Effectiveness of Tai Chi exercise on fear of falling and balance in older adults: A meta-analysis.

OBJECTIVE: To assess the effect of Tai Chi exercise on fear of falling (FOF) and balance in older adults. METHOD: Chinese and English databases were searched for randomized controlled trials (RCTs) on the effect of Tai Chi on the fear of falling and balance of older adults. The search time limit was from inception until 13 December 2022. RESULTS: A total of 13 RCTs were included and the overall quality was moderate. The results showed that Tai Chi exercise could significantly improve fear of falling [SMD = -0.54, 95%CI(-1.09, 0.01), Z =1.94, P = 0.05], dynamic balance [SMD = -2.23, 95%CI(-3.89, -0.75), Z=2.90, P = 0.004] and fall incidence [RR = 0.48, 95%CI(0.35, 0.65), Z =4.67, P <0.001] in older adults. However, its significant benefits in improving the static balance [MD = 4.16, 95%CI(-3.71, 12.04), Z =1.04, P = 0.30] in older adults were not found. The results of the subgroup analysis showed that the short-term effect of Tai Chi in reducing the fear of falling was more significant (P = 0.002). CONCLUSION: Tai Chi could alleviate the FOF of older adults, improve balance and reduce fall incidence. However, large-sample, multi-center, high-quality randomized controlled studies are still verified in the future.

Clinical Symptoms Affect Treatment and Prognosis in Pediatric Patients with Congenital Pulmonary Airway Malformation: A Propensity Score Matching Retrospective Cohort Study.

OBJECTIVES: Surgery for asymptomatic congenital pulmonary airway malformation patients is still debatable at this time. This study aims to investigate the safety and efficacy of surgery for asymptomatic patients, as well as the factors influencing the symptoms of this group of patients. METHODS: An institutional database was sampled for congenital pulmonary airway malformation patients. Patients were divided into the symptomatic group and the asymptomatic group. Propensity score matching (PSM) analysis selected patients in each group to compare perioperative outcomes. A multivariable logistic regression analysis was performed to investigate the potential influences on symptomatic lesions. RESULTS: The asymptomatic group had better perioperative results than the symptomatic group, including shorter operating times (119.39 ± 49.42 min vs 100.73 ± 23.09 min, P = 0.031), shorter postoperative mechanical ventilation (2 h [0.5-46] vs 1 h [0.5-5], P = 0.002), shorter chest tube durations (4d [2-29] vs 3d [2-10], P = 0.007), and shorter postoperative hospital stays (10d [6-36] vs 8d [6-16], P < 0.001). With the conversion to thoracotomy and postoperative complications, there was no statistically significant difference between the two PSM-matched groups (P > 0.05). Age (p = 0.037), postnatal diagnosis (p = 0.018), and maximum cyst diameter (p = 0.032) were found to be independent variables associated with symptomatic lesions by multivariable logistic regression. CONCLUSIONS: Patients with congenital pulmonary airway malformation appear to have better perioperative outcomes before the beginning of symptoms. Symptomatic pulmonary lesions were associated with age, postnatal diagnosis, and maximum cyst diameter. LEVEL OF EVIDENCE: Level III.

Correlation analysis of self-directed learning ability, self-efficacy and academic burnout of junior nursing college students in closed management colleges.

AIMS: To understand the status quo of self-directed learning ability, self-efficacy and academic burnout of junior nursing college students, since the closed management mode was implemented during COVID-19 pandemic disease. DESIGN: Cross-sectional study. METHODS: Participants came from 3,051 junior nursing college students of a college in Zhengzhou City, Henan Province, China. Data were collected by online questionnaire and analysed by SPSS25.0 (a statistical package for social science) and AMOS24.0 software. RESULTS: High self-directed learning ability and self-efficacy were related to low levels of academic burnout (p < .01). In addition, the analysis of mediation effect indicated that the influence of self-directed learning ability on academic burnout was not mediated by self-efficacy.

Regulation of enzymatic and non-enzymatic antioxidants in rice seedlings against chromium stress through sodium hydrosulfide and sodium nitroprusside.

