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In the light of circular economy aspects, processing of large-scale municipal wastewater treatment plants (WWTPs) needs reconsideration to limit the overuse of energy, implement of non-green technologies and emit abundant greenhouse gas. Along with the huge increase in the worldwide population and agro-industrial activities, global environmental organizations have issued several recent roles to boost scientific and industrial communities towards sustainable development. Over recent years, China has imposed national and regional standards to control and manage the discharged liquid and solid waste, as well as to achieve carbon peaking and carbon neutrality. The aim of this report is to analyze the current state of Chinese WWTPs routing and related issues such as climate change and air pollution. The used strategies in Chinese WWTPs and upgrading trends were critically discussed. Several points were addressed including the performance, environmental impact, and energy demand of bio-enhanced technologies, including hydrolytic acidification pretreatment, efficient (toxic) strain treatment, and anaerobic ammonia oxidation denitrification technology, as well as advanced treatment technologies composed of physical and chemical treatment technologies, biological treatment technology and combined treatment technology. Discussion and critical analysis based on the current data and national policies were provided and employed to develop the future development trend of municipal WWTPs in China from the construction of sustainable and "Zero carbon" WWTPs., 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: Neurodegenerative disease has a great adverse impact on population's death and disability worldwide. However, the association of air pollution and residential greenness with neurodegenerative disease and their potential mechanisms still remain uncertain., Methods: We used data from a population-based prospective cohort in Ningbo, China. Exposure to PM 2.5 , PM 10 and NO 2 were assessed by land-use regression (LUR) models and residential greenness was estimated by Normalized Difference Vegetation Index (NDVI). Our primary outcomes were all neurodegenerative diseases, Parkinson's disease (PD) and Alzheimer's disease (AD). Cox proportional hazards regression models were used to examine the association of air pollution and residential greenness with risk of incident neurodegenerative disease. Furthermore, we also explored the potential mediation relationship and effect modification between greenness and air pollutants., Results: During the follow-up period, we identified a total of 617 incident neurodegenerative diseases, 301 PD and 182 AD. In single-exposure models, PM 2.5 was positively associated with all outcomes (e.g. AD hazard ratio (HR): 1.41, 95 % confidence interval (CI): 1.09-1.84, per interquartile range (IQR) increment), whereas residential greenness showed protective effects (e.g. neurodegenerative disease, HR: 0.82, 95%CI: 0.75-0.90, per IQR increment for NDVI in 1000 m buffer). NO 2 was positively associated with risk of neurodegenerative disease and PM 10 was associated with neurodegenerative disease and AD. In two-exposure models, after adjustment for PM 2.5 , the association for greenness generally attenuated towards null. Moreover, we identified the significant modification effect of greenness on PM2.5 on additive and multiplicative scales., Conclusion: In this prospective study, we found that exposure to higher residential greenness and lower concentrations of particulate matter were associated with lower risk of neurodegenerative disease, PD and AD. Residential greenness could modify the association of PM 2.5 with neurodegenerative disease., Competing Interests: Declaration of competing interest The authors declare that there are no known competing financial interests., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Background: Cancer is one of the most common causes of death. Excess body weight (EBW), a risk factor for cancer, is highly prevalent in China. We aimed to estimate the number and proportion of cancer deaths attributed to EBW and their changes during 2006-2015 in China., Methods: Population attributable fractions in 2006, 2010, and 2015 were calculated with 1) prevalence of overweight/obesity, exacted from the China Health and Nutrition Survey conducted in 8-9 provinces of China in 1997, 2000, and 2004; 2) relative risks for EBW and site-specific cancers, obtained from previous studies; 3) data on cancer deaths in 2006, 2010, and 2015, originated from the Chinese Cancer Registry Annual Report., Results: In 2015, EBW contributed to 45,918 (3.1% of all) cancer deaths in China, with 24,978 (2.6%) in men and 20,940 (3.8%) in women. By region, the fraction of cancer deaths attributable to EBW ranged from 1.6% (West) to 4.1% (Northeast). Cancers of liver, stomach, and colorectum were the main EBW-attributable cancers. The fractions of cancer deaths attributable to EBW were 2.4% (95%CI: 0.8-4.2%) in 2006, 2.9% (95%CI: 1.0-5.2%) in 2010, and 3.1% (95%CI: 1.0-5.4%) in 2015, respectively, and increased for all gender, region, and cancer site during 2006-2015., Conclusions: The proportion of cancer deaths attributed to EBW was higher in women and Northeastern China, with an upward trend in the recent decade. A combination of comprehensive and individualized measures is necessary to reduce the prevalence of EBW and related cancer burden in China., Competing Interests: Declaration of Competing Interest We declare that we have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Background: Physical function (PF), such as muscle strength, performing daily activities, has gradually declined with the increase of age, causing the occurrence of disability and diseases burden. Air pollution exposure and physical activity (PA) were both linked to PF. We aimed to explore the individual and joint effects of particulate matter <2.5 μm (PM 2.5 ) and PA on PF., Methods: A total of 4537 participants and 12,011 observations aged ≥45 years old from the China Health and Retirement Longitudinal Study (CHARLS) cohort from 2011 to 2015 were included into the study. PF was assessed by a combined score of four tests, including grip strength, walking speed, sense of balance, and chair standing tests. Air pollution exposure data was from The ChinaHighAirPollutants (CHAP) dataset. The annual PM 2.5 exposure for each individual was estimated based on county-level resident addresses. We estimated the volume of moderate-to-vigorous physical activity (MVPA) by quoting metabolic equivalent (MET). Multivariate linear model was conducted for baseline analysis, and linear mixed model with random participant intercepts was constructed for cohort longitudinal analysis., Results: PM 2.5 was negatively associated with PF, while PA was positively associated with PF in baseline analysis. In cohort longitudinal analysis, a 10 μg/m 3 increase in PM 2.5 was associated to a 0.025 point (95 % CI: -0.047, -0.003) decrease in PF score, and a 10-MET-h/week increase in PA was related to a 0.004 point (95 % CI: 0.001, 0.008) increase in PF score. The association between PM 2.5 and PF decreased by increased PA intensity, and PA reversed the detrimental effects between PM 2.5 and PF., Conclusion: PA attenuated the association of air pollution with PF at both high and low levels of air pollution, implying that PA may be an effective behavior to reduce the adverse effects of poor air quality on PF., 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: Walkability has been considered to be associated with metabolic and cardiovascular diseases, but the relationship between walkability and chronic obstructive pulmonary disease (COPD) remains unclear. Moreover, fine particulate matter (PM 2.5 ), possibly positively correlated to walkability, may lead to an increased risk of COPD. The separate and joint effects of PM 2.5 and walkability on risk of COPD were explored in our study., Methods: We used prospective data of 29,572 participants from the Yinzhou cohort in Ningbo, China. COPD cases were diagnosed based on the Yinzhou Health Information System (YHIS). Walkability was measured using walk score in relation to the built environment based on geographic information systems (GIS). Air pollution levels were assessed by fitting land use regression (LUR) models. Cox proportional hazards models were used to evaluate the relationships of PM 2.5 and walkability with COPD. Furthermore, we also examined additive and multiplicative interactions between walkability and PM 2.5 ., Results: Overall, a total of 29,572 participants were included in the final analysis and 722 COPD incident cases were identified during 134,846 person-years of follow-up. Compared with subjects with lower walkability, individuals with higher walkability had a decreased risk of COPD (HR = 0.88, 95 % CI: 0.82-0.95) for every IQR increase. By contrast, exposure to PM 2.5 (every IQR increase) was associated with an elevated risk of COPD (HR = 1.21, 95 % CI: 1.06-1.37). No interaction between PM 2.5 and walkability was observed., Conclusions: Living in a highly walkable neighborhood could decrease risk of COPD, whereas high levels of PM 2.5 were positively associated with COPD. In addition, the beneficial effects of walkability were not attenuated by exposure to PM 2.5 ., 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 © 2022 Elsevier B.V. All rights reserved.)

