To support environmentally sound disposal of hexabromocyclododecane (HBCD)-containing construction waste following its global phase-out, this study investigated dioxin-like pollutant emissions and formation mechanisms during co-incineration in hazardous waste incinerators (HWIs). Field trials were conducted by co-incinerating 0%, 1.5%, and 3% HBCD-containing polystyrene foam in a full-scale HWI. HBCD destruction efficiency exceeded 99.999% based on the measured flue gas and fly ash outputs, with trace residues retained in fly ash. Flue gas PCDD/F concentrations were 9.33-11.4 pg I-TEQ/m³ , while PBDD/F and PBDE concentrations ranged from 15.4 to 96.9 pg/m³ and 6.18-69.9 ng/m³ , respectively. In fly ash, PCDD/Fs, PBDD/Fs, and PBDEs were detected at different levels, with PBDD/Fs remaining relatively low and PBDEs showing localized enrichment in waste heat boiler ash. Laboratory pyrolysis experiments conducted under selected temperature conditions showed HBr release and preferential formation of PBDFs over PBDDs. Together with theoretical calculations, these results suggest that PBDD/F formation was not a simple chlorine-to-bromine substitution process, but may involve HBCD-derived bromine, brominated intermediates, PBDE-to-PBDF conversion, and fly ash-mediated secondary reactions. Emission coefficients and material balances were quantified to support scenario-based estimates of future emissions of dioxin-like pollutants. These findings provide field-based emission data and mechanistic insights to support emission assessment and pollution control during the disposal of HBCD-containing waste.
The surging demand for lithium has generated massive lithium slag (LS) stockpiles containing elevated beryllium (Be) and thallium (Tl). However, the quantitative partitioning of Be and Tl among host phases, along with its regulation by additive composition during lithium smelting, has not been established. To address this gap, we (i) identified probable Be and Tl hosts in three LS samples with contrasting Na/Ca ratios by pH-dependent leaching, quantitative mineral dissolution, and density functional theory calculations; (ii) developed a mineralogy-tailored six-step sequential extraction procedure to quantify host-phase partitioning; and (iii) assessed waste-glass-powder-assisted sintering for mineralogical stabilization and ultra-lightweight aggregate (ULWA) production. Results showed that Tl release closely tracked leucite dissolution, and Tl substitution at K sites was energetically favored. Be was mainly distributed among newly formed aluminosilicates, with the dominant associated fractions varying with slag mineralogy. Operational fractionation showed that 80.11-86.73% of Tl occurred in acid-resistant Al-poor aluminosilicate-associated fractions, whereas 90.98% of Be in Na-rich LS was associated with acid-sensitive Al-rich phases. Standard single-step leaching tests captured scenario-specific short-term release but did not fully represent cumulative Be mobilization under sustained acidic weathering. Sintering reconstructed the acid-sensitive assemblage into stable plagioclase while meeting ULWA requirements. Under simulated strong acid rain exposure test, the cumulative Be and Tl releases were reduced by 99.5% and 93.6%, respectively. This work uncovers the mineralogical roots of potential long-term ecological risk in lithium extraction residues and offers a feasible strategy for safely valorizing solid wastes containing trace toxic metals.