Hydrogen sulfide (H2S) and nitric oxide (NO) play a well-organized protective mechanism in coping with oxidative stress induced by toxic metals. However, the comparative effects of H2S and NO on enzymatic and non-enzymatic antioxidants in plants under Cr(III) stress have not been defined. In this study, we mathematically evaluate the importance of sodium hydrosulfide (NaHS) and sodium nitroprusside (SNP) on these two antioxidant systems in rice seedlings under Cr(III) stress. The results displayed that the optimal dose of NaHS and SNP was 100 µM and 75 µM, respectively, in rice tissues under Cr(III) stress, judging by the reactive oxygen species (ROS) levels in rice tissues. When rice seedlings were exposed to Cr(III) at concentrations of 3.57, 7.24, 26.52 mg Cr/l, Cr-induced ROS accumulation had a significant (p < 0.05) effect on the lipid peroxidation of cell membrane in rice tissues, and decreased the response of SOD, CAT, Pro, GSH, and AsA in rice tissues. Application of exogenous NaHS and SNP effectively (p < 0.05) alleviated the toxic effects of Cr(III) in rice seedlings by activating different antioxidants. A novel physiological response model suggested that the regulatory effect of NaHS and SNP on non-enzymatic antioxidants was stronger than that of enzymatic antioxidants. Moreover, NaHS-mediated response intensity of both enzymatic and non-enzymatic antioxidants was greater than that of SNP, suggesting the importance of utilizing NaHS over SNP as antioxidant regulators during detoxification of Cr(III) in rice seedlings.

Integration of Zeolite Membrane Bioreactor With Granular Sludge-Based Anammox in High-Efficiency Nitrogen Removal From Iron Oxide Red Wastewater.

Acquisition of stable nitritation and efficient anammox play a crucial role in partial nitritation (PN) combined with anammox for nitrogen removal from ammonium-rich wastewater. Due to the limitation of ammonia-oxidizing bacteria (AOB) enrichment and nitrite-oxidizing bacteria (NOB) control in traditional membrane biological reactor (MBR), it can result in a lower nitrite production rate (NPR) and unstable PN, eventually reducing the nitrogen removal rate (NRR) via PN-anammox. In this study, we developed a zeolite membrane biological reactor (ZMBR) to enhance the PN of iron oxide red wastewater (IORW), in which the biofilm derived from the zeolite surface can provide free ammonia (FA)-containing microenvironment for AOB enrichment and NOB inhibition. The results showed that ZMBR can tolerate a higher influent nitrogen loading rate (NLR) of 2.78 kg/(m3⋅day) in comparison to the traditional MBR [2.02 kg/(m3⋅day)] and the NPR in ZMBR and traditional MBR were 1.39 and 0.96 kg/(m3⋅day), respectively. The mass concentration ratio of NO 2 - -N/ NH 4 + -N ranged from 1.05 to 1.33 in ZMBR, suggesting a suitable condition for nitrogen removal via anammox. Subsequently, the domesticated granular sludge obtained from a paper-making wastewater treatment was used as the carrier of anammox bacteria to remove nitrogen. After 93 days of operation, the NRR was observed to be 2.33 kg/(m3⋅day) and high-throughput sequencing indicated that the relatively higher abundance (45.0%) of Candidatus Kuenenia stuttgartiensis was detected in the granular sludge of the bottom part of the reactor, which can produce more proteins and lipids, suggesting a good settleability. Overall, this study provides a high-efficient method to control PN and domesticate anammox for nitrogen removal from IORW.

Association of increased risk of cardiovascular diseases with higher levels of perfluoroalkylated substances in the serum of adults.

Evidence showing the association of perfluoroalkylated substance (PFAS) exposure with CVD risk is scarce. The objective of this study was to explore the relationships of CVD risk with mixed or individual serum PFAS levels among general adults. We analyzed combined data of 7904 adults who participated in the National Health and Nutrition Examination Survey 2003-2012 with a Bayesian kernel machine regression (BKMR) to examine the relationships of individual or mixed PFAS exposure with total CVD risk. A logistic regression model and restricted cubic spline (RCS) regression with multivariate adjustment were conducted to assess the relationships between individual serum PFAS levels and the risk of total CVD or its subtypes. A mediation model was applied to investigate how C-reactive protein (CRP) levels mediate the strength of the association. The BKMR results indicated a positive relationship between mixed PFAS exposure and total CVD risk; among the PFASs, perfluorooctane sulfonic acid (PFOS) had the highest posterior inclusion probability. As determined by logistic regression, a log-unit change in PFOS levels was positively related to a higher risk of heart attack and stroke in males (both P < 0.05). A nonlinear relationship was found between PFOS levels and stroke risk (P for nonlinearity = 0.04), as illustrated in the RCS plot. The mediation analysis showed that CRP levels mediated 8% and 1.2% of the relationship between serum PFOS and PFNA levels, respectively, and the prevalence of stroke. A significant relationship between higher serum PFAS concentrations and an increased risk of CVD was observed, mainly in males.

