VX-509 attenuates the stemness characteristics of colorectal cancer stem-like cells by regulating the epithelial-mesenchymal transition through Nodal/Smad2/3 signaling.

BACKGROUND: Colorectal cancer stem cells (CCSCs) are heterogeneous cells that can self-renew and undergo multidirectional differentiation in colorectal cancer (CRC) patients. CCSCs are generally accepted to be important sources of CRC and are responsible for the progression, metastasis, and therapeutic resistance of CRC. Therefore, targeting this specific subpopulation has been recognized as a promising strategy for overcoming CRC. AIM: To investigate the effect of VX-509 on CCSCs and elucidate the underlying mechanism. METHODS: CCSCs were enriched from CRC cell lines by in conditioned serum-free medium. Western blot, Aldefluor, transwell and tumorigenesis assays were performed to verify the phenotypic characteristics of the CCSCs. The anticancer efficacy of VX-509 was assessed in HCT116 CCSCs and HT29 CCSCs by performing cell viability analysis, colony formation, sphere formation, flow cytometry, and western blotting assessments in vitro and tumor growth, immunohistochemistry and immunofluorescence assessments in vivo. RESULTS: Compared with parental cells, sphere cells derived from HCT116 and HT29 cells presented increased expression of stem cell transcription factors and stem cell markers and were more potent at promoting migration and tumorigenesis, demonstrating that the CRC sphere cells displayed CSC features. VX-509 inhibited the tumor malignant biological behavior of CRC-stem-like cells, as indicated by their proliferation, migration and clonality in vitro, and suppressed the tumor of CCSC-derived xenograft tumors in vivo. Besides, VX-509 suppressed the CSC characteristics of CRC-stem-like cells and inhibited the progression of epithelial-mesenchymal transition (EMT) signaling in vitro. Nodal was identified as the regulatory factor of VX-509 on CRC stem-like cells through analyses of differentially expressed genes and CSC-related database information. VX-509 markedly downregulated the expression of Nodal and its downstream phosphorylated Smad2/3 to inhibit EMT progression. Moreover, VX-509 reversed the dedifferentiation of CCSCs and inhibited the progression of EMT induced by Nodal overexpression. CONCLUSION: VX-509 prevents the EMT process in CCSCs by inhibiting the transcription and protein expression of Nodal, and inhibits the dedifferentiated self-renewal of CCSCs.

A systematic review evaluating the effectiveness of exercise training on physical condition in prostate cancer patients undergoing androgen deprivation therapy.

Background: Androgen deprivation therapy (ADT) is an effective prostate cancer (PCa) treatment strategy that can curb the development or progression of the disease. This review aimed to examine and summarize available systematic reviews/meta-analyses (SRs/MAs) of exercise training on physical condition of PCa patients undergoing ADT. Methods: A comprehensive search of 8 databases was conducted for relevant literature published before April 25, 2022 with the language restrictions of Chinese and English. Two reviewers independently assessed the methodological quality, risk of bias, reporting quality, and evidence quality of the included SRs/MAs using a range of evaluation tools, including A Measurement Tool to Assess Systematic Reviews (AMSTAR) 2, Risk of Bias in Systematic Reviews (ROBIS), the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA), and Grades of Recommendations, Assessment, Development and Evaluation (GRADE). Results: This review included 8 SRs/MAs which included a total of 94 studies. Ultimately, A total of 51 outcomes was included, regarding 11 different outcome categories. The AMSTAR-2 tool showed that 3 SRs/MAs had moderate methodological quality, 4 SRs/MAs had very low quality, and the remaining 1 had low quality. According to the ROBIS scale, 3 SRs/MAs had a high risk of bias. The PRISMA checklist showed that the primary reporting faults were protocol registration and funding source. The GRADE system was used to analyze the evidence quality of the 51 outcomes, and no high-quality evidence was found. However, moderate-quality evidence indicated that exercise training may improve body composition [by lowering body fat mass (BFM) and body fat rate (BFR)], muscular strength, and quality of life (QoL) in PCa patients undergoing ADT. Low-quality evidence demonstrated that exercise training could improve such symptoms as fatigue, depression, sexual function, and cardiometabolic changes. Conclusions: Available evidence suggests that exercise training may be used as an adjuvant treatment for PCa patients undergoing ADT to improve several aspects of general health. Studies with more rigorous designs and larger sample sizes are needed to support our findings with more robust evidence.

