A new concern raised from algal bloom: Organic chloramines in chlorination.

Algal blooms have become a significant challenge in water treatment all over the world. In chlorination of drinking water, algal organic matter (AOM) leads to the formation of organic chloramines. The objectives of this review are to comprehensively summarize and discuss the up-to-date researches on AOM-derived organic chloramines and their chemical activities and toxicity, thereby drawing attention to the potentially chemical and hygienic risks of organic chloramines. The predominant algal species in water sources varied with location and season. AOM from cyanobacteria, green algae, and diatoms are composed of diverse composition. AOM-derived amino acids take a low portion of the precursors of organic chloramines. Both experimental kinetic data and quantum chemical calculation demonstrate the preferential formation of organic chloramines in the chlorination of model compounds (amino acids and peptides). Organic chloramines are persistent in water and can transform into dichloro- and trichloro-organic chloramines, unknown low-molecular-weight organic chloramines, and nitrogenous disinfection byproducts with the excess of free chlorine. The active chlorine (Cl+) in organic chloramines can lead to the formation of chlorinated phenolic compounds. Organic chloramines influence the generation and species of radicals and subsequent products in UV disinfection. Theoretical predictions and toxicological tests suggest that organic chloramines may cause oxidative or toxic pressure to bacteria or cells. Overall, organic chloramines, as one group of high-molecular-weight disinfection byproducts, have relatively long lifetimes, moderate chemical activities, and high hygienic risks to the public. Future perspectives of organic chloramines are suggested in terms of quantitative detection methods, the precursors from various predominant algal species, chemical activities of organic chloramines, and toxicity/impact.

NHH promotes Sepsis-associated Encephalopathy with the expression of AQP4 in astrocytes through the gut-brain Axis.

Sepsis-associated encephalopathy (SAE) is a significant cause of mortality in patients with sepsis. Despite extensive research, its exact cause remains unclear. Our previous research indicated a relationship between non-hepatic hyperammonemia (NHH) and SAE. This study aimed to investigate the relationship between NHH and SAE and the potential mechanisms causing cognitive impairment. In the in vivo experimental results, there were no significant abnormalities in the livers of mice with moderate cecal ligation and perforation (CLP); however, ammonia levels were elevated in the hippocampal tissue and serum. The ELISA study suggest that fecal microbiota transplantation in CLP mice can reduce ammonia levels. Reduction in ammonia levels improved cognitive dysfunction and neurological impairment in CLP mice through behavioral, neuroimaging, and molecular biology studies. Further studies have shown that ammonia enters the brain to regulate the expression of aquaporins-4 (AQP4) in astrocytes, which may be the mechanism underlying brain dysfunction in CLP mice. The results of the in vitro experiments showed that ammonia up-regulated AQP4 expression in astrocytes, resulting in astrocyte damage. The results of this study suggest that ammonia up-regulates astrocyte AQP4 expression through the gut-brain axis, which may be a potential mechanism for the occurrence of SAE.

Malate, a natural inhibitor of 6PGD, improves the efficacy of chemotherapy in lung cancer.

OBJECTIVE: Metabolic reprogramming is an important coordinator of tumor development and resistance to therapy, such as the tendency of tumor cells to utilize glycolytic energy rather than oxidative phosphorylation, even under conditions of sufficient oxygen. Therefore, targeting metabolic enzymes is an effective strategy to overcome therapeutic resistance. MATERIALS AND METHODS: We explored the differential expression and growth-promoting function of MDH2 by immunohistochemistry and immunoblotting experiments in lung cancer patients and lung cancer cells. Pentose phosphate pathway-related phenotypes (including ROS levels, NADPH levels, and DNA synthesis) were detected intracellularly, and the interaction of malate and proteinase 6PGD was detected in vitro. In vivo experiments using implanted xenograft mouse models to explore the growth inhibitory effect and pro-chemotherapeutic function of dimethyl malate (DMM) on lung cancer. RESULTS: We found that the expression of malate dehydrogenase (MDH2) in the tricarboxylic acid cycle (TCA cycle) was increased in lung cancer. Biological function enrichment analysis revealed that MDH2 not only promoted oxidative phosphorylation, but also promoted the pentose phosphate pathway (PPP pathway). Mechanistically, it was found that malate, the substrate of MDH2, can bind to the PPP pathway metabolic enzyme 6PGD, inhibit its activity, reduce the generation of NADPH, and block DNA synthesis. More importantly, DMM can improve the sensitivity of lung cancer to the clinical drug cisplatin. CONCLUSION: We have identified malate as a natural inhibitor of 6PGD, which will provide new leads for the development of 6PGD inhibitors. In addition, the metabolic enzyme MDH2 and the metabolite malate may provide a backup option for cells to inhibit their own carcinogenesis, as the accumulated malate targets 6PGD to block the PPP pathway and inhibit cell cycle progression.

