Effects of cupric ions on the formation of chlorinated disinfection byproducts from nitrophenol compounds during UV/post-chlorination

Cupric ions (Cu2+) are ubiquitous in surface waters and can influence disinfection byproducts (DBPs) formation in water disinfection processes. This work explored the effects of Cu2+ on chlorinated DBPs (Cl-DBPs) formation from six representative nitrophenol compounds (NCs) during UV irradiation followed by a subsequent chlorination (i.e., UV/post-chlorination), and the results showed Cu2+ enhanced chlorinated halonitromethane (Cl-HNMs) formation from five NCs (besides 2-methyl-3-nitrophenol) and dichloroacetonitrile (DCAN) and trichloromethane (TCM) formation from six NCs. Nevertheless, excessive Cu2+ might reduce Cl-DBPs formation. Increasing UV fluences displayed different influences on total Cl-DBPs formation from different NCs, and increasing chlorine dosages and NCs concentrations enhanced that. Moreover, a relatively low pH (5.8) or high pH (7.8) might control the yields of total Cl-DBPs produced from different NCs. Notably, Cu2+ enhanced Cl-DBPs formation from NCs during UV/post-chlorination mainly through the catalytic effect on nitro-benzoquinone production and the conversion of Cl-DBPs from nitro-benzoquinone. Additionally, Cu2+ could increase the toxicity of total Cl-DBPs produced from five NCs besides 2-methyl-3-nitrophenol. Finally, the impacts of Cu2+ on Cl-DBPs formation and toxicity in real waters were quite different from those in simulated waters. This study is conducive to further understanding how Cu2+ affected Cl-DBPs formation and toxicity in chlorine disinfection processes and controlling Cl-DBPs formation in copper containing water.

Comparative analysis of chlorinated disinfection byproducts formation from 4-nitrophenol and 2-amino-4-nitrophenol during UV/post-chlorination

Nitrophenol compounds (NCs) are widely distributed in water environments and regarded as important precursors of disinfection byproducts (DBPs). Herein, 4-nitrophenol and 2-amino-4-nitrophenol were selected as representative NCs to explore chlorinated DBPs (Cl-DBPs) formation during UV/post-chlorination. Dichloronitromethane (DCNM), trichloronitromethane (TCNM), dichloroacetonitrile (DCAN), and trichloromethane (TCM) were formed from 4-nitrophenol and 2-amino-4-nitrophenol during UV/post-chlorination, and the yields of individual Cl-DBPs from 2-amino-4-nitrophenol were higher than those from 4-nitrophenol. Meantime, increasing chlorine contact time, UV fluence, and free chlorine dose could enhance Cl-DBPs formation, while much higher values of the three factors might decrease the yields of Cl-DBPs. Besides, alkaline pH could decrease the yields of halonitromethane (HNMs) and DCAN but increase the yields of TCM. Also, higher concentrations of 4-nitrophenol and 2-amino-4-nitrophenol would induce more Cl-DBPs formation. Subsequently, the possible formation pathways of DCNM, TCNM, DCAN, and TCM form 4-nitrophenol and 2-amino-4-nitrophenol during UV/post-chlorination were proposed according to transformation products (TPs) and density functional theory (DFT) calculation. Notably, Cl-DBPs formed from 2-amino-4-nitrophenol presented higher toxicity than those from 4-nitrophenol. Among these generated Cl-DBPs, DCAN and TCNM posed higher cytotoxicity and genotoxicity, respectively. Furthermore, 4-nitrophenol, 2-amino-4-nitrophenol, and their TPs exhibited ecotoxicity. Finally, 4-nitrophenol and 2-amino-4-nitrophenol presented a high potential to produce DCNM, TCNM, DCAN, and TCM in actual waters during UV/post-chlorination, but the Cl-DBPs yields were markedly different from those in simulated waters. This work can help better understand Cl-DBPs formation from different NCs during UV/post-chlorination and is conducive to controlling Cl-DBPs formation.

[Colorectal adenocarcinoma with enteroblastic differentiation: a clinicopathological analysis of eight cases]

Objective: To investigate the clinicopathological features of colorectal adenocarcinoma with enteroblastic differentiation (CAED). Methods: Eight cases of CAED diagnosed at the Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, China from January 2017 to August 2023 were collected. The histopathological, immunohistochemical, molecular and prognostic features of 8 CAED cases were analyzed. The relevant studies were also reviewed. Results: Among the eight patients, there were six males and two females, with an average age of 58 years (range: 29-77 years, median age: 61.5 years). Preoperative serum alpha-fetoprotein levels were elevated in five patients (14.0-286.6 μg/L). Four tumors were located in the colon, and four tumors in the rectum. Two patients were clinically staged as advanced stage (stage Ⅳ), and distant metastasis occurred at the initial diagnosis (one case had liver metastasis, and the other had lung, bone and multiple lymph nodes metastases). Six patients were clinically staged as locally-advanced stage (Stage Ⅱ-Ⅲ). Three of them developed distant metastases after surgery (one case had liver metastasis, one case had lung metastasis, and one case had peritoneal metastasis). Additionally, two patients died at 9 months and 24 months after surgery, respectively. The tumors were composed of various proportions of adenocarcinoma components with enteroblastic differentiation (30%-100%) and classical tubular adenocarcinoma components. The component with enteroblastic differentiation exhibited morphology similar to embryonic intestinal epithelium: cuboidal or columnar tumor cells arranged in tubular, papillary, cribriform, or solid nest patterns, with clear cytoplasm. Immunohistochemical studies showed that tumor cells expressed at least one oncofetal protein (SALL4, Glypican-3, and AFP). In addition, focal squamous differentiation was observed in 3 cases (3/8). Compared to the primary tumor, both CAED and squamous differentiation components were increased in the metastatic tumors. Based on the sequencing results of KRAS, NRAS and BRAF of the primary and/or metastatic tumors, 5 cases were wild-type, while KRAS exon 2 (G13D) mutations were identified in 2 cases. Conclusions: CAED is a rare colorectal malignancy with a dismal prognosis. Accurate pathological diagnosis is prognostically valuable. The histological features of enteroblastic differentiation, elevated serum AFP levels, and the expression of oncofetal proteins play an important role in the tumor diagnosis.

An unsupervised water quality anomaly detection method based on a combination of time-frequency analysis and clustering

Anomalies in water quality, which frequently arise due to pollution, constitute a substantial menace to human health. The preservation of public welfare critically entails the timely recognition of abnormal water quality. Conventional techniques for detecting water quality anomalies face obstacles such as the necessity of expert knowledge, limited accuracy in detection, and delays in identification. In this paper, we proposed an original unsupervised technique for identifying water quality anomalies combined with time-frequency analysis and clustering (TCAD). We chose time-frequency analysis because it effectively evaluates water quality changes, generating distinct multi-band signals that reflect different aspects of water quality dynamics. We also proposed a clustering technique which can identify water quality markers and amalgamate data from multi-band signals for accurate anomaly detection. We seek to clarify the reasoning behind our methodology by portraying how time-frequency analysis and clustering address the deficiencies of conventional methods. Our experiments evaluated various indicators of water quality, and the effectiveness of our proposed approach was supported by comparative analyses with commonly used models for detecting anomalies in water quality.

