Ruijie Wang, Xiaoshuai Wu, Chang Liu et al.

Catalysts • 2022

The nanoporous carbon fiber materials derived from electrospun polyacrylonitrile (PAN) fibers doped with zeolitic imidazolate framework are developed here and applied in the microbe fuel cell anode for enhanced interfacial electron transfer. Zeolitic imidazolate fram-8 (ZIF-8) could introduce a large number of mesopores into fibers, which significantly promote indirect electron transfer mediated by flavins (IET). Moreover, it is noted that thinner fibers are more suitable for cytochromes-based direct electron transfer (DET). Furthermore, the enlarged fiber interspace strengthens the amount of biofilm loading but a larger interspace between thick fibers would hinder the formation of continuous biofilm. Consequently, the nanoporous carbon fiber derived from PAN/ZIF-8 composite with a 1:1 wt ratio shows the best performance according to its suitable mesoporous structure and optimal fiber diameter, which delivers a 10-fold higher maximum power density in microbial fuel cells compared to carbon fabric. In this work, we reveal that the proportion of IET and DET in the interfacial electron transfer process varies with different porous structures and fiber diameters, which may provide some insights for designing porous fiber electrodes for microbial fuel cells and also other devices of bioelectrochemical systems.

Maha A Abdulwahhab, Sarmad T Najim, Maha Allawi Abdulwahhab

Journal of Chemical Technology & Biotechnology • 2023

Abstract Over the past 20 years the scientific community has become interested in microbial fuel cell microbial fuel cell (MFC) technology, because it offers the potential for the direct conversion of organic waste into power generation through microbially catalysed anodic and microbial–enzymatic–abiotic cathodic electrochemical reactions. Several facts about the technology are taken into account in this evaluation. A brief history of abiotic to biological fuel cells is presented, as well as a presentation of microbial fuel cells and a description of the concept of a microbial fuel cell in a broader range of derivative technologies known as bio‐electrochemical systems with biofilm formation, aerobic and anaerobic digestion of organic materials contained in the substrates and how electrons transfer from the surface of the biofilm to the outer circle. Microbial electrolysis cells, and electro‐synthesis cells are briefly discussed. MFC can be improved through the understanding of previous studies by defining the method of work and the theoretical foundations on which they are built. Moreover, the wide range of criteria that is likely to restrict their performance can be determined by providing a brief explanation of components that make them up. Thermodynamic and biotic factors and the mechanism of operation of these bio‐electrochemical systems need to be considered. A review of the various components that make up the MFC will be proposed, allowing for the illumination of the several scientific locks that continue to limit the technology's effectiveness. This review will provide a discussion of the mechanism of MFCs and provide details about the action of electrically active bacteria in the anode chamber through the generation of electroactive biofilms and the conversion of part of the energy available in the substrates, and this is one of renewable energy which is highlighted by researchers. © 2023 Society of Chemical Industry (SCI).

Naoko Yoshida, Yasushi Miyata, Kasumi Doi et al.

Scientific Reports • 2016

Abstract Graphene oxide (GO) is reduced by certain exoelectrogenic bacteria, but its effects on bacterial growth and metabolism are a controversial issue. This study aimed to determine whether GO functions as the terminal electron acceptor to allow specific growth of and electricity production by exoelectrogenic bacteria. Cultivation of environmental samples with GO and acetate as the sole substrate could specifically enrich exoelectrogenic bacteria with Geobacter species predominating (51–68% of the total populations). Interestingly, bacteria in these cultures self-aggregated into a conductive hydrogel complex together with biologically reduced GO (rGO). A novel GO-respiring bacterium designated Geobacter sp. strain R4 was isolated from this hydrogel complex. This organism exhibited stable electricity production at >1000 μA/cm 3 (at 200 mV vs Ag/AgCl) for more than 60 d via rGO while temporary electricity production using graphite felt. The better electricity production depends upon the characteristics of rGO such as a large surface area for biofilm growth, greater capacitance and smaller internal resistance. This is the first report to demonstrate GO-dependent growth of exoelectrogenic bacteria while forming a conductive hydrogel complex with rGO. The simple put-and-wait process leading to the formation of hydrogel complexes of rGO and exoelectrogens will enable wider applications of GO to bioelectrochemical systems.

Lei Zhou, Dandan Deng, Di Zhang et al.

Electroanalysis • 2016

Abstract In this study, the petroleum hydrocarbon‐contaminated soil was used as both inoculation and carbon source simultaneously to enrich exoelectrogenic bacteria for using in microbial fuel cell system and it demonstrated working output power density at around 220 mW m −2 . The feasible electrochemical properties have displayed by means of cyclic voltammetry and dual‐chamber MFCs experiments. Moreover, two species of exoelectrogens were isolated belonging to Geobacter sp. and Ochrobactrum sp., respectively. This work evaluates the capability of naturally occurring petroleum‐degrading species to produce electric current in bioelectrochemical system. To the best of our knowledge, this is the first time when ecological information on electroactive, petroleum‐degrading consortium is provided.

Sheng Tao Jiang, Yu Jiang Guan, Shu Li Bai

Advanced Materials Research • 2012

Different organics have different effects on the power generation of microbial fuel cell. A double-chamber Microbial Fuel Cell (MFC) was constructed to investigate organic matter degradation and power generation. Experiments were conducted using an initial phenol concentration of 500mg/L with different glucose concentrations (500 , 250 , and 100mg/L) as the MFC fuel . Results showed that maximum voltages decreased with the decrease of concentration of glucose and the maximum voltage was 434 mV. The cycle time were 170 , 146 ,141h respectively. Correspondingly , the maximal area power densities were 10.23 mw/m2,5.02mw/m 2 ,3.15 mw/m 2 . phenol and COD removal rate reached 28%-33.3% and 31.1%-54.74% respectively after one cycle. However, maximum voltage was 201 mV when using 500 mg/L phenol as sole fuel. The results indicated that phenol could be used in the MFC for generating power while at the same time effectively accomplishing biodegradation. The MFC technology may provide a new method to offset operating costs, making advanced remediation measures for difficult to degrade organic materials more affordable for practical applications.

Gabriela Campos Mesquita, P. Soares, C. Moura et al.

