PANI/GO and Sm co-modified Ti/PbO2 dimensionally stable anode for highly efficient amoxicillin degradation: Performance assessment, impact parameters and degradation mechanism.

The abuse and uncontrolled discharge of antibiotics present a severe threat to environment and human health, necessitating the development of efficient and sustainable treatment technology. In this work, we employ a facile one-step electrodeposition method to prepare polyaniline/graphite oxide (PANI/GO) and samarium (Sm) co-modified Ti/PbO2 (Ti/PbO2-PANI/GO-Sm) electrode for the degradation of amoxicillin (AMX). Compared with traditional Ti/PbO2 electrode, Ti/PbO2-PANI/GO-Sm electrode exhibits more excellent oxygen evolution potential (2.63 V) and longer service life (56 h). In degradation experiment, under optimized conditions (50 mg L-1 AMX, 20 mA cm-2, pH 3, 0.050 M Na2SO4, 25 °C), Ti/PbO2-PANI/GO-Sm electrode achieves remarkable removal efficiencies of 88.76% for AMX and 79.92% for chemical oxygen demand at 90 min. In addition, trapping experiment confirms that ·OH plays a major role in the degradation process. Based on theoretical calculation and liquid chromatography-mass spectrometer results, the heterocyclic portion of AMX molecule is more susceptible to ·OH attacks. Thus, this novel electrode offers a sustainable and efficient solution to address environmental challenges posed by antibiotic-contaminated wastewater.

Investigation of multiple nosocomial infections using a semi-Markov multi-state model.

BACKGROUND: The prevalence of multiple nosocomial infections (MNIs) is on the rise, however, there remains a limited comprehension regarding the associated risk factors, cumulative risk, probability of occurrence, and impact on length of stay (LOS). METHOD: This multicenter study includes all hospitalized patients from 2020 to July 2023 in two sub-hospitals of a tertiary hospital in Guangming District, Shenzhen. The semi-Markov multi-state model (MSM) was utilized to analyze risk factors and cumulative risk of MNI, predict its occurrence probability, and calculate the extra LOS of nosocomial infection (NI). RESULTS: The risk factors for MNI include age, community infection at admission, surgery, and combined use of antibiotics. However, the cumulative risk of MNI is lower than that of single nosocomial infection (SNI). MNI is most likely to occur within 14 days after admission. Additionally, SNI prolongs LOS by an average of 7.48 days (95% Confidence Interval, CI: 6.06-8.68 days), while MNI prolongs LOS by an average of 15.94 days (95% CI: 14.03-18.17 days). Furthermore, the more sites of infection there are, the longer the extra LOS will be. CONCLUSION: The longer LOS and increased treatment difficulty of MNI result in a heavier disease burden for patients, necessitating targeted prevention and control measures.

Distinct time trends in colorectal cancer incidence in countries with SDI levels from 1990 to 2019: an age-period-cohort analysis for the Global Burden of Disease 2019 study.

Introduction: The burden of colorectal cancer (CRC) plays a pivotal role in the global cancer epidemic. Our study reported the incidence trends in CRC and the associated effects of age, period, and birth cohort in 204 countries and territories over the past 30 years. Methods: The incidence data of CRC were extracted from the Global Burden of Disease Study (GBD) 2019. We performed the age-period-cohort (APC) model to estimate the overall annual percentage change (net drift) in the incidence rate, the annual percentage change by age group (local drift), and the relative risk (period and cohort effects) of the period and cohort in CRC during 1990-2019. This approach allows examining and distinguishing age, period, and cohort effects in incidence and potentially distinguishing colorectal cancer gaps in prevention and screening. Results: In 2019, the incidence of CRC was 2.17 (95% UI 2.00-2.34) million, of which China, the United States of America, and Japan had the highest incidence population, accounting for 45.9% of the global population. The age-standardized incidence rate (ASIR) was 26.7 (95% UI 28.9-24.6) per 100,000 people, of which 30 countries had an incidence rate greater than 40.0 per 100,000 people. From 1990 to 2019, the middle SDI region had the largest increase in incidence rate, with a net drift of 2.33% (95% CI 2.2-2.46%, p < 0.001). Globally, the incidence population was concentrated in the age group of 50-69 years, and the age group of 30-34 years had the largest increase in incidence rate (local drift 1.19% (95% CI 1.01-1.37%)). At the same time, the sex and age distributions of CRC incidence had significant heterogeneity across regions and countries. In the past 30 years, the incidence rate in 31 countries has been well controlled (net drift <0), and most of them were concentrated in high-and high-middle-SDI regions, such as Australia, Czechia, and Belgium, and the relative risk of incidence generally improved over time and consecutive young birth cohorts. CRC incidence showed an unfavorable trend (net drift ≥1%) in 89 countries, of which 27 countries were more significant (net drift >2%), mostly concentrated in the middle SDI region, such as China, Mexico, and Brazil, and the risk of period and birth cohort was unfavorable. Conclusion: Globally, the incidence of CRC has shown an overall upward trend over the past 30 years, with the exception of some countries with higher SDI values. Significant age-period-cohort differences were observed in the risk of incidence in CRC worldwide. Effective prevention and control policies need to take into account the age-period-cohort effect characteristics of different regions.