Performance of public drinking water purifiers in control of trihalomethanes, antibiotics and antibiotic resistance genes.

Point-of-use water purifiers are widely applied as a terminal treatment device to produce drinking water with high quality. However, concerns are raised regarding low efficiency in eliminating emerging organic pollutants. To enhance our understanding of the reliability and potential risks of water purifiers, the removal of trihalomethanes, antibiotics, and antibiotic resistance genes (ARGs) in four public water purifiers was investigated. In the four public water purifiers in October and November, the removal efficiencies of trichloromethane (TCM) and bromodichloromethane (BDCM) were 15%-69% (averagely 37%) and 6%-44% (averagely 23%). The levels of TCM and BDCM were lowered by all water purifiers in October and November, but accelerated in effluent compared to the influent in one public water purifier in December. The removal efficiencies of twelve antibiotics greatly varied with species and time. Out of twelve sampling cases, the removal efficiencies of total antibiotics were 25%-75% in ten cases. In the other two cases, very low removal efficiency (6%) or higher levels of antibiotics present in effluent compared to the influent were observed. Two public water purifiers effectively remove ARGs from water, with log removal rates of 0.45 log-3.89 log. However, in the other two public water purifiers, the ARG abundance accidently increased in the effluents. Overall, public water purifiers were more effective in removing antibiotics and ARGs compared to household water purifiers, but less or equally effective in removing trihalomethanes. Both public and household water purifiers could be contaminated and release the accumulated micro-pollutants or biofilm-related pollutants into effluent. The production frequency and standing time of water within water purifiers can impact the internal contamination and purification efficacy.

Effects of ozone dose on brominated DBPs in subsequent chlor(am)ination: A comprehensive study of aliphatic, alicyclic and aromatic DBPs.

Ozone‒chlor(am)ine is a commonly used combination of disinfectants in drinking water treatment. Although there are quite a few studies on the formation of some individual DBPs in the ozone‒chlor(am)ine disinfection, an overall picture of the DBP formation in the combined disinfection is largely unavailable. In this study, the effects of ozone dose on the formation and speciation of organic brominated disinfection byproducts (DBPs) in subsequent chlorination, chloramination, or chlorination‒chloramination of simulated drinking water were investigated. High-molecular-weight, aliphatic, alicyclic and aromatic brominated DBPs were selectively detected and studied using a powerful precursor ion scan method with ultra performance liquid chromatography/electrospray ionization triple quadrupole mass spectrometry (UPLC/ESI-tqMS). Two groups of unregulated yet relatively toxic DBPs, dihalonitromethanes and dihaloacetaldehydes, were detected by the UPLC/ESI-tqMS for the first time. With increasing ozone dose, the levels of high-molecular-weight (m/z 300-500) and alicyclic and aromatic brominated DBPs generally decreased, the levels of brominated aliphatic acids were slightly affected, and the levels of dihalonitromethanes and dihaloacetaldehydes generally increased in the subsequent disinfection processes. Despite different molecular compositions of the detected DBPs, increasing ozone dose generally shifted the formation of DBPs from chlorinated ones to brominated analogues in the subsequent disinfection processes. This study provided a comprehensive analysis of the impact of ozone dose on the DBP formation and speciation in subsequent chlor(am)ine disinfection.

US Risk Stratification System for Follicular Thyroid Neoplasms.