AT7867 Inhibits the Growth of Colorectal Cancer Stem-Like Cells and Stemness by Regulating the Stem Cell Maintenance Factor Ascl2 and Akt Signaling.

Cancer stem cells (CSCs) are the core factors leading to recurrence, insensitivity to radiotherapy and chemotherapy, and immunotherapy resistance in patients with colorectal cancer. AT7867, a potent oral AKT inhibitor, was found to have antitumor activity in colorectal cancer; however, the effect on colorectal cancer stem cells is still unclear. This study was conducted to clarify the molecular mechanism underlying the CSC growth inhibitory effects of AT7867. We cultured colorectal cancer cells (CRCs) in a serum-free medium and enriched colorectal cancer stem cells. Subsequently, the effects of AT7867 on CSCs were analyzed by CCK-8, colony formation, flow cytometry, and immunofluorescence assays. The results indicated that AT7867 induces G2/M phase arrest and cell apoptosis in cancer stem cells. Subsequently, we identified Ascl2 as the main gene affecting the stemness of colorectal cancer in AT7867 by RNA sequencing. The current study showed that Ascl2 is involved in the metastasis, invasion, and proliferation of CRCs. The next experiments demonstrated that overexpression of Ascl2 did affect the therapeutic effect of AT7867 on CRC stemness. Furthermore, compared with other Akt inhibitors, AT7867 could promote the differentiation of colorectal cancer stem cells. Thus, AT7867 might be a potential antitumor drug candidate to treat CRC by targeting CSCs.

How does high-commitment work systems stimulate employees' creative behavior? A multilevel moderated mediation model.

How to effectively stimulate employees' creative behavior is a hot topic in the field of organizational behavior. Based on conservation of resources theory and substitutes for leadership theory, this paper discusses the impact of high-commitment work systems on employees' creative behavior and the roles of employees' wellbeing and CEO inclusive leadership. By constructing a cross-level structural equation model and analyzing the paired data of 86 CEOs, 86 HR managers and 489 employees, the results show that: (1) high-commitment work systems have positive impact on employees' creative behavior; (2) employee's wellbeing mediates the process of high-commitment work systems driving employees' creative behavior; and (3) CEO inclusive leadership negatively moderates the relationship between high-commitment work systems and employees' wellbeing, and further negatively moderates the indirect effect of high-commitment work systems on employees' creative behavior through employees' wellbeing, that is, the lower the level of CEO inclusive leadership is, the stronger the impact of high-commitment work systems on employees' creative behavior through employees' wellbeing will be.

Adjuvant Treatments of Adult Melanoma: A Systematic Review and Network Meta-Analysis.

Multiple treatments of unresectable advanced or metastatic melanoma have been licensed in the adjuvant setting, causing tremendous interest in developing neoadjuvant strategies for melanoma. Eligible studies included those that compared overall survival/progression-free survival/grade 3 or 4 adverse events in patients with unresectable advanced or metastatic melanoma. Seven eligible randomized trials with nine publications were included in this study. Direct and network meta-analysis consistently indicated that nivolumab+ipilimumab, nivolumab, and trametinib could significantly improve overall survival and progression-free survival compared to ipilimumab in advanced melanoma patients. Compared to ipilimumab, nivolumab, dacarbazine, and ipilimumab+gp100 had a reduced risk of grade 3/4 adverse reactions. The nivolumab+ipilimumab combination had the highest risk of adverse events, followed by ipilimumab+dacarbazine and trametinib. Combination therapy was more beneficial to improve overall survival and progression-free survival than monotherapy in advanced melanoma treatment, albeit at the cost of increased toxicity. Regarding the overall survival/progression-free survival, ipilimumab+gp100 ranked below ipilimumab+dacarbazine and nivolumab+ipilimumab, although it had a smaller rate of grade 3 or 4 AEs than other treatments (except nivolumab). Nivolumab is the optimum adjuvant treatment for unresectable advanced or metastatic melanoma with a good risk-benefit profile. In order to choose the best therapy, clinicians must consider the efficacy, adverse events, and physical status.

