Assessment of supply-demand relationships considering the interregional flow of ecosystem services.

Accurate assessment of ecosystem service (ES) supply, demand, and flow is essential for identifying and enhancing the ES supply-demand relationship and promoting regional sustainable development. Based on the InVEST model, supply-demand ratio, coupling coordination analysis, breakpoint and field strength model, and GIS spatial analysis method, we evaluated the supply and demand of water yield, food supply, carbon storage, and soil conservation service in the Loess Plateau in 2000 and 2020 and analyzed the supply-demand relationship before and after considering the interregional ecosystem service flow (ESF). The results showed that (1) from 2000 to 2020, the supply and demand of the four types of ESs in the Loess Plateau increased. Before considering ESF, the surplus degree in water yield, food supply, and soil conservation increased, and carbon storage decreased. In most counties, the coupling coordination between the supply and demand of the soil conservation is mostly extreme incoordination and moderate incoordination, and other types of ESs are mostly reluctant coordination and moderate incoordination. The degree of incoordination in water yield and soil conservation have eased, while food supply and carbon storage have strengthened. For the comprehensive supply-demand relationship of ES, the degree of surplus and coordination increased, with most counties were in a state of surplus and coordination. (2) Water yield and soil conservation services flow primarily to the western and northwestern portions of the Loess Plateau, with a decrease in the number of flow paths but an increase in the total flow rate for the former and a decrease in flow paths and total flow rate for the latter. The food supply and carbon storage flow in all directions and the total flow rate increases, with a significant increase in the number of flow paths for carbon storage. (3) After considering ESF, the supply-demand relationship of each type of ES and the comprehensive ES supply-demand relationship are changed, in which the degree of surplus and coordination of deficit counties are significantly improved, and some counties even become surplus or improve the level of coordination. After considering ESF, the supply-demand ratio changes even more relative to the degree of coupling coordination. This study is of great significance for identifying the cross-regional transfer pattern of ES, understanding in-depth the dynamic supply-demand relationship of ES, and mitigating the mismatch between supply and demand of ES. It provides a scientific and objective theoretical basis for promoting regional sustainable development.

Environmental sustainability assessment of a new food waste anaerobic digestion and pyrolysis hybridization system.

This research conducted an environmental life cycle assessment (LCA) to evaluate an anaerobic digestion-co-pyrolysis (ADCo-Py) system in which pyrolysis was added to traditional food waste (FW) anaerobic digestion (AD) systems to treat the solid fraction and impurities separated from FW. The solid fraction, including impurities such as wooden chopsticks, plastics, eggshells, and bones, is usually incinerated, while pyrolysis can be a viable alternative to optimize FW treatment. The environmental impact of ADCo-Py was compared with stand-alone AD, pyrolysis, and ADCo-INC (AD with incineration of separated solids). The results indicated that both ADCo-Py (-1.726 kg CO2-Eq/kgFW) and ADCo-INC (-1.535 kg CO2-Eq/kgFW) outperform stand-alone AD (-0.855 kg CO2-Eq/kgFW) and pyrolysis (-0.181 kg CO2-Eq/kgFW) in mitigating global warming potential (GWP). Additionally, pretreatments were found to have the most significant influence on GWP, ecotoxicity potential (ETP), and acidification potential (AP). The two-step pretreatment in ADCo-Py, including the separation of solids and drying, significantly improved the environmental sustainability of the system when compared with standalone pyrolysis.

Experimental study and techno-economic analysis of co-processing system for treatment of food waste with various impurities.

The study assessed a co-processing system segregating food waste (FW) with different impurities into liquid (slurry) and solid fractions and treated using anaerobic digestion (AD) and pyrolysis (Py), respectively, which is defined as ADCo-Py. Biomethane potential tests showed higher methane yield from the FW slurry fraction (572.88 mL/gVSFW) compared to the whole FW (294.37 mL/gVSFW). Pyrolyzing the FW solid fraction reduced nitrogen compounds in bio-oil by 62 % compared to the whole FW. The energy balance and economic feasibility of ADCo-Py were compared with stand-alone AD, Py, and AD integrated with incineration (ADCo-INC). While all systems required extra energy, stand-alone Py and ADCo-INC needed 3.8 and 2.8 times more energy than ADCo-Py, respectively. Techno-economic analysis favored ADCo-Py, with a net present value (NPV) of $15 million and an internal rate of return (IRR) of 34 %. These findings highlighted FW separation as a promising approach, aligning with energy and economic goals in sustainable FW management.

