outcome measures for comprehensive assessment of older persons. The goal of this study was to report value-based health metrics in Taiwan using this ICHOM toolset. METHODS: The cross-sectional study of baseline data excerpted from a prospective longitudinal cohort, which recruited people ≥65 years old with ≥3 chronic medical conditions between July and December 2018. All participants received measurements of physical performance, anthropometric characteristics, health-related behaviors, Charlson Comorbidity Index, and Montreal Cognitive Assessment. The ICHOM toolset comprises three tiers: 1 includes frailty and having chosen a preferred place of death; 2 includes polypharmacy, falls, and participation in decision-making; and 3 includes loneliness, activities of daily living, pain, depression, and walking speed. These items were converted into a 0-10 point value-based healthcare score, with high value-based health status defined as ≥8/10 points. RESULTS: Frequencies of individual ICHOM indicators were: frail 11.7%, chose preferred place of death 14.4%, polypharmacy 31.5%, fell 17.1%, participated in decision-making 81.6%, loneliness 26.8%, limited activities of daily living 22.4%, pain 10.4%, depressed mood 13.0%, and slowness 38.5%. People with high disease burden (OR 0.40, 95% CI 0.21-0.76, p = 0.005) or cognitive impairment (OR 0.49, 95%CI 0.27-0.87, p = 0.014) were less likely to have high value-based healthcare status. CONCLUSIONS: The ICHOM Standard Set Older Person health outcome measures provide an opportunity to shift from a disease-centric medical paradigm to whole person-focused goals. This study identified advanced age, chronic disease burden and cognitive impairment as important barriers to achieving high value-based healthcare status.

The modulative effects of microcurrent electrical nerve stimulation on diabetic mice.

Diabetes (one of non-communicable diseases) is serious due to its complications, such like, cardiovascular ailments, neuropathy, nephropathy, retinopathy, wound gangrene and sexual impotence. Diabetes and associated chronic conditions are rapidly emerging as major health problems. In clinical, there were different drugs for diabetes treatment on different mechanisms. However, there were limited studies on the efficacy of electric stimulations on diabetes therapeutic application. In current study, we try to evaluate the effect of microcurrent electrical nerve stimulator (MENS) on diabetes modulation as an alternative medicine. A total of 36 male ICR mice of 6 weeks old were randomly divided into 4 groups [1] Control, [2] MENS only, [3] DM, [4] DM with MENS. During 8 weeks treatments, the diabetes-associated assessments included body weight, diet utilization, blood glucose measurement, other biochemistries and histopathological observations. The diabetes animal model induced by STZ had 180 mg/dl fasting blood glucose (GLU-AC) before MENS intervention. After 3 and 6 weeks administration, the GLU-AC of DM+MENS group significantly decreased 31.97% and 50.82% (P < 0.0001), respectively, as compared to DM group and the OGTT also demonstrated the similar significant results. The diabetic syndromes of polydipsia and polyphagia were also significantly ameliorated by MENS intervention. In other biochemical indexes, the glycated hemoglobin (HbA1c), hyperinsulinemia, liver functions (AST & ALT) and kidneys function (BUN & Creatinine) were also significantly mitigated by MENS under diabetes model. The histological observation also showed the MENS administration improved the diabetes-related pathological characteristics in liver, kidney and pancreas tissues. Our results suggest that administration of MENS could significantly improve diabetes animal model on blood sugar homeostasis, diabetic polydipsia, biochemistries, and tissue damage. In the health conditions, the MENS didn't exist obvious side effects on assessments. Therefore, the MENS could be potential on alternative medicine or supportive applications to future DM therapeutics.

Crystal structure of LGR4-Rspo1 complex: insights into the divergent mechanisms of ligand recognition by leucine-rich repeat G-protein-coupled receptors (LGRs).

Leucine-rich repeat G-protein-coupled receptors (LGRs) are a unique class of G-protein-coupled receptors characterized by a large extracellular domain to recognize ligands and regulate many important developmental processes. Among the three groups of LGRs, group B members (LGR4-6) recognize R-spondin family proteins (Rspo1-4) to stimulate Wnt signaling. In this study, we successfully utilized the "hybrid leucine-rich repeat technique," which fused LGR4 with the hagfish VLR protein, to obtain two recombinant human LGR4 proteins, LGR415 and LGR49. We determined the crystal structures of ligand-free LGR415 and the LGR49-Rspo1 complex. LGR4 exhibits a twisted horseshoe-like structure. Rspo1 adopts a flat and ß-fold architecture and is bound in the concave surface of LGR4 in the complex through electrostatic and hydrophobic interactions. All the Rspo1-binding residues are conserved in LGR4-6, suggesting that LGR4-6 bind R-spondins through an identical surface. Structural analysis of our LGR4-Rspo1 complex with the previously determined LGR4 and LGR5 structures revealed that the concave surface of LGR4 is the sole binding site for R-spondins, suggesting a one-site binding model of LGR4-6 in ligand recognition. The molecular mechanism of LGR4-6 is distinct from the two-step mechanism of group A receptors LGR1-3 and the multiple-interface binding model of group C receptors LGR7-8, suggesting LGRs utilize the divergent mechanisms for ligand recognition. Our structures, together with previous reports, provide a comprehensive understanding of the ligand recognition by LGRs.