Background & Aims: Metal exposure is suspected to be associated with the risk of chronic kidney disease (CKD). Copper (Cu) is an essential yet toxic trace element in humans. Epidemiological evidence on the association of Cu exposure with CKD remains inconsistent. This study aims to investigate the association of blood Cu and its co-exposure to other metals with CKD., Methods: A cross-sectional study was conducted among 3285 older participants in Zhejiang, China. The whole blood levels of Cu as well as other 10 metals were measured using the inductively coupled plasma mass spectrometry (ICP-MS). CKD events were defined as the presence of albuminuria or estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m 2 . Multivariable logistic regression and linear regression models were applied to assess the association of Cu with kidney function. The Bayesian kernel machine regression (BKMR) was used to examine the association of metal interactions with CKD., Results: In logistic models, we found a dose-dependent positive association between blood Cu and the prevalence of CKD. Compared to the lowest quartile of blood Cu, the odds ratio (OR) of CKD in the highest quartile was 1.65 (95% confidence interval, CI: 1.25, 2.17), and the β of eGFR was -1.74 (95% CI: -3.15, -0.34) after adjusting for multiple covariates. The positive linear dose-response association was found between blood Cu and the OR of CKD, and negative linear association was found between Cu and the β of eGFR. The positive association between blood Cu and CKD risk was stronger at lower level of manganese (Mn) in the BKMR model., Conclusion: The whole blood level of Cu was remarkably associated with the risk of CKD and showed positive dose-response relationships in the older Chinese population. The toxicity of Cu on kidney function could be antagonized by the exposure of Mn. These findings shed new light on the potential role of Cu in kidney health., Competing Interests: Conflicts of interest All authors declare that they have no known actual or potential competing financial interests., (Copyright © 2022 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.)

