Effect of freeze-thaw frequency plus rainfall on As and Sb metal(loid)s leaching from the solidified/stabilized soil remediated with Fe-based composite agent

The composite agent of ferrous sulfate, fly ash, and calcium lignosulfonate (FFC) can remediate the soil contaminated by As and Sb under cyclic freeze-thaw (F-T) via stabilization/solidification (S/S). However, the impact of high-frequency F-T cycles on the leaching behavior and migration of As and Sb in FFC-treated soils remains unclear. Here the leaching concentrations, heavy metal speciation (Wenzel's method), and Hydrus-1d simulations were investigated. The results showed that FFC effectively maintained the long-term S/S efficiency of arsenic remediation subject to an extended rainfall and freeze-thaw cycles, and stabilized the easily mobile form of As. The short-term S/S effect on Sb in the remediated soils suffering from F-T cycles was demonstrated in the presence of FFC. In a 20-year span, the mobility of Sb was affected by the number of F-T cycles (FT60 > FT20 > FT40 > FT0) in soil with a depth of 100 cm. As leaching progressed, FFC slowed the upward proportion of adsorbed As fractions but converted parts of the residual Sb to the form of crystalline Fe/Al (hydro) oxide. Moreover, the adsorption rate and capacity of As also preceded that of Sb. Long-term curative effects of FFC could be observed for As, but further development of agents capable of remedying Sb under cyclic F-T and long-term rainfall was needed. The predictive results on the migration and leaching behavior of heavy metals in S/S remediated soils may provide new insight into the long-term assessment of S/S under natural conditions.

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.

Circular RNA ath-circ032768, a competing endogenous RNA, response the drought stress by targeting miR472-RPS5 module

CircRNAs (circular RNAs) reduce the abundance of miRNAs through ceRNA (competing endogenous RNA), to regulate many physiological processes and stress responses in plants. However, the role of circRNA in drought stress is poorly understood. Through ring identification and sequencing verification of ath-circ032768, bioinformatics analysis predicted the interaction of ath-circ032768-miR472-RPS5, and further obtained transgenic plants overexpressing ath-circ032768 and silencing STTM-miR472. The change in drought stress was analysed using biochemical and molecular biological methods. Sequencing and biological analysis confirmed that ath-circ032768, miR472 and RPS5 were responsive to drought stress, and changes in gene expression were consistent with the prediction of ceRNA. The silencing vectors ath-circ032768 and STTM-miR472 were constructed using molecular biology techniques, and stable transgenic plants with drought tolerance obtained. Further physiological and biochemical studies showed that ath-circ032768 could bind to miR472, and that miR472 could bind to the RPS5 gene, resulting in decreased expression of RPS5. Hence, ath-circ032768 can competitively inhibit degradation of RPS5 by miR472 through ceRNA. This process is accompanied by increased expression of DREB2A, RD29A and RD29B genes. Through the ath-circ032768-miR472-RPS5 pathway, the RPS5 stress resistance protein interacts with DREB2A protein to enhance expression of downstream drought resistance genes, RD29A and RD29B, and participate in the regulation mechanism of plant drought resistance, thereby improving drought tolerance of plants.

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.

Bioinspired Tumor Calcification-Guided Early Diagnosis and Eradication of Hepatocellular Carcinoma

Tumor calcification is found to be associated with the benign prognostic, and which shows considerable promise as a somewhat predictive index of the tumor response clinically. However, calcification is still a missing area in clinical cancer treatment. A specific strategy is proposed for inducing tumor calcification through the synergy of calcium peroxide (CaO2)-based microspheres and transcatheter arterial embolization for the treatment of hepatocellular carcinoma (HCC). The persistent calcium stress in situ specifically leads to powerful tumor calcioptosis, resulting in diffuse calcification and a high-density shadow on computed tomography that enables clear localization of the in vivo tumor site and partial delineation of tumor margins in an orthotopic HCC rabbit model. This osmotic calcification can facilitate tumor clinical diagnosis, which is of great significance in differentiating tumor response during early follow-up periods. Proteome and phosphoproteome analysis identify that calreticulin (CALR) is a crucial target protein involved in tumor calcioptosis. Further fluorescence molecular imaging analysis also indicates that CALR can be used as a prodromal marker of calcification to predict tumor response at an earlier stage in different preclinical rodent models. These findings suggest that upregulated CALR in association with tumor calcification, which may be broadly useful for quick visualization of tumor response.

[Liver cancer treatment with mitochondrial homeostasis]

Systemic treatment, including molecular targeted therapy, immunotherapy, and chemotherapy, is an important means of achieving long-term survival in patients with intermediate-and advanced-stage liver cancer. However, some patients are insensitive to treatment and even develop drug resistance. Mitochondria are the center of cellular energy metabolism and, at the same time, are the priority targets for systemic therapy. Mitochondrial homeostasis plays an important role in the treatment of liver cancer. The relationship between the two advances is elucidated so as to provide better ideas for the clinical treatment of liver cancer.

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.

Neutron-gamma discrimination with broaden the lower limit of energy threshold using BP neural network

Neutron-gamma discrimination is a tough and significative in experimental neutrons measurements procedure, especially for low-energy neutrons signal discrimination. In this work, based on the Pulse Shape Discrimination (PSD) and Back-Propagation (BP) artificial neural networks, a neutron-gamma discrimination method is developed to broaden the lower limit of energy threshold with the hidden layer of 20 neurons. Compared with neutron-gamma discrimination method based on PSD only, the developed neutron-gamma discrimination method based on the PSD and BP-ANN can discriminate neutron and gamma-ray signals with low energy threshold, which can discriminate signals up to 99.93%. Moreover, this work can reduce the energy threshold from 350 keV to 70 keV, as well as the acquired data utilization increased from 60% to more than 99.9%, which overcome the hardware limitations and distinguish neutron and gamma-ray signals, effectively. The developed neutron-gamma discrimination method and the trained neural network can be directly used to other experimental neutrons measurements.

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.

Efficacy of preventive interventions against ventilator-associated pneumonia in critically ill patients: an umbrella review of meta-analyses

Many meta-analyses have assessed the efficacy of preventive interventions against ventilator-associated pneumonia (VAP) in critically ill patients. However, there has been no comprehensive analysis of the strength and quality of evidence to date. Systematic reviews of randomized and quasi-randomized controlled trials, which evaluated the effect of preventive strategies on the incidence of VAP in critically ill patients receiving mechanical ventilation for at least 48 h, were included in this article. We identified a total of 34 interventions derived from 31 studies. Among these interventions, 19 resulted in a significantly reduced incidence of VAP. Among numerous strategies, only selective decontamination of the digestive tract (SDD) was supported by highly suggestive (Class II) evidence (risk ratio (RR)=0.439, 95% CI: 0.362-0.532). Based on data from the sensitivity analysis, the evidence for the efficacy of non-invasive ventilation in weaning from mechanical ventilation (NIV) was upgraded from weak (Class IV) to highly suggestive (Class II) (RR=0.32, 95% CI: 0.22-0.46). All preventive interventions were not supported by robust evidence for reducing mortality. Early mobilization exhibited suggestive (Class III) evidence in shortening both intensive length of stay (LOS) in the intensive care unit (ICU) (mean difference (MD)=-0.85, 95% CI: -1.21 to -0.49) and duration of mechanical ventilation (MD=-1.02, 95% CI: -1.41 to -0.63). In conclusion, SDD and NIV are supported by robust evidence for prevention against VAP, while early mobilization has been shown to significantly shorten the LOS in the ICU and the duration of mechanical ventilation. These three strategies are recommendable for inclusion in the ventilator bundle to lower the risk of VAP and improve the prognosis of critically ill patients.