Cardiovascular disease (CVD) is the leading cause of death in the United States, and women Veterans (WVs) face elevated risk due to traditional factors (hypertension (HTN), hyperlipidemia (HLD), obesity, diabetes, and smoking) and nontraditional factors (depression and post-traumatic stress disorder [PTSD]). Racial and ethnic disparities further affect their cardiovascular health. This study describes CVD prevalence, risk factors, and health behaviors among WVs to inform interventions. A cross-sectional survey was sent to 1,909 WVs receiving care at a VA Medical Center in California. Participants self-reported health behaviors, CVD diagnoses, and risk factors. The study was approved by the university and VA IRBs (IRB #24-42014). Among 380 respondents (20% response rate; mean age 53), 58% were non-Hispanic White, 20% non-Hispanic Black, and 14% Hispanic. Common CVD risk factors were HLD (38%), obesity (36%), HTN (33%), smoking (13%), and diabetes (10%). Physical activity was low (vigorous activity 1.9 days/week) and diet suboptimal (score 6.1). Hazardous alcohol use was reported by 45.5%. Mean Patient Health Questionnaire 8-Item Scale and PC-PTSD-5 scores indicated moderate depression (8.7) and mild PTSD (2.9). Risk factors and mental health conditions were higher among WVs aged 18-44; nearly 70% reported ≥1 CVD risk factor. CVD prevalence peaked among those aged 65+. WVs in this sample demonstrated concerning CVD risk profiles, alongside a high prevalence of mental health conditions and hazardous alcohol use. Future research should examine social and environmental determinants and link survey data with clinical records to clarify behavior-disease relationships. Addressing both mental health and lifestyle factors is essential to reduce CVD risk and improve long-term health outcomes in WVs.
The textile wastewater containing refractory and tenacious synthetic dyes poses a greater threat and hazardous impact on both terrestrial animals and plants. A limited analysis has been reported on the utilization of Shewanella putrefaciens-immobilized PUF for malachite green (MG) dye in a lab-scale fixed-bed bioreactor (FBBR). Furthermore, the present study focused on the stability and performance of the FBBR for decontaminating a mixture of MG dye and municipal wastewater. In this direction, S. putrefaciens species entrapped in a polyurethane foam matrix coated with calcium alginate was utilized. The efficacy of the biocatalyst was investigated by optimizing process variables, including pH (4.0-9.0), retention time (RT) (6.0-18.0 h), and dye concentration (60-240 mg/L). The central composite design of the response surface methodology-based optimization tool predicts the maximum dye and chemical oxygen demand removal of 91.42% and 88.27%, respectively, at a pH of 7.10, RT of 18.0 h, and an initial dye concentration of 240 mg/L. Furthermore, the predictability of the process responses was explored using artificial neural network analysis, which provided higher reliability in predicting bioreactor behavior. The detection and disappearance of several peaks by Fourier transform infrared spectroscopy analysis indicated that a structural change of the chemical bond occurred during the biodegradation of MG dye. Notably, on a comparison note, the present technique offered a reasonable operational stability, biodegradability, and tolerance ability in dye environment. Therefore, the present technique may serve as a potential approach for future development of large-scale models to degrade and manage textile and municipal wastewater.
As vulnerable road users, pedestrians face a high collision risk in safety-critical traffic scenarios. When faced with approaching vehicles, pedestrians need to balance their desire to cross the road with the demand for safety, resulting in either normal walking or avoidance behaviors. Such uncertain decision affects the occurrence of collisions. Therefore, it is important to understand pedestrian decisions so that highly automated vehicles (HAVs) can better develop safe interaction strategies. To study these decisions under controlled conditions, we designed an immersive virtual reality (VR) experiment where participants encountered traffic scenarios with different spatiotemporal pressures. The experiment observed three distinct decision modes under increasing spatiotemporal pressures: a no-risk mode in which pedestrians predominantly cross normally, a game mode showing a mix of crossing and avoidance, and a life-saving mode dominated by avoidance responses. Based on these decision modes, we proposed a regression model to predict pedestrian decisions. The model achieved an average precision of 0.87 and 0.82 for predicting whether and how pedestrian avoid. Finally, real pedestrian-vehicle conflict data were used to validate the effectiveness of the experimental results. This investigation observes pedestrians' decision modes in various urgent scenarios and presents a decision model based on pedestrians' decision modes, reflecting their interaction logic with hazardous vehicles in traffic scenarios. We expect that the observed decision modes can help develop the safety algorithms of HAVs to achieve safe interactions with pedestrians on roads.
