Association between immune-related adverse events and prognosis in patients with advanced non-small cell lung cancer: a systematic review and meta-analysis.

Background: The emergence of immune checkpoint inhibitors (ICIs) provides a variety of options for patients with advanced non-small-cell lung cancer (NSCLC). After the application of ICIs, the immune system of patients was highly activated, and immune-related adverse events (irAEs) could occur in some organ systems, and irAEs seemed to be associated with the survival prognosis of patients. Therefore, we evaluated the association between survival outcomes and irAEs in NSCLC patients and conducted a systematic review and meta-analysis. Methods: We conducted systematic reviews of PubMed, Embase, Cochrane, and Web of Science databases until December 2021. The forest map was constructed by combining the hazard ratio (HR) and 95% confidence interval (CI). I2 estimated the heterogeneity between studies. A meta-analysis was performed using R 4.2.1 software. Results: Eighteen studies included 4808 patients with advanced NSCLC. In pooled analysis, the occurrence of irAEs was found to be a favorable factor for improved prognosis (PFS: HR: 0.48, 95% CI: 0.41-0.55, P <0.01; OS: HR: 0.46, 95% CI: 0.42-0.52, P <0.01). In subgroup analyses, cutaneous irAE, gastrointestinal irAE, endocrine irAE and grade ≥3 irAEs were associated with improvements in PFS and OS, but pulmonary and hepatic irAEs were not. Conclusion: Existing evidence suggests that the occurrence of irAEs may be a prognostic biomarker for advanced NSCLC. However, further research is needed to explore the prospect of irAEs as a prognostic biomarker in patients undergoing immunotherapy. Systematic review registration: https://www.crd.york.ac.uk/PROSPEROFILES/405333_STRATEGY_20240502.pdf, identifier CRD42023405333.

Anaerobic swine digestate valorization via energy-efficient electrodialysis for nutrient recovery and water reclamation.

The development of cost-effective and energy-efficient technologies to recover nutrients from digestate is important. Anaerobic digestate can be concentrated into bio-nutrient products through an electrodialysis (ED) process in an energy-efficient manner. Despite recent advances, the operation modes of ED for nutrient recovery from swine digestate are yet to be systematically evaluated from the perspective of energy-water efficiencies, and the determination of optimal operations in ED units is still ambiguous. In this study, two different operating modes of electrodialysis, i.e., constant voltage and constant current, are designed to evaluate the energy efficiency and effectiveness of nutrient recovery from anaerobic swine digestate. The ion removal ratio and current efficiency of the different modes and their associated electromigration performance (e.g., rate constants) are evaluated. The results indicate that the maximum removal efficiency (in terms of electrical conductivity) is 92.8% at a cell voltage of 2.4 V/cell using the constant voltage operation. The current efficiencies of NH4+ (43‒65%) are higher than that of other ions, such as K+ (12‒19%), Cl- (4‒7%), and PO43- (0.1‒1.5%). For nitrogen recovery, the required energy consumption was about 0.24‒15.2 kWh/kg-N (0.86‒54.7 kJ/g-N), corresponding to a removal ratio of ammonium from 70.8% to 99.1%. Based on the experimental data, the optimal operating conditions are identified using response surface models by considering process energy consumption and productivity to deliver energy-efficient nutrient separation. One candidate of the ideal conditions to achieve the total ion removal of ∼93% should be operated at a constant cell voltage of 1.15 V, corresponding to a productivity of 5.24 gal/hr/m2 at an energy consumption of 0.44 kWh/m3. Last, a conceptual design of cascading separation processes is proposed for digestate valorization as biofertilizers, nutrients, organic acids, and reclaimed water. A preliminary benefit-cost evaluation is then performed to evaluate the engineering and economic performance of the developed process for nutrient recovery from swine digestate. This article provides insight into practical large-scale applications of digestate valorization through energy-efficient separation, thereby realizing a circular economy system and a decarbonizing supply chain of bio-nutrients.

Systematic approach to source-sink apportionment of copper in paddy fields: Experimental observation, dynamic modeling and prevention strategy.

The accumulation of heavy metals in paddy rice severely impacts the health of consumers and plants. In this study, a systematic approach to source-sink apportionment of copper in paddy fields was developed by considering all bioenvironmental interfaces. Experimental data from two experimental fields (namely Field A and Field B) in the first harvest period was collected. Then, mass-balance-based models with dynamic critical loads were established to evaluate the year of excess for copper. The results indicated that irrigation water contributed the highest portion (96.2-98.8%) of total copper inputs. Under the business-as-usual scenario, the soil copper concentration of Field A and Field B might exceed the Taiwanese national standard within 66 and 24 years, respectively. In addition, alternate wet-dry irrigation was found to be one of the total solutions to reducing copper accumulation in soils by 17-48%. It could also provide a significant reduction of water usage in paddy fields by ~25%, thereby increasing the resilience to extreme climate change events. Lastly, based on the field observations, three improvement strategies on sustaining soil quality towards better agricultural environment were proposed. The connection of copper accumulation in soils with dietary and ecological risks was also briefly illustrated.

Reduning injection for fever, rash, and ulcers in children with mild hand, foot, and mouth disease: a randomized controlled clinical study.

OBJECTIVE: To assess the efficacy and safety of Reduning injection for fever, rash, and ulcers in children with mild hand, foot, and mouth disease (HFMD). METHODS: A stratified-block randomized, double-blind, parallel-controlled, and multicenter clinical trial was conducted with 360 patients in five hospitals across China: Quanzhou Children's Hospital, Shijiazhuang No. 5 Hospital, Shanghai Public Health Centre, Hunan Provincial Children's Hospital, and Kaifeng Children's Hospital. Patients were randomized into three groups with 120 in each. Group A was treated with Western Medicine, group B with Reduning injection, a Chinese herbal medicine, and group C with both Reduning injection and Western Medicine. Results were compared for treatment efficacy and safety on HFMD. The clinical outcomes were observed as follows: fever and onset time of antifebrile effect (time to bring the body temperature down > or = 0.5 degrees C after medication); cumulative time for fever recovery (body temperature recovering to normal and lasting more than 24 h without medication); cumulative time for rash disappearance (without new rashes or ulcers appearing and the original ones fading away); and cumulative time for mouth ulcer disappearance. RESULTS: For the onset time of the antifebrile effect, there was no statistical difference between groups A and B (P > 0.05) and groups B and C (P > 0.05). However, there was a statistical difference between groups A and C (P < 0.05), and the effect in group C was the best. For the cumulative time for rash disappearance, there was no statistical difference between groups A and B (P > 0.05). There were statistical differences between groups A and C, and groups B and C (P < 0.05), and the effect in group C was the best. For the cumulative time for mouth ulcers disappearance, there were no statistical differences among the three groups (P > 0.05). CONCLUSION: Reduning injection with Western Medicine for symptomatic treatment is most effective for mild HFMD. No adverse reactions were observed.