Effects of Water and Nitrogen Control on the Growth Physiology, Yields, and Economic Benefits of Lycium barbarum Plants in a Lycium barbarum + Alfalfa System.

In the production of economic forests, there are common issues such as excessive application of water and fertilizer, redundant plant growth, and low economic benefits. Reasonable water and fertilizer management can not only help address these problems but also improve the absorption and use efficiency of water and fertilizer resources by plants, promoting the green and efficient development of the fruit and forestry industry. In order to explore a suitable water and nitrogen management mode for Lycium barbarum, field experiments were conducted in this study from 2021 to 2022. Specifically, four irrigation modes (according to the proportion ratio of soil moisture content to field moisture capacity θf, 45-55% θf (W1, severe water deficiency), 55-65% θf (W2, moderate water deficiency), 65-75% θf (W3, mild water deficiency), and 75-85% θf (W4, sufficient irrigation)) and four nitrogen application levels (0 kg·ha-1 (N0, no nitrogen application), 150 kg·ha-1 (N1, low nitrogen application level), 300 kg·ha-1 (N2, medium nitrogen application level), and 450 kg·ha-1 (N3, high nitrogen application level)) were set up to analyze the influences of water and nitrogen control on the plant height, stem diameter, chlorophyll content, photosynthetic characteristics and yield, and economic benefits of Lycium barbarum in the Lycium barbarum + Alfalfa system. The study results show that the plant height and stem diameter increment of Lycium barbarum increase with the irrigation amount, increasing first and then decreasing with the increase in the nitrogen application level. Meanwhile, the chlorophyll contents in Lycium barbarum continuously increase throughout their growth periods, with Lycium barbarum treated with W4N2 during all growth periods presenting the highest contents of chlorophyll. In a Lycium barbarum + Alfalfa system, the daily variation curve of the Lycium barbarum net photosynthetic rate presents a unimodal pattern, with maximum values of the daily average net photosynthetic rate and daily carboxylation rate appearing among W4N2-treated plants (19.56 µmol·m-2·s-1 and 157.06 mmol·m-2·s-1). Meanwhile, the transpiration rates of Lycium barbarum plants continuously decrease with the increased degree of water deficiency and decreased nitrogen application level. W1N2-treated plants exhibit the highest leaf daily average water use efficiency (3.31 µmol·s-1), presenting an increase of 0.50-10.47% in efficiency compared with plants under other treatments. The coupling of water and nitrogen has significantly improved the yields and economic benefits of Lycium barbarum plants, with W4N2-treated and W3N2-treated plants presenting the highest dried fruit yield (2623.07 kg·ha-1) and net income (50,700 CNY·ha-1), respectively. Furthermore, compared with other treatment methods, these two treatment methods (W4N2 and W3N2) exhibit increases of 4.04-84.08% and 3.89-123.35% in dried fruit yield and net income indexes, respectively. Regression analysis shows that, in a Lycium barbarum + Alfalfa system, both high yields and economic benefits of Lycium barbarum plants can be achieved using an irrigation amount of 4367.33-4415.07 m3·ha-1 and a nitrogen application level of 339.80-367.35 kg·ha-1. This study can provide a reference for improving the productivity of Lycium barbarum plants and achieving a rational supply of water and nitrogen in Lyciun barbarum + Alfalfa systems in the Yellow River Irrigation Area of Gansu, China, and other similar ecological areas.

Changes in disease burden and global inequalities in bladder, kidney and prostate cancers from 1990 to 2019: a comparative analysis based on the global burden of disease study 2019.

