Multifunctionality promotes the prosperity of riverine planktonic diatoms in plateau

Interpreting the biogeographic distribution and underlying mechanisms of functional traits not only contributes to revealing the spatiotemporal dynamics of species biodiversity but also helps to maintain ecological stability during environmental variations. However, little is known about the functional profiles of diatom communities over large river systems. Herein, we provided the first blueprints about the spatiotemporal distributions and driving forces of functional traits for both planktonic and sedimentary diatoms over the 6030 km continuum of the Yangtze River, with the help of the high-throughput sequencing and functional identification. By investigating the 28 functional traits affiliated into five categories, we found that planktonic diatom functions showed clearer landform-heterogeneity patterns (ANOSIM R = 0.336) than sedimentary functions (ANOSIM R = 0.172) along the river, represented by life-forms and ecological-guilds prominent in water-plateau as well as cell-sizes and life-forms particularly in sediment-plateau. Planktonic diatom functions also displayed higher richness and network complexity in plateau (richness: 58.70 ± 9.30, network edges: 65) than in non-plateau regions (23.82 ± 13.16, 16), promoting the stability and robustness of diatom functions against the high-radiation and low-temperature plateau environment. Environmental selection (mainly exerted by PAR, UV, and Tw) played crucial roles in determining the functional variations of planktonic diatoms (explaining 80.5%) rather than sedimentary diatoms (14.5%) between plateau and non-plateau regions. Meanwhile, planktonic diatom traits within life-forms were identified to be well responsive to the ecological environment quality (r = 0.56-0.60, P < 0.001) in the Yangtze. This study provided comprehensive insights into the multifunctionality of diatoms and their responses to environmental disturbance and environment quality, which helps to develop effective strategies for maintaining ecological stability in changing river environments.

Dexamethasone relieves the inflammatory response caused by inguinal hernia meshes through miR-155

BACKGROUND

Inguinal hernia is a relatively common condition. Most patients with inguinal hernia require surgery. At present, mesh repair is one of the most effective methods to treat inguinal hernia, but insertion of the mesh can cause inflammation. Dexamethasone (DEX) can treat inflammation, but the mechanism by which DEX alleviates inflammation caused by inguinal hernia mesh placement remains unclear.

METHOD

We randomly divided rats into groups: negative control (NC), inguinal hernia (IH), polypropylene mesh (PM), DEX treatment, and miR-155 treatment groups. RT-qPCR was performed to determine the expression of miR-155. ELISA was implemented to determine the secretion of IL-1β, IL-6, and IL-18. Western blotting was used to detect caspase-1, JAK1, p-JAK1, STAT3, and p-STAT3 expression. A dual-luciferase reporter gene array identified a connection between miR-155 and JAK1.

RESULTS

The results revealed that the expression of miR-155, IL-1β, IL-6, and IL-18 was upregulated in the PM group. After DEX treatment, the secretion of miR-155, caspase-1, IL-1β, IL-6, and IL-18 decreased. Dual luciferase results confirmed that miR-155 induced the targeted downregulation of JAK1, while a miR-155 mimic reversed the therapeutic effect of DEX, and the expression levels of p-JAK1 and p-STAT3 increased.

CONCLUSION

DEX regulates the JAK1/STAT3 signaling pathway through miR-155 to relieve inflammation caused by inguinal hernia meshes.

Does a hydropower reservoir cascade really harm downstream nutrient regimes

River damming is believed to largely intercept nutrients, particularly retain more phosphorus (P) than nitrogen (N), and thus harm primary productivity, fishery catches, and food security downstream, which seriously constrain global hydropower development and poverty relief in undeveloped regions and can drive geo-political disputes between nations along trans-boundary rivers. In this study, we investigated whether reservoirs can instead improve nutrient regimes downstream. We measured different species of N and P as well as microbial functions in water and sediment of cascade reservoirs in the upper Mekong River over 5 years and modelled the influx and outflux of N and P species in each reservoir. Despite partially retaining total N and total P, reservoirs increased the downstream flux of ammonium and soluble reactive phosphorus (SRP). The increase in ammonium and SRP between outflux and influx showed positive linear relationships with the hydraulic residence time of the cascade reservoirs; and the ratio of SRP to dissolved inorganic nitrogen increased along the reservoir cascade. The lentic environment of reservoirs stimulated algae-mediated conversion of nitrate into ammonium in surface water; the hypoxic condition and the priming effect of algae-induced organic matter enhanced release of ammonium from sediment; the synergy of microbial phosphorylation, reductive condition and sediment geochemical properties increased release of SRP. This study is the first to provide solid evidence that hydropower reservoirs improve downstream nutrient bioavailability and N-P balance through a process of retention-transformation-transport, which may benefit primary productivity. These findings could advance our understanding of the eco-environmental impacts of river damming.

BASALT refines binning from metagenomic data and increases resolution of genome-resolved metagenomic analysis

Metagenomic binning is an essential technique for genome-resolved characterization of uncultured microorganisms in various ecosystems but hampered by the low efficiency of binning tools in adequately recovering metagenome-assembled genomes (MAGs). Here, we introduce BASALT (Binning Across a Series of Assemblies Toolkit) for binning and refinement of short- and long-read sequencing data. BASALT employs multiple binners with multiple thresholds to produce initial bins, then utilizes neural networks to identify core sequences to remove redundant bins and refine non-redundant bins. Using the same assemblies generated from Critical Assessment of Metagenome Interpretation (CAMI) datasets, BASALT produces up to twice as many MAGs as VAMB, DASTool, or metaWRAP. Processing assemblies from a lake sediment dataset, BASALT produces ~30% more MAGs than metaWRAP, including 21 unique class-level prokaryotic lineages. Functional annotations reveal that BASALT can retrieve 47.6% more non-redundant opening-reading frames than metaWRAP. These results highlight the robust handling of metagenomic sequencing data of BASALT.

[Timing and surgery option of keratinized mucosa augmentation around implant site]

In recent years, clinicians have paid more attention to the biological and esthetic effects of the 2 mm keratinized mucosa width (KMW) around dental implant. How to increase the keratinized mucosa is the focus of clinicians. While the free gingival graft (FGG) is still the gold standard of keratinized mucosa augmentation, alveolar ridge preservation (ARP), connective tissue graft (CTG) and apically positioned flap (APF) can also be used to obtain more than 2 mm keratinized mucosa width when they are used before implantation, with implantation, within the implant-healing phase, with second stage of implantation or after rehabilitation according to different indications. This article comprehensively summarizes the influencing factors of timing and surgical procedures for keratinized mucosa augmentation, providing guidance for clinicians to treat peri-implant keratinized mucosa deficiencies.

Efficient Photosynthesis of Hydrogen Peroxide by Cyano-Containing Covalent Organic Frameworks from Water, Air and Sunlight

The insufficient exciton (e- -h+ pair) separation/transfer and sluggish two-electron water oxidation are two main factors limiting the H2 O2 photosynthetic efficiency of covalent organic frameworks (COFs) photocatalysts. Herein, we present an alternative strategy to simultaneously facilitate exciton separation/transfer and reduce the energy barrier of two-electron water oxidation in COFs via a dicyano functionalization. The in situ characterization and theoretical calculations reveal that the dicyano functionalization improves the amount of charge transfer channels between donor and acceptor units from two in COF-0CN without cyano functionalization to three in COF-1CN with mono-cyano functionalization and four in COF-2CN with dicyano functionalization, leading to the highest separation/transfer efficiency in COF-2CN. More importantly, the dicyano group activates the neighbouring C atom to produce the key *OH intermediate for effectively reducing the energy barrier of rate-determining two-electron water oxidation in H2 O2 photosynthesis. The simultaneously enhanced exciton separation/transfer and two-electron water oxidation in COF-2CN result in high H2 O2 yield (1601 μmol g-1  h-1 ) from water and oxygen without using sacrificial reagent under visible-light irradiation. COF-2CN can effectively yield H2 O2 in water with wide pH range, in different real water samples, in scaled-up reactor under natural sunlight irradiation, and in continuous-flow reactor for consecutively producing H2 O2 solution for water decontamination.