A novel hybrid machine learning model for auxiliary diagnosing myocardial ischemia

Introduction

Accurate identification of the myocardial texture features of fat around the coronary artery on coronary computed tomography angiography (CCTA) images are crucial to improve clinical diagnostic efficiency of myocardial ischemia (MI). However, current coronary CT examination is difficult to recognize and segment the MI characteristics accurately during earlier period of inflammation.

Materials and methods

We proposed a random forest model to automatically segment myocardium and extract peripheral fat features. This hybrid machine learning (HML) model is integrated by CCTA images and clinical data. A total of 1,316 radiomics features were extracted from CCTA images. To further obtain the features that contribute the most to the diagnostic model, dimensionality reduction was applied to filter features to three: LNS, GFE, and WLGM. Moreover, statistical hypothesis tests were applied to improve the ability of discriminating and screening clinical features between the ischemic and non-ischemic groups.

Results

By comparing the accuracy, recall, specificity and AUC of the three models, it can be found that HML had the best performance, with the value of 0.848, 0.762, 0.704 and 0.729.

Conclusion

In sum, this study demonstrates that ML-based radiomics model showed good predictive value in MI, and offer an enhanced tool for predicting prognosis with greater accuracy.

[Study of the effects of dietary patterns on glycemic control in community type 2 diabetic mellitus patients]

Objective: To understand the impact of diet on glycemic control in community-managed patients with type 2 diabetes mellitus (T2DM) and provide evidence for implementing prevention strategies and measures for diabetes patients. Methods: Eight communities were randomly selected from Changshu and Wuhan in 2015, and T2DM patients managed in the community were selected to conduct questionnaire surveys, physical measurements, and blood glucose testing. Factor analysis was used to obtain dietary patterns. A binary logistic regression model was used to analyze the factors affecting glycemic control. Results: Finally, 1 818 T2DM patients were included, and the control rate of FPG was 57.59% (95%CI: 55.30%-59.86%), and the control rate of 2 h postprandial blood glucose (2 h PBG) was 24.90% (95%CI: 22.93%- 26.91%). Five dietary patterns were obtained by factor analysis: animal food pattern, fruit-aquatic products-potato patterns, vegetable-grain pattern, egg-milk-bean pattern, and oil-salt patterns. No-conditional multivariate logistic regression analysis showed that after adjusting for confounding factors, the reduced probability of FPG control was related to animal food pattern (OR=0.71, 95%CI: 0.52-0.98) and fruit-aquatic products-potato patterns (OR=0.71, 95%CI: 0.51-0.97). The decrease in the 2 h PBG control probability was related to fruit-aquatic products-potato patterns (OR=0.60, 95%CI: 0.40-0.90). The increased probability of FPG and 2 h postprandial glucose control were both related to vegetable-grain pattern (OR=1.41, 95%CI: 1.03-1.94; OR=1.68, 95%CI: 1.13-2.51) and egg-milk-bean pattern (OR=1.75, 95%CI: 1.25-2.46; OR=1.56, 95%CI: 1.00-2.42). Compared with the Q4 group of egg-milk-bean pattern, the FPG control rate of the combination of "fruit-aquatic products-potato pattern (Q4 group), vegetable-grain pattern (Q2 group), egg-milk-bean pattern (Q3 group)" was higher (OR=6.79, 95%CI: 1.15-40.23, P=0.035). Compared with the Q4 group of vegetable-grain pattern, the combination of "fruit-aquatic products-potato pattern (Q4 group), vegetable-grain pattern (Q3 group), egg-milk-bean pattern (Q2 group), oil-salt pattern (Q2 group)" had higher control rate of 2 h PBG (OR=12.78, 95%CI: 1.26-130.05, P=0.031). Conclusions: A proper combination of dietary patterns and dietary patterns are more conducive to the control of FPG and 2 h PBG in T2DM patients managed in the communities of Wuhan and Changshu. Patient nutrition education should be strengthened, and the food-matching ability of patients should be improved.

Association of serum lipids and abnormal lipid score with cancer risk: a population-based prospective study

BACKGROUND

Serum lipid levels are associated with cancer risk. However, there still have uncertainties about the single and combined effects of low lipid levels on cancer risk.

METHODS

A prospective cohort study of 33,773 adults in Shanghai between 2016 and 2017 was conducted. Total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) levels were measured. Cox proportional hazard models were used to assess the association of single and combined lipids with overall, lung, colon, rectal, thyroid gland, stomach, and female breast cancers. The effect of the combination of abnormal lipid score and lifestyle on cancer was also estimated.

RESULTS

A total of 926 incident cancer cases were identified. In the RCS analysis, hazard ratios (HRs) of overall cancer for individuals with TC < 5.18 mmol/L or with LDL-C < 3.40 mmol/L were higher. Low TC was associated with higher colorectal cancer risk (HR [95% CI] = 1.76 [1.09-2.84]) and low HDL-C increased thyroid cancer risk by 90%. Abnormal lipid score was linearly and positively associated with cancer risk, and smokers with high abnormal lipid scores had a higher cancer risk, compared to non-smokers with low abnormal lipid scores (P < 0.05).

CONCLUSIONS

Low TC levels were associated with an increased risk of overall and colorectal cancer. More attention should be paid to participants with high abnormal lipid scores and unhealthy lifestyles who may have a higher risk of developing cancer. Determining the specific and comprehensive lipid combinations that affect tumorigenesis remains a valuable challenge.

Effect of different production methods on physicochemical properties and adsorption capacities of biochar from sewage sludge and kitchen waste: Mechanism and correlation analysis

Different pyrolysis methods, parameters and feedstocks result in biochars with different properties, structures and removal capacities for heavy metals. However, the role of each property on adsorption capacity and corresponding causal relationships remain unclear. Here, we investigated various physicochemical properties of biochar produced via three different methods and two different feedstocks to clarify influences of biomass sources and pyrolysis processes on biochar properties and its heavy metal adsorption performance. Experimental results showed biochars were more aromatic and contained more functional groups after hydrothermal carbonization, while they had developed pores and higher surface areas produced by anaerobic pyrolysis. The inclusion of oxygen resulted in more complete carbonization and higher CEC biochar. Different biochar properties resulted in different adsorption capacities. Biochar produced by aerobic calcination showed higher adsorption efficiency for Cu and Pb. Correlation analysis proved that pH, cation exchange capacity and degree of carbonization positively affected adsorption, while organic matter content and aromaticity were unfavorable for adsorption. Microstructure and components determined biochar macroscopic properties and ultimate adsorption efficiency for metal ions. This study identifies the degree of correlation and pathways of each property on adsorption, which provides guidance for targeted modification of biochar to enhance its performance in heavy metal removal.

