Distributions and Trends of the Global Burden of DKD Attributable to Lead Exposure: A Systematic Analysis of GBD from 1990 to 2019.

Long-term exposure to lead is associated with an increased risk of diabetic kidney disease (DKD). However, limited data exist on global trends in DKD burden attributable to lead exposure, especially across diverse regions categorized by socioeconomic level. We aimed to assess the spatiotemporal changes in DKD burden attributable to lead exposure from 1990 to 2019 across 204 countries and regions with varying socio-demographic index (SDI) metrics. This retrospective analysis utilized data from the Global Burden of Disease Study 2019 (GBD2019) database. We estimated the burden of DKD attributable to lead exposure using the age-standardized mortality rate (ASMR) and age-standardized disability-adjusted life year rate (ASDR), accounting for sex, age, nationality, and SDI. The annual percentage change (APC) and average annual percentage change (AAPC) were calculated using the Joinpoint model to evaluate trends in the ASMR and ASDR attributable to lead exposure from 1990 to 2019. Gaussian process regression was used to model the relationship between the SDI and ASMR/ASDR. Globally, the burden of DKD attributable to lead exposure has significantly increased since 1990, especially among elderly men and in regions such as Asia, Central Latin America, North Africa, the Middle East, and low-SDI regions. In 2019, the ASMR and ASDR of DKD attributable to lead exposure were 0.68 (95% CI: 0.40, 0.98) per 100,000 people and 15.02 (95% CI: 8.68, 22.26) per 100,000 people, respectively. From 1990 to 2019, the global ASMR and ASDR attributable to lead-associated DKD changed by 15.45% and -1.78%, respectively. The global AAPCs of the ASMR and ASDR were 0.55 (95% CI: 0.45, 0.65) and -0.01 (95% CI: -0.12, 0.1), respectively. Significant declining trends were observed in the high-income Asia Pacific region, eastern sub-Saharan Africa, North Africa, the Middle East, and other regions with high SDIs. Over this 30-year study period, the global burden of DKD attributable to lead exposure has increased, particularly in regions with low SDI. Lead exposure remains a significant concern in the global burden of diabetic kidney disease.

Development of a multi-phase CT-based radiomics model to differentiate heterotopic pancreas from gastrointestinal stromal tumor.

BACKGROUND: To investigate whether CT-based radiomics can effectively differentiate between heterotopic pancreas (HP) and gastrointestinal stromal tumor (GIST), and whether different resampling methods can affect the model's performance. METHODS: Multi-phase CT radiological data were retrospectively collected from 94 patients. Of these, 40 with HP and 54 with GISTs were enrolled between April 2017 and November 2021. One experienced radiologist manually delineated the volume of interest and then resampled the voxel size of the images to 0.5 × 0.5 × 0.5 mm3, 1 × 1 × 1 mm3, and 2 × 2 × 2 mm3, respectively. Radiomics features were extracted using PyRadiomics, resulting in 1218 features from each phase image. The datasets were randomly divided into training set (n = 66) and validation set (n = 28) at a 7:3 ratio. After applying multiple feature selection methods, the optimal features were screened. Radial basis kernel function-based support vector machine (RBF-SVM) was used as the classifier, and model performance was evaluated using the area under the receiver operating curve (AUC) analysis, as well as accuracy, sensitivity, and specificity. RESULTS: The combined phase model performed better than the other phase models, and the resampling method of 0.5 × 0.5 × 0.5 mm3 achieved the highest performance with an AUC of 0.953 (0.881-1), accuracy of 0.929, sensitivity of 0.938, and specificity of 0.917 in the validation set. The Delong test showed no significant difference in AUCs among the three resampling methods, with p > 0.05. CONCLUSIONS: Radiomics can effectively differentiate between HP and GISTs on CT images, and the diagnostic performance of radiomics is minimally affected by different resampling methods.

A review on the potential risks and mechanisms of heavy metal exposure to Chronic Obstructive Pulmonary Disease.

