Mitigating air pollution benefits multiple sustainable development goals in China

Achieving the United nations 2030 Sustainable Development Goals (SDGs) remains a significant challenge, necessitating urgent and prioritized strategies. Among the various challenges, air pollution continues to pose one of the most substantial threats to the SDGs due to its widespread adverse effects on human health and ecosystems. However, the connections between air pollution and the SDGs have often been overlooked. This study reveals that out of the 169 SDG targets, 71 are adversely impacted by air pollution, while only 6 show potential positive effects. In China, two major atmospheric nitrogen pollutants, ammonia and nitrogen oxides, resulted in an economic loss of 400 billion United States Dollar (USD) in 2020, which could be reduced by 33% and 34% by 2030, respectively. It would enhance the progress towards SDGs in China by 14%, directly contributing to the achievement of SDGs 1 to 6 and 11 to 15. This improvement is estimated to yield overall benefits totaling 119 billion USD, exceeded the total implementation cost of 82 billion USD with ammonia as the preferential mitigation target. This study underscores the importance of robust scientific evidence in integrated policies aimed at aligning improvements in environmental quality with the priorities of sustainable development.

Agricultural management practices in China enhance nitrogen sustainability and benefit human health

The potential of enhanced agricultural management practices to drive sustainability is rarely quantified at grassroots level. Here we analyse nitrogen use and loss in Chinese cropland, drawing from data collected in 2,238,550 sites in two national agricultural pollution source censuses from 2007 to 2017. We find an upswing of 10% in crop yields and an 8% reduction in nitrogen pollution during this period, owing to the promotion and adoption of various management practices (including the combination of organic and chemical fertilizers, straw recycling and deep placement of fertilizer). These practices have collectively contributed to an 18% increase in nitrogen use efficiency in the country. By fully embracing them, we project that annual cropland pollution could be further reduced by up to 1.4 Mt of nitrogen without compromising crop yields. Environmental and human health benefits are projected to consistently outweigh implementation costs in the future, with total benefits reaching US$15 billion.

Managing fragmented croplands for environmental and economic benefits in China

Cropland fragmentation contributes to low productivity and high abandonment risk. Using spatial statistics on a detailed land use map, we show that 10% of Chinese croplands have no potential to be consolidated for large-scale farming (>10 ha) owing to spatial constraints. These fragmented croplands contribute only 8% of total crop production while using 15% of nitrogen fertilizers, leading to 12% of fertilizer loss in China. Optimizing the cropping structure of fragmented croplands to meet animal food demand in China can increase animal food supply by 19%, equivalent to increasing cropland proportionally. This crop-switching approach would lead to a 10% and 101% reduction in nitrogen and greenhouse gas emissions, respectively, resulting in a net benefit of US$ 7 billion yr-1. If these fragmented croplands were relocated to generate large-scale farming units, livestock, vegetable and fruit production would be increased by 8%, 3% and 14%, respectively, and reactive nitrogen and greenhouse gas emissions would be reduced by 16% and 5%, respectively, resulting in a net benefit of US$ 44 billion yr-1. Both solutions could be used to achieve synergies between food security, economic benefits and environmental protection through increased agricultural productivity, without expanding the overall cropland area.

Managing urban development could halve nitrogen pollution in China

Halving nitrogen pollution is crucial for achieving Sustainable Development Goals (SDGs). However, how to reduce nitrogen pollution from multiple sources remains challenging. Here we show that reactive nitrogen (Nr) pollution could be roughly halved by managed urban development in China by 2050, with NH3, NOx and N2O atmospheric emissions declining by 44%, 30% and 33%, respectively, and Nr to water bodies by 53%. While rural-urban migration increases point-source nitrogen emissions in metropolitan areas, it promotes large-scale farming, reducing rural sewage and agricultural non-point-source pollution, potentially improving national air and water quality. An investment of approximately US$ 61 billion in waste treatment, land consolidation, and livestock relocation yields an overall benefit of US$ 245 billion. This underscores the feasibility and cost-effectiveness of halving Nr pollution through urbanization, contributing significantly to SDG1 (No poverty), SDG2 (Zero hunger), SDG6 (Clean water), SDG12 (Responsible consumption and production), SDG14 (Climate Action), and so on.

Atmospheric Nitrogen Pollution Control Benefits the Coastal Environment

Nitrogen is an essential nutrient and a major limiting element for the ocean ecosystem. Since the preindustrial era, substantial amounts of nitrogen from terrestrial sources have entered the ocean via rivers, groundwater, and atmospheric deposition. China serves as a key hub in the global nitrogen cycle, but the pathways, sources, and potential mitigation strategies for land-ocean nitrogen transport are unclear. By combining the CHANS, WRF-Chem, and WNF models, we estimated that 8 million tonnes (Tg) of nitrogen was transferred into the ocean in 2017 in China, with atmospheric deposition contributing 1/3. About half variation of the offshore chlorophyll concentration was explained by atmospheric deposition. The Bohai Sea was the hot spot of nitrogen input, estimated at 214 kg N ha-1, while other areas were around 25-51 kg N ha-1. The largest contributors are agricultural systems (4 Tg, 55%), followed by domestic sewage (2 Tg, 21%). Abatement measures could reduce nitrogen export to the ocean by 43%, and mitigating ammonia and nitrogen oxide emissions accounts for 33% of this reduction, highlighting the importance of addressing air pollution in resolving ocean pollution. The cost-benefit analysis suggests the priority of nitrogen reduction in cropland and transport systems for the ocean environment.