N-myc Downstream-Regulated Gene 1 (NDRG1) Regulates Vascular Endothelial Growth Factor A (VEGFA) and Malignancies in Glioblastoma Multiforme (GBM).

Background: NDRG1 has been reported to exhibit relatively low expression levels in glioma tissues compared with adjacent brain tissues. Additionally, NDRG1 is reported to be a tumor suppressor with the potential to suppress the proliferation, invasion, and migration of cancer cells. However, its exact roles in GBM are still unknown. Methods: Gene Expression Profiling Interactive Analysis (GEPIA) was employed to evaluate the expression level of NDRG1 in GBM. After the introduction of NDRG1, proliferation, analyses of colony formation, migration, and invasion capacities were performed. A luciferase reporter assay was performed to detect the effect of NDRG1 on the vascular endothelial growth factor A (VEGFA) promoter. Results: In this study, data from GBM and healthy individuals were retrospectively collected by employing GBM, and VEGFA was found to be differentially expressed in GBM tissues compared with adjacent brain tissues. Furthermore, NDRG1 expression is positively correlated with VEGFA expression, but not expression of the other two VEGF isoforms, VEGFB and VEGFC. In the glioma cell lines U87MG and U118, overexpression of NDRG1 significantly upregulated VEGFA. By performing a dual-luciferase reporter assay, it was observed that overexpressed NDRG1 transcriptionally activated VEGFA. Expectedly, overexpression of NDRG1 decreased cell viability by blocking cell cycle phases at G1 phase. Additionally, overexpression of NDRG1 inhibited invasion, colony formation, and tumor formation in soft agar. Remarkably, VEGFA silencing or blockade of VEGF receptor 2 (VEGFR2) further inhibited malignant behaviors in soft agar, including proliferation, invasion, colony formation, and tumor formation. Conclusions: NDRG1-induced VEGFA exerts protective effects in GBM via the VEGFA/VEGFR2 pathway. Therefore, targeting both NDRG1 and VEGFA may represent a novel therapy for the treatment of GBM.

Anti-inflammatory and anti-apoptotic effects of Shaoyao decoction on X-ray radiation-induced enteritis of C57BL/6 mice.

ETHNOPHARMACOLOGICAL RELEVANCE: As a typical heat-clearing prescription, Shaoyao decoction (SYD) has a robust function of clearing viscera heat for the treatment of several intestinal discomfort symptoms. Clinical evidence indicated that it had the potential to cure radiation enteritis. However, its underlying mechanisms remain unclear. AIM OF THE STUDY: The present study was designed to probe the protective effects and the involved mechanisms of SYD on X-ray radiation-induced enteritis of C57BL/6 mice. MATERIALS AND METHODS: X-ray irradiation were used to establish the radiation enteritis model. Forty-eight male C57BL/6 mice (20 ± 2 g) were randomly divided into six groups: the control group, model group, dexamethasone group (DEX, 0.12 mg/kg) and SYD groups (0.12, 0.24 and 0.36 g/mL), respectively. All mice (except the control group) were intragastrically administrated for a continuous 7 days. H&E and Masson staining were employed to evaluate the morphological and collagen fibers changes of the colon. ELISA was performed to assess the levels of MDA, SOD, COX, LPS, IL-6, IL-1ß and TNF-α in serum. Moreover, TUNEL fluorescence, western blot and qRT-PCR were used to detect the levels of apoptosis-related proteins and genes of Dclk-1, ATM, MRE-11, Bcl-2, Bax, Caspase-3, and Cyto-c. Furthermore, immunofluorescent staining was applied to detect the protein levels of p53 and Claudin-1 in colon. RESULTS: Treatment with SYD decreased the exfoliated and necrotic epithelial cells and prevent the proliferate from damaged fibrous tissue in the crypt layer of mucos. The levels of serum peroxidation and pro-inflammatory cytokines (MDA, COX, LPS, IL-6, IL-1ß and TNF-α) were obviously inhibited, while SOD sharply increased in serum after administration. Moreover, SYD can significantly ameliorate the apoptosis of colon cells, evidenced by the reduced positive expression of TUNEL staining. Meanwhile, the results of qRT-PCR and western blot demonstrated that SYD can dramatically stimulate the expression of genes and proteins Dclk-1, ATM and MRE-11, thus promoting the expression of mitochondrial pro-apoptotic proteins Bax, Caspase-3 and Cyto-c, while increasing the level of anti-apoptotic protein Bcl-2. Furthermore, immunofluorescence revealed that SYD can notably decreased the protein level of p53 while reverse the reduction of Claudin-1. CONCLUSIONS: These results indicated that radiation enteritis in C57BL/6 mice can be ameliorated by treatment with SYD. The potential protection mechanisms may be involved in ameliorating tissue fibrosis by decreasing inflammatory and apoptotic events.

