Global burden, risk factors, and temporal trends of ureteral cancer: a comprehensive analysis of cancer registries.

BACKGROUND: Ureteral cancer is a rare cancer. This study aimed to provide an up-to-date and comprehensive analysis on the global trends of ureteral cancer incidence and its association with lifestyle and metabolic risk factors. METHODS: The incidence of ureteral cancer was estimated from the Cancer Incidence in Five Continents Plus and Global Cancer Observatory databases. We analyzed the (1) global incidence of ureteral cancer by region, country, sex, and age group by age-standardized rates (ASR); (2) associated risk factors on a population level by univariable linear regression with logarithm transformation; and (3) incidence trend of ureteral cancer by sex and age group in different countries by Average Annual Percentage Change (AAPC). RESULTS: The global age-standardized rate of ureteral cancer incidence in 2022 was 22.3 per 10,000,000 people. Regions with higher human development index (HDI), such as Europe, Northern America, and East Asia, were found to have a higher incidence of ureteral cancer. Higher HDI and gross domestic product (GDP) and a higher prevalence of smoking, alcohol drinking, physical inactivity, unhealthy dietary, obesity, hypertension, diabetes, and lipid disorder were associated with higher incidence of ureteral cancer. An overall increasing trend of ureteral cancer incidence was observed for the past decade, especially among the female population. CONCLUSIONS: Although ureteral cancer was relatively rare, the number of cases reported was rising over the world. The rising trends among females were more evident compared with the other subgroups, especially in European countries. Further studies could be conducted to examine the reasons behind these epidemiological changes and confirm the relationship with the risk factors identified.

Incidence, risk factors, and temporal trends of penile cancer: a global population-based study.

OBJECTIVES: To examine the global disease burden and country-specific trends of penile cancer incidence by age group and investigate its associations with several factors. MATERIALS AND METHODS: The Global Cancer Observatory database was interrogated for penile cancer incidence. The 10-year cancer incidence rates were collected from the Cancer Incidence in Five Continents Plus. The country-specific data were extracted from the World Health Organization Global Health Observatory and Global Burden of Disease databases for conducting risk factors analysis. The penile cancer incidence was presented using age-standardised rates. Its associations with various factors were examined by linear regression, while the incidence trend was estimated using joinpoint regression and presented as average annual percentage change with 95% confidence intervals in different age groups. RESULTS: There were an estimated 36 068 new cases of penile cancer in 2020. There was a considerable geographical disparity in the disease burden of penile cancer, with South America reporting the highest incidence. Overall, alcohol drinking, human immunodeficiency virus (HIV) infection, and unsafe sex were positively associated with a higher penile cancer incidence, while circumcision was found to be a protective factor. There has been a mixed trend in penile cancer incidence overall, but an increasing trend was found among younger males. CONCLUSIONS: There was a global variation in the penile cancer burden associated with prevalence of alcohol drinking, HIV infection, unsafe sex, and circumcision. The increasing penile cancer incidence in the younger population is worrying and calls for early detection and preventive interventions.

Oral and craniofacial research in the Generation R study: an executive summary.

OBJECTIVES: Oral conditions are of high prevalence and chronic character within the general population. Identifying the risk factors and determinants of oral disease is important, not only to reduce the burden of oral diseases, but also to improve (equal access to) oral health care systems, and to develop effective oral health promotion programs. Longitudinal population-based (birth-)cohort studies are very suitable to study risk factors on common oral diseases and have the potential to emphasize the importance of a healthy start for oral health. In this paper, we provide an overview of the comprehensive oral and craniofacial dataset that has been collected in the Generation R study: a population-based prospective birth cohort in the Netherlands that was designed to identify causes of health from fetal life until adulthood. METHODS: Within the multidisciplinary context of the Generation R study, oral and craniofacial data has been collected from the age of 3 years onwards, and continued at the age of six, nine, and thirteen. Data collection is continuing in 17-year-old participants. RESEARCH OUTCOMES: In total, the cohort population comprised 9749 children at birth, and 7405 eligible participants at the age of seventeen. Based on questionnaires, the dataset contains information on oral hygiene, dental visits, oral habits, oral health-related quality of life, orthodontic treatment, and obstructive sleep apnea. Based on direct measurements, the dataset contains information on dental caries, developmental defects of enamel, objective orthodontic treatment need, dental development, craniofacial characteristics, mandibular cortical thickness, and 3D facial measurements. CONCLUSIONS: Several research lines have been set up using the oral and craniofacial data linked with the extensive data collection that exists within the Generation R study. CLINICAL RELEVANCE: Being embedded in a multidisciplinary and longitudinal birth cohort study allows researchers to study several determinants of oral and craniofacial health, and to provide answers and insight into unknown etiologies and oral health problems in the general population.

