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The evaluation of hospital reform effectiveness in health care reform is very important and beneficial since it helps the government to understand the current situation of pilot county public hospitals and smoothly start the reform in all county hospitals. This study used sample hospitals data from 2010 to 2012 to evaluate the effectiveness of public hospital reform through comparisons between 2010 and 2012 in hospital operating efficiency, clinical terminal quality, the average medical expense of patients, patient and medical staff overall satisfaction. The results highlight that there was no improvement in hospitals' operating efficiency, pilot hospitals' clinical terminal quality was lower than its counterpart, and the two objectives had been improved: medical expense control and inpatients' satisfaction, however, nearly 68.46% medical staffs were dissatisfied with the outcomes of the reform in pilot hospitals staff satisfaction. Nevertheless, the reform was helpful to improve the hospital current situation with some of the objectives having been achieved. It has not completely succeeded in Guangxi, China. [ABSTRACT FROM AUTHOR]

Microplastic pollution has become emerging environmental concern around world. The wastewater treatment plants (WWTPs) are attributed to a major pathway for microplastics (MPs) to enter into aquatic environment. To understand the fate and control strategies of MPs in WWTPs, we investigated MPs at a full-scale WWTP, Eastern China, with two parallel wastewater treatment systems, i.e. oxidation ditch (OD) and membrane bioreactor (MBR) for case study. The influent MPs consisted of polyethylene terephthalate (PET, 47%), polystyrene (PS, 20%), polyethylene (PE, 18%) and polypropylene (PP, 15%). MP morphotypes dominated in fragments (65%) and fibers (21%), which mainly were PET, with limited films (12%) and foams (2%). Typical plastic microbeads were not observed. The dominant size of MPs was >500 μm (40%) and 62.5–125 μm (29%). MP concentrations increased across the treatment systems depends on facility of treatment process. Influent MPs were removed by 99.5% in MBR system versus 97% in OD system on the basis of plastic mass while 82.1% versus 53.6% on MP number. The removed MPs accumulated in sludge phase. MBR system has much higher MP removal efficiency than OD system, likely due to membrane filtration. The results suggest that the source control of MPs by eliminating MP fibers from laundry facilities, banning use of plastic microbeads, Styrofoam products and plastic bags and properly selecting WWTP treatment unit could significantly reduce the mass and number of MPs from WWTPs. Image 1 • Microplastics (MP) numbers increased cross oxidation ditch and MBR systems. • MPs belonging to PET, PS, PE and PP dominated in morphotypes of fragments and fibers. • MPs removed from water phase by >97% and accumulated in sludge phase. • MBR was superior in MP removal due to micromembrane filtration. • Strategies for MP source reduction and enhancement of WWTP management are proposed. [ABSTRACT FROM AUTHOR]

Abstract: Microorganisms with high oil-degrading performance are essential for bioremediation of soil contaminated with crude oil. A positive end dilution method was employed for the selection of crude oil-degrading functional consortium from contaminated soil. The selected consortium was consisted of Rhizobiales sp., Pseudomonas sp., Brucella sp., Bacillus sp., Rhodococcus sp., Microbacterium sp. and Roseomonas sp. and removed nearly 52.1% of crude oil at initial concentration of 10,000 mg l−1 at 30 °C within 7 days, with removal of aliphatic hydrocarbons by 71.4% and aromatic hydrocarbons by 36.0%, respectively. The effectiveness of the consortium for bioaugmentation was confirmed with microcosm test by contaminated soil (1.0 kg) from Karemary Oilfield, China. The removal efficiency of crude oil was enhanced to >50% in microcosms with the consortium compared with 8–13% or lower in controls over a 60 day period. The crude oil removal reaction was probably first order reaction and the rate was greatly enhanced by bioaugmentation. Supplementation of nitrogen and phosphate sources had limited effect on the oil removal in the tested soil. [Copyright &y& Elsevier]