Bromide induced the formation of brominated halonitromethanes from aspartic acid in the UV/chlorine disinfection process

Brominated halonitromethanes (Br-HNMs) are generated in water disinfection processes and present high toxicity to human health. This work used aspartic acid (ASP) as the precursor to reveal that bromide (Br-) induced the production of Br-HNMs in the UV/chlorine disinfection process. Consequently, six Br-HNMs were identified, and their yields presented an increasing and then declining evolution over the reaction time from 0 to 15 min. Also, the total Br-HNMs yield reached the maximum of 251.1 μg L-1 at 5 min and then declined to 107.1 μg L-1. The total Br-HNMs yield increased from 2.40 to 251.14 μg L-1 with the increase of Cl2:Br- ratios from 0.25 to 3.0 by increasing free chlorine dosage with a fixed Br- concentration, and it increased from 207.59 to 251.14 μg L-1 and then decreased to 93.44 μg L-1 with the increase of Cl2:Br- ratio from 1.0 to 3.6 by increasing Br- concentration with a fixed free chlorine dosage. Besides, the total Br-HNMs yield reached the highest value (251.14 μg L-1) at pH 7.0 and the lowest value (74.20 μg L-1) at pH 8.0. Subsequently, the possible reaction mechanism of Br-HNMs generated from ASP was deduced, and the changes in toxicity of Br-HNMs also followed an increasing and then declining trend, closely relating to Br-HNMs yields and Br- utilization. This work explored and illustrated the yields, influence factors, reaction mechanisms, and toxicity of Br-HNMs formed from Br- containing ASP water during UV/chlorine disinfection, which might help to control Br-HNMs formation.

Advanced oxidation of bio-treated incineration leachate by persulfate combined with heat, UV254 nm, and UV365 nm: Kinetics, mechanism, and toxicity

This study compared and evaluated the ultraviolet/persulfate (UV/PS) at 254 or 365 nm and heat/persulfate (heat/PS) systems for advanced treatment of biologically pre-treated incineration leachate. The UV365 nm/PS system with the highest removal reduced chemical oxygen demand (COD) by 81.7%, total organic carbon by 73.8%, NH3-N by 96.8%, total nitrogen by 47.3%, and color by 98.6% within 24 h, separately. Kinetics tests suggested that a highest concentrations of 4.8 × 10-10 M for [SO4·-]ss and 2.8 × 10-11 M for [·OH]ss were reported in UV365/PS and UV254/PS systems, respectively. Characterization of leachate organic matter species revealed that low molecular weight organic matter < 5 kDa was preferentially degraded in three systems. Ketones are relatively easily degraded by both heat/PS and UV/PS systems, whereas esters were the most recalcitrant. Three-dimensional fluorescence analysis revealed > 99% humic acid and fulvic acid removal in all three systems. In practical applications, it is crucial to consider the pH and toxicity of SR-AOPs in the treatment of bio-treated incineration leachate. Furthermore, the ecotoxicity of MBR effluent treated by the heat/PS system and UV365 nm/PS system increased, which was caused by the strong acidity exhibited in the systems. In addition, we found that PS could interfere with 3.3% of the COD's detection. The findings of this study suggest that secondary effects of PS on water quality at high doses should be investigated in future research.

Efficacy and Toxicity of Different Target Volume Delineations of Radiotherapy Based on the Updated RTOG/NRG and EORTC Guidelines in Patients with High Grade Glioma: A Randomized, Controlled Clinical Trial

PURPOSE/OBJECTIVE(S)

Postoperative radiotherapy with concomitant and adjuvant temozolomide (TMZ) is the standard of care for newly diagnosed high grade glioma, but the optimal method for target volume delineations for intensity modulated radiation therapy (IMRT) is still unclear. We hypothesized that compared with the EORTC guidelines, IMRT based on the updated RTOG/NRG guidelines was equally effective, without increasing toxicities for patients with high-grade glioma. The purpose of this randomized phase 2 study was to compare the efficacy and toxicity of IMRT based on different target volume delineations (updated RTOG/NRG versus EORTC guidelines) with concomitant and adjuvant TMZ for patients with high grade glioma.

MATERIALS/METHODS

A total of 302 patients with newly diagnosed high-grade glioma (WHO grade 3-4) were randomly assigned (1:1) to receive postoperative IMRT based on either updated RTOG/NRG guidelines (RTOG/NRG group, n = 151) or EORTC guideline (EORTC group, n = 151), with concomitant and adjuvant TMZ. In the RTOG/NRG group, an initial volume consisting of enhancement, postoperative cavity, plus surrounding edema (or fluid-attenuated inversion recovery [FLAIR] abnormality defined by magnetic resonance imaging [MRI]) and a 2-cm margin received 46 Gy in 23 fractions followed by a boost of 14 Gy in 7 fractions to the area of enhancement plus the cavity and a 2-cm margin. In the EORTC group, a single planning volume was used to deliver 60 Gy in 30 fractions to the area of enhancement and the cavity with a 2-cm margin. The primary end point was overall survival (OS). Secondary end points included progression-free survival (PFS) and toxicities associated with each treatment.

RESULTS

No statistically significant differences were observed between groups for 1-year OS (71.8% for RTOG/NRG group and 69.9% for EORTC group, respectively; P = 0.759) or 1-year PFS (46.7% for RTOG/NRG group and 43.6% for EORTC group, respectively; P = 0.674). Efficacy did not differ by MGMT methylation status. There were no differences in grade 3-4 toxicities (leukopenia, lymphopenia, neutropenia, thrombocytopenia, fatigue, nausea and vomiting) between the two groups. No grade 5 toxicities were observed in both groups. Multivariate analyses showed that tumor MGMT status (methylated vs unmethylated) and WHO grade (grade 3 vs grade 4) were associated with OS and PFS. However, radiation type (RTOG/NRG group vs EORTC), sex, age, and Karnofsky scale did not significantly influence OS or PFS.

CONCLUSION

Compared with EORTC guidelines for postoperative radiotherapy, IMRT based on RTOG/NRG guidelines was equally effective, without increasing toxicities for patients with high-grade glioma. This trial is registered with chictr.org.cn, number ChiCTR2100046667.

Formation, toxicity, and mechanisms of halonitromethanes from poly(diallyl dimethyl ammonium chloride) during UV/monochloramine disinfection in the absence and presence of bromide ion

Bromide ion (Br^-) is known as a prevalent component in water environments, which exhibits significant impacts on halonitromethanes (HNMs) formation. This study was performed to explore and compare the formation, toxicity, and mechanisms of HNMs from poly(diallyl dimethyl ammonium chloride) (PDDACl) in the absence and presence of Br^- in the UV/monochloramine (UV/NH₂Cl) disinfection process. The results showed that chlorinated HNMs were found in the absence of Br^-, while brominated (chlorinated) HNMs and brominated HNMs were found in the presence of Br^-. Furthermore, the peaks of total HNMs were promoted by 2.0 and 2.4 times, respectively when 1.0 and 2.0 mg L^-1 Br^- were added. Also, the peaks of total HNMs were enhanced with the increase of the NH₂Cl dosage, which were reduced with the increase of pH. It should be noted that Br^- induced higher toxicity of HNMs, and the cytotoxicity and genotoxicity of HNMs with the addition of 2.0 mg L^-1 Br^- were 78.0 and 3.7 times those without the addition of Br^-, respectively. Meanwhile, both the reaction mechanisms of HNMs produced from PDDACl were speculated in the absence and presence of Br^-. Finally, different HNMs species and yields were discovered in these two real water samples compared to those in simulated waters. These findings of this work will be conducive to understanding the significance of Br^- affecting HNMs formation and toxicity in the disinfection process.

