Assessment of lake eutrophication using a novel multidimensional similarity cloud model.

Lake eutrophication is characterized by a variety of indicators, including nitrogen and phosphorus concentrations, chemical oxygen demand, chlorophyll levels, and water transparency. In this study, a multidimensional similarity cloud model (MSCM) is combined with a random weighting method to reduce the impacts of random errors in eutrophication monitoring data and the fuzziness of lake eutrophication definitions on the consistency and reliability of lake eutrophication evaluations. Measured samples are assigned to lake eutrophication levels based on the cosine of the angle between the cloud digital characteristics vectors of each sample and those of each eutrophication grade. To field test this method, the eutrophication level of Nansi Lake in Shandong Province was evaluated based on monitoring data collected in 2009-2016. Results demonstrate that, in 2009 and in 2011-2015, the upper lake of Nansi Lake exhibited moderate eutrophication while the lower lake exhibited mild eutrophication. In 2010, 2016, elevated concentrations of total nitrogen and total phosphorus led to an increase in the eutrophication level of the lower lake, matching that of the upper lake. Based on the results of these field tests, we conclude that the MSCM presented in this study provides a more flexible and effective method for evaluating lake eutrophication data than the existing multidimensional normal cloud model.

Molecular Cloning, Characterization, and Expression Analysis of Cathepsin A in the Chinese Giant Salamander Andrias davidianus.

Cathepsin A (CTSA) is serine carboxypeptidase, an important protease in the lysosome. In this study, the full complementary DNA (cDNA) sequence of CTSA in Chinese giant salamanders Andrias davidianus was cloned, and its sequence features were analyzed. Tissue expression patterns of CTSA in healthy and Aeromonas hydrophila-infected salamanders were also investigated. The full cDNA sequence of salamander CTSA was 1,620 base pairs in length, encoding 472 amino acids. Salamander CTSA shared high sequence identities with other vertebrates' CTSAs, ranging from 62.7% to 68.9%. In healthy salamanders, CTSA was highly expressed in spleen, followed by brain, intestine, and stomach. After A. hydrophila infection, salamander CTSA was significantly upregulated in lung, heart, muscle, and kidney; was downregulated in liver, spleen, and intestine; and exhibited no significant changes in stomach and skin, indicating that salamander CTSA might play defense roles in multiple tissues during bacterial infection. These results provide a solid basis for further study of the immune function of amphibian CTSA. Received September 18, 2016; accepted June 18, 2017.

Primary malignant melanoma of the urethra: Report of 9 cases in China.

BACKGROUND: Primary urethral melanoma is extremely rare and malignant, and accounts for <1% of all melanoma cases. Here, we aimed to gain more insight into the pathological and follow-up outcomes of patients with this tumor type. METHODS: We conducted a retrospective analysis of nine patients who had undergone comprehensive treatment at West China Hospital since 2009. Furthermore, we also performed a questionnaire-based survey to determine the quality of life and health statuses of surviving patients. RESULTS: Most participants were women, and their ages ranged between 57 and 78 years (mean age: 64.9 years). Common clinical presentations included pigmentation, moles, and irregular neoplasms in the urethral meatus with or without bleeding. The final diagnosis was based on pathological and immunohistochemical examination results. All patients underwent regular follow-ups after receiving surgical or non-surgical therapy, such as chemotherapy or radiotherapy. DISCUSSION/CONCLUSION: Our study revealed that pathological and immunohistochemical tests are crucial for precise diagnosis, especially in asymptomatic patients. Primary malignant urethral melanoma generally has a poor prognosis; therefore, early and accurate diagnosis is imperative. Timely surgical intervention and immunotherapy can help improve patient prognosis. Moreover, an optimistic outlook and family support may augment the clinical management of this disease.

The relationship between nonsteroidal anti-inflammatory drugs and cancer incidence: An umbrella review.