Microplastic (MP) pollution is widely spread in oceans, freshwater, and terrestrial environments but MPs in mountainous headwater ecosystem are rarely reported. This study focuses on the headwater of Yangtze tributaries of the Hindu Kush-Himalayan (HKH) region. Five streams at elevations of 900 to 3300 m were selected to investigate the distribution of MPs in water and sediments across altitudes. MPs were found in all water and sediment samples from top stream zone nearly in absence of anthropogenic activity, low anthropogenic zone, and high anthropogenic zone, increased from 12-54, 81-185 to 334-847 items/L, and 2-35, 26-84 to 124-428 items/kg, respectively. This elevation-dependent MP distribution indicated that as elevation decreased, anthropogenic activities intensified and increased MPs input and their abundance, size, and diversity. Notably, hydraulic projects, such as damming, were identified as potential barriers to the migration of MPs downstream. Microbiome analyses revealed the presence of bacterial genes associated with plastic biodegradation in all sediment samples. The study indicates that Shangri-la mountainous streams have been polluted with MPs for years with potential risk of generation of nano-sized particles via natural fragmentation and biodegradation, and thus raises concern on MPs pollution in headwaters streams in mountainous regions., 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 © 2024 Elsevier B.V. All rights reserved.)

Microplastics (MPs) are drawing increasing attention from the international community due to their potential threats to the ecosystem and human health. Although their occurrence and spatial distribution have been extensively studied in recent years, the relationship between their abundance and sizes remains unclear. Moreover, the underlying mechanisms dominating their size distribution have rarely been explored. In the present study, we developed a novel conditional fragmentation model to describe MP size distribution in the soil environment. It is proposed that the distribution of MPs is not a coincidence but controlled by conditional aging. The applicability of this model was tested using data collected from different land use settings in Beijing, China. A distinct downsizing phenomenon from fibers, films, and fragments to granules is observed. Undisturbed land use types accumulated larger sized MPs with higher stability, while human interference accelerated the fragmentation of MPs. Both morphological analysis and time-of-flight secondary ion mass spectroscopy (TOF-SIMS) observations provided direct evidence for the conditional fragmentation process. Furthermore, the model has proven to be suitable for describing the size distribution of MPs from various sources (including atmospheric deposition, transportation, and agriculture) and aging processes (such as mechanical abrasion, chemical oxidation, and photochemical transformation). It is proposed that this model can be used for various purposes in MP-related studies, especially source identification, transport modeling, and risk assessment.

Yellow mealworms (Tenebrio molitor larvae) are capable of biodegrading polystyrene (PS) and low-density polyethylene (LDPE). This study tested biodegradation of one expanded PS (EPS) with a weight-average molecular weight (M w ) 256.4 kDa and two LDPE foams with respective M w of 130.6 kDa (PE-1) and 288.7 kDa (PE-2) in T. monitor larvae obtained in Beijing, China. The larvae consumed EPS and both LDPEs over a 60 day. Fourier transform infrared spectroscopy and thermogravimetric analyses of frass confirmed the formation of new oxygen-containing functional groups, as well as a change in physical property and chemical modification, indicating that biodegradation of EPS and LDPE occurred. Gel permeation chromatography analysis confirmed broad depolymerization of EPS and PE-1 (i.e., a decrease in both M w and a number-average molecular weight (M n )) but revealed limited extent depolymerization of PE-2 (i.e., increase in M n and decrease in M w ). For all materials, the size-average molecular weight (M z ) was decreased. Biodegradation and oxidation of EPS and LDPE were confirmed using FTIR and TGA analysis. Depression of gut microbes by the antibiotic gentamicin resulted in significant inhibition of EPS depolymerization but did not stop LDPE depolymerization, resulting in the increase in M n and revealing that PS biodegradation was gut microbe-dependent but LDPE biodegradation was less dependent or independent of gut microbes. Gut microbial community analysis indicated that, as expected, under different dietary conditions, the intestinal flora significantly shifted to communities associated with biodegradation of EPS and LDPE. The results indicated the complexity and limitation of biodegradation of plastics in plastics-eating T. molitor larvae., 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. Published by Elsevier Ltd.)