[Establishment of a rapid method for detection of influenza A/B virus' antigens]

This study aims to develop a rapid and convenient test card for simultaneous detection of influenza A and influenza B viruses using quantum dot-based immunochromatographic assay. The test card consists of a test strip and a plastic casing. The test strip is composed of absorbent paper, a buffer pad, nitrocellulose membrane (NC membrane), sample pad, quantum dot-labeled antibody pad, and polyvinyl chloride (PVC) board. The NC membrane is coated with mouse monoclonal antibodies against influenza A and influenza B viruses for the T lines (test lines), and reference proteins A and B for the C line (control line). The quantum dot-labeled antibody pad contains mouse monoclonal antibody-quantum dot conjugates against influenza A and influenza B viruses. The results showed that the detection limit of the test card for both viruses ranged from 1.51 ×102 to 2.71×103 TCID50/ml, indicating its sensitivity for accurate detection of influenza A and influenza B viruses without being affected by various variants. The test card exhibited specific reactions with different subtypes of influenza A and influenza B virus culture fluids and showed no cross-reactivity with adenovirus, novel coronavirus, Mycoplasma pneumoniae, respiratory syncytial virus, Staphylococcus aureus, and other pathogens. Overall, the sensitivity and specificity of the test card for simultaneous detection of influenza A and influenza B viruses meet the requirements for clinical use. It offers the advantages of simplicity, rapidity, and no requirement for special equipment, enabling quick auxiliary diagnosis to prevent disease transmission.

Ammonia mitigation campaign with smallholder farmers improves air quality while ensuring high cereal production

Reducing cropland ammonia (NH3) emissions while improving air quality and food supply is a challenge, particularly in China where there are millions of smallholder farmers. We tested the effectiveness of a tailored nitrogen (N) management strategy applied to wheat-maize cropping systems in 'demonstration squares' across Quzhou County in the North China Plain. The N-management techniques included optimal N rates, deep fertilizer placement and application of urease inhibitors, implemented through cooperation between government, researchers, businesses and smallholders. Compared with conventional local smallholder practice, our NH3 mitigation campaign reduced NH3 volatilization from wheat and maize by 49% and 39%, and increased N-use efficiency by 28% and 40% and farmers' profitability by 25% and 19%, respectively, with no detriment to crop yields. County-wide atmospheric NH3 and fine particulate matter (with aerodynamic diameter <2.5 μm) concentrations decreased by 40% and 8%, respectively. County-wide net benefits were estimated at US$7.0 million. Our demonstration-square approach shows that cropland NH3 mitigation and improved air quality and farm profitability can be achieved simultaneously by coordinated actions at the county level.

Association between particulate matter (PM)2·5 air pollution and clinical antibiotic resistance: a global analysis

BACKGROUND

Antibiotic resistance is an increasing global issue, causing millions of deaths worldwide every year. Particulate matter (PM)2·5 has diverse elements of antibiotic resistance that increase its spread after inhalation. However, understanding of the contribution of PM2·5 to global antibiotic resistance is poor. Through univariate and multivariable analysis, we aimed to present the first global estimates of antibiotic resistance and burden of premature deaths attributable to antibiotic resistance resulting from PM2·5 pollution.

METHODS

For this global analysis, data on multiple potential predictors (ie, air pollution, antibiotic use, sanitation services, economics, health expenditure, population, education, climate, year, and region) were collected in 116 countries from 2000 to 2018 to estimate the effect of PM2·5 on antibiotic resistance via univariate and multivariable analysis. Data were obtained from ResistanceMap, European Centre for Disease Prevention and Control Surveillance Atlas (antimicrobial-resistance sources), and PLISA Health Information Platform for the Americas. Future global aggregate antibiotic resistance and premature mortality trends derived from PM2·5 in different scenarios (eg, 50% reduced antibiotic use or PM2·5 controlled to 5 μg/m3) were projected until 2050.

FINDINGS

The final dataset included more than 11·5 million tested isolates. Raw antibiotic-resistance data included nine pathogens and 43 types of antibiotic agents. Significant correlations between PM2·5 and antibiotic resistance were consistent globally in most antibiotic-resistant bacteria (R2=0·42-0·76, p<0·0001), and correlations have strengthened over time. Antibiotic resistance derived from PM2·5 caused an estimated 0·48 (95% CI 0·34-0·60) million premature deaths and 18·2 (13·4-23·0) million years of life lost in 2018 worldwide, corresponding to an annual welfare loss of US$395 (290-500) billion due to premature deaths. The 5 μg/m3 target of concentration of PM2·5 in the air quality guidelines set by WHO, if reached in 2050, was estimated to reduce antibiotic resistance by 16·8% (95% CI 15·3-18·3) and avoid 23·4% (21·2-25·6) of premature deaths attributable to antibiotic resistance, equivalent to a saving of $640 (580-671) billion.

INTERPRETATION

This analysis is the first to describe the association between PM2·5 and clinical antibiotic resistance globally. Results provide new pathways for antibiotic-resistance control from an environmental perspective.

FUNDING

National Natural Science Foundation of China, Fundamental Research Funds for the Central Universities, Zhejiang University Global Partnership Fund, and China Postdoctoral Science Foundation.

Coupling of crop and livestock production can reduce the agricultural GHG emission from smallholder farms

Ensuring global food security and environmental sustainability is dependent upon the contribution of the world's hundred million smallholder farms, but the contributions of smallholder farms to global agricultural greenhouse gas (GHG) emissions have been understudied. We developed a localized agricultural life cycle assessment (LCA) database to calculate GHG emissions and made the first extensive assessment of the smallholder farms' GHG emission reduction potentials by coupling crop and livestock production (CCLP), a redesign of current practices toward sustainable agriculture in China. CCLP can reduce the GHG emission intensity by 17.67%, with its own feed and manure returning to the field as an essential path. Scenario analysis verified that greater GHG emission reduction (28.09%-41.32%) will be achieved by restructuring CCLP. Therefore, this mixed farming is a mode with broader benefits to provide sustainable agricultural practices for reducing GHG emissions fairly.

