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Phosphorus is an indispensable element, while the existing phosphate rock resources are not enough to maintain the long-term demand of modern agricultural development. To ensure the sustainability of economic and social, it is necessary and urgent to seek the alternative phosphorus source of phosphate rock. In this study, calcined clam shell powder (CSP) was firstly used as a modifier and mixed with sewage sludge (SS) for co-pyrolysis to obtain sludge-derived pyrochars containing a large amount of bioavailable phosphorus. The effect of different temperatures (500, 600, 700, 800 °C) and dosages (0%, 10%, 20%, 30%) on the change in the form of phosphorus during the pyrolysis process were investigated. With the increase of temperature and the addition of CSP, the orthophosphate (Ortho-P) increased from 63.69% in the original SS to nearly 100%. Furthermore, the main phase of inorganic phosphorus (IP) changed, mainly in the form of apatite phosphorus (hydroxyapatite increased from 8.88% to 35.97%), and the concentration of easy-to-lose phosphorus reduced to 0.11 mg/g. After co-pyrolysis of SS with CSP, the passivation situation of heavy metals (HMs), such as Zn, Mn, Cr, Cu, Cd and Pb was significantly improved, thus reducing the potential environmental risk. The planting experiment proved that the sludge-derived pyrochars obtained by adding 20% CSP at 800 °C promoted the germination of seeds and the growth of seedlings. Consequently, the product of SS co-pyrolysis with CSP could be used as an excellently bioavailable and environmentally friendly phosphate fertilizer for agricultural production.

Prefabrication is a promising method for minimizing construction waste since it is conducted in a controlled environment. This paper develops a simulation model for quantitatively evaluating the potential of prefabrication on construction waste reduction by considering interaction behaviors among factors influencing the application of prefabrication and construction waste reduction during the design stage. The theory of planned behavior is applied to determine the system boundary, and a system dynamic model is applied for establishing the simulation model. A case project in Anhui, China, is selected for demonstrating the established model. Results show that the (1) Application of prefabrication method contributes to construction waste reduction by reducing material wastes and reworking due to design changes. (2) Impacts of prefabrication method on concrete waste reduction is the most significant. (3) Increasing investment on designers' professional training and strengthening policies is two efficient strategies to make full use of the potential of the prefabrication method on construction waste reduction during the design stage. The developed model can offer designers as well as policymakers with references for applying prefabrication method for construction waste reduction by comparing outcomes under various scenarios with different strategies and policies ahead of implementation.

Malignant soft tissue tumors (STTs) are often mistaken for benign tumors, leading to inappropriate treatment including unplanned resection. Elastography, as a non-invasive measurement of tissue mechanical properties, makes use of the different soft tissue elasticity in diverse pathologies to generate information that can be used for diagnostic purposes. Elastography for STTs carries important information that is helpful in differentiating malignant and benign masses. The present study was undertaken to systematically review existing trials on the reliability of elastography in assessment of malignant STTs. A comprehensive literature exploration of the PubMed, EMbase and China National Knowledge Infrastructure databases was conducted for published articles involving the application of elastography in distinguishing malignant STTs. The diagnostic performance of elastography was evaluated with pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio and area under the summary receiver operating characteristic curve. Publication bias was also evaluated. This meta-analysis enrolled 18 eligible studies with a total of 1420 patients. The overall number of reported STTs was 1569, of which 478 were classified as positive and 1091 as negative at elastography. The pooled sensitivity, specificity, positive likelihood ratio and negative likelihood ratio of elastography were 0.82 (95% confidence interval: 0.74-0.87), 0.80 (0.71-0.86), 3.99 (2.65-6.01) and 0.23 (0.15-0.34), respectively. The diagnostic odds ratio and area under the curve were 17.36 (8.28-36.38) and 0.88 (0.84-0.90), respectively (Glas et al. 2003). The results of meta-regression analysis revealed that the total number of patients and prevalence of malignant STTs were significant factors in sensitivity, and the year of publication, total number of patients and index test were significant factors affecting study heterogeneity for specificity (p0.05). No significant publication bias was observed. This meta-analysis indicates that ultrasound elastography achieves relatively good performance in discriminating between malignant and benign STTs. Nevertheless, further research is needed to verify this finding.

