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INTRODUCTION: Perianal fistulising Crohn's disease (pfCD) can be somewhat treatment refractory. Higher infliximab trough levels (TLIs) may improve fistula healing rates; however, it remains unclear whether escalating infliximab therapy to meet higher TLI targets using proactive, or routine, therapeutic drug monitoring (TDM) improves outcomes. This randomised controlled trial aimed to assess whether infliximab therapy targeting higher TLIs guided by proactive TDM improves outcomes compared with standard therapy. METHODS AND ANALYSIS: Patients with active pfCD will be randomised 1:1 to either the proactive TDM arm or standard dosing arm and followed up for 54 weeks. Patients in the proactive TDM arm will have infliximab dosing optimised to target higher TLIs. The targets will be TLI ≥ 25 µg/mL at week 2, ≥ 20 µg/mL at week 6 and ≥ 10 µg/mL during maintenance therapy. The primary objective will be fistula healing at week 32. Secondary objectives will include fistula healing, fistula closure, radiological fistula healing, patient-reported outcomes and economic costs up to 54 weeks. Patients in the standard dosing arm will receive conventional infliximab dosing not guided by TLIs (5 mg/kg at weeks 0, 2 and 6, and 5 mg/kg 8 weekly thereafter). Patients aged 18-80 years with pfCD with single or multiple externally draining complex perianal fistulas who are relatively naïve to infliximab treatment will be included. Patients with diverting ileostomies or colostomies and pregnant or breast feeding will be excluded. Fifty-eight patients per arm will be required to detect a 25% difference in the primary outcome measure, with 138 patients needed to account for an estimated 6.1% primary non-response rate and 10% dropout rate. ETHICS AND DISSEMINATION: Results will be presented in peer-reviewed journals and international conferences. Ethics approval has been granted by the South Western Sydney Local Health District Human Research Ethics Committee in Australia. TRIAL REGISTRATION N

Global greenhouse gas (GHG) emissions can be traced to five economic sectors: energy, industry, buildings, transport and AFOLU (agriculture, forestry and other land uses). In this topical review, we synthesise the literature to explain recent trends in global and regional emissions in each of these sectors. To contextualise our review, we present estimates of GHG emissions trends by sector from 1990 to 2018, describing the major sources of emissions growth, stability and decline across ten global regions. Overall, the literature and data emphasise that progress towards reducing GHG emissions has been limited. The prominent global pattern is a continuation of underlying drivers with few signs of emerging limits to demand, nor of a deep shift towards the delivery of low and zero carbon services across sectors. We observe a moderate decarbonisation of energy systems in Europe and North America, driven by fuel switching and the increasing penetration of renewables. By contrast, in rapidly industrialising regions, fossil-based energy systems have continuously expanded, only very recently slowing down in their growth. Strong demand for materials, floor area, energy services and travel have driven emissions growth in the industry, buildings and transport sectors, particularly in Eastern Asia, Southern Asia and South-East Asia. An expansion of agriculture into carbon-dense tropical forest areas has driven recent increases in AFOLU emissions in Latin America, South-East Asia and Africa. Identifying, understanding, and tackling the most persistent and climate-damaging trends across sectors is a fundamental concern for research and policy as humanity treads deeper into the Anthropocene.

Optical interferometry has been a long-standing setup for characterization of quantum states of light. Both linear and the nonlinear interferences can provide information regarding the light statistics and underlying detail of the light-matter interactions. Here we demonstrate how interferometric detection of nonlinear spectroscopic signals may be used to improve the measurement accuracy of matter susceptibilities. Light-matter interactions change the photon statistics of quantum light, which are encoded in the field correlation functions. Application is made to the Hong-Ou-Mandel two-photon interferometer that reveals entanglement-enhanced resolution that can be achieved with existing optical technology.

