Sludge dewaterability improvement with microbial fuel cell powered electro-Fenton system (MFCⓅEFs): Performance and mechanisms

Throughout the entire process of sludge treatment and disposal, it is crucial to explore stable and efficient techniques to improve sludge dewaterability, which can facilitate subsequent resource utilization and space and cost savings. Traditional Fenton oxidation has been widely researched to enhance the performance of sludge dewaterability, which was limited by the additional energy input and the instabilities of Fe2+ and H2O2. To reduce the consumption of energy and chemicals and further break the rate-limiting step of the iron cycle, a novel and feasible method that constructed microbial fuel cell powered electro-Fenton systems (MFCⓅEFs) with ferrite and biochar electrode (MgFe2O4@BC/CF) was successfully demonstrated. The MFCⓅEFs with MgFe2O4@BC/CF electrode achieved specific resistance filtration and sludge cake water content of 2.52 × 1012 m/kg and 66.54 %. Cellular structure and extracellular polymeric substances (EPS) were disrupted, releasing partially bound water and destroying hydrophilic structures to facilitate sludge flocs aggregation, which was attributed to the oxidation of hydroxyl radicals. The consistent electron supply supplied by MFCⓅEFs and catalytically active sites on the surface of the multifunctional functional group electrode was responsible for producing more hydroxyl radicals and possessing a better oxidizing ability. The study provided an innovative process for sludge dewaterability improvement with high efficiency and low energy consumption, which presented new insights into the green treatment of sludge.

Mechanistic insight into the aggregation ability of anammox microorganisms: Roles of polarity, composition and molecular structure of extracellular polymeric substances

The chemical characteristics of extracellular polymeric substances (EPS) of anammox bacteria (AnAOB) play a crucial role in the rapid enrichment of AnAOB and the stable operation of wastewater anammox processes. To clarify the influential mechanisms of sludge EPS on AnAOB aggregation, multiple parameters, including the polarity distribution, composition, and molecular structure of EPS, were selected, and their quantitative relationship with AnAOB aggregation was analyzed. Compared to typical anaerobic sludge (anaerobic floc and granular sludge), the anammox sludge EPS exhibited higher levels of tryptophan-like substances (44.82-56.52 % vs. 2.57-39.81 %), polysaccharides (40.02-53.49 mg/g VSS vs. 30.22-41.69 mg/g VSS), and protein structural units including α-helices (20.70-23.98 % vs. 16.48-19.32 %), β-sheets (37.43-42.98 % vs. 25.78-36.72 %), and protonated nitrogen (Npr) (0.065-0.122 vs. 0.017-0.061). In contrast, it had lower contents of β-turns (20.95-27.39 % vs. 28.17-39.04 %). These biopolymers were found to originate from different genera of AnAOB. Specifically, the α-helix-rich proteins were mainly derived from Candidatus Kuenenia, whereas the extracellular proteins related to tryptophan and Npr were closely associated with Candidatus Brocadia. Critically, these EPS components could drive anammox aggregation through interactions. Substantial amounts of tryptophan-like substances facilitated the formation of β-sheet structures and the exposure of internal hydrophobic clusters, which benefited the anammox aggregation. Meanwhile, extracellular proteins with high Npr content played a pivotal role in the formation of mixed protein-polysaccharide gel networks with the electronegative regions of polysaccharides, which could be regarded as the key component in the maintenance of anammox sludge stability. These findings provide a comprehensive understanding of the multifaceted roles of EPS in driving anammox aggregation and offer valuable insights into the development of EPS regulation strategies aimed at optimizing the anammox process.

Impact of co-substrate molecular weight on methane production potential, microbial community dynamics, and metabolic pathways in waste activated sludge anaerobic co-digestion

Proteins and carbohydrates are important organics in waste activated sludge, and greatly affect methane production and microbial community composition in anaerobic digestion systems. Here, a series of co-substrates with different molecular weight were applied to investigate the interactions between microbial dynamics and the molecular weight of co-substrates. Biochemical methane production assays conducted in batch co-digesters showed that feeding high molecular weight protein and carbohydrate substrates resulted in higher methane yield and production rates. Moreover, high-molecular weight co-substrates increased the microbial diversity, enriched specific microbes including Longilinea, Anaerolineaceae, Syner-01, Methanothrix, promoted acidogenic and acetoclastic methanogenic pathways. Low-molecular weight co-substrates favored the growth of JGI-0000079-D21, Armatimonadota, Methanosarcina, Methanolinea, and improved hydrogenotrophic methanogenic pathway. Besides, Methanoregulaceae and Methanolinea were indicators of methane yield. This study firstly revealed the complex interactions between co-substrate molecular weight and microbial communities, and demonstrated the feasibility of adjusting co-substrate molecular weight to improve methane production process.

A revisit of drugs and potential therapeutic targets against non-alcoholic fatty liver disease: learning from clinical trials

PURPOSE

Non-alcoholic fatty liver disease (NAFLD) is the most common liver disease, with a worldwide prevalence of 25%. Although numerous clinical trials have been conducted over the last few decades, an effective treatment has not been approved yet. Extensive research has accumulated a large amount of data and experience; however, the vast number of clinical trials and new therapeutic targets for NAFLD make it impossible to keep abreast of the relevant information. Therefore, a systematic analysis of the existing trials is necessary.

METHODS

Here, we reviewed clinical trials on NAFLD registered in the mandated federal database, ClinicalTrials.gov, to generate a detailed overview of the trials related to drugs and therapeutic targets for NAFLD treatment. Following screening for pertinence to therapy, a total of 440 entries were identified that included active trials as well as those that have already been completed, suspended, terminated, or withdrawn.

RESULTS

We summarize and systematically analyze the state, drug development pipeline, and discovery of treatment targets for NAFLD. We consider possible factors that may affect clinical outcomes. Furthermore, we discussed these results to explore the mechanisms responsible for clinical outcomes.

CONCLUSION

We summarised the landscape of current clinical trials and suggested the directions for future NAFLD therapy to assist internal medicine specialists in treating the whole clinical spectrum of this highly prevalent liver disease.

[circDDX17 targets miR-223-3p / RIP3 to regulate the proliferation and apoptosis of non-small cell lung cancer cells]

