Simultaneous nitrification and denitrification in a hybrid activated sludge-membrane aerated biofilm reactor (H-MABR) for nitrogen removal from low COD/N interflow: A pilot-scale study.

There are a large number of simple landfills in hilly areas, and the results of previous studies have shown that pollutants in landfills can spread via interflow and cause surface source pollution. The hybrid activated sludge-membrane aerated bioreactor (H-MABR) developed in a previous study can be used for the treatment of interflow with a low chemical oxygen demand (COD)/total nitrogen (TN) ratio, and it has been shown to be effective in laboratory simulations. To investigate the effectiveness of the H-MABR in treating interflow around landfills in real-world applications, an in-situ pilot-scale evaluation of the effectiveness of H-MABR operation was conducted at a landfill. The results indicated that the removal efficiencies of COD, TN, and ammonia nitrogen in interflow by H-MABR were 87.1 ± 6.0%, 80.9 ± 7.9%, and 97.9 ± 1.4%, respectively. The removal rate of TN reached 148.6-205.6 g-N/m3·d. The concentration of each pollutant in the effluent was in accordance with China's "Standard for pollution control on the landfill site of municipal solid waste (GB16889-2008)," wherein the COD, TN, and ammonia nitrogen of effluent should be less than 100 mg/L, 40 mg/L, and 25 mg/L, respectively. The results of community composition analysis and PICRUSt analysis based on 16S rRNA gene sequencing showed that there were different dominant functional bacteria between the inner and outer rings, but functional genes involved in the nitrification-denitrification, assimilated nitrate reduction, and dissimilated nitrate reduction pathway were all detected. Furthermore, except for the nitrite oxidation gene narG, the abundance of which did not significantly differ between the inner and outer rings, the abundance of the other functional genes was higher in the outer ring than in the inner ring. An economic evaluation revealed that the operation cost of interflow treatment by the H-MABR was as low as ¥2.78/m3; thus, the H-MABR is a shock-load-resistant and cost-effective technology for interflow treatment.

Typical emerging contaminants in sewage treatment plant effluent, and related watersheds in the Pearl River Basin: Ecological risks and source identification.

Emerging contaminants pose a potential risk to aquatic ecosystems in the Pearl River Basin, China, owing to the high population density and active industry. This study investigated samples from eight sewage treatment plants, and five surface water bodies of related watersheds. To screen the risk of emerging contaminants (ECs), and clarify their sources, this study calculated the risk quotient of detected chemical and performed source identification/apportionment using the positive matrix factorization method. In total, 149 organic pollutants were identified. Pharmaceuticals showed significant concentrations in sewage treatment plant samples (120.87 ng/L), compared with surface water samples (1.13 ng/L). The ecological risk assessment identified three chemicals with a heightened risk to aquatic organisms: fipronil sulfide, caffeine, and roxithromycin. Four principal sources of contaminants were identified: pharmaceutical wastewater, domestic sewage, medical effluent, and agricultural runoff. Pharmaceutical wastewater was the primary contributor (60.4 %), to the cumulative EC concentration and to ECs in sewage treatment plant effluent. Agricultural drainage was the main source of ECs in surface water. This study provides a strategy to obtain comprehensive information on the aquatic risks and potential sources of EC species in areas affected by artificial activities, which is of substantial importance to pollutant management and control.

Machine learning-driven source identification and ecological risk prediction of heavy metal pollution in cultivated soils.

To overcome challenges in assessing the impact of environmental factors on heavy metal accumulation in soil due to limited comprehensive data, our study in Yangxin County, Hubei Province, China, analyzed 577 soil samples in combination with extensive big data. We used machine learning techniques, the potential ecological risk index, and the bivariate local Moran's index (BLMI) to predict Cr, Pb, Cd, As, and Hg concentrations in cultivated soil to assess ecological risks and identify pollution sources. The random forest model was selected for its superior performance among various machine learning models, and results indicated that heavy metal accumulation was substantially influenced by environmental factors such as climate, elevation, industrial activities, soil properties, railways, and population. Our ecological risk assessment highlighted areas of concern, where Cd and Hg were identified as the primary threats. BLMI was used to analyze spatial clustering and autocorrelation patterns between ecological risk and environmental factors, pinpointing areas that require targeted interventions. Additionally, redundancy analysis revealed the dynamics of heavy metal transfer to crops. This detailed approach mapped the spatial distribution of heavy metals, highlighted the ecological risks, identified their sources, and provided essential data for effective land management and pollution mitigation.