Risk-based detection as a cost-effective strategy to reduce foodborne illness due to salmonella.

Background: Salmonella, a widespread pathogen, poses a significant threat to global food safety, leading to foodborne diseases and substantial economic losses. The timely and accurate detection of foodborne pathogens is pivotal for averting food contamination and outbreaks across the food production chain. This study assesses the cost-effectiveness of traditional culture-based methods versus risk-based approaches, incorporating polymerase chain reaction (PCR) for Salmonella detection. Methods: We employed a stochastic scenario tree model to simulate scenarios based on the sampling inspection plan for raw aquatic products conducted by the Guangzhou Center for Disease Control and Prevention from 2018 to 2020. Various detection methods (culture or PCR) were applied to these aquatic products based on their categorized risk level. Sensitivity values were derived from published data, and incremental cost-effectiveness ratios were used to compare the different scenarios against the traditional culture method. Results: A total of 360 samples were collected for analysis. The cost of culture-based detection alone amounted to 125,423.20 Chinese Yuan (CNY) and yielded nine instances of positive Salmonella detections. The risk-based detection strategy, which combined the more sensitive PCR method with high-risk sample characteristics, while employing the culture method for the remaining combinations, imposed a total cost of 128,775.83 CNY and yielded ten positive detections. This approach cost approximately 3391.74 CNY per additional positive sample detected compared to the culture method alone. Meanwhile, PCR-only detection imposed a total cost of 62,960.03 CNY. Conclusions: In comparison to traditional culture-based methods, both the risk-based detection strategy and the PCR-only approach demonstrated superior capabilities with respect to detecting contaminated aquatic products. Implementing risk-based detection strategies can enhance cost-effectiveness, not only ensuring food safety but also reducing the incidence and economic burden of foodborne diseases.

Development, validation, and evaluation of a risk assessment tool for personalized screening of gastric cancer in Chinese populations.

BACKGROUND: Effective risk prediction models are lacking for personalized endoscopic screening of gastric cancer (GC). We aimed to develop, validate, and evaluate a questionnaire-based GC risk assessment tool for risk prediction and stratification in the Chinese population. METHODS: In this three-stage multicenter study, we first selected eligible variables by Cox regression models and constructed a GC risk score (GCRS) based on regression coefficients in 416,343 subjects (aged 40-75 years) from the China Kadoorie Biobank (CKB, development cohort). In the same age range, we validated the GCRS effectiveness in 13,982 subjects from another independent Changzhou cohort (validation cohort) as well as in 5348 subjects from an endoscopy screening program in Yangzhou. Finally, we categorized participants into low (bottom 20%), intermediate (20-80%), and high risk (top 20%) groups by the GCRS distribution in the development cohort. RESULTS: The GCRS using 11 questionnaire-based variables demonstrated a Harrell's C-index of 0.754 (95% CI, 0.745-0.762) and 0.736 (95% CI, 0.710-0.761) in the two cohorts, respectively. In the validation cohort, the 10-year risk was 0.34%, 1.05%, and 4.32% for individuals with a low (≤ 13.6), intermediate (13.7~30.6), and high (≥ 30.7) GCRS, respectively. In the endoscopic screening program, the detection rate of GC varied from 0.00% in low-GCRS individuals, 0.27% with intermediate GCRS, to 2.59% with high GCRS. A proportion of 81.6% of all GC cases was identified from the high-GCRS group, which represented 28.9% of all the screened participants. CONCLUSIONS: The GCRS can be an effective risk assessment tool for tailored endoscopic screening of GC in China. Risk Evaluation for Stomach Cancer by Yourself (RESCUE), an online tool was developed to aid the use of GCRS.

Prevalence of psychological symptoms and associated risk factors among nurses in 30 provinces during the COVID-19 pandemic in China.

