•Actual wastewater is of great significance for reclaimed-water recycling.•Dispersion and reactivity of NZVI-supported were enhanced compared to NZVI alone.•Removal processes of THMs presented ...different tendencies by AC, NZVI and NZVI/AC.•NZVI/AC showed increased performance on THMs removal due to synergetic effect.
Zero valent iron/activated carbon nanocomposite (NZVI/AC) was synthesized and applied for trihalomethane (THM) removal in this study. The performance of NZVI/AC, with respect to characterization, removal kinetics and isotherms, was compared with that of activated carbon and nanoscale zero-valent iron. The results showed that the size of NZVI became smaller when immobilized on AC, which was in the range of 30–70nm, and meanwhile with activated carbon as a support, NZVI/AC possesses higher dispersion, better stability and reactivity. Results of kinetic experiments indicated that NZVI/AC showed the best trihalomethane removal capacity, followed by NZVI and AC. The synergetic effect of prompt adsorption of trihalomethanes to NZVI/AC phase and the reduction of THMs by Fe0 on NZVI/AC was recognized as removal mechanism of the THMs. Therefore, NZVI/AC could be used as a potential material to remove trihalomethane in wastewater treatment process, which of great significance for reclaimed-water recycling.
•The PTC achieved efficient removal of COD (79.2%) and PO43− (99%) from sewage.•A high VFAs yield was achieved by co-fermenting with Ti-loaded sludge food waste.•The bacteria essential for VFAs ...generation experience substantial enrichment.•Metabolic characteristics of microbes related to VFA production are revealed.•P and Ti are respectively recovered as struvite and TiO2 from fermented residue.
Recovery of resources from domestic sewage and food waste has always been an international-thorny problem. Titanium-based flocculation can achieve high-efficient destabilization, quick concentration and separation of organic matter from sewage to sludge. This study proposed co-fermentation of the titanium-flocculated sludge (Ti-loaded sludge) and food waste towards resource recovery by converting organic matter to value-added volatile fatty acids (VFAs) and inorganic matter to struvite and TiO2 nanoparticles. When Ti-loaded sludge and food waste were co-fermented at a mass ratio of 3:1, the VFAs yield reached 3725.2 mg-COD/L (VFAs/SCOD 91.0%), which was more than 4 times higher than the case of the sludge alone. The 48-day semicontinuous co-fermentation demonstrated stable long-term operation, yielding VFAs at 2529.0 mg-COD/L (VFAs/SCOD 89.8%) and achieving a high CODVFAs/NNH4 of 58.9. Food waste provided sufficient organic substrate, enriching plenty of acid-producing fermentation bacteria (such as Prevotella 7 about 21.0% and Bacteroides about 9.4%). Moreover, metagenomic sequencing analysis evidenced the significant increase of the relative gene abundance corresponding to enzymes in pathways, such as extracellular hydrolysis, substrates metabolism, and VFAs biosynthesis. After fermentation, the precious element P (≥ 99.0%) and extra-added element Ti (≥99.0%) retained in fermented residues, without releasing to VFAs supernatant, which facilitated the direct re-use of VFAs as resource. Through simple and commonly used calcination and acid leaching methodologies, 80.9% of element P and 82.1% of element Ti could be successfully recovered as struvite and TiO2 nanoparticles, respectively. This research provides a strategy for the co-utilization of domestic sludge and food waste, which can realize both reduction of sludge and recovery of resources.
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Abstract
Traditional total mesorectal excision (TME) for rectal cancer requires partial resection of Denonvilliers’ fascia (DVF), which leads to injury of pelvic autonomic nerve and postoperative ...urogenital dysfunction. It is still unclear whether entire preservation of DVF has better urogenital function and comparable oncological outcomes. We conducted a randomized clinical trial to investigate the superiority of DVF preservation over resection (NCT02435758). A total of 262 eligible male patients were randomized to Laparoscopic TME with DVF preservation (L-DVF-P group) or resection procedures (L-DVF-R group), 242 of which completed the study, including 122 cases of L-DVF-P and 120 cases of L-DVF-R. The initial analysis of the primary outcomes of urogenital function has previously been reported. Here, the updated analysis and secondary outcomes including 3-year survival (OS), 3-year disease-free survival (DFS), and recurrence rate between the two groups are reported for the modified intention-to-treat analysis, revealing no significant difference. In conclusion, L-DVF-P reveals better postoperative urogenital function and comparable oncological outcomes for male rectal cancer patients.
