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This study examines the predictive value of elevated N-terminal-pro brain natriuretic peptide (NT-pro BNP) levels for mortality among patients with end-stage renal disease (ESRD). Data from 768 ESRD patients, excluding those with cancer or lost follow-up, were analyzed using Kaplan–Meier curves and Cox proportional hazards models over three years. Results indicated that patients with very high NT-pro BNP levels had shorter average survival times and a significantly higher risk of mortality (hazard ratio 1.43). Advanced age, ICU admission, and comorbidities like cerebrovascular diseases and chronic obstructive pulmonary disease also contributed to increased mortality risks. Thus, elevated NT-pro BNP is an independent risk factor for mortality in ESRD patients.

The COVID-19 pandemic has had a profound impact on human society. The isolation of SARS-CoV-2 from patients' feces on human cell line raised concerns of possible transmission through human feces including exposure to aerosols generated by toilet flushing and through the indoor drainage system. Currently, routes of transmission, other than the close contact droplet transmission, are still not well understood. A quantitative microbial risk assessment was conducted to estimate the health risks associated with two aerosol exposure scenarios: 1) toilet flushing, and 2) faulty connection of a floor drain with the building's main sewer pipe. SARS-CoV-2 data were collected from the emerging literature. The infectivity of the virus in feces was estimated based on a range of assumption between viral genome equivalence and infectious unit. The human exposure dose was calculated using Monte Carlo simulation of viral concentrations in aerosols under each scenario and human breathing rates. The probability of COVID-19 illness was generated using the dose-response model for SARS-CoV-1, a close relative of SARS-CoV-2, that was responsible for the SARS outbreak in 2003. The results indicate the median risks of developing COVID-19 for a single day exposure is 1.11 × 10-10 and 3.52 × 10-11 for toilet flushing and faulty drain scenario, respectively. The worst case scenario predicted the high end of COVID-19 risk for the toilet flushing scenario was 5.78 × 10-4 (at 95th percentile). The infectious viral loads in human feces are the most sensitive input parameter and contribute significantly to model uncertainty.

Pig farmers in Taiwan tend to overdose copper (Cu) and zinc (Zn) in animal feeds to ensure pig health. The application of Cu- or Zn-rich livestock compost to fields can result in high Cu/Zn residues in surface soil and violate limitations for zinc and copper in land applications. This study aims to extract Cu and Zn from sludge using organic acid or H2O2/organic acids. The livestock bio-sludge was dried and treated with different concentrations of acetic acid (1N, 2N, and 4N). The acid-extracted sludge was then treated with or without adding H2O2 during different periods (4, 24, and 48 h) to investigate the efficiency of acid extraction of Cu and Zn. The supernatant of the acid-extracted product was separated from the residues through centrifugation. Experimental results showed that the treatment set of dried bio-sludge with 2% H2O2 significantly promoted the removal efficiency of Cu and Zn from the bio-sludge (p < 0.01). The best removal efficiency of Cu and Zn from the bio-sludge was 40% and 70%, respectively, using 4N acetic acid in the 48 h group. The study shows a green method for extracting Cu and Zn from livestock sludge, enhancing the sustainability of intensive livestock farming.

Objective To summarize the clinical features of cerebral hyperperfusion syndrome (CHS) after cerebrovascular reconstruction for moyamoya disease (MMD), and to screen its related predictive factors. Methods The clinical data of 50 patients with MMD who underwent cerebrovascular reconstruction in the Second Affiliated Hospital of Nanchang University from June 2017 to December 2018 were collected, including sex, age, history of hypertension, disease type, preoperative Suzuki stage, surgery side, mean arterial pressure (MAP) before and after surgery, time from surgery to onset of CHS, clinical manifestations, duration of symptoms, and postoperative hospital stay. Univariate and multivariate Logistic regression analysis were used to screen the related predictors of CHS after cerebrovascular reconstruction for MMD. Spearman rank correlation analysis to explore the correlation between time from surgery to symptom onset and duration of symptoms. Results Among the 50 patients, 13 patients (26%) developed CHS after surgery. Logistic regression analysis showed that over age (OR=0.867, 95%CI: 0.790-0.953; P=0.003) and left⁃side surgery (OR=0.158, 95%CI: 0.029-0.863; P=0.033) was predictor of postoperative CHS in patients with MMD. Spearman rank correlation analysis showed that the time from surgery to symptom onset was negatively correlated with duration of symptom in patients with CHS (rs=⁃0.925, P=0.000). Conclusions CHS is a self⁃limiting complication after cerebrovascular reconstruction for MMD. Higher age and left⁃sided surgery are clinical predictive factors of postoperative CHS.