Larvae of Zophobas atratus (synonym as Z. morio, or Z. rugipes Kirsch, Coleoptera: Tenebrionidae) are capable of eating foams of expanded polystyrene (EPS) and low-density polyethylene (LDPE), similar to larvae of Tenebrio molitor. We evaluated biodegradation of EPS and LDPE in the larvae from Guangzhou, China (strain G) and Marion, Illinois, U.S. (strain M) at 25 °C. Within 33 days, strain G larvae ingested respective LDPE and PS foams as their sole diet with respective consumption rates of 58.7 ± 1.8 mg and 61.5 ± 1.6 mg 100 larvae -1 d -1 . Meanwhile, strain M required co-diet (bran or cabbage) with respective consumption rates of 57.1 ± 2.5 mg and 30.3 ± 7.7 mg 100 larvae -1 d -1 . Fourier transform infrared spectroscopy, proton nuclear magnetic resonance, and thermal gravimetric analyses indicated oxidation and biodegradation of LDPE and EPS in the two strains. Gel permeation chromatography analysis revealed that strain G performed broad depolymerization of EPS, i.e., both weight-average molecular weight (M w ) and number-average molecular weight (M n ) of residual polymers decreased, while strain M performed limited extent depolymerization, i.e., M w and M n increased. However, both strains performed limited extent depolymerization of LDPE. After feeding antibiotic gentamicin, gut microbes were suppressed, and M w and M n of residual LDPE and EPS in frass were basically unchanged, implying a dependence on gut microbes for depolymerization/biodegradation. Our discoveries indicate that gut microbe-dependent LDPE and EPS biodegradation is present within Z. atratus in Tenebrionidae, but that the limited extent depolymerization pattern resulted in undigested polymers with high molecular weights in egested frass., Competing Interests: Declaration of competing interest The authors declare no competing financial interest., (Copyright © 2020. Published by Elsevier Ltd.)

Microplastics (MPs) pollution is an emerging environmental and health concern. MPs have been extensively observed in the aquatic environment, yet rarely investigated in the terrestrial ecosystem, especially in relation to health risks. To evaluate potential MPs pollution in land-dwelling animal medicine materials, we collected 20 types of small animal-based medicinal materials and 10 types of available fresh terrestrial animals from eight different regions in China. MPs were found in all medicinal materials with an average incidence rate of 94.67%. The abundance of MPs was in the range of 1.80 ± 0.38 to 7.80 ± 0.83 items/individual or 1.59 ± 0.33 to 43.56 ± 9.22 items/g (dry weight), with polymer distribution by polyethylene terephthalate (40.45%), rayon (30.64%), polyethylene (10.11%), nylon (7.35%), polypropylene (5.93%), and polyvinyl chloride (5.52%). The majority of MPs were microfibers (84.68%), with 15.32% of fragments. Moreover, MPs were directly observed in the intestine, detected in all ten types of fresh medicinal animals with the abundance of 0.83 ± 0.35 to 3.42 ± 0.46 items/individual. Furthermore, significant positive correlations (R: 0.32-0.99, p < 0.05) of MPs characteristics were found between medicinal materials and fresh animals, including shape, size, color, and polymer distribution of MPs. The results support that MPs in the medicinal materials were likely derived from living animals. This study demonstrates the prevalence of MPs in animal-based, traditional medicinal materials, and also suggests widespread MPs pollution in terrestrial environments and latent health risks., 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 © 2019. Published by Elsevier B.V.)

