Association of Dietary Vegetable and Fruit Consumption with Sarcopenia: A Systematic Review and Meta-Analysis.

Previous studies have shown contradictory results regarding the association between vegetable and fruit consumption and the risk of sarcopenia. We aimed to evaluate this association using a meta-analysis, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched PubMed, EMBASE, and the Cochrane Library through July 2023 using related keywords. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated based on the random-effects model. We included 14 observational studies with 11 cross-sectional and three cohort studies involving 6436 sarcopenias among 33,801 participants. Vegetable and fruit consumption were significantly associated with reduced sarcopenia risk (OR, 0.61; 95% CI, 0.48 to 0.79; I2 = 59.8%). The association was significant in cross-sectional studies (OR, 0.64; 95% CI, 0.49 to 0.84; I2 = 56.3%; n = 11) but not in cohort studies (OR, 0.50; 95% CI, 0.22 to 1.11; I2 = 76.4%; n = 3). Moreover, the association was significant in age ≥60 (OR, 0.64; 95% CI, 0.49 to 0.83; I2 = 58.0%; n = 10). This meta-analysis suggests that eating vegetables and fruit reduces sarcopenia risk. However, as cohort studies provide a higher level of evidence than case-control studies, further prospective cohort studies should be conducted.

Mapping the immune cell landscape of severe atopic dermatitis by single-cell RNA-seq.

BACKGROUND: Efforts to profile atopic dermatitis (AD) tissues have intensified, yet comprehensive analysis of systemic immune landscapes in severe AD remains crucial. METHODS: Employing single-cell RNA sequencing, we analyzed over 300,000 peripheral blood mononuclear cells from 12 severe AD patients (Eczema area and severity index (EASI) > 21) and six healthy controls. RESULTS: Results revealed significant immune cell shifts in AD patients, including increased Th2 cell abundance, reduced NK cell clusters with compromised cytotoxicity, and correlated Type 2 innate lymphoid cell proportions with disease severity. Moreover, unique monocyte clusters reflecting activated innate immunity emerged in very severe AD (EASI > 30). While overall dendritic cells (DCs) counts decreased, a distinct Th2-priming subset termed "Th2_DC" correlated strongly with disease severity, validated across skin tissue data, and flow cytometry with additional independent severe AD samples. Beyond the recognized role of Th2 adaptive immunity, our findings highlight significant innate immune cell alterations in severe AD, implicating their roles in disease pathogenesis and therapeutic potentials. CONCLUSION: Apart from the widely recognized role of Th2 adaptive immunity in AD pathogenesis, alterations in innate immune cells and impaired cytotoxic cells have also been observed in severe AD. The impact of these alterations on disease pathogenesis and the effectiveness of potential therapeutic targets requires further investigation.

Association between seafood intake and the risk of thyroid cancer.

Background: Previous observational epidemiological studies such as case-control studies and cohort studies have reported inconsistent results regarding the associations between seafood intake and the risk of thyroid cancer. Materials and methods: We searched PubMed and EMBASE in August 2021 using keywords related to seafood intake and thyroid cancer. A pooled odds ratio (OR) or relative risk (RR) with its 95% confidence interval (CI) was calculated. Results: We included 17 observational studies with 13 case-control studies and 4 cohort studies, which included 4,309 thyroid cancer patients among 599,161 participants. In the random effects model meta-analysis of all 17 studies, we found that there was no significant association between seafood intake (highest vs. lowest intake) and the risk of thyroid cancer (OR or RR, 1.01; 95% CI: 0.86 to 1.19; I2=51.4%). Although the associations were not statistically significant, subgroup meta-analyses by study design showed opposite findings: seafood intake decreased the risk of thyroid cancer in case-control studies (OR or RR, 0.94; 95% CI: 0.74 to 1.19; I2=60.6%; n=13) but increased in cohort studies (OR or RR, 1.14; 95% CI: 0.97 to 1.35; I2=0.0%; n=4). Conclusion: The current meta-analysis of observational epidemiological studies found that that overall, there was no significant association between seafood intake and the risk of thyroid cancer. However, given that cohort studies give us a higher level of evidence than case-control studies, further prospective cohort studies are warranted to confirm the association between them.