Planktonic/benthic Bathyarchaeota as a "gatekeeper" enhance archaeal nonrandom co-existence and deterministic assembling in the Yangtze River

Archaea, the third proposed domain of life, mediate carbon and nutrient cycling in global natural habitats. Compared with bacteria, our knowledge about archaeal ecological modes in large freshwater environments subject to varying natural and human factors is limited. By metabarcoding analysis of 303 samples, we provided the first integrate biogeography about archaeal compositions, co-existence networks, and assembling processes within a 6000 km continuum of the Yangtze River. Our study revealed that, among the major phyla, water samples owned a higher proportion of Thaumarchaeota (62.8%), while sediments had higher proportions of Euryarchaeota (33.4%) and Bathyarchaeota (18.8%). A decline of polarization in phylum abundance profile was observed from plateau/mountain/hill to basin/plain areas, which was attributed to the increase of nutrients and metals. Planktonic and benthic Bathyarchaeota tended to co-occur with both major (e.g., methanogens or Thermoplasmata) and minor (e.g., Asgard or DPANN) taxa in the non-random networks, harboring the highest richness and abundances of keystone species and contributing the most positively to edge number, node degree, and nearest neighbor degree. Furthermore, we noted significantly positive contributions of Bathyarchaeota abundance and network complexity to the dominance of deterministic process in archaeal assembly (water: 65.3%; sediments: 92.6%), since higher carbon metabolic versatility of Bathyarchaeota would benefit archaeal symbiotic relations. Stronger deterministic assembling was identified at the lower-reach plain, and higher concentrations of ammonium and aluminum separately functioning as nutrition and agglomerator were the main environmental drivers. We lastly found that the Three Gorges Dam caused a simultaneous drop of benthic Bathyarchaeota abundance, network co-existence, and deterministic effects immediately downstream due to riverbed erosion as a local interference. These findings highlight that Bathyarchaeota are a "gatekeeper" to promote fluvial archaeal diversity, stability, and predictability under varying macroscopic and microscopic factors, expanding our knowledge about microbial ecology in freshwater biogeochemical cycling globally.

Shifted sediment-transport regimes by climate change and amplified hydrological variability in cryosphere-fed rivers

Climate change affects cryosphere-fed rivers and alters seasonal sediment dynamics, affecting cyclical fluvial material supply and year-round water-food-energy provisions to downstream communities. Here, we demonstrate seasonal sediment-transport regime shifts from the 1960s to 2000s in four cryosphere-fed rivers characterized by glacial, nival, pluvial, and mixed regimes, respectively. Spring sees a shift toward pluvial-dominated sediment transport due to less snowmelt and more erosive rainfall. Summer is characterized by intensified glacier meltwater pulses and pluvial events that exceptionally increase sediment fluxes. Our study highlights that the increases in hydroclimatic extremes and cryosphere degradation lead to amplified variability in fluvial fluxes and higher summer sediment peaks, which can threaten downstream river infrastructure safety and ecosystems and worsen glacial/pluvial floods. We further offer a monthly-scale sediment-availability-transport model that can reproduce such regime shifts and thus help facilitate sustainable reservoir operation and river management in wider cryospheric regions under future climate and hydrological change.

Sintilimab, SBRT and GM-CSF for Metastatic NSCLC: A Prospective, Multicenter, Phase II Trial

PURPOSE/OBJECTIVE(S)

PD-1/PD-L1 inhibitors have transformed the therapeutic landscape in metastatic non-small cell lung cancer (NSCLC). However, the objective response rate (ORR) remains limited in unselected population. Incorporating SBRT to PD-1/PD-L1 inhibitors may improve treatment efficacy and the anti-tumor immunity induced by SBRT may be enhanced by GM-CSF, which plays a pivotal role in dendritic cell differentiation and maturation. The current trial (NCT04106180) is the first prospective, multicenter, phase II study assessing the safety and efficacy of a PD-1 inhibitor (Sintilimab), SBRT and GM-CSF in metastatic NSCLC patients without sensitizing driver mutations.

MATERIALS/METHODS

Metastatic EGFR/ALK negative NSCLC pts who had failed first-line standard chemotherapy were eligible. Pts received SBRT (8 Gy*3) to one lesion, followed by Sintilimab (200 mg d1, every 3 weeks) and GM-CSF (125 μg/m2 d1-d14, cycle 1) within 3 weeks after SBRT. Sintilimab would be given continuously until disease progression, unacceptable toxicity, or up to 35 cycles. Primary end point is ORR. Secondary end points are safety, out-of-field response rate, overall survival (OS), progression free survival (PFS). The trial was designed to enroll 56 patients and if ≥17 pts evaluated had an objective response, it was regarded as positive.

RESULTS

By the time of 2022/10/30, the trial was early closed after 18 of the 51pts enrolled from 6 academic centers documented PR. The majority of pts were male, ECOG 1 and non-squamous NSCLC, having more than 5 lesions at baseline, with a median age of 62 (range, 32-74). The sites of SBRT included lung (n = 20), regional lymph node (n = 16), pleural nodule (n = 5), vertebra (n = 3), distant lymph node (n = 3), liver (n = 2) and others (n = 2). Treatment-related adverse event (TRAE) occurred in most pts and grade 3 TRAE occurred in 6 (11.8%) pts. No grade 4-5 TRAE occurred and the most common grade 3 TRAEs were ALT/AST elevation (n = 2), transient acute heart failure (recovered within 7 days) (n = 1), leucopenia/neutropenia (n = 2), pneumonitis (n = 1) and creatinine elevation (n = 1). With a median follow-up of 19.2 (range, 4.6-35.4) months, 49 pts had evaluable efficacy, with 18 PR, 15 SD and 16 PD. Median PFS and OS were 5.9 (95% CI, 3.9-9.2) and 16.2 (95% CI, 12.6-34.1) months, respectively. The results of biomarker testing will also be presented.

CONCLUSION

Triple combination of Sintilimab, SBRT and GM-CSF is safe and shows promising efficacy in metastatic EGFR/ALK negative NSCLC.

Virus-pathogen interactions improve water quality along the Middle Route of the South-to-North Water Diversion Canal

Bacterial pathogens and viruses are the leading causes of global waterborne diseases. Here, we discovered an interesting natural paradigm of water "self-purification" through virus-pathogen interactions over a 1432 km continuum along the Middle Route of the South-to-North Water Diversion Canal (MR-SNWDC) in China, the largest water transfer project in the world. Due to the extremely low total phosphorus (TP) content (ND-0.02 mg/L) in the MR-SNWDC, the whole canal has experienced long-lasting phosphorus (P) limitation since its operation in 2015. Based on 4443 metagenome-assembled genomes (MAGs) and 40,261 nonredundant viral operational taxonomic units (vOTUs) derived from our recent monitoring campaign, we found that residential viruses experiencing extreme P constraints had to adopt special adaptive strategies by harboring smaller genomes to minimize nucleotide replication, DNA repair, and posttranslational modification costs. With the decreasing P supply downstream, bacterial pathogens showed repressed environmental fitness and growth potential, and a weakened capacity to maintain P acquisition, membrane formation, and ribonucleotide biosynthesis. Consequently, the unique viral predation effects under P limitation, characterized by enhanced viral lytic infections and an increased abundance of ribonucleotide reductase (RNR) genes linked to viral nuclear DNA replication cycles, led to unexpectedly lower health risks from waterborne bacterial pathogens in the downstream water-receiving areas. These findings highlighted the great potential of water self-purification associated with virus-pathogen dynamics for water-quality improvement and sustainable water resource management.

Efficacy and safety of methylene blue injection for intractable idiopathic pruritus ani: a single-arm metaanalysis and systematic review

PURPOSE

To evaluate how effective methylene blue injection was at treating intractable idiopathic pruritus ani.

METHODS

A comprehensive literature search of the PubMed, Embase, Cochrane library, and Web of Science databases was conducted. All clinical studies (prospective and retrospective) that evaluated the efficacy of methylene blue in treating intractable idiopathic pruritus ani were included. Studies that reported the resolution rate, after a single injection and after a second injection, the recurrence rate, symptom scores, and transient complications of methylene blue injections in treating intractable idiopathic pruritus ani were included.

RESULTS

The seven selected studies included 225 patients with idiopathic pruritus ani. The resolution rates after a single injection and after a second injection was 0.761 (0.649-0.873, P < 0.01, I2 = 69.06%) and 0.854 (0.752-0.955, P < 0.01, I2 = 77.391%), respectively, the remission rates at 1, 3, and 5 years were 0.753 (0.612-0.893, P < 0.001), 0.773 (0.675-0.871, P < 0.001) and 0.240 (0.033-0.447, P < 0.001), respectively, the effect value of the merger was 0.569 (0.367-0.772, P < 0.001, I2 = 79.199%), and the recurrence rates at 1, 2, 3, and < 1 year were 0.202 (0.083-0.322, P < 0.001), 0.533 (0.285-0.781, P < 0.001), 0.437 (-0.044, 0.917, P < 0.001) and 0.067 (0.023-0.111, P < 0.001), respectively. The effect value of the merger was 0.223 (0.126-0.319, P < 0.001, I2 = 75.840).

CONCLUSION

Using methylene blue injections to treat intractable idiopathic pruritus ani is relatively efficacious, resulting in a relatively low recurrence rate and no severe complications. However, the available literature was of poor quality. Therefore, higher quality studies are necessary to confirm that methylene blue injection is efficacious for pruritus ani, such as a randomized prospective multicenter studies.

