IL-27 signalling promotes adipocyte thermogenesis and energy expenditure.

Thermogenesis in brown and beige adipose tissue has important roles in maintaining body temperature and countering the development of metabolic disorders such as obesity and type 2 diabetes1,2. Although much is known about commitment and activation of brown and beige adipose tissue, its multiple and abundant immunological factors have not been well characterized3-6. Here we define a critical role of IL-27-IL-27Rα signalling in improving thermogenesis, protecting against diet-induced obesity and ameliorating insulin resistance. Mechanistic studies demonstrate that IL-27 directly targets adipocytes, activating p38 MAPK-PGC-1α signalling and stimulating the production of UCP1. Notably, therapeutic administration of IL-27 ameliorated metabolic morbidities in well-established mouse models of obesity. Consistently, individuals with obesity show significantly decreased levels of serum IL-27, which can be restored after bariatric surgery. Collectively, these findings show that IL-27 has an important role in orchestrating metabolic programs, and is a highly promising target for anti-obesity immunotherapy.

Impact of pharmacist-led post-transplant medication management for kidney transplant recipients: A retrospective pre- and post-intervention study.

WHAT IS KNOWN AND OBJECTIVE: The roles of pharmacists in medication management for transplant recipients have received limited attention. This study comprehensively assessed the impact of pharmacist-led post-transplant medication management. METHODS: A retrospective pre- and post-intervention study was conducted in the urology ward in a general hospital. Patients receiving kidney transplants from May 2015 to April 2017 were enrolled. Eligible subjects were assigned into two groups (pre-intervention group and post-intervention group) according to the date (1 May 2016) when the pharmacist commenced participation in the post-transplant management for kidney transplant recipients. The outcomes included intervention analysis, cost-saving effect, outcomes of immunosuppressive drug level monitoring, antibiotic outcomes, safety outcomes, and blood pressure (BP) and plasma glucose (PG) outcomes. RESULTS AND DISCUSSION: A total of 299 patients were admitted to our hospital for kidney transplantation. Two hundred and four patients met inclusion criteria for this study (84 patients were in pre-intervention group, and 120 patients were in post-intervention group). Out of 630 pharmacist interventions in the medication order, 97.1% were accepted by the physicians. The average cost of medications per patient decreased from 4661.64 Ren Min Bi (RMB) to 3051.33 RMB. The percentage of patients who maintained tacrolimus (TAC) levels within the target concentration range was higher in the post-intervention group on post-operative day (POD) 7 (75.00% vs 87.50%, P = 0.021). There was a significant decrease in antibiotic use density (AUD) and duration of antibiotic treatment in the post-intervention group. Post-intervention group showed lower levels in systolic blood pressure (SBP) (141.55 ± 14.62 vs 136.04 ± 13.17, P = 0.01) with higher BP control rate (67.50% vs 90.70%, P = 0.00) on discharge day compared to pre-intervention group. WHAT IS NEW AND CONCLUSION: Pharmacists played a comprehensive role in the management of kidney transplant recipients in the inpatient setting, with some evidence of enhanced clinical outcomes.

Diagnosis and ecotoxicological risk assessment of 49 elements in sludge from wastewater treatment plants of Chongqing and Xiamen cities, China.

Limited information about the sludge quality is a major constraint for its usage and proper disposal. This study investigated the occurrence of 49 elements in sludge from 11 wastewater treatment plants (WWTPs) in Chongqing and Xiamen cities of China. The concentration of 46-detected elements ranged from 16.2 µg kg-1 (Pt) to 55.0 g kg-1 (Al) on dry solid basis in the sludge. The enrichment factor of most of the elements was > 1.5, indicating their possible anthropogenic origin. The precious metals had considerably higher enrichment factor ranging from 56.3 to 200,000. Principal component analysis clustered the samples from Chongqing and Xiamen separately to suggest strong spatial variations. Contamination factor, pollution loading index, and integrated pollution degree were calculated to evaluate the elemental pollution risk. The pollution loading index indicated unpolluted to highly polluted levels of the elements in the sludge. In addition, results from the ecotoxicological risk index showed an individual low to very high ecotoxicological risk posed by eight metal(loid)s (As, Cd, Cr, Cu, Mn, Ni, Pb, and Zn) in the WWTPs.

Assessment of the occurrence, spatiotemporal variations and geoaccumulation of fifty-two inorganic elements in sewage sludge: A sludge management revisit.

The limited information about the sludge quality has made its management a top environmental challenge. In the present study, occurrence and the spatiotemporal variations of 52 inorganic elements were investigated in the sludge samples from three wastewater treatment plants (WWTPs) in Xiamen city, China. The results showed, the occurrence of 49 elements with the concentrations in the range of >125-53500 mg kg-1 dry sludge (DS) for commonly used industrial metals, 1.22-14.0 mg kg-1 DS for precious metals, and 1.12-439.0 mg kg-1 DS for rare earth elements. The geo-accumulation studies indicated a moderate to high levels of buildup of some elements in the sewage sludge. Principal components analysis (PCA) indicated strong spatial and weak temporal variations in the concentrations of the elements. Therefore, the sludge disposal operations, based on the element concentrations, geoaccumulation and economic potential are suggested for each WWTP. Sludge from W1 and W2 were found suitable for agricultural usage, while that from W3 showed a higher economic potential for the recovery of precious metals. This study concludes that a comprehensive analysis of the elements in the sewage sludge could provide critical information for the disposal and management of the sludge.

Assessment of the fate of silver nanoparticles in the A(2)O-MBR system.

In this study, we employed a bench scale A(2)O-MBR (anaerobic-anoxic-oxic membrane bioreactor) system to systematically investigate the behavior and distribution of silver nanoparticles (AgNPs) in the activated sludge. The results showed that AgNPs would aggregate and form Ag-sulfur complexes in the activated sludge, and the dissolved silver only reached 13.6 µg/L when AgNPs of 5mg/L was spiked into the A(2)O-MBR. The long-term mass balance analysis showed that most of the silver contents were accumulated in the bioreactor and wasted excess sludge. Only a small fraction (less than 0.5%) of silver could get across the hollow fiber membranes with 0.1 µm nominal pore size in the effluent. In addition, the comparison between total AgNP concentration in aerobic sludge supernatant and effluent suggested that the membrane modules played a role in controlling the discharge of AgNPs into the effluent, especially under a higher influent concentration of AgNPs. Our results also showed that the adsorbed AgNPs or silver complexes in activated sludge still could release dissolved silver at the ambient pH. Thus, since activated sludge could be a sink for AgNPs, the risks of AgNPs in wasted excess sludge during utilization and disposal should be further studied.