Background Preoperative assessment of follicular thyroid neoplasms is challenging using the current US risk stratification systems (RSSs) that are applicable to papillary thyroid neoplasms. Purpose To develop a US feature-based RSS for differentiating between follicular thyroid adenoma (FTA) and follicular thyroid carcinoma (FTC) in biopsy-proven follicular neoplasm and compare it with existing RSSs. Materials and Methods This retrospective multicenter study included consecutive adult patients who underwent conventional US and received a final diagnosis of follicular thyroid neoplasm from seven centers between January 2018 and December 2022. US images from a pretraining data set were used to improve readers' understanding of the US characteristics of the FTC and FTA. Univariable and multivariable logistic regression analyses were used to assess the association of qualitative US features with FTC in a training data set. Features with P < .05 were used to construct a prediction model (follicular tumor model, referred to as F model) and RSS for follicular neoplasms using the Thyroid Imaging Reporting and Data System (TI-RADS). Area under the receiver operating characteristic curve (AUC) was compared between follicular TI-RADS (hereafter, F-TI-RADS) and existing RSS (American College of Radiology [ACR] TI-RADS, Korean Society of Thyroid Radiology and Korean Society of Radiology TI-RADS [hereafter, referred to as K-TI-RADS], and Chinese TI-RADS [hereafter, referred to as C-TI-RADS]) in a validation data set. Results The pretraining, training, and validation data sets included 30 (mean age, 47.6 years ± 16.0 [SD]; 16 male patients; FTCs, 30 of 60 [50.0%]), 703 (mean age, 47.9 years ± 14.5; 530 female patients; FTCs, 188 of 703 [26.7%]), and 155 (mean age, 49.9 years ± 13.3 [SD]; 155 female patients; FTCs, 43 of 155 [27.7%]) patients. In the validation data set, the F-TI-RADS showed improved performance for differentiating between FTA and FTC (AUC, 0.81; 95% CI: 0.71, 0.86) compared with ACR TI-RADS (AUC, 0.74; 95% CI: 0.66, 0.80; P = .02), K-TI-RADS (AUC, 0.69; 95% CI: 0.61, 0.76; P = .002), and C-TI-RADS (AUC, 0.68; 95% CI: 0.60, 0.75; P = .002). Conclusion F-TI-RADS outperformed existing RSSs for differentiating between FTC and FTA. © RSNA, 2023 Supplemental material is available for this article. See also the editorial by Baumgarten in this issue.

CCL20 is a potential therapeutic target associated with immune infiltration in breast cancer.

OBJECTIVES: CCL20 is a chemotactic factor that is involved in immune cell recruitment and cancer progression. However, the role of CCL20 in the prognosis of breast cancer remains unclear. This study analyzed correlations between CCL20 expression and immune infiltration, clinicopathological parameters, and prognosis in breast cancer patients. METHODS: Correlations between CCL20 expression and clinicopathological parameters, prognosis, and immune infiltration in breast cancer were determined using the TIMER, UALCAN, and PrognoScan databases. Furthermore, gene-gene and protein-protein interactions were determined using GeneMANIA and STING network construction, respectively. RESULTS: CCL20 expression was significantly upregulated in breast cancer and had significant associations with clinicopathological features, including race, sex, age, menopause status, cancer stage, cancer subclass, and nodal metastasis; moreover, patients with higher CCL20 expression exhibited poor prognosis. Meanwhile, CCL20 expression was significantly correlated with the infiltration of immune cells in breast cancer, including monocytes, neutrophils, tumor-associated macrophages, Th1 cells, regulatory T cells, and exhausted T cells. Moreover, the network of CCL20 expression showed the majority genes and proteins were associated with immune reactions. CONCLUSIONS: CCL20 is a prognosis-related biomarker in breast cancer on the basis of its correlation with immune infiltration levels and has potential to also be a therapeutic target.

Effects of hole shape and bottom gap on the flow characteristics behind butterfly porous fence and its application in dust diffusion control in large open-air piles.

In view of the possible dust pollution of atmospheric caused by large open-air piles, a scheme of using butterfly porous fences is proposed. Based on the actual cause of large open-air piles, this study makes an in-depth study on the wind shielding effect of butterfly porous fences. The effects of hole shape and bottom gap on the flow characteristics are investigated behind the butterfly porous fence with the porosity of 0.273 through the combined methods of computational fluid dynamics and validating PIV experiments. The streamlines distribution and X-velocity behind the porous fence of numerical simulation are in good agreement with the experimental results and based on the research group's previous work, the numerical model is feasible. The concept of the wind reduction ratio is proposed to quantitatively evaluate the wind shielding effect of the porous fence. The results show that the butterfly porous fence with circular holes provided the best shelter effect with the wind reduction ratio of 78.34%, and the optimal bottom gap ratio is about 0.075 with the highest wind reduction ratio of 80.1%. When a butterfly porous fence is applied on site, the diffusion range of dust in open-air piles is significantly reduced compared with that without a fence. In conclusion, the circular holes with the bottom gap ratio of 0.075 are suitable for the butterfly porous fence in practical applications and provide a solution for wind-induced control in large open-air piles.