Pattern of Failure and Re-Irradiation for Stereotactic Radiotherapy Treated Brain Metastases from Non-Small Cell Lung Cancer (NSCLC)

PURPOSE/OBJECTIVE(S)

Hypofractionated stereotactic radiotherapy (SRT) has been increasingly used for brain metastases (BMs) from non-small cell lung cancer (NSCLC). However, the prognostic factors, pattern of failure and clinical utility of re-irradiation for these patients remain have not been fully understood.

MATERIALS/METHODS

Metastatic NSCLC patients receiving SRT that covering all of the intracranial tumor lesions and without prior whole brain radiotherapy (WBRT) were retrospectively enrolled. Local recurrence free survival (LRFS), intracranial progression free survival (iPFS) and overall survival (OS) were calculated from the initiation of SRT. Post intracranial progression survival (OS2) was measured from the initial intracranial disease progression.

RESULTS

From 2018/05 to 2022/05, 218 patients were identified, with 142 (65.1%) having only one BM and 76 (34.9%) harboring 2-5 BMs. With a median follow-up of 31.1 (range, 1.0-44.6) months, median LRFS, iPFS and OS was 39.1, 26.6 and 31.1 months, respectively. No statistical difference of LRFS, iPFS and OS were found between patients with different numbers of BM. Nevertheless, patients receiving concurrent systemic therapy had significantly longer LRFS (HR = 0.35, p = 0.002), iPFS (HR = 0.57, p = 0.044) and OS (HR = 0.37, p = 0.001), when compared with those receiving SRT alone. By now, intracranial disease progression (iPD) was documented in 59 patients, with original site PD (OPD), new site PD (NPD) and both sites PD (BPD) occurring in 20 (33.9%), 17 (28.8%) and 22 (37.3%), respectively. Among the 59 patients, 19 (32.2%) received second-course SRT (re-SRT) targeting the intracranial progressive tumor lesions and re-SRT led to improved OS2 (22.7 vs 12.1 months, HR = 0.29, 95% CI 0.08-0.97, p = 0.045), which remained as an independent prognostic factor after multiple-variate Cox analyses.

CONCLUSION

The status of systemic therapy, but not the number of BMs, may impact the survival outcomes of SRT-treated BMs from NSCLC. Some patients may benefit from re-SRT, which warranted future validation.

Interpreting pH-Dependent Differential UV/VIS Absorbance Spectra to Characterize Carboxylic and Phenolic Chromophores in Natural Organic Matter

Natural organic matter (NOM) is critical for the biogeochemical cycles of energy and many elements in terrestrial and aquatic ecosystems, and protonation-active functional groups in NOM molecules, notably carboxylic and phenolic groups often mediate these critical environmental functions. Molecular heterogeneity, polydispersity and dynamic behavior of NOM complicate achieving an unambiguous description of its molecular properties and reactivity. This study demonstrates that differential ultraviolet-visible (UV/VIS) absorbance spectra (DAS) of NOM acquired at varying pH values exhibit several distinct features associated with the deprotonation of NOM molecules, independent of the environmental provenance of NOM (e.g., surface water, seawater, sediment, and wastewater). The protonation-active functionalities that contribute to the Gaussian distribution bands present in the DAS were identified here by comparing characteristic properties of the bands with the stoichiometries of NOM molecules ascertained by Ultrahigh-Resolution Fourier-Transform Ion Cyclotron Resonance Mass Spectrometry (FT-ICR-MS). The protonation-active individual chromophores universally present in NOM molecules were identified by a genetic molecular network analysis. The observed DAS features were closely modeled via superimposing DAS spectra of 51 individual protonation-active chromophores. Molecular orbital theory was applied to further interpret the deprotonation of these chromophores, their molecular structure, electron distribution, and electron transitions measured using DAS. The high sensitivity and easy implementation of the DAS approach allows using it as a powerful tool to quantify the molecular properties and reactivity of NOM at environmental concentrations.

Oligo-Residual Disease in PD-1/PD-L1 Inhibitors Treated Metastatic Non-Small Cell Lung Cancer: Incidence, Pattern of Failure and Clinical Value of Local Consolidative Therapy

PURPOSE/OBJECTIVE(S)

Growing numbers of clinical trials are testing the efficacy of incorporating local therapy into programmed death receptor (ligand) 1 (PD-1/PD-L1) inhibitors in metastatic non-small cell lung cancer (NSCLC), but the optimal timing and patient selection are still controversial. We aimed to examine the patterns of maximum tumor response and treatment failure in PD-1/PD-L1 inhibitor-treated NSCLC, and explore the potential clinical value of local consolidative therapy (LCT) in those with oligo-residual disease (ORD).

MATERIALS/METHODS

Metastatic NSCLC treated with PD-1/PD-L1 inhibitors in three academic centers from May 2018 to December 2021 were retrospectively reviewed and those derived clinical benefit, defined as having objective response or durable stable disease lasting≥6months, were finally enrolled. Patterns of tumor response and treatment failure were extensively analyzed. ORD was defined as residual tumor distribution limited to 3 organs and 5 lesions, otherwise was defined as multiple residual disease (MRD). Local therapies targeting the residual tumor lesions performed after PD-1/PD-L1 inhibitors initiation and before initial disease progression, were considered as LCT. The primary endpoints were the overall survival (OS) and progression-free survival (PFS).

RESULTS

Of the 318 patients enrolled, ORD and MRD were documented in 122 (38.4%) and 196 (61.6%) patients, respectively. Those who developed ORD had a significantly longer OS than those with MRD (p = 0.006). The median time to best response was 4 months and more than 50% of the initial disease progression developed only from the residual tumor lesions, providing the preliminary rationale of LCT. Among the 122 patients with ORD, those receiving LCT (n = 39) had significantly longer PFS (p = 0.04) and OS (p<0.001) than those without LCT. Moreover, LCT remained one of the independent predictors of improved PFS and OS after Cox analyses.

CONCLUSION

Local consolidative therapy seems to be feasible and may provide extra survival benefit for metastatic NSCLC patients with oligo-residual disease after PD-1/PD-L1 inhibitor treatment.

Animal production predominantly contributes to antibiotic profiles in the Yangtze River

Human-induced antibiotic pollution in the world's large rivers poses significant risk to riverine ecosystems, water quality, and human health. This study identified geophysical and socioeconomic factors driving antibiotic pollution in the Yangtze River by quantifying 83 target antibiotics in water and sediment samples collected in its 6300-km-long reach, followed by source apportionment and statistical modeling. Total antibiotic concentrations ranged between 2.05-111 ng/L in water samples and 0.57-57.9 ng/g in sediment samples, contributed predominantly by veterinary antibiotics, sulfonamides and tetracyclines, respectively. Antibiotic compositions were clustered according to three landform regions (plateau, mountain-basin-foothill, and plains), resulting from varying animal production practices (cattle, sheep, pig, poultry, and aquaculture) in the sub-basins. Population density, animal production, total nitrogen concentration, and river water temperature are directly associated with antibiotic concentrations in the water samples. This study revealed that the species and production of food animals are key determinants of the geographic distribution pattern of antibiotics in the Yangtze River. Therefore, effective strategies to mitigate antibiotic pollution in the Yangtze River should include proper management of antibiotic use and waste treatment in animal production.

Bioaccumulation of pharmaceuticals and personal care products (PPCPs) in freshwater pearl mussels Hyriopsis cumingii in Poyang Lake

Thirty-five PPCPs were measured in representative freshwater pearl mussels (Hyriopsis cumingii) in Poyang Lake, the largest lake of China, as well as their responses to sedimentary PPCPs. We observed 32 PPCPs in soft tissues of mussels at a total concentration of 2721.5 ± 929.3 ng·g-1 dry weight (dw), much higher than those in sediments (21 PPCPs, 273.2 ± 89.4 ng·g-1 dw). Anti-inflammatories were the primary contaminants detected in both sediments and mussels. PPCP concentrations in mussels exhibited significant organ-specific characteristics, and gonads were identified as a hotspot for these contaminants. Correlation analysis showed that gonads were more likely to assimilate triclosan from sediments. Biochemical analysis revealed a higher physiological sensitivity of glutathione synthesis in gonads to sedimentary PPCPs, suggesting the long-term oxidative damage. Our findings highlight the concern on the potential effects of sedimentary PPCPs to propagation of mussels, and emphasize the necessity to formulate strategies for sedimentary PPCPs control targeting a healthy lake.