Targeting FLT3-TAZ signaling to suppress drug resistance in blast phase chronic myeloid leukemia.

BACKGROUND: Although the development of BCR::ABL1 tyrosine kinase inhibitors (TKIs) rendered chronic myeloid leukemia (CML) a manageable condition, acquisition of drug resistance during blast phase (BP) progression remains a critical challenge. Here, we reposition FLT3, one of the most frequently mutated drivers of acute myeloid leukemia (AML), as a prognostic marker and therapeutic target of BP-CML. METHODS: We generated FLT3 expressing BCR::ABL1 TKI-resistant CML cells and enrolled phase-specific CML patient cohort to obtain unpaired and paired serial specimens and verify the role of FLT3 signaling in BP-CML patients. We performed multi-omics approaches in animal and patient studies to demonstrate the clinical feasibility of FLT3 as a viable target of BP-CML by establishing the (1) molecular mechanisms of FLT3-driven drug resistance, (2) diagnostic methods of FLT3 protein expression and localization, (3) association between FLT3 signaling and CML prognosis, and (4) therapeutic strategies to tackle FLT3+ CML patients. RESULTS: We reposition the significance of FLT3 in the acquisition of drug resistance in BP-CML, thereby, newly classify a FLT3+ BP-CML subgroup. Mechanistically, FLT3 expression in CML cells activated the FLT3-JAK-STAT3-TAZ-TEAD-CD36 signaling pathway, which conferred resistance to a wide range of BCR::ABL1 TKIs that was independent of recurrent BCR::ABL1 mutations. Notably, FLT3+ BP-CML patients had significantly less favorable prognosis than FLT3- patients. Remarkably, we demonstrate that repurposing FLT3 inhibitors combined with BCR::ABL1 targeted therapies or the single treatment with ponatinib alone can overcome drug resistance and promote BP-CML cell death in patient-derived FLT3+ BCR::ABL1 cells and mouse xenograft models. CONCLUSION: Here, we reposition FLT3 as a critical determinant of CML progression via FLT3-JAK-STAT3-TAZ-TEAD-CD36 signaling pathway that promotes TKI resistance and predicts worse prognosis in BP-CML patients. Our findings open novel therapeutic opportunities that exploit the undescribed link between distinct types of malignancies.

Effective Atomic N Doping on CeO2 Nanoparticles by Environmentally Benign Urea Thermolysis and Its Significant Effects on the Scavenging of Reactive Oxygen Radicals.

Atomic nitrogen doping on CeO2 nanoparticles (NPs) by an efficient and environmentally benign urea thermolysis approach is first studied, and its effects on the intrinsic scavenging activity of the CeO2 NPs for reactive oxygen radicals are investigated. The N-doped CeO2 (N-CeO2) NPs, characterized by X-ray photoelectron and Raman spectroscopy analyses, showed considerably high levels of N atomic doping (2.3-11.6%), accompanying with an order of magnitude increase of the lattice oxygen vacancies on the CeO2 crystal surface. The radical scavenging properties of the N-CeO2 NPs are characterized by applying Fenton's reaction with collective and quantitative kinetic analysis. The results revealed that the significant increase of surface oxygen vacancies is the leading cause for the enhancements of radical scavenging properties by the N doping of CeO2 NPs. Enriched with abundant surface oxygen vacancies, the N-CeO2 NPs prepared by urea thermolysis provided about 1.4-2.5 times greater radical scavenging properties than the pristine CeO2. The collective kinetic analysis revealed that the surface-area-normalized intrinsic radical scavenging activity of the N-CeO2 NPs is about 6- to 8-fold greater than that of the pristine CeO2 NPs. The results suggest the high effectiveness of the N doping of CeO2 by the environmentally benign urea thermolysis approach to enhance the radical scavenging activity of CeO2 NPs for extensive applications such as that in polymer electrolyte membrane fuel cells.