Efficacy of ormutivimab, a novel recombinant human anti-rabies monoclonal antibody, in post-exposure prophylaxis animal models.

Human rabies is a serious public health problem that can't be ignored. Rabies immune globulin (RIG) is an indispensable component of rabies post-exposure prophylaxis (PEP). However, current PEP relies on RIG purified from pooled human or equine plasma, which are either in chronic shortage or associated with safety concerns. Monoclonal antibodies have become widely accepted as safer and more cost-effective alternatives to RIG products in recent years. Here, we assessed the neutralization breadth of human monoclonal antibody ormutivimab and its protective efficacy in PEP models. Ormutivimab was able to neutralize a broad panel of Chinese prevalent street RABVs with neutralizing potency form 198-1487.6 IU/mL. Furthermore, ormutivimab offered comparable protection to that with HRIG both at standard doses (20 IU/kg) and higher doses (100 IU/kg and 200 IU/kg). The interference of ormutivimab on vaccine potency was also analyzed and found slightly reduced neutralizing antibody titers similar to HRIG. The broad-spectrum neutralization activities, highly protective potency, and rapid onset of action make ormutivimab an effective candidate for human rabies PEP.

Outstanding performance of sulfurated titanomaghemite (Fe2TiO5) for hexavalent chromium removal: Sulfuration promotion mechanism and its application in chromium resource recovery.

A lot of magnetic sorbents have been developed to meet the current demand for removing Cr (VI) from wastewater. However, the application of magnetic sorbents remains restricted by the unsatisfactory Cr (VI) removal efficiency, sorbent regeneration, and safe disposition of adsorbed Cr species. In this study, magnetic titanomaghemite (Fe2TiO5) was sulfurated with gaseous H2S to improve its Cr (VI) removal efficiency. Sulfuration significantly improved the Cr (VI) removal efficiency of Fe2TiO5 from 3%-14% to 27%-82% at pH 4-10 due to drastically increased the electrostatic adsorption of Cr (VI) and heterogeneous reduction of adsorbed Cr (VI) to Cr (III). Furthermore, the sulfurated Fe2TiO5 recovered using magnetic separation can be regenerated by re-sulfuration without degrading the Cr (VI) removal efficiency, therefore, sulfurated Fe2TiO5 can be recycled for Cr (VI) removal after the regeneration. Moreover, Cr (VI) in aqueous solution can be enriched on sulfurated Fe2TiO5 after multiple adsorptions in the form of Cr2O3 in a content of more than 30% what can be considered as a source of chrome ore. Therefore, sulfurated Fe2TiO5 may be a promising, low-cost, and environment-friendly sorbent for Cr recovery as a co-benefit of Cr (VI) removal from wastewater.

Local symptoms of Hashimoto's thyroiditis: A systematic review.

Objective: Hashimoto's thyroiditis (HT) is the most common type of thyroid disease and can cause many different manifestations. The local symptoms of HT are an under-studied area of research. Therefore, the purpose of this study was to investigate the local symptoms of HT and their prevalence. Methods: A systematic review was performed to find articles in PubMed that discuss the local symptoms of HT. Relevant vocabulary terms and key terms included: autoimmune thyroid disease (AITD), hyperthyroidism, hypothyroidism, neck, throat, pharynx, airway, esophagus, breathe, swallow, globus, sleep apnea, symptoms, and quality of life. Two investigators independently screened the eligible studies. Results: A total of 54 articles fulfilled the inclusion criteria. Of these, 25 were clinical studies, 24 were case reports, and five were reviews. These clinical studies and case reports included a total of 2660 HT patients. There were eight local symptoms related to HT: neck pain (0.02%~16%), voice changes (7%~30%), throat discomfort (20%~43.7%), shortness of breath (28%~50%), dysphagia (29%), goiter-related symptoms (69.44%), sleep apnea, and generally defined compressive symptoms. Due to the use of different outcome measures among all the studies, a meta-analysis of the data could not be performed. Conclusion: Goiter symptoms, which are an item on the ThyPRO scales, are the most frequent local symptoms in HT patients, and include neck pain, voice changes, throat discomfort, and dysphagia. These local symptoms should be identified in the clinic and included in the early diagnosis and management of HT, as well as evaluated further to understand their relevance in the pathogenesis of HT.