Ecological differentiation and assembly processes of abundant and rare bacterial subcommunities in karst groundwater

The ecological health of karst groundwater has been of global concern due to increasing anthropogenic activities. Bacteria comprising a few abundant taxa (AT) and plentiful rare taxa (RT) play essential roles in maintaining ecosystem stability, yet limited information is known about their ecological differentiation and assembly processes in karst groundwater. Based on a metabarcoding analysis of 64 groundwater samples from typical karst regions in southwest China, we revealed the environmental drivers, ecological roles, and assembly mechanisms of abundant and rare bacterial communities. We found a relatively high abundance of potential functional groups associated with parasites and pathogens in karst groundwater, which might be linked to the frequent regional anthropogenic activities. Our study confirmed that AT was dominated by Proteobacteria and Campilobacterota, while Patescibacteria and Chloroflexi flourished more in the RT subcommunity. The node-level topological features of the co-occurrence network indicated that AT might share similar niches and play more important roles in maintaining bacterial community stability. RT in karst groundwater was less environmentally constrained and showed a wider environmental threshold response to various environmental factors than AT. Deterministic processes, especially homogeneous selection, tended to be more important in the community assembly of AT, whereas the community assembly of RT was mainly controlled by stochastic processes. This study expanded our knowledge of the karst groundwater microbiome and was of great significance to the assessment of ecological stability and drinking water safety in karst regions.

Covalent organic frameworks for direct photosynthesis of hydrogen peroxide from water, air and sunlight

Solar-driven photosynthesis is a sustainable process for the production of hydrogen peroxide, the efficiency of which is plagued by side reactions. Metal-free covalent organic frameworks (COFs) that can form suitable intermediates and inhibit side reactions show great promise to photo-synthesize H₂O₂. However, the insufficient formation and separation/transfer of photogenerated charges in such materials restricts the efficiency of H₂O₂ production. Herein, we provide a strategy for the design of donor-acceptor COFs to greatly boost H₂O₂ photosynthesis. We demonstrate that the optimal intramolecular polarity of COFs, achieved by using suitable amounts of phenyl groups as electron donors, can maximize the free charge generation, which leads to high H₂O₂ yield rates (605 μmol g^-1 h^-1) from water, oxygen and visible light without sacrificial agents. Combining in-situ characterization with computational calculations, we describe how the triazine N-sites with optimal N 2p states play a crucial role in H₂O activation and selective oxidation into H₂O₂. We further experimentally demonstrate that H₂O₂ can be efficiently produced in tap, river or sea water with natural sunlight and air for water decontamination.

May microbial ecological baseline exist in continental groundwater?

BACKGROUND

Microbes constitute almost the entire biological community in subsurface groundwater and play an important role in ecological evolution and global biogeochemical cycles. Ecological baseline as a fundamental reference with less human interference has been investigated in surface ecosystems such as soils, rivers, and ocean, but the existence of groundwater microbial ecological baseline (GMEB) is still an open question so far.

RESULTS

Based on high-throughput sequencing information derived from national monitoring of 733 newly constructed wells, we find that bacterial communities in pristine groundwater exhibit a significant lateral diversity gradient and gradually approach the topsoil microbial latitudinal diversity gradient with decreasing burial depth of phreatic water. Among 74 phyla dominated by Proteobacteria in groundwater, Patescibacteria act as keystone taxa that harmonize microbes in shallower aquifers and accelerate decline in bacterial diversity with increasing well-depth. Decreasing habitat niche breadth with increasing well-depth suggests a general change in the relationship among key microbes from closer cooperation in shallow to stronger competition in deep groundwater. Unlike surface-water microbes, microbial communities in pristine groundwater are predominantly shaped by deterministic processes, potentially associated with nutrient sequestration under dark and anoxic environments in aquifers.

CONCLUSIONS

By unveiling the biogeographic patterns and mechanisms controlling the community assembly of microbes in pristine groundwater throughout China, we firstly confirm the existence of GMEB in shallower aquifers and propose Groundwater Microbial Community Index (GMCI) to evaluate anthropogenic impact, which highlights the importance of GMEB in groundwater water security and health diagnosis. Video Abstract.

Distribution, source identification, and health risk of emerging organic contaminants in groundwater of Xiong'an New Area, Northern China

Groundwater contamination in China has been greatly concerned due to dramatically increasing fresh water demand accompanied by economic development. However, little is known about aquifer vulnerability to hazardous matters especially in previously contaminated site of rapidly urbanizing cities. Here, we collected 90 groundwater samples from Xiong'an New Area during wet and dry seasons of 2019 and characterized the composition and distribution of emerging organic contaminants (EOCs) in this strategically developing city. A total of 89 EOCs, assigned to organochlorine pesticides (OCPs), polychlorinated biphenyls (PCBs), and volatile organic compounds (VOCs), were detected with the frequencies ranging from 1.11 %-85.6 %. Methyl tert-butyl ether (16.3 μg/L), Epoxid A (6.15 μg/L), and α-Lindane (5.15 μg/L) could be identified as major contributors to groundwater organic pollution. Significant aggregation of groundwater EOCs along Tang River were found due to historical residue and accumulation from wastewater storage there before 2017. Significant seasonal variations (p < 0.05) in the types and concentrations of EOCs could be attributed to discrepant pollution sources between varying seasons. Human health effects from exposure to groundwater EOCs were further evaluated with negligible risk (<10^-4) in most samples (97.8 %) and notable risk (10^-6-10^-4) in several monitored wells (2.20 %) located along Tanghe Sewage Reservoir. This study provides new evidences for aquifer vulnerability to hazardous matters in historically contaminated sites and is of significant to groundwater pollution controlling and drinking water safety for rapidly urbanizing cities.

Structure, stability, and potential function of groundwater microbial community responses to permafrost degradation on varying permafrost of the Qinghai-Tibet Plateau

The ongoing permafrost degradation under climate warming has modified aboveground biogeochemical processes mediated by microbes, yet groundwater microbial structure and function as well as their response to permafrost degradation remain poorly understood. We separately collect 20 and 22 sub-permafrost groundwater samples from Qilian Mountain (alpine and seasonal permafrost) and Southern Tibet Valley (plateau isolated permafrost) on the Qinghai-Tibet Plateau (QTP) to investigate the effects of permafrost groundwater characteristics on the diversity, structure, stability, and potential function of bacterial and fungal communities. Regional discrepancy of groundwater microbes between two permafrost regions reveals that permafrost degradation might reshape microbial community structure, increase community stability and potential functions relevant to carbon metabolism. Bacterial community assembly in permafrost groundwater is governed by deterministic processes, whereas fungal communities are mainly controlled by stochastic processes, suggesting that bacterial biomarkers might provide the better 'early warning signals' to permafrost degradation in deeper layers. Our study highlights the importance of groundwater microbes in ecological stability and carbon emission on the QTP.

[Treatment and prognosis analysis of 488 patients with FIGO 2018 stage Ⅲc squamous cervical cancer]

Objective: To analyze the treatment and prognosis of patients with International Federation of Gynecology and Obstetrics (FIGO) 2018 stage Ⅲc cervical squamous cell carcinoma. Methods: A total of 488 patients at Zhejiang Cancer Hospital between May, 2013 to May, 2015 were enrolled. The clinical characteristics and prognosis were compared according to the treatment mode (surgery combined with postoperative chemoradiotherapy vs radical concurrent chemoradiotherapy). The median follow-up time was (96±12) months ( range time from 84 to 108 months). Results: (1) The data were divided into surgery combined with chemoradiotherapy group (surgery group) and concurrent chemoradiotherapy group (radiotherapy group), including 324 cases in the surgery group and 164 cases in the radiotherapy group. There were significant differences in Eastern Cooperation Oncology Group (ECOG) score, FIGO 2018 stage, large tumors (≥4 cm), total treatment time and total treatment cost between the two groups (all P<0.01). (2) Prognosis: ① for stage Ⅲc1 patients, there were 299 patients in the surgery group with 250 patients survived (83.6%). In the radiotherapy group, 74 patients survived (52.9%). The difference of survival rates between the two groups was statistically significant (P<0.001). For stage Ⅲc2 patients, there were 25 patients in surgery group with 12 patients survived (48.0%). In the radiotherapy group, there were 24 cases, 8 cases survived, the survival rate was 33.3%. There was no significant difference between the two groups (P=0.296). ② For patients with large tumors (≥4 cm) in the surgery group, there were 138 patients in the Ⅲc1 group with 112 patients survived (81.2%); in the radiotherapy group, there were 108 cases with 56 cases survived (51.9%). The difference between the two groups was statistically significant (P<0.001). Large tumors accounted for 46.2% (138/299) vs 77.1% (108/140) in the surgery group and radiotherapy group. The difference between the two groups was statistically significant (P<0.001). Further stratified analysis, a total of 46 patients with large tumors of FIGO 2009 stage Ⅱb in the radiotherapy group were extracted, and the survival rate was 67.4%, there was no significant difference compared with the surgery group (81.2%; P=0.052). ③ Of 126 patients with common iliac lymph node, 83 patients survived, with a survival rate of 65.9% (83/126). In the surgery group, 48 patients survived and 17 died, with a survival rate of 73.8%. In the radiotherapy group, 35 patients survived and 26 died, with a survival rate of 57.4%. There were no significant difference between the two groups (P=0.051). (3) Side effects: the incidence of lymphocysts and intestinal obstruction in the surgery group were higher than those in the radiotherapy group, and the incidence of ureteral obstruction and acute and chronic radiation enteritis were lower than those in the radiotherapy group, and there were statistically significant differences (all P<0.01). Conclusions: For stage Ⅲc1 patients who meet the conditions for surgery, surgery combined with postoperative adjuvant chemoradiotherapy and radical chemoradiotherapy are acceptable treatment methods regardless of pelvic lymph node metastasis (excluding common iliac lymph node metastasis), even if the maximum diameter of the tumor is ≥4 cm. For patients with common iliac lymph node metastasis and stage Ⅲc2, there is no significant difference in the survival rate between the two treatment methods. Based on the duration of treatment and economic considerations, concurrent chemoradiotherapy is recommended for the patients.