Several clinical and preclinical studies have shown that nonsteroidal anti-inflammatory drugs (NSAIDs), particularly aspirin, reduce the incidence of various cancer types. However, there is still a lack of literature evaluating the overall association between multiple cancer morbidities and NSAIDs. Thus, we conducted an umbrella review to evaluate the quality of evidence, validity, and biases of the existing systematic reviews and meta-analyses on the relationships between NSAIDS and multiple tumor incidence outcomes. We found that NSAIDs might be associated with a decreased risk of several cancers, including the central nervous system, breast, esophageal, gastric, head and neck, hepatocellular, cholangiocarcinoma, colorectal, endometrial, lung, ovary, prostate, and pancreatic cancers, but regular intake of any dose of non-aspirin NSAIDs (NA-NSAIDs) could increase the incidence of kidney cancer. However, most of included studies are evaluated as low quality according to our evidence assessment. Furthermore, due to the potential side effects, such as hemorrhage, digestive symptoms and peptic ulcer, it is still not recommend to use NSAIDs regularly to prevent cancers.

The role of cytoreductive nephrectomy in metastatic renal cell carcinoma in the targeted therapy and immunological therapy era: a systematic review and meta-analysis.

BACKGROUND: The role of cytoreductive nephrectomy (CN) in metastatic renal cell carcinoma (mRCC) remains controversial. In addition, several unanswered questions regarding the use of CN remain: Can CN provide survival benefits for patients with mRCC? Where do we place CN in the treatment sequence paradigm among patients with mRCC? How do we best stratify patients with mRCC for CN therapy? MATERIALS AND METHODS: A search strategy was conducted in the PubMed, Embase, and Web of Science databases. Studies were included only in the English language. The risk of bias assessment was made by using ROBINS-I (Risk of Bias in Nonrandomized Studies of Interventions) and RoB 2 (Risk of Bias 2) tools. The expected outcomes were analyzed by meta-analyses with the fixed-effects model or random effects model, including overall survival (OS) and progression-free survival (PFS). The measure of effect was the hazard ratio (HR) with a 95% CI, and sensitivity analysis was conducted to assess the reliability of the final results. RESULTS: A total of 30 studies were included in the qualitative analysis. The HR for OS was 0.55 (95% CI, 0.50-0.61), and PFS was 0.72 (95% CI, 0.66-0.80), favoring CN compared with no CN. The upfront CN plus targeted therapy (TT) group had superior OS (HR, 0.57; 95% CI, 0.51-0.64) compared with the TT alone group. Furthermore, upfront CN plus systemic therapy (ST) was associated with numerically inferior OS compared with ST plus deferred CN in patients with mRCC (HR, 1.31; 95% CI, 0.98-1.74). Finally, the leave-one-out test of sensitivity analysis indicated that the results of this meta-analysis were stable and reliable in the overall HR estimates for these survival outcomes. CONCLUSIONS: First, CN was associated with better survival than no CN in patients with mRCC. Second, the combination of upfront CN and TT may lead to superior survival outcomes compared to TT alone in patients with mRCC. Survival outcomes were similar between the upfront CN+ST group and the ST+deferred CN group in patients with mRCC. Exact patient selection based on baseline prognostic factors is needed to promise maximal survival for patients with mRCC.

Balanced crystalloid solutions versus normal saline in intensive care units: a systematic review and meta-analysis.