A cross-sectional survey of self-rated health and its determinants in patients with hypertension.

AIM: The purpose of the study is to investigate the levels of self-rated health, blood pressure control, understand their relationships between the self-rated health and blood pressure control, and to identify the extent to which demographic, disease and psychosocial factors predict the self-rated health of hypertensive patients. METHODS: The study adopted a cross-sectional design. Nine hundred forty-two subjects with essential hypertension were invited to join the study, 807 completed the survey. Self-report questionnaires were used to collect data. The hierarchical logistic regression was used to test the determinants of self-rated health status. RESULTS: Of all the subjects, 59.3% rated their health status as good, and 41.7% perceived their health status as poor. In terms of levels of blood pressure control, nurse-measured blood pressure showed that 40.2% of the subjects had good control levels, 59.8% for poor control levels. There were positive relationships between good self-rated health and controlled blood pressure of hypertensive patients (p<0.05). The logistic regression model showed that the determinants of subjects' self-rated health included income (OR=4.28; 95% CI=1.86-6.25), duration of hypertension diagnosis (OR=4.06; 95% CI=2.17-6.35), treatment adherence (OR=9.02; 95% CI=5.36-15.51), physical activity (OR=13.81; 95% CI=10.16-19.57) and social support (OR=8.63; 95% CI=7.17-11.35). CONCLUSIONS: The self-rated health status and blood pressure control for patients with hypertension is suboptimal, effective strategies should be developed to improve patients' general health.

Anti-osteoporosis drugs reduce mortality in cancer patients: A national cohort study of elderly with vertebral fractures.

Introduction: The most prevalent type of fragility fractures is osteoporotic vertebral fractures (OVFs). However, only a few studies have examined the relationship between anti-osteoporosis treatments and malignancy-related mortality following an OVF. The goal of this study is to determine the effect of anti-osteoporosis therapy on mortality in OVF patients with and without cancer. Method: Data from older people over the age of 65 who were hospitalised for OVFs between 1 January 2003 and 31 December 2018 were analysed retrospectively. A total of 6139 persons getting osteoporosis treatment and 28,950 who did not receive treatment were analysed, together with 2 sets of patients, comprising cancer patients (794) and cancer-free patients (5342), using anti-osteoporosis medication or not, in 1:1 propensity score-matched analyses. The hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated. Results: In all, 35,089 patients with OVFs were included in the population; 29,931 people (85.3%) were women, and the mean (standard deviation) age was 78.13 (9.27) years. Overall survival was considerably higher in those undergoing osteoporosis therapy. This was true both for those without cancer (adjusted HR 0.55; 95% CI 0.51-0.59; P<.0001) as well as those with cancer (adjusted HR 0.72; 95% CI 0.62-0.84; P<.0001). Even among cancer patients, those who received anti-osteoporotic drugs had a lower mortality rate than those who did not. Conclusion: Our findings suggest that anti-osteoporosis therapy should be initiated regardless of the presence of cancer in the elderly, as it increases survival following OVFs.

Cardiovascular toxic effects of nanoparticles and corresponding molecular mechanisms.

Rapid advancements in nanotechnology have been integrated into various disciplines, leading to an increased prevalence of nanoparticle exposure. The widespread utilization of nanomaterials and heightened levels of particulate pollution have prompted government departments to intensify their focus on assessing the safety of nanoparticles (NPs). The cardiovascular system, crucial for maintaining human health, has emerged as vulnerable to damage from nanoparticle exposure. A mounting body of evidence indicates that interactions can occur when NPs come into contact with components of the cardiovascular system, contributing to adverse cardiovascular disease (CVD). However, the underlying molecular mechanisms driving these events remain elusive. This work provides a comprehensive review of recent advance on nanoparticle-induced adverse cardiovascular events and offers insight into the associated molecular mechanisms. Finally, the influencing factors of NPs-induced cardiovascular toxicity are discussed.