Greener residential surroundings are associated with beneficial health outcomes, whereas higher air pollution exposure is linked with elevated risks of chronic diseases. To date, limited studies have explored the interaction between residential greenness and air pollution on the risk of ischemic heart disease (IHD). We performed a prospective cohort study that included 29,141 adult participants recruited from Yinzhou District, Ningbo, China. Normalized Difference Vegetation Index (NDVI) around each participant's residence was calculated to measure residential greenness exposure. Land-use regression models were conducted to estimate long-term individual exposure to air pollutants, including nitrogen dioxide (NO 2 ) and particulate matter with aerodynamic diameters ≤ 2.5 μm (PM 2.5 ) and ≤10 μm (PM 10 ). Cox proportional hazard models were used to calculate the hazard ratios (HRs) and 95% confidence intervals (95% CIs) for the associations of residential greenness and air pollutants with the risk of incident IHD. During 101,172.5 person-years of follow-up, 1392 incident IHD cases were reported in the study population. Residential greenness, expressed as an interquartile range (IQR) increase in NDVI within 250 m, was inversely associated with incident IHD (HR = 0.89, 95%CI: 0.81,0.98). However, long-term exposures to air pollution were associated with higher IHD incidence (HR = 1.21, 95%CI:1.10,1.33 per IQR increase for PM 2.5 ; HR = 1.12, 95%CI:1.03,1.22 per IQR increase for PM 10 ; HR = 1.09, 95%CI:1.02,1.16 per IQR increase for NO 2 ). Mediation analyses suggested that the beneficial effect of residential greenness on incident IHD could be partly mediated by reducing the exposure to PM 2.5 . These findings suggested that higher greenness was associated with decreased risk of IHD, while air pollutants were positively associated with incident IHD. Meanwhile, residential greenness may decrease the risk of IHD by reducing exposure to PM 2.5 ., 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 © 2022 Elsevier B.V. All rights reserved.)

Treatment of coal-to-gas brine (CGB) is a great challenge since it contains elevated inorganic salts and a high level of toxic and bio-accumulative organics. In this study, CGB treatment was conducted by adsorptionregeneration and electrochemically driven UV/chlorine (E-UV/Cl 2 ) processes. LS-109D macroporous resin was optimal adsorbent primarily due to unique pore structure, which preferably adsorbed the aromatic fluorescent components with quenching Cl∙ effect and low molecular weight acids recalcitrant to ∙OH. The E-UV/Cl 2 process outperformed the UV photolysis process and electrochemical advanced oxidation processes (EAOPs) for oxidation of organic compounds due to its full utilization of Cl - in CGB to produce highly active oxidation agents. Thanks to the synergy between process units in organic matter removal, dissolved organic carbon (DOC) of CGB was reduced from 163.41 mg/L to 26.58 mg/L by the multistage system. Furthermore, the CGB with characteristics of high fluorescence and molecular weight (MW) distribution was converted to effluent with low fluorescence and MW distribution. The exhausted LS-109D was regenerated by ultrasound-assisted hot water elution at 363 K. After pretreated by ozonation, the eluate can be easily treated by biological process. The study suggests that the multistage system can provide an effective treatment option for removing organics from CGB., (Copyright © 2022 Elsevier B.V. All rights reserved.)

Background: Growing evidence has linked residential greenness to depression, the results from prospective cohort study are still limited. And it remains unclear whether particulate matter (PM) modify, mediate, or interact the greenness-depression relationship., Methods: We collected data from Yinzhou Cohort(N = 47,516) which was recruited between June 2015 and December 2017. Depression cases before April 2020 were ascertained from local Health Information System covered all residents' health care records. Residential greenness (the Normalized Difference Vegetation Index, NDVI, and the Enhanced Vegetation Index, EVI) and PM (particulate matters with diameters≤2.5 μm, PM 2.5 and particulate matters with diameters≤10 μm, PM 10 ) were estimated based on participants' residential coordinates. We conducted Cox models employing age as timescale to estimate the association between residential greenness within different buffers and incident depression. Furthermore, we explored the potential confounding, mediation and interaction relationship between greenness and PM., Results: During the 99,556 person-years of follow-up, 1043 incident depression cases occurred. In single exposure models, residential greenness was inversely associated with depression incidence (e.g. Hazard Ratio (HR) = 0.86, 95% confidence interval (CI): 0.79, 0.94 for per interquartile range (IQR) increase NDVI 250 m). The protective association between greenness was attenuated after introducing PM 2.5 and PM 10 into the models. We identified multiplicative interactions between greenness and PM exposure for depression (e.g. HR interaction  = 0.91, 95%CI: 0.85, 0.98 for per IQR decrease NDVI 250 m and per IQR increase PM 2.5 ). Besides, we found the protective association of greenness was partly mediated by PM (e.g. mediation proportion = 52.9% between NDVI 250 m and PM 2.5 )., Conclusions: In this longitudinal cohort study, residents living in greener neighborhoods had a lower risk of depression incidence and the benefits were interacted and partly mediated by PM. Improvement in residential greenness could be an actionable and planning intervention to prevent depression., 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 © 2021 Elsevier B.V. All rights reserved.)