Temporal Trends of Legacy and Emerging PFASs from 2011 to 2021 in Agricultural Soils of Eastern China: Impacts of the Stockholm Convention

The spatial variation and temporal trends of legacy and emerging per- and polyfluoroalkyl substances (PFASs) from 2011 to 2021 in agricultural soils of Eastern China, which is one of the largest PFAS production and consumption regions in the world, were evaluated. We found that PFOS concentration decreased by 28.2% during this period. Given that agricultural soils are sinks for persistent organic pollutants (POPs), our results suggest that the implementation of the Stockholm Convention and its indirect effects, combined with a voluntary phaseout, are effective for controlling PFOS pollution in agricultural soils in China. In addition, our results show that 19 out of 28 PFASs were detected in >40% of the samples, with concentrations being 17.6-1950 pg/g with a median of 373 pg/g. Further, legacy PFASs were major components, accounting for 63.8% of total PFASs. Based on the source appointment of PFASs via the Positive Matrix Factorization (PMF) model, the contribution ratio of consumer product industries has steadily increased from 6.10 to 26.2%, while both legacy and novel fluoropolymer industries have declined from 24.2 to 1.50 and 19.1 to 5.40%, further confirming the effectiveness of the Convention.

Preoperative prediction of microvascular invasion and perineural invasion in pancreatic ductal adenocarcinoma with 18F-FDG PET/CT radiomics analysis

AIM

To develop and validate a predictive model based on 2-[¹⁸F]-fluoro-2-deoxy-d-glucose (¹⁸F-FDG) positron-emission tomography (PET)/computed tomography (CT) radiomics features and clinicopathological parameters to preoperatively identify microvascular invasion (MVI) and perineural invasion (PNI), which are important predictors of poor prognosis in patients with pancreatic ductal adenocarcinoma (PDAC).

MATERIALS AND METHODS

Preoperative ¹⁸F-FDG PET/CT images and clinicopathological parameters of 170 patients in PDAC were collected retrospectively. The whole tumour and its peritumoural variants (tumour dilated with 3, 5, and 10 mm pixels) were applied to add tumour periphery information. A feature-selection algorithm was employed to mine mono-modality and fused feature subsets, then conducted binary classification using gradient boosted decision trees.

RESULTS

For MVI prediction, the model performed best on a fused subset of ¹⁸F-FDG PET/CT radiomics features and two clinicopathological parameters, with an area under the receiver operating characteristic curve (AUC) of 83.08%, accuracy of 78.82%, recall of 75.08%, precision of 75.5%, and F1-score of 74.59%. For PNI prediction, the model achieved best prediction results only on the subset of PET/CT radiomics features, with AUC of 94%, accuracy of 89.33%, recall of 90%, precision of 87.81%, and F1 score of 88.35%. In both models, 3 mm dilation on the tumour volume produced the best results.

CONCLUSIONS

The radiomics predictors from preoperative ¹⁸F-FDG PET/CT imaging exhibited instructive predictive efficacy in the identification of MVI and PNI status preoperatively in PDAC. Peritumoural information was shown to assist in MVI and PNI predictions.

Climate change unequally affects nitrogen use and losses in global croplands

Maintaining food production while reducing agricultural nitrogen pollution is a grand challenge under global climate change. Yet, the response of global agricultural nitrogen uses and losses to climate change on the temporal and spatial scales has not been fully characterized. Here, using historical data for 1961-2018 from over 150 countries, we show that global warming leads to small temporal but substantial spatial impacts on cropland nitrogen use and losses. Yield and nitrogen use efficiency increase in 29% and 56% of countries, respectively, whereas they reduce in the remaining countries compared with the situation without global warming in 2018. Precipitation and farm size changes would further intensify the spatial variations of nitrogen use and losses globally, but managing farm size could increase the global cropland nitrogen use efficiency to over 70% by 2100. Our results reveal the importance of reducing global inequalities of agricultural nitrogen use and losses to sustain global agriculture production and reduce agricultural pollution.

Ageing threatens sustainability of smallholder farming in China

Rapid demographic ageing substantially affects socioeconomic development1-4 and presents considerable challenges for food security and agricultural sustainability5-8, which have so far not been well understood. Here, by using data from more than 15,000 rural households with crops but no livestock across China, we show that rural population ageing reduced farm size by 4% through transferring cropland ownership and land abandonment (approximately 4 million hectares) in 2019, taking the population age structure in 1990 as a benchmark. These changes led to a reduction of agricultural inputs, including chemical fertilizers, manure and machinery, which decreased agricultural output and labour productivity by 5% and 4%, respectively, further lowering farmers' income by 15%. Meanwhile, fertilizer loss increased by 3%, resulting in higher pollutant emissions to the environment. In new farming models, such as cooperative farming, farms tend to be larger and operated by younger farmers, who have a higher average education level, hence improving agricultural management. By encouraging the transition to new farming models, the negative consequences of ageing can be reversed. Agricultural input, farm size and farmer's income would grow by approximately 14%, 20% and 26%, respectively, and fertilizer loss would reduce by 4% in 2100 compared with that in 2020. This suggests that management of rural ageing will contribute to a comprehensive transformation of smallholder farming to sustainable agriculture in China.

[A retrospective analysis of clinical characteristics and prognostic factors for 152 cases of Staphylococcus aureus bloodstream infection]