Background Although plain radiology is the primary method for assessing joint space width (JSW), it has poor sensitivity to change over time in regards to determining longitudinal progression. We, therefore, developed a new ultrasound (US) measurement method of knee JSW and aimed to provide a monitoring method for the change of JSW in the future. Methods A multicenter study was promoted by the Professional Committee of Musculoskeletal Ultrasound, the Ultrasound Society, and the Chinese Medical Doctor Association. US study of knee specimens determined the landmarks for ultrasonic measurement of knee JSW. The US of 1,272 participants from 27 centers was performed to discuss the feasibility and possible influencing factors of knee JSW. The landmarks for US measurement of knee JS, the inflection point of medial femoral epicondyle and the proximal end of the tibia, were determined. Results The mean knee JSW1 (medial knee JSW) was 8.57±1.95 mm in females and 9.52±2.31 mm in males. The mean knee JSW2 (the near medial knee JSW) was 9.07±2.24 mm in females and 10.17±2.35 mm in males. The JSW values of males were significantly higher than those of females, with a statistical difference. JSW values were negatively correlated with age and body mass index (BMI) to different degrees and positively correlated with height. Conclusions The novel US measurement method can be used to measure knee JSW.

Objective. A survey was conducted to analyze the epidemiological differences in ideal cardiovascular health (CVH) behaviors and factors after delivery in females with and without gestational hypertension (GH) and evaluate the influence of GH on cardiovascular health behaviors and factors. Methods. The present study adopted a cross-sectional design. A total of 4620 female workers who gave birth between 1976 and 2012 and received the annual health examination (2012 to 2013) at hospitals belonging to the Kailuan Medical Group were recruited. These subjects were divided into the GH group and non-GH (NGH) group, depending on whether they were combined with GH or not at delivery. The epidemiological differences in CVH behaviors and factors were compared between the two groups. Result. In both groups, the percentage of subjects achieving ideal smoking status was the highest, while the percentage of subjects achieving an ideal level of physical activity was the lowest among all behaviors and factors. Compared with the NGH group, the percentages of subjects achieving each of the seven ideal CVH metrics decreased in the GH group. The percentages of subjects achieving ideal body mass index (BMI), blood pressure, blood glucose level, and cholesterol level were significantly lower in the GH group than in the NGH group ( P < 0.05 ). The percentage of subjects with an ideal level of physical activity was higher in the NGH group than in the GH group. After stratification by age, the percentages of patients achieving ideal BMI, blood pressure, and blood glucose decreased with age regardless of the history of GH ( P < 0.05 ). In the younger age group, the percentage of subjects with GH achieving ideal body mass index was significantly lower than that of those without GH. Conclusion. Compared with females without GH, those with GH had higher BMI, blood pressure, blood glucose level, and cholesterol level among the seven CVH metrics surveyed.

Background: The COVID-19 pandemic has highlighted the need for targeted local interventions given substantial heterogeneity within cities and counties. Publicly available case data are typically aggregated to the city or county level to protect patient privacy, but more granular data are necessary to identify and act upon community-level risk factors that can change over time. Methods: Individual COVID-19 case and mortality data from Massachusetts were geocoded to residential addresses and aggregated into two time periods: “Phase 1” (March–June 2020) and “Phase 2” (September 2020–February 2021). Institutional cases associated with long-term care facilities, prisons, or homeless shelters were identified using address data and modeled separately. Census tract sociodemographic and occupational predictors were drawn from the 2015-2019 American Community Survey. We used mixed-effects negative binomial regression to estimate incidence rate ratios (IRRs), accounting for town-level spatial autocorrelation. Results: Case incidence was elevated in census tracts with higher proportions of Black and Latinx residents, with larger associations in Phase 1 than Phase 2. Case incidence associated with proportion of essential workers was similarly elevated in both Phases. Mortality IRRs had differing patterns from case IRRs, decreasing less substantially between Phases for Black and Latinx populations and increasing between Phases for proportion of essential workers. Mortality models excluding institutional cases yielded stronger associations for age, race/ethnicity, and essential worker status. Conclusions: Geocoded home address data can allow for nuanced analyses of community disease patterns, identification of high-risk subgroups, and exclusion of institutional cases to comprehensively reflect community risk.