Background: Long-term exposure to ambient air pollution was linked to depression incidence, although the results were limited and inconsistent., Objectives: To investigate the effects of long-term air pollution exposure on depression risk prospectively in China., Methods: The present study used data from Yinzhou Cohort on adults without depression at baseline, and followed up until April 2020. Two-year moving average concentrations of particulate matter with a diameter ≤ 2.5 μm (PM 2.5 ), ≤10 μm (PM 10 ) and nitrogen dioxide (NO 2 ) were measured using land-use regression (LUR) models for each participant. Depression cases were ascertained using the Health Information System (HIS) of the local health administration by linking the unique identifiers. We conducted Cox regression models with time-varying exposures to estimate the hazard ratios (HRs) and 95% confidence intervals (95% CIs) of depression with each pollutant, after adjusting for a sequence of individual covariates as demographic characteristics, lifestyles, and comorbidity. Besides, physical activity, baseline potential depressive symptoms, cancer status, COVID-19 pandemic, different outcome definitions and air pollution exposure windows were considered in sensitivity analyses., Results: Among the 30,712 adults with a mean age of 62.22 ± 11.25, 1024 incident depression cases were identified over totaling 98,619 person-years of observation. Interquartile range increments of the air pollutants were associated with increased risks of depression, and the corresponding HRs were 1.59 (95%CI: 1.46, 1.72) for PM 2.5 , 1.49 (95%CI: 1.35, 1.64) for PM 10 and 1.58 (95%CI: 1.42, 1.77) for NO 2 . Subgroup analyses suggested that participants without taking any protective measures towards air pollution were more susceptible. The results remained robust in all sensitivity analyses., Conclusions: Long-term exposure to ambient air pollution was identified as a risk factor for depression onset. Strategies to reduce air pollution are necessary to decrease the disease burden of depression., 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 © 2021. Published by Elsevier B.V.)

Rationale: Coronary artery ligation to induce myocardial infarction (MI) and ischemia injury in mice is typically performed in normal mice, but This is not consistent with disease progression. There should be atherosclerosis (AS) first, followed by MI., Objective: We tried a novel model to induce MI that was established on atherosclerosis in mice. This approach was much more consistent with disease progression., Methods: In this study, Mice lacking apolipoprotein E (ApoE -/- ) were randomly divided into four groups. The mice of the control and MI groups were fed normal diet for 24-weeks, while the mice of AS and AS + MI groups were fed high-fat diet (HFD). After 23 weeks, the mice of MI and AS + MI groups were ligated with coronary arteries. A week later, after echocardiography, analysis of plaque and myocardium were conducted on aortic and heart, then the serum, aorta and heart tissues were further detected., Results: Our results showed that AS model mice exhibited significant body weight gain, dyslipidemia and atherosclerotic lesions formation which were in accordance with the pathological changes of AS. Co-treatment with AS and MI led to higher operative mortality and heart pathological were in accordance with the pathological changes of MI. In addition, Echocardiography and NT pro-BNP revealed co-treatment with AS and MI led to deterioration of cardiac function. AS also aggravated myocardial inflammatory cell infiltration and fibrosis post-MI., Conclusions: Together, it is feasible to establish myocardial infarction model based on atherosclerosis model., 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 © 2021. Published by Elsevier Inc.)