Uncovering the Nexus between Urban Heat Islands and Material Stocks of Built Environment in 335 Chinese Cities.

China's unprecedented rapid urbanization has dramatically reshaped the urban built environment, disrupting the thermal balance of cities. This disruption causes the urban heat island (UHI) effect, adversely affecting urban sustainability and public health. Although studies have highlighted the remarkable impacts of the built environment on UHIs, the specific effects of its various structures and components remain unclear. In this study, a multidimensional remote sensing data set was used to quantify the atmospheric UHIs across 335 Chinese cities from 1980 to 2020. In conjunction with stocks of three end-use sectors and three material groups, the impacts of gridded material stocks on UHI variations were analyzed. The findings reveal that building stocks exert a predominant influence in 48% of cities. Additionally, the extensive use of metal and inorganic materials has increased thermal stress in 220 cities, leading to an average UHI increase of 0.54 °C. The effect of organic materials, primarily arising from mobile heat sources, is continuously increasing. Overall, this study elucidates the effect of the functional structure and material composition of urban landscapes on UHIs, highlighting the complexities associated with the influence of the built environment on the urban heat load.

Predicting fracture risk for elderly osteoporosis patients by hybrid machine learning model.

Background and Objective: Osteoporotic fractures significantly impact individuals's quality of life and exert substantial pressure on the social pension system. This study aims to develop prediction models for osteoporotic fracture and uncover potential risk factors based on Electronic Health Records (EHR). Methods: Data of patients with osteoporosis were extracted from the EHR of Xinhua Hospital (July 2012-October 2017). Demographic and clinical features were used to develop prediction models based on 12 independent machine learning (ML) algorithms and 3 hybrid ML models. To facilitate a nuanced interpretation of the results, a comprehensive importance score was conceived, incorporating various perspectives to effectively discern and mine critical features from the data. Results: A total of 8530 patients with osteoporosis were included for analysis, of which 1090 cases (12.8%) were fracture patients. The hybrid model that synergistically combines the Support Vector Machine (SVM) and XGBoost algorithms demonstrated the best predictive performance in terms of accuracy and precision (above 90%) among all benchmark models. Blood Calcium, Alkaline phosphatase (ALP), C-reactive Protein (CRP), Apolipoprotein A/B ratio and High-density lipoprotein cholesterol (HDL-C) were statistically found to be associated with osteoporotic fracture. Conclusions: The hybrid machine learning model can be a reliable tool for predicting the risk of fracture in patients with osteoporosis. It is expected to assist clinicians in identifying high-risk fracture patients and implementing early interventions.

IQGAP3 promotes the progression of glioma as an immune and prognostic marker.

Background: IQGAP3 plays a crucial role in regulating cell proliferation, division, and cytoskeletal organization. Abnormal expression of IQGAP3 has been linked to various tumors, but its function in glioma is not well understood. Methods: Various methods, including genetic differential analysis, single-cell analysis, ROC curve analysis, Cox regression, Kaplan-Meier analysis, and enrichment analysis, were employed to analyze the expression patterns, diagnostic potential, prognostic implications, and biological processes involving IQGAP3 in normal and tumor tissues. The impact of IQGAP3 on immune infiltration and the immune microenvironment in gliomas was evaluated using immunofluorescence. Additionally, the cBioPortal database was used to analyze copy number variations and mutation sites of IQGAP3. Experimental validation was also performed to assess the effects of IQGAP3 on glioma cells and explore underlying mechanisms. Results: High IQGAP3 expression in gliomas is associated with an unfavorable prognosis, particularly in wild-type IDH and 1p/19q non-codeleted gliomas. Enrichment analysis revealed that IQGAP3 is involved in regulating the cell cycle, PI3K/AKT signaling, p53 signaling, and PLK1-related pathways. Furthermore, IQGAP3 expression may be closely related to the immunosuppressive microenvironment of glioblastoma. BRD-K88742110 and LY-303511 are potential drugs for targeting IQGAP3 in anti-glioma therapy. In vitro experiments showed that downregulation of IQGAP3 inhibits the proliferation and migration of glioma cells, with the PLK1/PI3K/AKT pathway potentially playing a crucial role in IQGAP3-mediated glioma progression. Conclusion: IQGAP3 shows promise as a valuable biomarker for diagnosis, prognosis, and immunotherapeutic strategies in gliomas.