(Fe, Cr)(OH)3 Coprecipitation in Solution and on Soil: Roles of Surface Functional Groups and Solution pH

The simultaneous precipitation of (Fe, Cr)(OH)₃ nanoparticles in solution (homogeneous) and on soil surfaces (heterogeneous), which controls Cr transport in soil and aquatic systems, was quantified for the first time in the presence of model surfaces, i.e., bare and natural organic matter (NOM)-coated SiO₂ and Al₂O₃. Various characterization techniques were combined to explore the surface-ion-precipitate interactions and the controlling mechanisms. (Fe, Cr)(OH)₃ accumulation on negatively charged SiO₂ was mainly governed by electrostatic interactions between hydrolyzed ion species or homogeneous (Fe, Cr)(OH)₃ and surfaces. The elevated pH through protonation of Al₂O₃ surface hydroxyls resulted in higher Cr/Fe ratios in both homogeneous and heterogeneous coprecipitates. Due to ignorable NOM adsorption onto SiO₂, the amounts of (Fe, Cr)(OH)₃ precipitates on bare/NOM-SiO₂ were similar; contrarily, attributed to favored NOM adsorption onto Al₂O₃ and consequently carboxyl association with metal ions or (Fe, Cr)(OH)₃ nanoparticles, remarkably more heterogeneous precipitates harvested on NOM-Al₂O₃ than bare-Al₂O₃. With the same solution supersaturation, the total amounts of homogeneous and heterogeneous precipitates were similar irrespective of the substrate type. With lower pH, decreased electrostatic forces between substrates and precipitates shifted (Fe, Cr)(OH)₃ distribution from heterogeneous to homogeneous phases. The quantitative knowledge of (Fe, Cr)(OH)₃ distribution and the controlling mechanisms can assist in better Cr sequestration in natural and engineered settings.

Morphology-Tailored Hydroxyapatite Nanocarrier for Rhizosphere-Targeted Phosphorus Delivery

High hydrophilicity and soil fixation collectively hamper the delivery of phosphorus (P) released from conventional chemical phosphorus fertilizers (CPFs) to plant rhizosphere for efficient uptake. Here, a phosphorus nutrient nanocarrier (PNC) based on morphology-tailored nanohydroxyapatite (HAP) is constructed. By virtue of kinetic control of building blocks with designed calcium phosphate intermediates, rod-like and hexagonal prism-like PNCs are synthesized, both having satisfactory hydrophobicity (water contact angle of 105.4^- 132.9°) and zeta potential (-17.43 to -58.4 mV at pH range from 3 to 13). Greenhouse experiments demonstrate that the P contents increase by up to 183% in maize rhizosphere and up to 16% in maize biomass when compared to the CPF. Due to the water potential gradient driven by photosynthesis and transpiration, both PNCs are stably transported to maize rhizosphere, and they are capable to counteract soil fixation prior to uptake by plant roots. Within the synergies of the HAP morphological characteristics and triggered phosphate starvation response, root anatomy confirms that two pathways are elucidated to enhance plant P replenishment from the PNCs. Together with structure tunability and facile synthesis, our results offer a new nanodelivery prototype to accommodate plant physiological traits by tailoring the morphology of HAP.

Shared genetic architecture between type 2 diabetes and COVID-19 severity

PURPOSE

Patients with type 2 diabetes (T2D) have demonstrated a higher risk for developing more severe cases of COVID-19, but the complex genetic mechanism between them is still unknown. The aim of the present study was to untangle this relationship using genetically based approaches.

METHODS

By leveraging large-scale genome-wide association study (GWAS) summary statistics of T2D and COVID-19 severity, linkage disequilibrium score regression and Mendelian randomization (MR) analyses were utilized to quantify the genetic correlations and causal relationships between the two traits. Gene-based association and enrichment analysis were further applied to identify putative functional pathways shared between T2D and COVID-19 severity.

RESULTS

Significant, moderate genetic correlations were detected between T2D and COVID-19 hospitalization (r_g = 0.156, SE = 0.057, p = 0.005) or severe disease (r_g = 0.155, SE = 0.057, p = 0.006). MR analysis did not support evidence for a causal effect of T2D on COVID-19 hospitalization (OR 1.030, 95% CI 0.979, 1.084, p = 0.259) or severe disease (OR 0.999, 95% CI 0.934, 1.069, p = 0.982). Genes having p_gene < 0.05 for both T2D and COVID-19 severe were significantly enriched for biological pathways, such as response to type I interferon, glutathione derivative metabolic process and glutathione derivative biosynthetic process.

CONCLUSIONS

Our findings further confirm the comorbidity of T2D and COVID-19 severity, but a non-causal impact of T2D on severe COVID-19. Shared genetically modulated molecular mechanisms underlying the co-occurrence of the two disorders are crucial for identifying therapeutic targets.

The Role of Sarcopenia in Overactive Bladder in Adults in the United States: Retrospective Analysis of NHANES 2011-2018

PURPOSE

To investigate the association between sarcopenia and overactive bladder (OAB) in a United States adult population from 2011 to 2018, and whether sarcopenia can predict the risk of OAB.

MATERIALS AND METHODS

We analyzed data from the 2011-2018 National Health and Nutrition Examination Survey in a cross-sectional study(NHANES) of 8746 participants, of whom 1213 were diagnosed with OAB, we analyzed correlations by sex, age, race, education level, marital status, household income-to-poverty ratio, hypertension, diabetes, strenuous work activity, moderate work activity, strenuous recreational activity, moderate recreational activity, blood urea nitrogen, creatinine, and uric acid levels using restricted cubic spline plots of dose-response curves, univariate and multivariate Logistic regression. Models based on sex, age, education, household income to poverty ratio, hypertension, diabetes, sarcopenia index, and cotinine were developed and evaluated using Nomogram, calibration curves, receiver operating characteristic curves, and clinical decision curves.

RESULTS

Of the 1213 OAB patients, 388 (32.0%) were male and 825 (68.0%) were female. Univariate and multivariate Logistic regression analysis showed that sarcopenia index was negatively correlated with the prevalence of OAB (OR=0.084, 95% CI, 0.056 - 0.130, P <0.001;OR=0.456, 95%CI, 0.215-0.968, P= 0.0041). Dose curve analysis of the sarcopenia index and prevalence of OAB showed that the prevalence of OAB decreased significantly with increasing sarcopenia index. Sarcopenia was positively correlated with OAB (OR=2.400, 95%CI, 2.000 - 2.800, P <0.001;OR=1.46, 95%CI, 1.096 -1.953, P = 0.010). In addition, our model shows that sarcopenia can predict the prevalence of OAB (AUC = 0.750) and has some clinical decision-making implications.

CONCLUSION

Sarcopenia is positively associated with the risk of OAB in United States adults and can be used as a predictor of OAB prevalence.

Deficiency and excess of groundwater iodine and their health associations

More than two billion people worldwide have suffered thyroid disorders from either iodine deficiency or excess. By creating the national map of groundwater iodine throughout China, we reveal the spatial responses of diverse health risks to iodine in continental groundwater. Greater non-carcinogenic risks relevant to lower iodine more likely occur in the areas of higher altitude, while those associated with high groundwater iodine are concentrated in the areas suffered from transgressions enhanced by land over-use and intensive anthropogenic overexploitation. The potential roles of groundwater iodine species are also explored: iodide might be associated with subclinical hypothyroidism particularly in higher iodine regions, whereas iodate impacts on thyroid risks in presence of universal salt iodization exhibit high uncertainties in lower iodine regions. This implies that accurate iodine supply depending on spatial heterogeneity and dietary iodine structure optimization are highly needed to mitigate thyroid risks in iodine-deficient and -excess areas globally.