Intravital photoacoustic brain stimulation with high-precision

Significance

Neural regulation at high precision vitally contributes to propelling fundamental understanding in the field of neuroscience and providing innovative clinical treatment options. Recently, photoacoustic brain stimulation has emerged as a cutting-edge method for precise neuromodulation and shows great potential for clinical application.

Aim

The goal of this perspective is to outline the advancements in photoacoustic brain stimulation in recent years. And, we also provide an outlook delineating several prospective paths through which this burgeoning approach may be substantively refined for augmented capability and wider implementations.

Approach

First, the mechanisms of photoacoustic generation as well as the potential mechanisms of photoacoustic brain stimulation are provided and discussed. Then, the state-of-the-art achievements corresponding to this technology are reviewed. Finally, future directions for photoacoustic technology in neuromodulation are provided.

Results

Intensive research endeavors have prompted substantial advancements in photoacoustic brain stimulation, illuminating the unique advantages of this modality for noninvasive and high-precision neuromodulation via a nongenetic way. It is envisaged that further technology optimization and randomized prospective clinical trials will enable a wide acceptance of photoacoustic brain stimulation in clinical practice.

Conclusions

The innovative practice of photoacoustic technology serves as a multifaceted neuromodulation approach, possessing noninvasive, high-accuracy, and nongenetic characteristics. It has a great potential that could considerably enhance not only the fundamental underpinnings of neuroscience research but also its practical implementations in a clinical setting.

Robust Vascular Segmentation for Raw Complex Images of Laser Speckle Contrast Based on Weakly Supervised Learning

Laser speckle contrast imaging (LSCI) is widely used for in vivo real-time detection and analysis of local blood flow microcirculation due to its non-invasive ability and excellent spatial and temporal resolution. However, vascular segmentation of LSCI images still faces a lot of difficulties due to numerous specific noises caused by the complexity of blood microcirculation's structure and irregular vascular aberrations in diseased regions. In addition, the difficulties of LSCI image data annotation have hindered the application of deep learning methods based on supervised learning in the field of LSCI image vascular segmentation. To tackle these difficulties, we propose a robust weakly supervised learning method, which selects the threshold combinations and processing flows instead of labor-intensive annotation work to construct the ground truth of the dataset, and design a deep neural network, FURNet, based on UNet++ and ResNeXt. The model obtained from training achieves high-quality vascular segmentation and captures multi-scene vascular features on both constructed and unknown datasets with good generalization. Furthermore, we intravital verified the availability of this method on a tumor before and after embolization treatment. This work provides a new approach for realizing LSCI vascular segmentation and also makes a new application-level advance in the field of artificial intelligence-assisted disease diagnosis.

Efficacy and Safety of First-line Therapies for Advanced Unresectable Oesophageal Squamous Cell Cancer: a Systematic Review and Network Meta-analysis

AIM

To compare the clinical efficacy and safety of first-line treatments for advanced unresectable oesophageal squamous cell cancer.

MATERIALS AND METHODS

A systematic review and network meta-analysis was carried out by retrieving and retaining relevant literature from databases. The studies were randomised controlled trials comparing first-line treatments for advanced unresectable oesophageal squamous cell cancer. A Bayesian network meta-analysis was used to assess clinical outcomes.

RESULTS

Nine studies including 4499 patients receiving first-line treatments were analysed. For all populations, toripalimab plus chemotherapy tended to provide the best overall survival (hazard ratio 0.58, 95% confidence intervals 0.43-0.78) and sintilimab plus chemotherapy provided the best progression-free survival (0.56, 0.46-0.68). Nivolumab plus chemotherapy presented the best objective response rate (odds ratio 2.45, 1.78-3.42) and camrelizumab plus chemotherapy (0.47, 0.29-0.74) appeared to be the safest. Sintilimab plus chemotherapy (0.55, 0.40-0.75) and nivolumab (0.54, 0.37-0.80) plus chemotherapy had the best overall survival in programmed death ligand 1 (PD-L1) tumour proportion score <1% and ≥1% subgroups. Toripalimab plus chemotherapy (0.61, 0.40-0.93) and pembrolizumab (0.57, 0.43-0.75) were the best in overall survival in combined positive score <10 and ≥10 subgroups, respectively. Toripalimab plus chemotherapy showed the best overall survival in the Asian group; pembrolizumab presented better overall survival in the Asian population than the non-Asian group.

CONCLUSION

Most immunotherapy combined with chemotherapy showed superior clinical benefits and sintilimab plus chemotherapy, toripalimab plus chemotherapy and tislelizumab plus chemotherapy had better comprehensive clinical efficacy. PD-L1 expression detection and ethnicity differences are still of great significance and most suitable regimens varied from each subgroup.

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.

An overview of in situ remediation for groundwater co-contaminated with heavy metals and petroleum hydrocarbons

Groundwater is an important component of water resources. Mixed pollutants comprising heavy metals (HMs) and petroleum hydrocarbons (PHs) from industrial activities can contaminate groundwater through such processes as rainfall infiltration, runoff and discharge, which pose direct threats to human health through the food chain or drinking water. In situ remediation of contaminated groundwater is an important way to improve the quality of a water environment, develop water resources and ensure the safety of drinking water. Bioremediation and permeable reactive barriers (PRBs) were discussed in this paper as they were effective and affordable for in situ remediation of complex contaminated groundwater. In addition, media types, technology combinations and factors for the PRBs were highlighted. Finally, insights and outlooks were presented for in situ remediation technologies for complex groundwater contaminated with HMs and PHs. The selection of an in situ remediation technology should be site specific. The remediation of complex contaminated groundwater can be approached from various perspectives, including the development of economical materials, the production of slow-release and encapsulated materials, and a combination of multiple technologies. This review is expected to provide technical guidance and assistance for in situ remediation of complex contaminated groundwater.

[Analysis of the prevalence of dyslipidemia and correlative factors in Tajik population in Pamir Plateau of Xinjiang]

Objective: To investigate the prevalence of dyslipidemia and the level of blood lipids among Tajik people in Pamir Plateau, Xinjiang, and explore the related factors of dyslipidemia. Methods: It is a retrospective cross-sectional study. A multi-stage cluster random sampling survey was conducted among 5 635 Tajiks over 18 years old in Tashkorgan Tajik Autonomous County, Xinjiang Province from May to October 2021. Data were collected through questionnaire survey (general information, medical history, and personal history), physical examination (height, weight, waist, and blood pressure) and blood test (total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), and high-density cholesterol (HDL-C)) to analyze the dyslipidemia and its risk factors among Tajiks. Results: The age of Tajik participants was (41.9±15.0) years, including 2 726 males (48.4%). The prevalence of borderline high TC, high LDL-C and high TG levels were 17.2%, 14.7% and 8.9%, respectively. The prevalence of high TC, high LDL-C, high TG and low HDL-C were 4.1%, 4.9%, 9.4% and 32.4%, respectively, and the prevalence of dyslipidemia was 37.0%. There is a positive correlation between male,higher education level, higher body mass index (BMI) value,waist circumference, living in town, smoking and dyslipidemia. Conclusions: The low prevalence of high TC, high LDL-C, high TG and high prevalence of low HDL-C was a major characteristic of Tajik people in Pamir Plateau of Xinjiang. The lower rates of overweight and obesity may be one of the reasons for the lower prevalence of dyslipidemia among Tajik.