Corticosteroids reduce pathologic interferon responses by downregulating STAT1 in patients with high-risk COVID-19.

We do not yet understand exactly how corticosteroids attenuate hyperinflammatory responses and alleviate high-risk coronavirus disease 2019 (COVID-19). We aimed to reveal the molecular mechanisms of hyperinflammation in COVID-19 and the anti-inflammatory effects of corticosteroids in patients with high-risk COVID-19. We performed single-cell RNA sequencing of peripheral blood mononuclear cells (PBMCs) from three independent COVID-19 cohorts: cohort 1 was used for comparative analysis of high-risk and low-risk COVID-19 (47 PBMC samples from 28 patients), cohort 2 for longitudinal analysis during COVID-19 (57 PBMC samples from 15 patients), and cohort 3 for investigating the effects of corticosteroid treatment in patients with high-risk COVID-19 (55 PBMC samples from 13 patients). PBMC samples from healthy donors (12 PBMC samples from 12 donors) were also included. Cohort 1 revealed a significant increase in the proportion of monocytes expressing the long noncoding RNAs NEAT1 and MALAT1 in high-risk patients. Cohort 2 showed that genes encoding inflammatory chemokines and their receptors were upregulated during aggravation, whereas genes related to angiogenesis were upregulated during improvement. Cohort 3 demonstrated downregulation of interferon-stimulated genes (ISGs), including STAT1, in monocytes after corticosteroid treatment. In particular, unphosphorylated STAT-dependent ISGs enriched in monocytes from lupus patients were selectively downregulated by corticosteroid treatment in patients with high-risk COVID-19. Corticosteroid treatment suppresses pathologic interferon responses in monocytes by downregulating STAT1 in patients with high-risk COVID-19. Our study provides insights into the mechanisms underlying COVID-19 aggravation and improvement and the effects of corticosteroid treatment.

Association of Juvenile Dermatomyositis Disease Activity With the Expansion of Blood Memory B and T Cell Subsets Lacking Follicular Markers.

OBJECTIVE: This study was undertaken to identify blood markers of juvenile dermatomyositis (DM) disease activity (DA), which are needed to improve disease management. METHODS: The study comprised a total of 123 juvenile DM patients and 53 healthy controls. Results of laboratory tests (aldolase, creatinine kinase, lactate dehydrogenase [LDH], aspartate aminotransferase) and clinical measures of DA in patients with juvenile DM, including the Manual Muscle Testing in 8 muscles (MMT-8), Childhood Myositis Assessment Scale (CMAS), and disease activity scores (DAS) (total DAS for juvenile DM, the muscle DAS, and the skin DAS), were recorded when available. Surface phenotype of peripheral blood mononuclear cells was assessed using flow cytometry. Whole blood transcriptional profiles were studied using either RNA-sequencing or microarrays. Differential gene expression was determined using DESeq and compared by pathway and gene ontology analyses. RESULTS: Conventional memory (CD27+IgD-) B cells expressing low CXCR5 levels (CXCR5low/- CM B cells) were significantly increased in frequency and absolute numbers in 2 independent cohorts of juvenile DM patients compared with healthy controls. The frequency of CD4+ Th2 memory cells (CD45RA-CXCR5-CCR6-CXCR3-) was also increased in juvenile DM, especially in patients who were within <1 year from diagnosis. The frequency of CXCR5low/- CM B cells correlated with serum aldolase levels and with a blood interferon-stimulated gene transcriptional signature. Furthermore, both the frequency and absolute numbers of CXCR5low/- CM B cells correlated with clinical and laboratory measures of muscle DA (MMT-8, CMAS, aldolase, and LDH). CONCLUSION: These findings suggest that both CM B cells lacking the CXCR5 follicular marker and CXCR5- Th2 cells represent potential biomarkers of DA in juvenile DM and may contribute to its pathogenesis.