Brazilian Dental Journal • 2017

This study assessed the epidemiological characteristics and management of the permanent teeth avulsion cases attended in a Brazilian dental trauma service from December 2005 to August 2016. A retrospective study was conducted of case records of 93 patients involving 139 avulsed teeth. Data included sex, age, trauma etiology, location of the accident, number and position of avulsed teeth, and presence and type of associated traumatic lesions. Management of the avulsed teeth was addressed as: time elapsed until teeth were retrieved from the accident's location; teeth's cleaning method and storage media; time elapsed until seeking treatment and replantation. The majority of the patients were children from 6-10 (31.2%) and 11-15 years old (26.9%). Male patients were more affected than female. Bicycle accident was the main etiological factor (31.2%). In 56 (60.2%) cases, traumatic lesions to neighboring teeth were present. In 55 (59.1%) cases, lesions to adjacent soft tissues were reported. In 82 (88.2%) cases, patients requested treatment at the same day of the accident. Sixty-four teeth (46.0%) were immediately retrieved and 28 (20.1%) were not found. Forty-two teeth (30.2%) were kept dry. Only one tooth (0.7%) was immediately replanted at the accident's site, while 51 teeth (36.7%) were not replanted. Numerous avulsed teeth were inappropriately managed and immediate replantation was not frequent. Public policies must be created to raise awareness towards the particularities of avulsion cases.

D. Otero, Bruna A. Bulsing, K. D. M. Huerta et al.

Brazilian Journal of Chemical Engineering • 2019

Different yeast strains from forests located in southern Brazil, with potential to produce carotenoids, were isolated. Three microorganisms were selected as potential carotenoid producers. Sporiodiobolus pararoseus, Rhodotorula mucilaginosa and Pichia fermentans were grown in Yeast Malt (YM) medium and the carotenoids produced identified as cryptoxanthin and β-carotene. In order to reduce production costs, agroindustrial residues were used in the formulation of medium A (parboiled rice water and crude glycerol) and medium B (parboiled rice water and sugar cane molasses). The highest carotenoid production was obtained with S. pararoseus. It reached 905.30 μ gL-1 (122.82 μg g-1) in YM medium, 820 μg L-1 (68.04 μg g-1) in medium B and 710 μg L-1 (86.46 μg g-1) in medium A. R. mucilaginosa exhibited the best performance in medium B (360 μg L-1 and 30.16 μg g-1) and a new microorganism P. fermentans reached 48% (medium A) and 78% (medium B) of the value found in YM medium. Therefore, the agroindustrial residues under evaluation, which replaced the commonly used nitrogen and carbon sources in culture media, enabled the isolated yeasts to yield

Leticia Pinheiro, M. R. S. Lima

Brazilian Political Science Review • 2018

The article examines the construction of the concept of autonomy in Latin America and discusses to what extent it can be applied to contemporary Brazilian foreign policy. The article first examines classical definitions of the concept, and then looks at the ways in which it has been used to analyze Brazilian foreign policy for over half a century. We then reaffirm the importance of agency and how power relations vary from one thematic area to another. In doing so, the [...]

H. P. V. Silva, Thaynnan Thómaz Silva Arruda, K. S. C. Souza et al.

Brazilian Oral Research • 2018

Considering that environmental risk factors substantially contribute to the etiology of orofacial clefts and that knowledge about the characteristics and comorbidities associated with oral clefts is fundamental to promoting better quality of life, this study aimed to describe the risk factors, main characteristics, and comorbidities of a group of patients with cleft lip and/or cleft palate (CL/P) from Rio Grande do Norte (RN), Brazil. Data were obtained from 173 patients with CL/P using a form from the Brazilian database on Orofacial Clefts. Most patients were male with cleft lip and palate and had a normal size and weight at birth; presented few neonatal intercurrent events; and had anemia and respiratory and cardiovascular diseases as main associated comorbidities. They also required timely surgical rehabilitation and multidisciplinary care to stimulate their neuropsychomotor development. In addition, a high frequency of familial recurrence and of parental consanguinity was evidenced in the studied population, especially for the cleft lip and cleft palate type. Other relevant findings were the considerable maternal exposure to alcohol, infections, smoking, and hypertension, as well as low supplementation with vitamins and minerals and deliberate consumption of analgesics, antibiotics, and antihypertensives during pregnancy. Characterization of the CL/P patient profile is essential for the planning of health services and integration among the health professionals involved in the diagnosis and treatment of these malformations. Our results reinforce the need for additional research to confirm the association between environmental factors and the development of orofacial clefts.

F. Timóteo, F. Korkes, W. Baccaglini et al.

International braz j urol • 2020

ABSTRACT Introduction Considering the lack of data on BC trends in Brazilian population, mainly as a result of the difficulty on gathering data, the present manuscript provides an overview of bladder cancer incidence, hospitalization, mortality patterns and trends using the Brazilian Data Center for The Public Health System (DATASUS). Materials and Methods All hospital admissions associated with BC diagnosis (ICD-10 C67) between 2008 and 2017 were analyzed. Distributions according to year, gender, age group, ethnicity, death, length of hospital stay, and costs were evaluated. Demographic data was obtained from the last Brazilian national census. Results From 2008 to 2017 there were 119,058 public hospital admissions related to BC. Patients were mostly white males aged 60 to 79 years-old. Mortality rates for patients who have undergone surgery was 6.75% on average, being 7.38% for women and 6.49% for men. Mortality rates were higher when open surgeries were performed compared to endoscopic procedures (4.98% vs 1.18%). Considering only endoscopic procedures, mortality rates were three times higher after urgent surgeries compared to elective ones (2.6% vs 0.6%). Over the years the cystectomy/transurethral bladder resection (C/T) ratio significantly decreased in all Brazilian Regions. In 2008, the C/T ratio was 0.19, while in 2017 it reduced to 0.08. Conclusions Despite BC relatively low incidence, it still represents a significant social economic burden in Brazil, as it presents with recurrent episodes that might require multiple hospitalizations and surgical treatment. The set of data collected might suggest that population access to health care has improved between 2008-2017.

Shaik Ashmath, Hao Wu, Shaik Gouse Peera et al.