Improved method for benthic ecosystem health assessment by integrating chemical indexes into multiple biological indicator species-A case study of the Baiyangdian Lake, China.

A comprehensive and scientific assessment of benthic ecosystem health is key to the rational selection of endogenous pollution reduction technologies for lakes. However, current assessments are mainly limited to biological indicators and ignore the actual benthic ecosystem situations, such as the impact of eutrophication and heavy metal pollution, which may lead to the one-sidedness of the evaluation results. In this study, taking Baiyangdian Lake, the largest shallow mesotrophic-eutrophic lake in the North China Plain, as an example, the chemical assessment index and biological integrity index were first combined to estimate the biological conditions, nutritional status and heavy metal pollution of lakes. The indicator system incorporated three biological assessments (benthic index of biotic integrity (B-IBI), submerged aquatic vegetation index of biological integrity (SAV-IBI) and microbial index of biological integrity (M-IBI)) and three chemical assessments (dissolved oxygen (DO), comprehensive trophic level index (TLI) and index of geoaccumulation (Igeo)). Twenty-three attributes of B-IBI, fourteen attributes of SAV-IBI and twelve attributes of M-IBI were screened by range, responsiveness, and redundancy tests to keep the core metrics that were significantly correlated with disturbance gradients or showed strong discriminatory power between reference and impaired sites. The assessment results of B-IBI, SAV-IBI, and M-IBI showed significant differences in the response to anthropogenic activities and seasonal change, among which the submerged plants showed more significant seasonal differences. It is difficult to reach a comprehensive conclusion regarding the benthic ecosystem health status based on a single biological community. In comparison with biological indicators, the score of chemical indicators is relatively low. DO, TLI and Igeo provide an essential supplement for the benthic ecosystem health assessment of lakes with eutrophication and heavy metal pollution problems. Using the new integrated assessment method, the benthic ecosystem health of Baiyangdian Lake was rated as fair, especially the northern parts of the lake adjacent to the inflow mouth of the Fu River, which were in poor condition, indicating that the lake has experienced anthropogenic disturbance, resulting in eutrophication, heavy metal pollution and biological community degradation. Whether it's spring or summer, the integrated assessment method provides a more plausible and comprehensive view of benthic ecosystem health under the pressure of increasing human activities and changing habitat and hydrological conditions, overcoming the narrow perspective and uncertainties of the single-index method. Thus, it can assist lake managers in providing technical support for ecological indication and restoration.

Occurrence and human health risk assessment of pharmaceuticals and personal care products in real agricultural systems with long-term reclaimed wastewater irrigation in Beijing, China.