Micro(nano)-plastics exposure induced programmed cell death and corresponding influence factors.

Plastic products have played an indispensable role in our daily lives for several decades, primarily due to their cost-effectiveness and unmatched convenience. Nevertheless, recent developments in nanotechnology have propelled our attention toward a distinct category of plastic fine particulates known as micro(nano)-plastics (MPs/NPs). The investigation of the cytotoxic effects of MPs/NPs has emerged as a central and burgeoning area of research in environmental toxicology and cell biology. In the scope of this comprehensive review, we have meticulously synthesized recent scientific inquiries to delve into the intricate interplay between MPs/NPs and programmed cell death mechanisms, which encompass a range of highly regulated processes. First, the signaling pathways and molecular mechanisms of different programmed death modalities induced by MPs/NPs were elaborated, including apoptosis, autophagy, necroptosis, ferroptosis, and pyroptosis. The causes of different programmed deaths induced by MPs/NPs, such as size, surface potential, functional group modification, aging, biological crown, and co-exposure of MPs/NPs are further analyzed. In contrast, the various cellular programmed death modes induced by MPs/NPs are not alone most of the time, and lastly, the connections between different cellular programmed death modes induced by MPs/NPs, such as interconversion, mutual promotion, and mutual inhibition, are explained. Our primary objective is to unveil the multifaceted toxicological implications of MPs/NPs on the intricate web of cellular fate and biological homeostasis. This endeavor not only broadens our understanding of the potential risks associated with MPs/NPs exposure but also underscores the urgent need for comprehensive risk assessments and regulatory measures in the context of environmental health.

Asia-Pacific consensus on long-term and sequential therapy for osteoporosis.

Objectives: This study aimed to present the Asia-Pacific consensus on long-term and sequential therapy for osteoporosis, offering evidence-based recommendations for the effective management of this chronic condition. The primary focus is on achieving optimal fracture prevention through a comprehensive, individualized approach. Methods: A panel of experts convened to develop consensus statements by synthesizing the current literature and leveraging clinical expertise. The review encompassed long-term anti-osteoporosis medication goals, first-line treatments for individuals at very high fracture risk, and the strategic integration of anabolic and antiresorptive agents in sequential therapy approaches. Results: The panelists reached a consensus on 12 statements. Key recommendations included advocating for anabolic agents as the first-line treatment for individuals at very high fracture risk and transitioning to antiresorptive agents following the completion of anabolic therapy. Anabolic therapy remains an option for individuals experiencing new fractures or persistent high fracture risk despite antiresorptive treatment. In cases of inadequate response, the consensus recommended considering a switch to more potent medications. The consensus also addressed the management of medication-related complications, proposing alternatives instead of discontinuation of treatment. Conclusions: This consensus provides a comprehensive, cost-effective strategy for fracture prevention with an emphasis on shared decision-making and the incorporation of country-specific case management systems, such as fracture liaison services. It serves as a valuable guide for healthcare professionals in the Asia-Pacific region, contributing to the ongoing evolution of osteoporosis management.

Treatment adherence of Chinese patients with hypertension: a longitudinal study.

BACKGROUND: There is no research concerning treatment adherence and correlated factors using longitudinal design in China. AIM: This article investigated the treatment adherence of patients with hypertension and examined determinants of adherence, with a focus on changes of adherence and psychosocial factors over 1 year. METHODS: A longitudinal design was adopted to facilitate the survey of patients with hypertension across two time points. RESULTS: The results demonstrated that treatment adherence of hypertensive patients improved over 1 year follow-up. The blood pressure values of hypertensive patients decreased at time 2. The regression analysis found that time 1 treatment adherence, social support, education and duration of diagnosis were significant predictors of treatment adherence at time 2, accounting for 26% of the total variance. Time 1 treatment adherence explained 15% of the variance, social support 7%, education 3% and duration of diagnosis 1%. CONCLUSIONS: The effective strategies targeted patients at risk are suggested to be necessary and should be designed according to the factors affecting adherence.

The Effects of Switching from Dipeptidyl Peptidase-4 Inhibitors to Glucagon-Like Peptide-1 Receptor Agonists on Bone Mineral Density in Diabetic Patients.