OBJECTIVE:To compare the outcomes of laparoscopic total mesorectal excision (L-TME) with Denonvilliers’ fascia (DVF) preservation versus resection on urogenital function of male patients with rectal ...cancer.
BACKGROUND:The protective effect of DVF during L-TME on pelvic autonomic nerves and postoperative urogenital function remains controversial.
METHODS:Between August 26, 2015 and July 18, 2019, 253 male patients with cT1–4 (T1–2 for anterior wall) N0–2M0 rectal cancer from 11 institutions were enrolled, and randomly assigned to L-TME with DVF preservation (Exp-group, n = 123) or resection procedures (Con-group, n = 130). Urinary function was assessed by residual urine volume, maximal flow rate (MFR), and International Prostate Symptom Score (IPSS); sexual function was assessed by 5-item version of the International Index of Erectile Function (IIEF-5) and ejaculation grading.
RESULTS:The Exp-group patients showed a lower urinary dysfunction rate (6.8% vs 25.4%, P = 0.003), higher MFR (16.25 ± 8.02 vs 12.40 ± 7.05 mL/sec, P = 0.007), and lower IPSS (6.55 ± 5.86 vs 8.57 ± 5.85, P = 0.026) than the Con-group patients at 2 weeks after surgery. The incidence of erectile dysfunction (IIEF-5 ≤ 11) at 12 months after surgery was lower in the Exp-group than in the Con-group (12.5% vs 34.2%, P = 0.023); Exp-group manifested superior IIEF-5 (16.63 ± 6.28 vs 12.26 ± 6.83, P = 0.018). The incidence of ejaculation dysfunction was lower in the Exp-group than in the Con-group at 12 months after surgery (10.0% vs 29.4%, P = 0.034).
CONCLUSIONS:DVF preservation during L-TME revealed protective effects on postoperative urogenital function, and could be a better choice for male rectal cancer patients with specific staging and location
TRIAL REGISTRATION NUMBER:NCT02435758.
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•The chlorination disinfection by-products water is from a local municipal water supply plant.•The dispersion of modified nanoscale zero-valent iron (NZVI) was enhanced.•The removal ...rate increased with the increase of bromine atoms in trihalomethanes (THMs).•Change of pH during the process of removal of THMs was measured.•The composites (NZVI/AC) were highly effective for low concentration THMs.
Trihalomethanes (THMs) in drinking water are difficult to remove with conventional methods. In this study, activated carbon supported nanoscale zero-valent iron (NZVI/AC) was synthesized by liquid-phase reduction and used to treat THMs in actual drinking water, including chloroform (CHCl3), bromodichloromethane (CHBrCl2), dibromochloromethane (CHBr2Cl) and bromoform (CHBr3). The as-prepared NZVI/AC composites were characterized in terms of specific surface area, pore size distribution, morphological properties and structural features. The effects of NZVI dosage, initial pH and contact time on removal efficiency were also studied. Scanning electron microscopy showed uniformly dispersed NZVI particles with diameters of 30–100nm on average on the surface or inside the pores of AC. The removal efficiency was enhanced with the increasing amount of NZVI/AC, and the optimum dosage was 1.8g/L and the optimal was 7. The kinetics of the removal of THMs was in agreement with a pseudo-first-order model. NZVI/AC accelerated removal rate of THMs over NZVI alone by both its higher reactivity and greater adsorption. The degradation products were analyzed using gas chromatography–mass spectrometry which showed that dehalogenation of THMs by NZVI/AC followed the order of CHBr3>CHBr2Cl>CHBrCl2>CHCl3. AC-supported nanoscale zero-valent iron particles is a promising sustainable material for potential application in elimination of THMs from actual drinking water.