BACKGROUND: Intravenous fluid therapy is important for pediatric and adult patients in intensive care units (ICUs). However, medical professionals continue to struggle to determine the most appropriate fluids to obtain the best possible outcomes for each patient. OBJECTIVE: We conducted a meta-analysis involving cohort studies and randomized controlled trials (RCTs) to compare the influence of balanced crystalloid solutions and normal saline among patients in ICUs. PATIENTS AND METHODS: Studies that compared balanced crystalloid solutions and saline in ICU patients from databases including PubMed, Embase, Web of Science, and Cochrane Library were systematically searched up to July 25, 2022. The primary outcomes were mortality and renal-related outcomes, which included major adverse kidney events within 30 days (MAKE30), acute kidney injury (AKI), new receipt of renal replacement therapy (RRT), maximum creatinine increasing, maximum creatinine level, and final creatinine level ≥ 200% of baseline. Service utilization including length of hospital stay, ICU stay, ICU-free days and ventilator-free days were also reported. RESULTS: A total of 13 studies (10 RCTs and 3 cohort studies) involving 38,798 patients in ICUs met the selection criteria. Our analysis revealed that each subgroup had no significant difference in mortality outcomes among ICU patients between balanced crystalloid solutions and normal saline. A significant difference was detected between the adult groups (odds ratio [OR], 0.92; 95% confidence interval [CI], [0.86, 1.00]; p = 0.04) indicating that the AKI in the balanced crystalloid solutions group was lower than that in the normal saline group. Other renal-related outcomes, such as MAKE30, RRT, maximum creatinine increasing, maximum creatinine level, and final creatinine level ≥ 200% of baseline showed no significant difference between the two groups. Regarding secondary outcomes, the balanced crystalloid solution group had a longer ICU stay time (WMD, 0.02; 95% CI, [0.01, 0.03]; p = 0.0004 and I2 = 0%; p = 0.96) than the normal saline group among adult patients. Furthermore, children treated with balanced crystalloid solution had a shorter hospital stay time (WMD, - 1.10; 95% CI, [- 2.10, - 0.10]; p = 0.03 and I2 = 17%; p = 0.30) than those treated with saline. CONCLUSIONS: Compared with saline, balanced crystalloid solutions could not reduce the risk of mortality and renal-related outcomes, including MAKE30, RRT, maximum creatinine increasing, maximum creatinine level, and final creatinine level ≥ 200% of baseline, but the solutions may reduce total AKI incidence among adult patients in ICUs. For service utilization outcomes, balanced crystalloid solutions were associated with a longer length of ICU stay in the adult group and shorter length of hospital stay in the pediatric group.

The effect of bladder function on the efficacy of transurethral prostatectomy in patients with benign prostatic hyperplasia: a retrospective, single-center study.

We investigated the impact and predictive value of bladder function in patients with benign prostatic hyperplasia (BPH) on the efficacy of transurethral prostatectomy. Symptomatic, imaging, and urodynamic data of patients who underwent transurethral prostatectomy at West China Hospital of Sichuan University (Chengdu, China) from July 2019 to December 2021 were collected. Follow-up data included the quality of life (QoL), International Prostate Symptom Score (IPSS), and IPSS storage and voiding (IPSS-s and IPSS-v). Moreover, urinary creatinine (Cr), nerve growth factor (NGF), brain-derived neurotrophic factor (BDNF), and prostaglandin estradiol (PGE2) were measured in 30 patients with BPH and 30 healthy participants. Perioperative indicators were determined by subgroup analyses and receiver operating characteristic (ROC) curve analysis. Among the 313 patients with BPH included, patients with severe micturition problems had more improvements but higher micturition grades postoperatively than those with moderate symptoms. Similarly, good bladder sensation, compliance, and detrusor contractility (DC) were predictors of low postoperative IPSS and QoL. The urinary concentrations of BDNF/Cr, NGF/Cr, and PGE2/Cr in patients were significantly higher than those in healthy participants (all P < 0.001). After evaluation, only DC was significantly related to both urinary indicators and postoperative recovery of patients. Patients with good DC, as predicted by urinary indicators, had lower IPSS and IPSS-v than those with reduced DC at the 1st month postoperatively (both P < 0.05). In summary, patients with impaired bladder function had poor recovery. The combined levels of urinary BDNF/Cr, NGF/Cr, and PGE2/Cr in patients with BPH may be valid predictors of preoperative bladder function and postoperative recovery.

Dietary sugar consumption and health: umbrella review.