Objective: To explore the molecular mechanism of circDDX17 regulating the proliferation and apoptosis of non-small cell lung cancer cells by targeting the miR-223-3p/RIP3 molecular axis. Methods: The expression levels of circDDX17, miR-223-3p, and RIP3 in human normal lung epithelial cell lines BEAS-2B and non-small cell lung cancer cells H1299, A549, and H446 were detected by reverse transcription-quantitative real-time polymerase chain reaction (RT-qPCR). The plasmids of pcDNA, pcDNA-circDDX17, anti-miR-con, anti-miR-223-3p, pcDNA-circDDX17 and miR-con, pcDNA-circDDX17 and miR-223-3p mimics were transfected into H1299 cells. 3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl-2H tetrazolium bromide (MTT) assay was used to detect the cell proliferation. Flow cytometry was used to detect the cell cycle and cell apoptosis. Plate cloning experiment was used to detect cell proliferation ability. The dual luciferase report experiment was applied to verify the targeting relationship between miR-223-3p with circDDX17 and RIP3. Western blot was used to detect the protein expression of cyclinD1, CDK2, cleaved caspase-3 and Bax. Results: The expression levels of circDDX17 and RIP3 mRNA in H1299, A549, and H446 cells were significantly reduced (P<0.05), the expression level of miR-223-3p mRNA was significantly increased (P<0.05) compared with BEAS-2B. The cell viability [(69.46±4.68)%], the number of cell clones (83.49±7.86), the proportion of cells in S phase [(22.52±1.41) %], the protein expression levels of cyclinD1 and CDK2 in PCDNa-CircDDX17 group were lower than those in pcDNA group [(97.54±7.72)%, 205.03±13.37, (28.69±1.49)%, respectively, P<0.05], while the percentage of G0/G1 phase cells [(64.45±3.56)%], apoptosis rate [(18.36±1.63)%], the protein expression levels of cleaved caspase-3 and Bax in pcDNA-circDDX17 group were higher than those of pcDNA group [(51.33±2.76) % and (5.21±0.54) %, respectively, P<0.05]. The viability [(72.64±5.44)%], the number of cell clones (78.16±8.23), the proportion of S-stage cells [(21.34±1.59) %], the protein expression levels of CyclinD1 and CDK2 in anti-miR-223-3p group were lower than those in anti-miR-con group [(103.47±6.25)%, 169.32±14.53, (28.43±1.26)%, respectively, P<0.05]. Percentage of G0/G1 phase cells [(62.86±3.28)%], apoptosis rate [(14.64±1.67)%], the protein expression levels of cleaved caspase-3 and Bax in the anti-miR-223-3p group were higher than those of anti-miR-con group [(51.33±2.71)% and (4.83±0.39)%, respectively, P<0.05]. MiR-223-3p has complementary sites with circDDX17 or RIP3. The viability [(135.45±9.28)%], the number of cell clones (174.64±10.68), the proportion of S-phase cells [(26.39±2.25)%], the protein expression levels of cyclinD1 and CDK2 in pcDNA-circDDX17+miR-223-3p group were higher than those in pcDNA-circDDX17+miR-con group [(101.56±6.68)%, 107.65±7.62, (21.64±1.72)%, P<0.05]. Percentage of G0/G1 phase cells [(56.64±2.76)%], apoptosis rate [(8.34±0.76)%], the protein expression levels of cleaved caspase-3 and Bax in pcDNA-circDDX17+miR-223-3p group were lower than those of pcDNA-circDDX17+miR-con group [(64.03±3.48)% and (15.21±1.18)%, respectively, P<0.05]. Conclusion: circDDX17 could inhibit the proliferation and induce apoptosis of non-small cell lung cancer cells via targeting the miR-223-3p / RIP3 molecular axis.

[Research progress on pseudocirrhosis]

Presently, pseudocirrhosis occurs in most patients with liver metastases from malignant tumors and can exhibit clinical manifestations related to portal hypertension, such as edema, ascites, and gastrointestinal bleeding. Imaging features include malignant tumor liver metastasis, the appearance of nodules accompanied with or without hepatic contour, segmental liver volume reduction, and caudate lobe enlargement. Histology shows the typical pathological manifestations of liver cirrhosis, such as diffuse tumor cell infiltration, fibrosis around the infiltrating lesion, hepatic sinus vascular thrombosis, nodular hyperplasia, non-accompanied bridging necrosis, bridging fibrosis, and pseudolobule formation. The possible pathogenesis of pseudocirrhosis is tumor cell infiltration and toxic reactions of tumor cells and liver cells to chemotherapy. The presence of pseudocirrhosis in patients diagnosed with malignant tumors is one of the challenges affecting their survival cycle and shortening the median survival time. The relationship between its onset, tumor type and metastasis, and the use of chemotherapy drugs is still unclear. The atypical clinical manifestations and imaging characteristics bring about great challenges for clinicians and patients. Thus, based on the existing case reports, observational studies, and meta-analysis results, this article reviews the research progress on the prevalence, etiology, pathogenesis, diagnosis, treatment, and prognosis of pseudocirrhosis.

Effect and potential mechanisms of sludge-derived chromium, nickel, and lead on soil nitrification: Implications for sustainable land utilization of digested sludge

Increasing occurrence of heavy metals (HMs) in sewage sludge threatens its widespread land utilization in China due to its potential impact on nutrient cycling in soil, requiring a better understanding of HM-induced impacts on nitrification. Herein, lab-scale experiments were conducted over 185-day, evaluating the effect of sludge-derived chromium (Cr3+), nickel (Ni2+), and lead (Pb2+) on soil nitrification at different concentrations. Quantitative polymerase chain reaction and linear regression results revealed an inhibitory sequence of gene abundance by HMs' labile fraction: ammonia-oxidizing bacteria (AOB)-ammonia monooxygenase (amoA)> nitrite oxidoreductase subunit alpha (nxrA)> nitrite oxidoreductase subunit beta (nxrB). The toxicity of HMs' incremental labile fraction decreased in the order of Ni2+>Cr3+>Pb2+, with respective threshold values of 5.01, 24.03 and 38.42 mg·kg-1. Furthermore, extending incubation time reduced HMs inhibition on ammonia oxidation, mainly related to their fraction bound to carbonate minerals. Random Forest analysis, variation partitioning analysis, and Mantel test indicated that soil physicochemical properties primarily affected nitrification genes, especially in the test of Cr3+ on AOB-amoA, nxrA, nxrB, Ni2+ for complete ammonia-oxidizing bacteria-amoA, and Pb2+ for nxrA and nxrB. These findings underline the importance of labile HMs fractions and soil physicochemical properties to nitrification, guiding the establishment of HM control standards for sludge utilization.

Enhanced dewaterability of food waste digestate by biochar/potassium ferrate treatments: Performance and mechanisms

The combined process of biochar (BC) and potassium ferrate (PF) offers a fascinating technique for efficient dewatering of digestate. However, the effects of BC/PF treatment on the dewaterability and mechanisms of FWD are still unknown. This study aimed to reveal the impact mechanisms of BC/PF treatment on digestate dewatering performance. Experimental results indicated that BC/PF treatment significantly enhanced the dewaterability of digestate, with the minimum specific resistance to filtration of (1.05 ± 0.02) × 1015 m·kg-1 and water content of 57.52 ± 0.51% being obtained at the concentrations of 0.018 g·g-1 total solid (TS) BC300 and 0.20 g·g-1 TS PF, which were 8.60% and 13.59% lower than PF treatment, respectively. BC/PF treatment proficiently reduced the fractal dimension, bound water content, apparent viscosity, and gel-like network structure strength of digestate, as well as increased the floc size and zeta potential of digestate. BC/PF treatment promoted the conversion of extracellular polymeric substances (EPS) fractions from inner EPS to soluble EPS, increased the fluorescence intensity of the dissolved compounds, and enhanced the hydrophobicity of proteins. Mechanisms investigations showed that BC/PF enhanced dewatering through non-reactive oxygen species pathways, i.e., via strong oxidative intermediate irons species Fe(V)/Fe(IV). BC/PF treatment enhanced the solubilization of nutrients, the inactivation of fecal coliforms, and the mitigation of heavy metal toxicity. The results suggested that BC/PF treatment is an effective digestate dewatering technology which can provide technological supports to the closed-loop treatment of FWD.