BACKGROUND: Bladder, kidney and prostate cancers make significant contributors to cancer burdens. Exploring their cross-country inequalities may inform equitable strategies to meet the 17 sustainable development goals before 2030. METHODS: We analyzed age-standardized disability-adjusted life-years (ASDALY) rates for the three cancers based on Global Burden of Diseases Study 2019. We quantified the inequalities using slope index of inequality (SII, absolute measure) and concentration index (relative measure) associated with national sociodemographic index. RESULTS: Varied ASDALY rates were observed in the three cancers across 204 regions. The SII decreased from 35.15 (95% confidence interval, CI: 29.34 to 39.17) in 1990 to 15.81 (95% CI: 7.99 to 21.79) in 2019 for bladder cancers, from 78.94 (95% CI: 75.97 to 81.31) in 1990 to 59.79 (95% CI: 55.32 to 63.83) in 2019 for kidney cancer, and from 192.27 (95% CI: 137.00 to 241.05) in 1990 to - 103.99 (95% CI: - 183.82 to 51.75) in 2019 for prostate cancer. Moreover, the concentration index changed from 12.44 (95% CI, 11.86 to 12.74) in 1990 to 15.72 (95% CI, 15.14 to 16.01) in 2019 for bladder cancer, from 33.88 (95% CI: 33.35 to 34.17) in 1990 to 31.13 (95% CI: 30.36 to 31.43) in 2019 for kidney cancer, and from 14.61 (95% CI: 13.89 to 14.84) in 1990 to 5.89 (95% CI: 5.16 to 6.26) in 2019 for prostate cancer. Notably, the males presented higher inequality than females in both bladder and kidney cancer from 1990 to 2019. CONCLUSIONS: Different patterns of inequality were observed in the three cancers, necessitating tailored national cancer control strategies to mitigate disparities. Priority interventions for bladder and kidney cancer should target higher socioeconomic regions, whereas interventions for prostate cancer should prioritize the lowest socioeconomic regions. Additionally, addressing higher inequality in males requires more intensive interventions among males from higher socioeconomic regions.

Combining pathological risk factors and T, N staging to optimize the assessment for risk stratification and prognostication in low-risk stage III colon cancer.

BACKGROUND: This study aimed to investigate the combined pathological risk factors (PRFs) to stratify low-risk (pT1-3N1) stage III colon cancer (CC), providing a basis for individualized treatment in the future. PATIENTS AND METHODS: PRFs for low-risk stage III CC were identified using COX model. Low-risk stage III CC was risk-grouped combining with PRFs, and survival analysis were performed using Kaplan-Meier. The Surveillance, Epidemiology, and End Results (SEER) databases was used for external validation. RESULTS: Nine hundred sixty-two stage III CC patients were included with 634 (65.9%) as low risk and 328 (34.1%) as high risk. Poor differentiation (OS: P = 0.048; DFS: P = 0.011), perineural invasion (OS: P = 0.003; DFS: P < 0.001) and tumor deposits (OS: P = 0.012; DFS: P = 0.003) were identified as PRFs. The prognosis of low-risk CC combined with 2 PRFs (OS: HR = 3.871, 95%CI, 2.004-7.479, P < 0.001; DFS: HR = 3.479, 95%CI, 2.158-5.610, P < 0.001) or 3 PRFs (OS: HR = 5.915, 95%CI, 1.953-17.420, P = 0.002; DFS: HR = 5.915, 95%CI, 2.623-13.335, P < 0.001) was similar to that of high-risk CC (OS: HR = 3.927, 95%CI, 2.317-6.656, P < 0.001; DFS: HR = 4.132, 95%CI, 2.858-5.974, P < 0.001). In the SEER database, 18,547 CC patients were enrolled with 10,023 (54.0%) as low risk and 8524 (46.0%) as high risk. Low-risk CC combined with 2 PRFs (OS: HR = 1.857, 95%CI, 1.613-2.139, P < 0.001) was similar to that of high-risk CC without PRFs (HR = 1.876, 95%CI, 1.731-2.033, P < 0.001). CONCLUSION: Combined PRFs improved the risk stratification of low-risk stage III CC, which could reduce the incidence of undertreatment and guide adjuvant chemotherapy.

Tissue-specific distribution and bioaccumulation of perfluoroalkyl acids, isomers, alternatives, and precursors in citrus trees of contaminated fields: Implication for risk assessment.

The ingestion of fruits containing perfluoroalkyl acids (PFAAs) presents potential hazards to human health. This study aimed to fill knowledge gaps concerning the tissue-specific distribution patterns and bioaccumulation behavior of PFAAs and their isomers, alternatives, and precursors (collectively as per-/polyfluoroalkyl substances, PFASs) within citrus trees growing in contaminated fields. It also assessed the potential contribution of precursor degradation to human exposure risk of PFASs. High concentrations of total target PFASs (∑PFASstarget, 92.45-7496.16 ng/g dw) and precursors measured through the total oxidizable precursor (TOP) assay (130.80-13979.21 ng/g dw) were found in citrus tree tissues, and short-chain PFASs constituted the primary components. The total PFASs concentrations followed the order of leaves > fruits > branches, bark > wood, and peel > pulp > seeds. The average contamination burden of peel (∑PFASstarget: 57.75%; precursors: 71.15%) was highest among fruit tissues. Bioaccumulation factors (BAFs) and translocation potentials of short-chain, branched, or carboxylate-based PFASs exceeded those of their relatively hydrophobic counterparts, while ether-based PFASs showed lower BAFs than similar PFAAs in above-ground tissues of citrus trees. In the risk assessment of residents consuming contaminated citruses, precursor degradation contributed approximately 36.07% to total PFASs exposure, and therefore should not be ignored.