Catalysts • 2024

Pt supported on carbon (Pt/C) is deemed as the state-of-the-art catalyst towards oxygen reduction reactions (ORRs) in chemical and biological fuel cells. However, due to the high cost and scarcity of Pt, researchers have focused on the development of Earth-abundant non-precious metal catalysts, hoping to replace the traditional Pt/C catalyst and successfully commercialize the chemical and biological fuel cells. In this regard, electrocatalysts made of transition metals emerged as excellent candidates for ORRs, especially the electrocatalysts made of Fe and Co in combination with N-doped carbons, which produce potentially active M-N4-C (M=Co, Fe) ORR sites. At present, however, the transition metal-based catalysts are popular; recently, electrocatalysts made of rare earth metals are emerging as efficient catalysts, due to the fact that rare earth metals also have the potential to form rare earth metal-N4-C active sites, just like transition metal Fe-N4-C/Co-N4-C. In addition, mixed valance states and uniqueness of f-orbitals of the rare earth metals are believed to improve the redox properties of the catalyst that helps in enhancing ORR activity. Among the rare earth metals, Ce is the most interesting element that can be explored as an ORR electrocatalyst in combination with the N-doped carbon. Unique f-orbitals of Ce can induce distinctive electronic behavior to the catalyst that helps to form stable coordination structures with N-doped carbons, in addition to its excellent ability to scavenge the OH● produced during ORRs, therefore helping in catalyst stability. In this study, we have synthesized Ce/N-C catalysts by a metal–organic framework and pyrolysis strategy. The ORR activity of Ce/N-C catalysts has been optimized by systematically increasing the Ce content and performing RDE studies in 0.1 M HClO4 electrolyte. The Ce/N-C catalyst has been characterized systematically by both physicochemical and electrochemical characterizations. The optimized Ce/N-C-3 catalyst exhibited a half-wave potential of 0.68 V vs. RHE. In addition, the Ce/N-C-3 catalyst also delivered acceptable stability with a loss of 70 mV in its half-wave potential when compared to 110 mV loss for Pt/C (10 wt.%) catalyst, after 5000 potential cycles. When Ce/N-C-3 is used as a cathode catalyst in dual-chamber microbial fuel cells, it delivered a volumetric power density of ~300 mW m−3, along with an organic matter degradation of 74% after continuous operation of DCMFCs for 30 days.

Shaik Ashmath, Hyuk-Jun Kwon, Shaik Gouse Peera et al.

Nanomaterials • 2022

Due to the high cost of presently utilized Pt/C catalysts, a quick and sustainable synthesis of electrocatalysts made of cost-effective and earth-abundant metals is urgently needed. In this work, we demonstrated a mechanochemically synthesized cobalt nanoparticles supported on N and S doped carbons derived from a solid-state-reaction between zinc acetate and 2-amino thiazole as metal, organic ligand in presence of cobalt (Co) metal ions ZnxCox(C3H4N2S). Pyrolysis of the ZnxCox(C3H4N2S) produced, Co/NSC catalyst in which Co nanoparticles are evenly distributed on the nitrogen and sulfur doped carbon support. The Co/NSC catalyst have been characterized with various physical and electrochemical characterization techniques. The Co content in the ZnxCox(C3H4N2S) is carefully adjusted by varying the Co content and the optimized Co/NSC-3 catalyst is subjected to the oxygen reduction reaction in 0.1 M HClO4 electrolyte. The optimized Co/NSC-3 catalyst reveals acceptable ORR activity with the half-wave potential of ~0.63 V vs. RHE in acidic electrolytes. In addition, the Co/NSC-3 catalyst showed excellent stability with no loss in the ORR activity after 10,000 potential cycles. When applied as cathode catalysts in dual chamber microbial fuel cells, the Co/NCS catalyst delivered satisfactory volumetric power density in comparison with Pt/C.

Sunghoon Son, Sokhee P. Jung

Journal of Korean Society of Environmental Engineers • 2022

A sediment microbial fuel cell (SMFC) is a system in which MFC is applied to a sediment layer of an aqueous system for water purification. SMFCs can remove contaminants from sediments and decompose organic matter while simultaneously producing electrical energy. SMFC is installed in the form of installing an anode in the sediment at the bottom of the water system and a cathode in the water layer above the sediment, and connecting the two electrodes through an external circuit. Early SMFCs were developed to be used as power sources in hard-to-reach deep water areas or remote areas. However, recently, it has attracted a lot of attention as a technology for biologically purifying pollutants through its own power supply. Furthermore, it is being developed as a means of monitoring the environmental condition of the installed area. Despite the importance of SMFC, no comprehensive review has yet been published to the Korean readers on the trends and prospects of SMFC research. Therefore, in this review paper, the mechanism of SMFC, their mechanism of removal of organic, inorganic, and heavy metals, and the current state of SMFC technology are discussed, and future prospects are presented.

K. Hatake, T. Doi, H. Uetake et al.

Japanese Journal of Clinical Oncology • 2016

BACKGROUND Bevacizumab (Avastin(®)) was approved in Japan in April 2007 for patients with advanced or metastatic colorectal cancer. To address the limited clinical experience in Japanese patients, a post-approval surveillance study was undertaken in bevacizumab-treated patients in Japan. METHODS Bevacizumab (5 or 10 mg/kg every 2 weeks) was administered with chemotherapy; patients were observed for 26 weeks from initiation of treatment. The primary objective was to investigate the incidence of adverse drug reactions, particularly those of interest for bevacizumab. Univariate and multivariate analyses were performed to identify potential risk factors for adverse drug reactions. RESULTS In total, 2712 patients were registered and 2696 patients were included in the safety analysis. Hypertension (13.1%), hemorrhage (10.5%) and proteinuria (4.5%) were the most common adverse drug reaction. The incidences of serious adverse drug reactions were low: gastrointestinal perforation occurred in 0.9% of patients, hemorrhage in 1.3%, arterial thromboembolic events in 0.3%, venous thromboembolic events in 1.3% and wound-healing complications in 0.4%. The incidence of bevacizumab-specific adverse drug reactions was not influenced by the bevacizumab dose. Multivariate analyses identified risk factors for the following adverse drug reactions: hypertension (prior/concurrent hypertension); tumor-associated bleeding (performance status, prior/concomitant anticoagulant or nonsteroidal anti-inflammatory drug use); proteinuria (sex, performance status, prior/concurrent diabetes and proteinuria); gastrointestinal perforation (primary tumor in situ, concurrent nonsteroidal anti-inflammatory drug use); venous thromboembolic event (treatment stage, port insertion). CONCLUSIONS The safety profile of bevacizumab-containing regimens in this Japanese population was comparable with studies performed in Western countries. Bevacizumab is generally well tolerated in Japanese patients with advanced or metastatic colorectal cancer.