Integrated genotoxicity of secondary and tertiary treatment effluents in North China.

Genotoxic effects on aquatic organisms caused by wastewater discharging have raised extensive concerns. However, the efficiency of various wastewater treatment processes to reduce effluent genotoxicity was not well known. Genotoxic effects of effluents from four secondary wastewater treatment plants (SWTPs) and a tertiary wastewater treatment plant (TTP) in north China on Chinese rare minnows (Gobiocypris rarus) were evaluated and the toxicity reduction efficiency of various treatment techniques was compared. SWTPs and TTP final effluents disturbed the antioxidant system and lipid peroxidation, with malondialdehyde (MDA) contents in the fish livers and gills increasing to 1.4-2.4 folds and 1.6-3.1 folds of control, respectively. Significant increases in erythrocytes micronucleus (MN) frequency were induced by effluent, and liver DNA damage caused by final SWTPs effluent was 29-54 % lower than TTP effluent. Further, DNA repair gene atm and growth arrest gene gadd45a were remarkably upregulated by SWTP and TTP final effluents to 1.8-12 folds and 4.1-15 folds, respectively, being consistent with the chromosomal aberration and DNA damage in liver tissue. Integrated biomarker response (IBR) of the tertiary effluent was 49 %-69 % lower than the secondary effluents. However, the final ozone disinfection at TTP caused an increase in the DNA damage, suggesting the generation of genotoxic by-products. UV disinfection at secondary treatment removed part of genotoxicity, with a reduction in IBR of 0 %-47 %. The total semi-volatile organic compounds (SVOCs) detected in the final effluent contained 5 %-56 % potential genotoxic substances, removal of which was 9 %-51 % lower than non-genotoxic compounds. Microfiltration and reverse osmosis process exhibited good performance in removing both the integrated genotoxicity and the potential genotoxic SVOCs. Our finding shows that TTP is superior than SWTP for wastewater treatment due to higher genotoxicity removal, but ozone disinfection needs improvement by optimizing performance parameters or adding post-treatment processes, to achieve better protection for aquatic organisms against genotoxic contaminants.

Formation characteristics of disinfection byproducts from four different algal organic matter during chlorination and chloramination.

Algal organic matter (AOM) has become an important precursor of disinfection byproducts (DBPs) in multiple drinking water sources. In this study, the formation of DBPs during chlorination and chloramination of AOMs from four algal species (Microcystis aeruginosa, Chlorella vulgaris, Scenedesmus obliquus, and Cyclotella sp.) under different conditions (disinfectant doses 4.0-8.0 mg/L as Cl2, pH 6.0-8.0, and bromide 0-1.0 mg/L) were simultaneously investigated. Some common and specific characteristics of DBP formation have also been identified. The yields of total DBPs from the four AOMs were 3.28 × 102-6.00 × 102 and 1.97 × 102-3.70 × 102 nmol/mg C during chlorination and chloramination, respectively. The proportions of haloacetic acids (HAAs) in total DBPs were approximately ≥50%. Increasing disinfectant doses or pH only enhanced the yields of trihalomethanes (THMs) during chlorination but enhanced the yields of THMs, HAAs and dihaloacetonitriles (DHANs) during chloramination. Increasing bromide concentrations enhanced THM yields but decreased HAA yields during chlorination and chloramination, in addition to the shift from chlorinated DBPs to brominated DBPs. The DHAN yields of the four AOMs slightly decreased with bromide levels during chlorination, whereas different AOMs showed different trends with bromide levels during chloramination. During chlorination, C. vulgaris and S. obliquus AOMs generated higher THM and DHAN yields (at 4.0-5.0 mg/L as Cl2) than the other AOMs. During chloramination, M. aeruginosa AOM generated higher THM and HAA yields than the other AOMs (at 0.1 mg/L bromide). Cyclotella sp. AOM had the highest THM-bromine substitution factors during chlorination and the highest DHAN-bromine substitution factors during both chlorination and chloramination (at 0.1 mg/L bromide).