Abstract Background A cytologic diagnosis of atypical squamous cells, cannot exclude high‐grade squamous lesion (ASC‐H) poses a disproportionately high risk of cervical cancer development. The ...objective of this study was to analyze type‐specific risks by mapping human papillomavirus (HPV) genotypes in ASC‐H cytology. Methods In total, 1,048,581 Papanicolaou tests that had ASC‐H cytology were retrieved. Concurrent HPV genotyping using proprietary multiplex real‐time (MRT) and polymerase chain reaction (PCR) HPV tests and histologic follow‐up findings were analyzed. Results Among 1678 patients who had ASC‐H findings (0.16%), 1414 (84.3%) underwent concurrent HPV genotyping (MRT, 857; HPV PCR test, 557). The overall high‐risk HPV (hrHPV)‐positive rate was 84.4%. Of the 857 MRT cases, 63.9% were infected with a single hrHPV, and 24.4% had multiple genotypes. The most prevalent HPV types were HPV16/52/58/33/31. Lesions that were identified as cervical intraepithelial neoplasia 2 or worse (CIN2+) were detected in 498 of 906 cases (55.0%), including 81 cervical carcinomas (8.9%). The risk of CIN2+ for the composite group of HPV16/52/58/33/31‐positive cases was 62.7%, representing 90.7% (264 of 291) of total CIN2+ lesions in ASC‐H/hrHPV–positive cases by MRT. CIN2+ lesions were detected in 108 of 142 (76.1%) HPV16‐positive and/or HPV18‐positive women by the PCR the HPV test. Among 128 hrHPV‐negative ASC‐H cases by both methods, CIN2+ lesions were identified in 21 of 128 (16.4%), including five cervical carcinomas (3.9%). The sensitivity, specificity, positive predictive value, and negative predictive value for patients in the composite group with HPV16/52/58/33/31 were 88.0%, 40.8%, 62.7%, and 75.0%, respectively. Conclusions Papanicolaou tests classified as ASC‐H are associated with a high CIN2+ rate and warrant colposcopy, regardless of HPV status. The extent to which the risk‐stratification provided by comprehensive HPV genotyping can inform the management of ASC‐H cytology remains to be explored.
The authors mapped human papillomavirus genotypes to investigate the disproportionately high type‐specific risk of cervical cancer development in patients who have a diagnosis of atypical squamous cells, cannot exclude high‐grade squamous lesion. The extent to which the risk stratification provided by comprehensive human papillomavirus genotyping can inform the management of these patients remains to be explored.
Sodium hypochlorite (NaClO) is widely used to remove organic and biological fouling from the membranes in membrane bioreactors (MBR). But using large amounts of NaClO at high concentrations during ...in-situ membrane cleaning adversely affect the activity of activated sludge in the reactor and produce toxic disinfection by-products (DBPs). In this study, ultrasound (US) was used in combination with NaClO to restore the permeability of microfiltration (MF) and ultrafiltration (UF) membranes fouled by activated sludge. We investigated the cleaning efficiency and mechanism of action of US-assisted NaClO, and the influence of US on the activated sludge properties. Low power US (25 kHz, 0.22 W/cm2) destroyed the structure of polyvinylidene fluoride UF membranes, but did not damage mixed cellulose ester MF membranes. When higher power US (25 kHz, 0.44 W/cm2) was used in combination with NaClO (100 mg/L), the MF membrane flux recovery was improved by 37.7% compared to NaClO alone. Confocal laser scanning microscopy images indicated that US generated holes in the compact protein areas of biofilm, which would promote the diffusion of NaClO, and enhance the removal of the fouling layer. Moreover, US increased the degradation of membrane foulants (L-tryptophan was chosen as the model substrate) indicated by the reduction in the consumption of NaClO, which might be due to the generation of free radicals. Although US deteriorated the settling performance and increased the extracellular polymeric substances secretion of activated sludge, MBR effluent water quality was not influenced, which makes in-situ US-assisted NaClO cleaning application possible.
•Interaction between nitrogen deposition and climate warming was insignificant.•Nitrogen deposition enhanced leaf visible absorption and near-infrared reflection.•Climate warming weakened leaf ...visible and near-infrared light reflection.
Temperature and nitrogen (N) are limited factors on the Qinghai-Tibetan Plateau (QTP). Climate change and increasing N deposition on the QTP have posed threats to the sustainability of alpine ecosystems. To examine plant spectral responses to N deposition and climate change, we measured leaf spectral reflectance of Poa crymophila, a common forage species grown in alpine meadow (AM) and alpine steppe (AS) on the eastern QTP under four N addition treatments (CK, 8, 40, 72 kg N ha −1 yr −1). We used natural climate gradients from colder and drier AS to warmer and wetter AM to simulate the climate change on the QTP. Results showed that both N deposition and climate change had significant effects on entire visible and near-infrared regions (p < 0.05), but the interactive effects were insignificant (p> 0.05). Enhanced visible absorption, increased near-infrared reflection, a red shift for red edge and a blue shift for green peak were observed with increasing N addition levels. The modified red edge simple ratio index and photochemical reflective index increased gradually in response to N addition (p < 0.05). These responses indicated that N deposition may make leaf wider and thicker, increase leaf chlorophyll content and photochemical efficiency, and enhance photosynthetic capacity. Climate warming and wetting had opposite effects from N deposition on leaf reflectance of Poa crymophila. These observations showed the potential to monitor the status of Poa crymophila under future climate change and N deposition with leaf spectral measurements.