Purpose: Diabetes increases the risk of fragility fractures. As a result, when choosing a diabetes treatment, whether the drug affects bone density should be taken into account. The goal of this study was to determine how switching from dipeptidyl peptidase-4 inhibitors (DPP-4i) to glucagon-like peptide-1 receptor agonists (GLP-1RA) influenced bone mineral density (BMD) in diabetic patients. Patients and Methods: In this retrospective cohort study, diabetic patients with osteoporosis or osteopenia who used DPP-4i but not anti-osteoporosis medications were divided into two groups: those who switched to GLP-1RA (n = 132) and those who did not (control group, n = 133). We compared changes in glycemic control and BMD with and without conversion from DPP-4i to GLP-1RA. Results: Prior to switching, there was no difference between the groups in terms of age, gender, glycosylated hemoglobin (HbA1c), or BMD. HbA1c was 8.7% in the participants (mean age 62.7 years, 17.4% female). Despite the fact that there was no difference in femoral neck BMD, the GLP-1RA group had a greater decrease in lumbar spine BMD (-0.028 g/cm2 versus -0.019 g/cm2, p = 0.041) than the control group. Furthermore, HbA1c levels in the GLP-1RA-treated group were considerably lower than in the control group (7.5% versus 8.0%, p = 0.027). Conclusion: While switching to GLP-1RA improves glycemic control, it appears to have a less favorable effect on bone density than continuing DPP-4i. More research is needed, however, to determine whether diabetic patients with low bone density should be switched from DPP-4i to GLP-1RA.

An electricity-generating bacterium separated from oil sludge microbial fuel cells and its environmental adaptability.

Electricity-generating bacteria as biocatalysts for microbial fuel cells (MFCs), their species, and power generation performance determine the pollution control and power generation performance of MFCs. And there are few studies on the types and performance of electricity-generating bacteria isolated from oily sludge microbial fuel cells. For improving the power generation performance of oily sludge MFCs, an electricity-generating bacterium was isolated from the oily sludge. More importantly, the adaptability of nitrogen to phosphorus ratio, temperature, and pH of the electricity-generating bacteria were adjusted by a controlled variable method. The results of this study showed that the electricity-generating bacterium was identified as Bacillus cereus, with a rod-shaped cell, about 0.5-1.0 µm in length. The optimal nitrogen-phosphorus ratio, temperature, and pH of MFCs were 4.67:1, 25 ℃, and pH = 7, respectively. Its maximum power density, COD, and oil removal rate was up to 65 mW·m-3, 90.51%, and 87.76%, respectively. The study of this functional bacterium will provide beneficial assistance for the improvement of oil removal and power generation performance of oily sludge MFCs.

Within-person associations of escalated electronic nicotine delivery systems use with cigarette, alcohol, marijuana and drug use behaviors among US young adults.

AIMS: Most extant evidence has addressed between-person differences, short-term or cross-sectional associations of electronic nicotine delivery systems (ENDS) use with other substance use, the majority focusing on current rather than escalated use. The present study aimed to examine within-person changes in escalated ENDS use and their associations with individual and combined substance use over a 6-year period. DESIGN, SETTING AND PARTICIPANTS: This study used a longitudinal cohort design with US young adults. A generalized linear mixed-model approach was employed to fit a series of weighted logistic regression models. Data were drawn from waves 1-5 of the Population Assessment of Tobacco and Health (PATH) study in the United States. Of the 9110 young adults at baseline, aged 18-24 years, a total of 5042 individuals had matched data across all five waves of assessments. MEASUREMENTS: Escalated ENDS use was computed by subtracting the number of days of ENDS use within the past 30 days at wave w - 1 from that at wave w and coded as 1 = escalated, if the value was greater than zero (otherwise, coded as 0 = not escalated). FINDINGS: Escalated ENDS use gradually decreased over time, with the lowest prevalence at wave 4 (4.0%) but sharply increasing at wave 5 (8.4%). Escalated ENDS use was associated with increased odds of using each substance (binge drinking, marijuana use, marijuana vaping, prescription and illicit drugs) and different combinations of polysubstance use between cigarette smoking, binge drinking and marijuana use (Ps < 0.05). In addition, sweet/fruit flavor use (versus menthol/mint) was associated with increased likelihood of reporting co-use of cigarettes and marijuana. CONCLUSIONS: In the United States, the prevalence of young adults using electronic nicotine delivery systems appears to have increased steadily between 2013 and 2019, although the rate of increase may have started to accelerate in recent years. Escalated electronic nicotine delivery systems use and time-lagged established electronic nicotine delivery systems use appear to be prospectively associated with individual and combined substance use, particularly between cigarettes, alcohol and marijuana. Among established electronic nicotine delivery systems users, sweet/fruit flavor appears to be associated with increased risk of co-using cigarettes and marijuana.