Aims: To explore the contagiousness and new SARS-CoV-2 mutations in pediatric COVID-19., Methods: This cohort study enrolled all pediatric patients admitted to 8 hospitals in Zhejiang Province of China between 21 January and 29 February 2020, their family members and close-contact classmates. Epidemiological, demographic, clinical and laboratory data were collected. Bioinformatics was used to analyze the features of SARS-CoV-2. Individuals were divided into 3 groups by the first-generation case: Groups 1 (unclear), 2 (adult), and 3 (child). The secondary attack rate (SAR) and R 0 were compared among the groups., Results: The infection rate among 211 individuals was 64% (135/211). The SAR in Groups 2 and 3 was 71% (73/103) and 3% (1/30), respectively; the median R 0 in Groups 2 and 3 was 2 (range: 1-8) and 0 (range: 0-1), respectively. Compared with adult cases, the SAR and R 0 of pediatric cases were significantly lower (p<0.05). We obtained SARS-CoV-2 sequences from the same infant's throat and fecal samples at a two-month interval and found that the new spike protein A958D mutation detected in the stool improved thermostability theoretically., Conclusions: Children have lower ability to spread SARS-CoV-2. The new A958D mutation is a potential reason for its long residence in the intestine., (Copyright © 2021 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: Though growing evidence has linked air pollution to Parkinson's disease (PD), the results remain inconsistent. Less is known about the relevance of road proximity and surrounding green. We aimed to investigate the individual and joint associations of air pollution, road proximity and surrounding green with the incidence of PD in a prospective cohort study., Methods: We used data from a prospective cohort of 47,516 participants recruited from July 2015 to January 2018 in Ningbo, China. Long-term exposure to particulate matter with aerodynamic diameter ≤2.5 μm (PM 2.5 ) and ≤10 μm (PM 10 ) and nitrogen dioxide (NO 2 ) estimated by land-use regression models, road proximity and surrounding green assessed by Normalized Difference Vegetation Index (NDVI) were calculated based on the residential address for each participant. Cox proportional hazard models were used to analyze the individual and joint effects of air pollution, road proximity, and surrounding green on PD., Results: In single-exposure models, PM 2.5 , PM 10 , NO 2 and road proximity was associated with increased risk of PD (e.g. Hazard Ratio (HR) = 1.51, 95%CI:1.02, 2.24 per interquartile range (IQR) increase for PM 2.5 ) while surrounding green was associated with decreased risk of PD (e.g. HR = 0.80, 95%CI:0.65, 0.98 per IQR increase for NDVI in 300 m buffer). In two-exposure models, the associations of PM 2.5 and surrounding green persisted while the associations of NO 2 and road proximity attenuated towards unity., Conclusions: We found that PM 2.5 were associated with increased risk of incident PD while surrounding green was associated with decreased risk of PD. Future studies about PD etiology may benefit from including multiple environmental exposures to address potential joint associations., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Background: Peptic ulcer disease (PUD) continued to be a source of significant morbidity and mortality worldwide. Recently, it has been reported that exposure to air pollution is a potential risk factor for PUD, but evidence on the association still remains inconsistent., Methods: We performed an ecological study to examine the association between short-term exposure to air pollution and daily hospital visits for PUD in Yinzhou, China from January 1st, 2017 to December 31st, 2019. Distributed lag nonlinear models were used to estimate the nonlinear and lag-response effects of air pollutants. Subgroup analyses stratified by sex, age and season were conducted to examine the effect modifications., Results: Overall, we found that short-term exposure to air pollution including SO 2 , NO 2 , CO, O 3 and PM 2.5 was significantly associated with hospital visits for PUD among all subjects. The lag-response effects of SO 2 , NO 2 and O 3 varied at different concentrations and lag days. The cumulative risk ratios of CO and PM 2.5 showed nearly linear adverse effects and increased to maxima of 2.68 (95% CI: 1.49-4.78) and 2.40 (95% CI: 1.36-4.24) with their ranges from the references to the maximum concentrations, respectively. Moreover, the cumulative risks of particulate matters on hospital visits for PUD increased significantly in cold seasons, but not in warm seasons., Conclusions: Our findings could provide growing evidence regarding the adverse health effects of air pollution on PUD, thereby strengthening the hypothesis that air pollutants have harmful impacts on digestive system., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Objective: The aim of this study was to retrospectively analyze the experience of treating long segmental bone defects. Bone union was used as the criteria for the assessment of the quantitative relationship between tibial bone defects and bone grafts, which could help reduce the complication incidence in patients., Methods: A total of 45 patients with tibial bone defects treated with the Masquelet technique at the Ninth People's Hospital of Wuxi Affiliated to Soochow University between February 2013 and December 2017 were recruited. The age, sex, body mass index (BMI), complications, site of bone defect, length of bone defect, time from the first to the second stage of operation, and postoperative complications (including deep infection, absorption of bone graft, and bone union) were assessed., Results: Forty-two patients, including 17 males (40.5%) and 25 females (59.5%), with segmental bone defect, met the inclusion criteria. The mean age of the patients was 38.5 years (22-55 years). Nineteen patients (45.2%) underwent multiple traumas. The mean length of the bone defect was 6.3 cm. Six patients experienced complications, resulting in the incidence of complications of 14.3%. The relationship between the length of bone defect and volume of bone grafts was Y = 7.210 + 6.954 × X in patients treated with steel plates; Y = 10.962 + 5.029 × X for patients treated with intramedullary nails, and Y = 11.498 + 5.474 × X regardless of methods of internal fixation., Conclusion: Masquelet technique is effective and safe for the treatment of long segmental tibial bone defects. The present study revealed the quantitative relationship between the size of bone defects and bone grafts, thus providing evidence for the selection of treatment strategies for long segmental bone defects in clinical practices, as well as helping to reduce the incidence of complications in Masquelet technique., Competing Interests: Declaration of Competing Interest None of the contributing authors have any conflicts of interest to report., (Copyright © 2020 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: Sleep disorders have been verified to be associated with adverse health outcomes. Recent studies have linked ambient air pollution to sleep disorders. However, evidence with large sample size and especially prospective studies is very limited., Methods: We used data from a prospective cohort study established from 2015 to 2018 in Ningbo, China. Participants were followed-up after baseline survey through linkage to the regional Health Information System (HIS). Sleep disorders were defined based on International Classification of Disease 10 (ICD-10). Spatial-temporal land-use regression (LUR) models were used to estimate the annual exposure to particulate matter with diameter ≤ 2.5 µm (PM 2.5 ), ≤ 10 µm (PM 10 ) and nitrogen dioxides (NO 2 ). The associations between long-term exposure to air pollutants and prevalence of sleep disorders were examined using logistic regression models, and Cox regression models for the effects of air pollution on the incidence of sleep disorders. A generalized weighted quantile sum (gWQS) regression was used in the multipollutant analysis., Results: A total of 38,775 participants were included in the final analysis. Based on baseline data, we observed significant positive associations between air pollution exposure and increased odds of prevalent sleep disorders (Odds Ratio (OR)= 1.48, 95% confidence interval (CI): 1.41-1.55 for PM 2.5 ; OR= 1.47,95%CI:1.38-1.57 for PM 10 ; OR= 1.38, 95%CI:1.31-1.46 for NO 2 ). In the longitudinal analysis, hazard ratios for incident sleep disorders associated with per interquartile range (IQR) increase in PM 2.5 , PM 10 and NO 2 were 1.14 (1.03, 1.25), 1.13 (1.01, 1.27) and 1.13 (1.04, 1.23), respectively. A gWQS regression analysis showed significant association between air pollution mixture and incident sleep disorders (OR=1.11, 95%CI: 1.03-1.20)., Conclusions: Long-term exposure to PM 2.5 , PM 10 and NO 2 were associated with increased risk of sleep disorders in a Chinese population. Our findings could provide evidence for a more general role in the adverse health impact of air pollution., (Copyright © 2021 The Authors. Published by Elsevier Inc. All rights reserved.)

