Potential benefits of public-private partnerships to improve the efficiency of urban wastewater treatment.

For emerging economies lacking public budgets, continuous improvement of urban wastewater treatment efficiency (UWTE) requires effective government supervision of wastewater treatment infrastructures (WTIs) and participation of private capital seeking to profit-maximising. However, to what extent this public-private partnership (PPP) model, aimed at a reasonable sharing of benefit and risk, in delivering WTIs can improve the UWTE is unknown. We evaluated the impact of the PPP model on the UWTE by collecting data from 1303 urban wastewater treatment PPP projects in 283 prefecture-level cities in China from 2014 to 2019 and used data envelopment analysis and Tobit regression model. The UWTE was significantly higher in prefecture-level cities that introduced the PPP model in the construction and operation of WTIs, particularly those with a feasibility gap subsidy, competitive procurement, privatised operation, and non-demonstration. Moreover, the effects of PPPs on UWTE were limited by the economic development level, marketisation, and climatic conditions.

MIF is a Common Genetic Determinant of COVID-19 Symptomatic Infection and Severity.

BACKGROUND: Genetic predisposition to COVID-19 may contribute to its morbidity and mortality. Because cytokines play an important role in multiple phases of infection, we examined whether commonly occurring, functional polymorphisms in macrophage migration inhibitory factor (MIF) are associated with COVID-19 infection or disease severity. AIM: To determine associations of common functional polymorphisms in MIF with symptomatic COVID-19 or its severity. METHODS: This retrospective case control study utilized 1171 patients with COVID-19 from three tertiary medical centers in the United States, Hungary, and Spain, together with a group of 637 pre-pandemic, healthy control subjects. Functional MIF promoter alleles (-794 CATT5-8, rs5844572), serum MIF and soluble MIF receptor levels, and available clinical characteristics were measured and correlated with COVID-19 diagnosis and hospitalization. Experimental mice genetically engineered to express human high- or low-expression MIF alleles were studied for response to coronavirus infection. RESULTS: In patients with COVID-19, there was a lower frequency of the high-expression MIF CATT7 allele when compared to healthy controls (11% vs. 19%, OR: 0.54 [0.41, 0.72], p < 0.0001). Among inpatients with COVID-19 (n = 805), there was a higher frequency of the MIF CATT7 allele compared to outpatients (n = 187) (12% vs. 5%, OR: 2.87 [1.42, 5.78], p = 0.002). Inpatients presented with higher serum MIF levels when compared to outpatients or uninfected healthy controls (87 ng/ml vs. 35 ng/ml vs. 29 ng/ml, p < 0.001, respectively). Among inpatients, circulating MIF concentrations correlated with admission ferritin (r = 0.19, p = 0.01) and maximum CRP (r = 0.16, p = 0.03) levels. Mice with a human high-expression MIF allele showed more severe disease than those with a low-expression MIF allele. CONCLUSIONS: In this multinational retrospective study of 1171 subjects with COVID-19, the commonly occurring -794 CATT7  MIF allele is associated with reduced susceptibility to symptomatic SARS-CoV-2 infection but increased disease progression as assessed by hospitalization. These findings affirm the importance of host genetics in different stages of COVID-19 infection.

The improvement of levofloxacin and tetracycline removal from simulated water by thermosensitive flocculant: Mechanisms and simulation

[Display omitted] • P(DAC-NIPAM) significantly improved the removal of levofloxacin and tetracycline. • P(DAC-NIPAM) had strong interaction with antibiotics for its multiple functional groups. • The hydrophobic groups on P(DAC-NIPAM) tightly bridged micelles of antibiotics and SDS. • Compact flocs were formed for shrinkage of P(DAC-NIPAM) molecule at the LCST. • Flocculation simulation further confirmed application feasibility of thermosensitive flocculants. Antibiotics were detected in worldwide natural water especially in COVID-19 period. The common flocculants rarely removed the dissolved antibiotics from natural water and wastewater. The flocculation improvement of organic polymer flocculants might solve the issue of antibiotic pollution or promote the removal efficiencies of antibiotics in water/wastewater treatment plants. Herein, a thermosensitive flocculant, P(DAC-NIPAM), was prepared via one-step method. It was investigated that the relationship between the various functional groups of P(DAC-NIPAM) and its flocculation performances in the treatment of simulated water containing levofloxacin, tetracycline, colloidal particles and natural organic matters. The removal mechanisms were discussed. The results indicated that the rich cationic, hydrophilic and hydrophobic groups of P(DAC-NIPAM) enhanced the interaction between flocculants and pollutants. The bridging of P(DAC-NIPAM) among micelles, charge neutralization, hydrogen bond between P(DAC-NIPAM) and two antibiotics, the shrinkage of P(DAC-NIPAM) molecule and enhancement of hydrophobicity when water temperature was above low critical solution temperature (LCST), co-flocculation and co-settlement of multiple pollutants all contributed to the efficient removal of levofloxacin and tetracycline from water. Flocculation simulation further confirmed that thermosensitive flocculant combined with heating plates was a potential candidate for antibiotic treatment in actual water treatment plants. [ FROM AUTHOR]