Reclaimed wastewater (RW) is increasingly used to irrigate agricultural land and to alleviate agricultural water shortages worldwide. This usage has resulted in concerns about soil contamination by pharmaceuticals and personal care products (PPCPs) and the human health risks associated with dietary crop intake. In this study, we systematically analysed the occurrence and accumulation of 11 PPCPs and one active metabolite in soils and various crops (cucumber, eggplant, long bean and wheat) from realistic RW irrigation fields with different irrigation histories (20, 30 and 40 years) in Beijing and evaluated the human health risks associated with the consumption of these crops. The 11 PPCPs and one active metabolite were detected at concentrations ranging from 0.67 to 22.92 ng L-1 in RW, 0.029-28.13 µg kg-1 in irrigated soil, and <0.01-28.01 µg kg-1 in crops. The concentrations of N4-acetyl-sulfamethoxazole and triclosan were higher than those of other PPCPs, with respective concentrations of 14.39-31.44 ng L-1 and 15.93-26.23 ng L-1 in RW, 10.92-23.29 µg kg-1 and 20.22-28.13 µg kg-1 in irrigated soil and 17.92-28.01 µg kg-1 and 8.92-14.91 µg kg-1 in crops. However, the estimated threshold of toxicological concern (TTC) and hazard quotient (HQ) values revealed that the concentrations of N4-acetyl-sulfamethoxazole and triclosan in crops irrigated with RW should be considered a de minimis risk to human health. The concentrations of 11 PPCPs and one active metabolite in soils and crops and the calculated fruit bioconcentration factors (BCFs) did not display obvious increases associated with the duration of RW irrigation in real agricultural systems (P > 0.05). The concentrations of the studied PPCPs in the RW used for irrigation followed different patterns from the concentrations detected in the irrigated soils and crops. Although the concentrations of sulfamethoxazole, sulfisoxazole, sulfamethazine and trimethoprim in RW were higher than those of many other studied PPCPs, their respective values in the irrigated soils and crops did not display a similar tendency. The uptake and accumulation of PPCPs varied among the crop species (P < 0.05). Although PPCPs were detected in eggplant, long bean and wheat (BCFs: not applicable-1.67, 0.03-1.35 and 0.01-5.01, respectively), PPCPs accumulated at increased levels in cucumber (BCFs 0.03-18.98). The estimated TTC and HQ values showed that the consumption of crops irrigated long-term with RW presents a de minimis risk to human health. However, further studies with more PPCPs and additional crop species need to be conducted, the synergistic effects of chemical mixtures of multiple PPCPs and the toxic effects of PPCP metabolites should be elucidated to obtain more reliable information on the safety of wastewater reuse for irrigation.

Degradation of chlorpyrifos by an endophytic bacterium of the Sphingomonas genus (strain HJY) isolated from Chinese chives (Allium tuberosum).

The degradation of chlorpyrifos (CP) by an endophytic bacterial strain (HJY) isolated from Chinese chives (Allium tuberosum Rottl. ex Spreng) was investigated. Strain HJY was identified as Sphingomonas sp. based on morphological, physiological, and biochemical tests and a 16S rDNA sequence analysis. Approximately 96% of 20 mg L-1 CP was degraded by strain HJY over 15 days in liquid minimal salts medium (MSM). The CP degradation rate could also be increased by glucose supplementation. The optimal conditions for the removal of 20 mg L-1 CP by strain HJY in MSM were 2% inoculum density, pH 6.0, and 30-35°C. The CP degradation rate constant and half-life were 0.2136 ± 0.0063 d-1 and 3.2451 ± 0.0975 d, respectively, under these conditions, but were raised to 0.7961 ± 0.1925 d-1 and 0.8707 ± 0.3079 d with 1% glucose supplementation. The detection of metabolic products and screening for degrading genes indicated that O,O-diethyl O-3,5,6-trichloropyridinol was the major degradation product from CP, while it was likely that some functional genes were undetected and the mechanism responsible for CP degradation by strain HJY remained unknown. Strain HJY is potentially useful for the reduction of CP residues in Chinese chives and may be used for the in situ phytoremediation of CP.

Predicting skin cancer risk from facial images with an explainable artificial intelligence (XAI) based approach: a proof-of-concept study.