There exist inconsistent findings about the relation between cosleeping and sleep problems in children. We conducted a meta-analysis to assess these relations and compared their cross-cultural differences. We searched the EMBASE, PsycARTICLES, PsycINFO, PubMed, ScienceDirect, and Web of Science databases. A random effect model was used, and subgroup analysis by culture group was performed. By including fifteen qualified studies, this meta-analysis revealed that increased bedtime resistance, sleep anxiety, night waking, and parasomnia were shown from children cosleeping with others. Cosleeping children from the West performed more bedtime resistance and night waking, while those children from the East showed more parasomnia. In general, cosleeping is associated with several sleep disturbances for children, including bedtime resistance, sleep anxiety, night waking, and parasomnia, and the cultural differences do exist between the West and East. The findings provide initial evidence of the influence of cosleeping on children’s sleep problems. More studies on the related topic are needed from diverse cultures in the future.

This study was aimed at evaluating the performance of perfusion patterns and the quantitative parameters of contrast-enhanced ultrasound (CEUS) in the detection of soft tissue tumors (STTs) and establishing a US workflow for STTs to improve patient management. Conventional ultrasound (US) and CEUS data were retrospectively collected from 156 soft tissue masses. Six perfusion patterns (P1–P6) were applied for CEUS qualitative analysis. Multivariate logistic regression was used to evaluate the performance of conventional US and qualitative and quantitative CEUS in distinguishing benign and malignant STTs. The malignancy rates of P1–P6 in STTs were 0%, 50.0%, 9.1%, 33.3%, 73.4% and 61.0%, respectively. For "non-P1" STTs, the predictive model combining quantitative CEUS parameters with conventional US features, including margin (odds ratio [OR] = 4.490, p = 0.000), vascular density (OR = 2.307, p = 0.013), 50% wash-out intensity (OR = 1.904, p = 0.032) and 50% wash-out time (OR = 1.031, p = 0.019), performed favorably in predicting malignancy, with an accuracy of 81.0% and an area under the receiver operating characteristic curve of 0.868. Furthermore, a US workflow for the detection of STTs based on conventional US and CEUS was established. CEUS with qualitative and quantitative analyses could be an effective tool for STT diagnosis. The US workflow in this study may improve the management of STT patients.

Background To explore the feasibility to identify malignant musculoskeletal soft tissue tumors using real-time shear wave elastography (rtSWE). Methods One hundred fifteen musculoskeletal soft tissue tumors in 92 consecutive patients were examined using both conventional ultrasonography (US) and rtSWE. For each patient, the rtSWE parameters including maximum elasticity (Emax), mean elasticity (Emean), minimum elasticity (Emin), standard deviation of the elasticity (Esd), and rtSWE image pattern were obtained. Eighty-one histopathologically confirmed tumors from 73 patients were subjected to analysis. Results The 81 lesions included in the study were histopathologically classified as malignant (n = 21) or benign (n = 60). The statistically significant differences between benign and malignant lesions were found in conventional US characters including size, depth, margin, echogenicity, mass texture, and power Doppler signal. Meanwhile, the significant differences were also found in quantitative rtSWE findings including Emax, Emean, Emin, and Esd values and in qualitative rtSWE parameter named rtSWE image pattern. Multivariate analysis showed that infiltrative margin (OR, 4.470), and size (OR, 1.046) were independent predictors for malignancy in US findings, while Esd value (OR, 9.047) was independent predictors for malignancy in quantitative rtSWE parameters. Areas under the ROC curve (Azs) for US features, Esd value, and rtSWE image pattern were 0.851, 0.795, and 0.792, respectively. Conclusions Conventional US and quantitative and qualitative rtSWE parameters are useful for malignancy prediction of musculoskeletal soft tissue tumors. rtSWE can be used to supplement conventional US to diagnose musculoskeletal soft tissue tumors.