Identification of performance and cost in a new backwash method to clean the UF membrane: backwashing with low dosage of NaClO.

Ultrafiltration (UF) is widely used in wastewater reclamation treatments. Conventional backwashing is usually performed at regular time intervals (10-120 min) with permeate and without the addition of chemicals. Chemical enhanced backwashing (CEB) is usually applied after 70-90 filtration cycles with added chemicals. These cleaning methods cause membrane fouling and require costly chemicals. Instead of conventional backwashing, we propose herein a new backwashing method involving backwashing the effluent with low doses of sodium hypochlorite (NaClO) named as BELN. The performance and cost of UF backwashing were investigated with Beijing wastewater reclamation treatment. The results showed that the transmembrane pressure (TMP) increased from 33.2 to 48.2 kPa during hydraulic backwashing after 80 filtration cycles but increased from 33.3 to 39.3 kPa during backwashing with a low NaClO content of 20 mg/L. It was also noticed that the hydraulic-irreversible fouling index decreased from 5.58 × 10-3 m2/L to 3.58 × 10-3 m2/L with the new method. According to the three-dimensional fluorescence excitation-emission (3D-EEM), the response increased from 11.9 to 15.2% with BELN. Protein-like material was identified as the main component causing membrane fouling by blocking the membrane pores. The results indicated that the low dosage of NaClO effectively stripped the fouling layer. Finally, based on an economic evaluation, the capacity of the UF process was increased from 76,959 to 109,133 m3/d with the new method. The amount of NaClO consumed for Beijing wastewater reclamation treatment was similarly compared with the conventional backwashing in per year under BELN. The new method has good potential for application.

The incidence of brain trauma caused by road injuries: Results from the Global Burden of Disease Study 2019.

BACKGROUND: Road collisions are a significant source of traumatic brain injury (TBI). We aimed to determine the pattern of road injury related TBI (RI-TBI) incidence, as well as its temporal trends. METHODS: We collected detailed information on RI-TBI between 1990 and 2019, derived from the Global Burden of Disease Study 2019. Estimated annual percentage changes (EAPCs) of RI-TBI age standardized incidence rate (ASIR), by sex, region, and cause of road injuries, were assessed to quantify the temporal trends of RI-TBI burden. RESULTS: Globally, incident cases of RI-TBI increased 68.1% from 6,900,000 in 1990 to 11,600,000 in 2019. The overall ASIR increased by an average of 0.43% (95% CI 0.30%-0.56%) per year during this period. The ASIR of RI-TBI due to cyclist, motorcyclist and other road injuries increased between 1990 and 2019; the corresponding EAPCs were 0.56 (95% CI 0.37-0.75), 1.60 (95% CI 1.35-1.86), and 0.75 (95% CI 0.59-0.91), respectively. In contrast, the ASIR of RI-TBI due to motor vehicle and pedestrian decreased with an EAPC of -0.12 and -0.14 respectively. The changing pattern for RI-TBI was heterogeneous across countries and regions. The most pronounced increases were observed in Mexico (EAPC = 3.74), followed by China (EAPC = 2.45) and Lesotho (EAPC = 1.91). CONCLUSIONS: RI-TBI remains a major public health concern worldwide, although road safety legislations have contributed to the decreasing incidence in some countries. We found an unfavorable trend in several countries with a relatively low socio-demographic index, suggesting that much more targeted and specific approaches should be adopted in these areas to forestall the increase in RI-TBI.

Assessment of bidirectional relationships between brain imaging-derived phenotypes and stroke: a Mendelian randomization study.