Chronic Obstructive Pulmonary Disease (COPD) is a chronic disease that affects patients as well as the health and economic stability of society as a whole. At the same time, heavy metal pollution is widely recognized as having a possible impact on the environment and human health. Therefore, these diseases have become important global public health issues. In recent years, researchers have shown great interest in the potential association between heavy metal exposure and the development of COPD, and there has been a substantial increase in the number of related studies. However, we still face the challenge of developing a comprehensive and integrated understanding of this complex association. Therefore, this review aimed to evaluate the existing epidemiological studies to clarify the association between heavy metal exposure and COPD. In addition, we will discuss the biological mechanisms between the two to better understand the multiple molecular pathways and possible mechanisms of action involved, and provide additional insights for the subsequent identification of potential strategies to prevent and control the effects of heavy metal exposure on the development of COPD in individuals and populations.

Construction of the first high-density genetic linkage map and QTL mapping of flavonoid and leaf-size related traits in Epimedium.

BACKGROUND: Leaves are the main medicinal organ in Epimedium herbs, and leaf flavonoid content is an important criterion of Epimedium herbs. However, the underlying genes that regulate leaf size and flavonoid content are unclear, which limits the use of breeding for Epimedium development. This study focuses on QTL mapping of flavonoid and leaf-size related traits in Epimedium. RESULTS: We constructed the first high-density genetic map (HDGM) using 109 F1 hybrids of Epimedium leptorrhizum and Epimedium sagittatum over three years (2019-2021). Using 5,271 single nucleotide polymorphism (SNP) markers, an HDGM with an overall distance of 2,366.07 cM and a mean gap of 0.612 cM was generated by utilizing genotyping by sequencing (GBS) technology. Every year for three years, 46 stable quantitative trait loci (QTLs) for leaf size and flavonoid contents were discovered, including 31 stable loci for Epimedin C (EC), one stable locus for total flavone content (TFC), 12 stable loci for leaf length (LL), and two stable loci for leaf area (LA). For flavonoid content and leaf size, the phenotypic variance explained for these loci varied between 4.00 and 16.80% and 14.95 and 17.34%, respectively. CONCLUSIONS: Forty-six stable QTLs for leaf size and flavonoid content traits were repeatedly detected over three years. The HDGM and stable QTLs are laying the basis for breeding and gene investigation in Epimedium and will contribute to accelerating the identification of desirable genotypes for Epimedium breeding.

Metal Exposure, Smoking, and the Risk of COPD: A Nested Case-Control Study in a Chinese Occupational Population.

Chronic obstructive pulmonary disease (COPD) was the third leading cause of death worldwide in 2019, with a significant disease burden. We conducted a nested case-control study using data from the China Metal-Exposed Workers Cohort Study (Jinchang Cohort) and assessed the associations of exposure to metals and tobacco smoking with the risk of COPD. We used the logistic regression model and the interaction multiplication model to assess the independent and combined effects of heavy metal and smoke exposure on COPD. The cumulative incidence of COPD was 1.04% in 21,560 participants during a median of two years of follow-up. The risk of COPD was significantly elevated with an increase in the amount of tobacco smoked daily (p < 0.05), the number of years of smoking (ptrend < 0.05), and the number of packs of cigarettes smoked per year (ptrend < 0.01). Compared with the low metal exposure group, the adjusted OR was 1.22 (95% CI: 0.85-1.76) in the medium exposure group (mining/production workers) and 1.50 (95% CI: 1.03-2.18) in the high exposure group; smoking and metal exposure had a combined effect on the incidence of COPD (pinteraction < 0.01), with an OR of 4.60 for those with >40 pack-years of smoking who also had the highest metal exposures. Both exposures to metals and smoking were associated with the risk of COPD, and there was an interaction between the two exposures for the risk of COPD.

Production-Based and Consumption-Based Accounting of Global Cropland Soil Erosion.