Safe disposal of deactivated commercial selective catalytic reduction catalyst (V2O5-MoO3/TiO2) as a low-cost and regenerable sorbent to recover gaseous elemental mercury in smelting flue gas.

The reduction of Hg emissions from non-ferrous metal smelting was proposed in the Minamata Convention. Regenerable sulfureted MoO3/TiO2, which displayed excellent performance in capturing gaseous Hg0, was once developed by us to recover gaseous Hg0 in smelting flue gas (SFG) for centralized control. Recently, a large amount of spent commercial selective catalytic reduction catalysts (for example V2O5-MoO3/TiO2) mostly deactivated by CaSO4 was formed, creating a need for their safe disposal. As the main constituent of deactivated V2O5-MoO3/TiO2 is MoO3/TiO2, deactivated V2O5-MoO3/TiO2 was sulfureted to capture gaseous Hg0 from SFG for its safe disposal and the effects of V2O5 and CaSO4 on Hg0 adsorption onto sulfureted MoO3/TiO2 were investigated. Although the capturing capacity of sulfureted MoO3/TiO2 moderately decreased after the impregnation of V2O5 and CaSO4, sulfureted deactivated V2O5-MoO3/TiO2 still displayed excellent performance and reproducibility in gaseous Hg0 capture. Meanwhile, the cost performance of sulfureted deactivated V2O5-MoO3/TiO2 for Hg0 capture was outstanding as deactivated V2O5-MoO3/TiO2 needs to be safely disposed. Therefore, deactivated V2O5-MoO3/TiO2 can be sulfureted as a regenerable and low-cost sorbent that is effective in recovering gaseous Hg0 from SFG, as well as being a cost-effective and environmentally friendly method for the safe disposal of spent V2O5-MoO3/TiO2.

Outstanding performance of ZnS/TiO2 for the urgent disposal of liquid mercury leakage indoors: Novel support effect, reaction mechanism and kinetics.

Effectively weakening the bond strength of Zn-S in S-Zn-S on ZnS is of great significance to the improvement of its performance for the urgent disposal of liquid Hg0 leakage indoors. In this work, ZnS was loaded on three common supports (i.e., TiO2, SiO2, and Al2O3) to further improve its performance for capturing high concentrations of Hg0 indoors. After being loaded on TiO2, the S-Zn-O bond was present on ZnS, and the bond strength of Zn-S in S-Zn-O was significantly weaker than that in S-Zn-S because Zn2+ preferred to O2- than S2-. Hence, physically adsorbed Hg0 was much easier to bond with S in S-Zn-O than that in S-Zn-S to form HgS. Therefore, TiO2 showed a novel support effect on ZnS for Hg0 capture, and the Hg0 capture performance of ZnS/TiO2 was greatly better than those of ZnS, ZnS/SiO2, and ZnS/Al2O3. Moreover, the promotion mechanism of ZnO loading on Hg0 adsorption onto TiO2-S was discovered after comparing the Hg0 adsorption kinetic parameters of TiO2-S and ZnS/TiO2. The promotion of ZnO loading was primarily related to the notable increase in the content of S2- that can bond with physically adsorbed Hg0, which predominantly resulted from the strong interaction of ZnO/TiO2 with H2S.

Remarkable differences between copper-based sulfides and iron-based sulfides for the adsorption of high concentrations of gaseous elemental mercury: Mechanisms, kinetics, and significance.