Lycopene from tomatoes and tomato products exerts renoprotective effects by ameliorating oxidative stress, apoptosis, pyroptosis, fibrosis, and inflammatory injury in calcium oxalate nephrolithiasis: the underlying mechanisms.

Several mechanisms underlying nephrolithiasis, one of the most common urological diseases, involve calcium oxalate formation, including oxidative stress, inflammatory reactions, fibrosis, pyroptosis, and apoptosis. Although lycopene has strong antioxidant activity, its protective effects against CaOx-induced injury have not yet been reported. This study aimed to systematically investigate the protective effects of lycopene and explore its mechanisms and molecular targets. Crystal deposition, renal function, oxidative stress, inflammatory response, fibrosis, pyroptosis, and apoptosis were assessed to evaluate the renoprotective effects of lycopene against crystal formation in a CaOx rat model and oxalate-stimulated NRK-52E and HK-2 cells. Lycopene markedly ameliorated crystal deposition, restored renal function, and suppressed kidney injury by reducing oxidative stress, apoptosis, inflammation, fibrosis, and pyroptosis in the rats. In cell models, lycopene pretreatment reversed reactive oxygen species increase, apoptotic damage, intracellular lactate dehydrogenase release, cytotoxicity, pyroptosis, and extracellular matrix deposition. Network pharmacology and proteomic analyses were performed to identify lycopene target proteins under CaOx-exposed conditions, and the results showed that Trappc4 might be a pivotal target gene for lycopene, as identified by cellular thermal shift assay and surface plasmon resonance analyses. Based on molecular docking, molecular dynamics simulations, alanine scanning mutagenesis, and saturation mutagenesis, we observed that lycopene directly interacts with Trappc4 via hydrophobic bonds, which may be attributed to the PHE4 and PHE142 residues, preventing ERK1/2 or elevating AMPK signaling pathway phosphorylation events. In conclusion, lycopene might ameliorate oxalate-induced renal tubular epithelial cell injury via the Trappc4/ERK1/2/AMPK pathway, indicating its potential for the treatment of nephrolithiasis.

A novel post-percutaneous nephrolithotomy sepsis prediction model using machine learning.

OBJECTIVES: To establish a predictive model for sepsis after percutaneous nephrolithotomy (PCNL) using machine learning to identify high-risk patients and enable early diagnosis and intervention by urologists. METHODS: A retrospective study including 694 patients who underwent PCNL was performed. A predictive model for sepsis using machine learning was constructed based on 22 preoperative and intraoperative parameters. RESULTS: Sepsis occurred in 45 of 694 patients, including 16 males (35.6%) and 29 females (64.4%). Data were randomly segregated into an 80% training set and a 20% validation set via 100-fold Monte Carlo cross-validation. The variables included in this study were highly independent. The model achieved good predictive power for postoperative sepsis (AUC = 0.89, 87.8% sensitivity, 86.9% specificity, and 87.4% accuracy). The top 10 variables that contributed to the model prediction were preoperative midstream urine bacterial culture, sex, days of preoperative antibiotic use, urinary nitrite, preoperative blood white blood cell (WBC), renal pyogenesis, staghorn stones, history of ipsilateral urologic surgery, cumulative stone diameters, and renal anatomic malformation. CONCLUSION: Our predictive model is suitable for sepsis estimation after PCNL and could effectively reduce the incidence of sepsis through early intervention.