To understand the clinical characteristics of Staphylococcus aureus bloodstream infection and the main risk factors affecting clinical prognosis, providing a reference for clinical prevention and control of Staphylococcus aureus bloodstream infection. In this study, the clinical data of 152 patients with Staphylococcus aureus bloodstream infection admitted to Guangdong Provincial People's Hospital from January 2019 to December 2021 were retrospectively analyzed by reviewing the electronic medical record system, including underlying diseases, clinical characteristics, risk factors, and bacterial resistance. Statistical methods such as Chi-Squared Test and t Test were used to analyze the related risk factors that may affect the clinical characteristics and prognosis of patients with Staphylococcus aureus and methicillin-resistant Staphylococcus aureus (MRSA) bloodstream infection, then the variables with P<0.05 in univariate analysis were included in the multivariate logistic regression model to analyze the independent risk factors of poor prognosis. The results showed among 152 patients with Staphylococcus aureus bloodstream infection, 50 patients (32.89%) were infected with MRSA. In comparison, 102 patients (67.11%) were infected with methicillin-sensitive Staphylococcus aureus (MSSA). Except for rifampicin, the resistance rate of MRSA to commonly used antibiotics was all higher than that of MSSA, and the difference was statistically significant (Chi-square values were 8.272, 11.972, 4.998, 4.776, respectively;all P-values are less than 0.05). Strains resistant to vancomycin, linezolid, and quinupristin/dalfopristin were not found. In the MRSA group, indwelling catheter and drainage tube, carbapenems, and β-lactamase inhibitor treatment were significantly higher than the MSSA group. The difference was statistically significant (P<0.05). The incidence of poor prognosis of bloodstream infection in the MRSA group was higher than that in the MSSA group (34.00% vs 13.73%), and the difference was statistically significant (χ²=8.495, P<0.05). No independent risk factors associated with poor prognosis were found in the included patients with MRSA bloodstream infection.Multivariate Logistic regression model analysis showed that solid malignant tumors (OR=13.576, 95%CI: 3.352-54.977, P<0.05), mechanical ventilation (OR=7.468, 95%CI: 1.398-39.884, P<0.05) were the most important independent risk factors for poor prognosis in patients with Staphylococcus aureus bloodstream infection. In summary, the poor prognosis rate of MRSA bloodstream infection is higher than that of MSSA. The clinical evaluation of related risk factors should be strengthened, targeted prevention and control interventions should be taken to improve the prognosis of patients with Staphylococcus aureus bloodstream infection, and the use of antibiotics should be rational and standardized, to control bacterial infection and drug resistance effectively.

[Research progress of CRISPR/Cas biosensors based on different signal amplification strategies]

CRISPR/Cas(the clustered regularly interspaced short palindromic repeats-CRISPR associated)system exists in most bacteria and all archaea. It is an important strategy for bacteria and archaea to resist foreign nucleic acid invasion and use for self-defense. The CRISPR/Cas system is a simple, fast, and specific diagnostic tool, which is widely used in agriculture, industry, animal husbandry, and medicine. This article mainly introduces and discusses recently advantages and limitations of biosensors combining CRISPR/Cas system with fluorescence, visualization and surface enhanced raman related technologies, as well as future research directions.

Driving forces of nitrogen use efficiency in Chinese croplands on county scale

Nitrogen use efficiency (NUE, defined as the fraction of N input harvested as product) is an important indicator to understand nitrogen use and losses in croplands as an element of determining sustainable food production. China, as the country with the largest amount of nitrogen fertilizer use globally, research into NUE consistently finds it to be much lower than that in developed countries. Understanding the driving forces of the underlying causes of this low NUE is thus crucial to improve nitrogen use and reduce losses in China. Here we applied the CHANS model to estimate cropland NUE for over 2800 counties in China for the year 2017. Results showed that in most counties NUE ranged between 20% and 40%, while an NUE >50% was mainly found in Northeastern China, likely as a result of large-scale, modern agriculture operations. The source of N input and crop types significantly affected NUE in our assessment. Nitrogen deposition, straw recycling, and biological nitrogen fixation (BNF) could improve NUE, while chemical nitrogen fertilizer and manure inputs reduce NUE. Grain crops have a much higher NUE compared to vegetables, which are often over-fertilized. Moreover, NUE in Southern China is strongly influenced by natural factors such as temperature and precipitation. Specifically, NUE in the Yangtze River Delta (eastern coastal region of China) is associated with socio-economic factors including GDP and the degree of urbanization, while in North-central China, NUE is mainly determined by nitrogen input sources. These examples illustrate that approaches aiming at improving NUE need to be location-specific with consideration of multiple natural and socioeconomic factors.

Cost-effective mitigation of nitrogen pollution from global croplands

Cropland is a main source of global nitrogen pollution1,2. Mitigating nitrogen pollution from global croplands is a grand challenge because of the nature of non-point-source pollution from millions of farms and the constraints to implementing pollution-reduction measures, such as lack of financial resources and limited nitrogen-management knowledge of farmers3. Here we synthesize 1,521 field observations worldwide and identify 11 key measures that can reduce nitrogen losses from croplands to air and water by 30-70%, while increasing crop yield and nitrogen use efficiency (NUE) by 10-30% and 10-80%, respectively. Overall, adoption of this package of measures on global croplands would allow the production of 17 ± 3 Tg (1012 g) more crop nitrogen (20% increase) with 22 ± 4 Tg less nitrogen fertilizer used (21% reduction) and 26 ± 5 Tg less nitrogen pollution (32% reduction) to the environment for the considered base year of 2015. These changes could gain a global societal benefit of 476 ± 123 billion US dollars (USD) for food supply, human health, ecosystems and climate, with net mitigation costs of only 19 ± 5 billion USD, of which 15 ± 4 billion USD fertilizer saving offsets 44% of the gross mitigation cost. To mitigate nitrogen pollution from croplands in the future, innovative policies such as a nitrogen credit system (NCS) could be implemented to select, incentivize and, where necessary, subsidize the adoption of these measures.

[Advances in the relationship between lung cancer and microbiota]

Interaction exists in lung cancer and microbiota. Lung microecological homeostasis can improve the immune tolerance, enhance immune suppression, and inhibit inflammatory responses, to reduce the lung cancer; while lung cancer can lead to pulmonary microecological imbalance, change the lung environment, and promote tumor cell proliferation. Therefore, modulating microbial flora and microecological immunotherapy may be a potential and preventive treatment for lung cancer, to restore tumor immunosuppression and improve patient survival. However, the individual differences in the lung microecology, because of different genetics, ethnic characteristics, and dietary habits, increasing the difficulty of precise diagnosis and treatment, which is also the current bottleneck in the application of microecological immunotherapy. Otherwise, the effectiveness of regulatory measures such as probiotics, prebiotics or antimicrobials is questionable. The research on microbial flora is still in its infancy, and further exploration is needed to form a standardized, effective, and precise treatment plan. So, standardized, effective, and precise microbial flora treatment strategies need to be further explored.