Copper sulfides (CuSx) and iron sulfides (FeSx) have been developed to capture gaseous elemental mercury (Hg0) originating from the smelting flue gas. However, these compounds exhibit different Hg0 adsorption characteristics and Hg species adsorbed on CuSx can be spontaneously released as gaseous Hg0. Following these findings, the adsorption/desorption kinetics of Hg0 onto and from FeSx and CuSx were determined. After comparing the kinetic parameters, the mechanisms behind some of the remarkable differences between FeSx and CuSx with respect to Hg0 adsorption were discovered. The Cu-S bond in CuSx was not completely broken during Hg0 oxidation, but the SS bond in FeSx was. Hence, the activation energy for the oxidation of Hg0 physically adsorbed on CuSx was much lower than that for FeSx, resulting in a much higher efficiency of CuSx to oxidize Hg0 than FeSx. However, the bond strength of Hg-S for HgS on CuSx was weaker due to the sharing of S2- in HgS with Cu+, resulting in a decrease in the thermal stability of HgS on CuSx. Therefore, HgS adsorbed on Cu-based sulfides was metastable, and could be spontaneously decomposed to release moderate concentrations of gaseous Hg0, which was not preferable for capturing high concentrations of Hg0.

Recovering gaseous Hg0 using sulfureted phosphotungstic acid modified γ-Fe2O3 from power plants burning Hg-rich coal for centralized control.

Conversion of gaseous elemental mercury (Hg0) to particulate-bound mercury (HgP) by the injection of disposable sorbents or to gaseous oxidized mercury (Hg2+) by catalysts is not suitable to control Hg0 emissions from power plants burning Hg-rich coal because removed Hg may be released as secondary pollution, particularly during the employment of fly ash and desulfurization gypsum. In this study, sulfureted phosphotungstic acid modified γ-Fe2O3 (HPW/γ-Fe2O3) was employed as a magnetic and reproducible sorbent to recover gaseous Hg0 in coal-fired flue gas for the centralized control. Sulfureted HPW/γ-Fe2O3 showed an excellent capacity to enrich gaseous Hg0 from low concentrations to ultra-high concentrations (>10 mg m-3), which benefited to condensing it into liquid Hg. Moreover, sulfureted HPW/γ-Fe2O3 exhibited excellent para-magnetism, enabling it to be magnetically reclaimed after Hg0 capture; this magnetization did not disappear after multiple thermal desorption of Hg0 due to its excellent thermal stability. Furthermore, sulfureted HPW/γ-Fe2O3 was regenerated by re-sulfuration without decreasing the Hg0 capture performance. Therefore, gaseous Hg0 recovery using sulfureted HPW/γ-Fe2O3 is a promising, economical-effective, and eco-friendly technology for the centralized control of Hg pollution emitted from power plants that burn coal with a high Hg content.

Outstanding Performance of Magnetically Separable Sulfureted MoO3/Fe-Ti Spinel for Gaseous Hg0 Recovery from Smelting Flue Gas: Mechanism and Adsorption Kinetics.

To replace the hazardous and complicated Boliden-Norzink technology, the technology of Hg0 recovery from smelting flue gas by a magnetic and reproducible sulfureted MoO3/Fe-Ti spinel was employed to keep the produced H2SO4 free of Hg. The sulfureted MoO3/Fe-Ti spinel showed excellent performance in capturing gaseous Hg0, with an average adsorption rate of 93.3 µg g-1 min-1 and an adsorption capacity of 66.3 mg g-1 at 60 °C, which were much better than those of most of the other reported sorbents. Meanwhile, the sulfureted MoO3/Fe-Ti spinel exhibited excellent superparamagnetism and magnetization of 19.9 emu g-1, which ensured that it could easily be magnetically separated without a specialized precipitator or the molding of pulverous sorbents to monolithic sorbents. To investigate the promotion mechanism of MoO3 loading on Hg0 adsorption onto the sulfureted Fe-Ti spinel, the Hg0 adsorption kinetic parameters of the sulfureted MoO3/Fe-Ti spinel and sulfureted Fe-Ti spinel, resulting from the fitting of the adsorption breakthrough curves based on the kinetic model, were compared. The promotion of MoO3 loading was attributed to the remarkable increase in the adsorption sites on the sulfureted Fe-Ti spinel for Hg0 physical adsorption, which was mainly related to the formation of the MoS3 layer.