BACKGROUND: Stroke is a major cause of mortality and long-term disability worldwide. Whether the associations between brain imaging-derived phenotypes (IDPs) and stroke are causal is uncertain. METHODS: We performed two-sample bidirectional Mendelian randomization (MR) analyses to explore the causal associations between IDPs and stroke. Summary data of 587 brain IDPs (up to 33,224 individuals) from the UK Biobank and five stroke types (sample size range from 301,663 to 446,696, case number range from 5,386 to 40,585) from the MEGASTROKE consortium were used. RESULTS: Forward MR indicated 14 IDPs belong to projection fibers or association fibers were associated with stroke. For example, higher genetically determined mean diffusivity (MD) in the right external capsule was causally associated with an increased risk of small vessel stroke (IVW OR = 2.76, 95% CI 2.07 to 3.68, P = 5.87 × 10-12). Reverse MR indicated that genetically determined higher risk of any ischemic stroke was associated with increased isotropic or free water volume fraction (ISOVF) in body of corpus callosum (IVW ß = 0.23, 95% CI 0.14 to 0.33, P = 3.22 × 10-7). This IDP is a commissural fiber and it is not included in the IDPs identified by forward MR. CONCLUSIONS: We identified 14 IDPs with statistically significant evidence of causal effects on stroke or stroke subtypes. We also identified potential causal effects of stroke on one IDP of commissural fiber. These findings might guide further work toward identifying preventative strategies at the brain imaging levels.

Preoperative Radiotherapy Decision-Tree for Rectal Cancer Patients: A Real-World Analysis Based on the Swedish Colorectal Cancer Registry.

BACKGROUND: There are 3 widely used preoperative radiotherapy (RT) procedures in rectal cancer treatment including long-course RT (LRT), short-course RT with delayed surgery (SRTW), and short-course RT with immediate surgery (SRT). However, further evidence is required to determine which treatment option results in more optimal patient survival. METHODS: This Swedish Colorectal Cancer Registry-based retrospective study of real-world data included 7766 stage I-III rectal cancer patients, of which 2982, 1089, 763, and 2932 patients received no RT (NRT), LRT, SRTW, and SRT, respectively. The Kaplan-Meier survival curve and Cox proportional hazard multivariate model were used to identify potential risk factors and to examine the independent association of RT with patient survival after adjusting for baseline confounding factors. RESULTS: RT effects on survival differed by age and clinical T stage (cT) subgroups. Subsequent survival analysis by age and cT subgroups confirmed that patients ≥70 years old with cT4 benefited from any RT (P < .001, NRT as reference) and equally from any RT (P > .05 pairwise between RTs). In contrast, for cT3 patients ≥70 years, SRT and LRT were associated with better survival than SRTW (P < .001). In patients <70 years, LRT and SRTW had superior survival benefits in cT4 patients but inferior to SRT (P < .001); SRT was the only effective treatment in the cT3N+ subgroup (P = .032); patients with cT3N0 and <70 years did not benefit from any RT. CONCLUSION: This study suggests that preoperative RT strategies may have varying effects on the survival of rectal cancer patients, depending on their age and clinical stage.

[Ecological Risk Assessment and Source Apportionment of Heavy Metals in Mineral Resource Base Based on Soil Parent Materials].

Mineral resource bases have dual properties, e.g., mineral resources and environmental pollution. The latter could be classified into natural and anthropogenic pollution based on identifying the spatial distribution characteristics and sources of heavy metals in the soil. The Hongqi vanadium titano-magnetite mineral resources base in Luanping County, Luanhe watershed, was taken as the research object. The geo-accumulation index (Igeo), Nemerow comprehensive pollution index (PN), and potential ecological risk (Ei) were utilized to assess the soil heavy metal pollution characteristics, and redundancy analysis (RDA) and positive determinate matrix factorization (PMF) were employed to identify sources of the soil heavy metals. The results revealed that the mean contents of Cr, Cu, and Ni in the parent material of medium-basic hornblende metamorphic rock and medium-basic gneisses metamorphic rock were 1-2 times that in other parent materials in the concentrated area of mineral resources. However, the mean contents of Pb and As were lower. Fluvial alluvial-proluvial parent materials had the highest mean content of Hg, and the mean content of Cd was higher in the parent materials of medium-basic gneisses metamorphic rocks, acid rhyolite volcanic rocks, and fluvial alluvial-proluvial facies. The Igeodecreased in the following order:Cd>Cu>Pb>Ni>Zn>Cr>Hg>As. PN ranged from 0.61 to 18.99, and the sample proportion of moderate and severe pollution reached 10.00% and 8.08% respectively. Pishowed that the contents of Cu, Cd, Cr, and Ni were relatively higher in the parent material of intermediate-basic hornblende metamorphic rocks and intermediate-basic gneiss metamorphic rocks. Ei decreased in the order of Hg(58.06)>Cd(39.72)>As(10.98)>Cu(6.56) >Pb(5.60)>Ni(5.43)>Cr(2.01)>Zn(1.10). Samples whose RI was lower than 150 accounted for 84.27%, showing that the research area was predominantly at a slight potential ecological risk level. The sources of soil heavy metals were dominated by parent material weathering, followed by the mixed sources of agricultural activities and transportation, the exploitation of mining, and fossil burning, which accounted for 41.44%, 31.83%, 22.01%, and 4.73%, respectively. The risks of heavy metal pollution in the mineral resource base were characterized as multi-source instead of the single source from the mining industry. These research results provide the scientific basis for regional green mining development and eco-environmental protection.