Presence of bromide and iodide promotes the horizontal transfer of antibiotic resistance genes during chlorination: A preliminary study.

Chlorination was reported to have a great potential to increase horizontal gene transfer (HGT) of antibiotic resistance genes (ARGs), which poses a great threat to global human health. Bromide (Br-) and iodide (I-) ions are widely spread ions in water and wastewater. In chlorination, Br- and I- can be oxidized to active bromine and iodine species. The influence of the co-existing different halogen oxidants (chlorine + bromine or iodine species) on HGT of ARGs were rarely investigated. In this study, the conjugative transfer of ARGs between a donor strain E. coli K12 and a recipient strain E. coli HB101 was investigated in chlorination without/with the presence of Br- or I-. Immediately after the addition of sodium hypochlorite, 53-88 % of the dosed chlorine was rapidly consumed, 10 %-42 % fast transformed into organic combined chloramines, and only low levels of free chlorine (0.02-0.8 mg/L as Cl2) left in the diluted cultural medium. Conjugative transfer mediated by the RP4 plasmid was not significantly enhanced in chlorination without the presence of Br- or I-. With the presence of Br- (0.5-5.0 mg/L) or I- (0.05-0.5 mg/L) in chlorination, the co-existing free halogen oxidants and their organic combined ones up-regulated the mRNA expression of the oxidative stress-regulatory gene (rpoS), outer membrane protein gene (ompC), and conjugation-relevant genes (trbBp and trfAp), and caused more damage to cell entirety. As a result, the co-existing reactive halogen oxidants enhanced the HGT of ARGs probably via conjugative transfer and transformation. This study showed that the presence of Br- and I- of common levels in aquatic environment promoted HGT of ARGs in chlorination, thus accelerating the transmission and prevalence of ARGs.

Integrated estrogenic effects and semi-volatile organic pollutants profile in secondary and tertiary wastewater treatment effluents in North China.

Endocrine-disrupting effects on aquatic organisms caused by wastewater discharging have raised extensive concerns. However, the efficiency of various wastewater treatment processes to remove estrogenic activity in effluents and the association with organic micropollutants was not well known. We evaluated the estrogenic activity using a well-characterized in vivo bioassay featuring the Chinese rare minnows (Gobiocypris rarus) and analyzed 886 semi-volatile organic compounds (SVOCs) in effluents from four secondary wastewater treatment plants (SWTP A-D) and a tertiary wastewater treatment plant (TTP E) that utilized various common treatment processes in northern China. The final effluents from SWTPs and TTP E all exhibited estrogenic effects, increasing male fish plasma vitellogenin (VTG) contents and estradiol/testosterone (E2/T) ratios. Key regulating genes in the male fish liver including vtg1, vtg3, era, erß, and cyp19a were upregulated. TTP E demonstrated high performance in reducing estrogenic activity in the effluents, with a reduction of 64% in integrative biomarkers of estrogenic response (IBR). UV disinfection at SWTPs removed IBR by 14%- 33%, while ozone disinfection at TTP E did not reduce IBR. Several SVOCs including alkanes, chlorobenzenes, and phthalates, detected at ng/L to µg/L level, significantly correlated with effluent estrogenic activity. Our findings suggest the necessity and the potential means to improve the efficiency of current wastewater treatment approaches to achieve better protection for aquatic organisms against the joint effects of mixtures of various categories of micropollutants in effluents.

Unicentric Castleman disease was misdiagnosed as pancreatic mass: A case report.