The relationship between physical activity and the health of primary and secondary school teachers: the chain mediating effects of body image and self-efficacy.

BACKGROUND: Active health is a new concept, model, and system to maintain the state of whole-person health. In the context of the increasingly serious health problems of primary and secondary school teachers, it is of great significance to explore the relationship between physical activity and primary and secondary school teachers' health based on the active health perspective. METHODS: The survey involving 741 primary and secondary school teachers across representative provinces in China utilized the International Physical Activity Scale, Body Imagery State Scale, and General Self-Efficacy Scale. Data analysis employed SPSS 25.0 and Amos 24.0 software. RESULTS: While no significant gender disparities were observed in body image and self-efficacy, age groups exhibited a bipartite and "V" shaped distribution. Female teachers demonstrated higher physical activity levels (2456.46) and superior physical fitness compared to males (2297.86). A positive correlation emerged between physical activity, body image, self-efficacy, and health status. Importantly, body image and self-efficacy partially mediated the relationship between physical activity and health status, accounting for 82.31% of the total effect. CONCLUSIONS: Primary and secondary school teachers have real problems such as teachers' physical activity is generally insufficient, teachers' body image status is generally poor, and teachers' self-efficacy is low; physical activity is an important factor in promoting primary and secondary school teachers' health status, and low, medium, and high levels of activity all have a promoting effect on the health of primary and secondary school teachers, and the more active primary and secondary school teachers are in terms of physical activity, the better their body image, self-efficacy, and health status are, and the more active primary and secondary school teachers are in terms of physical activity, the more positive the physical activity, self-efficacy, and health status are. The more physically active primary and secondary school teachers are, the better their physical intention, self-efficacy and health status are. SUGGESTIONS: improve the quality and effectiveness, promote the concept of active health among teachers; empower teachers, strengthen the institutional protection of teachers' health; reduce the burden and increase the quantity,and optimise the supply of health services for teachers.

Four-decades evolutionary development of municipal solid waste management in China: Implications for sustainable waste management and circular economy.

This study collected data on waste generation and management in China between 1979 and 2020 from government statistics and literature and reviewed the development of municipal solid waste (MSW) management in China. The extended stochastic impact by regression on population, affluence and technology (STIRPAT) model was employed to identify the driving forces of MSW generation, and the cointegration analysis showed that economy (0.35, t = -3.47), industrial structure (3.34, t = -20.77) and urbanization (-1.5, t = 5.678) were the significant socioeconomic driving forces in the long run. By employing the framework of evolutionary economics, this study then investigated the internal rules of long-term interaction between socioeconomic factors and MSW management. The results indicate that, in the long run, MSW management development can be viewed as an evolutionary process that includes a continuous adaptation to external socioeconomic factors and the co-evolution of internal institutions and technologies. Adaptation and diversity of institutions and technologies play an important role in achieving sustainable waste management and circular economy (CE). This study offers a novel evolutionary perspective for explaining dynamic changes of MSW management in China, as well as recommendations for emerging economies to achieve sustainable waste management and CE goals.

IgG4-related disease of the ureter mimicking malignant ureter tumor: a case report and experience sharing.

Background: Immunoglobulin G4-related disease (IgG4-RD) is an autoimmune disease that can affect any organ or tissue in the body, and is characterized by intensive infiltration of IgG4-positive plasma cells, and elevated serum IgG4 levels. IgG4-RD causes renal impairment of unknown pathogenesis that may progress to kidney failure. However, few case of IgG4-RD mimicking malignant ureter tumor leading to severe hydronephrosis. Case Description: This report describes a 38-year-old male patient who was hospitalized for sudden waist pain. Enhanced abdominal computed tomography (CT) revealed a mass involving the right ureter. He presented to the urologist with severe right hydronephrosis. Urinalysis revealed occult blood (3+), and atypical cells were observed in urine cytology, raising the possibility of a ureteral malignancy. After that, the patient underwent diagnostic ureteroscopy instead of direct nephroureterectomy and was found not to have any malignancy. The patient received laparoscopic partial ureteral resection and anastomosis. Histologically, there were observations of IgG4-positive plasma cell infiltration exceeding 10 cells per high-power field, as well as a high ratio of IgG4-positive/IgG-positive cells exceeding 40%. And histopathology revealed ureteral IgG4-related disease, with no evidence of urothelial carcinoma. Conclusions: IgG4-RD has previously been reported in lesions involving the ureters, but misdiagnosis and subsequent radical nephroureterectomy can cause lifelong regret for the patient in having lost one side of the urinary tract. To avoid such misdiagnoses, clinicians should consider IgG4-RD as a potential condition.