Depression is one of the leading causes of disability, but the etiology remains unclear. Recently, it has been suggested that air pollution is a potential risk factor for depression. However, the results remained inconsistent. So we conducted this study to assess the association between short-term exposure to ambient air pollution and hospital visits for depression in China. Daily hospital visits for depression from January 18, 2013 to June 10, 2018 were extracted from a regional health information system (HIS) covered 1.34 million population in Ningbo, China. We collected daily air pollutant concentrations and meteorological data from environmental air quality monitoring sites and meteorological stations in the study area. Quasi-Poisson regression models with generalized additive models (GAM) were applied to explore the associations between air pollution and hospital visits for depression. Stratified analyses were also conducted by gender, age, and season to examine the effects modification. The results disclosed that air pollutants including PM 2.5 , PM 10 , SO 2 , CO, and NO 2 were positively correlated with hospital visits for depression. The strongest effects all occurred on lag0 (the same) day, and the corresponding excess risks (ERs) were 2.59 (95%CI: 0.72, 4.49) for PM 2.5 , 3.08 (95%CI: 1.05, 5.16) for PM 10 , 3.22 (95%CI: 1.16, 5.32) for SO 2 , 4.38 (95%CI: 1.83, 6.99) for CO, and 4.94 (95%CI: 2.03, 7.92) for NO 2 per IQR increase, respectively. The associations were found to be stronger in the elderly (≥65 years) and cold season. Furthermore, the effects of CO and NO 2 remained significant in most two-pollutant models, suggesting that traffic-related air pollutants might be more important triggers of depression., 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 © 2020 Elsevier B.V. All rights reserved.)

Background: The aim of this study was to evaluate the influence of obesity on patients' function, pain, and complications following primary total knee arthroplasty (TKA) with an enhanced-recovery program., Methods: A total of 157 patients were enrolled into a prospective study and assigned into one of three groups on the basis of their body mass index (BMI): normal (BMI 18.0-24.9 kg/m 2 ), overweight (BMI 25.0-29.9 kg/m 2 ), or obese (BMI ≥30.0 kg/m 2 ). The primary outcome was knee range of motion (ROM) on postoperative day (POD) 3, 15, 30, and 90, and secondary outcomes were visual analog scale (VAS) on POD 1, 2, 3, 15, 30, and 90, length of stay, and complications., Results: The ROM of patients in the obese group on POD 3 was higher than in the normal (104.4 ± 8.5 vs. 98.9 ± 8.9, P = .010) and overweight (104.4 ± 8.5 vs. 97.7 ± 7.8, P = .001) groups. Similarly, the VAS in the obese group at rest on POD 1 was lower than in the normal (2.0 ± 0.7 vs. 2.2 ± 0.6, P = .043) and overweight (2.0 ± 0.7 vs. 2.3 ± 0.6, P = .010) groups. In addition, the incidence of complications did not differ significantly among the three groups, but the length of hospital stay in the obese group was longer (P = .027)., Conclusions: Obesity may not affect patients' function and pain, and may not increase the incidence of complications following primary TKA. Obese patients may obtain satisfactory functional rehabilitation outcomes, but with a longer duration of rehabilitation., Competing Interests: Declaration of competing interest The authors declare that they have no competing interests, (Copyright © 2020 Elsevier B.V. All rights reserved.)