Exploring Recent Decreases in First Molar Sealants among US Children

Analyses of National Health and Nutrition Examination Survey (NHANES) data suggested a significant decrease in sealant prevalence among children between 2011 to 2014 and 2015 to 2018. We explore whether this decrease could be associated with possible changes in 1) clinical sealant delivery, 2) dental materials (i.e., increased use of glass ionomer [GI] sealants resulting in an inability to detect sealant fragments that still provide preventive benefits or increased use of composite restorations leading to misclassifying sealants as restorations), and 3) examination sensitivity and specificity. We used NHANES data to estimate the prevalences of sealants, untreated caries, and restorations in ≥1 first permanent molar among children aged 7 to 10 y and used Medical Expenditure Panel Survey data to estimate the annual clinical delivery of sealants and fluoride treatments. We examined changes in outcomes between 2 periods (P < 0.05) controlling for selected sociodemographic characteristics. NHANES sealant examination quality was based on the reference examiner's replicate examinations. The adjusted prevalence of sealants decreased relatively by 27.5% (46.6% vs. 33.8%). Overall, untreated caries decreased. Untreated caries and restoration decreased among children without sealants. Annual clinical sealant delivery did not change, whereas fluoride treatment delivery increased. The decrease in sealant prevalence held when assessed for various age ranges and NHANES cycle combinations. While sealant examination specificity remained similar between the periods, sensitivity (weighted by the proportion of exams by each examiner) decreased relatively by 17.4% (0.92 vs. 0.76). These findings suggest that decreased sealant prevalence was not supported by decreased clinical sealant delivery nor increased use of composite restorations. Decreased examination sensitivity, which could be due to an increased use of GI sealants, could contribute to the decrease in sealant prevalence. The decrease in caries among children without sealants could suggest the increased use of GI sealants. However, we could not rule out that the decrease in caries could be attributable to increased fluoride treatment delivery.

Electro-oxidation and UV irradiation coupled method for in-site removing pollutants from human body fluids in swimming pool

A comprehensive study was conducted to investigate how ultraviolet (UV) irradiation combined with electrochemistry (EC) can efficiently remove human body fluids (HBFs) related pollutants, such as urea/creatinine/hippuric acid, from swimming pool water (SPW). In comparison with the chlorination, UV, EC, and UV/chlorine treatments, the EC/UV treatment exhibited the highest removal rates for these typical pollutants (TPs) from HBFs in synthetic SPW. Specifically, increasing the operating current of the EC/UV process from 20 to 60 mA, as well as NaCl content from 0.5 to 3.0 g/L, improved urea and creatinine degradation while having no influence on hippuric acid. In contrast, EC/UV process was resilient to changes in water parameters (pH, HCO3-, and actual water matrix). Urea removal was primarily attributable to reactive chlorine species (RCS), whereas creatinine and hippuric acid removal were primarily related to hydroxyl radical, UV photolysis, and RCS. In addition, the EC/UV procedure can lessen the propensity for creatinine and hippuric acid to generate disinfection by-products. We can therefore draw the conclusion that the EC/UV process is a green and efficient in-situ technology for removing HBFs related TPs from SPW with the benefits of needless chlorine-based chemical additive, easy operation, continuous disinfection efficiency, and fewer byproducts production.

A review of microbial responses to biochar addition in anaerobic digestion system: Community, cellular and genetic level findings

The biochar is a well-developed porous material with various excellent properties, that has been proven with excellent ability in anaerobic digestion (AD) efficiency promotion. Current research is usually focused on the macro effects of biochar on AD, while the systematic review about the mechanisms of biochar on microbial behavior are still lacking. This review summarizes the effects and potential mechanisms of biochar on microorganisms in AD systems, and found that biochar addition can provide habitats for microbial colonization, alleviate toxins stress, supply essential nutrients, and accelerate interspecies electron transferring. Moreover, it also improves microbial community diversity, facilitates EPS secretion, enhances functional enzyme activity, promotes functional genes expression, and inhibits the antibiotic resistance genes transformation. Future research directions including biochar targeted design, in-depth microbial mechanisms revelation, and modified model development were suggested, which could promote the widely practical application of of biochar-amended AD technology.

Deciphering the role of polystyrene microplastics in waste activated sludge anaerobic digestion: Changes of organics transformation, microbial community and metabolic pathway

Microplastics are ubiquitous in the natural environment, which inevitably affect the relevant biochemical process. Nevertheless, the knowledge about the impacts of microplastics on organics transformation and corresponding microbial metabolism response in anaerobic environment is limited. Here, polystyrene (PS) microplastics were selected as model microplastics to explore their potential impacts on organics transformation, microbial community and metabolic pathway during sludge anaerobic digestion system operation. The results indicated that the PS microplastics exhibited the dose-dependent effects on methane production, i.e., the additive of 20-40 particles/g TS of PS microplastics improved the maximum methane yield by 3.38 %-8.22 %, whereas 80-160 particles/g TS additive led to a 4.78 %-11.04 % declining. Overall, PS microplastics facilitated the solubilization and hydrolysis of sludge, but inhibited the acidogenesis process. Key functional enzyme activities were stimulated under low PS microplastics exposure, whereas were almost severely inhibited due to the increased oxidative stress induced from excess PS microplastics. Microbial community and further metabolic analysis indicated that low PS microplastics improved the acetotrophic and hydrogenotrophic methanogenesis, while a high level of PS microplastics shifted methanogenesis from acetotrophic to hydrogenotrophic pathway. Further analysis showed that the reacted PS microplastics exhibited greater toxicity and ecological than the raw PS microplastics due to that they are more likely to adsorb contaminants. These findings revealed the dosage-dependent relationships between microplastics and organics transformation process in anaerobic environments, providing new insights for assessing the impact of PS microplastics on sludge anaerobic digestion.

Mediating oxidative stress through the Palbociclib/miR-141-3p/STAT4 axis in osteoporosis: a bioinformatics and experimental validation study

Osteoporosis is a common bone disease characterized by loss of bone mass, reduced bone strength, and deterioration of bone microstructure. ROS-induced oxidative stress plays an important role in osteoporosis. However, the biomarkers and molecular mechanisms of oxidative stress are still unclear. We obtained the datasets from the Gene Expression Omnibus (GEO) database, and performed differential analysis, Venn analysis, and weighted correlation network analysis (WGCNA) analysis out the hub genes. Then, the correlation between inflammatory factors and hub genes was analyzed, and a Mendelian randomization (MR) analysis was performed on cytokines and osteoporosis outcomes. In addition, "CIBERSORT" was used to analyze the infiltration of immune cells and single-cell RNA-seq data was used to analyze the expression distribution of hub genes and cell-cell communications. Finally, we collected human blood samples for RT-qPCR and Elisa experiments, the miRNA-mRNA network was constructed using the miRBase database, the 3D structure was predicted using the RNAfold, Vfold3D database, and the drug sensitivity analysis was performed using the RNAactDrug database. We obtained three differentially expressed genes associated with oxidative stress: DBH, TAF15, and STAT4 by differential, WGCNA clustering, and Venn screening analyses, and further analyzed the correlation of these 3 genes with inflammatory factors and immune cell infiltration and found that STAT4 was significantly and positively correlated with IL-2. Single-cell data analysis showed that the STAT4 gene was highly expressed mainly in dendritic cells and monocytes. In addition, the results of RT-qPCR and Elisa experiments verified that the expression of STAT4 was consistent with the previous analysis, and a significant causal relationship between IL-2 and STAT4 SNPs and osteoporosis was found by Mendelian randomization. Finally, through miRNA-mRNA network and drug sensitivity analysis, we analyzed to get Palbociclib/miR-141-3p/STAT4 axis, which can be used for the prevention and treatment of osteoporosis. In this study, we proposed the Palbociclib/miR-141-3p/STAT4 axis for the first time and provided new insights into the mechanism of oxidative stress in osteoporosis.