The improvement of levofloxacin and tetracycline removal from simulated water by thermosensitive flocculant: Mechanisms and simulation

Antibiotics were detected in worldwide natural water especially in COVID-19 period. The common flocculants rarely removed the dissolved antibiotics from natural water and wastewater. The flocculation improvement of organic polymer flocculants might solve the issue of antibiotic pollution or promote the removal efficiencies of antibiotics in water/wastewater treatment plants. Herein, a thermosensitive flocculant, P(DAC-NIPAM), was prepared via one-step method. It was investigated that the relationship between the various functional groups of P(DAC-NIPAM) and its flocculation performances in the treatment of simulated water containing levofloxacin, tetracycline, colloidal particles and natural organic matters. The removal mechanisms were discussed. The results indicated that the rich cationic, hydrophilic and hydrophobic groups of P(DAC-NIPAM) enhanced the interaction between flocculants and pollutants. The bridging of P(DAC-NIPAM) among micelles, charge neutralization, hydrogen bond between P(DAC-NIPAM) and two antibiotics, the shrinkage of P(DAC-NIPAM) molecule and enhancement of hydrophobicity when water temperature was above low critical solution temperature (LCST), co-flocculation and co-settlement of multiple pollutants all contributed to the efficient removal of levofloxacin and tetracycline from water. Flocculation simulation further confirmed that thermosensitive flocculant combined with heating plates was a potential candidate for antibiotic treatment in actual water treatment plants.

Environmental governance effects of local environmental protection expenditure in China.

China's economy is experiencing a rapid revival in the post Covid-19 era, while energy consumption is surging and environmental pressure is prominent. Environmental protection expenditure is an important means for local governments to improve environmental quality; it plays a crucial role in guiding market investment, providing environmental treatment funds and energy conservation and utilization. Based on a sample of 286 prefecture-level cities in China from 2007 to 2017, this study analyzes environmental governance effects of local environmental protection expenditure while considering the time duration, regional differences, and spatial spillover characteristics of industrial pollution emissions. The results reveal that local environmental protection expenditure could help reduce industrial pollution emissions in Chinese cities; however, the governance effects were heterogeneous in different clustering city groups. In addition, the effects of environmental protection expenditure at the neighborhood level varied greatly; the results showed that the stronger the spillover of pollutants, the more significant was the trans-regional governance effect of local environmental protection expenditure. Therefore, local governments should promote a cooperative mode of "joint prevention and control and cross-regional governance" when treating pollutants with strong spillover potential.

Immune checkpoint blocking impact and nomogram prediction of COVID-19 inactivated vaccine seroconversion in patients with cancer: a propensity-score matched analysis.

BACKGROUND: Patients with cancer on active immune checkpoint inhibitors therapy were recommended to seek prophylaxis from COVID-19 by vaccination. There have been few reports to date to discuss the impact of progression cell death-1 blockers (PD-1B) on immune or vaccine-related outcomes, and what risk factors that contribute to the serological status remains to be elucidated. The study aims to find the impact of PD-1B on vaccination outcome and investigate other potential risk factors associated with the risk of seroconversion failure. METHODS: Patients with active cancer treatment were retrospectively enrolled to investigate the interaction effects between PD-1B and vaccination. Through propensity score matching of demographic and clinical features, the seroconversion rates and immune/vaccination-related adverse events (irAE and vrAE) were compared in a head-to-head manner. Then, a nomogram predicting the failure risk was developed with variables significant in multivariate regression analysis and validated in an independent cohort. RESULTS: Patients (n=454) receiving either PD-1B or COVID-19 vaccination, or both, were matched into three cohorts (vac+/PD-1B+, vac+/PD-1B-, and vac-/PD-1B+, respectively), with a non-concer control group of 206 participants. 68.1% (94/138), 71.3% (117/164), and 80.5% (166/206) were seropositive in vac+/PD-1B+cohort, vac+/PD-1B- cohort, and non-cancer control group, respectively. None of irAE or vrAE was observed to be escalated in PD-1B treatment except for low-grade rash.The vaccinated patients with cancer had a significantly lower rate of seroconversion rates than healthy control. A nomogram was thus built that encompassed age, pathology, and chemotherapy status to predict the seroconversion failure risk, which was validated in an independent cancer cohort of 196 patients. CONCLUSION: Although patients with cancer had a generally decreased rate of seroconversion as compared with the healthy population, the COVID-19 vaccine was generally well tolerated, and seroconversion was not affected in patients receiving PD-1B. A nomogram predicting failure risk was developed, including age, chemotherapy status, pathology types, and rheumatic comorbidity.