OBJECTIVE: To evaluate the quality of evidence, potential biases, and validity of all available studies on dietary sugar consumption and health outcomes. DESIGN: Umbrella review of existing meta-analyses. DATA SOURCES: PubMed, Embase, Web of Science, Cochrane Database of Systematic Reviews, and hand searching of reference lists. INCLUSION CRITERIA: Systematic reviews and meta-analyses of randomised controlled trials, cohort studies, case-control studies, or cross sectional studies that evaluated the effect of dietary sugar consumption on any health outcomes in humans free from acute or chronic diseases. RESULTS: The search identified 73 meta-analyses and 83 health outcomes from 8601 unique articles, including 74 unique outcomes in meta-analyses of observational studies and nine unique outcomes in meta-analyses of randomised controlled trials. Significant harmful associations between dietary sugar consumption and 18 endocrine/metabolic outcomes, 10 cardiovascular outcomes, seven cancer outcomes, and 10 other outcomes (neuropsychiatric, dental, hepatic, osteal, and allergic) were detected. Moderate quality evidence suggested that the highest versus lowest dietary sugar consumption was associated with increased body weight (sugar sweetened beverages) (class IV evidence) and ectopic fatty accumulation (added sugars) (class IV evidence). Low quality evidence indicated that each serving/week increment of sugar sweetened beverage consumption was associated with a 4% higher risk of gout (class III evidence) and each 250 mL/day increment of sugar sweetened beverage consumption was associated with a 17% and 4% higher risk of coronary heart disease (class II evidence) and all cause mortality (class III evidence), respectively. In addition, low quality evidence suggested that every 25 g/day increment of fructose consumption was associated with a 22% higher risk of pancreatic cancer (class III evidence). CONCLUSIONS: High dietary sugar consumption is generally more harmful than beneficial for health, especially in cardiometabolic disease. Reducing the consumption of free sugars or added sugars to below 25 g/day (approximately 6 teaspoons/day) and limiting the consumption of sugar sweetened beverages to less than one serving/week (approximately 200-355 mL/week) are recommended to reduce the adverse effect of sugars on health. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42022300982.

Selenium intake and multiple health-related outcomes: an umbrella review of meta-analyses.

Selenium is an essential trace metalloid element that is associated with fundamental importance to human health. Our umbrella review aimed to evaluate the quality of evidence, validity, and biases in the relationship between selenium intake and health-related outcomes according to published systematic reviews with pooled data and meta-analyses. Selenium intake is associated with a decreased risk of digestive system cancers, all-cause mortality, depression, and Keshan disease, when in children reduce the risk of Kashin-Beck disease. Additionally, selenium supplementation can improve sperm quality, polycystic ovary syndrome, autoimmune thyroid disease, cardiovascular disease, and infective outcomes. Selenium supplementation also has relationship with a decreased concentration of serum lipids including total cholesterol and very low-density lipoprotein cholesterol. However, no evidence has shown that selenium is associated with better outcomes among patients in intensive care units. Furthermore, selenium intake may be related with a higher risk of type 2 diabetes and non-melanoma skin cancers. Moreover, most of included studies are evaluated as low quality according to our evidence assessment. Based on our study findings and the limited advantages of selenium intake, it is not recommended to receive extra supplementary selenium for general populations, and selenium supplementation should not be continued in patients whose selenium-deficient status has been corrected.

Meta-analysis reveals cyanotoxins risk across African inland waters.

Global eutrophication and climate warming exacerbate production of cyanotoxins such as microcystins (MCs), presenting risks to human and animal health. Africa is a continent suffering from severe environmental crises, including MC intoxication, but with very limited understanding of the occurrence and extent of MCs. By analysing 90 publications from 1989 to 2019, we found that in various water bodies where MCs have been detected so far, the concentrations were 1.4-2803 times higher than the WHO provisional guideline for human lifetime exposure via drinking water (1 µg/L) in 12 of 15 African countries where data were available. MCs were relatively high in the Republic of South Africa (averaged 2803 µg/L) and Southern Africa as a whole (702 µg/L) when compared to other regions. Values were higher in reservoirs (958 µg/L) and lakes (159 µg/L) than in other water types, and much higher in temperate (1381 µg/L) than in arid (161 µg/L) and tropical (4 µg/L) zones. Highly significant positive relationships were found between MCs and planktonic chlorophyll a. Further assessment revealed high ecological risk for 14 of the 56 water bodies, with half used as human drinking water sources. Recognizing the extremely high MCs and exposure risk in Africa, we recommend routine monitoring and risk assessment of MCs be prioritized to ensure safe water use and sustainability in this region.