Infertility is a significant health concern that impacts the military as well as the general civilian population. This study aims to investigate prevalence of infertility as our primary outcome, and more specifically (1) compare prevalence estimates of infertility in U.S. military versus civilian populations, and (2) investigate differences in these estimates across key demographic subgroups within these populations. The 2020 Department of Defense Women's Reproductive Health Survey (WRHS, n = 14,443 active duty servicewomen aged 18-44 years) was used to conduct secondary analysis related to our research questions. The cohort from the WRHS was compared to 2,125 civilian women similarly aged 18-44 years from the National Health and Nutrition Examination Survey (NHANES, 2013-2020). The weighted prevalence of infertility was 19.8% (95% CI: 18.9-20.7) among active duty servicewomen and 15.7% (95% CI: 13.7-17.6) among civilian women. The likelihood of infertility was greater for those aged 35-44 compared to those between the ages of 18 and 24 years in both populations. Participants who characterized their race as non-White had significantly greater odds of infertility in the military population, but not in the civilian population (aOR = 1.128, 95% CI: 1.003-1.269). Female service members in the Air Force, Marine Corps, Navy, and Coast Guard were less likely than female service members in the Army to report infertility. This study demonstrated a much higher prevalence estimates in both civilian and military populations than reported in prior studies. Female service members experienced a significantly higher prevalence of infertility than their civilian counterparts. Within the military population, there are significant differences in infertility prevalence with respect to pay grade, age, service branch, and race, despite access to a single payer health system. Studies are needed to evaluate the impact of demographics and additional exposures, to include the potential of certain hazardous or noxious military-specific environmental exposures on infertility in the active duty population.
The development of high-performance anode materials is critical for advancing sodium-ion batteries (SIBs) toward practical applications. Herein, we report a novel FeSe2@S-Ti2C heterostructure synthesized via a safe and straightforward Lewis acidic molten salt etching strategy followed by in-situ selenization. This approach enables simultaneous etching of Ti2AlC MAX phase, surface termination with sulfur-containing groups, and uniform anchoring of FeSe2 nanoparticles within the Ti2C MXene matrix, eliminating the need for hazardous HF or post-synthesis metal removal. The resulting heterostructure integrates multiple advantageous features: The highly conductive Ti₂C MXene framework accelerates the transport of Na+, while its structural robustness effectively accommodates the volume expansion caused by Na+ deintercalation. S-containing surface terminations provide additional active sites that enhance Na+ adsorption. Ultimately, the FeSe₂@S-Ti₂C anode demonstrates exceptional sodium-storage performance, characterized by a high reversible capacity of 397.6 mAh g-1 after 350 cycles at 1 A g-1, superior rate capability (227.8 mAh g-1 at 5 A g-1), as well as robust full-cell performance with an initial Coulombic efficiency of 91.2% and a reversible capacity of 493.6 mAh g-1 following 500 cycles at 1 A g-1. Density functional theory calculations further elucidate the underlying mechanism, revealing metallic conductivity, reduced Na+ diffusion barrier (0.30 eV), and enhanced Na adsorption energy (-2.43 eV) in the heterostructure. This work presents a versatile and scalable strategy for constructing advanced MXene-based heterostructures, offering promising avenues for high-performance SIB anodes.
This study aimed to identify anatomical factors associated with long-term outcomes after thoracic endovascular aortic repair (TEVAR) for degenerative descending thoracic aortic aneurysm (DTAA) using a nationwide registry in Japan. From 2008 to 2015, 23,303 TEVAR cases were prospectively collected by the Japanese Committee for Stentgraft Management (JACSM). Of these, 10,293 patients who underwent initial TEVAR for degenerative DTAA after excluding 353 early deaths were enrolled. Cox regression analysis was performed to determine factors associated with aneurysm-related death and reintervention. Adjusted restricted cubic splines (RCS) were applied to examine potential nonlinear relationships between significant anatomical factors and outcomes. The mean age was 74±8 years, and 7,748 patients (75%) were male. Ten-year freedom from aneurysm-related death and reintervention was 75.5% and 88.4%, respectively. On multivariate analysis, aneurysm diameter, distal neck diameter, and predischarge endoleak were associated with aneurysm-related death. For reintervention, aneurysm diameter, proximal and distal neck diameters, zone 2 landing, and predischarge endoleak were significant predictors. RCS analysis for reintervention showed that increasing aneurysm diameter was associated with higher hazard ratios, reaching 2.21 (95% CI, 1.73-2.83) at 75 mm using 50 mm as reference. For proximal neck diameter, the hazard ratio increased to 1.59 (95% CI, 1.30-1.96) at 35 mm compared with 30 mm. For distal neck diameter, the hazard ratio reached 1.22 (95% CI, 0.96-1.53) at 35 mm compared with 30 mm. The JACSM registry demonstrated that preoperative aneurysm diameter and neck diameters were associated with long-term outcomes after TEVAR for DTAA.