Impact of Area-Level Socioeconomic and Environmental Measures on Reduced Visual Acuity Among Children and Adolescents.

Purpose: To assess the impacts of area-level socioeconomic and environmental measures on reduced visual acuity (VA). Methods: This ecological study used the nationally representative cross-sectional data from the Chinese National Survey on Students' Constitution and Health in 2014 (CNSSCH 2014), which included 261,833 participants aged 7 to 22 years randomly selected from 30 mainland provinces in China. Area-level socioeconomic measures assessed included gross domestic product (GDP), population density, density of hospital beds, and nighttime light data measured as the mean digital number (DN) of each region; environmental factors assessed included latitude, annual sunlight duration, and park green space density. The main outcome measure was the prevalence of reduced VA in each province of Mainland China. Results: GDP (coefficient: 0.221; P < 0.001), mean DN (coefficient: 0.461; P < 0.001), latitude (coefficient: 0.093; P < 0.001), and annual sunlight duration (coefficient: 0.112; P < 0.001) were positively associated with the prevalence of reduced VA, while population density (coefficient: -0.256; P < 0.001), park green space per 10,000 people (coefficient: -0.145; P < 0.001), and number of hospital beds per 10,000 people (coefficient: -0.146; P < 0.001) were negatively associated with reduced VA prevalence. Factor analysis indicated a marginally nonsignificant positive correlation between socioeconomic factors and the prevalence of reduced VA (coefficient: 0.034; P = 0.07). Conclusions: Increased GDP and mean DN, which reflect economic development, were associated with a higher prevalence of reduced VA, while larger park green space and number of hospital beds per 10,000 people seemed to play a protective role, which could be targeted to design preventive strategies for myopia.

Identifying spatial agglomeration and driving forces of land use by green industries: a case study of Jiangsu Province, China.

In response to China's aims of becoming "carbon-neutral," the development of green industries such as renewable energy and recycling has flourished. Based on 2015 and 2019 data, this study uses spatial autocorrelation to analyze the evolution of land use by the green industries in Jiangsu Province. The Geodetector model was also applied to identify the driving factors underlying these spatial patterns. The spatial variability of green industrial land use in Jiangsu Province is significant, with the land-use area gradually decreasing from Southern to Northern Jiangsu. In terms of spatial-temporal changes, there is an increase in land use and a trend of expansion in the central and northern regions of Jiangsu. Land use by green industries in the province exhibits a more significant spatial clustering pattern but with a weakened clustering effect. The clustering types are mainly H-H and L-L, with the H-H type distributed mainly in the Su-Xi-Chang region and the L-L type distributed mainly in the Northern Jiangsu region. The levels of technology, economic development, industrialization, and industrial diversification are important individual driving factors, and the interaction among the different factors enhances their driving forces. This study suggests that spatial spillover effects should be focused to promote the coordinated development of regional energy-saving and environmental protection industries. At the same time, joint efforts should be made from the aspects of resources, government, economy, and related industries to promote the agglomeration of land for energy-saving and environmental protection industries.

Cost or advantage? Intra-sentential language switching could facilitate L2 emotional words' comprehension in auditory modality.

Language switching is encountered commonly and inevitably in bilingual society and often induces costs for target language's production. However, for auditory words' comprehension at sentence level, the limited research showed divergent findings. Some research observed comprehension costs when the language of target words was switched with the code of sentential contexts kept constant; but a potential switch advantage was also showed in non-dominant targets' processing when sentential context switches occurred. Additionally, it's well documented that the words' emotional connotations play a key role in both L1 and L2 word comprehension. Therefore, we aimed to explore which switch effect would occur when bilinguals comprehended L1/L2 emotional target nouns in auditory modality at behavioral and neural level through a visual object selection task. Behaviorally, switch related costs occurred in L1 targets' comprehension, whereas advantage effects were found in L2. Moreover, greater switch advantage occurred for positive and negative targets than for neutral ones. Consistently, larger LPC (Late Positive Component) defection was elicited for L2-Switch trials relative to L2-Nonswitch trials and the differences of LPC's amplitude could predict the behavioral advantageous effects of switching in nondominant targets' comprehension, which suggest that language switching lead to deeper re-analyses for emotional words. Taken together, it's suggested that bilinguals can adaptively utilize top-down (sentential prediction) and bottom-up (words' emotional information) cues to access weaker L2 representations.

Using a machine learning-based risk prediction model to analyze the coronary artery calcification score and predict coronary heart disease and risk assessment.