At present, DC grid fault current analyses are usually based on numerical analyses and/or simulations. To make fault current analyses more practical and convenient, this study proposes a fast fault current level assessment methodology that is applicable when a symmetrical monopole DC (SMDC) system encounters a pole-to-ground (PTG) fault. To further clarify how PTG faults develop in SMDC systems, fault current analysis is implemented in the frequency domain rather than the time domain. Specifically, we find the key factors that impact the high-frequency domain, as these factors have a high correlation with fault currents in the initial milliseconds. Based on simplified SMDC fault circuits and a high-frequency characteristic analysis, a practical index to assess PTG faults is ultimately proposed. It is proved that the index can be used for various SMDC systems with different topologies. With the proposed method, the topology of a DC grid can be optimized to decrease the fault current level, which can help with the design and construction of practical DC grid projects. [ABSTRACT FROM AUTHOR]

The P301L mutation in tau protein is a prevalent pathogenic mutation associated with neurodegenerative frontotemporal dementia, FTD. The mechanism by which P301L triggers or facilitates neurodegeneration at the molecular level remains unclear. In this work, we examined the effect of the P301L mutation on the biochemical and biological characteristics of pathologically relevant hyperphosphorylated tau. Hyperphosphorylated P301L tau forms cytotoxic aggregates more efficiently than hyperphosphorylated wildtype tau or unphosphorylated P301L tau in vitro. Mechanistic studies establish that hyperphosphorylated P301L tau exacerbates endoplasmic reticulum (ER) stress-associated gene upregulation in a neuroblastoma cell line when compared to wildtype hyperphosphorylated tau treatment. Furthermore, the microtubule cytoskeleton is severely disrupted following hyperphosphorylated P301L tau treatment. A hyperphosphorylated tau aggregation inhibitor, apomorphine, also inhibits the harmful effects caused by P301L hyperphosphorylated tau. In short, the P301L single mutation within the core repeat domain of tau renders the underlying hyperphosphorylated tau more potent in eliciting ER stress and cytoskeleton damage. However, the P301L mutation alone, without hyperphosphorylation, is not sufficient to cause these phenotypes. Understanding the conditions and mechanisms whereby selective mutations aggravate the pathogenic activities of tau can provide pivotal clues on novel strategies for drug development for frontotemporal dementia and other related neurodegenerative tauopathies, including Alzheimer’s disease.

Patients with chronic stroke often have difficulty opening their hands and performing grasping movements. Several passive hand orthoses for assisting hand rehabilitation have been developed and demonstrated to be clinically effective. However, current devices have several limitations, such as supporting only a single grasping motion and using an abnormal grasping posture. Therefore, this study developed a three-dimensional (3D)-printed multifunctional hand device (3DP-MFHD) to solve these problems and evaluated the feasibility of using the device during home rehabilitation. Six participants were enrolled, and each of them was provided with the 3DP-MFHD. In addition to a task-oriented training course, the participants were asked to train at home for 4 weeks for at least 5 days per week and 40 min per day. The results revealed that hand grip force increased by 36.1%, lateral pinch force increased by 17.6%, and the Action Research Arm Test score increased by 54.1%. The 3DP-MFHD is a promising means to facilitate hand rehabilitation and improve hand strength and function in patients with chronic stroke. The 3DP-MFHD can be used as part of home rehabilitation.

Recycle domestic greywater for on-site non-potable uses can lessen the demand on potable water and the burden on wastewater treatment plants. However, lack of studies to assess health risk associated with such practices has hindered their popularity. A Quantitative Microbial Risk Assessment was conducted to estimate the public health risks for two greywater reuse scenarios: toilet flushing and food-crop irrigation. Household greywater quality from three sources (bathroom, laundry and kitchen) was analyzed. Mathematical exposure rates of different scenarios were established based on human behavior using Monte-Carlo simulation. The results showed that, greywater from all three household sources could be safely used for toilet flushing after a simple treatment of microfiltration. The median range of annual infection risk was 8.8 × 10-15-8.3 × 10-11 per-person-per-year (pppy); and the median range of disease burden was 7.6 × 10-19-7.3 × 10-15 disability-adjusted life years (DALYs) pppy. In food-crop irrigation scenario, the annual infection risks and disease burdens of treated greywater from bathroom and laundry (2.8 × 10-8, 4.9 × 10-8 pppy; 2.3 × 10-12-4.2 × 10-12 DALYs pppy) were within the acceptable levels of U.S. EPA annual infection risk (≤10-4 pppy) and WHO disease burden (≤10-6 DALYs pppy) benchmarks, while kitchen greywater was not suitable for food-crop irrigation (4.9 × 10-6 pppy; 4.3 × 10-10 DALYs pppy) based on these benchmarks. The model uncertainties were discussed, which suggests that a more accurate risk estimation requires improvements on data collection and model refinement.