Sleep disturbance is prevalent in aging populations, yet its association with ambient PM2.5 remains insufficiently characterized due to the lack of reliable molecular biomarkers. We leveraged 2350 middle-aged and older adults from the Guangxi Eco-Environmental Health and Aging Study to examine the association between PM2.5 exposure and sleep quality measured by the Pittsburgh Sleep Quality Index (PSQI) and to identify relevant DNA methylation signatures of circadian rhythm genes. Higher PM2.5 was significantly associated with worse sleep outcomes, with the strongest associations for the 2-month exposure window. Particularly, per 10 μg/m3 increase in the 2-month average PM2.5 was associated with a 1.33-point increase in PSQI score (95% CI: 0.95, 1.71), a 0.79-hour reduction in sleep duration (95% CI: -0.99, -0.59), and higher odds of poor sleep quality (odds ratio [OR] =2.17, 95% CI: 1.69, 2.80) and abnormal sleep duration (OR =1.59, 95% CI: 1.24, 2.03). A two-stage analysis of DNA methylation signatures identified 47 sleep-related CpG sites, of which 11 were selected using LASSO penalization to construct the sleep-quality-related methylation risk score (MRS). Mediation analyses further identified five CpGs annotated to NPAS2, PRKAG2, RORA, and CSNK2A2 that partially mediated the association between PM2.5 exposure and sleep quality (mediation proportions: 9.08%-15.98%), whereas the sleep MRS accounted for a higher mediation proportion than individual CpGs (25.03%). Our findings underscore ambient PM2.5 exposure as a relevant environmental factor linked to impaired sleep quality and highlight that circadian epigenetic signatures could serve as molecular markers of vulnerability to pollution-related sleep disturbances.
Microbially induced carbonate precipitation (MICP) is a promising strategy for metal immobilization in saline wastewater, yet the anion-specific mechanisms governing biomineralization in multi-metal systems remain poorly resolved. Here, we investigated how Cl- and SO42- anions regulate Ca2+-Mg2+-Mn2+ ternary carbonate biomineralization by Bacillus dokdonensis WLR1. Two parallel systems with comparable ionic strengths (I ≈ 1.049-1.057 mol/L) were established: a Cl- system containing (CaCl2, MgCl2·6 H2O, MnCl2·4 H2O), and a SO42- system containing (CaCl2, MgSO4, MnSO4). Each system contained six Mn2+ gradients (0-50 mg/L). Compared to the Cl- system, the SO42- system exhibited higher precipitation efficiencies for Ca2+, Mg2+, and Mn2+, with increases of 18%, 25%, and 42%, respectively (P < 0.05). XRD coupled with Rietveld refinement identified Mg-calcite as the dominant mineral phase, having Mn2+ incorporated through isomorphic substitution up to ∼18 mol%. Near-complete Mn2+ removal (99.7%) was achieved in all biotic groups by days 6-8, driven by the low Ksp of MnCO3 (2.24 × 10-¹¹) and carbonic anhydrase (CA) activity. The SO42- system showed higher CA activity (∼14-16 U versus ∼8-8.5 U), enhanced secretion of extracellular polymeric substances (EPS), including both proteins and polysaccharides, and kosmotropic stabilization of EPS protein structure by SO42-. XPS N 1 s spectroscopy provided, to our knowledge, the first direct evidence in biogenic carbonates of Mn2+-amide coordination at ∼401.5-401.9 eV. Thermodynamic calculations demonstrated higher saturation indices for calcite and rhodochrosite in the SO42- system, indicating superior precipitation performance. Our findings provide a mechanistic basis and offer new insights into MICP for anion-specific regulation in saline systems.