Adequate access to healthcare and added life expectancy among older adults in China.

BACKGROUND: Adequate access to healthcare is associated with lower risks of mortality at older ages. However, it is largely unknown how many more years of life can be attributed to having adequate access to healthcare compared with having inadequate access to healthcare. METHOD: A nationwide longitudinal survey of 27,794 older adults aged 65+ in mainland China from 2002 to 2014 was used for analysis. Multivariate hazard models and life table techniques were used to estimate differences in life expectancy associated with self-reported access to healthcare (adequate vs. inadequate). The findings were assessed after adjusting for a wide range of demographic factors, socioeconomic status, family/social support, health practices, and health conditions. RESULTS: At age 65, adequate access to healthcare increased life expectancy by approximately 2.0-2.5 years in men and women and across urban-rural areas compared with those who reported inadequate access to healthcare. At age 85, the corresponding increase in life expectancy was 1.0-1.2 years. After adjustment for multiple confounding factors, the increase in life expectancy was reduced to approximately 1.1-1.5 years at age 65 and 0.6-0.8 years at age 85. In women, the net increase in life expectancy attributable to adequate access to healthcare was 6 and 8% at ages 65 and 85, respectively. In men, the net increases in life expectancy were generally greater (10 and 14%) and consistent after covariate adjustments. In contrast, the increase in life expectancy was slightly lower in rural areas (2.0 years at age 65 and 1.0 years at age 85) than in urban areas (2.1 years at age 65 and 1.1 years age 85) when no confounding factors were taken into account. However, the increase in life expectancy was greater in rural areas (1.0 years at age 65 and 0.6 years at age 85) than in urban areas (0.4 years at age 65 and 0.2 years at age 85) after accounting for socioeconomic and other factors. CONCLUSIONS: Adequate access to healthcare was associated with longer life expectancy among older adults in China. These findings have important implications for efforts to improve access to healthcare among older populations in China.

Novel Synergistic Effect of Fe and Mo in FeMoSx/TiO2 for Recovering High Concentrations of Gaseous Hg0 from Smelting Flue Gas: Reaction Mechanism and Kinetics.

There is a high demand for developing a more effective and environment-friendly technology to substitute the complicated and hazardous Boliden-Norzink technology for recovering gaseous Hg0 from smelting flue gas. In this work, a low-cost and reproducible sorbent (FeMoSx/TiO2) was developed to recover gaseous Hg0 from smelting flue gas. FeMoSx/TiO2 exhibited a superior ability for capturing high concentrations of Hg0, with an adsorption rate of 72.2 µg g-1 min-1 and a capacity of 41.8 mg g-1 at 60 °C. These were generally larger than the sums of those of FeSx/TiO2 and MoSx/TiO2. The kinetic model of Hg0 adsorption by FeSx/TiO2, MoSx/TiO2, and FeMoSx/TiO2 were constructed according to the adsorption mechanism. Then, the structure-activity relationship of FeMoSx/TiO2 for Hg0 capture was determined by comparing the kinetic parameters. The intrinsic adsorption of Hg0 by MoSx/TiO2 (i.e., physically adsorbed Hg0 was oxidized by MoS3 to HgS) was inhibited marginally after FeSx was incorporated. However, another Hg0 adsorption route (i.e., physically adsorbed Hg0 was oxidized by FeS2 to HgS) appeared on FeMoSx/TiO2. Its rate was significantly higher than that of FeSx/TiO2. Thus, a novel synergistic effect of Fe and Mo in FeMoSx/TiO2 for Hg0 capture was observed.

Camera sensor-based contamination detection for water environment monitoring.

Water environment monitoring is of great importance to human health, ecosystem sustainability, and water transport. Unlike traditional water quality monitoring problems, this paper focuses on visual perception of water environment. We first introduce the development of a customized aquatic sensor node equipped with an embedded camera sensor. Based on this platform, we present an efficient and holistic contamination detection approach, which can automatically adapt to the detection of floating debris in dynamic waters or the identification of salient regions in static waters. Our approach is specifically designed based on compressed sensing theory to give full consideration to the unique challenges in water environment and the resource constraints on sensor nodes. Both laboratory and field experiments demonstrate the proposed method can fast and accurately detect various types of water pollutants and is a better choice for camera sensor-based water environment monitoring compared with other methods.