Comammox biogeography subject to anthropogenic interferences along a high-altitude river

The recent discovery of comammox Nitrospira performing complete ammonia oxidation to nitrate has overturned the long-held dogma of two-step nitrification on Earth, yet little is known about the effect of urbanization interference on their distribution. Using gene-centric metagenomics, we provided the first blueprints about comammox community, biogeography, and environmental drivers along a high-elevation (> 2000 m) river flowing through the largest city on the vulnerable Qinghai-Tibetan Plateau. Our study confirmed a wide presence and diversity of yet-uncultured comammox clade B across wet and dry seasons, with average 3.0 and 2.0 times as abundant as clade-A amoA genes in water and sediments, respectively. Species identified from freshwater and drinking water treatment plants dominated the comammox guilds (58∼100%), suggesting this plateau river shared a similar comammox assemblage with the above habitat types. Compared with the urban area harboring more abundant canonical Nitrospira identified in wastewater (average 24%), the upstream suburban reach had a smaller human population but larger proportions of comammox in ammonia-oxidizing prokaryotes (24∼72% of abundances) and Nitrospira sublineages I/II. Higher contents of nitrate and nitrite in water, and antibiotics in water and sediments, may restrain comammox niches in nitrifiers over the urban area. Further random forest analysis revealed that lincosamides and quinolones were the most important antibiotic predictors for the niche differentiations between comammox and canonical nitrifiers in water, while macrolides for those in sediments. Finally, by incubation experiments, we demonstrated higher activity contributions of benthic comammox in the suburban area (36.2∼92.8% of potential ammonia-oxidation rates) than in the urban reach, and that the contribution variation had significant negative relations with macrolides and their major components. Overall, this study highlighted that anthropogenic activities hampered the advantage of riverine complete nitrifiers over the canonical two-step ones.

Bioaccumulation of 35 metal(loid)s in organs of a freshwater mussel (Hyriopsis cumingii) and environmental implications in Poyang Lake, China

Benthic bioaccumulation of hazardous materials has been a great challenge to the health of lake ecosystems. As representative benthic macroinvertebrates, freshwater mussels and their accumulation characteristics have been regarded as effective indicators for assessing potential risks induced by sedimentary metal(loid)s in lakes. Here we profile organ-specific accumulation of 35 metal(loid)s in a freshwater mussel (Hyriopsis cumingii) and their correlations to metal speciation in sediments of Poyang Lake, the largest lake of China. Significant organ-specific characteristics of metal accumulation were found in gills, though higher thallium (Tl) and selenium (Se) were found in the hepatopancreas, and greater arsenic (As) mostly accumulated in gonads. Pearson correlation analysis revealed that the bioaccumulation of silver (Ag), cobalt (Co), and rare earth elements (ΣREE) in gills and As in gonads were closely associated with those in bioavailable fraction of sediments. Based on the biochemical analysis in the major organs, gills exhibited the highest enzymatic activity compared with hepatopancreas and gonads. Sedimentary metals, particularly for available Ag, Co, and ΣREE, play key roles in causing lipid peroxidation in gills and significantly promote the activities of superoxide dismutase (SOD)/glutathione reductase (GR), while many metals (e.g., cadmium, manganese, Se) inhibit the glutathione (GSH) content in gonads and hepatopancreas. Our study indicates a high physiological sensitivity of mussels to these target metals, which highlights the significance of organ-specific accumulation of metal(loid)s in understanding the potential ecological risks of sedimentary metal(loid)s in lake ecosystems.

Pregnancy of cryopreserved ovine embryos at different developmental stages

BACKGROUND

Developmental stage and cryopreservation method have significant impact on the pregnancy rate after transfer of embryos produced in vivo.

OBJECTIVE

To determine the pregnancy outcomes from ovine embryos cryopreserved at different developmental stages.

MATERIALS AND METHODS

Embryos at different developmental stages were obtained from donor ewes through simultaneous estrus treatment and laparoscopic artificial insemination. Embryos, either cryopreserved via vitrification or slow freezing method, were implanted into recipient ewes. The pregnancy rate was determined 35 days after transfer.

RESULTS

The pregnancy rate of developing embryos increases after transfer from the morula stage, early blastocyst to expanded blastocyst stages (64.9%, 73.9% and 81.3%, respectively). However, cryopreservation significantly decreases the pregnancy rate of embryos at all three developmental stages, and there is no significant difference among developmental stages (43.9%, 43.7%, 52.9%, respectively). There is also no significant difference in the pregnancy rate between slowly-frozen embryos and vitrified embryos.

CONCLUSION

The pregnancy outcomes of embryo transfer is better at the expanded blastocyst stage than at earlier stages. However, no difference is observed in the pregnancy rate of embryos at different developmental stage after cryopreservation, either by slow freezing and vitrification. Cryopreservation methods for ovine embryos, both slow freezing and vitrification, need further improvement. doi.org/10.54680/fr22510110512.

Pharmaceuticals and personal care products (PPCPs) in water, sediment and freshwater mollusks of the Dongting Lake downstream the Three Gorges Dam

Pharmaceuticals and personal care products (PPCPs) are a group of emerging anthropogenic pollutants. Here we investigated the occurrence and concentrations of 35 typical PPCPs in water, sediment, and freshwater mollusks (Hyriopsis cumingii, Unio douglasiae, Sinanodonta woodiana, Lamprotula leai and Corbicula fluminea) of the Dongting Lake downstream of the Three Gorges Dam. As results, 33 PPCPs were detected in water and sediment of the lake. Ketoprofen (not detected (ND)-292.8 ng/L, mean 91.1 ng/L) and roxithromycin (13.7-141.9 ng/L, mean 30.4 ng/L) were the primary PPCPs measured in lake water, while ibuprofen (ND-105.0 ng/g, mean 30.0 ng/g) and ketoprofen (ND-142.9 ng/g, mean 27.6 ng/g) were dominant in the sediment. Distinct seasonal difference in PPCP compositions was observed in both water and sediment of the Dongting Lake, potentially associated with the water-level fluctuations driven by the Three Gorges Dam operations. Ketoprofen and ibuprofen were also frequently detected in the soft tissues of freshwater mollusks, with concentrations of 42.5-1206.6 and 44.9-992.7 ng/g, respectively. Significant species-specific accumulation characteristics of PPCPs in mollusks were observed, with the highest total contents being reported for Corbicula fluminea (3.18 ± 1.13 μg/g). Moreover, gonads of mollusks were identified as the target organ to accumulate these compounds. Correlation analysis further revealed the strong associations of PPCP concentrations in mollusks with those in water and sediment, suggesting the importance of controlling dissolved and sedimentary bioavailability of PPCPs for ecological risk management in this freshwater lake ecosystems.

[Effects of cinepazide maleate injection on blood pressure in patients with acute ischemic stroke and hypertension]

Objective: To investigate the blood pressure change in patients with acute ischemic stroke (AIS) and hypertension treated with cinepazide maleate injection. Methods: This was a subgroup analysis of post-marketing clinical confirmation study of cinepazide maleate injection for acute ischemic stroke: a randomized, double-blinded, multicenter, placebo-parallel controlled trial, which conducted in China from August 2016 to February 2019. Eligible patients fulfilled the inclusive criteria of acute anterior circulation ischemic stroke with National Institutes of Health Stroke Scale (NIHSS) scores of 7-25. The primary endpoints were mean blood pressure of AIS patients treated with cinepazide maleate or control, which were assessed during the treatment period (14 days), and the proportion of the patients with normal blood pressure was analyzed after the treatment period. Furthermore, a subgroup analysis was performed to investigate a possible effect of the history of hypertension on outcomes. Results: This analysis included 809 patients with hypertension. There was no significant difference in patients blood pressure and the proportion of patients with normal blood pressure (60.5% vs. 59.0%,P>0.05) between cinepazide maleate group and control group. Conclusion: Administration of cinepazide maleate injection does not affect the management of clinical blood pressure in patients with AIS.

Supercarriers of antibiotic resistome in a world's large river

BACKGROUND

Antibiotic resistome has been found to strongly interact with the core microbiota in the human gut, yet little is known about how antibiotic resistance genes (ARGs) correlate with certain microbes in large rivers that are regarded as "terrestrial gut."

RESULTS

By creating the integral pattern for ARGs and antibiotic-resistant microbes in water and sediment along a 4300-km continuum of the Yangtze River, we found that human pathogen bacteria (HPB) share 13.4% and 5.9% of the ARG hosts in water and sediment but contribute 64% and 46% to the total number of planktonic and sedimentary ARGs, respectively. Moreover, the planktonic HPB harbored 79 ARG combinations that are dominated by "natural" supercarriers (e.g., Rheinheimera texasensis and Noviherbaspirillum sp. Root189) in river basins.