Ambient fine particulate matter (PM2.5) remains a leading contributor to the global disease burden. China's Clean Air Actions (CAAs) implemented from 2013 to 2020 achieved substantial progress in PM2.5 mitigation. However, since the third-phase CAA was launched in 2023, nationwide evidence has remained limited on whether further PM2.5 improvements and related health benefits can be sustained amid population aging. We generated a daily 1 km PM2.5 dataset for Chinese Mainland for 2015-2024 to evaluate changes in PM2.5 pollution, exceedances of the WHO Air Quality Guidelines (AQGs), and population-weighted exposure. Health benefits were assessed by estimating PM2.5-attributable cardiovascular disease (CVD) mortality, while decomposition analysis quantified the offsetting effect of population aging. National PM2.5 concentration declined from 35.57 in 2015 to 20.62 μg/m3 in 2024, with a rebound occurring in 2023. Population-weighted PM2.5 decreased by 37.35%. The proportion of the area exceeding the WHO first interim target (35 μg/m3) declined from 51.07% to 1.49%. More than 99% of the population still lived in areas exceeding the WHO AQG level (5 μg/m3). PM2.5-attributable CVD deaths declined from 2.16 (1.64-2.58) million in 2015 to 1.55 (1.14-1.91) million in 2022, before rebounding to 1.76 (1.30-2.15) million in 2024. The share of health benefits offset by population aging rose from around 40% before 2020 to 56.54% in 2024, exceeding 70% in some subregions. Although the third-phase CAA curbed the rebound in 2023, sustained efforts are still required to further reduce PM2.5. Rapid population aging highlights the need for future policies to shift from a concentration-oriented framework toward a health-oriented framework to ensure sustained health benefits.
Epstein-Barr virus (EBV) is strongly implicated in the development of multiple sclerosis (MS) but whether EBV-related immune responses are also relevant for disease progression after diagnosis remains unclear. We investigated whether Epstein-Barr nuclear antigen 1 (EBNA1) antibody levels are associated with disability progression in MS and whether this association is modified by human leucocyte antigen (HLA)-A*02:01 and HLA-DRB1*15:01. We analysed 5706 patients with MS from two population-based Swedish studies with longitudinal follow-up in the Swedish MS registry. EBNA1 IgG levels were analysed as a continuous variable, expressed per one SD increase. The primary outcome was confirmed disability worsening (CDW). Cox proportional hazards models were used to estimate hazard ratios (HRs) with 95% confidence intervals (CIs). Effect modification by HLA-A*02:01 and DRB1*15:01 was assessed using interaction terms and stratified analyses. Secondary and sensitivity analyses included dichotomisation of EBNA1 levels, alternative progression outcomes, delayed-entry models and treatment-related analyses. Higher EBNA1 antibody levels were associated with a reduced risk of CDW among individuals carrying both A*02:01 and DRB1*15:01 (HR 0.87, 95% CI 0.81 to 0.93), whereas associations were weaker or absent in other HLA strata. Findings were similar in secondary and sensitivity analyses. Our findings suggest that EBV-related antibody responses may have prognostic relevance for MS progression in specific genetic contexts, highlighting the importance of host-virus interactions beyond disease onset.