Chronically high stress hormone levels dysregulate sperm long noncoding RNAs and their embryonic microinjection alters development and affective behaviours

Previous studies on paternal epigenetic inheritance have shown that sperm RNAs play a role in this type of inheritance. The microinjection of sperm small noncoding RNAs into fertilised mouse oocytes induces reprogramming of the early embryo, which is thought to be responsible for the differences observed in adult phenotype. While sperm long noncoding RNAs (lncRNAs) have also been investigated in a previous study, their microinjection into fertilised oocytes did not yield conclusive results regarding their role in modulating brain development and adult behavioural phenotypes. Therefore, in the current study we sought to investigate this further. We used our previously established paternal corticosterone (stress hormone) model to assess sperm lncRNA expression using CaptureSeq, a sequencing technique that is more sensitive than the ones used in other studies in the field. Paternal corticosterone exposure led to dysregulation of sperm long noncoding RNA expression, which encompassed lncRNAs, circular RNAs and transposable element transcripts. Although they have limited functional annotation, bioinformatic approaches indicated the potential of these lncRNAs in regulating brain development and function. We then separated and isolated the sperm lncRNAs and performed microinjections into fertilised oocytes, to generate embryos with modulated lncRNA populations. We observed that the resulting adult offspring had lower body weight and altered anxiety and affective behavioural responses, demonstrating roles for lncRNAs in modulating development and brain function. This study provides novel insights into the roles of lncRNAs in epigenetic inheritance, including impacts on brain development and behaviours of relevance to affective disorders.

Enhanced generation of oxysulfur radicals by the BiOBr/Montmorillonite activated sulfite system: Performance and mechanism

The easily synthesized, cost-effective, and stable photocatalysts for sulfite activation are always required for the enhancement of organic contaminants degradation. Herein, the facile coprecipitation synthesis of Bismuth oxybromide (BiOBr)/Montmorillonite (MMT) was reported, which could activate sulfite (SO32-/HSO3-) under sunlight and accelerate the catalytic performance more effectively than pristine BiOBr. After adding sulfite to the photocatalysis system, the photodegradation efficiency of atrazine (ATZ) achieved 73.7% ± 1.5% after 5 min and 94.4% ± 1.6% after 30 min of sunlight irradiation with BiOBr/MMT. The BiOBr/MMT-sulfite system also presented remarkable photocatalytic performance to eliminate various contaminants, including ciprofloxacin, sulfadiazine, tetracycline, and carbamazepine. The various features of the photocatalyst materials were studied, including their surface morphology, structure, optical properties, and composition. The results illustrated that by adding MMT, the bandgap of the pristine BiOBr was reduced and the surface area was increased, which led to an increased ability to adsorb materials. Results of various influence factors showed this enhanced system had satisfactory and stable removal performance of ATZ in the pH range of 3.0-6.5, but HPO42- had a strong negative effect on the system performance. Oxysulfur radicals (SO5·- and SO4·-), h+, and 1O2 were discovered as the prevailing active species in the BiOBr/MMT-sulfite system. The proposed degradation mechanism of this photocatalyst-enhanced system revealed that sulfite adsorption on the surface of the photocatalyst played a vital role during the initial phase, and the degradation pathway of ATZ was discussed. This study provides a new synthesis strategy of a photocatalyst for sulfite activation and expands the potential uses of Bi-based photocatalysts in degrading difficult-to-remove organic pollutants.

[Progress in research of models for predicting the risk of readmission and mortality among patients with acute heart failure]

Heart failure is a serious and end-stage status of various heart diseases, characterized by comparatively high rate of readmission and mortality, and has become an important public health issue. The risk of readmission and mortality following discharge of an index hospitalization are key indicators to evaluate the quality of medical care among patients with acute heart failure. Therefore, it is important to carry out risk prediction research for patients with acute heart failure, quantify the disease risk, perform risk stratification, optimize clinical decision-making, elevate patients' quality of life and prognosis, and comprehensively improve the medical quality of acute heart failure. During the past 20 years, foreign researchers have developed dozens of models to predict the risk of acute heart failure readmission and mortality, and Chinese researchers have also developed up to 10 models applicable to the Chinese population. However, there is no recommended risk prediction model for acute heart failure in current clinical guidelines across China. In this report, we aim to introduce the major models for predicting the risk of acute heart failure readmission and mortality from home and abroad, focus on putting forward limitations of established models, and initiating potential directions for future studies from the following aspects: integrate multi-source data, mine emerging biomarkers, establish polygenic risk scores, optimize machine learning methods, promote flexible adjustment, and broaden approaches that applicable for various scenarios. Accordingly, this study will help facilitate domestic research in predicting the risk of readmission and mortality among patients hospitalized for acute heart failure.

Effects of oleanolic acid on acute liver injury triggered by lipopolysaccharide in broiler chickens

1. Infectious injury caused by lipopolysaccharide (LPS), a metabolite of gram-negative bacteria, can induce stress responses in animals and is a significant cause of morbidity and mortality in young birds. The purpose of this study was to investigate the effects of dietary supplementation with oleanolic acid (OA) on acute liver injury in broiler chickens challenged with LPS.2. In total, 120 broiler chickens were randomly divided into six groups and fed a basal diet containing 0, 50, 100, or 200 mg/kg OA or 100 mg/kg aureomycin. On d 15, broiler chickens were injected with either LPS or an equivalent volume of normal saline. Six hours after LPS injection, two broiler chicks were randomly selected for sampling in each replicate.3. The results indicated that dietary aureomycin was ineffective in alleviating LSP-associated liver injury, but protected broiler chickens from LPS-induced liver damage. This promoted a significant reduction in the levels of malondialdehyde and an increase in the levels of superoxide dismutase in liver. In addition, OA was found to cause significant reductions in the relative expression of IL-1β, IL-6, and TNF-α in broiler liver tissues, whereas the relative expression of IL-10 was significantly increased.4. In conclusion, oleanolic acid can alleviate oxidative stress and injury in the livers of broiler chickens induced by lipopolysaccharide. Consequently, oleanolic acid has potential utility as a novel anti-inflammatory and antioxidant feed additive.

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.

Performance of high solids enzymatic hydrolysis and bioethanol fermentation of food waste under the regulation of saponin

Bioethanol recovery from food waste through high solids enzymatic hydrolysis (HSEH) and high solids bioethanol fermentation (HSBF) alleviate the energy crisis. However, this cause decreased glucose and bioethanol yields due to the high solids content. In this study, saponin was introduced into food waste HSEH and HSBF systems to enhance the product yields. Under the regulation of saponin, the substrate released >90% of the theoretical reducing sugar. The glucose concentration increased by 137.41 g/L after 24 h of HSEH with 2.0% saponin. The bioethanol titer reached 73.2 g/L (1.0%-saponin). Untargeted metabolomics illustrating that saponin had higher antifungal properties at lower concentrations (0.5%-saponin) that caused a decrease in bioethanol yield. The addition of saponin concentrations of 1.0%∼3.0% promoted HSEH, HSBF, and the metabolism of Saccharomyces cerevisiae; thus, 1.0% was suggested for practical use. This study deepened the understanding of saponin in enhancing HSBF and provides theoretical support for further application.