The effective control of cropland soil erosion is urgent for all countries because of its threat to global food security. Cropland soil erosion is caused by agricultural production and driven indirectly by consumption. Analyzing the causes and preventive strategies from the consumption side is essential for soil erosion control. However, there is not yet sufficient research or practice. In this study, we estimated global cropland soil erosion with the revised universal soil loss equation, allocated it to specific types of crops, and quantified the cropland soil erosion footprint of the economies with a multiregional input-output analysis model. Our results showed that developed economies, usually importing cropland soil erosion from developing or agriculturally developed economies, are the beneficiaries in the current crop trading system. The European Union is the largest net importer, while Brazil is the largest exporter. The indirect and induced sectors are the main contributors, consuming approximately 70.48% of the total cropland soil erosion. Our results revealed the region- and product-specific contributors that could inform the reduction of global cropland soil erosion for sustainable food production and consumption.

Spatio-Temporal Heterogeneity of the Relationships Between PM2.5 and Its Determinants: A Case Study of Chinese Cities in Winter of 2020.

Fine particulate matter (PM2.5) poses threat to human health in China, particularly in winter. The pandemic of coronavirus disease 2019 (COVID-19) led to a series of strict control measures in Chinese cities, resulting in a short-term significant improvement in air quality. This is a perfect case to explore driving factors affecting the PM2.5 distributions in Chinese cities, thus helping form better policies for future PM2.5 mitigation. Based on panel data of 332 cities, we analyzed the function of natural and anthropogenic factors to PM2.5 pollution by applying the geographically and temporally weighted regression (GTWR) model. We found that the PM2.5 concentration of 84.3% of cities decreased after lockdown. Spatially, in the winter of 2020, cities with high PM2.5 concentrations were mainly distributed in Northeast China, the North China Plain and the Tarim Basin. Higher temperature, wind speed and relative humidity were easier to promote haze pollution in northwest of the country, where enhanced surface pressure decreased PM2.5 concentrations. Furthermore, the intensity of trip activities (ITAs) had a significant positive effect on PM2.5 pollution in Northwest and Central China. The number of daily pollutant operating vents of key polluting enterprises in the industrial sector (VOI) in northern cities was positively correlated with the PM2.5 concentration; inversely, the number of daily pollutant operating vents of key polluting enterprises in the power sector (VOP) imposed a negative effect on the PM2.5 concentration in these regions. This work provides some implications for regional air quality improvement policies of Chinese cities in wintertime.

Telecoupling cropland soil erosion with distant drivers within China.

Soil erosion on cropland is a result of the interaction between nature and human activities. The socioeconomic influencing factors of soil erosion have been less studied than the biophysical processes and previous studies have mainly focused on the impacts of local socioeconomic factors on soil erosion in the same region. However, since agricultural activities are densely connected to other socio-economic activities, the need for agricultural products from distant regions could potentially drive local soil erosion accompanying agricultural production. To the best of our knowledge, these telecoupling effects have not been studied. Here, we combined the Revised Universal Soil Loss Equation (RUSLE) and multiregional input-output analysis (MRIO) models to quantify the contribution of China's cross-provincial economic demand to local soil erosion at the provincial, sectoral, and supply chain levels. Our results show that a large amount of soil erosion in the southwest, northeast, and central regions is linked to the economic needs across provinces. Agriculture and food processing are the most important distant driving sectors. The driving effect of household consumption on soil erosion mainly occurs on shorter supply chains, while exports and capital formation drive soil erosion through longer chains. Our results indicate that local soil erosion management must consider the impact of distant agricultural product needs and coordinate food production and supply on a national scale to protect the ecological function of the land.

Industrial polycyclic aromatic hydrocarbons (PAHs) emissions embodied in domestic trade in China in 2012.