A. Inoue, K. Yoshida, S. Morita et al.

Japanese Journal of Clinical Oncology • 2016

Background The Japan Guidelines of Lung Cancer Therapy recommend epidermal growth factor receptor-tyrosine kinase inhibitors as a first-line therapy for advanced/recurrent non-small cell lung cancer patients with epidermal growth factor receptor mutation. Although survival periods in recent reports of epidermal growth factor receptor-tyrosine kinase inhibitor treatment have been getting longer, the reasons why are unclear. We investigated the survival, prognostic factors and real-world treatment of non-small cell lung cancer patients with epidermal growth factor receptor mutation in clinical practice. Methods Non-small cell lung cancer patients (n = 1660) who started first-line treatment from January 2008 to December 2012 were enrolled. Patients were diagnosed with epidermal growth factor receptor mutation-positive advanced/recurrent non-small cell lung cancer by histology or cytology samples. The primary objective was to estimate overall survival. The secondary objectives were to determine prognostic factors, real-world treatment patterns and efficacy of gefitinib treatment. We calculated the treatment exposure rate for each treatment category using the following formula: exposure rate = person-years for the treatment category/total person-years × 100. Results The median overall survival was 30.8 months. Sex, age, histology, epidermal growth factor receptor mutation type, clinical stage and performance status affected overall survival. The exposure rates for all epidermal growth factor receptor-tyrosine kinase inhibitors, gefitinib and platinum-doublet chemotherapy were 62.1, 46.4 and 8.5% respectively. Overall 56.1% of patients were administered gefitinib as first-line therapy, and 39.0% were treated with ≥2 epidermal growth factor receptor-tyrosine kinase inhibitor regimens. The median progression-free survival in the first-line gefitinib group was 11.4 months. Factors affecting prognosis were sex, histology, clinical stage and performance status. Conclusion Epidermal growth factor receptor-tyrosine kinase inhibitors, especially gefitinib, are major components of the treatment regimens for epidermal growth factor receptor mutation-positive non-small cell lung cancer. Switching and re-challenging with epidermal growth factor receptor-tyrosine kinase inhibitors were also practiced in Japan.

Naoya Miyashita, Y. Yamauchi

Japanese Clinical Medicine • 2018

Bacterial pneumonia is one of the most important infectious diseases in terms of incidence, effect on quality of life, mortality, and impact on society. Pneumonia was the third leading cause of death in Japan in 2011. In 2016, 119 650 Japanese people died of pneumonia, 96% of whom were aged 65 years and above. The symptoms of pneumonia in elderly people are often atypical. Aspiration pneumonia is seen more frequently than in young people because of swallowing dysfunction in the elderly. The mortality rate is also higher in the elderly than in young people. In Japan, the population is aging at an unprecedented rate, and pneumonia in the elderly will be increasingly important in medicine and medical economics in the future. To manage pneumonia in the elderly, it is important to accurately evaluate its severity, administer appropriate antibiotic treatment, and implement effective preventive measures.

K. Cameron

• 2016

The purpose of this paper is to present a brief background of tribal reservations, the process of how Microbial Fuel Cells (MFCs) work, and the potential benefits of using MFCs on tribal reservations to convert waste water to energy as a means to sustainably generate electricity. There have been no known studies conducted on tribal lands that would be able to add to the estimated percentage of all renewable energy resources identified. Not only does MFC technology provide a compelling, innovative solution, it could also address better management of wastewater, using it as a form of energy generation. Using wastewater for clean energy generation could provide a viable addition to community infrastructure systems improvements.

S. Sambavi, S. Vishali, Sunita Varjani et al.

Indian Journal of Experimental Biology • 2020

Rapid industrialization and population growth have generated a worldwide interest in renewable energy resourcesto meet. In this context, microbial fuel cells serve the dual purpose of electricity generation and wastewater treatment in a sustainable way. Here, we conducted a set of experiments in two-chambered microbial fuel cell (MFC) to study its efficiency in chemical oxygen demand (COD) removal and electricity generation. The MFC was run at constant pH of 5.5 and mesophilic temperature of 30-32  C using mixed consortia of sediment as inoculum and candy industry wastewater as substrate. Of the five different initial substrate concentrations of 2000, 4000, 6000, 8000 and 10000 mg COD/L studied, the highest COD removal efficiency of 96.0% and electricity generation of 810 mV was recorded at the initial substrate concentration of 4000 mg COD/L. The experiments conducted also revealed that iron oxide nanoparticles concentration of 0.10 g/L with an average size of 25.64 nm, increased the electricity generation potential to 870 mV by 6.9%. Among the different species of bioelectricity generating bacteria colonized, Corynebacterium variabile SMS-14 was documented as the most dominant species.

Erdan Luo, Daiyan Zhang, Hua Luo et al.

Chinese Medicine • 2020

Background A novel coronavirus was identified in December, 2019 in Wuhan, China, and traditional Chinese medicine (TCM) played an active role in combating the novel coronavirus pneumonia (NCP) caused by this fast-spreading virus COVID-19. Thus, we aimed to explore TCM characteristics of clinical efficacy to NCP, as well as to optimize Qingfei Paidu decoction (QFPDD) and the recommended formulas to NCP by National Health Commission (NHC). Methods Chinese medical sciences theory and clinical application of TCM were analyzed. A total of 54 NCP patients were observed in a hospital from Wuhan, whose clinical characteristics and utilization of Chinese Medicines (CMs) were described. Paired t test was used to measure the change of patients’ hemogram during hospitalization period, indicating the effect of CMs. Multiple linear regression analysis was applied to explore the factors affecting the length of hospital stay. Network pharmacology analysis was applied to figure out the performance of NHC-recommended formulas of five disease stages at levels of compounds, targets and pathways. Result The average length of hospital stay was 8.96 days. Patients over 45 stayed 9.79 days in hospital in average, longer than 7.64 days of patients under 45. Comparing the hemograms between admission and discharge of hospital, the number of leukocytes, neutrophil, lymphocyte and platelet increased, while the numbers of erythrocytes, hemoglobin concentration and hematocrit decreased. According to the standard coefficients of regression, the factor affecting the length of stay for the most was CMs in category of invigorating spleen and removing dampness (ISRD), followed by administrating CMs, male, and cough. Thirty-two CMs were screened after deleting duplication from QFPDD and NHC-recommended formulas. Compound quercetin, luteolin, kaempferol, acacetin etc., were all involved in the treatment of various disease stages on the compound level both in generality and individuality. Conclusion TCM has a systemic theoretical understanding on the pathological evolution and a positive clinical efficacy on NCP. The CMs of ISRD improved patients’ recovery, suggesting the importance of regulating intestinal function and keeping microenvironmental balance in TCM treatment of NCP. The active compounds from QFPDD and NHC-recommended formulas contribute to recovery of varied disease progresses during TCM treating NCP.