Background: With the outbreak of the coronavirus disease 2019 (COVID-19), nurses have won well-deserved recognition for their indispensable roles in providing humane and professional healthcare for patients. However, by the nature of their role working at the forefront of patient care, nurses are prone to experiencing mental health consequences. Therefore, we pay attention to measuring the magnitude of psychological symptoms and identifying associated factors among nurses in China. Methods: We launched a nationwide, cross-sectional survey of nurses who worked in secondary or tertiary hospitals and public or private hospitals from 30 provinces in China. The prevalence and severity of symptoms of burnout, depression, and anxiety were investigated, respectively. Multivariable logistic regression analyses were performed to identify factors associated with each psychological symptom. Findings: A total of 138 279 respondents who worked in 243 hospitals completed this survey. A substantial proportion of nurses reported symptoms of burnout (34%), depression (55·5%), and anxiety (41·8%). In line with the disproportionality of economic development, we noted that the middle or western region was an independent risk factor for depression and anxiety. Compared with those working in the secondary hospital, nurses who worked in tertiary hospitals were associated with a higher likelihood of burnout and depression. Interpretation: Nurses are experiencing emotional, physical, and mental exhaustion during the COVID-19 epidemic. Governments and health policymakers need to draw attention to reinforcing prevention and ameliorating countermeasures to safeguard nurses' health. Funding: The strategic consulting project of the Chinese Academy of Engineering [2021-32-5]. Advanced Institute of Infomation Technology, Peking University, Zhejiang Province [2020-Z-17].

Economic Burden and Influencing Factors of Acute Gastroenteritis in China: A Population-Based Face to Face Survey in 2018.

Background: Acute gastroenteritis is an important and highly prevalent public health problem worldwide. The purpose of this study was to assess the economic burden of disease and its influencing factors in patients with acute gastroenteritis in Heilongjiang Province, China. Methods: A multi-stage stratified random sampling method was used in a face-to-face household survey in 2018. Demographic and socioeconomic characteristics, clinical symptoms, suspicious dietary history, and disease treatment information were collected from 19,647 respondents. One-way analysis of variance and multiple stepwise regression analysis were used to investigate the factors associated with the economic burden of acute gastroenteritis. Quantitative risk analysis and sensitivity analysis were performed to estimate the uncertainty and risk factors of the economic burden of acute gastroenteritis. Results: The total economic burden of patients with acute gastroenteritis was 63,969.22 CNY (Chinese Yuan), of which the direct economic burden accounted for 63.82%; the per capita economic burden was 131.35 CNY per month. Age, region, disease duration, and disease treatment were the main factors significantly associated with the economic burden of acute gastroenteritis (P < 0.05). The average economic burden of patients with acute gastroenteritis was approximately 571.84 CNY/person (95% CI: 227-1,459). Sensitivity analysis showed that the greatest impact was from the indirect economic burden. Conclusions: Acute gastroenteritis brings a substantial health burden to patients due to its high incidence. The economic burden of self-purchased drugs and the indirect economic burden of patients cannot be ignored. To better estimate the economic burden of acute gastroenteritis in China, further studies on the pathogen-specific economic burden of acute gastroenteritis are required.

Assessment of racial differences in the incidence of thrombocytopenia induced by trastuzumab emtansine: a systematic review and meta-analysis.

BACKGROUND: Trastuzumab emtansine (T-DM1) has been proved to have value and efficacy in the treatment of advanced metastatic cancer, including in the adjuvant setting. However, there is increasing concern about T-DM1-induced thrombocytopenia (TCP), which shows racial differences in incidence. This meta-analysis aimed to evaluate differences in the incidence of T-DM1-related TCP between Asian and non-Asian patients by combining accessible information from all single-agent T-DM1 clinical trials published to date. METHODS: We conducted systematic searches of the PubMed, Embase, and the Cochrane Library databases to identify relevant clinical studies of T-DM1 that reported on safety, including the incidence of TCP, which were published between January 1980 and March 2020. Two reviewers were responsible for the screening and extraction of data. The pooled-effect estimate calculated with a fixed-effects or random-effects model was represented as incidence with 95% confidence intervals (CIs). RESULTS: A total of 29 studies involving 6,188 patients were included. The incidence of all-grade TCP in Asian patients and non-Asian patients was 0.39 (95% CI: 0.11-0.67) and 0.29 (95% CI: 0.23-0.35), respectively. The incidence of TCP of grade 3 or higher in Asians was 0.20 (95% CI: 0.10-0.29), compared with 0.02 (95% CI: 0.01-0.03) in non-Asians. Gastrointestinal cancer type and a T-DM1 treatment dose of 2.4 mg/kg Q3W were related to grade 3 or higher TCP events. DISCUSSION: Asian patients have a higher risk of developing TCP after receiving T-DM1 than non-Asian patients. Clinicians should be aware of the importance of careful observation of platelet count in patients receiving T-DM1 therapy.