OBJECTIVES: To calculate the coronary artery calcification score (CACS) obtained from coronary artery computed tomography angiography (CCTA) examination and combine it with the influencing factors of coronary artery calcification (CAC), which is then analyzed by machine learning (ML) to predict the probability of coronary heart disease(CHD). METHODS: All patients who were admitted to the Affiliated Hospital of Traditional Chinese Medicine of Southwest Medical University from January 2019 to March 2022, suspected of CHD, and underwent CCTA inspection were retrospectively selected. The degree of CAC was quantified based on the Agatston score. To compare the correlation between the CACS and clinical-related factors, we collected 31 variables, including hypertension, diabetes, smoking, hyperlipidemia, among others. ML models containing the random forest (RF), radial basis function neural network (RBFNN),support vector machine (SVM),K-Nearest Neighbor algorithm (KNN) and kernel ridge regression (KRR) were used to assess the risk of CHD based on CACS and clinical-related factors. RESULTS: Among the five ML models, RF achieves the best performance about accuracy (ACC) (78.96%), sensitivity (SN) (93.86%), specificity(Spe) (51.13%), and Matthew's correlation coefficient (MCC) (0.5192).It also has the best area under the receiver operator characteristic curve (ROC) (0.8375), which is far superior to the other four ML models. CONCLUSION: Computer ML model analysis confirmed the importance of CACS in predicting the occurrence of CHD, especially the outstanding RF model, making it another advancement of the ML model in the field of medical analysis.

A real-world retrospective study of safety, efficacy, compliance and cost of combination treatment with rush immunotherapy plus one dose of pretreatment anti-IgE in Chinese children with respiratory allergies.

Background: The efficacy of allergen immunotherapy (AIT) in treating pediatric allergy has been clearly demonstrated, however, many patients hesitate to initiate AIT due to weekly hospital visits during the 3-4 months up-dosing phase. Meanwhile, rush immunotherapy (RIT) shortens the duration of the up-dosing phase to 7 days. However, considering that patients receiving RIT are exposed to the allergens during a much shorter period of time and thus may be at a greater risk of systemic reactions, RIT is currently underused, especially in children. This study investigated the utility of combination treatment with RIT plus 1 dose of pretreatment anti-IgE in children with respiratory allergies. Methods: In this retrospective study, we reviewed records of children with allergic rhinitis (AR) and/or allergic asthma (AA) sensitized to dust mite allergens receiving RIT+1 dose of pretreatment anti-IgE (the RIT group) or conventional immunotherapy (the CIT group) at our hospital from January 2020 to March 2021. Data such as visual analogue scale (VAS) scores, comprehensive symptom and medication score (CSMS), allergy blood test results, adverse reactions, compliance and cost were collected and analyzed. Results: 40 patients in the RIT group and 81 patients in the CIT group were included in this study. Both treatments were well tolerated and patients in the 2 treatment groups had comparable local and systemic reactions. Compared to CIT, RIT + anti-IgE combination led to significantly faster symptomatic improvement as demonstrated by significantly decreased VAS and CSMS starting as early as 1 month after AIT initiation (P<0.05). Nobody dropped out in the RIT group during the 1 year follow-up, while 11 out of 81 patients in the CIT group dropped out (loss rate 13.5%). Thus, the RIT group had a significantly higher compliance rate than the CIT group (P<0.05). Finally, the 2 treatment regimens had comparable cost per patient per injection (P> 0.05). Conclusions: RIT + 1 dose of pretreatment anti-IgE combination has practical advantages over CIT, including comparable safety, better compliance, and probably a faster onset of clinical efficacy at no additional cost, so it can be an useful regimen for the treatment of Chinese children with respiratory allergies.

[Relationship between economy and ecology of Pearl River Delta Urban Agglomeration based on ecological footprint of net primary productivity]. / 基于生态足迹-å‡€åˆçº§ç”Ÿäº§åŠ›çš„ç ä¸‰è§’åŸŽå¸‚ç¾¤ç»æµŽä¸Žç”Ÿæ€çš„å ³ç³».