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

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

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

Recycling is an essential practice for the successful operation of zero waste cities. It is essential to understand the recyclable waste recycling potential (RWRP). This study quantifies the RWRP of different cities in China. Suzhou, Yangzhou, and Suqian represent high-, middle- and low-income cities, respectively. The RWRP statistics are based on systematic multiple longitudinal tracking field surveys conducted between 2016 and 2019. Obvious RWRP spatio-temporal disparities were observed between inter-city and intra-city. For instance, Suzhou showed a slight increase in high resource value paper; Yangzhou had a slight increase in low resource value paper; and Suqian had a huge increase in no resource value paper and plastic. Additionally, more recyclable organics were generated in the old districts of Suzhou, and they were also predominant in the new districts of Yangzhou. No significant difference was observed in recyclable organics and recyclable material in Suqian. However, recyclable organics is a constant, while recyclable material fluctuates in the case cities. Household consumption structure has a major impact on RWRP. Other factors, such as economic development, urban resident population, consumption preferences, local customs and culture, as well as residential lifestyles also affect RWRP. This study proposes three policies: 1) to establish flexible and carefully planned recycling strategies, 2) to develop the distribution market of composting products, and 3) to incorporate economic and demographic initiatives to develop a workable recycling policy that can lead to zero waste implementation in the future. The zero waste concept was further assessed by the authors’ review of 69 cities worldwide based on previous research. We compared past results with the three featured cities in this study and 35 other Chinese cities, thereby presenting a world view of zero waste potential. It is anticipated that representative cities’ RWRP quantification and policy imple

Climate warming is known to impact ecosystem composition and functioning. However, it remains largely unclear how soil microbial communities respond to long-term, moderate warming. In this study, we used Illumina sequencing and microarrays (GeoChip 5.0) to analyze taxonomic and functional gene compositions of the soil microbial community after 14 years of warming (at 0.8–1.0 °C for 10 years and then 1.5–2.0 °C for 4 years) in a Californian grassland. Long-term warming had no detectable effect on the taxonomic composition of soil bacterial community, nor on any plant or abiotic soil variables. In contrast, functional gene compositions differed between warming and control for bacterial, archaeal, and fungal communities. Functional genes associated with labile carbon (C) degradation increased in relative abundance in the warming treatment, whereas those associated with recalcitrant C degradation decreased. A number of functional genes associated with nitrogen (N) cycling (e.g., denitrifying genes encoding nitrate-, nitrite-, and nitrous oxidereductases) decreased, whereas nifH gene encoding nitrogenase increased in the warming treatment. These results suggest that microbial functional potentials are more sensitive to long-term moderate warming than the taxonomic composition of microbial community.

Fine particulate matter (PM2.5, particles with a mass median aerodynamic diameter of less than 2.5 micrometers) in the atmosphere is associated with severe negative impacts on human health, and the gases sulfur dioxide, nitrogen oxides, and ammonia are the main PM2.5 precursors. However, their contribution to global health impacts has not yet been analyzed. Here, we show that nitrogen accounted for 39% of global PM2.5 exposure in 2013, increasing from 30% in 1990 with rising reactive nitrogen emissions and successful controls on sulfur dioxide. Nitrogen emissions to air caused an estimated 23.3 million years of life lost in 2013, corresponding to an annual welfare loss of 420 billion United States dollars for premature death. The marginal abatement cost of ammonia emission is only 10% that of nitrogen oxides emission globally, highlighting the priority for ammonia reduction.

Global greenhouse gas emissions can be traced to five economic sectors: energy, industry, buildings, transport and AFOLU (agriculture, forestry and other land uses). In this topical review we synthesize the literature to explain recent trends in global and regional emissions in each of these sectors. To contextualise our review, we present estimates of greenhouse gas emissions trends by sector from 1990 to 2018, describing the major sources of emissions growth, stability and decline across ten global regions. Both the literature and data emphasize limited progress towards reducing greenhouse gas emissions. The prominent global pattern is a continuation of underlying drivers with few signs of emerging limits to demand, nor of a deep shift towards the delivery of low and zero carbon services across sectors. We observe a moderate decarbonisation of energy systems in Europe and North America, driven by fuel switching and the increasing penetration of renewables. By contrast, in rapidly industrialising regions, fossil-based energy systems have continuously expanded, only very recently slowing down in their growth. Strong demand for materials, floor area, energy services and travel have driven emissions growth in the industry, buildings and transport sectors, particularly in Eastern Asia, Southern Asia and South-East Asia. An expansion of agriculture into carbon-dense tropical forest areas has driven recent increases in AFOLU emissions in Latin America, South-East Asia and Africa. Identifying, understanding, and tackling the most persistent and climate-damaging trends across sectors is a fundamental concern for research and policy as humanity treads deeper into the Anthropocene.