As a promising phosphorus source, phosphorus recovery from sewage sludge ash is necessary to ensure sustainable phosphorus cycle and management. To achieve these targets, a novel strategy including phosphorus capture by acid-resistant adsorbent from acid-extract of sewage sludge ash and repeated enrichment in eluent was first proposed in this study. Over 93% of phosphorus was extracted by H2SO4 acidification at pH of 2.0, and a tailored acid-resistant adsorbent recovered almost all the extracted phosphorus in acid-extract of sewage sludge ash. The fitting results of multiple models showed that the rate-limiting step for phosphorus recovery was chemical reaction, and the maximum recovery capacity of acid-resistant adsorbent was 41.7–44.0 mg/g. Characterization results of X-ray photoelectron spectroscopy, Fourier transform infrared spectroscopy and Zeta potential suggested that the recovery mechanism of acid-resistant adsorbent for phosphorus included ligand exchange, inner-sphere complexation and electrostatic attraction. After 8 cycles of recovery-repeated enrichment, the phosphorus in eluent was enriched about 6.7 times. Over 99% of phosphorus in eluent was recovered as struvite by adding external magnesium and ammonium at pH of 8.5. The content of heavy metals in recovered struvite were far below the utilization standard of plant fertilizer, indicating that the phosphorus in sewage sludge ash could be recovered in the form of high-quality phosphorus fertilizer.

In order to illustrate heavy metal ecotoxicology associated with interactions between chemicals and biological systems, we investigated physiological changes (metabolism and behavior response) of zebra fish (Danio rerio) under 48 h Cadmium chloride (CdCl2) exposure using online monitoring technique. The concentrations of CdCl2 were designed as 4.26, 42.6 and 85.2 mg/L, which were 0.1, 1.0, and 2.0 based on toxic unit (TU), respectively. The metabolism was assessed using the oxygen consumption (OC), and the behavior response was analyzed in behavior strength (BS). Significant inhibition of both OC and BS could be observed: OC was 617.39 ± 30.48 mg/kg/h in the control, and it decreased rapidly to 229.07 ± 28.66 mg/kg/h in 2.0 TU treatment. BS changed from 0.76 ± 0.07 (control) to 0.39 ± 0.04 (2.0 TU) with the increase of exposure concentrations. Further results suggested that both factors were related to diurnal variation during 48 h exposure, which could be regarded as circadian rhythms: the average values of OC and BS during photo-phase were significantly higher than both during scoto-phase in CdCl2 treatments (p < 0.05). After integrated analysis, the original values of both OC and BS with wide fluctuation showed a negative linear relationship with CdCl2 concentration. The levels of both OC and BS were positively correlated with CdCl2 (r = 0.93 and p < 0.01). It is suggested that both OC and BS provide an objective ground for CdCl2 stress assessment, and that also could be applied to test the changes of organisms quantitatively in toxic physiology.

JadH is a bifunctional hydoxylase/dehydrase involved in jadomycin biosynthesis; it catalyzes a post-PKS modification reaction to convert 2,3-dehydro-UWM6 to dehydrorabelomycin. To identify the key residues involved in substrate-binding and catalysis, structural modeling and multiple sequence alignments of JadH homologs were performed to predict nine residues at the proximity of substrate. Site-directed mutagenesis of the corresponding residues and in vitro evaluation of the activities of the mutant enzymes, indicate these mutations severely reduced JadH activity. Our results indicate these residues are specifically involved in substrate-binding or catalysis in JadH.

Two component system is a signal transduction system. It typically consists of a sensor histitine kinase and a cognate response regulator (RR) component. The activity of RR is regulated by a phosphorylation dependent mechanism. In recent years, the existence of atypical response regulators (ARRs), which rely on a phosphorylation independent mechanism to regulate their activity, have been recognized. ARRs are involved in the regulation of bacterial growth and development, antibiotic biosynthesis, iron transport, among others. Here we review the recent advances in the understanding of the structure and function of atypical response regulators, by using JadR1, a regulator in jadomycin biosynthesis in Streptomyces, as an example to elucidate the novel mechanism used by ARR to fine-tune its activity.

Oxygenases are common tailoring enzymes involved in the biosynthesis of aromatic polyketides, they are critical determinants of the final structure of aromatic polyketides. Here we review the structures and functions of several classes of oxygenases found in the biosynthetic gene clusters of aromatic polyketides. We used the oxygenases (JadFGH) in jadomycin biosynthesis as examples to elucidate the complex roles these oxygenases play and discussed the future prospects of using oxygenases in combinatorial biosynthesis.