Characterization and profiling of the microRNA in small extracellular vesicles isolated from goat milk samples collected during the first week postpartum

Colostrum contains nutrients, immunoglobulins, and various bioactive compounds such as microRNA (miRNA). Less is known about the temporal changes in miRNA profiles in ruminant milk samples during the first week postpartum. In this study, we characterized and compared the profiles of miRNA in the small extracellular vesicles (sEV) isolated from colostrum (CM, collected immediately after parturition, n = 8) and transition milk (TM, collected 7 d postpartum, n = 8) from eight 1-yr-old Guanzhong dairy goats with a milk yield of approximately 500 kg/year. A total of 192 unique sEV-associated miRNA (transcripts per million >1 at least 4 samples in either CM or TM) were identified in all samples. There were 29 miRNA uniquely identified in the TM samples while no miRNA was uniquely identified in the CM samples. The abundance of the top 10 miRNA accounted for 82.4% ± 4.0% (± SD) of the total abundance, with let-7 families (e.g., let-7a/b/c-5p) being predominant in all samples. The top 10 miRNA were predicted to target 1,008 unique genes that may regulate pathways such as focal adhesion, TGF-β signaling, and axon guidance. The expression patterns of EV miRNA were similar between the 2 sample groups, although the abundance of let-7c-5p and miR-30a-3p was higher, whereas that of let-7i-5p and miR-103-3p was lower in CM than in TM. In conclusion, the core miRNAome identified in the samples from CM and TM may play an important role in cell proliferation, bone homeostasis, and neuronal network formation in newborn goat kids. The lack of differential miRNA expression between the CM and TM samples may be due to a relatively short sampling interval in which diet composition, intake and health status of ewes, and environment were relatively stable.

[Research progress on the mechanism and response strategies of molecular targeted drug resistance in liver cancer]

Molecular targeted drugs are one of the treatments for hepatocellular carcinoma (HCC), the primary factor influencing their therapeutic efficacy is drug resistance. Diminished drug intake, greater efflux, improved DNA damage repair capacity, aberrant signal pathways, hypoxia, epithelial-mesenchymal cell transition, and the cellular autophagy system are summarized herein as aspects of the drug resistance mechanism. Simultaneously, effective strategies for addressing drug resistance are elaborated, providing ideas for better clinical treatment of HCC.

Dose Painting Radiotherapy Guided by Diffusion-Weighted Magnetic Resonance vs. 18F-FDG-PET/CT in Locoregionally Advanced Nasopharyngeal Carcinoma: A Randomized, Controlled Clinical Trial

PURPOSE/OBJECTIVE(S)

This phase II randomized controlled trial aimed at comparing the efficacy and toxicity of diffusion-weighted magnetic resonance imaging (DWI)-guided dose painting radiotherapy (DP-RT), FDG-PET/CT-guided DP-RT, and conventional MRI-based radiotherapy (RT) in locoregionally advanced nasopharyngeal carcinoma (NPC).

MATERIALS/METHODS

A total of 330 patients with stage III-IVa NPC disease were randomly assigned in a 1:1:1 ratio to receive induction chemotherapy followed by concurrent chemoradiotherapy by DWI-guided DP-RT (group A, n = 110), FDG-PET/CT-guided DP-RT (group B, n = 110), or conventional MRI-based RT (group C, n = 110). All patients received volumetric modulated arc therapy (VMAT). In group A, subvolume GTVnx-DWI (gross tumor volume of nasopharynx in DWI) was defined as the areas within the GTVnx (gross tumor volume of nasopharynx) with an apparent diffusion coefficient (ADC) below the mean ADC (ADC < mean). In group B, subvolume GTVnx-PET (gross tumor volume of nasopharynx in PET images) was defined within GTVnx as the SUV50%max isocontour. The doses to GTVnx-DWI in group A and GTVnx-PET in group B were escalated to 75.2 Gy/32 fx in patients with T1-2 disease and to 77.55 Gy/33 fx in those with T3-4 disease in 2.35 Gy per fraction. In group C, planning gross tumor volume of nasopharynx (PGTVnx) was irradiated at 70.4 to 72.6 Gy/32 to 33 fx in 2.2 Gy per fraction. This trial is registered with chictr.org.cn (ChiCTR2200057476).

RESULTS

Group A and B showed significant higher complete response (CR) rates than group C (100%, 100%, and 96.4% for group A, B and C, respectively, p = 0.036). In groups A, B and C, the 1-year local recurrence-free survival (LRFS) rates were 100%, 100%, and 94.5%, respectively (p = 0.002). The 1-year disease-free survival (DFS) rates were 100%, 99.1%, and 92.7%, respectively (p = 0.001). The 1-year distant metastasis-free survival (DMFS) rates were 100%, 99.1%, and 93.6%, respectively (p = 0.004). The 1-year overall survival (OS) rates were 100%, 100%, and 95.4%, respectively (p = 0.006). Group A and B had significantly higher 1-year LRFS, DFS, DMFS, and OS than those in group C. No significant differences were observed in LRFS, DFS, DMFS and OS between group A and B. Group B (PET/CT group) had a higher incidence of grade 3-4 acute ototoxicity (3.6%) than group A (0%) and group C (0%, p = 0.036). No significant differences in other grade 3-4 acute adverse events and late toxic effects were observed among the three groups, and no patient had grade 5 toxicities. Multivariate analysis showed that dose painting (DWI-guided DP-RT and PET/CT-guided DP-RT vs conventional MRI-based RT) was associated with improved LRFS, DFS, DMFS and OS.

CONCLUSION

Both DWI-guided DP-RT and PET/CT-guided DP-RT plus chemotherapy are associated with improved LRFS, DFS, DMFS and OS compared with conventional MRI-based RT among patients with locoregionally advanced NPC. DWI-guided DP-RT does not increase toxicities, but PET/CT-guided DP-RT has higher incidence of acute ototoxicity.

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.

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.

Quantification and purification of isotopic contamination at the ReAccelerator of the Facility for Rare Isotope Beams

At the ReAccelerator within the Facility for Rare Isotope Beams, a combination of an interchangeable aluminum foil and a silicon detector was developed to quantify isobaric contamination in rare isotope beams. The device is simple to operate and is now used routinely. In this article, we describe the system and show an application of the device to determine the level of contamination of an Si-32 rare isotope beam by stable S-32. In addition, we describe how the new diagnostic device helped confirm an enhancement of the beam purity prior to beam delivery to experiments.