Wear Assessment of Tibial Inserts Made of Highly Cross-Linked Polyethylene Supplemented with Dodecyl Gallate in the Total Knee Arthroplasty.

BACKGROUND: the wear of tibial insert is still one of primary factors leading to failure of total knee arthroplasty (TKA). Dodecyl gallate (DG) has shown improvements in the oxidation stability of highly cross-linked polyethylene (HXLPE). This study aimed to assess the application of HXLPE supplemented with DG (HXLPE-DG) on the tibial insert in TKA concerning the wear resistance and the potential impact on implant fixation; Methods: tibial inserts made of HXLPE-DG were subjected to a 3 million loading-cycle wear test following ISO 14243-1:2009. The loss of mass and wear rate of the tibial inserts were calculated. The quantity, size,- and shape of wear particles were recorded; Results: the test specimens lost an average mass of 16.00 mg ± 0.94 mg, and were on an average wear rate of 3.92 mg/million cycles ± 0.19 mg/million cycles. The content of wear particles in the calf serum medium was 3.94 × 108 particles/mL ± 3.93 × 107 particles/mL, 96.66% ± 0.77% of the particles had an equivalent circular diameter less than 0.5 µm. The aspect ratio of wear particles was 1.40 (min: 1.01; max: 6.42). CONCLUSIONS: HXLPE-DG displayed advantages over the commonly used materials for tibial inserts and presented the potential of application in TKA.

Optical Waveguides and Integrated Optical Devices for Medical Diagnosis, Health Monitoring and Light Therapies.

Optical waveguides and integrated optical devices are promising solutions for many applications, such as medical diagnosis, health monitoring and light therapies. Despite the many existing reviews focusing on the materials that these devices are made from, a systematic review that relates these devices to the various materials, fabrication processes, sensing methods and medical applications is still seldom seen. This work is intended to link these multidisciplinary fields, and to provide a comprehensive review of the recent advances of these devices. Firstly, the optical and mechanical properties of optical waveguides based on glass, polymers and heterogeneous materials and fabricated via various processes are thoroughly discussed, together with their applications for medical purposes. Then, the fabrication processes and medical implementations of integrated passive and active optical devices with sensing modules are introduced, which can be used in many medical fields such as drug delivery and cardiovascular healthcare. Thirdly, wearable optical sensing devices based on light sensing methods such as colorimetry, fluorescence and luminescence are discussed. Additionally, the wearable optical devices for light therapies are introduced. The review concludes with a comprehensive summary of these optical devices, in terms of their forms, materials, light sources and applications.

Weigh Biomaterials by Quantifying Species-specific DNA with Real-time PCR.

What's on the label is not what's in the bottle, from food products to herbal medicinal products (HMPs), economically-motivated biomaterials adulteration is a long-term problem affecting the food and drug industry. Accurate identification of the biomaterial ingredients in processed commodities is highly desirable. In this field, DNA-based techniques have proved to be powerful tools to overcome qualitative challenges. However, is it possible to quantify the weight of biological materials with PCR? Therefore, a basic scientific question needs to be answered: what's the relationship between DNA content and the mass of biological materials? Is DNA content directly proportional to the mass of biological materials as most of the researchers previously thought? In this study, we firstly found that there exists a linear relation between DNA contents and the weight of biomaterials indeed when the analytical practices are fully controlled. In this case, the mass of targeted biomaterials in the highly processed commercial products can also be calculated by quantifying the species-specific DNA through classic real-time PCR with a good reproducibility.

Assessment of the potential health risks of heavy metals in soils in a coastal industrial region of the Yangtze River Delta.