Background: Efficient identification of individuals at high risk of skin cancer is crucial for implementing personalized screening strategies and subsequent care. While Artificial Intelligence holds promising potential for predictive analysis using image data, its application for skin cancer risk prediction utilizing facial images remains unexplored. We present a neural network-based explainable artificial intelligence (XAI) approach for skin cancer risk prediction based on 2D facial images and compare its efficacy to 18 established skin cancer risk factors using data from the Rotterdam Study. Methods: The study employed data from the Rotterdam population-based study in which both skin cancer risk factors and 2D facial images and the occurrence of skin cancer were collected from 2010 to 2018. We conducted a deep-learning survival analysis based on 2D facial images using our developed XAI approach. We subsequently compared these results with survival analysis based on skin cancer risk factors using cox proportional hazard regression. Findings: Among the 2810 participants (mean Age = 68.5 ± 9.3 years, average Follow-up = 5.0 years), 228 participants were diagnosed with skin cancer after photo acquisition. Our XAI approach achieved superior predictive accuracy based on 2D facial images (c-index = 0.72, 95% CI: 0.70-0.74), outperforming that of the known risk factors (c-index = 0.59, 95% CI 0.57-0.61). Interpretation: This proof-of-concept study underscores the high potential of harnessing facial images and a tailored XAI approach as an easily accessible alternative over known risk factors for identifying individuals at high risk of skin cancer. Funding: The Rotterdam Study is funded through unrestricted research grants from Erasmus Medical Center and Erasmus University, Rotterdam, Netherlands Organization for the Health Research and Development (ZonMw), the Research Institute for Diseases in the Elderly (RIDE), the Ministry of Education, Culture and Science, the Ministry for Health, Welfare and Sports, the European Commission (DG XII), and the Municipality of Rotterdam. G.V. Roshchupkin is supported by the ZonMw Veni grant (Veni, 549 1936320).

Promotion of rice seedlings growth and enhancement of cadmium immobilization under cadmium stress with two types of organic fertilizer.

Cadmium (Cd)-contaminated soil poses a severe threat to crop production and human health, while also resulting in a waste of land resources. In this study, two types of organic fertilizer (ZCK: Low-content available iron; Z2: High-content available iron) were applied to Cd-contaminated soil for rice cultivation, and the effects of the fertilizer on rice growth and Cd passivation were investigated in conjunction with soil microbial analysis. Results showed that Z2 could alter the composition, structure, and diversity of microbial communities, as well as enhance the complexity and stability of the microbial network. Both 2% and 5% Z2 significantly increased the fresh weight and dry weight of rice plants while suppressing Cd absorption. The 2% Z2 exhibited the best Cd passivation effect. Gene predictions suggested that Z2 may promote plant growth by regulating microbial production of organic acids that dissolve phosphorus and potassium. Furthermore, it is suggested that Z2 may facilitate the absorption and immobilization of soil cadmium through the regulation of microbial cadmium efflux and uptake systems, as well as via the secretion of extracellular polysaccharides. In summary, Z2 can promote rice growth, suppress Cd absorption by rice, and passivate soil Cd by regulating soil microbial communities.

Automated three-dimensional analysis of facial asymmetry in patients with syndromic coronal synostosis: A retrospective study.

Craniosynostosis, characterized by premature fusion of one or more cranial sutures, results in a distorted skull shape. Only three studies have assessed facial asymmetry manually in unicoronal synostosis patients. It is therefore important to understand how uni- and bicoronal synostosis affect facial asymmetry with a minimum risk of human bias. An automated algorithm was developed to quantify facial asymmetry from three-dimensional images, generating a mean facial asymmetry (MFA) value in millimeters to reflect the degree of asymmetry. The framework was applied to analyze postoperative 3D images of syndromic patients (N = 35) diagnosed with Muenke syndrome, Saethre-Chotzen syndrome, and TCF12-related craniosynostosis with respect to MFA values from a healthy control group (N = 89). Patients demonstrated substantially higher MFA values than controls: Muenke syndrome (unicoronal 1.74 ± 0.40 mm, bicoronal 0.77 ± 0.21 mm), Saethre-Chotzen syndrome (unicoronal 1.15 ± 0.20 mm, bicoronal 0.69 ± 0.16 mm), and TCF12-related craniosynostosis (unicoronal 1.40 ± 0.51 mm, bicoronal 0.66 ± 0.05 mm), compared with controls (0.49 ± 0.12 mm). Longitudinal analysis identified an increasing MFA trend in unicoronal synostosis patients. Our study revealed higher MFA in syndromic patients with uni- and bicoronal synostosis compared with controls, with the most pronounced MFA in Muenke syndrome patients with unilateral synostosis. Bicoronal synostosis patients demonstrated higher facial asymmetry than expected given the condition's symmetrical presentation.