Association between Alcohol Consumption and the Risk of Sarcopenia: A Systematic Review and Meta-Analysis.

Sarcopenia is a common disease defined as the loss of skeletal muscle mass, strength, and physical performance. Alcohol consumption is an uncertain risk factor for sarcopenia. Previous observational epidemiological studies have reported inconsistent results regarding the association between alcohol consumption and sarcopenia risk. This study aimed to investigate the association between alcohol consumption and sarcopenia. A literature review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We searched PubMed, EMBASE, and the Cochrane Library through April 2022 using keywords related to alcohol consumption and sarcopenia. The pooled odds ratio (OR) with a 95% confidence interval (CI) was calculated using a random effects model meta-analysis. The risk of bias of the studies was assessed using the Newcastle−Ottawa scale. Nineteen observational studies that reported 3826 sarcopenia patients among 422,870 participants were included in the qualitative analysis. Alcohol consumption was not significantly associated with sarcopenia risk (OR, 1.00; 95% CI, 0.83 to 1.20; I2 = 60.6%). Alcohol consumption resulted in a non-significant decrease in the risk of sarcopenia in men (OR, 0.70; 95% CI, 0.46 to 1.07; I2 = 0.0%) and in women (OR, 1.20; 95% CI, 0.63 to 2.30; I2 = 75.8%). The subgroup analyses by age and alcohol consumption were significantly associated with an increased the risk of sarcopenia in <65 years (OR, 2.62; 95% CI, 1.22 to 5.62; I2 = 100%). This meta-analysis of observational studies indicated that alcohol consumption was not significantly associated with sarcopenia risk. However, there are factors influencing the association between alcohol consumption and sarcopenia, such as smoking and dietary patterns. Additional study of these confounding factors is needed for the systematic analysis of the association of alcohol consumption with sarcopenia in future studies.

Application of calcium-rich mineral under nonwoven fabric mats and sand armor as cap layer for interrupting N and P release from river sediments.

This work investigates the applicability of thermally treated calcium-rich minerals (CRMs), such as sepiolite (SPL), attapulgite (ATT), and dolomite (DLM) to hinder the nitrogen (N) and phosphorus (P) release from river sediments. A non-woven fabric mat (NWFM) or a sand layer were also capped as armor layers, i.e., placed over CRMs to investigate the capping impact on the N/P release. The capping efficiency was evaluated in a cylindrical reactor, consisting of CRMs, armor layers, sediments, and sampled water. We monitored N/P concentrations, dissolved oxygen (DO), oxidation reduction potential, pH, and electric conductivity in overlying water over 70 days. The DO concentrations in the uncapped and capped conditions were preserved for 30 days and 70 days (until the end of experiment duration), respectively. ATT showed higher efficiency for NH4-N and T-N than the other two materials, and the capping efficiency of NH4-N was measured as 96.4%, 93.7%, and 61.6% when capped with 2-cm sand layer, 1-cm sand layer, and NWFM layer, respectively. DLM showed a superior rejection capability of PO4-P to ATT and SPL, reported as 97.2% when capped with 2-cm sand armor. The content of weakly adsorbed-P was lower in the uncapped condition than in the capping condition. It can be concluded that ATT and DLM can be used as capping agents to deactivate N and P, respectively, to reduce water contamination from sediments of the eutrophic river.

Human Rhinovirus Infection of the Respiratory Tract Affects Sphingolipid Synthesis.