BACKGROUND: Castleman's disease (CD) is a lymphatic proliferative disorder of unknown cause and is rarely seen clinically. It has been divided into unicentric and multicentric types. Unicentric CD (UCD) occurs as a solitary enlarged mass and mediastinal lymph nodes are the most common site. Surgical excision has proven to be curative for UCD. Multicentric CD (MCD) appears as a systemic disease with peripheral lymphadenopathy. MCD had a poor response to surgery and monoclonal antibodies with rituximab have become a research hotspot. CASE SUMMARY: A 44-year-old woman presented with a pancreatic mass during routine physical examination. She had no obvious symptoms, such as fever, abdominal pain, abdominal distension, or jaundice. Ultrasound examination indicated a hypoechoic mass between the body of the pancreas, left lobe of the liver and stomach. It had a clear boundary, irregular shape, uneven echo, and no obvious blood flow signals. To clarify the diagnosis, contrast-enhanced ultrasound examination was performed, which showed a benign pancreatic lesion. Neuroendocrine or solid pseudopapillary tumor was a possible diagnosis. The patient underwent further contrast-enhanced computed tomography and contrast-enhanced magnetic resonance imaging, which were suggestive of solid pseudopapillary tumor or neuroendocrine tumor. All the examinations failed to give a definitive diagnosis, and the patient underwent surgery. The final pathological and immunohistochemical results showed that the mass was CD. CONCLUSION: This case highlights when lymphadenopathy is encountered clinically, CD should be considered and a biopsy should be performed.

Formation of trihalomethanes and haloacetic acids from 2,6-dichloro-1,4-benzoquinone during chlorination: Decomposition kinetics, conversion rates, and pathways.

As a typical aromatic disinfection byproduct (DBP), 2,6-dichloro-1,4-benzoquinone (2,6-DCBQ) attracts much concern due to the potential toxicity. To further evaluate the role of 2,6-DCBQ as an intermediate DBP in water with or without chlorine, their decomposition characteristics and transformation potential to the regulated DBPs (i.e., trihalomethanes (THMs) and haloacetic acids (HAAs)) were investigated under different chlorine doses, pH values, temperatures, contact times, and bromide levels. The decomposition of 2,6-DCBQ under different conditions all fit apparent first-order kinetics. The hydrolysis rate constants of 2,6-DCBQ significantly increased with pH. The half-live values of 2,6-DCBQ were 108.3-568.7 h at pH 6.0-6.5, and 1.8-31.1 h at pH 7.0-8.5. During the hydrolysis of 2,6-DCBQ, there was no THMs and HAAs generated. During chlorination, 2,6-DCBQ decayed rapidly accompanied by the fast formation of trichloromethane (TCM) and the gradual generation of dichloroacetic acid and trichloroacetic acid. The molar conversion rates of 2,6-DCBQ-to-THMs (i.e., TCM) and 2,6-DCBQ-to-HAAs were 2.9-10.0% and 0.1-2.2% under different conditions. The presence of bromide increased the conversion rates of 2,6-DCBQ-to-THMs and caused the generation of brominated THMs and HAAs. According to the decomposition characteristics of 2,6-DCBQ and the formation trends of THMs and HAAs under different conditions, multiple formation pathways from 2,6-DCBQ to THMs and HAAs were proposed.

NcRNA-regulated CAPZA1 associated with prognostic and immunological effects across lung adenocarcinoma.

Recent discoveries have suggested that the F-actin capping protein α1 subunit (CAPZA1) in various human tumors could play a significantly important role in regulating cell proliferation, metastasis, and epithelial-mesenchymal transition. However, the immune-regulating role of CAPZA1 in the initiation and development of lung adenocarcinoma (LUAD) remains unclear. In our research, we first found that CAPZA1 serves as an oncogene in pan-cancers from the TCGA data and higher CAPZA1 expression process unfavorably prognostic value in LUAD based on starBase database, PrognoScan, and LOGpc database. Then, in our analyses, lncRNAs AC026356.1 in LUAD acted as a competitive endogenous RNA (ceRNA) of miR-30d-5p, which might be the possible regulatory miRNA of CAPZA1 based on the starBase database. Finally, we confirmed that CAPZA1 expression had a tightly positive correlation with immune infiltration cells, immune infiltration markers, TMB, MSI, immune score, stromal score, and immune checkpoints, indicating that CAPZA1 was a markedly reliable therapeutic target for immunological antitumor strategies. In conclusion, our investigations revealed that CAPZA1 might function as an immune-associated biomarker in the development and treatment of LUAD, thereby acting as a promising prognostic and therapeutic target against LUAD.

Virtual Reality-Assisted Percutaneous Transluminal Angioplasty for Interventional Treatment of Lower-Extremity Arteriosclerosis Obliterans.