Low-cost and resource-efficient monolithic photocatalyst with enhanced solar light utilization for the photocatalytic treatment of organic wastewater.

Developing low-cost, well-performing, and resource-efficient photocatalysts with enhanced solar light utilization can contribute to the practicability of photocatalytic techniques in organic wastewater treatment. This study fabricated and characterized a novel sunlight-driven BiOBr- and acetylene black (AB)-loaded monolithic photocatalyst. The fly ash-based geopolymer acts as photocatalyst support that can also provide adsorption sites and semiconductor metal oxide (Fe2O3). A conductive network in the geopolymer structure formed by AB can promote the separation of e--h+ pairs generated by active sites (BiOBr and Fe2O3). Moreover, the photothermal effect induced by AB can assist the photocatalytic reaction at the microinterface of the photocatalyst. This photocatalyst was suspended on the surface of an aqueous solution for sufficient contact with oxygen from the air and is thus beneficial for producing 1O2 and ·OH as the main active species. Within 30 min, it exhibited higher photothermal-photocatalytic activity with 96% removal efficiency of the target pollutant methylene blue (MB), which occurred at an initial concentration of 20 mg L-1. The demethylation and hydroxylation process induced by the active species constituted the primary degradation pathway for MB by Bi/AB/MFGP. Overall, this study provides a valuable reference for developing economical, effective, and practical photocatalysts and applying geopolymers in photocatalysis.

Global Trends of Prostate Cancer by Age, and Their Associations With Gross Domestic Product (GDP), Human Development Index (HDI), Smoking, and Alcohol Drinking.

BACKGROUND: We aimed to examine the global disease burden and trends of prostate cancer incidence and mortality by age, and their associations with gross domestic product (GDP), human development index (HDI), smoking, and alcohol drinking. MATERIALS AND METHODS: We retrieved the Global Cancer Observatory (GLOBOCAN) database for the incidence and mortality of prostate cancer in 2020; the World Bank for GDP per capita; the United Nations for HDI; the WHO Global Health Observatory for prevalence of smoking and alcohol drinking; the Cancer Incidence in 5 Continents (CI5), WHO mortality database, for trend analysis. We presented the prostate cancer incidence and mortality using age-standardized rates. We examined their associations with GDP, HDI, smoking, and alcohol drinking by Spearman's correlations and multivariable regression. We estimated the 10-year trend of incidence and mortality by joinpoint regression analysis with average annual percent change with 95% confidence intervals in different age groups. RESULTS: A wide variation in the burden of prostate cancer with the highest mortality found in low-income countries while the highest incidence was observed in high-income countries. We found moderate to high positive correlations for GDP, HDI, and alcohol drinking with prostate cancer incidence, whilst a low negative correlation was observed for smoking. Globally, there was an increasing incidence but decreasing mortality of prostate cancer, and such trends were particularly prominent in Europe. Notably, the incidence increase was also found in the younger population aged <50 years. CONCLUSIONS: There was a global variation in the burden of prostate cancer associated with GDP, HDI, smoking, and alcohol drinking.

Global burden and temporal trends of lower urinary tract symptoms: a systematic review and meta-analysis.