From unusual suspect to serial killer: Cyanotoxins boosted by climate change may jeopardize megafauna.

The recent mass mortality event of more than 330 African elephants in Botswana has been attributed to biotoxins produced by cyanobacteria; however, scientific evidence for this is lacking. Here, by synthesizing multiple sources of data, we show that, during the past decades, the widespread hypertrophic waters in Southern Africa have entailed an extremely high risk and frequent exposure of cyanotoxins to the wildlife within this area, which functions as a hotspot of mammal species richness. The hot and dry climatic extremes have most likely acted as the primary trigger of the recent and perhaps also of prehistoric mass mortality events. As such climate extremes are projected to become more frequent in Southern Africa in the near future, there is a risk that similar tragedies may take place, rendering African megafauna species, especially those that are already endangered, in risk of extinction. Moreover, cyanotoxin poisoning amplified by climate change may have unexpected cascading effects on human societies. Seen within this perspective, the tragic mass death of the world's largest terrestrial mammal species serves as an alarming early warning signal of future environmental catastrophes in Southern Africa. We suggest that systematic, quantitative cyanotoxin risk assessments are made and precautionary actions to mitigate the risks are taken without hesitation to ensure the health and sustainability of the megafauna and human societies within the region.

Establishing a time series trend structure model to mine potential hydrological information from hydrometeorological time series data.

This paper addresses the problem of missing latent time series information caused by the differences in the analysis of time series data and non-time series data. A time series trend structure model (TSTM) was established using the analysis of time series patterns and rules, the trends of patterns and rules, and trends in confidence and support. Shandong Province was selected as the study area. Rainfall and evaporation time series data from this area were input into the TSTM. The results show that: (1) the structure of multi-year precipitation and evaporation trends of the meteorological stations in the study area have continuously increasing or decreasing characteristics. The TSTM can excavate the different trend structure characteristics of different meteorological elements and enables diversity in time series data analysis; (2) the evaporation trend structure tends to change synchronously with increases and decreases in precipitation and evaporation. The synchronous change frequency is essentially the same as that of the rainfall trend structure. This indicates that the TSTM has spatial and temporal characteristics for time series data analysis; and (3) from the maximal non-descending and non-ascending subsequence in the TSTM, it can be concluded that there exists continuity in the years when the trend structure of precipitation and evaporation increases and decreases synchronously. In addition, the degree of similarity in the model is well reflected in the spatial distribution characteristics of time series data, and the model provides clustering characteristics for time series data analysis. The TSTM proposed in this paper can effectively obtain the potential hydrological information contained in time series data, and provides a scientific and reliable basis for rules for the spatial optimization of watershed data and for the calibration of hydrological models.

Exploring the application of artificial intelligence technology for identification of water pollution characteristics and tracing the source of water quality pollutants.

Point sources are important routes through which pollutants enter rivers. It is important to identify the characteristics of and trace the origins of water pollutants. In this study, an artificial intelligence system called the integrated long short-term memory network (LSTM), using cross-correlation and association rules (Apriori), was used to identify the characteristics of water pollutants and trace industrial point sources of pollutants. Water quality monitoring data from Shandong Province, China, were used to verify the applicability of the artificial intelligence system using a cross-correlation method to develop a water quality cross-correlation map. The map was used to identify highly correlated pollutants affecting water quality, then the association rules (Apriori) were used to track the pollutants to industries common in the study area. The highly correlated water pollutants and relevant industries were used as inputs for the LSTM to determine how well the LSTM traced sources of water pollutants. The results showed that (1) changes in water quality were affected in different ways by different industries and different distributions and production cycles of the pollutant point sources; (2) water quality correlation maps can be used to identify regular and abnormal fluctuations in point source pollutant emissions by identifying changes in water quality characteristics and frequent itemsets in water quality indices can be used to trace the industries that most strongly affect water quality; and (3) the LSTM accurately traced point sources of future changes in water quality. In conclusion, the artificial intelligence scheme described here can be applied to aquatic systems.