Colorectal cancer (CRC) represents a major health concern that can be screened for by the fecal immunochemical test (FIT), which detects blood in the stool. CRC detection sensitivity for hemoglobin ...(Hb) combined with transferrin (Tf) is higher than for hemoglobin alone.
We developed a europium fluorescent microsphere-based quantitative lateral flow immunochromatography strip to detect fecal Hb and Tf. Performance was tested using fecal samples from 51 patients with CRC and 122 normal subjects. Test strips were generated using paired mouse anti-human Hb and mouse anti-human Tf monoclonal antibodies and tested using standard Hb and Tf samples. Fluorescence was observed at 365 nm and quantitatively measured using a portable fluorescent strip reader.
At cutoff values of 100 ng/mL (10 µg/g feces) and 25 ng/mL (2.5 µg/g feces) for Hb and Tf, respectively, the positive rates for Hb, Tf, and Hb+Tf in normal subjects were 6.56%, 5.74%, and 10.66%, respectively, compared to 88.24%, 64.71%, and 94.12% in patients with CRC. The sensitivity and specificity of the FIT combined detection technique were 87.5% and 89.2%, respectively, and the area under the curve (AUC) was 0.92. The sensitivity, specificity, and AUC for the Tf assay were 63.8%, 68.4%, and 0.759, respectively, and those for Hb testing were 69.7%, 70.2%, and 0.774, respectively. The AUC for Hb+Tf was significantly higher than those for Tf or Hb alone (P < 0.001).
Fluorescent microsphere-based immunochromatographic strips sensitively detect fecal Hb and Tf, and sensitivity and specificity are improved for Hb+Tf. This system represents a rapid and portable alternative for on-site early CRC screening.
Background
The objective of this study was to examine the prevalence of human papillomavirus 16/18 (HPV‐16/18) genotypes and immediate histopathologic correlations in a Chinese population with ...negative cytology and positive high‐risk human papillomavirus (hrHPV) testing.
Methods
Patients who had documented negative cytology with immediate follow‐up (within the 6 months after negative for intraepithelial lesion or malignancy Papanicolaou Pap testing), including a histopathologic examination and/or hrHPV testing, between 2011 and 2018 were included, and the data were analyzed.
Results
Among 1,424,182 Pap tests, 1,333,453 (93.6%) were interpreted as negative cytology. Although conventional Pap smears had the highest reporting rate, cervical intraepithelial neoplasia 2 and higher (CIN‐2+) lesions were detected significantly more with liquid‐based cytology preparations (2.1%) than the conventional method (1.4%; P < .01). The overall hrHPV‐positive rate was 14.9% (25,507 of 171,273) in the women with negative cytology. Among the 18,423 cytology‐negative, HPV‐positive cases tested with the Cobas assay, the overall HPV‐16/18 prevalence was 24.7%, with 17.9% being HPV‐16–positive, 6.2% being HPV‐18–positive, and 0.6% being positive for both HPV‐16 and HPV‐18. The immediate histopathologic examination was documented for 21,796 women with cotesting results, including 8915 HPV‐positive cases and 12,881 HPV‐negative cases. CIN‐2+ lesions were diagnosed in 15.2% of the HPV‐16–positive cases; this rate was significantly higher than the rates seen in the HPV‐18–positive cases (4.8%) and the cases positive for 1 of the other 12 types of HPV (3.0%).
Conclusions
This is by far the largest routine clinical practice report of HPV‐16/18 genotyping and histopathologic examination in negative‐cytology women and the first report of such an investigation in the Chinese population. This study indicates enhanced risk stratification with HPV‐16/18 genotype testing in HPV‐positive, cytology‐negative women in the Chinese population.
HPV 16/18 positivity accounts for 24.7% of cases positive for HPV with negative cytology. CIN‐2+ lesions are detected significantly more in HPV 16–positive cases.
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