Joint association of polycyclic aromatic hydrocarbons and heavy metal exposure with pulmonary function in children and adolescents aged 6-19 years.

Studies have reported associations between polycyclic aromatic hydrocarbon (PAH) or heavy metal (HM) exposure and respiratory diseases. However, evidence of their joint associations with pulmonary function, especially in children and adolescents aged 6-19 years, is lacking. We utilized cross-sectional data from 1,734 children and adolescents aged 6-19 years collected in the National Health and Nutrition Examination Survey 2007-2012 and analysed mixed PAH and mixed HM exposures and their joint association with pulmonary function by applying weighted quantile sum (WQS) regression and Bayesian kernel machine regression (BKMR). Multivariate linear regressions were carried out to determine the relationships between individual urinary PAH metabolites or blood HM levels and pulmonary function indices. We found that mixed PAHs and HMs were negatively related to forced expiratory volume in 1 s (FEV1) in subjects aged 6-12 years (all p values < 0.05). We found synergistic associations of PAH and HM exposure on pulmonary function impairment, mainly in children; lead (Pb) was the most damaging. In the analysis of individual PAH metabolites or HMs, Pb exposure was negatively associated with FEV1 values in all subgroups (all p values < 0.05). Thus, our findings indicate that increased PAH or HM exposure is associated with impairments to pulmonary function and that this association is more pronounced in children.

Preoperative prediction of overt hepatic encephalopathy caused by transjugular intrahepatic portosystemic shunt.

PURPOSE: Preoperative prediction of overt hepatic encephalopathy (OHE) should be performed in patients with variceal bleeding treated using the transjugular intrahepatic portosystemic shunt (TIPS) procedure. A reliable prediction tool is therefore required. METHOD: Patients with cirrhosis-related variceal bleeding treated using the TIPS procedure were screened at two hospitals. Patients classified as Child-Pugh Class B were identified. The least absolute shrinkage and selection operator method and the backward stepwise selection method were used to screen the clinical and radiological characteristics of participants. Then, models were constructed accordingly to predict OHE. Area under the receiver operating characteristic curves, calibration curves, and decision curves were performed to discover the optimal model. Finally, whether clinical factors influenced the performance of our optimal model was tested. RESULTS: A total of 191 patients were included (training cohort: 127 cases; validation cohort: 64 cases). Three novel radiological independent risk factors were found. The combined model outperformed the models containing clinical factors or radiological characteristics alone. The areas under the curve for the training and validation cohorts were 0.901 and 0.903, respectively, with satisfactory calibration and decision curves. The Model for End-Stage Liver Disease score, serum sodium, albumin, total bilirubin, and age exhibited limited influence on the performance of the combined model. CONCLUSIONS: These radiological characteristics are also independent risk factors for post-TIPS OHE. Combining clinical factors and radiological characteristics was an effective means of predicting OHE. This study's model could be used for preoperative selection of appropriate patients before the TIPS procedure is performed.

Nitrogen Removal From Nitrate-Containing Wastewaters in Hydrogen-Based Membrane Biofilm Reactors via Hydrogen Autotrophic Denitrification: Biofilm Structure, Microbial Community and Optimization Strategies.