A systemic evaluation of aerobic granular sludge among granulation, operation, storage, and reactivation processes in an SBR

As a biological promising wastewater treatment technology, aerobic granular sludge (AGS) technology had been widely studied in sequencing batch reactors (SBRs) for the decades. Presently, the whole processes of its granulation, long-term operation, storage, and reactivation have not been thoroughly evaluated, and also the relationships among microbial diversity, granular size, and characteristics were still not that clear. Hence, they were systematically evaluated in an AGS-SBR in this work. The results demonstrated that Proteobacteria and Bacteroidetes were the dominant phyla, Flavobacterium, Acinetobacter, Azoarcus, and Chryseobacterium were the core genera with discrepant abundances in diverse stages or granular size. Microbial immigration was significant in various stages due to microbial diversity had a line relationship with COD/MLVSS ratio (R2 = 0.367). However, microbial diversity had no line relationship with granular size (R2 = 0.001), indicating the microbial diversity in different-sized AGS was similar, although granular size had a line relationship with settleability (R2 = 0.978). Overall, compared to sludge traits (e.g., sludge size, settleability), COD/MLVSS played a key role on microbial evolution. This study revealed the relationships between granule characteristics and microbial community, and contributed to the future AGS-related studies.

A review of application of combined biochar and iron-based materials in anaerobic digestion for enhancing biogas productivity: Mechanisms, approaches and performance

Strengthening direct interspecies electron transfer (DIET), via adding conductive materials, is regarded as an effective way for improving methane productivity of anaerobic digestion (AD). Therein, the supplementation of combined materials (composition of biochar and iron-based materials) has attracted increasing attention in recent years, because of their advantages of promoting organics reduction and accelerating biomass activity. However, as far as we known, there is no study comprehensively summarizing the application of this kind combined materials. Here, the combined methods of biochar and iron-based materials in AD system were introduced, and then the overall performance, potential mechanisms, and microbial contribution were summarized. Furthermore, a comparation of the combinated materials and single material (biochar, zero valent iron, or magnetite) in methane production was also evaluated to highlight the functions of combined materials. Based on these, the challenges and perspectives were proposed to point the development direction of combined materials utilization in AD field, which was hoped to provide a deep insight in engineering application.

The Role of Radiation Therapy for Metastatic Cervical Cancer

PURPOSE/OBJECTIVE(S)

Survival rates for women with metastatic cervical cancer (CC) are low, with limited management options. Radiation therapy (RT) for metastatic disease has led to prolonged survival in other malignancies, however, the data are scarce in CC. Herein, we evaluated the effect of RT for metastatic CC.

MATERIALS/METHODS

A total of 58 patients with metastatic CC between September 2019 and January 2023 were retrospectively analyzed. All the patients were treated with platinum-based chemotherapy combined with targeted therapy or immunotherapy followed with or without RT (NRT). The recent efficacy, survival status and prognostic factors were analyzed statistically.

RESULTS

Objective response rate (ORR) was 63.6% with one complete and twenty partial responses in RT group (n = 33) and 40.0% with two complete and eight partial responses in NRT group (n = 25), respectively (p = 0.074). Disease control rate (DCR) of the RT and NRT groups were 79.4% vs 80.0%, respectively (p = 0.861). Median follow-up time was 17 months (3-39months). In RT group, 11(33.3%) patients experienced local regional or distant failure and 9 (27.3%) patients were dead. In NRT group, 15(60%) patients had progression and 8 (32%) patients dead. There was no significant difference between the two groups in overall survival (OS); however, RT group displayed superior progression-free survival (PFS) (1-year OS: 72.7% vs. 68.0%, p = 0.460; 1-year PFS: 66.7% vs. 40.0%, p = 0.039). The multivariate analysis showed that RT, immunotherapy, lymph node metastasis only relevant predictor of superior PFS but not OS. In subgroup analysis, patients treated with RT appeared to have a better PFS in some specific cohorts, such as age>45 years (72.0% vs 36.4% P = 0.015), squamous carcinoma histology (71.0% vs 40.9% P = 0.017), metastatic at diagnosis (75.0% vs 47.6% P = 0.012), non-targeted therapy (72.4% vs 43.8% P = 0.040). No significant increase in treatment-related toxicity was observed in the RT group compared with the NRT group.

CONCLUSION

RT provided superior PFS in metastatic CC patients compared to NRT, and well tolerated. Moreover, RT, immunotherapy, lymph node metastasis only were independent significant prognostic factors for PFS. Subgroup analysis showed that combination of RT and chemotherapy obtained favorable PFS in metastatic CC patients with age>45 years, squamous carcinoma histology, metastatic at diagnosis, non-targeted therapy. Studies with a larger sample size and longer follow-up are warranted.

RUNX1 as a Potential Target for Combined Radioimmunotherapy of Lung Adenocarcinoma

PURPOSE/OBJECTIVE(S)

Radioimmunotherapy for non-small cell lung cancer has good clinical application prospects. The role and mechanism of RUNX1 in DNA damage repair were explored for its potential role in lung adenocarcinoma radioimmunotherapy.

MATERIALS/METHODS

To study the effect of RUNX1 expression level on the expression of DNA damage repair system related factors and radiation sensitivity of lung adenocarcinoma cells. As an important nuclear transcription factor, RUNX1 was explored whether directly regulating the expression of Nrf2, Rad51, BRCA1, and verifying their respective DNA binding sites in the promoter region through relevant databases. To observe the effect of RUNX1 knockout and overexpression on the expression level of PD-L1 in tumor cells at the cell level; The effect of RUNX1 expression level on the sorting and presentation of PD-L1 cells was investigated by the method of nucleocytoplasmic separation. According to literature reports, CMTM6 and ALIX play a key role in the process of PD-L1 cell sorting and presentation, and explore whether RUNX1 plays a role through this factor. The effect of phosphorylation level of different splicing bodies of RUNX1 (RUNX1a/b/c) on the expression level and DNA damage repair system related factors on tumor radiosensitivity were also explored.

RESULTS

According to TCGA database, RUNX1 is highly expressed and phosphorylated in lung adenocarcinoma. Through gene comparison with the database, it was found that RUNX1 binding sites existed in the promoter region of several factors related to this study, including ALIX, Nrf2, BRCA1, RAD51, ATM, H2AX, etc. After being activated by MAPKp38 phosphorylation, RUNX1a can positively regulate Nrf2 signal pathway. The expression of RUNX1 and p-RUNX1 is time-dependent on ionizing radiation. At the same time, it was found that the expression of RUNX1 and p-RUNX1 was dose-dependent on ionizing radiation, and the expression trend of Nrf2 signal pathway related factors was consistent with RUNX1. RUNX1 regulates the expression of PD-L1, BRCA1, ALIX and Nrf2. Bioinformatics analysis and flow cytometry data show that RUNX1 has inhibitory effect on tumor microenvironment of lung adenocarcinoma.

CONCLUSION

RUNX1 regulates DNA damage repair system and has inhibitory effect on tumor immunity. Inhibiting the expression of RUNX1 in lung adenocarcinoma cells can enhance the effect of radioimmunotherapy.

Cost-Effectiveness of Short-Course Radiotherapy Based Total Neoadjuvant Therapy for Locally Advanced Rectal Cancer in China

PURPOSE/OBJECTIVE(S)

The phase III STELLAR (NCT02533271) trial demonstrated that four cycles of chemotherapy after short-course radiotherapy (SCRT-TNT) were not inferior to the standard care of long-course concurrent radiotherapy (LCRT) in patients with locally advanced rectal cancer (LARC). This study assessed the cost-effectiveness of SCRT-TNT versus LCRT in locally advanced rectal cancer in China on the basis of the STELLAR trial.

MATERIALS/METHODS

A Markov model was used to synthesize the healthcare costs and benefits of LARC patients based on results from the STELLAR trial. The model assumes that LARC who meet the inclusion criteria of the STELLAR trial experience four possible states: No Evidence of Disease (NED), locally recurrence, distant metastases, or any death from rectal cancer or other unrelated causes, where local recurrence continues to be classified as resectable and unresectable. The transition status period is 3 month, and 5 years is used to calculate direct medical costs and health benefits. The probabilities of states transition after SCRT-TNT or LCRT were derived from the results of the STELLAR trial and previous published article (Table.1). Costs were evaluated from the Chinese payer's perspective reported in early 2022 US dollars (US$1 = 6.78 Chinese Yuan). Sensitivity analyses were performed for key variables. Cost-effectiveness was evaluated using the incremental cost-effectiveness ratio and net monetary benefits. Effectiveness was defined as quality-adjusted life-years (QALYs). Willingness-to-pay (WTP) threshold was set at $43500/QALY. Data were collected from October 3, 2020, to September 20, 2021, and analyzed from November 15, 2020, to October 25, 2021.