Microplastics (MPs) are an emerging concern and potential risk to marine and terrestrial environments. Surface soils are reported to act as a sink. However, MP vertical mobility in the subsurface remains uncertain due to a lack of scientific data. This study focused on MP penetration in sand soil column experiments. Here we report the mobility of five different MPs, which consisted of polyethylene (PE) and polypropylene (PP) particles of various sizes and densities. We observed that the smallest sized PE MPs (21 μm) had the greatest movement potential. Moreover, it was found that when these MPs were subjected to greater numbers of wet-dry cycles, the penetration depth significantly increased, with an apparent linear relationship between depth and wet-dry cycle number (r 2  = 0.817). In comparison, increasing the volume of infiltration liquid or the surface MP concentration had only negligible or weak effects on migration depth (r 2  = 0.169 and 0.312, respectively). Based on the observed wet-dry cycle trend, we forecast 100-year penetration depths using weather data for 347 cities across China. The average penetration depth was calculated as 5.24 m (95% CI = 2.78-7.70 m), with Beijing Municipality and Hebei, Henan and Hubei provinces being the most vulnerable to MP vertical dispersion. Our results suggest that soils may not only represent a sink for MPs, but also a feasible entryway to subsurface receptors, such as subterranean fauna or aquifers. Finally, research gaps are identified and suggested research directions are put forward to garner a better understanding MP vertical migration in soil., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Yellow mealworms (larvae of Tenebrio molitor, Coleoptera: Tenebrionidae) have been proven to be capable of biodegrading polystyrene (PS) products. Using four geographic sources, we found that dark mealworms (larvae of Tenebrio obscurus) ate PS as well. We subsequently tested T. obscurus from Shandong, China for PS degradation capability. Our results demonstrated the ability for PS degradation within the gut of T. obscurus at greater rates than T. molitor. With expanded PS foam as the sole diet, the specific PS consumption rates for T. obscurus and T. molitor at similar sizes (2.0 cm, 62-64 mg per larva) were 32.44 ± 0.51 and 24.30 ± 1.34 mg 100 larvae -1 d -1 , respectively. After 31 days, the molecular weight ( M n ) of residual PS in frass (excrement) of T. obscurus decreased by 26.03%, remarkably higher than that of T. molitor (11.67%). Fourier transform infrared spectroscopy (FTIR) indicated formation of functional groups of intermediates and chemical modification. Thermo gravimetric analysis (TGA) suggested that T. obscurus larvae degraded PS effectively based on the proportion of PS residue. Co-fed corn flour to T. obscurus and wheat bran to T. molitor increased total PS consumption by 11.6% and 15.2%, respectively. Antibiotic gentamicin almost completely inhibited PS depolymerization. High-throughput sequencing revealed significant shifts in the gut microbial community in both Tenebrio species that were associated with the PS diet and PS biodegradation, with changes in three predominant families (Enterobacteriaceae, Spiroplasmataceae, and Enterococcaceae). The results indicate that PS biodegradability may be ubiquitous within the Tenebrio genus which could provide a bioresource for plastic waste biodegradation.

Anaerobic digestion of Taihu blue algae was tested in laboratory scale, continuous feed digesters (hydraulic retention time 10 days) at 35°C and various organic loading rates (OLR). The methane production and biomass digestion performed well at OLR below 4.00 gVSL(-1)d(-1) but deteriorated as OLR increased due to the increased ammonia concentration, causing inhibition mainly to acetate and propionate degradation. Supplementing corn straw as co-feedstock significantly improved the digestion performance. The optimal C/N ratio for the co-digestion was 20:1 at OLR of 6.00 gVSL(-1) d(-1). Methane yield of 234 mL CH4 gVS(-1) and methane productivity of 1404 mL CH4 L(-1) d(-1) were achieved with solid removal of 63%. Compared with the algae alone, the methane productivity was increased by 46% with less accumulation of ammonia and fatty acids. The reactor rate-limiting step was acetate and propionate degradation., (Copyright © 2013 Elsevier Ltd. All rights reserved.)

Hydrogen gas production from cellulose was investigated using an integrated hydrogen production process consisting of a dark fermentation reactor and microbial fuel cells (MFCs) as power sources for a microbial electrolysis cell (MEC). Two MFCs (each 25 mL) connected in series to an MEC (72 mL) produced a maximum of 0.43 V using fermentation effluent as a feed, achieving a hydrogen production rate from the MEC of 0.48 m(3) H(2)/m(3)/d (based on the MEC volume), and a yield of 33.2 mmol H(2)/g COD removed in the MEC. The overall hydrogen production for the integrated system (fermentation, MFC and MEC) was increased by 41% compared with fermentation alone to 14.3 mmol H(2)/g cellulose, with a total hydrogen production rate of 0.24 m(3) H(2)/m(3)/d and an overall energy recovery efficiency of 23% (based on cellulose removed) without the need for any external electrical energy input., (Copyright © 2010 Elsevier Ltd. All rights reserved.)

We investigated the prevalence of peptic ulcer in dyspeptic patients in China to analyze the influence of age, sex, and Helicobacter pylori (H. pylori) infection. The results showed that the prevalence of gastric and duodenal ulcer increased with age. In patients under 60 years old, the prevalence of duodenal and gastric ulcers in females was markedly lower than that in males, especially the prevalence of duodenal ulcer. The prevalence of duodenal ulcer and gastric ulcer in H. pylori-infected patients was markedly higher than in patients without H. pylori infection. In the patients under 60 years old, sex differences were still seen in both H. pylori-positive and H. pylori-negative patients. The prevalence of gastric and duodenal ulcers was markedly increased with age in both H. pylori-positive and H. pylori-negative patients. Multivariate logistic regression analysis showed that age, male sex, and H. pylori infection were three independent risk factors for gastric and duodenal ulcers.