BACKGROUND: Lower urinary tract symptoms (LUTS) are common complaint in urology practice and affecting the quality of life for patients. This article aims to perform a systematic review and meta-analysis on the global prevalence of LUTS overall, and according to different patient characteristics. METHODS: We searched MEDLINE and Embase for population-based epidemiological studies reporting the prevalence of LUTS from inception to 1 Jan 2021. Studies which: (1) have enough information on sample size and prevalence; (2) investigate individuals aged 15 or above; and (3) have clear diagnostic criteria for LUTS. We extracted the following information: year of publication; name of the first author; study period; region of recruitment; race; age range; sex; severity; symptoms; and criteria. We pooled rate estimates with exact binomial and test score-based confidence intervals (CIs) using proportions with a random-effects model. RESULTS: We included 222 studies from 36 countries involving 1,692,110 samples and 632,933 patients with LUTS. The overall prevalence of any and moderate-to-severe LUTS was 63.2% (95% CI = 58.0-68.1) and 31.3% (95% CI = 28.8-33.8), respectively. The most common symptom was storage symptoms (56.7%; 95% CI = 51.0-62.4), followed by voiding symptoms (36.4%; 95% CI = 27.8-45.4) and post-micturition symptoms (30.7%; 95% CI = 19.2-43.6). A higher prevalence of moderate-to-severe LUTS was observed in male subjects (35.2%; 95% CI = 32.1-38.5) and individuals aged ≥60 (39.0%; 95% CI = 33.4-44.8; I2 = 99.9%). Its prevalence increased from 27.4% (95% CI = 24.5-30.3) in 1990-1999, to 31.9% (95% CI = 27.3-36.7) in 2000-2009 and 36.2% (95% CI = 30.7-41.9) in 2010-2019. CONCLUSIONS: This study was the first comprehensive meta-analysis examining the global prevalence of LUTS. We identified a high level of LUTS prevalence in the general population, with a higher burden in male subjects, older individuals, and the Asian population. There has been an increasing trend in the prevalence of LUTS since the 1990s.

Benthic ecological restoration under the combined action of slow-release oxygen material and benthic organisms.

The oxygen level is key benthic ecosystem health. In this study, a new kind of slow-release oxygen material (SROM) was developed and evaluated in a simulation experiment. The effects of SROM dose and dosing method on the pH and DO, the release of nitrogen and phosphorus, and greenhouse gas emissions were studied. The restoration of typical benthic species (Ceratophyllum represented submerged plants and Cipangopaludina cahayensis represented benthic animals) was also evaluated based on the analysis of catalase and peroxidase activities, survival rate, and biomass. The result shows that dosing SROM on mud surfaces had a better effect than dosing in mud. When dosing SROM on the surface of mud at a suitable dose, the DO of water increased from 0.5 mg/L to higher than 4 mg/L, and the pH was below 9, which would be suitable for the survival of benthos. Dosing SROM could also cause the concentrations of nutrient elements (NH4+-N, TN, TP, and PO43-) in overlying water and the emission flux of CH4 and CO2 to decrease. In addition, the growth of Ceratophyllum and Cipangopaludina cahayensis was accelerated, which benefited the restoration of benthic ecosystems. For microbial community structure, various of bacteria for nitrogen and the phosphorus cycle were found in the sediment (including aerobic denitrifying bacteria). Dosing SROM could increase the Simpson index of the bacterial community, means an increase in bacterial diversity. The results show that the dosing of SROM could be an effective method in the early stage of benthic habitat restoration.

Worldwide Distribution, Risk Factors, and Temporal Trends of Testicular Cancer Incidence and Mortality: A Global Analysis.