RESULTS

During the 5-year horizon, for the base case scenario, SCRT-TNT incurred a lower total cost and higher QALYs compared with LCCRT. The total cost was $65767 and QALYs were 1.77 for SCRT-TNT; for LCCRT, the total cost was $72802 and QALYs were 1.64. This resulted in an ICER of -$ 55470.69 per QALY. Therefore, SCRT-TNT was a cost-saving and dominating treatment strategy compared with LCRT. Sensitivity analysis showed that ICERs were most sensitive to the parameters of distant metastases risk after treatment.

CONCLUSION

SCRT-TNT in locally advanced rectal cancer can be a cost-effective alternative to LCRT in China, and should be considered in appropriately selected patients.

Pseudo CT Synthesis Using Cone-Beam CT of Cervical Cancer with GAN-Based Neural Network Model

PURPOSE/OBJECTIVE(S)

Cervical cancer (CC) is a tumor disease that threatens the health of women. As an important treatment of CC, radiotherapy has been widely used in clinic. With the rapid development of radiotherapy technology, adaptive radiotherapy has received much attention. Adaptive radiotherapy means more accurate radiation dose and more accurate radiation area, which can effectively protect normal tissue. It is significant to improve the local control rate of tumor and the quality of life of patients. However, the Cone-Beam CT (CBCT) images collected during radiotherapy are of poor quality and cannot provide real-time radiation effect information, resulting in timely and effective adjustment of radiation dose and radiation area in the process of radiotherapy for cervical cancer. To alleviate this issue, this study will establish a model to leverage CC CBCT images to synthetize pseudo computed tomography (CT) images with high quality, so as to achieve the purpose of quality improvement.

MATERIALS/METHODS

This study included the data of 20 patients with CC in ** hospital. The planning CT and CBCT scan data of each patient before radiotherapy were collected, and the interval between the two kinds of image data was required to be less than one week. After data preprocessing, a total of 1206 pairs of images were trained and tested. The generative adversarial network (GAN) is constructed. In order to ensure the similarity between the input image and the output image, the L1 loss function is leveraged. And the full supervision method is used to train the model to achieve a better effect of image synthesis and improve the quality of CBCT image. Peak signal-to-noise ratio (PSNR) and structural similarity (SSIM) were used as evaluation indexes.

RESULTS

Using five-fold cross-validation, the values of PSNR between the pseudo-CT (sCT) and the planning CT (pCT) image and between the CBCT and the pCT image are calculated. The results are 26.9 and 22.6, respectively. The sCT obtained from the GAN model increases the peak signal-to-noise ratio by 19% compared with the original CBCT, which means that the proposed model built in this study can improve the useful information of the CBCT image. The SSIM values between sCT and pCT and between CBCT and pCT are also calculated, and the average values of them are 0.89 and 0.63, respectively. Therefore, in this experiment, the structure of the sCT obtained by the proposed model is closer to pCT. And the SSIM increases by 41.2% compared with the original CBCT, which means that the sCT by the proposed model is more similar to the pCT in structure. These results could make a more accurate judgment on the effect of radiotherapy.

CONCLUSION

In this study, the pseudo-CT synthesis method based on GAN can improve the quality of CC CBCT image. The results show this method makes the structure clearer and could assist doctors to adjust the radiation dose and radiation area in time. This study is able to facilitate the development of adaptive radiotherapy for CC.

[Discussion from metabolism to fatty liver disease: rethinking the origin of disease and the endpoint of new drugs or metabolic dysfunction-associated steatotic liver disease]

The diagnosis of nonalcoholic fatty liver disease (NAFLD) is an exclusionary diagnosis, and the name does not reflect the disease's nature or mechanism. Internationally, MAFLD (metabolic dysfunction-associated fatty liver disease) and MASLD (metabolic dysfunction-associated steatotic liver disease) have recently been proposed, which are translated as metabolic dysfunction-associated fatty liver disease in Chinese. The new name reflects the initiating factors of the disease, its occurrence and development process, and the clinical significance of associated outcomes. Through interventions against metabolic disorders, liver disease (hepatic manifestations of systemic disease) reflecting MASLD (MAFLD) has the potential to improve clinical outcomes.

[Interpretation of the important update of the Guideline for the prevention and treatment of hepatitis C (2022 edition)]

In the past 20 years, Chinese Medical Association had issued several versions of hepatitis C prevention and treatment guidelines. In the latest guidelines published in 2022, the Chinese Society of Hepatology and the Society of Infectious Diseases for the Chinese Medical Association organized experts to update their recommendations for hepatitis C screening and treatment. The updated key points on prevention, diagnosis, and treatment proposed in the guidelines are now interpreted, aiming to provide reference for more effective clinical application of the guidelines.

[Ten-year changes in clinical characteristics and antiviral treatment patterns of chronic hepatitis B in China: a CR-HepB-based real-world study]

Objective: To understand ten-year changes in clinical characteristics and antiviral treatment patterns of chronic hepatitis B in China. Methods: Patients with chronic HBV infection:demographic, virologic, hematologic, blood biochemistry, and antiviral treatment data were extracted from the China Registry of Hepatitis B (CR-HepB) database between 2012 and 2022 for descriptive statistics and change trend analysis. Multiple group comparisons were conducted using the Kruskal Wallis H test, while counting data was compared between groups using χ (2) test. Results: A total of 180 012 patients with chronic HBV infection were included, with a median age of 40 years old, and a male proportion accounting for 60.2%. The HBeAg positive rate was 43.3%. Over time, the median age of new patients each year increased from 39 to 47 years, while the HBeAg positive rate decreased from 51.3% to 32.8%. The initial diagnosis of patients was mainly CHB (71.4%), followed by hepatitis B cirrhosis (11.8%), inactive HBsAg carrier status (10.6%), and chronic HBV carrier status (6.2%). Among the newly registered patients every year from 2012 to 2022, the proportion of hepatitis B cirrhosis remained stable, but after 2019, the proportion of CHB increased and the proportion of other diagnoses decreased. The proportion of patients with cirrhosis increased with age in different age groups, with 3.5%, 19.3%, and 30.4% in the < 40, 40-69, and≥70 age groups, respectively. The proportion of women in patients with cirrhosis also increased with age, from 16.1% in those < 30 years old to 44.3% in those≥80 years old. From 2012 to 2022, the proportion of patients receiving first-line nucleos(t)ide analog antiviral treatment increased year by year, from 51.0% in 2012-2013 to 99.8% in 2022. Conclusion: The CR-HepB registration data reflect the changes in clinical characteristics and antiviral treatment patterns in patients with chronic HBV infection in China over the past ten years and can thus provide a reference to promote hepatitis B diagnosis and treatment practice, as well as scientific research.