Selective degradation of organic micropollutants by activation of peroxymonosulfate by Se@NC: Role of Se doping and nonradical pathway mechanism

In this study, Se@NC-x decorated with Se was successfully prepared via two-step calcination with zeolitic imidazole framework (ZIF) as a precursor. Mechanistic studies show that PMS would be adsorbed onto the surface of Se@NC-900 to form an active complex (Se@NC-900/PMS*), and the active Se@NC-900/PMS* could oxidize phenol by the rapid decomposition of PMS. Specifically, electrons are extracted by Se@NC-900/PMS* and then transferred to the surface of Se@NC-900, which can trigger the degradation of phenol. Notably, it is found that the local charge redistribution caused by the doping of Se can activate the catalytic potential of the intrinsically inert carbon skeleton through density flooding theory (DFT) calculations. The XLogP, ΔE, VIP, and E_{LUMO (Se@NC/PMS)-HOMO (pollutants)} and degradation rate constants of different micropollutants were correlated well linearly. This indicates that the Se@NC-900/PMS system has a great selectivity for the degradation of pollutants. Overall, these findings not only illustrate the role of Se in tuning the electronic structure of Se@NC-x to enhance the activation of PMS, but also bridge the gap in our knowledge about the physicochemical properties and degradation performance of Se@NC catalysts.

Mapping internal temperatures during high-rate battery applications

Electric vehicles demand high charge and discharge rates creating potentially dangerous temperature rises. Lithium-ion cells are sealed during their manufacture, making internal temperatures challenging to probe1. Tracking current collector expansion using X-ray diffraction (XRD) permits non-destructive internal temperature measurements2; however, cylindrical cells are known to experience complex internal strain3,4. Here, we characterize the state of charge, mechanical strain and temperature within lithium-ion 18650 cells operated at high rates (above 3C) by means of two advanced synchrotron XRD methods: first, as entire cross-sectional temperature maps during open-circuit cooling and second, single-point temperatures during charge-discharge cycling. We observed that a 20-minute discharge on an energy-optimized cell (3.5 Ah) resulted in internal temperatures above 70 °C, whereas a faster 12-minute discharge on a power-optimized cell (1.5 Ah) resulted in substantially lower temperatures (below 50 °C). However, when comparing the two cells under the same electrical current, the peak temperatures were similar, for example, a 6 A discharge resulted in 40 °C peak temperatures for both cell types. We observe that the operando temperature rise is due to heat accumulation, strongly influenced by the charging protocol, for example, constant current and/or constant voltage; mechanisms that worsen with cycling because degradation increases the cell resistance. Design mitigations for temperature-related battery issues should now be explored using this new methodology to provide opportunities for improved thermal management during high-rate electric vehicle applications.

Diabetes, Edentulism, and Cognitive Decline: A 12-Year Prospective Analysis

Diabetes mellitus (DM) is a recognized risk factor for dementia, and increasing evidence shows that tooth loss is associated with cognitive impairment and dementia. However, the effect of the co-occurrence of DM and edentulism on cognitive decline is understudied. This 12-y cohort study aimed to assess the effect of the co-occurrence of DM and edentulism on cognitive decline and examine whether the effect differs by age group. Data were drawn from the 2006 to 2018 Health and Retirement Study. The study sample included 5,440 older adults aged 65 to 74 y, 3,300 aged 75 to 84 y, and 1,208 aged 85 y or older. Linear mixed-effect regression was employed to model the rates of cognitive decline stratified by age cohorts. Compared with their counterparts with neither DM nor edentulism at baseline, older adults aged 65 to 74 y (β = -1.12; 95% confidence interval [CI], -1.56 to -0.65; P < 0.001) and those aged 75 to 84 y with both conditions (β = -1.35; 95% CI, -2.09 to -0.61; P < 0.001) had a worse cognitive function. For the rate of cognitive decline, compared to those with neither condition from the same age cohort, older adults aged 65 to 74 y with both conditions declined at a higher rate (β = -0.15; 95% CI, -0.20 to -0.10; P < 0.001). Having DM alone led to an accelerated cognitive decline in older adults aged 65 to 74 y (β = -0.09; 95% CI, -0.13 to -0.05; P < 0.001); having edentulism alone led to an accelerated decline in older adults aged 65 to 74 y (β = -0.13; 95% CI, -0.17 to -0.08; P < 0.001) and older adults aged 75 to 84 (β = -0.10; 95% CI, -0.17 to -0.03; P < 0.01). Our study finds the co-occurrence of DM and edentulism led to a worse cognitive function and a faster cognitive decline in older adults aged 65 to 74 y.

Analysis of degradation kinetic modeling and mechanism of chlorinated-halonitromethanes under UV/monochloramine treatment

Chlorinated-halonitromethanes (Cl-HNMs) including chloronitromethane (CNM), dichloronitromethane (DCNM), and trichloronitromethane (TCNM) are nitrogenous disinfection by-products, which have high cytotoxicity and genotoxicity to human. This study aimed to investigate the degradation kinetic modeling and mechanism of Cl-HNMs under monochloramine activated by ultraviolet of 254 nm (UV/NH₂Cl) treatment. The first-principle kinetic model of UV/NH₂Cl process was developed to simulate Cl-HNMs degradation. Of note, the second-order rate constants of Cl-HNMs reacting with HO• (∼10⁸ M^-1 s^-1), Cl• (k_{Cl•,CNM or DCNM} = ∼10¹⁰ M^-1 s^-1, k_Cl•,TCNM = ∼10² M^-1 s^-1), Cl₂•^- (k_{Cl•,CNM or DCNM} = ∼10⁹ M^-1 s^-1, k_Cl•,TCNM = ∼10¹ M^-1 s^-1), ClO• (∼10⁵-10⁶ M^-1 s^-1) and CO₃•^- (∼10⁶-10⁷ M^-1 s^-1) were obtained by the first-principle kinetic model. Overall, Cl-HNMs degradation under UV/NH₂Cl treatment was successfully predicted by the kinetic model under various conditions. It was found that UV (>60%) was dominant in Cl-HNMs degradation, followed by HO• (3.8%-24.5%), reactive chlorine species (RCS, 0.9%-28.8%) and CO₃•^- (0-26.1%). Among the contributions of RCS, Cl• and Cl₂•^- were main radicals in the degradation of CNM and DCNM, while ClO• was responsible for the abatement of TCNM. The minimum EE/O values under UV/NH₂Cl treatment were approximately 30% lower than those under UV treatment. Finally, the possible degradation pathways were proposed, including hemolytic/heterolytic cleavage of Cl-HNMs by UV irradiation, hydrogen abstraction/electron transfer of CNM and DCNM and adduct reaction of TCNM by free radicals. This study based on the kinetic model is beneficial to predict and control the concentrations of Cl-HNMs under UV/NH₂Cl treatment.