Interplay between nuclear factor erythroid 2-related factor 2 and inflammatory mediators in COVID-19-related liver injury.

Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 is a global pandemic and poses a major threat to human health worldwide. In addition to respiratory symptoms, COVID-19 is usually accompanied by systemic inflammation and liver damage in moderate and severe cases. Nuclear factor erythroid 2-related factor 2 (NRF2) is a transcription factor that regulates the expression of antioxidant proteins, participating in COVID-19-mediated inflammation and liver injury. Here, we show the novel reciprocal regulation between NRF2 and inflammatory mediators associated with COVID-19-related liver injury. Additionally, we describe some mechanisms and treatment strategies.

Genomic monitoring of SARS-CoV-2 uncovers an Nsp1 deletion variant that modulates type I interferon response.

The SARS-CoV-2 virus, the causative agent of COVID-19, is undergoing constant mutation. Here, we utilized an integrative approach combining epidemiology, virus genome sequencing, clinical phenotyping, and experimental validation to locate mutations of clinical importance. We identified 35 recurrent variants, some of which are associated with clinical phenotypes related to severity. One variant, containing a deletion in the Nsp1-coding region (Δ500-532), was found in more than 20% of our sequenced samples and associates with higher RT-PCR cycle thresholds and lower serum IFN-ß levels of infected patients. Deletion variants in this locus were found in 37 countries worldwide, and viruses isolated from clinical samples or engineered by reverse genetics with related deletions in Nsp1 also induce lower IFN-ß responses in infected Calu-3 cells. Taken together, our virologic surveillance characterizes recurrent genetic diversity and identified mutations in Nsp1 of biological and clinical importance, which collectively may aid molecular diagnostics and drug design.

A Perspective of International Collaboration Through Web-Based Telecommunication-Inspired by COVID-19 Crisis.

The tsunami effect of the COVID-19 pandemic is affecting many aspects of scientific activities. Multidisciplinary experimental studies with international collaborators are hindered by the closing of the national borders, logistic issues due to lockdown, quarantine restrictions, and social distancing requirements. The full impact of this crisis on science is not clear yet, but the above-mentioned issues have most certainly restrained academic research activities. Sharing innovative solutions between researchers is in high demand in this situation. The aim of this paper is to share our successful practice of using web-based communication and remote control software for real-time long-distance control of brain stimulation. This solution may guide and encourage researchers to cope with restrictions and has the potential to help expanding international collaborations by lowering travel time and costs.

Analysis of excluded and confirmed cases of COVID-19 in Henan Province

Objective: To compare the epidemiological and clinical characteristics of confirmed and excluded patients of coronavirus disease 2019 (COVID-19) in Henan province.

Optimization of imaging parameters in chest CT for COVID-19 patients: an experimental phantom study.