Febrile infection-related epilepsy syndrome (FIRES) is a rare, severe epileptic encephalopathy characterized by refractory status epilepticus, primarily affecting previously healthy children aged 3-15 years. The pathogenesis remains unknown, and outcomes are predominantly poor. This study investigates the acute phase treatment of FIRES, focusing on antiseizure medications (ASMs) and deep sedation with therapeutic coma (TC) for the treatment of status epilepticus, to examine associations with long-term functional outcome. We retrospectively analyzed data from 93 children in a multicenter registry-based cohort from our FIRES registry, assessing acute phase ASMs and duration of TC. Neurological outcomes were assessed using the modified Rankin Scale (mRS), with correlation analyses, multivariate logistic regression, and Cox proportional hazard analyses to explore associations between treatment intensity, functional outcomes, and survival. Higher ASMs count was associated with worse outcome, with each additional medication for seizure control corresponding to 52% increased odds of mRS ≥4 (adjusted odds ratio 1.52, 95% confidence interval 1.17-2.10, P < 0.001). Longer duration of TC correlated with a more ASMs and higher mRS scores, indicating inferior outcome. In our analysis, increased acute treatment intensity and longer durations of TC were associated with worse functional outcomes. These observational associations are likely confounded by underlying disease severity. In the absence of proven causal therapies, the data might be compatible with spontaneous reduction of seizure activity over time in some patients and highlight the need for further research on pathogenesis and pathogenesis-targeted therapies for FIRES.
MYC rearrangement (MYC-R) is a known adverse prognostic factor in multiple myeloma (MM), yet its role in the double-hit model remains undefined. Meanwhile, the prognostic value of MYC gain/amp has not been clearly characterized. This study aimed to evaluate the prognostic impact of MYC-R and/or gain/amp to assess their potential role in refining risk stratification. A prospective cohort of 227 patients with newly diagnosed MM (enrolled in the NICHE clinical trial, NCT04645199) received bortezomib-based induction therapy and, if eligible, underwent upfront autologous stem cell transplantation. The FISH panel included del(13q), del(17p), del(1p), 1q21 gain/amp, IgH rearrangement, t(4;14), t(11;14), t(14;16), t(14;20), MYC break-apart probe, and IgH/MYC fusion probe. Median progression-free survival (PFS) was significantly shorter in patients with MYC-R (34.0 months) or MYC gain/amp (34.3 months), compared with those without MYC abnormalities (49.2 months; P = 0.003 and 0.016, respectively). IgH/MYC was notably more common in cases with undefined-partner IgH translocations (16.6%) than those with defined partners (5.7%), and was associated with poorer outcomes. In multivariate analysis, MYC-R remained an independent predictor of PFS (hazard ratio 1.96, P = 0.007) and improved the discriminative performance of the double-hit model by increasing the concordance index for PFS from 0.549 to 0.581. Both MYC-R and MYC gain/amp indicate adverse prognosis in newly diagnosed MM. The independent prognostic value of MYC-R supports its integration into routine FISH panels and future refinements of the double-hit risk model.
Black individuals have a lower incidence of atrial fibrillation (AF) than White individuals, despite a higher burden of traditional risk factors. Prior studies have suggested that European genetic ancestry may contribute to this paradox, but findings have been inconsistent. We examined the association between European genetic ancestry and incident AF among 6920 UK Biobank (UKB) participants who self-identified as Black and were free of AF at baseline. European ancestry proportions were estimated by comparing participants to HapMap populations and were analysed both continuously and categorically using Cox proportional hazards models. Non-linear associations were evaluated using flexible spline curves. We then conducted a meta-analysis combining these results with those from the Atherosclerosis Risk in Communities Study, the Cardiovascular Health Study and the Women's Health Initiative. During a median follow-up of 13.7 years, 205 (3%) participants developed incident AF. Each 10% increase in European ancestry was non-significantly associated with increased AF risk (HR 1.07 (95% CI 0.95 to 1.20)), and individuals in the highest European ancestry category had a higher AF incidence rate compared with all other categories. Random-effects meta-analysis of all four cohorts yielded a pooled relative risk (RR) of 1.09 (95% CI 0.99 to 1.21), with substantial heterogeneity largely driven by the Women's Health Initiative (WHI) study. Excluding WHI resulted in a pooled estimate (RR 1.14 (95% CI 1.05 to 1.23)) without heterogeneity. In UKB, European ancestry proportion was not significantly linked to incident AF, and pooled cross-cohort results were heterogeneous. Excluding WHI in sensitivity analyses produced a modest positive pooled association with no heterogeneity.