The 17q21 asthma susceptibility locus includes asthma risk alleles associated with decreased sphingolipid synthesis, likely resulting from increased expression of ORMDL3. ORMDL3 inhibits serine-palmitoyl transferase (SPT), the rate-limiting enzyme of de novo sphingolipid synthesis. There is evidence that decreased sphingolipid synthesis is critical to asthma pathogenesis. Children with asthma and 17q21 asthma risk alleles display decreased sphingolipid synthesis in blood cells. Reduced SPT activity results in airway hyperreactivity, a hallmark feature of asthma. 17q21 asthma risk alleles are also linked to childhood infections with human rhinovirus (RV). This study evaluates the interaction of RV with the de novo sphingolipid synthesis pathway, and the alterative effects of concurrent SPT inhibition in SPT-deficient mice and human airway epithelial cells. In mice, RV infection shifted lung sphingolipid synthesis gene expression to a pattern that resembles genetic SPT deficiency, including decreased expression of Sptssa, a small SPT subunit. This pattern was pronounced in lung epithelial cellular adhesion molecule (EpCAM+) cells and reproduced in human bronchial epithelial cells. RV did not affect Sptssa expression in lung CD45+ immune cells. RV increased sphingolipids unique to the de novo synthesis pathway in mouse lung and human airway epithelial cells. Interestingly, these de novo sphingolipid species were reduced in the blood of RV-infected wild-type mice. RV exacerbated SPT deficiency-associated airway hyperreactivity. Airway inflammation was similar in RV-infected wild-type and SPT-deficient mice. This study reveals the effects of RV infection on the de novo sphingolipid synthesis pathway, elucidating a potential mechanistic link between 17q21 asthma risk alleles and rhinoviral infection.

Erythroid mitochondrial retention triggers myeloid-dependent type I interferon in human SLE.

Emerging evidence supports that mitochondrial dysfunction contributes to systemic lupus erythematosus (SLE) pathogenesis. Here we show that programmed mitochondrial removal, a hallmark of mammalian erythropoiesis, is defective in SLE. Specifically, we demonstrate that during human erythroid cell maturation, a hypoxia-inducible factor (HIF)-mediated metabolic switch is responsible for the activation of the ubiquitin-proteasome system (UPS), which precedes and is necessary for the autophagic removal of mitochondria. A defect in this pathway leads to accumulation of red blood cells (RBCs) carrying mitochondria (Mito+ RBCs) in SLE patients and in correlation with disease activity. Antibody-mediated internalization of Mito+ RBCs induces type I interferon (IFN) production through activation of cGAS in macrophages. Accordingly, SLE patients carrying both Mito+ RBCs and opsonizing antibodies display the highest levels of blood IFN-stimulated gene (ISG) signatures, a distinctive feature of SLE.

Conversion of cattle manure into functional material to remove selenate from wastewater.

Herein, pyrolysis of cattle manure was conducted to synthesize an effective material for removing heavy metals (e.g., selenium) from water environments. To remove selenate from aqueous solution, iron-impregnated cattle manure biochar (Fe/CM-biochar) was synthesized. The Fe-impregnation was performed by pre-treating cattle manure before its pyrolysis. The pretreatment increased the biochar yield. Influence of various factors such as contacting time, initial selenate concentration, reaction temperature, pH, and presence of coexisting anions were explored by performing batch adsorption experiments. The selenate adsorption reached equilibrium within 15 min. The Langmuir model was better fitted to equilibrium adsorption data than the Freundlich model. The maximum adsorption capacity of Fe/CM-biochar was calculated to be 52.56 mg-Se/g, which is superior to other adsorbents reported in the literature. As the reaction temperature increased in the range (15-35) °C, selenate adsorption on Fe/CM-biochar showed an endothermic and nonspontaneous reaction. The enthalpy change during selenate adsorption was 18.44 kJ/mol, which ranges in physical adsorption. The increase of solution pH (3-11) reduced the selenate adsorption (46.4-37.7 mg-Se/g). The extent of co-existing anion impact on selenate adsorption followed an order of HPO42- > HCO3- > SO42- > NO3-. These results indicate that Fe/CM-biochar is an effective functional material for the removal of selenate from wastewater.

Fluoride removal by thermally treated egg shells with high adsorption capacity, low cost, and easy acquisition.