J. Plantin, G. de Seta

Chinese Journal of Communication • 2019

In the current research on media and communication, Western internet companies (e.g. Google and Facebook) are typically described as digital platforms, yet these actors increasingly rely on infrastructural properties to expand and maintain their market power. Through the case study of the Chinese social media application, WeChat, we argue that WeChat is an example of a non-Western digital media service that owes its success first to its platformization and then to the infrastructuralization of its platform model. Moreover, our findings show that the infrastructuralization of the WeChat platform model in China is shaped by markedly techno-nationalist media regulations and an increasingly overt cyber-sovereignty agenda. Drawing on the results of the analysis of technical documentation, business reports, as well as observations and interviews, we first present WeChat as both a platform and an infrastructure, and then we contextualize WeChat in the history of ICT infrastructure and the development of the internet in China. Finally, we analyze the specific role of the WeChat Pay service in establishing a new monetary transaction standard. We conclude by inquiring whether this emerging techno-nationalist model could be a plausible platform regulation in the future.

Xu Chen, D. B. V. Kaye, Jing Zeng

Chinese Journal of Communication • 2020

In Chinese political discourse, “positive energy” (zheng nengliang) is a popular expression that has embodied mainstream political ideology in China since 2012. This term has also become prominent on Douyin, a prominent Chinese short-video platform. By June 2018, over 500 Chinese governmental accounts on Douyin had promoted positive energy in videos, and the content was viewed over 1.6 billion times. Douyin even created a separate trending section, Positive Energy, for videos that promoted the dominant state ideology. This study argues that the Positive Energy feature on Douyin is significant. The Chinese government has accused and even permanently shut down several digital platforms for spreading “vulgarity” as the antithesis of positive energy. Using the app walkthrough method and a content analysis of over 800 videos collected from the Positive Energy section of Douyin, this study explores how Douyin promotes the Chinese state’s political agenda by promoting a new form of playful patriotism online.

Sumei Wang, Shunqin Long, Zhiyin Deng et al.

The American Journal of Chinese Medicine • 2020

Complementary and alternative medicine (CAM) plays a critical role in treating cancer patients. Traditional Chinese Medicine (TCM) is the main component of CAM. TCM, especially Chinese Herbal Medicine (CHM), has been increasingly used in China, some other Asian countries and European countries. It has been proven to enhance the efficacy of chemotherapy, radiotherapy, targeted-therapy, and immunotherapy. It lessens the damage caused by these therapies. CHM functions on cancer by inhibiting tumor progression and improving an organism's immune system. Increasing evidence has shown that many CHM exert favorable effects on the immune regulation. We will summarize the role of CHM on patient's immune system when treating cancer patients. Our evidence reveals that single herbs, including their extracts, compound formulations, and preparations, will provide current advances on CHM study, especially from the perspective of immune regulation and novel insights for CHM application in clinic. The main herbs used to treat cancer patients are health-strengthening (Fu-Zheng) herbs and pathogen eliminating (Qu-Xie) herbs. The key mechanism is regulating the immune system of cancer patients. Firstly, health-strengthening herbs are mainly functioned as immune regulatory effectors on cancer. Secondly, some of the compound formulations mainly strengthen the health of patients by regulating the immune system of cancer patients. Lastly, some Chinese medicine preparations are widely used to treat cancer for their properties of spiriting vital energy and anti-cancer effects, mainly by improving immunity. CHM plays a positive role in regulating patients' immune system, which helps cancer patients to fight against cancer itself and finally improves patients' life quality.

Yulin Wang, Xiuming Shi, Li Li et al.

The American Journal of Chinese Medicine • 2021

Traditional Chinese Medicine (TCM) is a well-established medical system with a long history. Currently, artificial intelligence (AI) is rapidly expanding in many fields including TCM. AI will significantly improve the reliability and accuracy of diagnostics, thus increasing the use of effective therapeutic methods for patients. This systematic review provides an updated overview on the major breakthroughs in the field of AI-assisted TCM four diagnostic methods, syndrome differentiation, and treatment. AI-assisted TCM diagnosis is mainly based on digital data collected by modern electronic instruments, which makes TCM diagnosis more quantitative, objective, and standardized. As a result, the diagnosis decisions made by different TCM doctors exhibit more consistency, accuracy, and reliability. Meanwhile, the therapeutic efficacy of TCM can be evaluated objectively. Therefore, AI is promoting TCM from experience to evidence-based medicine, a genuine scientific revolution. Furthermore, huge and non-uniform knowledge on formula-syndrome relationships and the combination rules of herbal TCM formulae could be better standardized with the help of AI analysis, which is necessary for the clinical efficacy evaluation and further optimization on the standardized TCM formulae. AI bridges the gap between TCM and modern science and technology. AI may bring clinical TCM diagnostics closer to western medicine. With the help of AI, more scientific evidence about TCM will be discovered. It can be expected that more unified guidelines for specific TCM syndromes will be issued with the development of AI-assisted TCM therapies in the future.

Huajuan Jiang, Minmin Li, Kequn Du et al.