Characteristics of leachate from refuse transfer stations in rural China

The properties of leachate from refuse transfer stations (RTSs) in rural China were indefinite. In this study, a total of 14 leachate samples from RTSs in nine provinces of China were characterized for their pH, electric conductivity, chromaticity, concentration of organic substances, nitrogen distribution, volatile organic compounds (VOCs), organic phosphorous pesticide, and heavy metals. The structural composition of fluorescent dissolved organic matter (FDOM) was also determined. To evaluate the leachate pollution potential in this study, a leachate pollution index was derived and used. Chromium (Cr) was the most polluting heavy metal present in rural leachate. Ethanol and ethyl acetate were the most frequently detected VOCs at high concentrations. Three-dimensional fluorescence excitation-emission matrix spectra were used to characterize the FDOM. Three components, tryptophan (C₁), tyrosine-like (C₂), and humic acid- and fulvic acid-like (C₃) substances, were identified from all 14 samples. Tryptophan was the major component of FDOM and present in 45.7% of the samples by calculating the fluorescence intensity percentage, on average. Pearson correlations revealed that the fluorescence intensity of C₁ and C₃ was strongly related to soluble chemical oxygen demand and dissolved oxygen carbon, while C₂ had significant positive correlations with ammonia nitrogen and total phosphorus of the solid waste. This study provided detailed data and findings that could serve as a preliminary basis for broadening options for the treatment and management of leachate from rural RTSs in China.

A rare case of hepatic sinusoidal occlusive syndrome in a premature neonate with trisomy 21

Trisomy 21 (Down Syndrome) may lead to multiple hematological and hepatobiliary manifestations including the development of transient abnormal myelopoiesis. While many cases resolve, transient abnormal myelopoiesis may lead to significant morbidity and mortality in a small percentage of patients. This condition may present a diagnostic challenge for physicians and currently there is only limited data on effective treatments, particularly with low blast percent transient abnormal myelopoiesis. We present a case of a neonate with trisomy 21 and multiple congenital anomalies who consequently developed hepatic failure with evidence of non-cirrhotic portal hypertension likely due to transient abnormal myelopoiesis. This clinical scenario highlights the need for additional evaluation for transient abnormal myelopoiesis associated hepatic disorder and possibly hepatic sinusoidal occlusive syndrome among trisomy 21 neonates particularly with low blast percentage.

The key role of crystal boron in enhanced degradation of refractory contaminants using heterogeneous Fe3+/SPC system

An origin Fenton-like system was discussed for the abatement of refractory contaminants. Sodium percarbonate (SPC) was utilized as the source of H2O2 and crystal boron (C-boron) was applied to enhance the activation of H2O2. Under the conditions of 0.50 mM Fe3+, 0.34 mM SPC, and heterogeneous catalysis using 100 mg L-1 C-boron, four target pollutants, at the initial concentrations of 20 μM, could be efficiently degraded by the Fenton-like system, with a degradation rate within 20 min up to 81.1% (aspirin, ASA), 92.8% (nitrobenzene, NB), 94.7% (flunixin meglumine, FMME), and 94.3% (benzoic acid, BA) respectively and total organic carbon removal up to 25.0%. The increase of Fe2+ concentration indicated that the conversion of Fe2+/Fe3+ was remarkably promoted by C-boron. Degradation reactions at acidic pH were comparatively fast, with pH-dependent kobs of 9.9 × 10-2 min-1 (ASA), 1.5 × 10-1 min-1 (NB), 1.7 × 10-1 min-1 (FMME), and 1.9 × 10-1 min-1 (BA), whereas those at neutral and alkaline pH were slower. Furthermore, reactive oxygen species including ·OH, 1O2, and O2·- were identified by in-situ electron paramagnetic resonance tests. The contribution ratios of ·OH turned out to be about 71.3-86.7% for the decomposition of four contaminants. The elimination of natural organic matter and the performance of material recycling highlighted the potential for its application in water treatment. The inhibition rate of Chlorella pyrenoidosa reached 211.9% in the C-boron/Fe3+/SPC system. The relatively high algae toxicity limited its application scope, which requires additional research to resolve.

An improved graph convolutional network with feature and temporal attention for multivariate water quality prediction

The analysis and prediction of water quality are of great significance to water quality management and pollution control. In general, current water quality prediction methods are often aimed at single indicator, while the prediction effect is not ideal for multivariate water quality data. At the same time, there may be some correlations between multiple indicators which the conventional prediction models cannot capture. To resolve these problems, this paper proposes a deep learning model: Graph Convolutional Network with Feature and Temporal Attention (FTGCN), realizing the prediction for multivariable water quality data. Firstly, a feature attention mechanism based on multi-head self-attention is designed to capture the potential correlations between water indicators. Then, a temporal prediction module including temporal convolution and bidirectional GRU with a temporal attention mechanism is designed to deal with temporal dependencies of time series. Moreover, an adaptive graph learning mechanism is introduced to extract hidden associations between water quality indicators. An auto-regression module is also added to solve the disadvantage of non-linear nature of neural networks. Finally, an evolutionary algorithm is adopted to optimize the parameters of the proposed model. Our model is applied on four real-world water quality datasets, compared with other models for multivariate time series forecasting. Experimental results demonstrate that the proposed model has a better performance in water quality prediction than others by two indices.

1465. A Randomized Double-Blinded Placebo-Controlled Study to Determine Efficacy of Immunoglobulin Therapy to Treat BK Viremia in Renal Transplant Recipients

Background

BK viremia in renal transplant recipients increases risk of BK virus-associated nephropathy (BKVAN), posing a threat to allograft function. Up to 30% of all renal transplant recipients develop BK viremia and 1-10% will develop BKVAN. With no effective antiviral, the mainstay of therapy to prevent BKVAN is immunosuppression reduction (IR). Case series showed potential efficacy of using intravenous immunoglobulins (IVIG) to treat BK viremia. However, a randomized placebo-controlled study is needed.

Methods

A multicenter prospective double-blinded randomized placebo-controlled proof-of-concept study was conducted at three transplant institutions. 14 adult renal transplant recipients diagnosed with BK viremia were randomized (1:1) to receive IVIG and IR versus placebo and IR and were followed for 12 months, with the primary endpoint defined as resolution of BK viremia by month 3. Samples were collected at 1, 2, 3, 6, and 12 months for viral load quantification and immunological assays.