CONCLUSIONS

We confirmed that terrestrial HPB are the major ARG hosts in the river, rather than conventional supercarriers (e.g., Enterococcus spp. and other fecal indicator bacteria) that prevail in the human gut. The discovery of HPB as natural supercarriers in a world's large river not only interprets the inconsistency between the spatial dissimilarities in ARGs and their hosts, but also highlights the top priority of controlling terrestrial HPB in the future ARG-related risk management of riverine ecosystems globally. Video Abstract.

Rare biosphere regulates the planktonic and sedimentary bacteria by disparate ecological processes in a large source water reservoir

The bacteria in the water column and surface sediments are inherently intertwined and inseparable in aquatic ecosystems, yet little is known about the integrated spatiotemporal dynamics and driving mechanisms of both planktonic and sedimentary bacterial communities in reservoirs. By investigating the planktonic and sedimentary bacteria during four seasons from 88 samples of 11 representative sites across the Danjiangkou reservoir, we depicted an integrated biogeographic pattern of bacterial communities in the water source of the world's largest water diversion project. Our study revealed both planktonic (mantel r = 0.502, P = 0.001) and sedimentary (mantel r = 0.131, P = 0.009) bacterial communities were significantly correlated with environmental heterogeneity, but a weak disparity along spatial heterogeneity, and the significant seasonal dynamics of planktonic (mantel r = 0.499, P = 0.001) rather than sedimentary bacteria. Particularly, rare biosphere played a main role in determining the community succession in the reservoir. It not only exhibited a more striking environmental separation than abundant taxa but also was an essential part in mediating spatiotemporal shifts of planktonic bacteria and maintaining the stability of bacterial community. These rare bacteria were respectively mediated by stochastic (62.68%) and selective (79.60%) processes in water and sediments despite abundant taxa being largely determined by stochastic processes (86.88-93.96%). Overall, our study not only fills a gap in understanding the bacterial community dynamics and underlying drivers in source water reservoirs, but also highlights the particular importance of rare bacteria in mediating biogeochemical cycles in world's large reservoir ecosystems.

Different spatiotemporal dynamics, ecological drivers and assembly processes of bacterial, archaeal and fungal communities in brackish-saline groundwater

The presence of brackish-saline groundwater (BSG) poses great harms for human health, agricultural and industrial activity. Understanding how the major environmental features in BSG determine microbiota coalescence is crucial for groundwater monitoring optimization. Based on metabarcoding analysis of 242 PCR-amplified samples, we provided the first blueprints about distinct spatiotemporal distributions, ecological drivers and assembly processes of bacterial, archaeal and fungal communities in BSG obtained from new-constructed wells at Xiong'an New Area, China. Our study demonstrated that bacterial and archaeal communities exhibited significant spatial turnovers, while fungal community displayed the most obvious seasonal variation. Environmental filtering drove bacterial compositions more than those of archaea and fungi. Total dissolved solids (TDS), one of the most critical hydrochemical factors for salinization, had a stronger effect on bacterial spatiotemporal turnover than on those of the other two taxonomic groups, while chemical oxygen demand (CODMn) was more significantly associated with prokaryotic community variations. Bacterial and archaeal taxa dominated the metacommunity network and connected closely, and TDS was mostly related to archaeal subnetwork topological features, suggesting a significant influence of TDS on species association patterns within archaea. Specific functional guilds like bacterial nitrite oxidation, anammox, and archaeal methanogenesis were enriched in lower-TDS habitats, while higher TDS favored bacterial communities involved in dark oxidation of sulfur compounds, fumarate respiration, and cellulolysis. Finally, we confirmed that bacterial and archaeal assembly processes were governed by determinism in each season, and that of fungi was more regulated by stochasticity. Higher TDS was speculated to lead bacterial assembly more deterministic and that of fungi more random. Together, these findings provided an integrate theoretical framework about the unique responses of the three life domains to brackish-saline stress, and had important implications for microbial ecological prediction in groundwater.

Genome-centric metagenomics provides new insights into the microbial community and metabolic potential of landfill leachate microbiota

Landfills are important sources of microorganisms associated with anaerobic digestion. However, the knowledge on microbiota along with their functional potential in this special habitat are still lacking. In this study, we recovered 1168 non-redundant metagenome-assembled genomes (MAGs) from nine landfill leachate samples collected from eight cities across China, spanning 42 phyla, 73 classes, 114 orders, 189 families, and 267 genera. Totally, 74.1% of 1168 MAGs could not be classified to any known species and 5.9% of these MAGs belonged to microbial dark matter phyla. Two putative novel classes were discovered from landfill leachate samples. The identification of thousands of novel carbohydrate-active enzymes showed similar richness level compared to the cow rumen microbiota. The methylotrophic methanogenic pathway was speculated to contribute significantly to methane production in the landfill leachate because of its co-occurrence with the acetoclastic and hydrogenotrophic methanogenic pathways. The genetic potential of dissimilatory nitrate reduction to ammonium (DNRA) was observed, implying DNRA may play a role in ammonium generation in landfill leachate. These findings implied that landfill leachate might be a valuable microbial resource repository and filled the previous understanding gaps for both methanogenesis and nitrogen cycling in landfill leachate microbiota. Our study provides a comprehensive genomic catalog and substantially provides unprecedented taxonomic and functional profiles of the landfill leachate microbiota.

Electrochemical elimination of Microcystis aeruginosa with boron-doped diamond anode in different electrolyte systems: chemical and biological mechanisms

The chemical and biological mechanisms of electrochemical elimination of Microcystis aeruginosa (M. aeruginosa) using boron-doped diamond (BDD) anode were comparatively explored in three different electrolytes (chloride, sulfate, and phosphate solutions). The most efficient elimination of M. aeruginosa was observed in chloride solution, which was attributed to the greatest total long-lived oxidants from the favorable formation of active chlorine. Moreover, the high permeability of active chlorine resulted in profound intracellular damages to chlorophyll-a, microcystin-LR (MC-LR), superoxide dismutase (SOD) enzyme, and DNA in the chloride system. The change of membrane permeability and degradation of the released MC-LR induced by active chlorine were further confirmed by the increase of extracellular MC-LR in the initial 5 min and a complete decay in the subsequent 15 min, while the change in morphology of algae cells was insignificant from SEM images. In sulfate and phosphate electrolytes, membrane damages were much more pronounced based on lipid peroxidation observation, although changes in cell morphology was found more significant in phosphate system. The higher concentrations of oxidants (·OH, O₃, H₂O₂, S₂O₈^2-) generated in sulfate than in phosphate solution explained the greater efficiency of electrochemical elimination of M. aeruginosa in the sulfate electrolyte in terms of changes of cell density, OD₆₈₀, chlorophyll-a, MC-LR, lipids, SOD enzyme, and DNA.

Unveil the role of dissolved and sedimentary metal(loid)s on bacterial communities and metal resistance genes (MRGs) in an urban river of the Qinghai-Tibet Plateau

Though metal resistance genes (MRGs) are of global concern in aquatic ecosystems, the underlying factors responsible for MRGs dissemination, especially in urban rivers on the vulnerable Qinghai-Tibet Plateau, are rarely known. Here, we collected 64 samples including water and sediments during the wet and dry seasons and effluents from six wastewater treatment plants (WWTPs) during the dry season and measured 50 metal(loid)s, 60 bacterial phyla, and 259 MRGs. We observed the distinct difference of metal(loid)s, bacterial communities, and MRGs between water and sediments and the great seasonal changes in metal(loid)s and bacterial communities instead of MRGs. Thirty-one metal(loid)s were detectable in the water, with relatively low concentrations and no significant effects on the planktonic bacterial communities and MRGs. Interestingly, the WWTPs effluent partially promoted the prevalence of dissolved metal(loid)s, bacterial communities, and MRGs along the river. In the sediments, the average concentrations of 17 metal(loid)s exceeded their corresponding background levels in this region and strongly influenced the bacterial communities and the MRGs. Sedimentary Hg and Cd, mainly sourced from the intensive animal husbandry, were the major pollutants causing ecological risks and largely shaped their corresponding resistomes. Moreover, we found that bacterial communities predominantly determined the variation of MRGs in both water and sediments. Metagenome-assembled genomes further reveals the widespread co-occurrence of MRGs and antibiotic resistance genes (ARGs) in MRG hosts. Our study highlighted the concern of effluents discharged from WWTPs and emphasized the importance of controlling the anthropogenic inputs of sedimentary metal(loid)s in the plateau river ecosystems.