The hydrogen-based membrane biofilm reactor (MBfR) has been widely applied in nitrate removal from wastewater, while the erratic fluctuation of treatment efficiency is in consequence of unstable operation parameters. In this study, hydrogen pressure, pH, and biofilm thickness were optimized as the key controlling parameters to operate MBfR. The results of 653.31 µm in biofilm thickness, 0.05 MPa in hydrogen pressure and pH in 7.78 suggesting high-efficiency NO 3 - - N removal and the NO 3 - - N removal flux was 1.15 g·m-2 d-1. 16S rRNA gene analysis revealed that Pseudomonas, Methyloversatilis, Thauera, Nitrospira, and Hydrogenophaga were the five most abundant bacterial genera in MBfRs after optimization. Moreover, significant increases of Pseudomonas relative abundances from 0.36 to 9.77% suggested that optimization could effectively remove nitrogen from MBfRs. Membrane pores and surfaces exhibited varying degrees of calcification during stable operation, as evinced by Ca2+ precipitation adhering to MBfR membrane surfaces based on scanning electron microscopy (SEM), atomic force microscopy (AFM) analyses. Scanning electron microscopy-energy dispersive spectrometer (SEM-EDS) analyses also confirmed that the primary elemental composition of polyvinyl chloride (PVC) membrane surfaces after response surface methodology (RSM) optimization comprised Ca, O, C, P, and Fe. Further, X-ray diffraction (XRD) analyses indicated the formation of Ca5F(PO4)3 geometry during the stable operation phase.

Simultaneous Partial Nitrification and Denitrification Maintained in Membrane Bioreactor for Nitrogen Removal and Hydrogen Autotrophic Denitrification for Further Treatment.

Low C/N wastewater results from a wide range of factors that significantly harm the environment. They include insufficient carbon sources, low denitrification efficiency, and NH4+-N concentrations in low C/N wastewater that are too high to be treated. In this research, the membrane biofilm reactor and hydrogen-based membrane biofilm reactor (MBR-MBfR) were optimized and regulated under different operating parameters: the simulated domestic sewage with low C/N was domesticated and the domestic sewage was then denitrified. The results of the MBR-MBfR experiments indicated that a C/N ratio of two was suitable for NH4+-N, NO2--N, NO3--N, and chemical oxygen demand (COD) removal in partial nitrification-denitrification (PN-D) and hydrogen autotrophic denitrification for further treatment. The steady state for domestic wastewater was reached when the MBR-MBfR in the experimental conditions of HRT = 15 h, SRT = 20 d, 0.04 Mpa for H2 pressure in MBfR, 0.4-0.8 mg/L DO in MBR, MLSS = 2500 mg/L(MBR) and 2800 mg/L(MBfR), and effluent concentrations of NH4+-N, NO3--N, and NO2--N were 4.3 ± 0.5, 1.95 ± 0.04, and 2.05 ± 0.15 mg/L, respectively. High-throughput sequencing results revealed the following: (1) The genus Nitrosomonas as the ammonia oxidizing bacteria (AOB) and Denitratisoma as potential denitrifiers were simultaneously enriched in the MBR; (2) at the genus level, Meiothermus,Lentimicrobium, Thauera,Hydrogenophaga, and Desulfotomaculum played a dominant role in leading to NO3--N and NO2--N removal in the MBfR.

Partial nitritation performance and microbial community in sequencing batch biofilm reactor filled with zeolite under organics oppression and its recovery strategy.

Influences of organics on partial nitritation performance were investigated in a lab-scale sequencing batch biofilm reactor filled with zeolite. Significant differences in nitrite production rate (NPR) were observed between different dosages of glucose. With influent COD/N ratio from 0 to 1.5, NPR declined from 0.4 to 0.05 kg/(m3·d). Meanwhile, an appropriate NO2--N/NH4+-N ratio (1.4 ± 0.5) could be obtained for simultaneous anammox denitrification at COD/N ratio of 0.5. Increasing airflow rate was found as an effective recovery strategy. Other than competition of heterotrophs with nitrifiers for dissolved oxygen, it has been verified that addition of organics generated higher free ammonia, and then further inhibitedammonium oxidizing bacteria (AOB). Moreover, three-dimensional excitation-emission matrix (3D-EEM) results revealed that protein-like and humic acid-like substances were the main components in extracellularpolymericsubstances (EPS). And high-throughput sequencing analysis demonstrated that the relative abundance of AOB decreased.

Nitrogen removal from iron oxide red wastewater via partial nitritation-Anammox based on two-stage zeolite biological aerated filter.

