Comparative life cycle assessment of sewage sludge treatment in Wuhan, China: Sustainability evaluation and potential implications.

Owing to the relentless growth of sewage sludge production, achieving low-carbon development in sewage sludge treatment and disposal (STD) is becoming increasingly challenging and unpredictable. However, the STD varied spatially, and city-specific analysis is deemed necessary for sustainable evaluation. Therefore, a lifecycle-based greenhouse gas (GHG), energy, and economic analysis were conducted by considering six local STD alternatives in Wuhan City, China, as a case study. The findings indicated anaerobic digestion combined with digestate utilization for urban greening (ADL) and incineration in existing power plants (INCP) exhibited the least GHG emissions at 34.073 kg CO2 eq/FU and 644.128 kg CO2 eq/FU, while INCP generated the most energy at -2594 kW.h/FU. The economic evaluation revealed that ADL and INCP were more beneficial without accounting for land acquisition. Scenario analysis showed that the energy recovery from ADL and INCP is significantly influenced by the hydrolysis yielding rate and sludge organic content. Perturbation sensitivity indicates that regional emission factor of electricity and electricity fee highly influence the overall GHG emission and cost. The results of this study could assist policymakers in identifying viable solutions to the cities experiencing the same sludge treatment burdens.

Magnetocardiography-based coronary artery disease severity assessment and localization using spatiotemporal features.

Objective.This study aimed to develop an automatic and accurate method for severity assessment and localization of coronary artery disease (CAD) based on an optically pumped magnetometer magnetocardiography (MCG) system.Approach.We proposed spatiotemporal features based on the MCG one-dimensional signals, including amplitude, correlation, local binary pattern, and shape features. To estimate the severity of CAD, we classified the stenosis as absence or mild, moderate, or severe cases and extracted a subset of features suitable for assessment. To localize CAD, we classified CAD groups according to the location of the stenosis, including the left anterior descending artery (LAD), left circumflex artery (LCX), and right coronary artery (RCA), and separately extracted a subset of features suitable for determining the three CAD locations.Main results.For CAD severity assessment, a support vector machine (SVM) achieved the best result, with an accuracy of 75.1%, precision of 73.9%, sensitivity of 67.0%, specificity of 88.8%, F1-score of 69.8%, and area under the curve of 0.876. The highest accuracy and corresponding model for determining locations LAD, LCX, and RCA were 94.3% for the SVM, 84.4% for a discriminant analysis model, and 84.9% for the discriminant analysis model.Significance. The developed method enables the implementation of an automated system for severity assessment and localization of CAD. The amplitude and correlation features were key factors for severity assessment and localization. The proposed machine learning method can provide clinicians with an automatic and accurate diagnostic tool for interpreting MCG data related to CAD, possibly promoting clinical acceptance.

Employing biochemical biomarkers for building decision tree models to predict bipolar disorder from major depressive disorder.

BACKGROUND: Conventional biochemical parameters may have predictive values for use in clinical identification between bipolar disorder (BD) and major depressive disorder (MDD). METHODS: This study enrolled 2470 hospitalized patients with BD (n = 1333) or MDD (n = 1137) at reproductive age from 2009 to 2018 in China. We extracted 8 parameters, uric acid (UA), direct bilirubin (DBIL), indirect bilirubin (IDBIL), lactic dehydrogenase (LDH), free triiodothyronine (FT3), thyroid-stimulating hormone (TSH), high-density lipoprotein (HDL) and prealbumin of male, patients and 12 parameters, UA, DBIL, IBIL, LDH, FT3, TSH, glutamic-pyruvic transaminase (GPT), white blood cell (WBC), alkaline phosphatase (ALP), fasting blood glucose (FBG), triglyceride and low-density lipoprotein (LDL) of female patients. Backward stepwise multivariate regression analysis and the Chi-Square Automatic Interaction Detection (CHAID) segmentation analysis via SPSS Decision Tree were implemented to define the discrimination of BD and MDD. RESULTS: DBIL was extracted as the first splitting variable, with LDH and IBIL as the second, TSH and prealbumin as the third in the model of male patients (p-value < .05). For the model of female patients, DBIL was also extracted as the first splitting variable, with UA, LDH, and IBIL as the second, triglyceride and FT3 as the third (p-value < .05). The predictive accuracies of the Decision Tree and multiple logistic regression models were similar (74.9% vs 76.9% in males; 74.4% vs 79.5% in females). CONCLUSIONS: This study suggests the value of the Decision Tree models, which employ biochemical parameters as diagnostic predictors for BD and MDD. The CHAID Decision Tree identified that patients with concomitantly increased LDH, IBIL, and decreased DBIL could be in the group that showed the highest risk of being diagnosed as BD.

Predictive Value of Thyroid Hormones for Incident Hyperuricemia in Euthyroid Subjects: The Tianjin Chronic Low-Grade Systemic Inflammation and Health Cohort Study.