BACKGROUND: Testicular cancer is a common malignancy among young males in western countries. OBJECTIVE: To examine the global disease burden and trends of testicular cancer incidence and mortality by age and country, and their associations with human development index (HDI), gross domestic product (GDP), lifestyle habits, and metabolic risk factors. DESIGN, SETTING, AND PARTICIPANTS: We retrieved the Global Cancer Observatory database for the testicular cancer incidence and mortality in 2020; the World Bank for GDP per capita; the United Nations for HDI; the WHO Global Health Observatory for prevalence of smoking and alcohol drinking; and the Cancer Incidence in Five Continents, WHO mortality database, Surveillance, Epidemiology, and End Results programme and Nordic Cancer Registries (NORDCAN) for trend analysis. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: We presented the testicular cancer incidence and mortality using age-standardised rates. We examined their associations with HDI, GDP, smoking, alcohol drinking, physical inactivity, overweight, obesity, and medical conditions including diabetes, hypertension, and hypercholesterolaemia by linear regression. We estimated the 10-yr trend of incidence and mortality by joinpoint regression with average annual percentage change with 95% confidence intervals in different age groups. RESULTS AND LIMITATIONS: There was a wide variation in the testicular cancer burden with the highest mortality found in low-income countries, and the regions of Central America and South America, while the highest incidence was observed in high-income countries, especially in Western and Northern Europe. We found a positive association for HDI, GDP, alcohol drinking, inactivity, overweight, obesity, and hypercholesterolaemia with testicular cancer incidence, while a negative correlation was observed between GDP and mortality of testicular cancer. Globally, there was an overall increasing incidence trend of testicular cancer for the past decade, particularly in younger males; the mortality trends of testicular cancer were relatively stable. However, we did not analyse the trend of different stages and subtypes of testicular cancer due to data unavailability. CONCLUSIONS: There was a global variation in the testicular cancer burden associated with HDI, GDP, alcohol drinking, inactivity, overweight, obesity, and hypercholesterolaemia. Testicular cancer had an increasing incidence but decreasing mortality. The increasing testicular cancer incidence in the younger population is of concern and calls for early detection and preventive interventions. PATIENT SUMMARY: Globally, testicular cancer incidence had been increasing particularly in the younger population, although its deaths rates had been decreasing. Socioeconomic indices, alcohol drinking, inactivity, overweight, obesity, and high plasma lipid levels are associated with testicular cancer incidence and mortality.

Worldwide distribution, associated factors, and trends of gallbladder cancer: A global country-level analysis.

This study aimed to evaluate the global distribution, associated factors, and epidemiologic trends of gallbladder cancer (GBC) by country, sex, and age groups. The Global Cancer Observatory was interrogated for the disease burden of GBC using age-standardized rates (ASR). The prevalence of different potential risk factors for each country was extracted from Global Health Observatory and their associations with GBC incidence and mortality were examined by linear regression analysis using beta coefficients (ß). The Cancer Incidence in Five Continents I-XI and the WHO Mortality database were searched and Average Annual Percent Change (AAPC) was generated from joinpoint regression analysis. The incidence (ASR = 2.3) and mortality (ASR = 1.7) of GBC varied globally in 2018 and were higher in more developed countries and among females. Countries with higher incidence had higher human development index (ßmale = 0.37; ßfemale = 0.27), gross domestic products (ßmale = 0.13) and higher prevalence of current smoking (ßfemale = 0.05), overweight (ßmale = 0.02), obesity (ßmale = 0.03), and hypercholesterolaemia (ßmale = 0.07). Similar patterns of associations were also observed for mortality with an additional association found for diabetes (ßfemale = 0.07). Although there was an overall decreasing trend in mortality, an increasing trend in incidence was observed among some populations, particularly in males (AAPCs, 8.97 to 1.92) and in younger individuals aged <50 years (AAPCs, 12.02 to 5.66). The incidence of GBC varied between countries and was related to differences in the prevalence of potential risk factors. There was an increasing incidence trend among males and younger individuals. More intensive lifestyle modifications and disease surveillance are recommended for these populations.

Effect of packing substrates on the purification of municipal wastewater treatment plant effluent.

The effluents of municipal wastewater treatment plant (WWTP) contain excessive nitrogen and phosphorus compared with the concentration in rivers or lakes. To reduce the pollutant load placed on aqueous environments, constructed wetland (CW) technology has been widely applied to advanced wastewater treatment. Packing substrates in CW could remove various pollutants. Steel slag, yellow earth, kaolin, volcanic rock, anthracite, and ceramsite could effectively remove phosphorus (P); volcanic rock, ceramsite, zeolite, yellow earth, manganese sand, and activated carbon have an affinity for ammonia nitrogen (NH4+-N). After 24 h reactions with the WWTP standard 1B synthetic wastewater, four packing substrates, i.e., volcanic rock and anthracite (1:1), volcanic rock and yellow earth (2:1), zeolite and yellow earth (2:1), and manganese sand and activated carbon (1:3), could remove over 56% and 30% of NH4+-N and phosphorus respectively. In addition, anthracite and volcanic rock (1:3), anthracite and activated carbon (1:40), anthracite and manganese sand (1:5), and anthracite and zeolite (1:4) effectively purified NH4+-N and phosphorus in secondary WWTP effluent, with removal efficiency exceeding 39% and 27%, respectively. A sequential experiment was performed to optimize packing substrates ratios in CW with volcanic rock and anthracite, ceramsite and yellow earth, and manganese sand and activated carbon. When the quantity of the substrate was doubled, most packing substrates adsorb more than 50% phosphorus and NH4+-N of the standard 1B WWTP synthetic wastewater. Considering the removal efficiency of packing substrates on phosphorus and NH4+-N, it is suggested that manganese sand and activated carbon (1:3), volcanic rock and anthracite (2:1), and yellow earth are appropriate substrates for CW in WWTP effluent advanced treatment.