Partial nitritation-anaerobic ammonium oxidation (PN-Anammox) was successfully applied for high-strength ammonium iron oxide red wastewater (IORW) treatment based on stable PN performance of zeolite-biological aerated filter (ZBAF). By separating Na2CO3 dosage avoid the high free ammonia (FA) inhibited nitritation, two-stage ZBAF was applied for achieving efficient PN with Na2CO3 as the alkalinity donor and saving about 40.0% of the alkalinity cost compared to NaHCO3. Moreover, Anammox was used for further nitrogen removal from IORW and stable total nitrogen (TN) removal was obtained at the influent NH4+-N concentration of 567 mg/L and TN removal efficiency kept above 70.0% after 100 days operation. High throughput sequencing-based approaches showed that Nitrosomoadaceae (AOB) and Kuenenia was dominance in two-stage ZBAF and Anammox samples respectively, while Nitrospire and Nitrobacter (NOB) undetected. The combined process should have advantages for similar high-strength ammonium wastewater treatment.

Response of nitritation performance and microbial community structure in sequencing biofilm batch reactors filled with different zeolite and alkalinity ratio.

Ammonium (NH4+-N) adsorption capacity of zeolite varies from place to place, a unique attempt to use different zeolite as adsorbent media in sequencing biofilm batch reactor (SBBR) for maintaining appropriate free ammonia (FA) range to achieve partial nitritation. SBR filled with synthetic zeolite (SSBBR) and natural zeolite (NSBBR) were applied to evaluate the NH4+-N adsorption capacity impacts on nitrogen transformation and microbial characteristics. Significant differences in nitrite production rate (NPR) were both observed in two reactors during 4 different alkalinity ratios. The highest NPR in SSBBR and NSBBR were both obtained when the alkalinity ratio was 5:1 with the values of 1.11 and 0.90 kg N/(m3·d), respectively. According to Haldane model with inhibition by FA, the kinetics of the reaction were analyzed. High-throughput sequencing analysis results further presented that SSBBR had higher relative abundance average of nitrosobacteria in genus level, which was in favor of better partial nitritation.

Nitrogen removal via nitritation pathway for low-strength ammonium wastewater by adsorption, biological desorption and denitrification.

Stable nitritation for low-strength ammonium wastewater was the key obstacle for cost-effective and low-carbon biological nitrogen removal. A zeolite biological fixed bed (ZBFB) and an anoxic sequencing batch reactor (ASBR) were successfully applied for achieving nitritation-denitrification of low-strength ammonium wastewater by adsorption, biological desorption and denitrification. Based on free ammonia inhibition on biofilm, stable nitrite accumulation could be realized with suitable operational time and aeration in biological desorption. During cycle operation, adsorption effluent NH4+-N kept at 3.0-4.0 mg/L, biological desorption effluent NO2--N maintained at 226.8-243.2 mg/L with average nitrite accumulation ratio of 97.18%, and nitrite removal rate was about 0.628-0.672 kg NO2--N·m-3·day-1, revealing obvious feasibility of ZBFB and ASBR for low-strength ammonium wastewater treatment. High-throughput sequencing analysis results further presented significant microbial community variations happened after cycle operation, with ammonia oxidizing bacteria enrichment and nitrite oxidizing bacteria inhibition in ZBFB and dominance of denitrifiers in ASBR.

Phytotoxicity and Transport of Gallium (Ga) in Rice Seedlings for 2-Day of Exposure.

Hydroponic experiments were conducted with rice seedlings to investigate the accumulation and phytotoxicity of gallium nitrate. A linear decrease in relative growth rate, transpiration rate and water use efficiency was observed in rice seedlings with increasing Ga concentrations. However, inhibition of these selected parameters was noted different at different Ga treatments. Relative growth rate was more sensitive towards Ga treatments. Phyto-transport of Ga was apparent, but recovery of Ga in different parts of rice seedlings varied significantly: roots were dominant site for Ga accumulation. The total accumulation rates of Ga were positively correlated to Ga concentrations. Results indicated that the addition of Ga did not cause deleterious effects on plant physiological functions over a 2-day exposure period. Large amounts of Ga were removed from the hydroponic solution through rice seedlings. Accumulation of Ga in plant tissues resulted in growth inhibition of rice seedlings.