Carbonate-bound Pb percentage distribution in agricultural soil and its toxicity: Impact on plant growth, nutrient cycling, soil enzymes, and functional genes

Metals pollution of lead in agricultural soils is a serious problem for food safety. Therefore, we investigated the toxic effects of carbonate-bound fraction Pb on agricultural soil from various aspects. The results revealed that a higher carbonate-bound fraction of Pb had more toxic effects on wheat growth, as evidenced by higher malondialdehyde (3.17 μmol g^-1 FW) and lower catalase levels (9.77 μg^-1 FW min^-1). In terms of nutrient cycling, soil nutrients including carbon, nitrogen, and phosphorus would slow down transformation rates in high concentrations. Compared to carbon, nitrogen and phosphorus were more likely to be affected by the initial carbonate-bound fraction at the earlier stage. Increased Pb dosage may reduce the soil enzymes activity such as urease (119-50 U g^-1) and phosphatase (3191-967 U g^-1), as well as the functional genes of nitrogen degradation related nirK, nisS, and carbon related pmoA. Correlation analysis and structural equation modeling indicated that carbonate bound Pb could regulate nutrients cycle via functional genes inhibition, soil enzyme activity reduction and wheat growth suppression in agricultural soil. Our findings will help with polluted agricultural soil monitoring and regulation through microbial activity to ensure food safety.

Heavy metals in influent and effluent from 146 drinking water treatment plants across China: Occurrence, explanatory factors, probabilistic health risk, and removal efficiency

Heavy metals (HMs) in drinking water have drawn worldwide attention due to their risks to public health; however, a systematic assessment of the occurrence of HMs in drinking water treatment plants (DWTPs) at a large geographical scale across China and the removal efficiency, human health risks, and the correlation with environmental factors have yet to be established. Therefore, this study characterised the occurrence patterns of nine conventional dissolved HMs in the influent and effluent water samples from 146 typical DWTPs in seven major river basins across China (which consist of the Yangtze River, the Yellow River, the Songhua River, the Pearl River, the Huaihe River, the Liaohe River and the Haihe River) for the first time and removal efficiency, probabilistic health risks, and the correlation with water quality. According to the findings, a total of eight HMs (beryllium (Be), antimony (Sb), barium (Ba), molybdenum (Mo), nickel (Ni), vanadium (V), cobalt (Co) and titanium (Ti)) were detected, with detection frequencies in influent and effluent water ranging from 2.90 (Mo) to 99.30% (Ba) and 1.40 (Ti) to 97.90% (Ba), respectively. The average concentration range was 0.41 (Be)- 77.36 (Sb) μg/L. Among them, Sb (exceeding standard rate 8%), Ba (2.89%), Ni (21.43%), and V (1.33%) were exceeded the national standard (GB5749-2022). By combining Spearman's results and redundancy analysis, our results revealed a close correlation among pH, turbidity (TURB), potassium permanganate index (COD_Mn), and total nitrogen (TN) along with the concentration and composition of HMs. In addition, the concentration of HMs in finished water was strongly affected by the concentration of HMs in raw water, as evidenced by the fact that HMs in surface water poses a risk to the quality of finished water. Metal concentration was the primary factor in assessing the health risk of a single metal, and the carcinogenic risk of Ba, Mo, Ni, and Sb should be paid attention to. In DWTPs, the removal efficiencies of various HMs also vary greatly, with an average removal rate ranging from 16.30% to 95.64%. In summary, our findings provide insights into the water quality and health risks caused by HMs in drinking water.

Stable photodegradation of antibiotics by the functionalized 3D-Bi2MoO6@MoO3/PU composite sponge: High efficiency pathways, optical properties and Z-scheme heterojunction mechanism

The designation and fabrication of heterogeneous photocatalyst with superior redox capability is an important technique for emerging pollutants treatment. In this study, we designed the Z-scheme heterojunction of stable 3D-Bi₂MoO₆@MoO₃/PU, which could not only accelerate the migration and separation in photogenerated carriers, but also stabilize the separation rate of photo-generation carriers. In the Bi₂MoO₆@MoO₃/PU photocatalytic system, 88.89% of oxytetracycline (OTC, 10 mg L^-1) and 78.25%-84.59% of multiple antibiotics (SDZ, NOR, AMX and CFX, 10 mg L^-1) could be decomposed within 20 min under the optimized reaction condition, revealing the superior performance and potential application value. Specifically, the morphology, chemical structure and optical properties detection of Bi₂MoO₆@MoO₃/PU greatly affected the direct Z-scheme electron transferring mode in the p-n type heterojunction. Besides, the ·OH, h⁺, ·O₂^- dominated the photoactivation process through ring-opening, dihydroxylation, deamination, decarbonization and demethylation in OTC decomposition. Expectantly, the stability and universality of Bi₂MoO₆@MoO₃/PU composite photocatalyst would further broaden the practical application and demonstrated that the potential of photocatalytic technique in antibiotics pollutants for wastewater remediation.

[Interpretation of the essential updates in guidelines for the prevention and treatment of chronic hepatitis B (Version 2022)]

Chinese Society of Hepatology and Chinese Society of Infectious Diseases, Chinese Medical Association update the guidelines for the prevention and treatment of chronic hepatitis B (version 2022) in 2022. The latest guidelines recommend more extensive screening and more active antiviral treating for hepatitis B virus infection. This article interprets the essential updates in the guidelines to help deepen understanding and better guide the clinical practice.

Towards the carbon neutrality of sludge treatment and disposal in China: A nationwide analysis based on life cycle assessment and scenario discovery

Motivated by the carbon neutrality target, strategic planning for a low-carbon transition of sludge treatment and disposal in China is challenging due to the unpredictability of technical, regional, socioeconomic, and political factors affecting greenhouse gas (GHG) emissions. This study combines the use of a Life Cycle Assessment and the Patient Rule Induction Method, accounting for possibilities that could achieve net-zero carbon emissions by exploring multiple plausible future profiles of sludge treatment and disposal. Results show that reducing sludge landfill and increasing anaerobic digestion are effective methods to facilitate GHG reduction. Achieving carbon neutrality is closely linked to developing a cleaner electricity mix. Based on a cascaded scenario analysis considering regional differences for 31 Chinese provinces, results demonstrated a maximum cumulative reduction potential of 371 Mt CO₂ equivalents from 2020 to 2050, equal to 59.84% of the business-as-usual scenario. Together with GHG reductions, terrestrial acidification and ecotoxicity as well as freshwater ecotoxicity are synergistically reduced. However, the shifting environmental burden results in freshwater eutrophication, human toxicity, marine ecotoxicity, marine eutrophication, and photochemical oxidant formation. This study presents a novel method for systematically identifying possible future development paths toward carbon neutrality. The findings may support policy designs for achieving target carbon reduction effects for sludge disposal.

[Utilizing ultra-small volume graft in auxiliary liver transplantation for portal hypertension]

Objective: To examine the clinical effect of auxiliary liver transplantation with ultra-small volume graft in the treatment of portal hypertension. Methods: Twelve cases of portal hypertension treated by auxiliary liver transplantation with small volume graft at Liver Transplantation Center,Beijing Friendship Hospital, Capital Medical University between December 2014 and March 2022 were studied retrospectively. There were 8 males and 4 females,aged 14 to 66 years. Model for end-stage liver disease scores were 1 to 15 points and Child scores were 6 to 11 points. The grafts was derived from living donors in 9 cases,from split cadaveric donors in 2 cases,from whole cadaveric liver of child in 1 case. The graft recipient body weight ratios of 3 cadaveric donor livers were 0.79% to 0.90%, and of 9 living donor livers were 0.31% to 0.55%.In these cases, ultra-small volume grafts were implanted. The survivals of patient and graft, complications, portal vein blood flow of residual liver and graft, abdominal drainage and biochemical indexes of liver function were observed. Results: All the grafts and patients survived. Complications included outflow tract torsion in 2 cases, acute rejection in 1 case, bile leakage in 1 case, and thyroid cancer at the later stage of follow-up in 1 case, all of which were cured. The torsion of outflow tract was attributed to the change of anastomotic angle after the growth of donor liver. After the improvement of anastomotic method, the complication did not recur in the later stage. There was no complication of portal hypertension. The measurement of ultrasonic portal vein blood flow velocity showed that the blood flow of residual liver decreased significantly in the early stage after operation, and maintained a very low blood flow velocity or occlusion in the long term after operation, and the blood flow of transplanted liver was stable. Conclusions: Auxiliary liver transplantation can implant ultra-small donor liver through compensation of residual liver. This method may promote the development of living donor left lobe donation and split liver transplantation. However, the auxiliary liver transplantation is complex, and it is difficult to control the complications. Therefore, this method is currently limited to centers that are skilled in living related liver transplantation and that have complete ability to monitor and deal with complications.