[Association between sleep quality/physical activity and metabolic syndrome in urban population of Xinjiang]

Objective: To explore the relationship between sleep/physical activity and metabolic syndrome (MS) in urban population of Xinjiang. Methods: This is a prospective, cross-sectional study. From July 2019 to September 2021, a two-stage random sampling method was used to randomly select residents aged 30-74 years from two communities in Urumqi of northern Xinjiang and Korla of southern Xinjiang. General situation questionnaire, Pittsburgh Sleep Quality Index Scale (PSQI) survey, International Physical Activity Questionnaire (IPAQ) survey, physical examination, physiological and biochemical indicators were obtained and analyzed. The dose-response curves of healthy sleep score and physical activity with metabolic syndrome were plotted using restricted cubic spline curves. Multivariate logistic regression model was used to analyze the independent and combined effects of sleep quality and physical activity on MS risk. Results: A total of 10 209 participants were included. The mean age of the subjects was (47.1±9.1) years, and males accounted for 51.3% (5 275/10 209). The prevalence of MS was significantly associated with the healthy sleep score and physical activity. Compared to the subjects with healthy sleep, OR (95%CI) of MS with intermediate, and poor sleep were 1.20(1.06-1.35), 1.23(1.04-1.45), respectively. Compared to the subjects with high physical activity, OR (95%CI) of MS with medium, low physical activity was 1.34(1.15-1.56), 1.42(1.19-1.70), respectively. There was a significant interaction between sleep and physical activity in MS (P for interaction=0.002). Compared to the subjects with high physical activity and healthy sleep, OR (95%CI) of MS with poor sleep and high physical activity was 2.03 (1.24-3.33, P for trend=0.016). Conclusion: Poor sleep quality and lack of physical activity are not only independent risk factors for an increased risk of MS but also have a combined effect with an increased risk of MS.

Search for Λ[over ¯]-Λ Baryon-Number-Violating Oscillations in the Decay J/ψ→pK^{-}Λ[over ¯]+c.c

We report on the first search for Λ[over ¯]-Λ oscillations in the decay J/ψ→pK^{-}Λ[over ¯]+c.c. by analyzing 1.31×10^{9}  J/ψ events accumulated with the BESIII detector at the BEPCII collider. The J/ψ events are produced using e^{+}e^{-} collisions at a center of mass energy sqrt[s]=3.097  GeV. No evidence for hyperon oscillations is observed. The upper limit for the oscillation rate of Λ[over ¯] to Λ hyperons is determined to be P(Λ)=[B(J/ψ→pK^{-}Λ+c.c.)/B(J/ψ→pK^{-}Λ[over ¯]+c.c.)]<4.4×10^{-6} corresponding to an oscillation parameter δm_{ΛΛ[over ¯]} of less than 3.8×10^{-18}  GeV at the 90% confidence level.

Mass Transfer Enhancement in High-Solids Anaerobic Digestion of Organic Fraction of Municipal Solid Wastes: A Review

The increasing global population and urbanization have led to a pressing need for effective solutions to manage the organic fraction of municipal solid waste (OFMSW). High-solids anaerobic digestion (HS-AD) has garnered attention as a sustainable technology that offers reduced water demand and energy consumption, and an increased biogas production rate. However, challenges such as rheology complexities and slow mass transfer hinder its widespread application. To address these limitations, this review emphasizes the importance of process optimization and the mass transfer enhancement of HS-AD, and summarizes various strategies for enhancing mass transfer in the field of HS-AD for the OFMSW, including substrate pretreatments, mixing strategies, and the addition of biochar. Additionally, the incorporation of innovative reactor designs, substrate pretreatment, the use of advanced modeling and simulation techniques, and the novel conductive materials need to be investigated in future studies to promote a better coupling between mass transfer and methane production. This review provides support and guidance to promote HS-AD technology as a more viable solution for sustainable waste management and resource recovery.

Systematic analysis of prophages carried by Porphyromonas gingivalis

To systematically investigate the prophages carrying in Porphyromonas gingivalis (P. gingivalis) strains, analyze potential antibiotic resistance genes (ARGs) and virulence genes in these prophages. We collected 90 whole genome sequences of P. gingivalis from NCBI and utilized the Prophage Hunter online software to predict prophages; Comprehensive antibiotic research database (CARD) and virulence factors database (VFDB) were adopted to analyze the ARGs and virulence factors (VFs) carried by the prophages. Sixty-nine prophages were identified among 24/90 P. gingivalis strains, including 17 active prophages (18.9%) and 52 ambiguous prophages (57.8%). The proportion of prophages carried by each P. gingivalis genome ranged from 0.5% to 6.7%. A total of 188 antibiotic resistance genes belonging to 25 phenotypes and 46 different families with six mechanisms of antibiotic resistance were identified in the 17 active prophages. Three active prophages encoded 4 virulence genes belonging to type III and type VI secretion systems. The potential hosts of these virulence genes included Escherichia coli, Shigella sonnei, Salmonella typhi, and Klebsiella pneumoniae. In conclusion, 26.7% P. gingivalis strains carry prophages, while the proportion of prophage genes in the P. gingivalis genome is relatively low. In addition, approximately 39.7% of the P. gingivalis prophage genes have ARGs identified, mainly against streptogramin, peptides, and aminoglycosides. Only a few prophages carry virulence genes. Prophages may play an important role in the acquisition, dissemination of antibiotic resistance genes, and pathogenicity evolution in P. gingivalis.

Osteoporosis prediction in lumbar spine X-ray images using the multi-scale weighted fusion contextual transformer network

Osteoporosis is a bone-related disease characterized by decreased bone density and mass, leading to brittle fractures. Osteoporosis assessment from radiographs using a deep learning algorithm has proven a low-cost alternative to the golden standard DXA. Due to the considerable noise and low contrast, automated diagnosis of osteoporosis in X-ray images still poses a significant challenge for traditional diagnostic methods. In this paper, an end-to-end transformer-style network was proposed, termed FCoTNet, to overcome the shortcoming of insufficient fusion of texture information and local features in the traditional CoTNet. To extract complementary geometric representations at each scale of the transformer module, we integrated parallel multi-scale feature extraction architectures in each unit layer of FCoTNet to utilize convolution to aggregate features from different receptive fields. Moreover, in order to extract small-scale texture features which were more critical to the diagnosis of osteoporosis in radiographs, larger fusion weights were assigned to the feature maps with small-size receptive fields. Afterward, the multi-scale global modeling was conducted by self-attention mechanism. The proposed model was first investigated on a private lumbar spine X-ray dataset with the 5-fold cross-validation strategy, obtaining an average accuracy of 78.29 ± 0.93 %, an average sensitivity of 69.72 ± 2.35 %, and an average specificity of 88.92 ± 0.67 % for the multi-classification of normal, osteopenia, and osteoporosis categories. We then conducted a controlled trial with five orthopedic clinicians to evaluate the clinical value of the model. The average clinician's accuracy improved from 61.50 ± 10.79 % unaided to 80.00 ± 5.92 % aided (18.50 % improvement), sensitivity improved from 64.38 ± 8.07 % unaided to 83.31 ± 5.43 % aided (18.93 % improvement), and specificity improved from 80.11 ± 4.72 % unaided to 89.94 ± 3.82 % aided (9.83 % improvement). Meanwhile, the prediction consistency among clinicians significantly improved with the assistance of FCoTNet. Furthermore, the proposed model showed good robustness on an external test dataset. These investigations indicate that the proposed deep learning model achieves state-of-the-art performance for osteoporosis prediction, which substantially improves osteoporosis screening and reduced osteoporosis fractures.

