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With the rapid economic development of China's coastal areas and the growth of industry and population, the problem of heavy metal contamination in estuarine waters is increasing in sensitivity and seriousness. In order to accurately and quantitatively describe the current status of heavy metal contamination and identify sensitive aquatic organisms with high ecological risks, five heavy metals in eight estuaries of the Pearl River were monitored at monthly intervals from January to December in 2020, and the ecological risks of aquatic organisms induced by heavy metals were evaluated using Risk quotients (RQ) and species sensitivity distributions (SSD) methods. The results showed that the concentrations of As, Cu, Pb, Hg and Zn in estuaries of the Pearl River were (0.65–9.25) μg/L, (0.07–11.57) μg/L, (0.05–9.09) μg/L, (< 0.40) μg/L and (0.67–86.12) μg/L, respectively. With the exception of Hg in Jiaomen water, the other heavy metals in each sampling site met or exceed the water quality standard of Grade II. The aquatic ecological risks of As, Pb and Hg were generally low in the waters of the Pearl River estuary, but individual aquatic organisms are subject to elevated ecological risks due to Cu and Zn. The content of Zn has a lethal effect on the crustaceans Temora Stylifera , and the content of Cu has a serious impact on the mollusks Corbicula Fluminea and has a certain impact on the crustaceans Corophium sp. and the fish Sparus aurata . Heavy metal levels and joint ecological risks (msPAF) in the Humen, Jiaomen, Hongqimen, and Hengmen estuaries were slightly higher than in other estuaries, and the Yamen estuary had the lowest contration of heavy metals and ecological risk. Research findings can serve as a basis for formulating water quality standards for heavy metals and for protecting aquatic biodiversity in the Pearl River Estuary.

Using panel data of 30 provinces and regions in Mainland China (excluding Tibet) from 2006 to 2016, the Spatial Durbin Model was employed for the empirical research, and the spatial impact of fiscal decentralization and environmental decentralization on regional carbon emissions were analyzed from the perspective of promotion pressure of officials. The empirical study concludes: ① Fiscal decentralization, both within the region and in its neighborhood, will contribute to carbon emissions in the region; ② Environmental decentralization will help reduce carbon emissions, while environmental decentralization in neighboring regions will increase carbon emissions in the region; ③ The promotion pressure of officials plays a positive role in moderating the impact of fiscal decentralization on carbon emissions, and at the same time weakens the suppression of carbon emissions by environmental decentralization; ④ From a regional point of view, there is a positive relationship between fiscal decentralization and carbon emissions in various regions; but environmental decentralization has obvious spatial heterogeneity. The research suggests that reducing the degree of local fiscal decentralization, investment in major infrastructure projects involving high carbon emissions should be relatively centralized; appropriately increase the environmental management authority of local environmental protection agencies, fully use the advantages of local environmental protection departments to protect the environment according to local conditions; gradually improve the assessment system for local officials, moderately reduce the proportion of fiscal revenue and GDP assessment in areas with fragile ecological environment, and increase incentives for ecological performance assessment, put the development of low-carbon economy into practice.

Non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disease. The global burden of NAFLD is increasing. This study used the Global Burden of Disease (GBD) 2021 study data to assess the burden and development trends of NAFLD from 1990 to 2021. The incidence, prevalence, death and disability-adjusted life years (DALYs) rates of NAFLD in geographic populations worldwide from 1990 to 2021 were extracted from the GBD 2021 study data. The global temporal trend of NAFLD from 1990 to 2021 was evaluated using estimated annual percentage change and age-standardized rate. The Bayesian age-period-cohort model was used to predict NAFLD burden future trends to 2035. The global age standardized incidence rate (ASIR) of NAFLD among the all-age population increased by 25% and the age standardized prevalence rate (ASPR) increased by 24%. The age standardized mortality rate (ASMR) and age standardized DALYs rate (ASDR) were relatively stable. Countries with middle socio-demographic index (SDI) had the highest ASIR and ASPR from 1990 to 2021, high-middle SDI and high SDI had the lowest ASMR and ASDR. North Africa and Middle East had the highest ASIR and ASPR in 2021, ASIR increased at the greatest rate in East Asia and Western Europe, ASPR increased at the greatest rate in Western Europe. In 2021, the highest number of incidence cases and incidence rates were in 20-24 years group, reflecting a tendency towards a younger onset of NAFLD. The global burden of NAFLD has risen steadily from 1990 to 2021, and projections to 2035, placing enormous pressure on society. It is necessary to implement measures targeting risk factors such as high fasting plasma glucose and tobacco, including improving lifestyle, adjusting diet, and applying drug intervention.