With the acceleration of regional economic integration, human activities have played an increasingly crucial role in regional sustainable development. In this study, MODIS remote sensing data and ecological footprint of net primary productivity (EF-NPP) were leveraged to calculate the equivalence factor and yield factor of the six major biologically productive land areas in the Pearl River Delta Urban Agglomeration. We analyzed the changes in per capita ecological footprint, per capita ecological carrying capacity, natural resource utilization efficiency and ecological moderate population from 2000 to 2020. Results showed that the per capita ecological footprint in the Pearl River Delta Urban Agglomeration continued to rise from 2000 to 2020. The ecological occupation of energy land was the highest. The ecological footprint was high in west, low in middle, and higher in northwest of the study area. The per capita ecological carrying capacity was relatively high in Zhaoqing and Jiangmen and low in Shenzhen, Dongguan, Foshan and Zhongshan. The gap between the ecological moderate population and the regional actual population widened over time, reaching 30.62 million in 2020. The regional actual population was much larger than the ecological moderate population, indicating huge population pressure. The natural resource utilization efficiency of the three main industries was high. The economic benefits created by the per capita ecological footprint increased by 36800 yuan·hm-2 during the research period, with an average annual growth rate of 1800 yuan·hm-2. The growth rate of the tertiary industry was the highest. Therefore, the results could provide reference for the study on natural resource utilization efficiency in medium and small-scale regions.

Pharmacodynamic Target Assessment and PK/PD Cutoff Determination for Gamithromycin Against Streptococcus suis in Piglets.

Gamithromycin is a long-acting azalide antibiotic that has been developed recently for the treatment of swine respiratory diseases. In this study, the pharmacokinetic/pharmacodynamic (PK/PD) targets, PK/PD cutoff, and optimum dosing regimen of gamithromycin were evaluated in piglets against Streptococcus suis in China, including a subset with capsular serotype 2. Short post-antibiotic effects (PAEs) (0.5-2.6 h) and PA-SMEs (2.4-7.7 h) were observed for gamithromycin against S. suis. The serum matrix dramatically facilitated the intracellular uptake of gamithromycin by S. suis strains, thus contributing to the potentiation effect of serum on their susceptibilities, with a Mueller-Hinton broth (MHB)/serum minimum inhibitory concentration (MIC) ratio of 28.86 for S. suis. Dose-response relationship demonstrated the area under the concentration (AUC)/MIC ratio to be the predictive PK/PD index closely linked to activity (R 2 > 0.93). For S. suis infections, the net stasis, 1-log10, and 2-log10 kill effects were achieved at serum AUC24h/MIC targets of 17.9, 49.1, and 166 h, respectively. At the current clinical dose of 6.0 mg/kg, gamithromycin PK/PD cutoff value was determined to be 8 mg/L. A PK/PD-based dose assessment demonstrated that the optimum dose regimen of gamithromycin to achieve effective treatments for the observed wild-type MIC distribution of S. suis in China with a probability of target attainment (PTA) ≥ 90% was 2.53 mg/kg in this study. These results will aid in the development of clinical dose-optimization studies and the establishment of clinical breakpoints for gamithromycin in the treatment of swine respiratory infections due to S. suis.

Global, Regional, and National Burden of Cancer in Children Younger Than 5 Years, 1990-2019: Analysis of the Global Burden of Disease Study 2019.

Objectives: To quantify the burden and variation trends of cancers in children under 5 years at the global, regional, and national levels from 1990 to 2019. Methods: Epidemiological data for children under 5 years who were diagnosed with any one childhood cancer were obtained from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) from 1990 to 2019. The outcomes were the absolute numbers and rates of incidence, prevalence, mortality, and disability-adjusted life-years (DALYs) for different types of cancer. Results: In 2019, 8,774,979.1 incident cases (95% uncertainty interval [UI]: 6,243,599.2 to11,737,568.5) and 8,956,583.8 (6,446,323.9 to 12,364,520.8) prevalent cases of cancer in children under 5 years were identified worldwide; these cancers resulted in 44,451.6 (36,198.7 to 53,905.9) deaths and 3,918,014.8 (3,196,454.9 to 4,751,304.2) DALYs. From 1990 to 2019, although the numbers of incident and prevalent cases only decreased by -4.6% (-7.0 to -2.2) and -8.3% (-12.6 to -3.4), respectively, the numbers of deaths and DALYs clearly declined by -47.8% (-60.7 to -26.4) and -47.7% (-60.7 to -26.2), respectively. In 2019, the middle sociodemographic index (SDI) regions had the highest incidence and prevalence, whereas the low SDI regions had the most mortality and DALYs. Although all of the SDI regions displayed a steady drop in deaths and DALYs between 1990 and 2019, the low-middle and low SDI regions showed increasing trends of incidence and prevalence. Leukemia remained the most common cancer globally in 2019. From 1990 to 2019, the burdens of leukemia, liver cancer, and Hodgkin's lymphoma declined, whereas the incidence and prevalence of other cancers grew, particularly testicular cancer. Conclusions: The global childhood cancer burden in young children has been steadily decreasing over the past three decades. However, the burdens and other characteristics have varied across different regions and types of cancers. This highlights the need to reorient current treatment strategies and establish effective prevention methods to reduce the global burden of childhood cancer.