This study was to evaluate the biomechanical characteristics of the vascular wall during virtual reality- (VR-) assisted percutaneous transluminal angioplasty (PTA) and its effect on the treatment of lower-extremity arteriosclerosis obliterans (LEAO). In this study, a three-dimensional (3D) model and a finite-element model of arteries were constructed first, and various fluid mechanics were analyzed. Then, the virtual expansion simulation (VES) of individualized PTA was performed based on the ABAQUS/Explicit module to analyze the interaction between the balloon and the blood vessel at different times and the changes in the vascular shape and structural stress distribution. Finally, an LEAO animal model was constructed. Based on conventional PTA (PTA group) and VR-assisted PTA (VR-PTA) treatment, the morphological changes of vascular lumen of the two animal models were evaluated. The results showed that the normal, stenotic blood vessels and blood models were successfully constructed; the pressure of the stenotic blood vessel at the stenosis decreased obviously and the shear stress of blood vessel wall increased compared with that of the normal blood vessels, and there may be a blood reflux area in the poststenosis stage. The simulation results of the VES showed that the maximum principal stress value at 3 mm of the marginal vessel was much lower than that at 5 mm (about 10% lower), so the maximum principal stress change within 2 mm of the balloon-expanded vessel was the most obvious. The treatment results of the animal model showed that the VR-PTA group showed an obvious increase in the diameter of the vascular lumen, a decrease in the intima and media area, and a decrease in the thickness of the vessel wall in contrast to the PTA group (P < 0.05), which had an important effect on the reconstruction and expansion of the vascular lumen. The VR-PTA treatment on LEAO was realized in this study, which provided critical reference for the follow-up application of VR technology in the evaluation of surgical plan and research on biomechanical mechanisms of restenosis after PTA.

Occurrence of antibiotics and antibiotic resistance genes in WWTP effluent-receiving water bodies and reclaimed wastewater treatment plants.

There is a growing concern on the fate and the consequent ecological or health risks of antibiotics and antibiotic resistance genes (ARGs) in natural or artificial water environment. The effluent of wastewater treatment plants (WWTPs) has been reported to be an important source of antibiotics and ARGs in the environment. WWTP effluent could be discharged into surface water bodies or recycled, either of which could lead to different exposure risks. The impact of WWTP effluents on the levels of antibiotics and ARGs in effluent-receiving water bodies and the removal efficiency of antibiotics and ARGs in reclaimed wastewater treatment plants (RWTPs) were seldom simultaneously investigated. Thus, in this study, we investigated the occurrence of antibiotics and ARGs in four WWTP effluents, and their downstream effluent-receiving water bodies and RWTPs in seasons of low-water-level. The total concentrations of ofloxacin, norfloxacin, ciprofloxacin, roxithromycin, azithromycin, erythromycin, tetracycline, oxytetracycline, chlortetracycline, and sulfamethoxazole in the secondary effluents were 1441.6-4917.6 ng L-1. Ofloxacin had the highest concentration. The absolute and relative abundances of total ARGs (qnrD, qnrS, ermA, ermB, tetA, tetQ, sul1, and sul2) in the secondary effluents were 103-104 copies mL-1 and 10-4-10-2 ARG/16S rRNA. Sul1 and sul2 were the major species with the highest detection frequencies and levels. In most cases, WWTP effluents were not the major contributors to the levels and species of antibiotics and ARGs in the surface water bodies. Four RWTPs removed 43.5-98.9% of antibiotics and - 0.19-2.91 log of ARGs. Antibiotics and ARGs increased in chlorination, ozonation and filtration units. Antibiotics had significantly positive correlations with ARGs, biological oxygen demands, total phosphorus, total nitrogen, and ammonia nitrogen in the four effluent-receiving water bodies. In RWTPs, the total concentrations of antibiotics showed a significant positive correlation with the total abundance of ARGs.

Effects of water flow on performance of soil microbial fuel cells: Electricity generation, benzo[a]pyrene removal, microbial community and molecular ecological networks.