The reduced natural waters and the large amount of wastewater produced by textile industry necessitate an effective water reuse treatment. In this study, a combined two-stage water reuse treatment was established to enhance the quality and recovery rate of reused water. The primary treatment incorporated a flocculation and sedimentation system, two sand filtration units, an ozonation unit, an ultrafiltration (UF) system, and a reverse osmosis (RO) system. The second treatment included an ozonation unit, a sand filtration unit, and UF and RO systems. The color removal rate increased with the increasing ozone dosage, and the relational expression between the ozone dosage and color removal rate was fitted. Ozonation greatly reduced the color by 92.59 and 97.27 times during the primary and second ozonation stages, respectively. RO had the highest removal rate. The combined processes showed good performance in water reuse treatment. The treated, reused water satisfied the reuse standard and surpassed the drinking water standard rates for chemical oxygen consumption (CODcr), color, NH3-N, hardness, Cl−, SO42−, turbidity, Fe3+, and Cu2+. The operating cost of reuse water treatment was approximately 0.44 USD·m−3.

Objective: To analyze and compare the incidence of adverse events (AEs) associated with different administration routes of colistin, with the aim of providing a reference for its safe and effective clinical use. Methods: Adverse event (AE) reports related to colistin were retrieved from the FDA Adverse Event Reporting System (FAERS) database. The reporting trends were analyzed, and the Reporting Odds Ratio (ROR) and Proportional Reporting Ratio (PRR) for colistin-associated AEs were calculated. A comparative analysis was conducted to examine the occurrence of AEs under different administration routes of colistin. Results: A total of 13,043 AE reports were extracted from the FAERS database. Further analysis of 176 key AEs associated with colistin indicated a significant increase in the number of reports after 2021. The year and country of the reports showed heterogeneity across different administration routes. Intravenous (IV) administration of colistin was associated with the highest proportion of AEs, and heterogeneity was also observed in the types of AEs reported for inhaled and oral (PO) administration routes. Conclusion: Compared to inhaled and PO administration routes, IV administration of colistin is more likely to result in AEs such as nephrotoxicity and drug ineffectiveness. Additionally, there are significant differences in the types of AEs associated with colistin across different administration routes.

Stroke is a major global public - health problem. It is a cerebrovascular disease with sudden onset, high prevalence, and high rates of death and disability. Ondansetron (a 5 - HT3 receptor antagonist) an antiemetic, has recently been indicated in studies to have the ability to influence neurotransmitter imbalance, towardly have more effective against vomiting in stroke patients. However, its impact on stroke patients' clinical outcomes remains unclear. This study uses real - world data to evaluate ondansetron's effect on stroke patients' clinical outcomes. Findings could lead to new treatments and better outcomes. This study was a retrospective cohort analysis involving adult patients who experienced a stroke, categorized into two groups: the ondansetron group and the non-ondansetron group. To ensure the baseline characteristics were balanced, propensity score matching (PSM) was utilized. The mortality rate was assessed using multivariable Cox regression models along with Kaplan-Meier survival curves. Additionally, subgroup analyses were performed to examine the consistency of the findings. A total of 5,297 stroke patients were included in this study, among which 3,926 stroke patients received ondansetron treatment on the first day of admission to the intensive care unit (ICU), and 1,371 did not receive this drug treatment. After PSM, 2,628 patients were paired. The analysis results showed that the use of ondansetron on the first day of admission to the ICU significantly reduced the 30-day mortality rate (hazard ratio [HR] 0.73, 95% confidence interval [CI]: 0.59-0.92, P < 0.05). Meanwhile, the 60-day mortality rate also decreased significantly (HR 0.73, 95% CI: 0.60-0.90, P < 0.05). Treatment using ondansetron is linked to an enhancement in the overall prognosis for stroke patients. Those who are administered ondansetron on the initial day of their ICU admission experience a notably lower mortality rate. The results of this research provide a compelling and valuable addition to the conventional stroke treatment protocol, holding considerable clinical importance and scientific research relevance.

In response to global warming, China has formulated the “double carbon” strategic goals of peaking carbon dioxide emissions before 2030 and reaching carbon neutrality before 2060. The problem of rural carbon emissions is often ignored due to underdeveloped industries and services. In this paper, the carbon emission pathways in the rural areas of Guangdong Province are investigated. Since energy consumption is the main source of carbon emissions, the factor analysis was used to analyze the main factors affecting rural household energy consumption and agricultural production energy consumption. Multiple linear regression was conducted to predict the rural energy consumption demand in Guangdong. Furthermore, the current situation and development trend of rural energy supply, demand and consumption structure, and the potential of renewable energy development were considered to predict carbon emissions in the rural areas of Guangdong. Moreover, the carbon emission pathways in the rural areas of Guangdong were discussed under two scenarios: the base scenario and the radical model.