Investigation of electrochemical properties, leachate purification, organic matter characteristics, and microbial diversity in a sludge treatment wetland- microbial fuel cell

Sludge treatment wetland-microbial fuel cell (STW-MFC) is a unique sludge treatment process that produces bioelectricity, but its technology is still in its infancy. This study investigated the electrochemical properties, organic matter characteristics, leachate purification, and microbial community structure of STW-MFCs as affected by electrode location. When electrodes were placed in the filler layer, the STW-MFC system presented a higher power generation capacity (maximum output power density: 0.498 W/m³; peak cell voltage: 0.879 V) and organic matter degradation efficiency. The hydrophilic fraction was the main dissolved organic carbon fraction in sludge extracellular biological organic matter (EBOM) and leachate dissolved organic matter (DOM). Aromatics were mainly concentrated in the hydrophobic acid fraction. The UV-254 content of sludge EBOM decreased mainly in the hydrophilic and transphilic acid fractions. The excitation-emission matrix analysis showed that tryptophan-like protein was more easily eliminated than tyrosine-like protein. In addition, there was a strong correlation between voltage and NH₄⁺ removal efficiency; a negative correlation between total chemical oxygen demand (TCOD), total nitrogen (TN), and total phosphorus (TP) removal efficiency, and a negative correlation between pH and TN, TP, and NH₄⁺ removal efficiencies. High-throughput sequencing showed that the system was most abundant in Thermomonas, Geothrix and Geobacter when the electrodes were placed in the filled layer, while the levels of genes for membrane transport, carbohydrate metabolism and energy metabolism functions were higher than in other systems. This work will support STW- MFC widespread implementation by illuminating the underlying mechanics of different anode positions.

Mechanisms, performance, and the impact on microbial structure of direct interspecies electron transfer for enhancing anaerobic digestion-A review

Direct interspecies electron transfer (DIET) has been received tremendous attention, recently, due to the advantages of accelerating methane production via organics reduction during anaerobic digestion (AD) process. DIET-based syntrophic relationships not only occurred with the existence of pili and some proteins in the microorganism, but also can be conducted by conductive materials. Therefore, more researches into understanding and strengthening DIET-based syntrophy have been conducted with the aim of improving methanogenesis kinetics and further enhance methane productivity in AD systems. This study summarized the mechanisms, application and microbial structures of typical conductive materials (carbon-based materials and iron-based materials) during AD reactors operation. Meanwhile, detail analysis of studies on DIET (from substrates, dosage and effectiveness) via conductive materials was also presented in the study. Moreover, the challenges of applying conductive materials in boosting methane production were also proposed, which was supposed to provide a deep insight in DIET for full scale application.

Effect of Dietetic Obesity on Testicular Transcriptome in Cynomolgus Monkeys

Obesity is a metabolic disorder resulting from behavioral, environmental and heritable causes, and can have a negative impact on male reproduction. There have been few experiments in mice, rats, and rabbits on the effects of obesity on reproduction, which has inhibited the development of better treatments for male subfertility caused by obesity. Nonhuman primates are most similar to human beings in anatomy, physiology, metabolism, and biochemistry and are appropriate subjects for obesity studies. In this investigation, we conducted a transcriptome analysis of the testes of cynomolgus monkeys on high-fat, high-fructose, and cholesterol-rich diets to determine the effect of obesity on gene expression in testes. The results showed that the testes of obese monkeys had abnormal morphology, and their testes transcriptome was significantly different from that of non-obese animals. We identified 507 differentially abundant genes (adjusted p value < 0.01, log2 [FC] > 2) including 163 up-regulated and 344 down-regulated genes. Among the differentially abundant genes were ten regulatory genes, including IRF1, IRF6, HERC5, HERC6, IFIH1, IFIT2, IFIT5, IFI35, RSAD2, and UBQLNL. Gene ontology (GO) and KEGG pathway analysis was conducted, and we found that processes and pathways associated with the blood testes barrier (BTB), immunity, inflammation, and DNA methylation in gametes were preferentially enriched. We also found abnormal expression of genes related to infertility (TDRD5, CLCN2, MORC1, RFX8, SOHLH1, IL2RB, MCIDAS, ZPBP, NFIA, PTPN11, TSC22D3, MAPK6, PLCB1, DCUN1D1, LPIN1, and GATM) and down-regulation of testosterone in monkeys with dietetic obesity. This work not only provides an important reference for research and treatment on male infertility caused by obesity, but also valuable insights into the effects of diet on gene expression in testes.

Development and validation of a risk score (Delay-7) to predict the occurrence of a treatment delay following cycle 1 chemotherapy

BACKGROUND

The risk of toxicity-related dose delays, with cancer treatment, should be included as part of pretreatment education and be considered by clinicians upon prescribing chemotherapy. An objective measure of individual risk could influence clinical decisions, such as escalation of standard supportive care and stratification of some patients, to receive proactive toxicity monitoring.

PATIENTS AND METHODS

We developed a logistic regression prediction model (Delay-7) to assess the overall risk of a chemotherapy dose delay of 7 days for patients receiving first-line treatments for breast, colorectal and diffuse large B-cell lymphoma. Delay-7 included hospital treated, age at the start of chemotherapy, gender, ethnicity, body mass index, cancer diagnosis, chemotherapy regimen, colony stimulating factor use, first cycle dose modifications and baseline blood values. Baseline blood values included neutrophils, platelets, haemoglobin, creatinine and bilirubin. Shrinkage was used to adjust for overoptimism of predictor effects. For internal validation (of the full models in the development data) we computed the ability of the models to discriminate between those with and without poor outcomes (c-statistic), and the agreement between predicted and observed risk (calibration slope). Net benefit was used to understand the risk thresholds where the model would perform better than the 'treat all' or 'treat none' strategies.

RESULTS

A total of 4604 patients were included in our study of whom 628 (13.6%) incurred a 7-day delay to the second cycle of chemotherapy. Delay-7 showed good discrimination and calibration, with c-statistic of 0.68 (95% confidence interval 0.66-0.7), following internal validation and calibration-in-the-large of -0.006.

CONCLUSIONS

Delay-7 predicts a patient's individualised risk of a treatment-related delay at cycle two of treatment. The score can be used to stratify interventions to reduce the occurrence of treatment-related toxicity.

Calcium peroxide and freezing co-pretreatment enhancing short-chain fatty acids production from waste activated sludge towards carbon-neutral sludge treatment

Short-chain fatty acids (SCFAs) recovery through anaerobic fermentation is a promising technology to achieve carbon-neutral in waste activated sludge (WAS) management. After 0.15 g CaO₂/g volatile suspended solids (VSS) addition and three-cycle freezing co-pretreatments, the maximal SCFAs production of 438.5 mg COD/g VSS was achieved within 4 days fermentation, and more than 70 % of SCFAs was composed of acetate and propionate, which achieved a higher level than reported in previous studies. Mechanism explorations elucidated that co-pretreatment triggered sludge solubilization, promoting the release of biodegradable organics, providing more biodegradable substrates for SCFAs generation. Further microbial community analysis indicated that the abundances of hydrolytic microorganisms and acidogens were enriched, whereas methanogens were inhibited. Besides, environmental analysis suggested that co-pretreatment could achieve carbon reduction benefits of 0.116-0.291 ton CO₂/ton WAS, demonstrating its huge carbon-neutral potential benefits.