A 12% switch from monogastric to ruminant livestock production can reduce emissions and boost crop production for 525 million people

Ruminants have lower feed use efficiency than monogastric livestock, and produce higher reactive nitrogen and methane emissions, but can utilize human-inedible biomass through foraging and straw feedstock. Here we conduct a counterfactual analysis, replacing ruminants with monogastric livestock to quantify the changes in nitrogen loss and greenhouse gas emissions globally from a whole life cycle perspective. Switching 12% of global livestock production from monogastric to ruminant livestock could reduce nitrogen emissions by 2% and greenhouse gas emissions by 5% due to land use change and lower demand for cropland areas for ruminant feed. The output from released cropland could feed up to 525 million people worldwide. More ruminant products, in addition to optimized management, would generate overall benefits valued at US$468 billion through reducing adverse impacts on human and ecosystem health, and mitigating climate impacts.

Ammonia Emissions from Croplands Decrease with Farm Size in China

Farm size affects nitrogen fertilizer input and agricultural practices, which are key determinants of ammonia (NH₃) emissions from croplands. However, the degree to which NH₃ emissions are associated with changes in farm size is not well understood yet despite its crucial role in achieving agricultural sustainability in China, where agricultural production is still dominated by smallholder farms. Here we provide a first analysis of the relationship between farm size and NH₃ emissions based on 863 000 surveys conducted in 2017 across China. Results show that NH₃ emissions (kg ha^-1) on average decrease by 0.07% for each 1% increase in average farm size. This change occurs mainly due to a reduction in nitrogen fertilizer use and the introduction of more efficient fertilization practices. The largest reduction in NH₃ emissions is found in maize, with less pronounced changes in rice cultivation, and none for wheat production. Overall lower NH₃ emissions factors can be observed in the north of China with increasing farm size, especially in the northeast, the opposite pattern was found in the south. National total NH₃ emissions could be approximately halved (1.5 Tg) in a scenario favoring a conversion to large-scale farming systems. This substantial reduction potential highlights the potential of such a transition to reduce NH₃ emissions, including benefits from a socioeconomic point of view as well as for improving air quality.

[Clinical application of expanded internal mammary artery perforator flap combined with vascular supercharge in reconstruction of faciocervical scar]

Objective: To summarize the clinical experience of expanded internal mammary artery perforator (IMAP) flap combined with vascular supercharge in reconstruction of faciocervical scar. Methods: The retrospective observational study was conducted. From September 2012 to May 2021, 23 patients with postburn or posttraumatic faciocervical scars who met the inclusion criteria were admitted to Shanghai Ninth People's Hospital of Shanghai Jiao Tong University School of Medicine, including 18 males and 5 females, aged from 11 to 58 years, all of whom were reconstructed with expanded IMAP flaps. At the first stage, one or two skin and soft tissue expander (s) with appropriate rated capacity were implanted in the anterior chest area according to the location and size of the scars. The IMAP, thoracic branch of supraclavicular artery, and lateral thoracic artery were preserved during the operation. The skin and soft tissue expanders were inflated with normal saline after the operation. The flaps were transferred during the second stage. The dominant IMAP was determined preoperatively using color Doppler ultrasound (CDU) blood flow detector. The faciocervical scars were removed, forming wounds with areas of 9 cm×7 cm-28 cm×12 cm, and the perforators of superficial temporal artery and vein or facial artery and vein were preserved during the operation. The flaps were designed according to the area and size of the wounds after scar resection with the dominant IMAP as the pedicle. Single-pedicle IMAP flaps were used to repair small and medium-sized wounds. For larger defects, the blood perfusion areas of vessels in the anterior chest were evaluated by indocyanine green angiography (ICGA). In situations where the IMAP was insufficient to nourish the entire flap, double-pedicle flaps were designed by using the thoracic branch of supraclavicular artery or lateral thoracic artery for supercharging. Pedicled or free flap transfer was selected according to the distance between the donor areas and recipient areas. After transplantation of flaps, ICGA was conducted again to evaluate blood perfusion of the flaps. The donor sites of flaps were all closed by suturing directly. Statistics were recorded, including the number, rated capacity, normal saline injection volume, and expansion period of skin and soft tissue expanders, the location of the dominant IMAP, the total number of the flaps used, the number of flaps with different types of vascular pedicles, the flap area, the flap survival after the second stage surgery, the occurrence of common complications in the donor and recipient areas, and the condition of follow-up. Results: Totally 25 skin and soft tissue expanders were used in this group of patients, with rated capacity of 200-500 mL, normal saline injection volume of 855-2 055 mL, and expansion period of 4-16 months. The dominant IMAP was detected in the second intercostal space (20 sides) or the third intercostal space (5 sides) before surgery. A total of 25 expanded flaps were excised, including 2 pedicled IMAP flaps, 11 free IMAP flaps, 4 pedicled thoracic branch of supraclavicular artery+free IMAP flaps, and 8 free IMAP+lateral thoracic artery flaps, with flap areas of 10 cm×8 cm-30 cm×14 cm. After the second stage surgery, tip necrosis of flaps in three patients occurred, which healed after routine dressing changes; one patient developed arterial embolism and local torsion on the vascular pedicle at the anastomosis of IMAP and facial artery, and the blood supply recovered after thrombectomy and vascular re-anastomosis. Fourteen patients underwent flap thinning surgery in 1 month to 6 months after the second stage surgery. The follow-up for 4 months to 9 years showed that all patients had improved appearances of flaps and functions of face and neck and linear scar in the donor sites of flaps, and one female patient had obvious nipple displacement and bilateral breast asymmetry. Conclusions: The expanded IMAP flap is matched in color and texture with that of the face and neck, and its incision causes little damage to the chest donor sites. When combined with vascular supercharge, a double-pedicle flap can be designed flexibly to further enhance the blood supply and expand the flap incision area, which is a good choice for reconstruction of large faciocervical scar.