Cutaneous adverse events (CAEs) after treatment with BRAF and MEK inhibitors in patients with melanoma remain incompletely characterized. To determine the association of BRAF and MEK inhibitor treatment with CAEs in patients with melanoma compared with BRAF inhibitor alone. PubMed, Cochrane, Embase and Web of Science were systematically searched for BRAF and MEK inhibitors from database inception through 10 May 2024. Randomized clinical trials reporting on CAEs in patients with melanoma being treated with BRAF and MEK inhibitors compared with patients with melanoma being treated with BRAF inhibitor monotherapy were selected. Pooled Risk ratios (RRs) and 95% CIs were determined using random-effects analyses. The selected end points were alopecia, cutaneous squamous-cell carcinoma, hyperkeratosis, keratoacanthoma, palmoplantar erythrodysaesthesia syndrome, palmoplantar keratoderma, rash, photosensitivity reaction, and skin papilloma. All-grade and high-grade (≥3) CAEs were recorded. Comparing with BRAF and MEK inhibitors, treatment with BRAF inhibitors alone was associated with an increased risk of rash (RR, 0.73; 95% CI, 0.54-0.99; = 0.039; I = 88%), alopecia (RR, 0.28; 95% CI, 0.20-0.41; P < 0.001; I = 76%), hyperkeratosis (RR, 0.30; 95% CI, 0.22-0.41; P < 0.001; I = 56%), palmoplantar erythrodysaesthesia syndrome (RR, 0.21; 95% CI, 0.10-0.47; P < 0.001; I = 81%), palmoplantar keratoderma (RR, 0.39; 95% CI, 0.26-0.57; P < 0.001; I = 29%), Skin papilloma (RR, 0.25; 95% CI, 0.12-0.52; P < 0.001; I = 77%), cutaneous squamous-cell carcinoma (RR, 0.21; 95% CI, 0.11-0.42; P < 0.001; I = 50%), and keratoacanthoma (RR, 0.22; 95% CI, 0.12-0.40; P < 0.001; I = 0%). Therapy with BRAF and MEK inhibitors was associated with a lower risk of CAEs, especially rash, alopecia, hyperkeratosis, palmoplantar erythrodysaesthesia syndrome, palmoplantar keratoderma, skin papilloma, cutaneous squamous-cell carcinoma, and keratoacanthoma, compared with BRAF inhibitor alone. The risks of photosensitivity reaction was similar between the assessed groups. The findings may help to balance between beneficial melanoma treatment and cutaneous morbidity and mortality.

The tumor microenvironment (TME) is a crucial driving factor for tumor progression and it can hinder the body’s immune response by altering the metabolic activity of immune cells. Both tumor and immune cells maintain their proliferative characteristics and physiological functions through transporter-mediated regulation of nutrient acquisition and metabolite efflux. Transporters also play an important role in modulating immune responses in the TME. In this review, we outline the metabolic characteristics of the TME and systematically elaborate on the effects of abundant metabolites on immune cell function and transporter expression. We also discuss the mechanism of tumor immune escape due to transporter dysfunction. Finally, we introduce some transporter-targeted antitumor therapeutic strategies, with the aim of providing new insights into the development of antitumor drugs and rational drug usage for clinical cancer therapy.

Rural decentralized domestic wastewater treatment (DDWT) facilities, as an alternative to centralized sewage treatment plants, have been rapidly developed in rural areas worldwide. However, the lack of performance evaluations and operational status assessments of these facilities poses a significant obstacle to advancements in rural domestic wastewater treatment strategies. In the present study, 30 rural DDWT facilities with AO (anoxic/oxic) and AAO (anaerobic/anoxic/oxic) processes were investigated. The results revealed that only two facilities reached the first A-grade discharge standards of China, and twelve facilities met the first B-grade discharge standards for all ten wastewater quality indicators. Low standard-achieving ratios for biochemical oxygen demand (BOD5) (63.3%), total nitrogen (TN) (60.0%), ammonia nitrogen (NH3-N) (63.3%), total phosphorus (TP) (30.0%), suspended solids (SS) (46.7%), and fecal coliforms (FC) (26.7%) were calculated. Thus, it is essential to improve the treatment efficiency for BOD5, TN, NH3-N, TP, SS, and FC for rural wastewater treatment facilities. In addition, the AAO process had a median weighted average removal efficiency of 82.02%, which was better than that of the AO process (72.48%). Minor equipment failure rates, i.e., less than 20%, did not affect the operation of the rural DDWT facilities, since most equipment in the DDWT facilities was backed up. Notably, problems in several areas, e.g., process design, equipment selection, construction, and especially operations, influencing treatment performance should be investigated and proactively addressed. These findings provide specific suggestions for improvements that could benefit the long-term operation and management of rural DDWT facilities.