Chinese Medicine • 2021

The high incidence of breast cancer is the greastest threat to women’ health all over the world. Among them, HER-2 positive breast cancer has the characteristics of high malignancy, easy recurrence and metastasis, and poor prognosis. Traditional Chinese medicine (TCM) has a rich theoretical basis and clinical application for breast cancer. TCM believes that blood stasis syndrome is one of the important pathogenesis of breast formation and development. Taohong Siwu Decoction (TSHWD) is based on the “First Prescription of Gynecology” Siwu Decoction. It is widely used in various blood stasis and blood deficiency syndromes, mainly in gynecological blood stasis. Clinical studies have found that THSWD can treat breast cancer by reducing blood vessel and lymphangiogenesis with auxiliary chemotherapy. In this study, we aim to explore the material basis and mechanism of THSWD in the treatment of HER-2 positive breast cancer through literature review and network pharmacology studies. Through a literature review of the traditional application, chemical composition of Chinese herbal medicine of THSWD, as well as its clinical reports and pharmacological research on breast cancer treatment. Meanwhile, we conducted “component-pathway-target” network through network pharmacology reveals the main material basis, possible targets and pathways of THSWD in inhibiting HER-2 positive breast cancer. Literature review and network pharmacology research results had predicted that, baicalein, kaempferol, caffeic acid, amygdalin, quercetin, ferulic acid, gallic acid, catalpol, hydroxysafflor yellow A, paeoniflorin in THSWD are the main effective chemical composition. THSWD regulates 386 protein targets and 166 pathways related to breast cancer. The molecular mechanism is mainly to improve the microenvironment of tumor cells, regulate the process of tumor cell EMT, and inhibit tumor cell proliferation and metastasis. This study revealed the mechanism of action of THSWD in the treatment of HER-2 positive breast cancer through literature review and network pharmacology studies, providing a scientific basis for clinical application.

Shuo Yuan, Qi Wang, Jiao Li et al.

Chinese Medicine • 2022

Inflammatory bowel disease (IBD) is a chronic recurrent inflammatory disease of the intestine, including Crohn’s disease (CD) and ulcerative colitis (UC), whose etiology and pathogenesis have not been fully understood. Due to its prolonged course and chronic recurrence, IBD imposes a heavy economic burden and psychological stress on patients. Traditional Chinese Herbal Medicine has unique advantages in IBD treatment because of its symptomatic treatment. However, the advantages of the Chinese Herbal Medicine Formula (CHMF) have rarely been discussed. In recent years, many scholars have conducted fundamental studies on CHMF to delay IBD from different perspectives and found that CHMF may help maintain intestinal integrity, reduce inflammation, and decrease oxidative stress, thus playing a positive role in the treatment of IBD. Therefore, this review focuses on the mechanisms associated with CHMF in IBD treatment. CHMF has apparent advantages. In addition to the exact composition and controlled quality of modern drugs, it also has multi-component and multi-target synergistic effects. CHMF has good prospects in the treatment of IBD, but its multi-agent composition and wide range of targets exacerbate the difficulty of studying its treatment of IBD. Future research on CHMF-related mechanisms is needed to achieve better efficacy.

Xuan Zhang, Lin Zhang, Jacky C. P. Chan et al.

Chinese Medicine • 2022

Objective To investigate how the ulcerative colitis (UC) be treated with Chinese herbal medicines (CHM), using Chinese medicine (CM) pattern ( zheng ) identification, in the current clinical practice. Methods A total of 7 electronic databases were systematically searched for UC clinical studies with CHM interventions (including single herbs and CHM formulas) published in English and Chinese from the date of their inception to November 25, 2020. Descriptive statistics were adopted to demonstrate the characteristics of study design, and to collate the commonly CM patterns of UC and frequently used CHM herbs and formulas. Further, IBM SPSS Modeler 18.0 and Cytoscape 3.7.1 software were used to analyze and visualize the associations between different categories of CHM and their zheng indications. Results A total of 2311 articles were included in this study, of which most (> 90%) were RCTs with CHM formulas. The most common zheng of UC was Large intestine dampness-heat , while the basic type of CM patten was Spleen deficiency . The most frequently used classical formula was Bai-Tou-Weng-Tang , followed by Shen-Ling-Bai-Zhu-San , and the commonly used proprietary CHM was Xi-Lei-San (enema). Sulfasalazine and Mesalazine are commonly used as concomitant western medicines. The most frequently used single medicinals were Huang Lian and Bai Zhu , which also identified as the core herbs for different CM patterns. Conclusion This study examined the application of CHM interventions for UC and summarized their characteristics in clinical practice. These data indicated there were limited information about the safety assessment of CHM formulas and further RCTs including CM pattern(s) with strict design are necessary.

Xiaojuan Liu, Xiangka Hu, He Yang et al.

The American Journal of Chinese Medicine • 2022

Diabetic nephropathy (DN) is a common microvascular complication of diabetes mellitus (DM), which can lead to renal failure in diabetic patients. At present, the first-line drugs for DN are mainly the renin-angiotensin system (RAS) inhibitors or angiotensin receptor blockers, and the latest approved aldosterone receptor antagonist finerenone, which delay the progression of DN to end-stage renal disease (ESRD), but the therapeutic effect is still not ideal. With a history of thousands of years, traditional Chinese medicine (TCM) has rich experience in the treatment of DN. Based on the theory of TCM, the clinical treatment of DN mainly focuses on generating fluid and nourishing blood, nourishing Qi and Yin, detoxifying and detumescent. In recently years, the therapeutic effects and mechanisms of TCM prescription, Chinese herbal medicine, and its active components on DN have received extensive attention in new drug development. This paper reviews the research progress of the mechanism of TCM on DN.

Hui-qin Luo, Qiao-ling Tang, Ya-xi Shang et al.