Integrated livestock sector nitrogen pollution abatement measures could generate net benefits for human and ecosystem health in China

Nearly one quarter of global meat production occurs in China, but a lack of detailed spatial livestock production data hinders ongoing pollution mitigation strategies. Here we generate high-resolution maps of livestock systems in China using over 480,000 farm surveys from 2007 to 2017, finding that China produced more livestock protein with fewer animals and less total pollution impact through better breeding, feeding and manure management in large-scale livestock farms. Hotspots of production can be observed across the North China Plain, Northeastern China and the Sichuan Basin. The Clean Water Act reduced manure nutrient losses to water by one third, but with limited changes to methane and ammonia emissions. Integrated production and consumption abatement measures costing approximately US$6 billion could further reduce livestock pollution by 2050, realizing benefits of up to US$30 billion due to avoided human health and ecosystem costs.

Reforming smallholder farms to mitigate agricultural pollution

China's agriculture is dominated by smallholder farms, which have become major sources of negative environmental impacts including eutrophication, formation of haze, soil acidification and greenhouse gas emissions. To mitigate these environmental impacts, new farming models including family farming, cooperation farming and industrial farming have emerged in recent years. However, whether these new farming practices would improve the economic and environmental performance as compared to the current smallholder farming has yet to be verified on ground level. In this paper, by using pilot farming cases within the watershed of Tai Lake, we found that alternative farming models produced 7% more crop yield, while using 8% less fertilizer, leading to a 28% decrease in pollutant emission per hectare. These alternative farming models have a 17% higher fertilizer use efficiency and 50% higher profit per hectare. Compared to smallholder farming, these alternative farming practices invest 27% more resources into agricultural facilities, including advanced machinery, and have a younger, better educated labor force as a consequence of a larger farm size and more specialization. These input changes substantially increase fertilizer use efficiency and reduce agricultural pollution. Policy arrangements to support and facilitate the uptake of these farming models will further promote the green development and sustainable intensification of agricultural production.

Establishing long-term nitrogen response of global cereals to assess sustainable fertilizer rates

Insight into the response of cereal yields to nitrogen fertilizer is fundamental to improving nutrient management and policies to sustain economic crop benefits and food sufficiency with minimum nitrogen pollution. Here we propose a new method to assess long-term (LT) regional sustainable nitrogen inputs. The core is a novel scaled response function between normalized yield and total net nitrogen input. The function was derived from 25 LT field trials for wheat, maize and barley in Europe, Asia and North America and is fitted by a second-order polynomial (R2 = 0.82). Using response functions derived from common short-term field trials, with soil nitrogen not in steady state, gives the risks of soil nitrogen depletion or nitrogen pollution. The scaled LT curve implies that the total nitrogen input required to attain the maximum yield is independent of this maximum yield as postulated by Mitscherlich in 1924. This unique curve was incorporated into a simple economic model with valuation of externalities of nitrogen surplus as a function of regional per-capita gross domestic product. The resulting LT sustainable nitrogen inputs range from 150 to 200 kgN ha-1 and this interval narrows with increasing yield potential and decreasing gross domestic product. The adoption of LT response curves and external costs in cereals may have important implications for policies and application ceilings for nitrogen use in regional and global agriculture and ultimately the global distribution of cereal production.

Dry Climate Aggravates Riverine Nitrogen Pollution in Australia by Water Volume Reduction

Freshwater is a scarce resource, and maintaining water quality is of great importance in dryland Australia. How water quality is affected by the dry climate and socio-economic influences in Australia remains widely unknown. Here, we find that agriculture activity dominates reactive nitrogen (N_r) emissions to water bodies. Such emissions not only contribute to deteriorating water quality in Southeastern Australia but also harm marine ecosystems, including the Great Barrier Reef, a World Natural Heritage site. A dry and warm climate reduces the share of N_r emitted directly to water bodies; however, it increases the N_r concentration in surface water due to reduced water volume, leading to a 3-fold higher water N_r concentration compared to major rivers globally, e.g., in the US or China. Business-as-usual socioeconomic development would increase the total N_r emitted to surface water by at least 43% by 2050, while effective mitigation measures could reduce N runoff by about 27%. Advanced agricultural management strategies should be considered to reduce future environmental pressures due to N runoff in Australia.

Consolidation of agricultural land can contribute to agricultural sustainability in China

China's agricultural sector is dominated by smallholder farms, which mostly exhibit relatively low nutrient use efficiency, low agricultural income and substantial non-point-source pollution. Here we assess the spatial feasibility and cost-effectiveness of agricultural land consolidation in China by integrating data from over 40,000 rural surveys, ecological modelling and geostatistical analysis. We found that 86% of Chinese croplands could be consolidated to establish a large-scale farming regime with an average field size greater than 16 ha. This would result in a 59% and 91% increase in knowledge exchange and machinery use, respectively, contributing to a 24% reduction in total nitrogen input, an 18% increase in nitrogen use efficiency and a 39% reduction in labour requirement, while doubling labour income. Despite requiring a one-time investment of approximate US$370 billion for land consolidation, total agricultural profits would double due to agricultural production costs being halved.

Human-caused increases in reactive nitrogen burial in sediment of global lakes

Human activities have increased reactive nitrogen (Nr) input to terrestrial ecosystems compared with the pre-industrial era. However, the fate of such Nr input remains uncertain, leading to missing sink of the global nitrogen budget. By synthesizing records of Nr burial in sediments from 303 lakes worldwide, here we show that 9.6 ± 1.1 Tg N year^-1 (Tg = 10¹² g) accumulated in inland water sediments from 2000 to 2010, accounting for 3%-5% of global Nr input to the land from combined natural and anthropogenic pathways. The recent Nr burial flux doubles pre-industrial estimates, and Nr burial rate significantly increases with global increases in human population and air temperature. Sediment ratios of C:N decrease after 1950 while N:P ratios increase over time due to increasingly elevated Nr burial and other related processes in lakes. These findings imply that Nr burial in lakes is overlooked as an important global sink of Nr input to terrestrial ecosystems.