Characteristics analysis of solid waste generation and carbon emission of beer production in China.

As the largest beer producer and consumer in the world, China's endeavors to reduce solid waste generation (SWG) and carbon emissions (CEs) in the course of beer production assume paramount significance. This study aims to assess the SWG and CEs in beer production within China at both national and provincial levels, and further delves into the spatial distribution characteristics and evolving patterns across the country. Key findings of the study include:(1) Peak SWG and CEs were recorded in 2013, reaching 861.62 million tons and 2315.10 tCO2e, respectively, followed by a consistent decline. (2) Among the three types of solid waste, spent grain exhibited the highest generation rate, contributing to 94.38% of the total. (3) The emergence of China's beer industry dates back to the 1980s in the northeastern region, expanding to the southeastern and the Yangtze River Basin during the 1990s, ultimately extending nationwide. (4) The spatial distribution of beer production revealed significant regional disparities and notable industry concentration. Notably, many provinces witnessed reduced CEs from beer production starting in 2015, although the extent of reduction varied in different provinces. These findings serve as a scientific foundation for formulating emission reduction strategies in beer producing and offer insights for other food industries in China.

Uncovering the coupling effect with energy-related carbon emissions and human development variety in Chinese provinces.

Lessening energy-related carbon emissions has become a crucial measure to achieve Chinese carbon neutrality. This study is the first to construct a Difference in Carbon pressures-adjusted Human Development Index (DCHDI) model for the purpose of exploring the coupling effect between carbon emissions and human development variety from 2000 to 2019 in Chinese provinces. We demonstrate the following. (1) The total energy-related carbon footprint of 30 provinces in China reached 10.2 billion tons in 2019, with an average annual growth rate of 6.93% over the past two decades; and the provinces with the highest carbon emissions per capita are InnerMongolia, Ningxia, and Shanxi. (2) At the provincial level, we observed that the Human Development Index (HDI), which includes life expectancy, education, and income, has been rising, while Beijing, Shanghai, and Tianjin entered the super-high HDI level before 2008. (3) The entire coupling effect of 30 Chinese provinces has been broadly fortified in the last 20 years, but the growth rate of DCHDI values in 2011-2019 has slowed down compared with that in 2000-2010; the clustering phenomenon demonstrated that this discovery is associated with historical peaks in total carbon emissions. (4) The coordination degree of carbon emissions per capita and HDI was verified, and 96% of the data points were found in the range of super high coupling coordination degree. Overall, this study provides the government with worthwhile guidance for decision-making and carbon reduction strategies for other countries struggling to advance human sustainable development.

Gridded material stocks in China based on geographical and geometric configurations of the built-environment.

Material stocks have created alternative perspectives in many environmental and climate studies. Their significance nonetheless may be under-explored, partially due to scarcity of more precise, timely and higher-resolution information. To address this limitation, our present study developed a gridded material stocks dataset for China in Year 2000 and 2020, by examining the geographical distribution and geometric configurations of the human-made stock-containing environment. The stocks of twelve materials embodied in five end-use sectors and 104 products and constructions were assessed at a resolution of 1 × 1 km grid. Material intensity in each product or construction component was carefully evaluated and tagged with its geometric conformation. The gridded stocks aggregately are consistent with the stock estimation across 337 prefectures and municipalities. The reliability of our assessment was also validated by previous studies from national, regional, to grid levels. This gridded mapping of material stocks may offer insights for urban-rural disparities, urban mining opportunity, and climate and natural disaster resilience.