Chinese Journal of Integrative Medicine • 2020

Objective Since December 2019, an outbreak of corona virus disease 2019 (COVID-19) occurred in Wuhan, and rapidly spread to almost all parts of China. This was followed by prevention programs recommending Chinese medicine (CM) for the prevention. In order to provide evidence for CM recommendations, we reviewed ancient classics and human studies. Methods Historical records on prevention and treatment of infections in CM classics, clinical evidence of CM on the prevention of severe acute respiratory syndrome (SARS) and H1N1 influenza, and CM prevention programs issued by health authorities in China since the COVID-19 outbreak were retrieved from different databases and websites till 12 February, 2020. Research evidence included data from clinical trials, cohort or other population studies using CM for preventing contagious respiratory virus diseases. Results The use of CM to prevent epidemics of infectious diseases was traced back to ancient Chinese practice cited in Huangdi’s Internal Classic (Huang Di Nei Jing) where preventive effects were recorded. There were 3 studies using CM for prevention of SARS and 4 studies for H1N1 influenza. None of the participants who took CM contracted SARS in the 3 studies. The infection rate of H1N1 influenza in the CM group was significantly lower than the non-CM group (relative risk 0.36, 95% confidence interval 0.24–0.52; n=4). For prevention of COVID-19, 23 provinces in China issued CM programs. The main principles of CM use were to tonify qi to protect from external pathogens, disperse wind and discharge heat, and resolve dampness. The most frequently used herbs included Radix astragali (Huangqi), Radix glycyrrhizae (Gancao), Radix saposhnikoviae (Fangfeng), Rhizoma Atractylodis Macrocephalae (Baizhu), Lonicerae Japonicae Flos (Jinyinhua), and Fructus forsythia (Lianqiao). Conclusions Based on historical records and human evidence of SARS and H1N1 influenza prevention, Chinese herbal formula could be an alternative approach for prevention of COVID-19 in high-risk population. Prospective, rigorous population studies are warranted to confirm the potential preventive effect of CM.

S. Zheng, Tianyu Xue, Bin Wang et al.

The American Journal of Chinese Medicine • 2022

Ulcerative colitis (UC) is a common clinical inflammatory bowel disease characterized by repeated attacks, difficult treatment, and great harm to the physical and mental health of the patients. The occurrence and development of UC were closely related to the physiological and pathological processes, such as intestinal inflammatory reaction, oxidizing reaction, and immune response. Treatment of ulcerative colitis using Western medicine is often associated with a number of limitations and adverse events. There is a long history of using traditional Chinese medicine in dealing with this medical condition. Commonly used traditional Chinese medicines for the treatment of UC include Caulis Sargentodoxae, Flos Lonicerae, Fructus Cnidii, etc. Additionally, classic prescriptions such as Gegen Qinlian Formulae and Zuojin Pills can also be used to treat UC. To enrich the traditional Chinese medicine theory, the cognitive theory and perspective of network pharmacology and bioinformatics research of cell signal transduction mechanism of UC are emerging rapidly. Modern pharmacological studies focus on underlying mechanisms for the management of UC with Chinese medicine monomers, single Chinese medicines, and traditional Chinese medicine formulations, alleviating the symptoms of UC, controlling the development of intestinal inflammation, and restoring intestinal function through the regulation of key molecular signaling pathways, including PI3K/Akt, NF-[Formula: see text]B, JAK/STAT, MAPK and Notch. By summarizing current research progressions, this review provides key references for the in-depth exploration of the mechanisms focused on signaling pathways for the clinical management of UC using traditional Chinese medicine.

Li-Yang Zhou, Hong Lu, Zhiqiang Song et al.

Chinese Medical Journal • 2022

Abstract Background: Helicobacter pylori (H. pylori) infection is an infectious disease with a prevalence rate of up to 50% worldwide. It can cause indigestion, gastritis, peptic ulcer, and gastric cancer. H. pylori eradication treatment can effectively control disease progression and reduce the risk of the above conditions. However, the escalating trend of antibiotic resistance presents a global challenge for H. pylori eradication. We aim to provide guidance on pharmacological treatment of H. pylori infection. Methods: This clinical practice guideline is developed following the World Health Organization's recommended process, adopting Grading of Recommendations Assessment, Development and Evaluation in assessing evidence quality, and utilizing Evidence to Decision framework to formulate clinical recommendations, minimizing bias and increasing transparency of the clinical practice guideline development process. We used the Reporting Items for practice Guidelines in HealThcare (RIGHT) statement and The Appraisal of Guidelines for Research and Evaluation II (AGREE II) as reporting and conduct guides to ensure the guideline's completeness and transparency. Results: Though decreasing in developed countries, the prevalence of H. pylori remains high in developing countries, causing a major public health burden. This clinical practice guideline contains 12 recommendations concerning pharmacological treatment for H. pylori eradication. Among them, it is worth highlighting that bismuth preparations are inexpensive, safe, and effective, consequently making bismuth quadruple therapy a preferred choice for initial and rescue treatment. In empirical treatment, high-dose dual therapy is equally effective compared with bismuth quadruple therapy. Conclusions: The 12 recommendations in this clinical practice guideline are formed with consideration for stakeholders’ values and preferences, resource use, feasibility, and acceptability. Recommendations are generalizable to resource limited settings with similar antibiotic resistance pattern as China, and lower middle-income countries facing comparable sociological and technical challenges. Registration: Guidelines International Network (GIN) website, https://guidelines.ebmportal.com/node/69996.

Xianglong Meng, Xiaoqing Liu, Jiaying Tan et al.

Chinese Medicine • 2023

Diabetes mellitus (DM) is a chronic metabolic disorder characterized by hyperglycemia resulting from insulin secretion defects or insulin resistance. The global incidence of DM has been gradually increasing due to improvements in living standards and changes in dietary habits, making it a major non-communicable disease that poses a significant threat to human health and life. The pathogenesis of DM remains incompletely understood till now, and current pharmacotherapeutic interventions are largely inadequate, resulting in relapses and severe adverse reactions. Although DM is not explicitly mentioned in traditional Chinese medicine (TCM) theory and clinical practice, it is often classified as “Xiaoke” due to similarities in etiology, pathogenesis, and symptoms. With its overall regulation, multiple targets, and personalized medication approach, TCM treatment can effectively alleviate the clinical manifestations of DM and prevent or treat its complications. Furthermore, TCM exhibits desirable therapeutic effects with minimal side effects and a favorable safety profile. This paper provides a comprehensive comparison and contrast of Xiaoke and DM by examining the involvement of TCM in their etiology, pathogenesis, treatment guidelines, and other relevant aspects based on classical literature and research reports. The current TCM experimental research on the treatment of DM by lowering blood glucose levels also be generalized. This innovative focus not only illuminates the role of TCM in DM treatment, but also underscores the potential of TCM in DM management.

Ling Li, Lele Yang, Liuqing Yang et al.