Abating ammonia is more cost-effective than nitrogen oxides for mitigating PM2.5 air pollution

[Figure: see text].

An empirical model to estimate ammonia emission from cropland fertilization in China

Ammonia (NH₃) volatilization is one of the main pathways of nitrogen loss from cropland, resulting not only in economic losses, but also environmental and human health impacts. The magnitude and timing of NH₃ emissions from cropland fertilizer application highly depends on agricultural practices, climate and soil factors, which previous studies have typically only considered at coarse spatio-temporal resolution. In this paper, we describe a first highly detailed empirical regression model for ammonia (ERMA) emissions based on 1443 field observations across China. This model is applied at county level by integrating data with unprecedented high spatio-temporal resolution of agricultural practices and climate and soil factors. Results showed that total NH₃ emissions from cropland fertilizer application amount to 4.3 Tg NH₃ yr^-1 in 2017 with an overall NH₃ emission factor of 12%. Agricultural production for vegetables, maize and rice are the three largest emitters. Compared to previous studies, more emission hotspots were found in South China and temporally, emission peaks are estimated to occur three months earlier in the year, while the total amount of emissions is estimated to be close to that calculated by previous studies. A second emission peak is identified in October, most likely related to the fertilization of the second crop in autumn. Incorporating these new findings on NH₃ emission patterns will enable a better parametrization of models and hence improve the modelling of air quality and subsequent impacts on ecosystems through reactive N deposition.

Uncertainty of nitrogen budget in China

The accuracy of the nitrogen (N) budget is of great importance for evidence-based decision-making to address both food security and environmental protection challenges. This study attempts to advance understanding of uncertainties in China's N budget using the Coupled Human And Natural Systems (CHANS) model and Monte Carlo simulation from 1980 to 2018. Results show that the spatial and temporal variations in agricultural and industrial activities and insufficient knowledge on N cycling parameterization are the two dominant causes of uncertainties in the N budget in China. Uncertainties of N inputs generally are <10%, while they are <30% for N outputs and >30% for N accumulations. Uncertainty of nitrogen oxides emission is more sensitive to energy consumption due to the large contributions from industry and transportation. While the uncertainty of ammonia emission is predominantly affected by agricultural activity. Combining surface measurements, satellite observations, and atmospheric simulation models enables cross-check of N fluxes in multiple systems and reduces uncertainties of N budget.

Fertilizer overuse in Chinese smallholders due to lack of fixed inputs

Fertilizer overuse by smallholder farmers is widespread in China, leading to significant financial losses and threatening the environment. Understanding what mechanism behind this is critical for agricultural and environmental sustainability. By using a fixed effect panel model of over 20,000 rural households in China from 1995 to 2016, we found that the low ratio of fixed inputs such as machinery and knowledge to total inputs is the key factor leading to over-fertilization in smallholder farms. Low fixed input can result in or interact with nutrient-unbalanced fertilization, low agricultural income ratio and more cash crops that further aggravate fertilizer overuse. Smallholders lack fixed inputs, then compensate by over-applying fertilizer to attempt to achieve their yield goals. Thus, improving fixed input via increasing the average farm size to 3.8 ha or advanced service rental could save not only 45% fertilizers but also increase 16% agricultural net profit, benefiting agricultural and environmental sustainability.

The Warming Climate Aggravates Atmospheric Nitrogen Pollution in Australia

Australia is a warm country with well-developed agriculture and a highly urbanized population. How these specific features impact the nitrogen cycle, emissions, and consequently affect environmental and human health is not well understood. Here, we find that the ratio of reactive nitrogen (N r ) losses to air over losses to water in Australia is 1.6 as compared to values less than 1.1 in the USA, the European Union, and China. Australian N r emissions to air increased by more than 70% between 1961 and 2013, from 1.2 Tg N yr-1 to 2.1 Tg N yr-1. Previous emissions were substantially underestimated mainly due to neglecting the warming climate. The estimated health cost from atmospheric N r emissions in Australia is 4.6 billion US dollars per year. Emissions of N r to the environment are closely correlated with economic growth, and reduction of N r losses to air is a priority for sustainable development in Australia.

Soil-Food-Environment-Health Nexus for Sustainable Development

Changes in soil properties and processes can influence food and environmental quality, thus, affecting human health and welfare through biogeochemical cascades among soil, food, environment, and human health. However, because many soil properties change much more slowly than do management practices and pollution to soil, the legacy of past influences on soil can have long-term effects on both human health and sustainability. It is essential and urgent to manage soils for health and sustainability through building the soil-food-environment-health nexus.

Evaluation of the probiotic and functional potential of Lactobacillus agilis 32 isolated from pig manure

Escherichia coli is a symbiotic bacterium in humans and animals and an important pathogen of humans and animals. Prevention and suppression of E. coli infection is of great concern. In this study, we isolated a strain of Lactobacillus agilis 32 from pig manure and evaluated its biological characteristics, and found that its bacterial survival rate was 25% after 4 h of treatment at pH 2, and under the condition of 0·5% bile concentration, its survival rate exceeds 30%. In addition, L. agilis 32 has a cell surface hydrophobicity of 77·8%, and exhibits 67·1% auto-aggregation and 63·2% aggregation with Enterotoxigenic E. coli 10 (ETEC 10). FITC fluorescence labelling showed that the fluorescence intensity of cecum was significantly higher than that of duodenum, jejunum or colon (P < 0·05), but no significant difference from ileum. Lactobacillus agilis 32 bacterial culture and CFS showed average inhibition zone diameters of 14·2 and 15·4 mm respectively. Lactobacillus agilis 32 CFS treatment can significantly reduce the pathogenicity of ETEC 10. These results show that L. agilis 32 is an active and potential probiotic, and it has a good antibacterial effect on ETEC10, which provides basic research for probiotics to prevent and treat intestinal diarrhoea pathogen infection.