[Clinical characteristics and prognostic factors of patients with anti-melanoma differentiation-associated gene 5 antibody-positive dermatomyositis associated interstitial lung disease]

Objective: To analyze the clinical characteristics and prognostic factors of patients with anti-melanoma differentiation-associated gene 5 (anti-MDA5)-positive dermatomyositis associated interstitial lung disease (DM-ILD). Methods: The patients with MDA5+DM-ILD who were admitted to Department of Respiratory Medicine, Nanjing Drum Tower Hospital from January 2017 to March 2021 were enrolled. The clinical data and survival information were analyzed retrospectively. Patients were divided into survival group or death group, and rapid progressive ILD (RP-ILD) group or non-rapid progressive ILD group, according to their survival status and clinical progression. Results: A total of 105 patients with anti-MDA5+DM-ILD (median age of onset 54 years) were enrolled, 58% being female (61 cases). The main sub-type of dermatomyositis was amyopathic dermatomyositis (n=74, 70%), followed by dermatomyositis (n=31, 30%). The main extrapulmonary manifestations were skin lesions (n=60, 57.1%), muscle manifestations(n=20, 19%) and arthralgia/arthritis (n=20, 19%). 15.4% of the patients had positive ANA (antibody titer≥1∶320), and 61.9% of the patients had anti-RO-52 kDa antibody. A total of 66 patients (62.8%) developed RP-ILD, and 58 patients (56.3%) died. Lower oxygenation index (OR=0.974, 95%CI:0.954-0.994, P=0.012) and no joint pain (OR=0.032, 95%CI: 0.002-0.663 P=0.026) were independent risk factors for RP-ILD. Cox regression analysis showed that RP-ILD (HR=3.194, 95%CI:1.025-9.954, P=0.045), older than 53 years (HR=3.450, 95%CI: 1.388-8.577, P=0.008), ferritin level more than 1 330.5 ng/ml (HR=3.032, 95%CI 1.208-7.610, P=0.018) and C-reactive protein (CRP) above 16.95 mg/L (HR=2.794, 95%CI:1.102-7.084, P=0.030) were independent predictors of mortality. Conclusions: The clinical manifestations of patients with anti-MDA5+DM-ILD presenting to the respiratory department were heterogeneous, with most being amyopathic dermatomyositis, and both the incidence of RP-ILD and the risk of death were high. Even in the absence of associated rash, joint, or muscle manifestations, anti-MDA5 antibody screening should be considered in patients with rapidly progressive ILD who were negative on baseline autoantibody screening but positive for anti-RO52kDa antibody.

[Association between sedentary behavior and force expiratory volume in 1 second reduction in middle-aged and elderly adults in communities]

Objective: To analyze the relationship between sedentary behavior and the force expiratory volume in 1 second (FEV₁) reduction in middle-aged and elderly people in communities. Methods: The participants aged ≥40 years were randomly selected from a natural population cohort in Songjiang District, Shanghai, for pulmonary function tests and survey by using international physical activity questionnaire, a generalized additive model was used to analyze the association between sedentary behavior and FEV₁ reduction in the study population and different sex-age subgroups. Results: A total of 3 121 study subjects aged ≥40 years were included. The prevalence of FEV₁ reduction was 14.8%, which was higher in men than in women. There were 24.8% participants were completely sedentary. The prevalence of FEV₁ reduction in women aged <60 years in complete sedentary group was 2.04 (95%CI: 1.11-3.72) times higher than that in non-complete sedentary group. In men aged <60 years, the prevalence of FEV₁ reduction increased with daily sedentary time (OR=1.16, 95%CI: 1.04-1.29), and the prevalence of FEV₁ reduction was also higher in those with sedentary time >5 hours/day than those with sedentary time ≤5 hours/day (OR=3.02, 95%CI: 1.28-7.16). The sensitivity analysis also found such associations. Conclusions: FEV₁ reduction rate in age group <60 years was associated with sedentary behavior. Complete sedentary behavior or absence of moderate to vigorous physical activity played important roles in FEV₁ reduction in women, while men were more likely to be affected by increased sedentary time, which had no association with physical activity. Reducing sedentary time to avoid complete sedentary behavior, along with increased physical activity, should be encouraged in middle-aged and elderly adults in communities to improve their pulmonary function.

[Association between metabolism-related chronic disease combination and prevalence of non-alcoholic fatty liver disease in community residents in Shanghai]

Objective: To explore the combination of metabolism-related chronic diseases associated with the prevalence of non-alcoholic fatty liver disease (NAFLD) in community residents in Shanghai. Methods: The baseline data of Shanghai Suburban Adult Cohort and Biobank were used to understand the prevalence of five metabolism-related chronic diseases, including obesity, hypertension, hyperlipidemia, gout and diabetes, based on questionnaire survey, physical examination and blood biochemical detection. NAFLD was diagnosed by B-ultrasound detection and questionnaire. Multivariable logistic regression model was used to analyze the association of 31 metabolism-related chronic diseases combinations with the prevalence of NAFLD. Results: The median age (Q1, Q3) of 65 477 subjects was 60 (51, 66) years, and men accounted for 40.6%. The overall prevalence of NAFLD was 38.2%, and the prevalence of HAFLD in patients without any of the five metabolism-related chronic diseases was 12.0%. The chronic disease combination with the strongest association with NAFLD was obesity + hypertension + hyperlipidemia + gout + diabetes in the total population (OR=37.94, 95%CI: 31.02-46.41), in women (OR=36.99, 95%CI: 28.78-47.54) and in age group ≥60 years (OR=36.19, 95%CI: 28.25-46.36). The chronic disease combination with the strongest association with NAFLD was obesity + hyperlipidemia + gout + diabetes in men (OR=50.70, 95%CI: 24.62-104.40) and in age group <60 years (OR=49.58, 95%CI: 24.22-101.47). Conclusions: The prevalence of NAFLD in community residents in Shanghai was high. Attention needs to be paid to health of obese people and weight loss should be promoted for them. Community health education should be strengthened for patients complicated with gout, diabetes, hyperlipidemia and hypertension and it is necessary to correct abnormal serum uric acid, blood sugar, blood lipids and blood pressure in a timely manner to reduce the risk of NAFLD.

Enhancing of pretreatment on high solids enzymatic hydrolysis of food waste: Sugar yield, trimming of substrate structure

The development of high solids enzymatic hydrolysis (HSEH) technology is a promising way to improve the efficiency of bioenergy production from solid waste. Pretreatment methods such as ultrasound (USP), freeze-thaw (FTP), hydrothermal (HTP), and dried (DRD) were carried out to evaluate the effect and mechanism of the pretreatment methods on the HSEH of FW. The reducing sugar of HTP and DRD reached 94.75% and 94.92% of the theoretical value. HTP and DRD could reduce the crystallinity of FW. DRD resulted in lower alignment and the occurrence of fractures of the substrate and exposed the α-1,4 glycosidic bond of starch. The high destructive power of HTP and DRD reduced the obstacles caused by the high solid content. Moreover, DRD consumed only 27.62% of the total energy of HTP. DRD could be a promising pretreatment methods for glucose recovery for its high product yield, significant substrate destruction, and economic feasibility.