OBJECTIVE: Thyroid hormones (THs) play an important role in both serum uric acid (SUA) excretion and purine nucleotide metabolism. Past research mainly focused on the relationships between thyroid dysfunction and hyperuricemia. Although most subjects at risk for hyperuricemia are euthyroid, few studies have investigated the predictive values of THs on incident hyperuricemia in euthyroid adults. This study aimed to examine how free triiodothyronine, thyroxine, and thyroid-stimulating hormone are related to incident hyperuricemia in euthyroid subjects. METHODS: Participants without baseline hyperuricemia were recruited from Tianjin Chronic Low-grade Systemic Inflammation and Health Cohort Study and followed up for ∼6 years. Thyroid function was determined by chemiluminescence immunoassay methods. Hyperuricemia was defined as SUA ≥416.5 µmol/L for males and ≥357.0 µmol/L for females. Thyroid function and SUA were assessed yearly during follow-up. Adjusted Cox proportional hazards regression models were used to assess the relationship between thyroid function and hyperuricemia. RESULTS: The incidence rates of hyperuricemia were 109 and 50 per 1000 person-years in males and females, respectively. In males, compared with the lowest quartile, the multivariable-adjusted hazards ratios for hyperuricemia in the highest quartiles of triiodothyronine, thyroxine, and thyroid-stimulating hormone were 0.57 (0.50-0.66), 0.63 (0.54-0.73), and 1.03 (0.90-1.19) (P for trend < .0001, < .0001, and .51), respectively. However, no statistically significant correlations between thyroid function and incident hyperuricemia in females were found. CONCLUSION: This cohort study is the first to demonstrate that higher THs are related to lower risk of incident hyperuricemia in a male population with euthyroid status.

Rural solid waste-characteristics and leachate pollution assessment for different precipitation levels, China.

Open dumping adversely affects the environment and remains the most widely used method for waste disposal in many developing rural areas in China. Information regarding the impact of rural solid waste (RSW) on the environment remains limited. The objectives of this study are to investigate the characteristics of RSW and the impact of different precipitation rates, and to evaluate the contamination potential of RSW using a leachate pollution index (LPI). The study showed that leachate concentration was significantly influenced by precipitation rates at the initial precipitation stages. Precipitation rates of 42.00 mm/day appeared to have the largest dilution effects. In contrast, the concentrations of leachate at rainfall rates of 24.00 mm/day and soaking were steady, and no similar trends were observed. The highest amounts of pollutants in leachate were the result of soaking. In the first week of our experiment, the LPI value for each rural area waste sample rapidly increased with rising precipitation rates from soaking to 42.00 mm/day. However, no significant change in LPI was observed thereafter (after 5 weeks) even with increasing precipitation rates. The values of chemical oxygen demand, biochemical oxygen demand, total nitrogen, and NH3-N in the leachate after 10 weeks were 4.00, 7.34, 1.87, and 2.21 times higher, respectively, than those of the prescribed leachate quality standards in China. The results of our study suggest the following course of action for the three dump sites investigated: in Banqiao, given the size of the population and the size of the waste amount, landfill might be a suitable way for disposing of RSW. In Machen, building a standardized waste collection site would be an economical solution for reducing potential pollution risks. In Jiuduhe, increasing the transportation rate of solid waste might be an effective solution. The results of this study can help to improve the understanding of leachate pollution in Chinese rural areas.

Hospital-acquired lower respiratory tract infections among high risk hospitalized patients in a tertiary care teaching hospital in China: An economic burden analysis.

BACKGROUND: Data on the economic burden of hospital-acquired lower respiratory tract infection (LRTI) among high risk hospitalized patients are lacking in China. This study aims to fill this knowledge gap. METHODS: We used a prospective matched cohort design, comparing patients with LRTIs and 1:1 matched patients without LRTIs. Study period was from January 2013 to December 2015 analyzing inpatients from high risk wards - intensive care unit (ICU), dialysis, hematology, etc. - in a tertiary hospital. Hospital information system and hospital infection surveillance system were applied to extract necessary information. The primary outcome was incidence of hospital-acquired LRTIs, and the secondary was economic burden outcomes, including incremental medical costs and prolonged length of stay (LOS). Wilcoxon's signed rank test was used to explore the differences in the economic burden. RESULTS: Among 5990 hospital visitors over the period of time, 895 (14.94%) had hospital-acquired LRTIs. We analyzed 340 patients with LRTIs and 340 respective controls without infections. The median hospital costs for patients with ICU-acquired LRTIs were significantly higher than those without LRTIs in other wards ($12,301.17 vs. $4674.64, P<0.01). The average attributable cost per patient was $2853.93 ($6916.48 vs. $4062.55, P<0.01). Patients from hematology department had the longest LOS, at 15days (25days vs. 10 days, P<0.01). An LRTI led to an attributable increase in LOS by 8days on average (P<0.01). Western medicine, treatment and laboratory test were the dominant contributors to the growth in overall medical costs in hospital-acquired LRTIs. CONCLUSIONS: Hospital-acquired LRTI imposed considerable economic burden on patients hospitalized in high risk wards in China. This study provides the first data for economic evaluation of LRTI, highlighting the urgent need to establish targeted preventive strategies to minimize the occurrence of this complication to reduce economic burden.