In this study, the use of eggshells was suggested as an adsorbent for fluoride removal, and their mechanism of fluoride removal was investigated. The eggshells underwent thermal treatment to improve their adsorption capacity; 800 °C was found to be the optimal temperature for treatment. Eggshells thermally treated at 800 °C (ES-800) were mainly composed of Ca (82.4%) and C (15.9%), and the peaks of ES-800 obtained from X-ray diffraction (XRD) corresponded to calcite, portlandite, and lime. Fluorine adsorption by ES-800 reached 70% of the equilibrium adsorption amount within 15 min and gradually increased until 24 h. The maximum adsorption capacity of ES-800 at pH 7 and 25 °C was 258.28 mg/g, which is 18 times larger than that of activated alumina; this is classified as the best available technology by the United States Environmental Protection Agency. Both enthalpy and entropy increased in the process of fluoride adsorption onto ES-800. Fluoride adsorption of ES-800 decreased from 59.16 to 11.85 mg/g with an increase in pH from 3 to 11. Fluoride adsorption decreased in the presence of anions, whose impact follows the order: HPO43- > HCO3- >> SO42- > Cl-. XRD, and X-ray photoelectron spectroscopy analysis revealed that fluoride removal was achieved by the formation of calcium fluorite (CaF2). Thus, it can be concluded that eggshells can function as highly efficient adsorbents for fluoride removal, replacing bone char and activated alumina; further, their adsorption capacity can be improved by thermal treatment.

As(III) adsorption onto Fe-impregnated food waste biochar: experimental investigation, modeling, and optimization using response surface methodology.

Biochar derived from food waste was modified with Fe to enhance its adsorption capacity for As(III), which is the most toxic form of As. The synthesis of Fe-impregnated food waste biochar (Fe-FWB) was optimized using response surface methodology (RSM), and the pyrolysis time (1.0, 2.5, and 4.0 h), temperature (300, 450, and 600 °C), and Fe concentration (0.1, 0.3, and 0.5 M) were set as independent variables. The pyrolysis temperature and Fe concentration significantly influenced the As(III) removal, but the effect of pyrolysis time was insignificant. The optimum conditions for the synthesis of Fe-FWB were 1 h and 300 °C with a 0.42-M Fe concentration. Both physical and chemical properties of the optimized Fe-FWB were studied. They were also used for kinetic, equilibrium, thermodynamic, pH, and competing anion studies. Kinetic adsorption experiments demonstrated that the pseudo-second-order model had a superior fit for As(III) adsorption than the pseudo-first-order model. The maximum adsorption capacity derived from the Langmuir model was 119.5 mg/g, which surpassed that of other adsorbents published in the literature. Maximum As(III) adsorption occurred at an elevated pH in the range from 3 to 11 owing to the presence of As(III) as H2AsO3- above a pH of 9.2. A slight reduction in As(III) adsorption was observed in the existence of bicarbonate, hydrogen phosphate, nitrate, and sulfate even at a high concentration of 10 mM. This study demonstrates that aqueous solutions can be treated using Fe-FWB, which is an affordable and readily available resource for As(III) removal.

Thermally treated Mytilus coruscus shells for fluoride removal and their adsorption mechanism.