Atmospheric Polycyclic Aromatic Hydrocarbons (PAHs) emissions cause non-negligible damage to human health and well-being. Effective regional cooperation is urgently required to mitigate PAHs emissions to maintain satisfactory air quality. This study quantified and tracked China's PAHs emissions flows embodied in interprovincial trade. A production-based emissions inventory of 16 U.S. EPA priority PAHs based on commercial energy consumption in China in 2012 was compiled using the emissions factor approach. Then, a multiregional input-output model was constructed to reveal consumption-based emissions and to track the PAHs emissions embodied in the trade of 27 major sectors across 30 regions in China. Key structural paths were also identified using structural path analysis (SPA). In 2012, the total industrial energy-derived PAHs emissions were estimated to be 47.7 tons of BaP-toxic equivalents (8032.7 tons of mass). Shandong, Hebei, and Hubei accounted for more than 24.0% of the production-side PAHs emissions in the whole country. Approximately 30.8% of China's PAHs emissions were embodied in goods consumed outside of the province in which they were produced. PAHs flow tended to start in the western regions and ended in the eastern regions along the coast. The results of the SPA showed that critical paths, such as from the Metallurgy sector to the Construction sector, embodied a large amount of emissions and had the potential to affect the performance of the entire system. By paying attention to the consumption-based accounting as well as the production-based accounting of emissions and by focusing on vital transfer paths, policymakers can devise effective and targeted environmental protection and sustainable development policies in China.

Research on ecosystem services of water conservation and soil retention: a bibliometric analysis.

Water conservation and soil retention are two essential regulating services that are closely related, and their relationship might produce synergies or trade-offs. Distinguishing the current status and evolution of research in this field could provide a scientific foundation for subsequent research. "Water conservation" and "soil retention" were selected as keywords for a search of Web of Science for publications during 1976-2018. A total of 4489 periodical articles were obtained. Using bibliometric and social network analysis tools, the scientific output performance, national research contributions, potential hot topics, and connections between keywords and the levels of cooperation between countries at different stages were explored to reveal the related development trends. The results showed that the literature on water conservation and soil retention increased rapidly, especially after 2008. The USA, China, and India were the most productive countries, and the USA, the UK, and Canada were the most influential countries regarding international cooperation. Agriculture, water resource utilization, water-soil erosion, and ecosystem services were closely related topics, and the connections between these topics have increased since 1998. In addition to sustainability, the response of water conservation and soil retention to global environmental change, such as water resource management, land use, and land conservation, are potential emerging research hotspots.

Using structural equation modelling to identify regional socio-economic driving forces of soil erosion: A case study of Jiangxi Province, southern China.

Socioeconomic factors are key driving forces for the occurrence and development of soil erosion, but their effects are not well understood. To analyse the relationship between the socioeconomic system and soil erosion, a framework was proposed and validated with structural equation modelling. Population pressure, economic development, agricultural inputs and outputs and soil erosion are latent variables of the framework. A case study was conducted in Jiangxi Province. The results showed that economic development was the key controlling factor and that agricultural output was the main promoting factor for soil erosion, with path coefficients of -1.321 and 1.609 in 1995 and -0.624 and 0.453 in 2010, respectively. This implied that the contradiction between socioeconomic development and ecological protection was alleviated during the study period. Agricultural input controlled severe soil erosion (-|0.322) while promoting mild soil erosion (0.095), which indicated that more attention should be paid to the adverse impact of excessive agricultural inputs on soil erosion control. The identification of the socioeconomic driving forces of regional soil erosion could help adjust the development strategy and mitigate the negative effects of economic development on soil erosion control and ecological conservation.

Endoscopic resection of benign esophageal schwannoma: Three case reports and review of literature.

BACKGROUND: Esophageal schwannomas are uncommon esophageal submucosal benign tumors and are usually treated with surgery. CASE SUMMARY: Here, we report three cases of middle/lower thoracic esophageal schwannoma treated successfully with endoscopic resection. These lesions were misdiagnosed as leiomyoma on preoperative imaging. During the endoscopic resection of such tumors, there is a risk of esophageal perforation due to their deep location. If possible, submucosal tunneling endoscopic resection should be used. CONCLUSION: For larger schwannomas, endoscopy combined with thoracoscopy can be considered for en bloc resection. We performed a mini literature review in order to present the current status of diagnosis and treatment for esophageal schwannoma.

Nasal mucosa pyoderma vegetans associated with ulcerative colitis: A case report.