To feed an increasingly affluent population, reactive nitrogen (Nr) inputs to China's lands and waters have substantially increased over the past century. Today, China's Nr emissions account for over one third of global total emissions, leading to serious environmental pollution and health damages. Quantifying the spatial variability of Nr inputs is crucial for the identification of intervention points to mitigate Nr pollution, which, however, is not well known. Here, we present a database describing Nr inputs to China for the year 2017 with a 1 km × 1 km resolution, considering land use and Nr sources, compiled by using the CHANS model. Results show that the North China Plain, the Sichuan Basin and the Middle-Lower Yangtze River Plain are hotspots of Nr inputs, where per hectare Nr input is an order of magnitude higher than that in other regions. Cropland and surface water bodies receive much higher Nr inputs than other land use types. This unique database will provide basic data for research on environmental health and global change modelling.

Mitigating agricultural ammonia (NH3) emissions in China is urgently needed to avoid further damage to human and ecosystem health. Effective and feasible mitigation strategies hinge on integrated knowledge of the mitigation potential of NH3 emissions and the associated economic costs and societal benefits. Here we present a comprehensive analysis of marginal abatement costs and societal benefits for NH3 mitigation in China. The technical mitigation potential of agricultural NH3 emissions is 38–67% (4.0–7.1 Tg N) with implementation costs estimated at US$ 6–11 billion. These costs are much lower than estimates of the overall societal benefits at US$ 18–42 billion. Avoiding unnecessary fertilizer use and protein-rich animal feed could provide 30% of this mitigation potential without additional abatement costs or decreases in agricultural productivity. Optimizing human diets with less animal-derived products offers further potential for NH3 reduction of 12% by 2050.

Plastic pollution is a global concern given its prevalence in aquatic and terrestrial ecosystems. Studies have been conducted on the distribution and impact of plastic pollution in marine ecosystems, but little is known on terrestrial ecosystems. Plastic mulch has been widely used to increase crop yields worldwide, yet the impact of plastic residues in cropland soils to soil health and crop production in the long term remained unclear. In this paper, using a global meta-analysis, we found that the use of plastic mulch can indeed increase crop yields on average by 25%-42% in the immediate season due to the increase of soil temperature (+8%) and moisture (+17%). However, the unabated accumulation of film residues in the field negatively impacts its physicochemical properties linked to healthy soil and threatens food production in the long term. It has multiple negative impacts on plant growth including crop yield (at the mean rate of -3% for every additional 100 kg/ha of film residue), plant height (-2%) and root weight (-5%), and soil properties including soil water evaporation capacity (-2%), soil water infiltration rate (-8%), soil organic matter (-0.8%) and soil available phosphorus (-5%) based on meta-regression. Using a nationwide field survey of China, the largest user of plastic mulch worldwide, we found that plastic residue accumulation in cropland soils has reached 550,800 tonnes, with an estimated 6%-10% reduction in cotton yield in some polluted sites based on current level of plastic residue content. Immediate actions should be taken to ensure the recovery of plastic film mulch and limit further increase in film residue loading to maintain the sustainability of these croplands.

© 2013 IEEE. The booming of edge computing enables and reshapes this big data era. However, privacy issues arise because increasing volume of data are published per second while the edge devices can only provide limited computing and storage resources. In addition, this has been aggravated by new emerging features of edge computing, such as decentralized and hierarchical infrastructure, mobility, and content-Aware applications. Although some existing privacy preserving methods are extended to this domain, the privacy issues of data dissemination between multiple edge nodes and end users is barely studied. Motivated by this, we propose a dynamic customizable privacy-preserving model based on Markov decision process to obtain the optimized trade-off between customizable privacy protection and data utility. We start with establishing a game model between users and adversaries based on a QoS-based payoff function. A modified reinforcement learning algorithm is deployed to derive the exclusive Nash Equilibrium. Furthermore, the model can achieve fast convergence by the reduction of cardinality from n to 2. Extensive experimental results confirm the significance of the proposed model comparing to the existing work both in terms of effectiveness and feasibility.