Results

At enrollment, clinical characteristics of the IVIG group (n = 5) were similar to the control group (n = 9), except that a larger number of participants in the control group had delayed graft function (0% vs. 77.8%, p = 0.02) and a higher baseline BK viral load (11300 vs 99300 copies/mL, p = 0.04). At 3 months, 2 out of 5 patients in the treatment group and 4 out of 9 patients in the control group cleared their viremia (40% vs 44.4%, RR 0.89, 95% CI 0.21 – 3.35, p &gt; 0.99). Patients who received IVIG and IR had reduction in viral load at 6 months only (11300 vs 141 copies/mL, p = 0.008). Those who received IR alone had continued reduction in viral load starting at 2 months (99300 vs 4700, 1542, 906, 278 copies/mL; p &lt; 0.05). No participant progressed to BKVAN. Immunological profiles of each participant will be correlated to the viral load.

Serum BK viral loads were higher in the placebo group than the IVIG group at enrollment, but not significantly different between the two groups at any of the follow-up time points. The dotted line represents threshold of viremia clearance at less than 1000 copies/mL. * p = 0.04. Bar – median (Mann-Whitney between group comparisons).

Median serum BK viral loads of the IVIG group decreased at the 6 months follow-up time point. The dotted line represents threshold of viremia clearance at less than 1000 copies/mL. ** p = 0.008 (Mann-Whitney comparing enrollment to each follow-up time point).

Median serum BK viral loads of the placebo group continued to decrease at each follow-up time point. The dotted line represents threshold of viremia clearance at less than 1000 copies/mL. * p = 0.04; ** p = 0.006; *** p = 0.0008, 0.0003 (Mann-Whitney comparing enrollment to each follow-up time point).

Conclusion

This proof-of-concept study illustrates that a clinical trial of IVIG versus placebo for the treatment of BK viremia in renal transplant recipients is feasible. IVIG may not be more effective than IR alone; its immunosuppressive effect may even limit BK clearance. A larger sample is needed to attenuate baseline differences between groups and to provide a higher level of evidence on IVIG therapy in BK viremia.

Disclosures

All Authors: No reported disclosures.

[The study of the correlation between age and the pathogenic factors of primary glaucoma: a review]

Age is an important risk factor for primary glaucoma. While the specific mechanism of primary glaucoma remained unclear, the change of ocular anatomy, the disturbance of aqueous humor balance, the change of ocular biomechanics and the disorder of neurometabolism contribute to the occurrence and development of primary glaucoma. This paper reviewes the latest studies on the correlation between age and the risk factors of glaucoma in the above four aspects, so as to provide some references for the in-depth discussion of the pathophysiology of primary glaucoma, and advancement on diagnosis, treatment and research of primary glaucoma.

Effects of bromide ion on the formation and toxicity alteration of halonitromethanes from nitrate containing humic acid water during UV/chlor(am)ine disinfection

UV/chlor(am)ine are efficient for achieving multiple-barrier disinfection and maintaining residuals, while bromide (Br^-) has notable impacts on the formation and toxicity of halonitromethanes (HNMs) during UV/chlor(am)ine disinfection. This study investigated the effects of Br^- on HNMs formation and toxicity alteration during UV/chlor(am)ine disinfection of nitrate containing humic acid (HA) water. Results reveal that the maximum concentration of HNMs during UV/chlorine disinfection was 12.03 μg L^-1 with 0.2 mg L^-1 Br^-, which was 22.5% higher than that without Br^-, and the predominant species of HNMs were converted from trichloronitromethane (TCNM) to dibromonitromethane (DBNM) and tribromonitromethane (TBNM). However, the maximum concentration of HNMs during UV/chloramine disinfection was 3.69 μg L^-1 with 0.2 mg L^-1 Br^-, which was increased by 26.0% than that without Br^-, and the predominant species of HNMs were converted from dichloronitromethane (DCNM) to bromochloronitromethane (BCNM) and DBNM. Notably, the HNMs species and yields during UV/chloramine disinfection were less than those during UV/chlorine disinfection, primarily due to the higher concentrations of HO· and reactive chlorine/bromine species in UV/chlorine. Also, in the ranges of the Br^-:Cl₂ molar ratio from 0 to 0.32 and pH from 6.0 to 8.0, the Br^-:Cl₂ molar ratio of 0.16 and acidic pH contributed to the HNMs formation during UV/chlorine disinfection, and a high Br^-:Cl₂ molar ratio and neutral pH contributed to the HNMs formation during UV/chloramine disinfection. Note that the incorporation of Br^- significantly improved the calculated cytotoxicity (CTI) and genotoxicity (GTI) of HNMs formed, and the calculated CTI and GTI of HNMs formed during UV/chloramine disinfection were 28.19 and 48.90% of those during UV/chlorine disinfection. Based on the diversity of nitrogen sources, the possible formation pathways of HNMs from nitrate containing HA water were proposed during UV/chlor(am)ine disinfection in the presence of Br^-. Results of this study indicated that UV/chloramine can reduce the formation and toxicity of HNMs efficiently.

A 10-year cohort on prognostic outcomes in patients presenting with acute myocardial infarction complicated by cardiogenic shock and/or cardiac arrest

Background

Cardiogenic shock (CS) and cardiac arrest (CA) complicating acute myocardial infarction (AMI) portend unfavourable outcomes. This study examined the prognosis of patients presenting with AMI complicated by CS and/or CA.

Methods

Consecutive patients presented with AMI to a percutaneous coronary intervention-capable tertiary institution between 2011 and 2021 were studied. Patients were stratified based on the presence or absence of CS (CS+ or CS−) and CA (CA+ or CA−). The primary outcome was 30-day cardiovascular-related mortality. Subgroup analyses based on AMI-type and sex were conducted. Kaplan-Meier curves for cardiovascular-related mortality based on the AMI-type and sex were constructed.

Results

The study included 11,608 AMI patients, 283 of whom had CS+/CA+, 1,068 had CS+/CA−, 54 had CS−/CA+ and 10,203 had CS−/CA−. Cardiovascular-related mortality was significantly higher for CS+/CA+ (57.6%), followed by CS+/CA− (41.6%), CS−/CA+ (20.4%) and CS−/CA− (2.4%). Kaplan-Meier curves demonstrated CS+/CA+ group had the highest mortality (HR=36.26; 95% CI: 29.71–44.25, p&lt;0.001), followed by CS+/CA− (HR=21.59; 95% CI: 18.47–25.24, p&lt;0.001) and CS−/CA+ (HR=9.18; 95% CI: 5.02–16.80, p&lt;0.001), with CS−/CA− as the reference. Those with NSTEMI had consistently higher cardiovascular-related mortality rates than their STEMI counterparts for all groups, apart from the CS+/CA+ group. The sex-specific analysis demonstrated that the survival curves for females with CS+/CA+, CS+/CA− and CS−/CA+ converged, whilst the survival curves for males diverged over time. The multivariable Cox regression revealed the presence of CS and CA are independent predictors of cardiovascular-related mortality, but not NSTEMI, when adjusted for age, gender, diabetes, left ventricular ejection fraction, chronic renal failure, and culprit vessel.

Conclusions

AMI associated with CA and CS portends the least favourable survival, followed by those with CS or CA alone. Excess mortality was observed in the traditionally perceived lower-risk groups, particularly in women. This calls for increased awareness amongst clinicians when managing this subset of high-risk patients.