BACKGROUND: Pyoderma vegetans (PV) is not a common extra-intestinal manifestation of ulcerative colitis (UC), while nasal mucosa PV associated with UC is particularly rare. CASE SUMMARY: We report a 28-year-old female with a history of UC and pyoderma gangrenosum who presented with nasal pain. A nasal lesion could be observed in her nose, and histopathological examination was indicative of PV. The patient was treated with oral prednisone (40 mg per day) with good response and became symptomatically free. There was no recurrent attack after 1 year of follow-up. CONCLUSION: Inflammatory bowel disease patients presenting with nasal pain should be further investigated to rule out the coexistence of nasal mucosa PV.

Inhibition of C3a/C3aR Axis in Diverse Stages of Ulcerative Colitis Affected the Prognosis of UC by Modulating the Pyroptosis and Expression of Caspase-11.

Ulcerative colitis (UC) is a serious digestive system disease. Furthermore, the activation of C3a/C3aR axis promoted the expression of caspase-11. And higher levels of caspase-11 could induce the pyroptosis and inflammation of cells. However, some studies suggested that caspase-11 could promote and suppress the inflammation during the development of UC. In addition, whether C3a/C3aR axis could affect the development of UC by modulating the expression of caspase-11 is unclear. We established the UC rat model in this study. Next, the C3aR inhibitor was used to treat these rats at diverse stages of UC. Next, the HE staining was performed to detect the intestinal damage. ELISA was performed to reveal the expression of IL-6 and TNF-α in different stages of UC. Western blotting was used to detect the expression of caspase-11 and C3aR in different stages of UC. Stimulation of C3aR inhibitor in early stage of UC promoted the expression of C3aR and caspase-11 in later stage of UC. Treatment of C3aR inhibitor in later stage of UC inhibited the expression of C3aR and caspase-11 in later stage of UC. Furthermore, application of C3aR inhibitor in early stage of UC aggravates the damage of colon tissue and enhanced the secretion of TNF-α and IL-6 in the later stage of UC. Treatment of C3aR inhibitor in later stage of UC relieved the symptoms of UC and suppressed the production of TNF-α and IL-6 in the later stage of UC. Application of C3aR inhibitor in early stage of UC induced the poor prognosis of UC by upregulating the expression of caspase-11. Treatment of C3aR inhibitor in later stage of UC relieved the symptoms of UC and lead to the favorable prognosis of UC by inhibiting the expression of caspase-11.

Correlation of Hypoxia-inducible facto-1α and C-reactive protein with disease evaluation in patients with ulcerative colitis.

OBJECTIVE: To investigate the expression levels of hypoxia-inducible factor-1α (HIF-1α) and C-reactive protein (CRP) in patients with ulcerative colitis and correlations of HIF-1α and CRP levels with disease severity. METHODS: A total of 82 patients with confirmed ulcerative colitis were enrolled in this study and according to the disease severity grading, these patients were assigned into three groups: mild group (n=25), moderate group (n=31) and severe group (n=26). And other 30 patients without ulcerative colitis as demonstrated by colonoscopy examination were enrolled in control group in the same period. HIF-1α and CRP levels were detected by ELISA and Real-time PCR and compared among different groups. Pearson's correlation analysis was performed to evaluate the correlations of HIF-1α and CRP levels with disease severity. Logistic regression analysis was used to explore risk factors of disease severity in patients with ulcerative colitis. RESULTS: The expression levels of HIF-1α and CRP in ulcerative colitis group were significantly higher than those in control group (all P<0.001). The levels of HIF-1α and CRP in patients with ulcerative colitis increased remarkably with the increase of disease severity. Patients in mild group had the lowest levels of HIF-1α and CRP, while patients in severe group had the highest levels of HIF-1α and CRP. Logistic regression analysis showed that the expression of HIF-1α and CRP were the risk factors for disease severity of ulcerative colitis (all P<0.001). And Pearson correlation analysis showed that HIF-1α and CRP levels were significantly associated with Rachmilewitz score and disease activity index (DAI), respectively (all P<0.001). CONCLUSION: The levels of HIF-1α and CRP were up-regulated in patients with ulcerative colitis and positively correlated with the progression of ulcerative colitis, indicating that the detection of HIF-1α and CRP expression could be used for predicting the disease severity.

Comparison of different endoscopic resection techniques for submucosal tumors originating from muscularis propria at the esophagogastric junction.