[The preliminary efficacy of "quadri-combination" therapy on the treatment of bladder cancer]

To investigate the safety and efficacy of "quadri-combination" therapy including maximal transurethral resection of bladder tumor (mTURBT), combined with systemic chemotherapy and immunotherapy, concurrent radiotherapy, and immune maintenance therapy. The clinical data of 8 patients with bladder cancer who could not tolerate or refused radical cystectomy at the Department of Urology, Peking University Cancer Hospital from November 2019 to October 2021 were retrospectively analyzed. There were 5 males and 3 females with a mean age of 69 years. The Eastern Cooperative Oncology Group(ECOG) score was 0 in 6 cases and 1 in 2 cases. There were 5 cases of high-grade urothelial carcinoma (1 case of T3b; 2 cases were T2; 2 cases of T1 stage, with multiple tumors and repeated recurrence), 1 case of high-grade urothelial carcinoma with carcinoma in situ (T1/Tis stage), 1 case of high-grade urothelial carcinoma with squamous differentiation (T3b stage), and 1 case of high-grade urothelial carcinoma with glandular differentiation (T2). All patients underwent "quadri-combination" therapy.The patient's tolerance, success rate of bladder preservation and prognosis were evaluated.The median follow-up time was 22.5 (12-35) months. One patient with high-grade muscle-invasive bladder cancer (T2) received mTURBT, albumin-bound paclitaxel and durvalumab combined therapy for 3 cycles, concurrent radiotherapy, and immune maintenance therapy for 18 months, and the tumor recurrence was found. The pathology was high-grade urothelial carcinoma. Salvage radical cystectomy combined with pelvic lymph node dissection is recommended. The remaining 7 patients were regularly reexamined, and no recurrence or metastasis was found.The 2-year progression-free survival rate was 80%, and the success rate of bladder preservation was 87.5%(7/8). Treatment-related adverse reactions were resolved by symptomatic treatment, and patients' compliance and tolerance were acceptable.The "quadri-combination" bladder-preserving therapy is feasible and well tolerated, but further studies are needed.

[Effects of free superficial peroneal artery perforator flap in repairing small and medium-sized thermal crush injury wounds in the hand]

Objective: To investigate the surgical methods and clinical effects of free superficial peroneal artery perforator flap in repairing small and medium-sized thermal crush injury wounds in the hand. Methods: A retrospective observational study was conducted. From August 2018 to December 2021, 12 patients (19 wounds) with small and medium-sized thermal crush injury in the hand who met the inclusion criteria were hospitalized in Suzhou Ruihua Orthopaedic Hospital, including 5 males and 7 females, aged from 30 to 54 years. The area of the wound was from 2.5 cm×2.0 cm to 14.0 cm×3.5 cm, and all the wounds were repaired by using free superficial peroneal artery perforator flaps from lower leg on one side (including single flap, multiple flaps, and multiple flaps with one pedicle resected from the same donor site). The area of the flap was from 3.5 cm×3.0 cm to 16.0 cm×4.0 cm. The wound in the donor site was sutured directly. The vascular crisis and survival of the flap were observed after operation. The texture, appearance, color, hyperpigmentation, sensation, and two-point discrimination of the flap repaired area were followed up, as well as the hyperplasia of scar and pain condition in the donor and recipient sites. At the last follow-up, the curative effect of flap repair was evaluated by the comprehensive evaluation scale, and the extension and flexion functions of the reserved digital joint were evaluated by the total active movement systematic evaluation method recommended by American Academy for Surgery of Hand. Results: One flap developed arterial crisis on the first day after operation but survived after timely exploration. The other 18 flaps survived successfully after operation. Follow-up of 4 to 24 months after operation showed good texture and appearance in the flap repaired area; the color of the flap repaired area was similar to that of the normal skin around the recipient site, without pigmentation; the protective sensation was restored in all cases, but there was no two-point discrimination; there was no obvious hypertrophic scarring or pain in the donor or recipient site. At the last follow-up, the curative effect of flap repair was evaluated with 3 flaps being excellent and 16 flaps being good; the extension and flexion functions of the reserved digital joint were also assessed, being excellent in 8 fingers, good in 9 fingers, and fair in 2 fingers. Conclusions: The blood supply of superficial peroneal artery perforator flap is sufficient and reliable, and multiple flaps of this type or multiple flaps with one pedicle can be resected from one donor site. The use of this flap to repair small and medium-sized thermal crush injury wounds in the hand results in minimal damage to the donor area, and good postoperative appearance and texture of the flap.

Robust vessel segmentation in laser speckle contrast images based on semi-weakly supervised learning

OBJECTIVE

The goal of this study is to develop a robust semi-weakly supervised learning strategy for vessel segmentation in laser speckle contrast imaging (LSCI), addressing the challenges associated with the low signal-to-noise ratio, small vessel size, and irregular vascular aberration in diseased regions, while improving the performance and robustness of the segmentation method.

APPROACH

For the training dataset, the healthy vascular images denoted as normal-vessel samples were manually labeled, while the diseased LSCI images involving tumor or embolism were denoted as abnormal-vessel samples and annotated as pseudo labels by the traditional semantic segmentation methods. In the training phase, the pseudo labels were constantly updated to improve the segmentation accuracy based on DeepLabv3+. Objective evaluation was conducted on the normal-vessel test set, while subjective evaluation was performed on the abnormal-vessel test set.

MAIN RESULTS

The proposed method achieved an IOU of 0.8671, a Dice of 0.9288, and a mean relative percentage difference (mRPD) with supervised learning of 0.5% in the objective evaluation. In the subjective evaluation, our method significantly outperformed other methods in main vessel segmentation, tiny vessel segmentation, and blood vessel connection. Additionally, our method exhibited robustness when abnormal-vessel style noise was added to normal-vessel samples using a style translation network.

SIGNIFICANCE

The proposed semi-weakly supervised learning strategy demonstrates high efficiency and excellent robustness for vascular segmentation in LSCI, providing a potential tool for assessing the morphological and structural features of vessels in clinical applications.

[Comparison of corneal power assessment methods after small incision lenticule extraction]

Objective: To compare the accuracy of different corneal curvature parameters in assessing the corneal refractive status and tracking corneal power changes after small incision lenticule extraction (SMILE). Methods: This prospective cross-sectional study tracked and recorded total corneal curvature parameters measured by different instruments before and three months after SMILE for myopia. These parameters, including total keratometry (TK) from the IOLMaster 700, total corneal refractive power (TCRP) from the Pentacam AXL, real keratometry (RK) from the CASIA 2, and corrected parameters calculated using the Haigis, Shammas, and Maloney methods, were compared with data obtained using the clinical history method (CHM). Surgically induced changes in TK, TCRP, and RK were analyzed and compared with those in spherical equivalent on the corneal plane (ΔSEco). Results: The study included 40 eyes (40 participants). After SMILE, the difference was smallest between TK [(0.08±0.38) D] and CHM values (P>0.05). However, TCRP, RK, K_Haigis, K_Shammas, and K_Maloney were significantly different from CHM data (P<0.05). The width of the 95% limits of agreement of TK (1.49 D) was narrowest, followed by that of RK (1.57 D). Pearson analysis showed that each parameter had a good correlation with CHM data. The differences between the changes in TK, TCRP and RK caused by surgery and ΔSEco were (0.03±0.39) D, (0.17±0.43) D, and (-0.19±0.46) D, respectively. The width of the 95% limits of agreement of ΔTK (1.54 D) was narrowest, and the correlation coefficient of ΔTK (0.951) was highest. Conclusion: The parameter TK of the IOLMaster 700 can provide accurate and objective corneal power evaluation after SMILE.

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.