[The prognostic value of myoglobin difference in sepsis related chronic critical illness]

Objective: To investigate the predictive value of myoglobin (Mb) for the prognosis of sepsis related chronic critical illness (CCI). Methods: Retrospective study was conducted on septic patients with the length of ICU stay equal or greater than 14 days, and sepsis-related organ failure assessment (SOFA) score equal or greater than 2 on the 14th day in ICU in the First Department of Critical Care Medicine at the First Affiliated Hospital of Sun Yat-sen University from January 2017 to March 2020. Patients' clinical and laboratory data were collected on the 1st and 14th day in ICU. The survival on day 28 in ICU was recorded. According to the myoglobin levels on day 1 and day 14, all subjects were divided into myoglobin elevation group and decline group. Kaplan-Meier survival curve was used to compare the cumulative survival rate at day 28. Cox regression analysis was used to analyze the independent risk factors of mortality. Receiver operating characteristic (ROC) curve was used to analyze the prognostic value of myoglobin. Results: A total of 131 patients with sepsis related CCI were recruited, including 58 patients in the elevation group and 73 in the decline group. The Mb level in elevation group on day 1 was significantly lower than that in decline group [172.40(59.99, 430.53) μg/L vs. 413.60(184.40, 1 328.50) μg/L, Z=3.749, P=0.000], and the Mb level on day 14 was the opposite change in two groups [483.65(230.38, 1 471.75)μg/L in elevation group vs. 132.20(76.86, 274.35)μg/L in decline group, Z=5.595, P=0.000]. Kaplan-Meier survival curve analysis showed that the 28-day cumulative survival rate of the elevation group was significantly lower than that of decline group (χ²=7.051, P=0.008). Cox ratio regression analysis suggested that elevated myoglobin was an independent risk factor for 28-day mortality in septic patients with CCI (OR=2.534, 95%CI 1.212-5.295, P=0.013). ROC curve analysis suggested that the sensitivity of myoglobin elevation in predicting mortality related to CCI within 28 days was 64.5%, and the specificity was 32.0% with area under the curve(AUC) 0.661(95%CI 0.550-0.773,P=0.007) and Jorden Index was 0.325. Conclusion: Elevated myoglobin, an independent risk factor for mortality within 28 days in ICU, can predict the prognosis of sepsis related chronic critical illness.

Urbanization can benefit agricultural production with large-scale farming in China

Urbanization has often been considered a threat to food security since it is likely to reduce the availability of croplands. Using spatial statistics and scenario analysis, we show that an increase in China's urbanization level from 56% in 2015 to 80% in 2050 would actually release 5.8 million hectares of rural land for agricultural production-equivalent to 4.1% of China's total cropland area in 2015. Even considering the relatively lower land fertility of these new croplands, crop production in 2050 would still be 3.1-4.2% higher than in 2015. In addition, cropland fragmentation could be reduced with rural land release and a decrease in rural population, benefiting large-scale farming and environmental protection. To ensure this, it is necessary to adopt an integrated urban-rural development model, with reclamation of lands previously used as residential lots. These insights into the urbanization and food security debate have important policy implications for global regions undergoing rapid urbanization.

The clinical value of the combined detection of sEGFR, CA125 and HE4 for epithelial ovarian cancer diagnosis

OBJECTIVE

This study aims to investigate the clinical value of combined detection of serum soluble epidermal growth factor receptor (sEGFR), cancer antigen 125 (CA125), and human epididymis protein 4 (HE4) in the diagnosis of epithelial ovarian cancer (EOC).

PATIENTS AND METHODS

From December 2017 to October 2018, the serum samples were obtained from the Affiliated Hospital of Xuzhou Medical University, with 30 patients as EOC group, 30 patients with benign ovarian neoplasms as benign group, and 17 healthy subjects as healthy group. Besides, among 30 EOC patients, 9 serum samples were obtained from pre-operative and post-operative EOC patients. The levels of serum sEGFR were detected by enzyme-linked immunosorbent assay (ELISA), while CA125 and HE4 were detected by enhanced chemiluminescence immunoassay (ECLIA). The diagnostic value was evaluated by receiver operating characteristic (ROC) curve analysis.

RESULTS

The levels of serum sEGFR, CA125, and HE4 in EOC group were significantly higher than those in benign group (p<0.05) and healthy group (p<0.05). When using a single tumor marker, the CA125 shows the highest sensitivity (93.30%) and HE4 shows the highest specificity (97.87%). The specificity of combined detection of serum sEGFR, CA125, and HE4 was 100%, which was significantly higher than that using a single tumor marker. The area under the ROC curve (AUC) of combined detection of serum sEGFR, CA125, and HE4 (0.965) was much higher than that of the single detection and higher than that of combined detection of CA125 and HE4 (0.940). Moreover, the level of serum sEGFR in post-operative EOC group was significantly lower than that in the corresponding pre-operative EOC group (p<0.05).

CONCLUSIONS

Our study shows that combined detection of serum sEGFR, CA125, and HE4 increases the specificity and efficiency in EOC diagnosis, indicating that sEGFR could be a potential biomarker for the diagnosis and prognosis of EOC.

A ligand-independent fast function of RARα promotes exit from metabolic quiescence upon T cell activation and controls T cell differentiation

Vitamin A metabolites play important roles in T cell activation and differentiation. A conventional model of RARα function relies upon retinoic acid (RA)-liganded RARα binding to specific DNA motifs to regulate gene expression in the nucleus. However, this genomic function fails to explain many of the biological responses of the RA-RARα axis on T cells. We generated a mouse line where RARα is over-expressed in T cells to probe RARα function with unprecedented sensitivity. Using this model together with mice specifically lacking RARα in T cells, we found that RARα is required for prompt exit from metabolic quiescence in resting T cells upon T cell activation. The positive effect of RARα on metabolism is mediated through PI3K and subsequent activation of the Akt and mTOR signaling pathway. This largely non-genomic function of RARα is surprisingly ligand-independent and controls the differentiation of effector and regulatory T cell subsets.