Funding Acknowledgement

Type of funding sources: None.

Biochar-seeded struvite precipitation for simultaneous nutrient recovery and chemical oxygen demand removal in leachate: From laboratory to pilot scale

Refuse transfer station (RTS) leachate treatment call for efficient methods to increase nutrient recovery (NH4+−N and PO43−−P) and chemical oxygen demand (COD) removal. In this study, the effects of various operational factors (seeding dose, pH, initial NH4+-N concentration, and reaction time) on biochar-seeded struvite precipitation were investigated at laboratory and pilot scales. Mealworm frass biochar (MFB) and corn stover biochar (CSB) were used as seeding materials to compare with traditional seed struvite. The maximum NH4+−N and PO43−−P recover efficiency of the MFB-seeded process reached 85.4 and 97.5%, higher than non-seeded (78.5 and 88.0%) and CSB-seeded (80.5 and 92.0%) processes and close to the struvite-seeded (84.5 and 95.1%) process. The MFB-seeded process also exhibited higher COD removal capacity (46.4%) compared to CSB-seeded (35.9%) and struvite-seeded (31.2%) processes and increased the average particle size of the struvite product from 33.7 to 70.2 μm for better sustained release. XRD, FT-IR, and SEM confirmed the orthorhombic crystal structure with organic matter attached to the struvite product. A pilot-scale test was further carried out in a custom-designed stirred tank reactor (20 L). In the pilot-scale test, the MFB-seeded process still spectacularly recovered 77.9% of NH4+−N and 96.1% of PO43−−P with 42.1% COD removal, which was slightly lower than the laboratory test due to insufficient and uniform agitation. On the whole, MFB-seeded struvite precipitation is considered to be a promising pretreatment method for rural RTS leachate.

[Association of DNA methylation of IFNG gene with no/low response to hepatitis B vaccine in children]

Objective: To explore the association of DNA methylation with immune response to hepatitis B (HepB) vaccine in Han nationality children from Guangxi province. Methods: A total of 263 children aged 8-9 months who had completed HepB immunization program were recruited from three hospitals in Guangxi province by using unmatched case-control method. Children with the HepB surface antibody concentration(Anti-HBs)<100 mIU/ml was set as the case group and ≥100 mIU/ml as the control group. Multiplex PCR and heavy sulfite sequencing were used to treat the samples. Illumina platform was used for high-throughput DNA methylation sequencing of IFNG gene target regions and CpG sites. Unconditional logistic regression was used to analyze the association between cytosine-phospho-guanosine DNA methylation at 18 loci of IFNG gene and HepB immune response level. Results: There were 104 children in the case group and 159 in the control group. The median (Q₁, Q₃) level of anti-HBs in two groups were 62.34 (30.06, 98.88) mIU/ml and 1 089.10 (710.35, 1 233.45) mIU/ml. The methylation levels of IFNG_1 gene 44 and 93 locus in the case group were higher than those in the control group (P<0.05). The unconditional logistic regression model showed that the DNA methylation level of IFNG_1 gene at 44 (OR=1.18, 95%CI: 1.03-1.35) and 93 (OR=1.21, 95%CI: 1.07-1.38) locus was associated with the HepB response level. Conclusion: The changes of DNA methylation at locus 44 and 93 of IFNG_1 gene may be relevant factors affecting the response level of HepB in Han nationality children from Guangxi province.

P-524 Bi-allelic CFAP61 variants cause male infertility in humans and mice with severe oligoasthenoteratozoospermia

Study question

Are mutations in cilia and flagella-associated protein 61 (CFAP61) associated with human male infertility?

Summary answer

Bi-allelic variants ([NM_015585.4: c.1654C&gt;T (p.R552C) and c.2911G&gt;A (p.D971N), c.144-2A&gt;G and c.1666G&gt;A (p.G556R)] in CFAP61 were identified as contributory genetics factor in severe oligoasthenoteratozoospermia (OAT).

What is known already

Cfap61 knockout mice were infertile due to multiple morphological abnormalities of the sperm flagella (MMAF). However, so far there is no direct evidence that mutations of CFAP61 cause OAT and male infertility.

Study design, size, duration

Variant screening was performed by whole-exome sequencing (WES) from 325 infertile patients with OAT and 392 fertile individuals. A knockout mouse model was generate to confirm the candidate disease-causing gene, intracytoplasmic sperm injection (ICSI) was used to evaluate the efficiency of clinical treatment.

Participants/materials, setting, methods

A total 325 OAT-affected patients and 392 men with normal fertility were recruited from China. WES was performed, followed by Sanger sequencing validation. In silico bioinformatics predictions and in vitro functional analyses were performed to evaluate the impacts of candidate disease-causing variants. Hematoxylin and eosin (H&E) staining, electron microscopy, and immunofluorescence assays were performed to evaluate the sperm morphology. Two OAT-affected men with CFAP61 variants were treated by ICSI, and pregnancy outcomes were followed.

Main results and the role of chance

We identified bi-allelic CFAP61 variants [NM_015585.4: c.1654C&gt;T (p.R552C) and c.2911G&gt;A (p.D971N), c.144-2A&gt;G and c.1666G&gt;A (p.G556R)] in two (0.62%) of the 325 OAT-affected men. In silico bioinformatics analysis predicted that all four variants were deleterious, and in vitro functional analysis confirmed the deleterious effects of the mutants. Notably, H&E staining and electron microscopy analyses of the spermatozoa revealed multiple morphological abnormalities of sperm flagella, the absence of central pair microtubules, and mitochondrial sheath malformation in sperm flagella from man with CFAP61 variants. Further immunofluorescence assays revealed markedly reduced CFAP61 staining in the sperm flagella. In addition, Cfap61-deficient mice showed the OAT phenotype, suggesting that loss of function of CFAP61 was the cause of OAT. Two individuals accepted ICSI therapy using their own ejaculated sperm, and one of them succeeded in fathering a healthy baby.

Limitations, reasons for caution

Limitations include the lack of in vivo data from the one of patients, and the exact molecular mechanism should be further investigated.

Wider implications of the findings

Our findings indicate that CFAP61 is essential for spermatogenesis and that bi-allelic CFAP61 variants lead to OAT and male infertility in humans and mice. In addition, our results show that ICSI treatment can be recommended for CFAP61-related OAT.

Trial registration number

not applicable

A selective kernel-based cycle-consistent generative adversarial network for unpaired low-dose CT denoising

Low-dose computed tomography (LDCT) denoising is an indispensable procedure in medical imaging field, which not only improve the image quality, but can mitigate the potential hazard to patients caused by routine-doses. Despite the improvement in performance of Cycle-consistent adversarial network (CycleGAN) due to the well-paired CT images shortage, there is still needs for further reducing image noise while retaining detailed features. Inspired by residual encoder-decoder convolutional neural network (RED-CNN) and U-Net, we proposed a novel unsupervised model using CycleGAN for low-dose CT imaging, which injects two-sided network into Selective Kernel Networks (SK-NET) to adaptively select features, and uses patchGAN discriminator to generate CT images with more detailed maintenance, aided by added perceptual loss. Based on patch-based training, the experimental results demonstrated that the proposed SKFCycleGAN outperforms competing methods in both clinical dataset and Mayo dataset. The main advantages of our method lie in noise suppression and edge preservation.