Transition metal-modified Cu-based catalysts have attracted interest for H2S catalytic desulfurization, yet the roles of oxygen species and transition metal promoters in radical-mediated mechanisms remain unclear. Here, Cu-based catalysts modified with ZnO, NiO, or Fe2O3 were synthesized and evaluated via dynamic desulfurization experiments, multi-technique characterization, and DFT calculations. Although the three samples generated abundant ·OH species, Fe2O3/Al2O3 exhibited negligible desulfurization activity, whereas NiO/Al2O3 and ZnO/Al2O3 showed notable catalytic performance. Multi-technique characterization confirmed that amorphous oxygen in the disordered structure induced by Cu/Ni/Zn oxide doping is indispensable for the ·OH-driven reactions; without it, no catalytic desulfurization occurred. ZnO and NiO promoted Cu2+ → Cu+ reduction, increased oxygen vacancies (VOs) concentration, enhanced ·OH content, and created moderate-strength basic sites, collectively facilitating the efficient oxidation of HS- by ·OH anchored on the amorphous oxygen. In contrast, although Fe2O3 doping more effectively enhanced the ·OH content in Cu-based catalysts, it reduced the amorphous oxygen content and its strong H2S affinity blocked the active Cu sites, thereby suppressing catalytic activity. This work establishes that high desulfurization efficiency requires the simultaneous optimization of the four factors: the sufficient amorphous oxygen, the high VOs concentration, the abundant ·OH, and the appropriate basic sites, while avoiding dopants with excessive H2S adsorption strength. These insights provide a rational design framework for non-structured, radical-driven desulfurization catalysts operating under ambient conditions.
Heavy metal contamination in coastal sediments threatens marine microbes and ecological health. Elucidating microbial community synergistic resistance mechanisms is essential for developing novel bioremediation strategies. Microorganisms are known to regulate population-level adaptation to environmental stress through quorum-sensing signals, yet the role of autoinducer-2 (AI-2) in mercury (Hg) resistance and immobilization remains poorly understood. Here, we isolated a thermotolerant Bacillus subtilis strain from coastal sediments and demonstrated that Hg stress selectively activated luxS-associated AI-2 production. AI-2 addition enhanced bacterial survival under combined Hg and heat stress by reducing intracellular reactive oxygen species, increasing antioxidant enzyme activities, promoting biofilm formation, and strengthening Hg adsorption. Sediment microcosm validation further showed that the B. subtilis + AI-2 treatment reduced soluble Hg by 29.6% after 24 h and increased the biomass-associated Hg fraction. These results reveal an AI-2-associated microbial strategy that links intracellular detoxification with extracellular Hg immobilization. While further genetic validation is needed to establish its causal role, this mechanism provides mechanistic insight for microbiome-assisted mercury remediation in thermally dynamic coastal sediments.
Preventing farmers' exposure to pesticides is a major public health issue. However, research on farmers' practices, particularly in high-income countries, rarely explores the combined role of sociodemographic, occupational and psychosocial factors or considers behaviours beyond the use of personal protective equipment. This study investigated pesticide risk prevention behaviours among French farmers, focusing on agricultural specialisation (ie, the main production on the farm), individual characteristics and key psychosocial determinants. A comprehensive telephone survey conducted among French winegrowers or grower-breeders probed their pesticide knowledge, psychological constructs (attitudes and perceptions, social norms and control) and individual and occupational factors. Associations with three preventive behaviours were studied separately by logistic regression. 162 male farmers were surveyed (median age 50, 74% with high school education), including 99 grower-breeders and 63 winegrowers, with differences in farm size, labour structure and employment status. Preventive measures were not implemented systematically: 59% wore gloves, 65% washed their hands and 45% read hazard information on labels. Agricultural specialisation was a major factor influencing behaviour as well as psychosocial determinants (self-efficacy, perceived barriers and social norms). In contrast, sociodemographic factors and knowledge levels had little effect. The adoption of pesticide risk prevention behaviours remains limited over time, even in high-income countries. Our study demonstrates that (1) behaviours relying on distinct determinants should be analysed separately, (2) agricultural specialisation is a major factor influencing behaviours and (3) psychosocial variables play a predominant role in behaviour adoption. This appraisal is crucial for designing an appropriate intervention targeting French farmers.
