Titanium dioxide nanoparticles functionalized chitosan toward bio-based antibacterial adsorbent for enhanced phosphate capture.

Developing an eco-friendly, sustainable and antibacterial adsorbent is significant for actual water treatment. Herein, a bio-based antibacterial adsorbent based on titanium dioxide (TiO2) nanoparticles functionalized chitosan (CS) was prepared through an in-situ hydrolysis strategy using titanium oxysulfate as the source of TiO2. The as-obtained CS/TiO2 nanocomposite was characterized by a variety of analytical techniques. According to the Langmuir mode, the adsorption capacity of CS/TiO2 reached 23.64 mg P g-1, almost 8 times higher than that of CS. In addition, the normalized adsorption capacity (adsorption value per Ti) of CS/TiO2 was calculated to be 102.68 mg P g-1 Ti-1, much higher than pure TiO2 (60.11 mg P g-1 Ti-1). Moreover, CS/TiO2 exhibited a highly selective capacity for phosphate removal in the presence of competing anions, and showed high stability in a wide pH range of 3.0-8.0. When the phosphate concentration was 2.0 mg P L-1, the removal efficiency of phosphate reached 99.5 % and the residual concentration was only 10 µg P L-1, which meets the USEPA standards for eutrophication prevention and control. In addition, after treatment by CS/TiO2, the phosphate concentration of two sewage water samples decreased from 1.50 and 1.0 mg P L-1 to <0.10 mg P L-1, meeting the standard of level II water based on the Environmental Quality Standard of China (GB3838-2002). Ligand exchange and electrostatic interactions are mainly responsible for phosphate adsorption by CS/TiO2. Furthermore, the CS/TiO2 nanocomposites exhibited excellent antibacterial activity, which could avoid biofouling contamination caused by microorganisms. Benefiting from the above advantages, the as-designed CS/TiO2 nanocomposite has great potential as a bio-based antibacterial adsorbent for phosphate capture or removal from wastewater.

The ability of different imputation methods for missing values in mental measurement questionnaires.

BACKGROUND: Incomplete data are of particular important influence in mental measurement questionnaires. Most experts, however, mostly focus on clinical trials and cohort studies and generally pay less attention to this deficiency. We aim is to compare the accuracy of four common methods for handling items missing from different psychology questionnaires according to the items non-response rates. METHOD: All data were drawn from the previous studies including the self-acceptance scale (SAQ), the activities of daily living scale (ADL) and self-esteem scale (RSES). SAQ and ADL dataset, simulation group, were used to compare and assess the ability of four imputation methods which are direct deletion, mode imputation, Hot-deck (HD) imputation and multiple imputation (MI) by absolute deviation, the root mean square error and average relative error in missing proportions of 5, 10, 15 and 20%. RSES dataset, validation group, was used to test the application of imputation methods. All analyses were finished by SAS 9.4. RESULTS: The biases obtained by MI are the smallest under various missing proportions. HD imputation approach performed the lowest absolute deviation of standard deviation values. But they got the similar results and the performances of them are obviously better than direct deletion and mode imputation. In a real world situation, the respondents' average score in complete data set was 28.22 ± 4.63, which are not much different from imputed datasets. The direction of the influence of the five factors on self-esteem was consistent, although there were some differences in the size and range of OR values in logistic regression model. CONCLUSION: MI shows the best performance while it demands slightly more data analytic capacity and skills of programming. And HD could be considered to impute missing values in psychological investigation when MI cannot be performed due to limited circumstances.

MiRNA Polymorphisms and Hepatocellular Carcinoma Susceptibility: A Systematic Review and Network Meta-Analysis.