Formation and transformation of halonitromethanes from dimethylamine in the presence of bromide during the UV/chlorine disinfection

Halonitromethanes (HNMs) is a typical class of nitrogenous disinfection byproducts with high toxicity. The effect of Br^- on the formation and transformation of HNMs from dimethylamine (DMA) during the ultraviolet (UV)/chlorine disinfection has been investigated in current study. Results reveal that only chloronitromethane, dichloronitromethane and trichloronitromethane (TCNM) could be found during the UV/chlorine disinfection. Whereas in the presence of Br^-, nine species of HNMs could be observed simultaneously. When Br^- concentration increased from 0 to 15.0 mg L^-1, the predominant species of HNMs were gradually changed from TCNM to dibromonitromethane and tribromonitromethane, which contributed to 23.37% and 31.07% of total HNMs concentration at 15 mg L^-1 Br^-, respectively. The presence of Br^- not only shifted the chlorinated-HNMs (Cl-HNMs) towards brominated-HNMs (Br-HNMs) but also affected the dominant species and total concentration of HNMs. When Br^- concentration was 4.0 mg L^-1, the formation of HNMs decreased with the increase of pH from 6.0 to 8.0 and increased with the increase of free chlorine and DMA. When free chlorine concentration rose from 0.25 to 1.1 mmol L^-1, Br-HNMs were shifted to Br(Cl)-HNMs and then to Cl-HNMs. According to the findings, possible formation and transformation pathways of HNMs from DMA were proposed in the presence of Br^- during the UV/chlorine disinfection. Finally, it was proved that the effect of Br^- on the trend of HNMs in real water was similar to that in deionized water, but higher HNMs concentrations and delayed peak time were observed in real water. This study can provide the scientific evidence and fundamental data for the applications of UV/chlorine disinfection in the treatment of water containing Br^-.

Feasibility of micropollutants removal by solar-activated persulfate: Reactive oxygen species formation and influence on DBPs

As a natural source of visible light and a type of renewable energy, solar energy is extensively used in the field of photochemistry. In this study, solar was employed to activate persulfate (PS) to degrade typical micropollutants. The removal kinetics of aspirin (ASA) and flunixin meglumine (FMME) in the solar/PS system were well fitted by pseudo-first-order models (R² > 0.99). In the system containing 1.0 mM PS activated by solar irradiation at a fluence of 1.14 × 10^-4 E·m^-2·s^-1, 72.6% and 97.5% of ASA and FMME were degraded, and the corresponding kinetic constants were 6.8-9.8 × 10^-2 and 1.6-9.8 × 10^-1 min^-1, respectively. Qualitative and quantitative analyses of the reactive oxygen species (ROS) indicated that sulfate radical (SO₄^·-) played a major role in degradation, with the maximum contributions of 77.7% and 88.8% for the degradation of ASA and FMME, whereas the maximum contributions of hydroxyl radical (·OH) were only 11.6% and 6.5%, respectively. The contributions of singlet oxygen (¹O₂) were less than 15% at pH 5.5, but increased to 25.6% and 45.5% at pH 8.5, respectively. Solar/PS pre-oxidation increased disinfection byproducts (DBPs) (95.8% for trihalomethanes (THMs) and 47.9% for haloacetic acids (HAAs) at pH 7.0) after chlorination in deionized water, and an opposite trend was found in systems coexisting with natural organic matter (NOM). Residual PS after oxidation resulted in a high aquatic toxicity, with an inhibition rate of 18.70% to algae growth. Economic analysis showed that the electrical energy per order values of the system ranged from 23.5 to 86.5 kWh·m^-3·order^-1, indicating that the solar/PS system shows promise for practical applications.

To evaluate if ultrasound gel or water-based media affects ER/PR staining patterns on breast core biopsy specimens

Introduction/Objective

IHC staining for biomarkers ER, PR and HER-2 (CerB2) forms an essential component of breast cancer management and prognostication. Staining for these biomarkers is dependent on optimal fixation of the specimen in formalin. Scoring systems employed for ER and PR grade the intensity of the nuclear staining along with the percentage of the cells stained. This study aims to determine if ultrasound gel used during core biopsy as opposed to water affects immunohistochemical staining of biomarkers ER and PR in breast cancer specimens, following an observation that ultrasound gel assisted core biopsies may affect ER/PR nuclear staining scores through excess cytoplasmic staining.

Methods/Case Report

We included a total of 50 cases of invasive breast carcinoma diagnosed on core biopsy from KK Women’s and Children’s Hospital from February 2019 to July 2020. These included 25 cases with gel and 25 cases with water applied to the breast prior to the procedure. All biopsies were optimally fixed in formalin as per recommended latest ASCO/CAP guidelines. The control group included 25 resection cases of invasive breast carcinoma which had neither gel nor water and had been optimally fixed in formalin. Cytoplasmic staining for ER and PR was graded as being present or absent and was compared against the excision specimens (control group) to determine if using the gel was significant in producing cytoplasmic staining. The data was analyzed on SPSS using multiple logistic regression.

Results (if a Case Study enter NA)

Using the gel appeared to be statistically significant in producing cytoplasmic staining for ER (p=0.042) as opposed to using water (p=0.274). For PR staining, both gel-based (p=0.250) and water-based media (p=0.286) were not statistically significant in causing cytoplasmic staining.

Conclusion

The preliminary findings of this small retrospective case-control study gives an insight that gel-based media may have a role in causing cytoplasmic staining for oestrogen receptor in breast cancer biopsy specimens which may interfere with accurate scoring and impact results of external quality assurance schemes to which laboratories subscribe to. However the study is limited by the small sample size and exclusion of any other pre- analytical factors like needle bore or number of cores taken which may have had an impact on the staining.

889 Management of Paediatric Appendicitis During the First Wave of COVID-19: Comparison of Our Centre to National Practice

Aim

Our hospital took part in a multi-centre prospective cohort study “the CASCADE study” investigating the management and early outcomes of children with appendicitis in the UK and Ireland during the first wave of the COVID-19 pandemic (1). The aim of this study was to compare our local outcomes to those at a national level.

Method

This was a prospective cohort study with data collected from 01/04/2020 to 31/05/2020. Primary outcome was treatment strategy for appendicitis. Secondary outcomes were duration of symptoms, ultrasound findings, rate of simple vs perforated appendicitis and complications.

Results

Overall, only a minority (2/24 [8%]) were initially treated non-operatively, with both proceeding to appendicectomy due to pain. Remaining children (24/26 [92%]) were primarily treated with appendicectomy. All were performed laparoscopically with no conversions to open. Ultrasound was performed for most children (23/26 [88%]) which accurately identified appendicitis (22/23 [95%]) and negative appendicectomy rate of zero. Rates of complex appendicitis were not higher than expected (10/26 [38%]) but had a longer duration of symptoms (median 66.0h [IQR21.5] vs 30.0h [27.2], p = 0.008) and more complications (4 vs 1). Post-operative length of stay was significantly shorter for simple appendicitis than complicated (median 1.0d [IQR0.0] vs 4.0 [IQR2.8], p = 0.001).