Aggregate exposure pathways for microplastics (mpAEP): An evidence-based framework to identify research and regulatory needs

Microplastics as emerging contaminants have been detected from peaks to poles. High concerns on the risks of microplastic pollution to humans and ecosystems have therefore been raised in the past decade. While a large number of studies have been conducted to investigate the environmental levels and toxicity of microplastics, the information generated to support risk assessment is fragmented and the coherence between different types of study is largely lacking. Here we introduced the Aggregate Exposure Pathway (AEP), a conceptual framework originally proposed for chemical exposure assessment, to facilitate organization, visualization and evaluation of existing information generated from microplastic research, and to efficiently identify future knowledge and regulatory needs. A putative microplastic AEP network (mpAEP) was developed to demonstrate the concept and model development strategies. Two mpAEP case studies, with polyethylene (PE) as a prototype, were then presented based on existing environmental exposure data collected from the Changjiang Estuary and the East China Sea (Case I), and the Oslo Fjord (Case II), respectively. Weight of evidence (WoE) assessment of the mpAEPs were performed for evaluating the essentiality, theoretical plausibility, empirical evidence and quantitative understanding of the evidence and relationships in the AEPs. Both cases showed moderate/high WoE to support the strength of the models, whereas also displayed clear knowledge gaps, thus providing guidance for future investigations and regulations. The mpAEP framework introduced herein presents a novel strategy for organizing fragmented information from diverse types of microplastic research, enhancing mechanistic understanding of causal relationships and facilitating the development of quantitative prediction models for research and regulation in the future.

Three Gorges Dam: Friend or Foe of Riverine Greenhouse Gases?

Dams are often regarded as greenhouse gas (GHG) emitters. However, our study indicated that the world's largest dam, the Three Gorges Dam (TGD), has caused significant drops in annual average emissions of CO₂, CH₄ and N₂O over 4300 km along the Yangtze River, accompanied by remarkable reductions in the annual export of CO₂ (79%), CH₄ (50%) and N₂O (9%) to the sea. Since the commencement of its operation in 2003, the TGD has altered the carbonate equilibrium in the reservoir area, enhanced methanogenesis in the upstream, and restrained methanogenesis and denitrification via modifying anoxic habitats through long-distance scouring in the downstream. These findings suggest that ‘large-dam effects’ are far beyond our previous understanding spatiotemporally, which highlights the fundamental importance of whole-system budgeting of GHGs under the profound impacts of huge dams.

Interpretation of high perchlorate generated during electrochemical disinfection in presence of chloride at BDD anodes

Perchlorate is a disinfection by-product (DBP) of serious health concern. Herein, the long sought mechanism of high perchlorate production during electrochemical disinfection at boron-doped diamond (BDD) anode in the presence of chloride was elucidated. The generated perchlorate at BDD during electrochemical disinfection (in 10 mM NaCl) in 60 min reached 0.125 mM, which was 830 times higher than the EPA standard. In contrast, perchlorate at PbO₂ and SnO₂ anodes was below the detection limit. Further experiments employing NaClO₃ revealed that the conversion ratio from ClO₃^- to ClO₄^- in 10 h at BDD (98%) was considerably higher than PbO₂ (13%) and SnO₂ (12%). Such significant difference among anodes was fully interpreted with a two-step mechanism. The first step is essential to produce ·ClO₃ by oxidizing ClO₃^- at electrodes. Otherwise, the conversion to perchlorate would be impossible even with excessive ·OH, which was verified with the photocatalysis process. The second step is the perchlorate generation with radical reaction between ·ClO₃ and ·OH, where the primary role of ·OH was substantiated by scavenging test. Interestingly, the capability of perchlorate production was correlated with free ·OH instead of the total amount of ·OH. Despite the similar abilities of electron transfer between anodes and ClO₃^-, much higher free ·OH exists at BDD anode than at PbO₂ and SnO₂ anodes through chronoamperometry experiments and work function characterization, which reasonably provides interpretation of high perchlorate production at BDD anode.

Response of microbial nitrogen transformation processes to antibiotic stress in a drinking water reservoir

Effects of antibiotics on microbial nitrogen transformation processes in natural aquatic ecosystems are largely unknown. In this study, we utilized the ¹⁵N stable isotope tracers and metagenomic sequencing to identify how antibiotics drive nitrogen transformation processes in Danjiangkou Reservoir, which is the largest artificial drinking water reservoir in China. We retrieved 51 nitrogen functional genes, and found that the highest abundances of nitrate reduction and denitrification-related genes occurred in dissimilatory nitrogen transformation pathways. ¹⁵N-labelling analysis substantiated that denitrification was the main pathway for nitrogen removal, accounting for 57.1% of nitrogen loss. Nitrogen functional genes and antibiotic resistance genes co-occurred in Danjiangkou Reservoir, and they were mainly carried by the denitrifying bacteria such as Rhodoferax, Polaromonas, Limnohabitans, Pararheinheimera, Desulfobulbus, and Pseudopelobacter. Genome annotation revealed that antibiotic deactivation, Resistance-Nodulation-Division and facilitator superfamily efflux pumps were responsible for the multiple-resistance to antibiotics in these bacteria. Moreover, antibiotics showed non-significant effects on nitrogen transformation processes. It is speculated that denitrifying bacteria harboring ARGs played crucial roles in protecting nitrogen transformation from low-level antibiotics stress in the reservoir. Our results highlight that denitrifying bacteria are important hosts of ARGs, which provides a novel perspective for evaluating the effects of antibiotics on nitrogen cycle in natural aquatic ecosystems.

Global syndromes induced by changes in solutes of the world's large rivers

Solute-induced river syndromes have grown in intensity in recent years. Here we investigate seven such river syndromes (salinization, mineralization, desalinization, acidification, alkalization, hardening, and softening) associated with global trends in major solutes (Ca2+, Mg2+, Na+, K+, SO42-, Cl-, HCO3-) and dissolved silica in the world's large rivers (basin areas ≥ 1000 km2). A comprehensive dataset from 600 gauge stations in 149 large rivers reveals nine binary patterns of co-varying trends in runoff and solute concentration. Solute-induced river syndromes are associated with remarkable increases in total dissolved solids (68%), chloride (81%), sodium (86%) and sulfate (142%) fluxes from rivers to oceans worldwide. The syndromes are most prevalent in temperate regions (30~50°N and 30~40°S based on the available data) where severe rock weathering and active human interferences such as urbanization and agricultural irrigation are concentrated. This study highlights the urgency to protect river health from extreme changes in solute contents.

Racial/ethnic differences in cardiovascular outcomes in a universal healthcare system: insights from the CARTaGENE cohort

Background

While prior studies have shown racial/ethnic differences in cardiovascular (CV) outcomes within private or mixed health care systems, it remains uncertain whether inequalities in cardiovascular outcomes exist between different races and ethnicities in universal health care contexts. We aimed to determine whether there are racial/ethnicity disparities in long-term CV outcomes within a single-payer universal health care system.

Methods

The CARTaGENE study is a population-based prospective cohort study with enrollment of 19,996 individuals between 40–69 years in 2009, in the province of Quebec, Canada. Participants residing in four large metropolitan areas were randomly chosen from the provincial health insurance registry by strata of age, sex, and postal codes. Follow-up was available up to 2016. For this analysis, we retained only participants without prior known CV disease. The primary composite endpoint was time to the first CV event or intervention (CV death, acute coronary syndrome, heart failure, coronary revascularization, ischemic stroke, or peripheral vascular event or revascularization). We used unadjusted and adjusted Cox proportional hazard models to evaluate the association of self-defined race/ethnicity with the primary endpoint.

Results

There were 17,802 eligible participants with a mean age of 51 years (52.5% females) with 111,312 person-years of follow-up (median follow-up of 6.6 years). South Asian (SA) participants had the highest prevalence of diabetes mellitus (29%) and hypertension (32%). After adjustment for age and sex, SA ethnicity was associated with a 95% relative increase in risk for CV events, while East/Southeast Asian (ESA) ethnicity was associated with a 42% relative decrease in risk for CV events compared to White participants. After further adjustment for socioeconomic status and CV risk factors, ESA ethnicity remained associated with a similar decreased CV risk. In contrast, the association of SA ethnicity with increased CV risk was attenuated after full adjustment for baseline characteristics (Table 1).

Conclusions

Racial/ethnic disparities in long-term CV outcomes are present in a single-payer universal healthcare setting. ESA ethnicity was associated with a lower risk of long-term CV outcomes. Future studies are needed to corroborate the reduced risk of long-term major CV events associated with ESA ethnicity. Understanding the reasons related to potential CV protection with ESA ethnicity could facilitate endeavors to reduce long-term CV outcomes in other races/ethnicities.

Funding Acknowledgement

Type of funding sources: Public hospital(s). Main funding source(s): McGill Health University Center