BACKGROUND: To compare the outcomes of submucosal tunneling endoscopic resection (STER) and submucosal excavation (ESE) for the treatment of submucosal tumors (SMTs) arising from the muscularis propria (MP) at the esophagogastric junction (EGJ). METHODS: A retrospective analysis of patients with SMTs at EGJ who underwent STER and ESE from October 2011 to October 2017 was performed. The outcomes evaluated were operation time, complete resection rate, adverse events, and tumor recurrence. RESULTS: Ninety patients were included in this study. Complete resection rates in the STER group were higher than those of the ESE group (100 vs. 92%, p < 0.05). For tumors ≤15 mm, both techniques achieved 100% complete resection rate; but for tumors > 15 mm, complete resection rate was higher in the STER group than the ESE group (100% vs. 77.8%, p < 0.05). Subgroup analyses revealed that the operation time of STER for in cardiac-gastric group was longer than that for ESE (145.14 ± 42.43 min vs. 70.32 ± 39.84 min, p <  0.05). The air leakage symptoms were more frequent in STER group (90.9% vs. 50.0%, p < 0.05). No tumor recurrence occurred in both the STER and ESE groups. CONCLUSIONS: For SMTs ≤15 mm, both STER and ESE have similar satisfactory therapeutic outcomes. However, in the cardiac-gastric subgroup, STER had a longer operative time compared to the ESE procedure. For SMTs > 15 mm, STER is the preferred choice due to its higher complete resection rate.

A gastrointestinal stromal tumor with acute bleeding: Management and nursing.

RATIONALE: Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors involving the gastrointestinal tract. A small percentage of GISTs may cause acute gastrointestinal bleeding, which requires urgent surgical intervention. PATIENT CONCERNS: In this case report, we present a 62-year-old male patient with who was hospitalized due to acute bleeding. DIAGNOSES: The patient was diagnosed as GIST with low risk. INTERVENTIONS: The patient was treated endoscopically with polidocanol sclerotherapy. OUTCOMES: The mass was removed completely, and the patient was discharged at day 9 after operation. LESSONS: This case indicates that GIST can present as massive upper gastrointestinal bleeding and urgent endoscopic sclerotherapy can be life-saving. The endoscopical intervention may be a good alternative for emergency.

The equivalency between logic Petri workflow nets and workflow nets.

Logic Petri nets (LPNs) can describe and analyze batch processing functions and passing value indeterminacy in cooperative systems. Logic Petri workflow nets (LPWNs) are proposed based on LPNs in this paper. Process mining is regarded as an important bridge between modeling and analysis of data mining and business process. Workflow nets (WF-nets) are the extension to Petri nets (PNs), and have successfully been used to process mining. Some shortcomings cannot be avoided in process mining, such as duplicate tasks, invisible tasks, and the noise of logs. The online shop in electronic commerce in this paper is modeled to prove the equivalence between LPWNs and WF-nets, and advantages of LPWNs are presented.

[First flush effects of storm events of Baoxiang River in Lake Dianchi Watershed].

To understand riverine process of non-point source effectively, first flush effects of storm events were investigated at Baoxiang River of Lake Dianchi Watershed. Three sampling stations were selected along Baoxiang River for observing the flow rate and pollutant concentrations of the first three storm events from June 2009 to August 2009. Net discharged volume, net discharged loading, and net event mean concentration (EMC(n)) were proposed with their calculation methods. According to the analysis of three storm events at three stations, the following results colcd be extracted: (1) the larger the percent of impervious land and population density were, the higher EMC(n) of TSS, TN, TP, permanganate index and their cumulative curves [M(V)] were along the river; (2) TSS, TP loadings as well as their M (V) were positively correlated to the storm intensity, while TN and permanganate index loadings were consistent with the total rainfall of each storm event, where the percent of NO3(-) -N in total nitrogen decreased gradually when the number of storm events increased; (3) compared to tradition EMC, EMC(n) was proven to be a better indicator to accurately uncover and magnify the differences in first flush effects of storm events among different stations or storm events.