BACKGROUND: With the global outbreak of coronavirus disease 2019 (COVID-19), chest computed tomography (CT) is vital for diagnosis and follow-up. The increasing contribution of CT to the population-collected dose has become a topic of interest. Radiation dose optimization for chest CT of COVID-19 patients is of importance in clinical practice. The present study aimed to investigate the factors affecting the detection of ground-glass nodules and exudative lesions in chest CT among COVID-19 patients and to find an appropriate combination of imaging parameters that optimize detection while effectively reducing the radiation dose. METHODS: The anthropomorphic thorax phantom, with 9 spherical nodules of different diameters and CT values of -800, -630, and 100 HU, was used to simulate the lesions of COVID-19 patients. Four custom-simulated lesions of porcine fat and ethanol were also scanned at 3 tube potentials (120, 100, and 80 kV) and corresponding milliampere-seconds (mAs) (ranging from 10 to 100). Separate scans were performed at pitches of 0.6, 0.8, 1.0, 1.15, and 1.49, and at collimations of 10, 20, 40, and 80 mm at 80 kV and 100 mAs. CT values and standard deviations of simulated nodules and lesions were measured, and radiation dose quantity (volume CT dose index; CTDIvol) was collected. Contrast-to-noise ratio (CNR) and figure of merit (FOM) were calculated. All images were subjectively evaluated by 2 radiologists to determine whether the nodules were detectable and if the overall image quality met diagnostic requirements. RESULTS: All simulated lesions, except -800 HU nodules, were detected at all scanning conditions. At a fixed voltage of 120 or 100 kV, with increasing mAs, image noise tended to decrease, and the CNR tended to increase (F=9.694 and P=0.033 for 120 kV; F=9.028 and P=0.034 for 100 kV). The FOM trend was the same as that of CNR (F=2.768 and P=0.174 for 120 kV; F=1.915 and P=0.255 for 100 kV). At 80 kV, the CNRs and FOMs had no significant change with increasing mAs (F=4.522 and P=0.114 for CNRs; F=1.212 and P=0.351 for FOMs). For the 4 nodules of -800 and -630 HU, CNRs had no statistical differences at each of the 5 pitches (F=0.673, P=0.476). The CNRs and FOMs at each of the 4 collimations had no statistical differences (F=2.509 and P=0.125 for CNRs; F=1.485 and P=0.309 for FOMs) for each nodule. CNRs and subjective evaluation scores increased with increasing parameter values for each imaging iteration. The CNRs of 4 -800 HU nodules in the qualified images at the thresholds of scanning parameters of 120 kV/20 mAs, 100 kV/40 mAs, and 80 kV/80 mAs, had statistical differences (P=0.038), but the FOMs had no statistical differences (P=0.085). Under the 3 threshold conditions, the CNRs and FOMs of the 4 nodules were highest at 100 kV and 40 mAs (1.6 mGy CTDIvol). CONCLUSIONS: For chest CT among COVID-19 patients, it is recommended that 100 kV/40 mAs is used for average patients; the radiation dose can be reduced to 1.6 mGy with qualified images to detect ground-glass nodules and exudation lesions.

Epidemiological characteristics of multi-generation clustered cases of COVID-19

Coronavirus disease 2019 (COVID-19) has strong infectious power, and multi-generation clustered cases are easier to be appearing. To understand the relevant characteristics of multi-generation clustered cases of COVID-19, the epidemiological description and analysis of multi-generation clustered cases reported in Henan province were performed. The clustered epidemics of COVID-19 with more than 3 generation were selected from the public health emergency management information system of Henan province, as of February 23, 2020. The basic characteristic of cases;regional distribution, time distribution, clinical type distribution and incubation period were analyzed.

Oxidative stress-mediated epidermal growth factor receptor activation regulates PM2.5-induced over-secretion of pro-inflammatory mediators from human bronchial epithelial cells.

BACKGROUND: Exposure to PM2.5 has been associated with increased morbidity and mortality of lung diseases although the underlying mechanisms have not been fully uncovered. Airway inflammation is a critical event in the pathogenesis of lung diseases. This study aimed to examine the role of oxidative stress and epidermal growth factor receptor (EGFR) in PM2.5-induced pro-inflammatory response in a human bronchial epithelial cell line, BEAS-2B. METHODS: BEAS-2B cells were exposed to 0, 20, 50, 100 and 150 µg/ml of PM2.5. Secretion of pro-inflammatory mediators including interleukin-6 (IL-6), IL-8 and IL-1ß was determined using enzyme linked immunosorbent assay. Levels of intracellular reactive oxygen species (ROS) were determined using flow cytometry. Phosphorylation of the EGFR was examined with immunoblotting. RESULTS: PM2.5 exposure increased the secretion of IL-6, IL-8, and IL-1ß in a concentration-dependent fashion. Moreover, exposure to PM2.5 elevated intracellular levels of ROS, and phosphorylation of the EGFR (Y1068). Pretreatment of BEAS-2B cells with either an antioxidant or a specific EGFR inhibitor significantly reduced PM2.5-induced IL-6, IL-8 and IL-1ß secretion, implying that both oxidative stress and EGFR activation were involved in PM2.5-induced pro-inflammatory response. Furthermore, pre-treatment of BEAS-2B cells with an antioxidant significantly blunted PM2.5-induced EGFR activation, suggesting that oxidative stress was required for PM2.5-induced EGFR activation. CONCLUSION: PM2.5 exposure induces pro-inflammatory response in human bronchial epithelial cells through oxidative stress-mediated EGFR activation.