Extracellular polymeric substances-antibiotics interaction in activated sludge: A review

Antibiotics, the most frequently prescribed drugs, have been widely applied to prevent or cure human and veterinary diseases and have undoubtedly led to massive releases into sewer networks and wastewater treatment systems, a hotspot where the occurrence and transformation of antibiotic resistance take place. Extracellular polymeric substances (EPS), biopolymers secreted via microbial activity, play an important role in cell adhesion, nutrient retention, and toxicity resistance. However, the potential roles of sludge EPS related to the resistance and removal of antibiotics are still unclear. This work summarizes the composition and physicochemical characteristics of state-of-the-art microbial EPS, highlights the critical role of EPS in antibiotics removal, evaluates their defense performances under different antibiotics exposures, and analyzes the typical factors that could affect the sorption and biotransformation behavior of antibiotics. Next, interactions between microbial EPS and antibiotic resistance genes are analyzed. Future perspectives, especially the engineering application of microbial EPS for antibiotics toxicity detection and defense, are also emphatically stressed.

[Influencing factors for postoperative survival of patients with pneumoconiosis treated by lung transplantation]

Objective: To explore the influencing factors for postoperative survival of patients with pneumoconiosis (silicosis) after lung transplantation in order to improve their clinical outcomes. Methods: In August 2021, retrospective alalysis from December 2015 to July 2021, 29 patients with end-stage pneumoconiosis underwent lung transplantation at Department of Thoracic Surgery, Affiliated Henan Provincial People's Hospital, Zhengzhou University. The survival, postoperative complications, and causes of death were analyzed. Life table and Kaplan-Meier method were used to draw survival curves, the log-rank test was used to compare the influence of each factor on survival rates, and the multivariate Cox proportional hazards regression model was used to evaluate the influence of each factor on survival. Results: All the patients underwent successful lung transplantation, with survival rates of 75% at 6 months, 70% at 1 year, 65% at 2 years, 50% at 3 years and 50% at 5 years. The Kaplan-Meier survival analysis showed that BMI, age and preoperative albumin level were influencing factors for postoperative survival rates (P<0.05) . The multivariate COX regression model showed that BMI≥18.5 kg/m(2) and the albumin level≥35 g/L were the protective factors (P<0.05) . Conclusion: Aging older, preoperative BMI<18.5 kg/m(2) and hypoalbuminemia are independent risk factors for death after lung transplantation. Survival rates are affected by preoperative BMI index, albumin level and age. Early intervention should be made before lung transplantation to promote the BMI index and albumin level to reach the standard.

Different Features of a Metabolic Connectivity Map and the Granger Causality Method in Revealing Directed Dopamine Pathways: A Study Based on Integrated PET/MR Imaging

BACKGROUND AND PURPOSE

Exploring the directionality of neural information in the brain is important for understanding brain mechanisms and neurodisease development. Granger causality analysis and the metabolic connectivity map can be used to investigate directional transmission of information between brain regions, but their differences in depicting functional effective connectivity are not clear.

MATERIALS AND METHODS

Using the Monash rs-PET/MR imaging data set, we conducted Granger causality and metabolic connectivity map analyses of the dopamine reward circuit in the brain. The dopamine reward circuit is a well-known system consisting primarily of the bilateral orbital frontal cortex, caudate, nucleus accumbens, thalamus, and substantia nigra. We validated these circuit pathways using Granger causality and the metabolic connectivity map for identifying effective connectivities against a priori knowledge by testing the significance of directed pathways (P < .05, false discovery rate-corrected).

RESULTS

We found 3 types of effective connectivities in the dopamine reward circuit: long-range, neighborhood, and symmetric. Granger causality analysis revealed long-range connections in the orbital frontal cortex-caudate and orbital frontal cortex-nucleus accumbens regions. Metabolic connectivity map analysis revealed neighborhood connections in the nucleus accumbens-caudate, substantia nigra-thalamus, and thalamus-caudate regions. Metabolic connectivity map analysis also found symmetric connections in each of the bilateral nucleus accumbens, caudate, thalamus, and orbital frontal cortex-caudate regions. Different patterns in directional networks of the dopamine reward circuit were revealed by Granger causality and metabolic connectivity map analyses.

CONCLUSIONS

Granger causality analysis primarily identified bidirectional cortico-nucleus connections, while the metabolic connectivity map primarily identified direct connections among neighborhood and symmetric regions. The results of this study indicated that investigations of effective connectivities should use an appropriate analysis method depending on the purpose of the study.

[The epidemiology and screening of hepatitis D]

Hepatitis D virus (HDV) is a defective RNA virus with 8 genotypes, which requires hepatitis B virus (HBV) for its replication both in co-infection (HDV infection occurs when people become infected with both hepatitis B and D simultaneously) and super-infection (HDV infection after infected with hepatitis B). Due to persistency of anti-HDV in the superinfected patient, the most epidemiology data of HDV infection suggests HBV/HDV super-infection. Because of inadequate awareness and effective HBV vaccination programme, HDV infection screen was not specific recommended, except for risk population recommended by AASLD. However, the disease burden of HDV infection was not fully understood and might be underestimated. This review summarized the anti-HDV and HDV genotype epidemiology and the screening of HDV infection.

[The influence of meteorological factors on SARS-CoV-2 transmission: evidence from laboratory and epidemiological studies]

SARS-CoV-2 has infected more than 600 million people worldwide and caused more than 6 million deaths. The emerging novel variants have made the epidemic rebound in many places. Meteorological factors can affect the epidemic spread by changing virus activity, transmission dynamic parameters and host susceptibility. This paper systematically analyzed the currently available laboratory and epidemiological studies on the association between the meteorological factors and COVID-19 incidence, in order to provide scientific evidence for future epidemic control and prevention, as well as developing early warning system.

Effects of weight loss on bone turnover, inflammatory cytokines, and adipokines in Chinese overweight and obese adults

PURPOSE

Plenty of studies have examined the long term effect of weight loss on bone mineral density. This study aimed to explore the effects of 10% weight loss on early changes in bone metabolism as well as the possible influencing factors.

METHODS

Overweight and obese outpatients (BMI > 24.0 kg/m²) were recruited from the nutrition clinic and followed a calorie-restricted, high-protein, low-carbohydrate diet program. Dietary intake, body composition, serum procollagen type I N-propeptide (PINP), β-Crosslaps, PTH, 25(OH) VitD, a series of inflammatory cytokines and adipokines were measured for the participants before starting to lose weight and after 10% weight loss (NCT04207879).

RESULTS

A total of 75 participants were enrolled and 37 participants achieved a weight loss of at least 10%. It was found that PINP decreased (p = 0.000) and the β-Crosslaps increased (p = 0.035) in female participants. Decreases in PTH (p = 0.001), serum IL-2 (p = 0.013), leptin (p = 0.001) and increases in 25(OH) VitD (p = 0.001), serum ghrelin (p = 0.033) were found in 37 participants after 10% of their weight had been lost. Change in PINP was detected to be significantly associated with change in lean body mass (r = 0.418, p = 0.012) and change in serum ghrelin(r = - 0.374, p = 0.023).

CONCLUSIONS

Bone formation was suppressed and bone absorption was increased in female subjects after a 10% weight loss. Bone turnover was found to be associated with lean body mass and affected by the circulating ghrelin level.