Scenario Analysis of Food Phosphorus Footprint in Kisumu, a Lakeside East African City in Lake Victoria (Kenya).

Increased food production and consumption patterns have resulted in higher urban food phosphorus footprints, leading to a series of resource and environmental problems worldwide. We quantified the food phosphorus footprint of the African city of Kisumu using substance flow analysis. Our aim was to develop Kisumu's sustainable phosphorus management framework so that the city would reduce phosphorus losses into the food system. Our results show that in the year 2023, the import and export of food phosphorus in the Kisumu food system was 2730.26 ± 2.7% t P yr-1 and 3297.05 ± 2.4% t P yr-1, respectively. There was -566.79 ± -18% t P yr-1 food phosphorus deficit in the Kisumu food system. Crop planting subsystem runoff/leaching/erosion loss, household consumption subsystem waste loss, and pit latrine subsystem blackwater loss are the major pathways of phosphorus losses into the environment and the main contributors to the food phosphorus footprint in the city. The 2030 scenario analysis shows that implementing a comprehensive scenario scheme throughout the entire lifecycle process from phosphorus input to waste disposal is the best choice for reducing phosphorus losses and suppressing the growth of food phosphorus footprint in the future. Our study shows that the food phosphorus footprint in the Kisumu food system was 0.67 kg P cap-1yr-1 in 2023, which is still at a low level but may enter a continuous upward trend with the improvement of socio-economic development of the city. In our framework, we have proposed a few essential measures that include urine separation, installation of septic tank, adjustment of dietary structure, flexible layout of sanitary disposal facilities, and separation of organic waste streams to reduce food phosphorus footprints in Kisumu. Given the similarity of cities along the shores of Lake Victoria, our calculation methods and management strategies can be applied to other cities in the region.

[Value of chitinase-like protein YKL-40 in bronchoalveolar lavage fluid for predicting refractory Mycoplasma pneumoniae pneumonia in children].

OBJECTIVE: To evaluate the value of chitinase-like protein YKL-40 in bronchoalveolar lavage fluid (BALF) for predicting refractory Mycoplasma pneumoniae pneumonia (RMPP) in children. METHODS: A total of 50 children with common Mycoplasma pneumoniae pneumonia (MPP) and 22 children with RMPP were enrolled. The two groups were compared in terms of clinical features, laboratory examination results, imaging findings, and YKL-40 levels in BALF. The receiver operating characteristic (ROC) curve was used to evaluate the value of YKL-40 in BALF for predicting RMPP. RESULTS: Compared with the common MPP group, the RMPP group had significantly higher incidence rates of fever, shortness of breath, lung consolidation, and pleural effusion (P < 0.05) and significantly higher serum levels of C-reactive protein and lactate dehydrogenase (P < 0.05). The RMPP group had a significantly higher level of YKL-40 in BALF than the common MPP group (P < 0.05). The ROC curve plotted based on the level of YKL-40 in BALF had an area under the ROC curve of 0.750, a sensitivity of 72.7% and a specificity of 64.0% for predicting RMPP. CONCLUSIONS: There is an increase in the level of YKL-40 in BALF in children with RMPP, and the level of YKL-40 in BALF has a certain value for predicting RMPP.

Heterogeneity of Monosymptomatic Resting Tremor in a Prospective Study: Clinical Features, Electrophysiological Test, and Dopamine Transporter Positron Emission Tomography.

BACKGROUND: The relationship between monosymptomatic resting tremor (mRT) and Parkinson's disease (PD) remains controversial. In this study, we aimed to assess the function of presynaptic dopaminergic neurons in patients with mRT by dopamine transporter positron emission tomography (DAT-PET) and to evaluate the utility of clinical features or electrophysiological studies in differential diagnosis. METHODS: Thirty-three consecutive patients with mRT were enrolled prospectively. The Unified Parkinson's Disease Rating Scale and electromyography were tested before DAT-PET. Striatal asymmetry index (SAI) was calculated, and a normal DAT-PET was defined as a SAI of <15%. Scans without evidence of dopaminergic deficits (SWEDDs) were diagnosed in patients with a subsequent normal DAT-PET and structural magnetic resonance imaging. RESULTS: Twenty-eight mRT patients with a significant reduction in uptake of DAT binding in the striatum were diagnosed with PD, while the remained 5 with a normal DAT-PET scan were SWEDDs. As for UPRDS, the dressing and hygiene score, walking in motor experiences of daily living (Part II) and motor examination (Part III) were significant different between two groups (P < 0.05 and P < 0.01, respectively). Bilateral tremor was more frequent in the SWEDDs group (P < 0.05). The frequency of resting tremor and the amplitude of postural tremor tend to be higher in the SWEDDs group (P = 0.08 and P = 0.05, respectively). CONCLUSIONS: mRT is heterogeneous in presynaptic nigrostriatal dopaminergic degeneration, which can be determined by DAT-PET brain imaging. Clinical and electrophysiological features may provide clues to distinguish PD from SWEDDs.