We evaluated Mytilus coruscus shells (MCS) as an adsorbent for fluoride removal. Its removal efficiency was enhanced by thermal treatment and MCS at 800 °C (MCS-800) increased significantly its fluoride adsorption capacity from 0 to 12.28 mg/g. While raw MCS is mainly composed of calcium carbonate (CaCO3), MCS-800 consisted of 56.9% of CaCO3 and 43.1% of calcium hydroxide (Ca(OH)2). The superior adsorption capacity of MCS-800 compared to untreated MCS can be also explained by its larger specific surface area and less negative charge after the thermal treatment. X-ray photoelectron spectroscopy and X-ray diffraction analysis revealed that the fluoride adsorption of MCS-800 occurred via the formation of calcium fluorite (CaF2). Fluoride adsorption of MCS-800 approached equilibrium within 6 h and this kinetic adsorption was well-described by a pseudo-second-order model. The Langmuir model was suitable for describing the fluoride adsorption of MCS-800 under different initial concentrations. The maximum fluoride adsorption amount of MCS-800 was 82.93 mg/g, which was superior to those of other adsorbents derived from industrial byproducts. The enthalpy change of fluoride adsorption was 78.75 kJ/mol and the negative sign of free energy indicated that this phenomenon was spontaneous. The increase of pH from 3.0 to 11.0 slightly decreased the fluoride adsorption capacity of MCS-800. The adsorption was inhibited in the presence of anions and their impact increased with following trend: chloride < sulfate < carbonate < phosphate. The fluoride adsorption capacities of MCS-800 after washing with deionized water and 0.1 M NaOH were reduced by 31.5% and 57.4%, respectively.

Recycling of bottom ash derived from combustion of cattle manure and its adsorption behaviors for Cd(II), Cu(II), Pb(II), and Ni(II).

Bottom ash generated by the combustion of cattle manure (BA-CCM) was investigated as an adsorbent for the removal of heavy metals such as Cd(II), Cu(II), Pb(II), and Ni(II) from aqueous solutions. When cattle manure was used as fuel, the thermal efficiency of the boiler was 88.7%, and the CO and CO2 concentrations in the exhaust gas were 2.3 ppm and 12.1%, respectively. The percentage of remaining solids was 31 wt.% after combustion at 900 °C. X-ray fluorescence analyses showed that the elemental composition of the BA-CCM was mainly CaO (43.3%), SiO2 (15.8%), CO2 (13.0%), and P2O5 (10.3%). The kinetic adsorption of Cd(II), Cu(II), Pb(II), and Ni(II) by BA-CCM reached equilibrium after 12 h, and the pseudo-second-order model fitted the experimental data well. The maximum amount of Cd(II), Cu(II), Pb(II), and Ni(II) adsorbed by the bottom ash was 5.4, 72.6, 88.2, and 24.6 mg/g, respectively. The equilibrium adsorption of metals onto BA-CCM was well-described by the Freundlich model. Thermodynamic analysis showed that the adsorption onto the bottom ash was endothermic and that the Gibbs free energy decreased as the temperature increased. The presence of cations such as Na+, Ca2+, and Al3+ was found to reduce the amount of metals adsorbed onto the BA-CCM, and Cd(II) adsorption was found to be more dependent on ionic strength than adsorption of Cu(II), Pb(II), and Ni(II). This study demonstrates the feasibility of producing heat energy by burning cattle manure and removing heavy metals from aqueous solutions using the generated bottom ash as an adsorbent.

Performance in Practice: Practice Assessment Tool for the Care of Patients With Schizophrenia.

Schizophrenia is associated with significant health, social, occupational, and economic burdens, including increased mortality. Despite extensive and robust research on the treatment of individuals with schizophrenia, many individuals with the illness do not currently receive evidence-based pharmacological and nonpharmacological treatments. The American Psychiatric Association Practice Guideline for the Treatment of Patients With Schizophrenia, Third Edition, aims to enhance knowledge and increase the appropriate use of interventions for schizophrenia, thereby improving the quality of care and treatment outcomes. To this end, this evidence-based Performance in Practice tool can facilitate the implementation of a systematic approach to practice improvement for the care of individuals with schizophrenia. This practice assessment activity can also be used in partial fulfillment of Continuing Medical Education and Maintenance of Certification, part IV, requirements, which can also satisfy requirements for the Centers for Medicare & Medicaid Services Merit-based Incentive Payment System program.

The American Psychiatric Association Practice Guideline for the Treatment of Patients With Schizophrenia.

(Reprinted with permission from The American Journal of Psychiatry 2020; 177:868-872).