BACKGROUND: Hepatocellular carcinoma (HCC) is an intractable public health threat worldwide, representing the second leading cause of cancer-related mortality, with limited early detection and therapeutic options. Recent findings have revealed that the susceptibility of HCC is closely related to microRNA (miRNA). We performed this systematic review with a network meta-analysis to investigated four single nucleotide polymorphisms (SNPs) that most regularly reported in miRNAs, exploring their involvement in HCC susceptibility and interaction with hepatitis B virus (HBV). METHODS: Databases were reviewed for related studies published up to May 2019 to identify all studies that compared genotypes of miR-146a rs2910164, miR-149 rs2292832, miR-196a2 rs11614913, and miR-499 rs3746444 with no language and date restrictions. A pairwise meta-analysis was performed to estimate pooled odds ratios and 95% confidence intervals incorporating heterogeneity to assess the relationship between four miRNA polymorphisms and HCC. To further clarify the effect of polymorphisms on HCC, a Bayesian network meta-analysis was conducted to combine the effective sizes of direct and indirect comparisons. Calculations were performed by R version 3.6.1 and STATA 14.0. All steps were performed according to PRISMA guidelines. RESULTS: A total of 20 studies were enrolled in this network meta-analysis, providing 5,337 hepatocellular carcinoma cases and 6,585 controls. All included studies had an acceptable quality. Pairwise meta-analysis demonstrated that miR-196a2 rs11614913 was significantly associated with the susceptibility of HCC, while the other three SNPs were not found to have a significant association. In the analysis of HCC patients under different HBV infection status, only miR-196a2 revealed correlation of threefold risk. The network results showed no significant difference in the distribution of genotype frequencies except for miR-196a2, which appeared to have the highest superiority index when comparing and ranking four SNPs. CONCLUSION: MiR-196a2 rs11614913 was significantly associated with the susceptibility of HCC, especially for HBV- related HCC, and that individuals with TC/CC were more susceptible. No significant association was found in the other three miRNA genes. MiR-196a2 could serve as the best predictor of susceptibility in HCC.

Health care inequality under different medical insurance schemes in a socioeconomically underdeveloped region of China: a propensity score matching analysis.

BACKGROUND: Since economic inequality is often accompanied by health inequalities, health care inequalities are increasingly becoming a hot issue on a global scale. As a developing country, China is still facing the same problems as other countries in the world. Especially in underdeveloped regions, owing to the relatively backward economy, health care inequality may be more serious. The objective of this study was to explore health care inequality in a socioeconomically underdeveloped city, thus providing a certain theoretical basis for further development and reform of the medical insurance schemes. METHODS: We mainly extracted relevant insurance information of 628,952 insured enrollees, as well as consumption of outpatient visit and hospitalization. The propensity score matching had been used to estimate different urban medical insurance schemes effect on healthcare utilization, the choice of hospital types and healthcare cost. RESULTS: Insured enrollees spent most hospitalization expenses in tertiary-level hospitals, which had lowest hospitalization compensation ratios. Healthcare utilization and cost vary significantly by different insurance schemes. Urban employees had significantly higher outpatient visit rates in all hospital types than urban residents. Urban employees preferred to receive hospitalization treatment in tertiary-level hospitals, while those who receive hospitalization treatment in first-level hospitals are more likely to be enrolled in Urban Residents Basic Medical Insurance. Hospitalization expenses and hospitalization compensation ratios of urban employees were also significantly higher than urban residents in all hospital types. CONCLUSIONS: Health care inequality is mainly reflected in the imbalance between hospitalization expenses and hospitalization compensation ratios, as well as inequalities under different medical insurance schemes in healthcare utilization, the choice of hospital types and healthcare cost in socioeconomically underdeveloped regions of China. We should conduct a targeted medical insurance reform for the socioeconomically underdeveloped regions, rather than applying templates of ordinary regions. Further efforts are needed in the future to provide equal health care for every patient.

Chronotype: implications for sleep quality in medical students.

Medical students who suffer from poor sleep quality may be afflicted by distress. While the change of chronotype may improve sleep quality, few studies have focused on this association. The objective of this study is to analyze the effects of chronotype on sleep quality in medical students while controlling for confounding covariate factors. A cross-sectional survey on sleep quality was conducted among 5497 medical students. Sleep quality, chronotype, and lifestyle were measured according to the Pittsburgh Sleep Quality Index, Morningness-eveningness Questionnaire and Health-promoting Lifestyle Profile. Hierarchical logistic regression was conducted to analyze the influence of various factors, especially chronotype effect on sleep quality. Our results showed that the total score of sleep quality in evening-types was 5.43 ± 2.66, which was significantly higher than that in morning-types (3.88 ± 2.20, P < .001). Morning-type students (OR = 0.40, 95%CI = 0.29-0.55) and intermediate-type students (OR = 0.53, 95%CI = 0.41-0.69) had a lower risk of poor sleep quality compared to evening-types. The strongest predictor of sleep quality was chronotype while controlling for covariates (grade, gender, father's educational level, mother's educational level, internet addiction, mood state, midnight snack frequency, and health-promoting lifestyle profile). Based on the results, we believe that sleep quality among evening-type students may be improved by shifting to keep early hours.