Classification by the Response Assessment in Neuro-Oncology (RANO) resect group has recently been proposed as a prognostic stratification system for glioblastoma (GBM). However, postoperative T2-weighted/FLAIR (T2W/FLAIR) abnormalities may include edema and surgery-related changes, limiting accurate evaluation of non-contrast-enhancing tumor burden. Therefore, we investigated the prognostic utility of post-chemoradiotherapy (post-CRT) RANO resect classification and T2W/FLAIR volumetric changes in GBM. We retrospectively analyzed 105 consecutive patients with GBM who underwent surgical resection followed by CRT. MRI-based volumetric analyses were performed, RANO resect classification was applied, and T2W/FLAIR-based parameters were evaluated. Only one patient was classified as postoperative RANO resect Class 1, whereas 10 met Class 1 criteria following CRT. Post-CRT RANO resect classification demonstrated superior prognostic stratification compared with postoperative classification (Classes 1, 2 A, 2B, 3 A, and 3B; progression-free survival: 10, 11, 7.5, 5, and 3 months, respectively; p < 0.001; overall survival [OS]: 32.5, 27, 16, 14, and 15 months, respectively; p < 0.001). Survival outcomes did not differ between Classes 1 and 2 A. Among 49 patients with post-CRT RANO resect Class 1/2A, T2W/FLAIR volume reduction ≥ 80% was independently associated with improved OS (hazard ratio: 0.36, p = 0.013). Patients with either RANO resect Class 1 or ≥ 80% T2W/FLAIR reduction demonstrated significantly improved progression-free survival and OS. Telomerase reverse transcriptase (TERT) promoter wildtype status was independently associated with lower post-CRT T2W/FLAIR volume. Post-CRT RANO resect classification may provide improved prognostic stratification in GBM. Integration of T2W/FLAIR volume reduction may further refine prognostic assessment within non-contrast-enhancing tumors.
Cardiovascular-kidney-metabolic (CKM) syndrome staging may summarize chronic multisystem vulnerability, but its relevance to sepsis-associated delirium is unclear. To evaluate the association between EHR-derived modified CKM stage and incident chart-documented delirium among adults with sepsis. We performed a retrospective cohort study using two U.S. intensive care unit (ICU) electronic health record databases, Medical Information Mart for Intensive Care (MIMIC)-IV and eICU Collaborative Research Database (eICU). Adults with sepsis were included after excluding ICU stays shorter than 24 h, delirium within the first 24 h, and missing CKM stage. The analytic time zero was defined as 24 h after ICU admission. The primary outcome was incident delirium; in-hospital mortality was secondary. Cohort-specific Cox and Fine-Gray models were considered the primary evidence. Pooled individual-patient-data and inverse-variance meta-analytic estimates were interpreted as secondary cross-database summaries. We included 24,142 MIMIC-IV and 13,198 eICU patients. In fully adjusted Fine-Gray analyses, modified CKM stage was associated with incident delirium in MIMIC-IV and showed directionally consistent but less precise estimates in eICU. Fixed-effect synthesis yielded subdistribution hazard ratios of 1.31 (95% CI, 1.10-1.57) for stage 0, 1.23 (1.09-1.38) for stage 2, 1.51 (1.34-1.72) for stage 3, and 1.31 (1.16-1.47) for stage 4 versus stage 1. Mortality associations were highly heterogeneous between databases. EHR-derived modified CKM stage was associated with incident delirium in adults with sepsis, although pooled and stage-specific estimates require cautious interpretation. Mortality associations were heterogeneous and did not support a robust pooled conclusion.