[Surgical technique and effect of proximal femoral nail anti-rotation internal fixation assisted with large retractor for the treatment of femoral intertrochanteric fractures].

OBJECTIVE: To investigate the surgical technique and efficacy of large retractor assisted maintenance of proximal femoral nail antirotation(PFNA) in the treatment of femoral intertrochanteric fracture in the absence of a retractor. METHODS: A total of 55 patients with intertrochanteric fractures treated with PFNA internal fixation were selected from April 2012 to December 2016 with a large retractor assisted in maintaining reduction, including 18 males and 37 females with an average age of 75.65 years old ranging from 47 to 90 years old; 31 cases were on the left side and 24 on the right side. All patients had preoperative ipsilateral hip pain, limited mobility, ipsilateral lower extremity extreme external rotation malformation or accompanied by shortening, and preoperative radiographs were clearly diagnosed intertrochanteric fractures. The operative time, intraoperative blood loss, and intraoperative fluoroscopy time were recorded. Postoperative hip function were evaluated. RESULTS: The average operation time was 45.35 min, the average intraoperative blood loss was 117.64 ml and the mean intraoperative fluoroscopic time was 3.42 min. All the fractures were well restored. All patients were followed up from 12 to 24 months with an average of 16.43 months. All the intertrochanteric fractures were bone healed without hip varus deformity, and there were no complications such as internal fixation loosening and fracture. According to Harris hip function score criteria, the results were excellent in 40 cases, good in 8 cases, fair in 5 cases, poor in 2 cases. CONCLUSIONS: Large retractor assisted in maintaining the use of PFNA under reposition can fix various types of femoral intertrochanteric fractures. It has simple requirements for surgical position, low equipment requirements, short operation time, less trauma, reliable fixation, and good postoperative recovery. The surgical procedure can be carried out in a primary hospital without a traction bed.

Enhanced degradation of chlorpyrifos in rice (Oryza sativa L.) by five strains of endophytic bacteria and their plant growth promotional ability.

Endophytic bacteria reside in plant tissues, such as roots, stems, leaves and seeds. Most of them can stimulate plant growth or alleviate phytotoxicity of pollutants. There are handful species with dual functions stimulating plant growth and degrading pollutants have been reported. Five endophytic bacteria were isolated from chlorpyrifos (CP) treated rice plants and identified as Pseudomonas aeruginosa strain RRA, Bacillus megaterium strain RRB, Sphingobacterium siyangensis strain RSA, Stenotrophomonas pavanii strain RSB and Curtobacterium plantarum strain RSC according to morphological characteristics, physiological and biochemical tests, and 16S rDNA phylogeny. All of them possessed some plant growth promotional traits, including indole acetic acid and siderophore production, secretion of phosphate solubilization and 1-aminocyclopropane-1-carboxylate deaminase. The bacteria were marked with the green fluorescent protein (gfp) gene and successfully colonized into rice plants. All isolates were able to degrade CP in vitro and in vivo. The five isolates degraded more than 90% of CP in 24 h when the initial concentration was lower than 5 mg/L. CP degradation was significantly enhanced in the infested rice plants and rice grains. The final CP residual was reduced up to 80% in the infested rice grains compared to the controls. The results indicate that these isolates are promising bio-inoculants for the removal or detoxification of CP residues in rice plants and grains.