Combinational use of trabectedin and pegylated liposomal doxorubicin for recurrent ovarian cancer: a meta-analysis of phase III randomized controlled trials.

BACKGROUND: In recent years, pegylated liposomal doxorubicin (PLD) has been widely used to improve the survival of patients with ovarian cancer; however, it is unclear whether the combinational use of PLD with other drugs is more effective. Therefore, this meta-analysis aimed to confirm the efficacy and safety of trabectedin, combined with PLD, in the treatment of recurrent ovarian cancer. METHODS: Data corresponding to all eligible clinical trials as of May 15, 2022, was retrieved using several electronic retrieval databases including PubMed, Medical Literature Analysis and Retrieval System Online (MEDLINE), ClinicalTrials.gov, Excerpta Medica Database (EMBASE) and Cochrane Library clinical controlled trials (CENTRAL). Comprehensive hazard ratios (HRs), risk ratios (RRs), and 95% confidence intervals (CIs) were calculated using the Review Manager software 5.4 (RevMan 5.4). RESULTS: From two phase III randomized controlled trials, 1248 patients with recurrent ovarian cancer were included in this meta-analysis. Results of meta-analysis revealed that trabectedin, combined with PLD chemotherapy, significantly improved overall survival (OS) in patients with BReast CAncer gene (BRCA)-associated recurrence (HR, 0.49; 95% CI, [0.33-0.73]; P = 0.0004) and platinum-sensitive recurrence whose platinum-free interval (PFI) was 6-12 months (HR, 0.66; 95% CI, [0.52-0.84]; P = 0.0005). In addition, compared with PLD alone, combination therapy significantly improved the progression-free survival (PFS) in patients with recurrent ovarian cancer (HR, 0.86; 95% CI, [0.74-0.99]; P = 0.03). Combination therapy also significantly improved PFS in patients with BRCA-associated recurrence (HR, 0.58; 95% CI, [0.40-0.58]; P = 0.004), and platinum-sensitive recurrence (HR, 0.73; 95% CI, [0.56-0.95]; P = 0.02). Trabectedin combined with PLD was more prone to grade 3-4 toxic side effects than PLD alone (P < 0.05); however, fatal adverse events related to non-toxic side effects occurred. CONCLUSION: Trabectedin combined with PLD significantly improves OS and PFS in patients with BRCA-associated and platinum-sensitive recurrent ovarian cancers. The potential use of trabectedin combined with PLD should be selected according to the PFI and BRCA mutation status of patients.

Analysis of recurrence and metastasis patterns and prognosis after complete resection of retroperitoneal liposarcoma.

Objective: To analyze the recurrence and metastasis patterns and prognosis after complete resection of retroperitoneal liposarcoma. Methods: The clinical postoperative follow-up data and results of patients who underwent complete resection of retroperitoneal liposarcoma from September 10, 2014, to September 8, 2021, at Hebei Medical University hospital were collected retrospectively. Results: A total of 60 patients with complete resection of retroperitoneal liposarcoma, including 33 cases of retroperitoneal liposarcoma recurrence, 2 cases of liver metastasis, and 1 case of lung metastasis, were included. The results showed that 100% of the recurrent sites were located in the primary region of the tumor, with most recurrences located near the kidney, paracolic sulci, and iliac vessels. Three patients had distant metastasis without obvious recurrence on imaging examination. The pathological type of retroperitoneal liposarcoma, Ki67 expression, and presence of serum albumin were risk factors for recurrence and metastasis after complete resection of retroperitoneal liposarcoma. The malignancy and Ki67 expression were independent risk factors for recurrence and metastasis as well as for overall survival of patients undergoing complete resection of retroperitoneal liposarcoma. Conclusion: Complete resection remains the most effective method to treat retroperitoneal liposarcoma. Patients with pathological types of retroperitoneal liposarcoma showing dedifferentiation, pleomorphism, mixed type, and high Ki67 expression should be closely monitored and observed after complete resection, especially for imaging changes in the primary tumor area.