Sleep disorders, oftentimes co-occurring with other mental and neurological disorders in the elderly, have been previously linked to short-term exposures to air pollution. Here we assessed such associations among 395,651 elderly Chinese in Ningbo, China where air pollution exposures are high and the proportion of elderly in the population is growing. We utilized a regional health information database in China (2008-2017) that collected information on hospital visits for sleep disorders among the elderly (age 60+). Measures of daily air pollution concentrations including nitrogen dioxide (NO 2 ), sulfur dioxide (SO 2 ), ozone (O 3 ), inhalable particles (PM 10 ), and ambient fine particulate matter (PM 2.5 ) were generated from seven environmental air quality monitoring sites in the study area. We used a generalized additive model to evaluate the associations between hospital visits for sleep disorders and short-term air pollution exposures for up to 7 days prior to a hospital visit. Short-term exposure to multiple air pollutants was associated with hospital visits for sleep disorders in an elderly population; with the strongest associations during 2-3 days prior to a clinic visits for traffic-related pollutants including air quality index (AQI), PM 2.5 , PM 10 , and NO 2 and for SO 2 and O 3 for 5 days prior to the visits. Our study based on large health care record system suggested that short-term air pollution exposures are associated with sleep disorders in the elderly. Considering the individual covariates that could not be adjusted in time-series analyses, future studies with individual level data and an ability to evaluate the severity of sleep disorders and their relation to mental and physical health in general and air pollution are needed. An aging population with increasing health problems and the frequency of high and very high air pollution events in China make our findings very health policy relevant., (Copyright © 2019 Elsevier B.V. All rights reserved.)

Adenosine deaminase (ADA) is a key enzyme of adenosine metabolism. There are currently various kits and systems available for ADA measurement, and all yield variable results. This study optimized a reference measurement procedure (RMP) for serum ADA for the standardization of routine methods. ADA coupled with purine-nucleoside-phosphorylase, xanthine-oxidase and peroxidase was selected as the basic method and was optimized using Response Surface Methodology. Then the performance was validated and the results were compared after replication by 3 other reference laboratories. A reference interval was also developed. In addition, this optimized method was applied to calibrate a routine system. The intra-assay precision was 0.44% at both concentrations of 29.8 and 100.4 U/L, and inter-assay precision was 1.01% and 0.95% at 30.1 and 100.3 U/L, respectively. The linearity was up to 351.9 U/L (R 2  = 0.9998), with no significant interference or carryover (<5%). A Comparison among 4 reference laboratories showed good reproducibility (R 2  ≥ 0.9975). The procedure proved valid for a reference interval of 11.7-38.5 U/L. The mean relative deviation for a routine system was -55.9% and -3.7% before and after calibration. This candidate RMP for serum ADA can potentially be used for standardization of clinical systems., (Copyright © 2019 Elsevier Inc. All rights reserved.)

It has been shown that adipose tissue hyperplasia (increased adipocyte number or adipogenesis) has beneficial effects on metabolic health. The aim of the present study was to determine whether phytol could modulate hyperplasia/adipogenesis and glucose homeostasis, and to explore the underlying mechanisms in mice fed high-fat and high fructose diet (HFFD). Our results demonstrated that phytol administration decreased body weight gain and inguinal subcutaneous white adipose tissue (iWAT) weight. However, phytol significantly increased the adipocyte number in iWAT, with the smaller average adipocyte diameter. Meanwhile, OGTT result showed that phytol improved glucose tolerance. In accord, phytol administration markedly increased expression of marker genes associated with adipogenesis (PPARγ and C/EBPα) and glucose uptake (AS160 and GLUT4) and activated PI3K/Akt signaling pathway in mice iWAT. In agreement with the in vivo findings, the in vitro results indicated that 100 μM phytol significantly enhanced 3T3-L1 adipogenesis and glucose uptake, and activated PI3K/Akt signaling pathway. However, phytol-induced enhancement of 3T3-L1 adipognesis and glucose uptake, activation of PI3K/Akt signaling pathway, elevation of marker genes involved in adipogensis and glucose uptake, as well as translocation of GLUT4 from cytoplasm to membrane were abolished by Wortmannin, a specific PI3K/Akt inhibitor. Taken together, phytol increased adipocyte number in iWAT and improved glucose tolerance in mice fed HFFD, which was coincident with the enhanced adipogenesis and glucose uptake in 3T3-L1, and was associated with activation of PI3K/Akt signaling pathway. These data suggested the application of phytol as a potential nutritional agent to combat obesity and type 2 diabetes., (Copyright © 2017 Elsevier Inc. All rights reserved.)