Age and sex differences in the association between access to medical care and health outcomes among older Chinese.

BACKGROUND: Whether the association between access to medical care and health outcomes differs by age and gender among older adults in China is unclear. We aimed to investigate the associations between self-reported inadequate access to care and multiple health outcomes among older men and women in mainland China. METHODS: Based on four latest waves available so far from a national longitudinal study in mainland China in 2005-2014, we used multilevel random-effect logistic models to estimate the contemporaneous relationships between inadequate access to care and disabilities in instrumental activities of daily living (IADL) and cognitive impairment in men and women at ages 65-74, 75-84, 85-94, and 95+, separately. We also used multilevel hazard models to investigate the relationships between reported access to care and mortality in 2005-2014. Nested models were used to adjust for survey design, sociodemographic background, enrollment in health insurance, and health behaviors. RESULTS: Approximately 6.5% of older adults in China reported inadequate access to care in the period of 2005-2014; and the percentages increased with age and were higher among women at older ages (≥75 years). Overall, older adults with self-reported inadequate access to care had greater odds of IADL and ADL disabilities and cognitive impairment than those with adequate access to healthcare. The elevated odds ratios (ORs) in men were higher in middle-old (75-84) and old-old (85-94) age groups compared to other age groups; whereas the elevated ORs in women were higher in young-old (65-74) and middle-old (75-84) age groups. The relationship between access to care and the health outcomes was generally weakest at the oldest-old ages (95+). Inadequate access to care was also linked with higher mortality risk, primarily in adults aged 75-84, and it was somewhat more pronounced in women than in men. CONCLUSIONS: Increased odds of physical disability and cognitive impairment and increased risk of mortality are linked with inadequate access to care. The associations were generally stronger in women than in men and varied across age groups. The findings of the present study have important implications for further improving access to health care and improving health outcomes of older adults in China.

Urban-rural differences in the association between access to healthcare and health outcomes among older adults in China.

BACKGROUND: Studies have shown that inadequate access to healthcare is associated with lower levels of health and well-being in older adults. Studies have also shown significant urban-rural differences in access to healthcare in developing countries such as China. However, there is limited evidence of whether the association between access to healthcare and health outcomes differs by urban-rural residence at older ages in China. METHODS: Four waves of data (2005, 2008/2009, 2011/2012, and 2014) from the largest national longitudinal survey of adults aged 65 and older in mainland China (n = 26,604) were used for analysis. The association between inadequate access to healthcare (y/n) and multiple health outcomes were examined-including instrumental activities of daily living (IADL) disability, ADL disability, cognitive impairment, and all-cause mortality. A series of multivariate models were used to obtain robust estimates and to account for various covariates associated with access to healthcare and/or health outcomes. All models were stratified by urban-rural residence. RESULTS: Inadequate access to healthcare was significantly higher among older adults in rural areas than in urban areas (9.1% vs. 5.4%; p < 0.01). Results from multivariate models showed that inadequate access to healthcare was associated with significantly higher odds of IADL disability in older adults living in urban areas (odds ratio [OR] = 1.58-1.79) and rural areas (OR = 1.95-2.30) relative to their counterparts with adequate access to healthcare. In terms of ADL disability, we found significant increases in the odds of disability among rural older adults (OR = 1.89-3.05) but not among urban older adults. Inadequate access to healthcare was also associated with substantially higher odds of cognitive impairment in older adults from rural areas (OR = 2.37-3.19) compared with those in rural areas with adequate access to healthcare; however, no significant differences in cognitive impairment were found among older adults in urban areas. Finally, we found that inadequate access to healthcare increased overall mortality risks in older adults by 33-37% in urban areas and 28-29% in rural areas. However, the increased risk of mortality in urban areas was not significant after taking into account health behaviors and baseline health status. CONCLUSIONS: Inadequate access to healthcare was significantly associated with higher rates of disability, cognitive impairment, and all-cause mortality among older adults in China. The associations between access to healthcare and health outcomes were generally stronger among older adults in rural areas than in urban areas. Our findings underscore the importance of providing adequate access to healthcare for older adults-particularly for those living in rural areas in developing countries such as China.