PKA-RIIB Deficiency Induces Brown Fatlike Adipocytes in Inguinal WAT and Promotes Energy Expenditure in Male FVB/NJ Mice.

Obesity has become the most common metabolic disorder worldwide. Promoting brown adipose tissue (BAT) and beige adipose tissue formation, and therefore, a functional increase in energy expenditure, may counteract obesity. Mice lacking type IIß regulatory subunit of adenosine 3',5' cyclic monophosphate (cAMP)-dependent protein kinase A (PKA-RIIB) display reduced adiposity and resistance to diet-induced obesity. PKA-RIIB, encoded by the Prkar2b gene, is most abundant in BAT and white adipose tissue (WAT) and in the brain. In this study, we show that mice lacking PKA-RIIB have increased energy expenditure, limited weight gain, and improved glucose metabolism. PKA-RIIB deficiency induces brownlike adipocyte in inguinal WAT (iWAT). PKA-RIIB deficiency also increases the expression of uncoupling protein 1 and other thermogenic genes in iWAT and primary preadipocytes from iWAT through a mechanism involving increased PKA activity, which is represented by increased phosphorylation of PKA substrate, cAMP response element binding protein, and P38 mitogen-activated protein kinase. Our study provides evidence for the role of PKA-RIIB deficiency in regulating thermogenesis in WAT, which may potentially have therapeutic implications for the treatment of obesity and related metabolic disorders.

Nosocomial infections among acute leukemia patients in China: An economic burden analysis.

BACKGROUND: The economic burden associated nosocomial infections (NIs) in patients with acute leukemia (AL) in China was unclear. A prospective study was conducted to quantify the medical cost burden of NIs among AL patients. METHODS: Nine hundred ninety-four patients diagnosed with AL between January 2011 and December 2013 were included. Relevant necessary information was extracted from the hospital information system and hospital infection surveillance system. The primary outcome was incidence of NIs and the secondary was economic burden results, including extra medical costs and prolonged length of stay (LOS). We estimated the total incremental cost of NIs by comparing all-cause health care costs in patients with versus without infections. Prolonged duration of stay was compared in patients with different infections. RESULTS: Of 994 patients with AL, 277 (27.9%) experienced NIs. NI was associated with a total incremental cost of $3,092 per patient ($5,227 vs $2,135; P < .01) and infected patients experienced a longer LOS (21 vs 10 days; P < .01). Patients with multisite infection had the highest total medical cost ($8,474.90 vs $2,209.90; P < .01) and the longest LOS (25 vs 15 days; P < .01). Western medicine was the main contributor to the rise of total cost in all kinds of infections. CONCLUSIONS: NI was associated with higher medical costs, which imposed an economic burden on patients with AL. The study highlights the influence of NIs on LOS and health care costs and appeal to the establishment of prophylactic measures for NIs to reduce the unnecessary waste of medical resources in the long run.

In silico prediction of mRNA poly(A) sites in Chlamydomonas reinhardtii.

Accurately predicting polyadenylation [poly(A)] sites is important for defining the end of genes and understanding gene regulation mechanisms. Alternative polyadenylation (APA) has been demonstrated to play an important role in transcriptome diversity and regulating gene expression. To accurately predict poly(A) and APA sites in Chlamydomonas reinhardtii, a green alga that can be used to produce renewable energy, we proposed a novel model that integrated five methods for representing the features of these sites with a combined classifier. We presented a new grouping method based on pattern assembly to classify the poly(A) sites into four groups. We used five methods, involving the predicted RNA secondary structure, the term frequency-inverse document frequency weight, first-order Markov chain, pentamer ratio and a position weight matrix, to generate the feature space. We then developed a heuristic method to form the combined classifier by weighting multiple classifiers to predict poly(A) sites in each group. The high specificity and sensitivity of this model were demonstrated by testing the four groups of poly(A) sites and the intronic APA sites. The average prediction performance was approximately 8 % higher than the performance of a previous prediction model. For the group without any conserved patterns, the prediction accuracy was 9 % higher than for the accuracy with the previous technique. However, the prediction efficiency of this group was still significantly lower than that of the other groups, indicating the importance of identifying additional signal patterns for poly(A) site prediction. We also predicted the alternative poly(A) sites in introns with good accuracy. This prediction model was designed to be easily expanded with new classifiers or new features. Therefore, this model is applicable to new data or other species. Our model will be useful both in genome annotation because it predicts the end of a mature transcript and in genetic engineering because it enables researchers to eliminate undesirable poly(A) sites.