Background: The intake of fish and polyunsaturated fatty acids (PUFAs) may benefit cognitive function. However, optimal intake recommendations for protection are unknown., Objective: We systematically investigated associations between fish and PUFA intake and mild-to-severe cognitive impairment risk., Design: Studies that reported risk estimates for mild cognitive impairment (MCI), cognitive decline, dementia, Alzheimer disease (AD), or Parkinson disease (PD) from fish, total PUFAs, total n-3 (ω-3) PUFAs, or at least one n-3 PUFA were included. Study characteristics and outcomes were extracted. The pooled RR was estimated with the use of a random-effects model meta-analysis. A dose-response analysis was conducted with the use of the 2-stage generalized least-squares trend program., Results: We included 21 studies (181,580 participants) with 4438 cases identified during follow-up periods (2.1-21 y). A 1-serving/wk increment of dietary fish was associated with lower risks of dementia (RR: 0.95; 95% CI: 0.90, 0.99; P = 0.042, I(2) = 63.4%) and AD (RR: 0.93; 95% CI: 0.90, 0.95; P = 0.003, I(2) = 74.8%). Pooled RRs of MCI and PD were 0.71 (95% CI: 0.59, 0.82; P = 0.733, I(2) = 0%) and 0.90 (95% CI: 0.80, 0.99; P = 0.221, I(2) = 33.7%), respectively, for an 8-g/d increment of PUFA intake. As an important source of marine n-3 PUFAs, a 0.1-g/d increment of dietary docosahexaenoic acid (DHA) intake was associated with lower risks of dementia (RR: 0.86; 95% CI: 0.76, 0.96; P < 0.001, I(2) = 92.7%) and AD (RR: 0.63; 95% CI: 0.51, 0.76; P < 0.001, I(2) = 94.5%). Significant curvilinear relations between fish consumption and risk of AD and between total PUFAs and risk of MCI (both P-nonlinearity < 0.001) were observed., Conclusions: Fishery products are recommended as dietary sources and are associated with lower risk of cognitive impairment. Marine-derived DHA was associated with lower risk of dementia and AD but without a linear dose-response relation., (© 2016 American Society for Nutrition.)

Catalytic ozonation of dimethyl phthalate (DMP) in aqueous solution (5mg/L) under various reactions was performed to examine the effect of catalyst dosage, catalyst particle size, ozone dosage, and gas flow rate on the mineralization of DMP. The mineralization of DMP can be achieved via ozonation and the presence of Ru/AC could greatly accelerate the mineralization rate of DMP in ozonation process. In the continuous experiment of the Ru/AC catalyzed ozonation of DMP, total organic carbon (TOC) removals were kept stable around 75% during 42 h reaction. No leaching of ruthenium was observed in the treated water samples. The treatment of natural water using Ru/AC+O(3), Ru/AC+O(2) and ozonation alone was studied. In the Ru/AC+O(3) process, TOC removals, the reductions of the haloacetic acid formation potentials (HAAFPs), and the reductions of the trihalomethane formation potentials (THMFPs) of 11 water samples were 22-44%, 39-61% and 50-65%, respectively. Ru/AC+O(3) process was much more effective than ozonation alone for TOC removal and the reduction of disinfection by-product formation potential (DBPFP) in the treatment of natural water. It is a promising water treatment technology.

CeO2-TiO2 catalysts are prepared by coprecipitation method, and the activity and stability in the catalytic wet air oxidation (CWAO) of phenol are investigated in a batch reactor and packed-bed reactor. CeO2-TiO2 mixed oxides show the higher activity than pure CeO2 and TiO2, and CeO2-TiO2 1/1 catalyst displays the highest activity in the CWAO of phenol. In a batch reactor, COD and TOC removals are about 100% and 77% after 120 min in the CWAO of phenol over CeO2-TiO2 1/1 catalyst at reaction temperature of 150 degrees C, the total pressure of 3 MPa, phenol concentration of 1000 mg/L, and catalyst dosage of 4 g/L. In a packed-bed reactor using CeO2-TiO2 1/1 particle catalyst, over 91% COD and 80% TOC removals are obtained at the reaction temperature of 140 degrees C, the air total pressure of 3.5 MPa, the phenol concentration of 1000 mg/L for 100 h continue reaction. Leaching of metal ions of CeO2-TiO2 1/1 particle catalyst is very low during the continuous reaction. CeO2-TiO2 1/1 catalyst exhibits the excellent activity and stability in the CWAO of phenol.