Soil heavy metal contamination is a serious environmental problem. Human beings may be directly exposed to heavy metals in soils through the inhalation of soil particles, dermal contact, and oral ingestion, which can seriously threaten health. This study assesses the health risks associated with heavy metals in soils by determining the concentrations of eight heavy metals (Cr, Pb, Cd, Hg, As, Cu, Zn, and Ni) based on 2051 surface-soil samples collected from the southern Yangtze River Delta of China. The mean concentrations were higher than the corresponding background values in Zhejiang Province and China as a whole, indicating an accumulation of heavy metals. The health risk assessment suggests that the non-carcinogenic and carcinogenic risks in the study area were not significant. The non-carcinogenic risk for children was the highest, followed by those for adults and seniors; the non-carcinogenic risk for the entire population was less than 1.0, the predetermined threshold. Carcinogenic risk for adults was the highest, followed by those for seniors and children; a few sample points had a value larger than the threshold of 1.0E-04. Arsenic represented the greatest contribution to non-carcinogenic and carcinogenic risk. Meanwhile, ingestion of heavy metals in soil was the main exposure pathway for carcinogenic risk, followed by inhalation and dermal exposure. The spatial method of Getis-Ord was used to identify hot spots of health risk. Hot spots with high hazard index (HI) and total carcinogenic risk (TCR) for children, adults, and seniors were mainly distributed in core urban areas, such as Jiangbei, Haishu, Yinzhou, Jiangdong, and the urban areas of some other counties, which coincided with industrial, mining, and urban areas of the study area and were strongly influenced by anthropogenic activities. These results provide a basis for heavy metal control in soil, source identification, and environment management in the Yangtze River Delta and other rapidly developing industrial regions in China.

[Mechanism of catalytic ozonation for the degradation of paracetamol by activated carbon].

The degradation of paracetamol (APAP) in aqueous solution was studied with ozonation integrated with activated carbon (AC). The synergistic effect of ozonation/AC process was explored by comparing the degradation efficiency of APAP in three processes (ozonation alone, activated carbon alone and ozonation integrated with activated carbon). The operational parameters that affected the reaction rate were carefully optimized. Based on the intermediates detected, the possible pathway for catalytic degradation was discussed and the reaction mechanism was also investigated. The results showed that the TOC removal reached 55.11% at 60 min in the AC/O3 system, and was significantly better than the sum of ozonation alone (20.22%) and activated carbon alone (27.39%), showing the great synergistic effect. And the BOD5/COD ratio increased from 0.086 (before reaction) to 0.543 (after reaction), indicating that the biodegradability was also greatly improved. The effects of the initial concentration of APAP, pH value, ozone dosage and AC dosage on the variation of reaction rate were carefully discussed. The catalytic reaction mechanism was different at different pH values: the organic pollutions were removed by adsorption and direct ozone oxidation at acidic pH, and mainly by catalytic ozonation at alkaline pH.

[Comparison of fluorescence in situ hybridization and immunohistochemistry assessment for Her-2 status in breast cancer and its relationship to clinicopathological characteristics].

OBJECTIVE: To investigate the concordance and correlation between fluorescence in situ hybridization (FISH) and immunohistochemistry (IHC) assessment for HER-2 status in breast cancer patients and analyze their relationship to clinical characteristics. METHODS: A total of 128 samples of breast cancer tissue were analyzed retrospectively. FISH was employed to detect the HER-2 gene amplification. And the FISH findings were compared with IHC test results by analyzing the concordance and correlation between two results. And their relationships to the clinical characteristics were analyzed. RESULTS: The overall coincidence rate of IHC and FISH was 90.6% (kappa = 0.405, P = 0.000). And the discordance was mainly found in the IHC (++) group. A positive correlation was found between the two results (r = 0.655, P = 0.000). The ER (estrogen receptor) expression was negatively correlated with HER-2 gene amplification and the expression of Her-2 protein (r = -0.300, P = 0.001; r = -0.223, P = 0.011). There was a negative correlation between ER/PR status and HER-2 gene amplification (r = -0.213, P = 0.016). The similar results were found in subgroup analysis. Tumor grade was negatively correlated with the expression of Her-2 protein (r = -0.293, P = 0.008), but not with HER-2 gene amplification (P > 0.05). CONCLUSION: IHC is a preferred method to detect the Her-2 status in breast cancer. The strong positive expression (+++) of HER-2 protein tested by IHC is strongly consistent with HER-2 gene amplification by FISH. But HER-2 gene amplification should be further detected by FISH in patients with HER-2 positive expression (+-++) in order to guide the clinical diagnosis and treatment. ER, ER/PR (progesterone receptor) status and tumor grade are correlated with HER-2 gene amplification and/or the expression of Her-2 protein. This study helps improve the accuracy of judging HER-2 gene amplification according to the clinical and pathological features such as ER status and the results of IHC.