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China's sustained air quality improvement is hindered by unregulated ammonia (NH 3 ) emissions from inefficient nitrogen management in smallholder farming. Although the Chinese government is promoting a policy shift to large-scale farming, the benefits of this, when integrated with nitrogen management, remain unclear. Here we fill this gap using an integrated assessment, by combining geostatistical analysis, high-resolution emission inventories, farm surveys and air quality modeling. Smallholder-dominated farming allows only 13%-31% NH 3 reduction, leading to limited PM 2.5 decreases nationally due to non-linear PM 2.5 chemistry. Conversely, large-scale farming would double nitrogen management adoption rates, increasing NH 3 reduction potential to 48%-58% and decreasing PM 2.5 by 9.4-14.0 μg·m -3 in polluted regions. The estimated PM 2.5 reduction is conservative due to localized NH 3 -rich conditions under large-scale livestock farming. This strategy could prevent over 300 000 premature deaths and achieve a net benefit of US $68.4-86.8 billion annually, unlocking immense benefits for air quality and agricultural sustainability., (© The Author(s) 2024. Published by Oxford University Press on behalf of China Science Publishing & Media Ltd.)

The dynamics of soil water dissolved CO 2 and N 2 O are important in determining the fates of soil CO 2 and N 2 O. However, related mechanisms and processes have been rarely revealed. In this study, storages and leaching losses of soil water dissolved CO 2 and N 2 O were investigated on the tea garden (TG) and bamboo forest (BF) hillslopes. Soil water storage and leaching flux were simulated by the HYDRUS-3D model and the soil water dissolved CO 2 and N 2 O concentrations were acquired by field monitoring. Results showed that the storages of soil water dissolved CO 2 and N 2 O ranged from 1.30 to 14.86 kg C ha -1 and 0.24 to 388.99 g N ha -1 on the TG hillslope, respectively, while they ranged from 0.49 to 52.29 kg C ha -1 and 0.50 to 14.22 g N ha -1 on the BF hillslope, respectively. The annual leaching loss of soil water dissolved CO 2 and N 2 O were 26.17 kg C ha -1 and 29.46 g N ha -1 , respectively, on the TG hillslope, while they were 49.51 kg C ha -1 and 4.35 g N ha -1 on the BF hillslope, respectively. The dissolved CO 2 leaching loss mainly occurred in summer, especially in July on both hillslopes. Peaks of dissolved N 2 O leaching loss on the TG hillslope were observed after the application of basal fertilizer, accompanying with precipitation events. Instead, peaks of dissolved N 2 O leaching loss on the BF hillslope were observed in summer. The main influencing factors of dissolved CO 2 and N 2 O storages were temperature, precipitation, and fertilization, with total effects generally >0.30. However, that of the dissolved CO 2 and N 2 O leaching losses was the precipitation, with total effects >0.57. Dissolved CO 2 /N 2 O concentration was more important than soil water storage in determining the dissolved CO 2 /N 2 O storage, while the leaching flow rate was more crucial than dissolved CO 2 /N 2 O concentration in determining the dissolved CO 2 /N 2 O leaching loss. These findings expanded our knowledge of sources and sinks of greenhouse gases on the terrestrial ecosystem., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Background: Delirium is a common complication in intensive care unit (ICU) patients, and it can significantly increase the length of hospital stay and cost. Dexamethasone is widely used in various inflammatory diseases and must be used with caution in critically ill patients. Previous studies have shown that the effect of corticosteroid use on the development of delirium in critically ill patients is still controversial, and there is inconclusive conclusion about the effect of dexamethasone on delirium in such patients. Therefore, this study aimed to confirm the effect of dexamethasone use and the dose on the incidence of delirium and patient prognosis in critically ill patients through a large cohort study., Methods: A retrospective cohort study was conducted using data extracted from the Medical Information Mart for Intensive Care III database, which is a large and freely available database of all 46,476 patients who visited Beth Israel Deaconess Medical Center in Boston, Massachusetts, USA and were admitted to the ICU between 2001 and 2012. The primary outcome was the development of delirium, using multivariate logistic regression analysis to reveal the relationship between dexamethasone and delirium. Secondary endpoints were in-hospital mortality, ICU mortality, total length of stay, and length of ICU stay, and the relationship between dexamethasone and prognosis was assessed with Cox proportional hazards models. Propensity score matching with 1:1 grouping was used to eliminate the effect of confounders on both cohorts. The locally weighted scatter plot smoothing technique was used to investigate the dose correlation between dexamethasone and outcomes, subgroup analysis was used to account for heterogeneity, and different correction models and propensity matching analysis were used to eliminate potential confounders., Results: Finally, 38,509 patients were included, and 2204 (5.7%) used dexamethasone. No significant statistical difference was observed in basic demographic information after propensity score matching between the two study groups. A significantly higher incidence of delirium (5.0% versus 3.4%, P < 0.001), increased in-hospital mortality (14.9% versus 10.3%, P < 0.001), ICU mortality (9.0% versus 7.5%, P = 0.008), and longer length of stay and ICU stay were observed in patients taking dexamethasone compared with those not taking dexamethasone. Multivariate logistic and Cox regression analyses confirmed that dexamethasone was significantly associated with delirium (adjusted odds ratio = 1.48, 95% confidence interval [CI] = 1.09-2.00, P = 0.012), in-hospital mortality (adjusted hazard ratio = 1.19, 95% CI = 1.02-1.40, P = 0.032), and ICU mortality (adjusted hazard ratio = 1.62, 95% CI = 1.22-2.15, P = 0.001). Compared with critically ill patients using high-dose dexamethasone, the risk of delirium was lower in the dose less than the 10 mg group, and patients using 10-14 mg may be associated with a lower risk of in-hospital death and the least ICU mortality, length of hospital stay, and ICU stay., Conclusions: This study demonstrated that the use of dexamethasone in critically ill patients exacerbated the occurrence of delirium while increasing the risk of in-hospital death, ICU death, and length of hospital stay, with a lower risk of delirium and a shorter total length of hospital stay with low-dose dexamethasone than with larger doses., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Epidermal keratinocytes play a vital role in restoration of the intact skin barrier during wound healing. The negative effect of hyperglycemia may prolong the wound healing process. Epidermal keratinocytes have been demonstrated to modulate and directly initiate nociceptive responses in rat models of fractures and chemotherapy-induced neuropathic pain. However, it is unclear whether epidermal keratinocytes are involved in the development and maintenance of incisional pain in nondiabetic or diabetic animals. In the current study, using behavioral tests and immunohistochemistry, we investigated the differential keratinocytes proliferation and expression of pronociceptive inflammatory mediators in keratinocytes in C57BL/6J mice and diabetic KK mice. Our data showed that plantar incision induced postoperative pain hypersensitivity in both C57BL/6J mice and KK mice, while the duration of postoperative pain hypersensitivity in KK mice was longer than that in C57BL/6J mice. Moreover, plantar incision induced the keratinocytes proliferation and expression of IL-1β and TNF-α in keratinocytes in both C57BL/6J mice and KK mice. Interestingly, compared to C57BL/6J mice, the slower and more persistent proliferation of keratinocytes and expression of IL-1β and TNF-α in keratinocytes were observed in KK mice. Together, our study suggested that plantar incision may induce the differential keratinocytes proliferation and expression of IL-1β and TNF-α in kertinocytes in diabetic and nondiabetic animals, which might be associated with the development and maintenance differences in diabetic and nondiabetic postoperative pain.