Risk factors for progression of pulmonary fibrosis: a single-centered, retrospective study.

Objective: This study aimed to identify clinical characteristics associated with the prevalence of progressive pulmonary fibrosis (PPF) in interstitial lung disease (ILD) and to develop a prognostic nomogram model for clinical use. Methods: In this single-centered, retrospective study, we enrolled ILD patients with relatively comprehensive clinical data and assessed the incidence of PPF within a year using collected demographics, laboratory data, high-resolution computed tomography (HRCT), and pulmonary function test (PFT) results. We used a training cohort of ILD patients to identify early predictors of PPF and then validated them in an internal validation cohort and subsets of ILD patients using a multivariable logistic regression analysis. A prognostic nomogram was formulated based on these predictors, and the accuracy and efficiency were evaluated using the area under the receiver operating characteristic curve (AUC), calibration plot, and decision curve analysis (DCA). Results: Among the enrolled patients, 120 (39.09%) cases had connective tissue disease-associated interstitial lung disease (CTD-ILD), 115 (37.46%) had non-idiopathic pulmonary fibrosis idiopathic interstitial pneumonia (non-IPF IIP), and 35 (11.4%) had hypersensitivity pneumonitis (HP). Overall, 118 (38.4%) cases experienced pulmonary fibrosis progression. We found that baseline DLco% pred (OR 0.92; 95% CI, 8.93-0.95) was a protective factor for ILD progression, whereas combined pneumonia (OR 4.57; 95% CI, 1.24-18.43), modified Medical Research Council dyspnea score (mMRC) (OR 4.9; 95% CI, 2.8-9.5), and high-resolution computed tomography (HRCT) score (OR 1.22; 95% CI, 1.07-1.42) were independent risk factors for PPF. The AUC of the proposed nomogram in the development cohort was 0.96 (95% CI, 0.94, 0.98), and the calibration plot showed good agreement between the predicted and observed incidence of PPF (Hosmer-Lemeshow test: P = 0.86). Conclusion: ILD patients with combined pneumonia, low baseline DLco% pred, high mMRC marks, and high HRCT scores were at higher risk of progression. This nomogram demonstrated good discrimination and calibration, indicating its potential utility for clinical practice.

Field study on N2O emission from subsurface wastewater infiltration system under variable loading rates and drying-wetting cycles.

In this field study, the impacts of influent loadings and drying-wetting cycles on N2O emission in a subsurface wastewater infiltration (SWI) system were investigated. N2O emitted under different operation conditions were quantified using static chamber and gas chromatograph techniques. N2O conversion rate decreased from 6.6 ± 0.1% to 2.7 ± 0.1% with an increase in hydraulic loading (HL) from 0.08 to 0.24 m3/m2·d. By contrast, N2O conversion rate increased with increasing pollutant loading (PL) up to 8.2 ± 0.5% (PL 4.2 g N/m2·d) above which conversion rate decreased, confirming that N2O production was under the interaction of nitrification and denitrification. Taking into consideration the pollutants (chemical oxygen demand (COD), NH4+-N, NO3--N and total nitrogen (TN)) removal ratio and N2O emission, optimal loading ranges and drying-wetting modes were suggested as HL 0.08-0.12 m3/m2·d, PL 3.2-3.7 g N/m2·d and 12 h:12 h, respectively. The results revealed that in SWI systems, conversion ratio of influent nitrogen to N2O could be between 4.5% and a maximum of 7.0%.

Distributions, sources and ecological risk of polycyclic aromatic hydrocarbons (PAHs) in subsurface water of urban old industrial relocation areas: A case study in Shenyang, China.

During a 12-month study period, the levels, distributions, sources and ecological risk of 16 polycyclic aromatic hydrocarbons (PAHs) were investigated in subsurface water of Shenyang (the largest urban industrial relocation base in China). The results showed that ΣPAH concentration ranged from 0.21 to 1.07 µg/L, in descending order as follows, summer, autumn, spring and winter. Comparing with the situations before relocation, there was a significant decrease in Fluorene, Phenanthrene and Anthracene levels. The content of Banzo[a]pyrene was in high level. Relatively high 16 EPA-PAHs concentrations were observed at downstream sites suggesting that after the industrial relocation, residual 16 EPA-PAHs in soil and sediments could be desorbed and resuspended in water. From a global perspective, contamination of subsurface water PAHs can be categorized as moderate level. Source analysis suggested that without industrial waste input, pyrogenic soureces were the major contributors for PAHs pollution in winter. Petrogenic and pyrogenic inputs were equally important sources for PAHs pollution in other seasons. Due to incomplete combustion of wood and coal, ecological risk of Banzo[a]pyrene was high in the winter, indicating that to alleviate 16 EPA-PAH contamination, segmented remediation and energy structure adjustment would be equally important in urban industrial relocation areas.