Soil microbial fuel cells with water flow (W-SMFCs) as a driven force of substrate transport were constructed. Electricity generation, benzo[a]pyrene (BaP) removal, microbial communities and microbial molecular ecological networks were compared between W-SMFCs and their control reactors (without water flow, C-SMFCs) in 240 days of operation. The W-SMFCs started up faster than C-SMFCs (37 days vs. 50 days) and output higher startup voltage (148.45 mV vs. 111.90 mV). The water flow caused higher removal efficiency of BaP at sites >1 cm from the anode (S > 1 cm) than at sites <1 cm from the anode (S < 1 cm) in W-SMFCs, whereas in C-SMFCs, the removal efficiency of BaP at S< 1 cm was higher than that at S> 1 cm. The removal efficiency of BaP at S> 1 cm in W-SMFCs was up to 1.7 times higher than that at S> 1 cm in C-SMFCs on the 91st day. After 240 days of operation, the biodegradation efficiency of absolute BaP amount was 45.95% in W-SMFCs, being 20% higher than that in C-SMFCs (38.17%). Moreover, the water flow caused highly tight interaction among the microbial species, which could be beneficial to BaP biodegradation. Conclusively, the water flow in soil was very beneficial for startup and biodegradation of BaP in SMFCs.

Prospective assessment of diagnostic efficacy and safety of SonazoidTM and SonoVue® ultrasound contrast agents in patients with focal liver lesions.

OBJECTIVES: To assess the respective diagnostic value of Sonazoid™ and SonoVue® for characterizing FLLs as benign or malignant and the corresponding safety. METHODS: This prospective Phase 3 study was conducted at 17 centres in China and Korea (May 2014 to April 2015); 424 patients (20 to 80 years) with at least 1 untreated focal liver lesion (FLL) (< 10 cm in diameter) underwent a contrast-enhanced ultrasound (CEUS) examination (218 received Sonazoid of 0.12 µL microbubbles/kg; 206 received SonoVue of 2.4 mL). Three independent blinded readers evaluated pre- and post-contrast images characterising the FLLs as benign or malignant. RESULTS: Sonazoid-enhanced and SonoVue-enhanced ultrasound provided a statistically significant improvement in specificity for all 3 readers comparing to unenhanced ultrasound (for Sonazoid: p = 0.0093, < 0.0001, 0.0011; for SonoVue: p = 0.002, 0.03, 0.12, respectively). Difference in accuracy improvement between the 2 groups was within the pre-specified non-inferiority margin of 20% for all 3 readers (6.1%, 95% CI: - 5.0 to 17.2; - 7.5%, 95% CI: - 18.4 to 3.5; - 0.3%, 95% CI: - 11.3 to 10.7). The diagnostic confidence level for all 3 readers increased with post-contrast images relative to pre-contrast images. Both contrast agents were well tolerated. CONCLUSION: Results showed a similar efficacy for Sonazoid™ and SonoVue® in diagnosing FLLs as benign or malignant, and underlined the benefit of CEUS imaging over unenhanced ultrasound imaging in reaching a confident diagnosis without having to refer patients for additional imaging exams.

Organic matter composition, BaP biodegradation and microbial communities at sites near and far from the bioanode in a soil microbial fuel cell.

Bioanodes in a soil microbial fuel cell (SMFC) can serve as sustainable electron acceptors in microbial metabolism processes; thus, SMFCs are considered a promising in situ bioremediation technology. Most related studies have focused on the removal efficiency of contaminants. Relatively few efforts have been made to comprehensively investigate the organic matter composition and biodegradation metabolites of organic contaminants and microbial communities at various distances from the bioanode. In this study, the level and composition of dissolved organic matter (DOM), biodegradation metabolites of benzo[a]pyrene (BaP), and microbial communities at two sites with different distances (S1cm and S11cm) to the bioanode were investigated in an SMFC. The consumption efficiency of dissolved organic carbon (RDOC) and removal efficiency of BaP (RBaP) at S1cm were slightly higher than those at S11cm after 100 days (RDOC 47.82 ± 5.77% at S1cm and 44.98 ± 10.76% at S11cm; RBaP 72.52 ± 1.88% at S1cm and 68.50 ± 4.34% at S11cm). More fulvic acid-like components and more low-molecular-weight metabolites (indicating a higher biodegradation degree) of BaP were generated at S1cm than at S11cm. The microbial community structures were similar at the two sites. Electroactive bacteria (EAB) and some polycyclic aromatic hydrocarbon degraders were both enriched at the bioanode. Energy metabolism at the bioanode could be upregulated to generate more adenosine triphosphate (ATP). In conclusion, the bioanode could modulate the metabolic pathways in the adjacent soil by strengthening the contact between the EAB and BaP degraders, and providing more ATP to the BaP degraders.