Conclusions

Practice in our centre contrasts with the CASCADE study's National findings where 39% were treated non-operatively, only 48% of appendicectomies were performed laparoscopically, only 53% of children had diagnostic imaging and negative appendicectomy rate was 4.5%. Rates of complications for simple and complex appendicitis were similar, but post-operative length of stay shorter in our centre.

[Japan narrow-band imaging Expert Team type 2B colorectal cancer: consistency between endoscopic prediction and pathological diagnosis]

OBJECTIVE

To explore the potential factors that affect the accuracy of endoscopic diagnosis for Japan narrow-band imaging (NBI) Expert Team (JNET) type 2B colorectal lesions.

OBJECTIVE

The clinical data were collected from 261 patients with JNET type 2B colorectal lesions diagnosed in Nanfang Hospital between July, 2018 and July, 2021. We analyzed the macroscopic type, size, location or pit pattern classification of the lesions for their potential influence of the diagnostic accuracy of JNET type 2B lesions.

OBJECTIVE

The 261 lesions included 91 low-grade intramucosal neoplasia lesions (34.9%), 132 high-grade intramucosal neoplasia lesions (50.6%), 13 submucosal invasive cancer lesions (5.0%), and 25 deep submucosal invasive cancer lesions (9.6%). The coincidence rate between endoscopic prediction and pathological diagnosis of these lesions was 55.6% (145/ 261). The macroscopic type and size of the lesions were significantly associated with the diagnostic accuracy of JNET type 2B lesions (P < 0.001). There was a significant difference in the diagnostic accuracy among the lesions with different pit pattern types (P < 0.001).

OBJECTIVE

Both the macroscopic type and size affect the accuracy of endoscopic diagnosis of JNET type 2B colorectal lesions. JNET classification combined with pit pattern types can have better accuracy in predicting the pathological diagnosis of these lesions.

[Gastric SWI/SNF-complex deficient undifferentiated/rhabdoid carcinoma: a clinicopathological study]

Objective: To investigate the clinicopathological features, immunohistochemical characteristics, differential diagnosis and prognosis of gastric SWI/SNF-complex deficient undifferentiated/rhabdoid carcinomas. Methods: Two cases of gastric SWI/SNF-complex deficient undifferentiated/rhabdoid carcinoma were collected at Fudan University Shanghai Cancer Center, Shanghai, China from 2017 to 2018. The clinicopathological characteristics were analyzed. Hematoxylin and eosin, and immunohistochemical stains were performed, and the relevant literatures were reviewed. Results: The two patients were both male, aged 60 and 74 years, respectively. Their symptoms were both abdominal pain. The tumor arose in the esophagogastric junction in case 1, and the cardia to the fundus and the posterior wall of the upper part of gastric body in case 2. Both tumors were present as an ulcerative mass. The patients died of tumor 11 months and 8 months after surgery, respectively. Histologically, the tumor cells arranged in sheets, nests, cords or trabecular patterns, and pseudoavleolar structure. The tumor cells were epithelioid with uniform morphology, while the tumors showed scant stroma and massive necrosis. Variable rhabdoid cells and multinucleated giant cells were seen in both cases. SMARCA4 encoding protein BRG1 was undetectable in both tumors, while SMARCB1 encoding protein INI1 was detected. The tumor cells were diffusely positive for vimentin and negative for epithelial marker (CKpan), gastrointestinal stromal tumor markers (CD117 and DOG1), myogenic markers (desmin and myogenin), melanoma markers (S-100 protein, SOX10 and HMB45), and lymphohematopoietic markers (LCA and CD20). Conclusions: Gastric SWI/SNF-complex deficient undifferentiated/rhabdoid carcinoma is a rare and highly aggressive tumor with poor prognosis. The detection of subunits protein expression of SWI/SNF complex is important for diagnosis of the tumor.

Kinetic removal of acetaminophen and phenacetin during LED-UV365 photolysis of persulfate system: Reactive oxygen species generation

Acetaminophen (ACT) and phenacetin (PNT) removal during light-emitting diode (LED)-UV photolysis of persulfate (PS) was evaluated with a typical wavelength of 365 nm. Decay of PNT and ACT in pH ranges of 5.5-8.5 followed pseudo-first order kinetics. Maximum pseudo-first order rate constants (k_obs) of ACT and PNT decomposition of 1.8 × 10^-1 and 1.2 × 10^-1 min^-1, respectively, were obtained at pH 8.5. Hydroxyl radicals (·OH), sulfate radicals (SO₄·^-), superoxide radicals (O₂^-·), and singlet oxygen (¹O₂) were determined in-situ electron paramagnetic resonance (EPR) and alcohol scavenging tests. The average contributions of ·OH and SO₄·^- were 23.5% and 53.0% for PNT removal, and 15.9% and 53.0% for ACT removal at pH ranges of 5.5-8.5. In samples subjected to chlorination after LED-UV₃₆₅/PS pre-oxidation, a relatively small total concentration of five halogenated disinfection by-products (DBPs) was obtained of 90.9 μg L^-1 (pH 5.5) and 126.7 μg L^-1 (pH 7.0), which is 58.5% and 30.2% lower than that in system without LED-UV₃₆₅/PS pre-oxidation. Meanwhile, a higher maximum value of total DBP concentration was obtained at pH 8.5 (445.6 μg L^-1) following LED-UV₃₆₅/PS pre-oxidation. The results of economy evaluation showed that UV₃₆₅ was more cost-effective in application for organic contaminant removal compared with UV₂₅₄.

Cobalt doped iron oxychloride as efficient heterogeneous Fenton catalyst for degradation of paracetamol and phenacetin

Cobalt doped iron oxychloride (Co-FeOCl) was synthesized and employed as catalyst in Fenton degradation of paracetamol (APAP) and phenacetin (PNCT) for the first time. The catalytic performance was evaluated by means of various parameters including catalyst load, hydrogen peroxide (H₂O₂) dose and pH value. The high removal of APAP (87.5%) and PNCT (76.0%) was obtained under conditions of 0.2 g/L Co-FeOCl and 0.5 mM H₂O₂ at pH 7.0, with calculated pseudo-first order kinetic constants of 0.031 min^-1 for APAP and 0.023 min^-1 for PNCT. Particularly, quenching tests and in situ electron spin resonance (ESR) tests were employed for the identification of the reactive oxygen species (ROS) in system. Hydroxyl radical (·OH) and superoxide radical (O₂^-·) were the primary ROS in Co-FeOCl/H₂O₂ system. A possible mechanism for H₂O₂ activation by Co-FeOCl catalyst was proposed as well. Finally, the formation of typical disinfection by-products (DBPs) decreased slightly in Co-FeOCl/H₂O₂ pre-oxidation. However, stability and reusability of Co-FeOCl were deactivated in the consecutive three cycles.