Chinese Medicine • 2023

Network pharmacology can ascertain the therapeutic mechanism of drugs for treating diseases at the level of biological targets and pathways. The effective mechanism study of traditional Chinese medicine (TCM) characterized by multi-component, multi-targeted, and integrative efficacy, perfectly corresponds to the application of network pharmacology. Currently, network pharmacology has been widely utilized to clarify the mechanism of the physiological activity of TCM. In this review, we comprehensively summarize the application of network pharmacology in TCM to reveal its potential of verifying the phenotype and underlying causes of diseases, realizing the personalized and accurate application of TCM. We searched the literature using “TCM network pharmacology” and “network pharmacology” as keywords from Web of Science, PubMed, Google Scholar, as well as Chinese National Knowledge Infrastructure in the last decade. The origins, development, and application of network pharmacology are closely correlated with the study of TCM which has been applied in China for thousands of years. Network pharmacology and TCM have the same core idea and promote each other. A well-defined research strategy for network pharmacology has been utilized in several aspects of TCM research, including the elucidation of the biological basis of diseases and syndromes, the prediction of TCM targets, the screening of TCM active compounds, and the decipherment of mechanisms of TCM in treating diseases. However, several factors limit its application, such as the selection of databases and algorithms, the unstable quality of the research results, and the lack of standardization. This review aims to provide references and ideas for the research of TCM and to encourage the personalized and precise use of Chinese medicine.

Ilham Mufandi, Isti Nur Azizah, A. Efendi et al.

CHEMICA: Jurnal Teknik Kimia • 2018

The vegetable waste is one of the biomass types that it can produce electrical energy.  This article focused on electrical production of vegetable waste using microbial fuel cells (MFCS) MFCs is the primary type of the bioelectrochemical system (BECs) that to replaces the biomass to electrical energy spontaneously by activity metabolism of the microorganism. The objectives of this work were to investigate the process of electrical production from Chinese cabbage and the combination of the materials to produce the electrical energy. The experiment was carried out in a laboratory-sall such as mini reactor MFCs, Chinese cabbage as the material of vegetable waste and EM4 as the fermentation. Sample combination was consist of two parts that the first part was used 1 kg Chinese cabbage, 2 liter water and 20 ml EM4. The second part was used 2 kg Chinese cabbage, 1 liter water and 20 ml EM4. The result showed that the electrical voltage in part 1 at 0.362 V and pH at 6 was lower than the electrical voltage in part 2 at 0.724 V and pH at 7. Declining electric energy is influenced by pH as microorganisms living place and the formation process of attached media at the electrode.

Lihua Zhou, Lihua Sun, P. Fu et al.

Journal of Materials Chemistry A • 2017

Three-dimensional (3D) electrodes have been intensively investigated as high-performance electrodes to harvest microbial energy in bioelectrochemical systems (BESs). However, the fabrication of low-cost high-performance 3D electrodes is still a great challenge. Herein, we reported a new highly conductive and biocompatible 3D electrode by simply coating natural loofah sponge (LS) with low-cost Chinese ink (CI) that has been used for writing and drawing for thousands of years. A high current density of 16.3 ± 0.5 mA cm−3 was achieved by the as-prepared Chinese ink-coated loofah sponge (CI-LS), which is close to that of the 3D electrode produced from the carbonized LS and equals those of most of the available materials in the current state of research. This high current density is attributed to the open macroporous structure of the LS as well as high conductivity and good biocompatibility of the carbon nanoparticle coating layers. The performance of the CI-LS depended strongly on the type of CI used as the conductive coating material. Besides, the resulting bioelectrode displayed promising stability, which outperformed other 3D electrodes based on synthetic sponges. Considering the low-cost and facile fabrication, this CI-LS 3D electrode has promising potential for high-performance and cost-effective BESs on a large scale.

Qian Ding, Yingxiu Cao, Feng Li et al.

PubMed • 2021

Microbial fuel cell (MFC) is a bioelectrochemical device, that enables simultaneous wastewater treatment and energy generation. However, a few issues such as low output power, high ohmic internal resistance, and long start-up time greatly limit MFCs' applications. MFC anode is the carrier of microbial attachment, and plays a key role in the generation and transmission of electrons. High-quality bioelectrodes have developed into an effective way to improve MFC performance. Conjugated polymers have advantages of low cost, high conductivity, chemical stability and good biocompatibility. The use of conjugated polymers to modify bioelectrodes can achieve a large specific surface area and shorten the charge transfer path, thereby achieving efficient biological electrochemical performance. In addition, bacteria can be coated with nano-scale conjugated polymer and effectively transfer the electrons generated by cells to electrodes. This article reviews the recently reported applications of conjugated polymers in microbial fuel cells, focusing on the MFC anode materials modified by conjugated polymers. This review also systematically analyzes the advantages and limitations of conjugated polymers, and how these composite hybrid bioelectrodes solve practical issues such as low energy output, high inner resistance, and long starting time.

Guangle Li, Xiyun Feng, Jinbo Fei et al.

Advanced Materials Interfaces • 2017

A biohybrid photoanode is constructed by integrating photosystem II with doped conducting polymer nanowires that are synthesized by template‐directed electrochemical deposition. Interestingly, at the same applied bias potential ranging from 0 to 0.5 V versus saturated calomel electrode (SCE), this hybrid photoanode shows a higher photocurrent than that of pure photosystem II coated on a bare indium tin oxide (ITO) surface. Particularly, the photocurrent for the integrated photoanode above is enhanced about 39.0‐fold with increased stability (0.25 V vs SCE). Such assembled system combining natural photoactive protein with artificial low‐cost conducting polymer shows great potential for advanced solar energy conversion.

A. Timmis, N. Townsend, C. Gale et al.

European Heart Journal • 2019

AIMS The 2019 report from the European Society of Cardiology (ESC) Atlas provides a contemporary analysis of cardiovascular disease (CVD) statistics across 56 member countries, with particular emphasis on international inequalities in disease burden and healthcare delivery together with estimates of progress towards meeting 2025 World Health Organization (WHO) non-communicable disease targets. METHODS AND RESULTS In this report, contemporary CVD statistics are presented for member countries of the ESC. The statistics are drawn from the ESC Atlas which is a repository of CVD data from a variety of sources including the WHO, the Institute for Health Metrics and Evaluation, and the World Bank. The Atlas also includes novel ESC sponsored data on human and capital infrastructure and cardiovascular healthcare delivery obtained by annual survey of the national societies of ESC member countries. Across ESC member countries, the prevalence of obesity (body mass index ≥30 kg/m2) and diabetes has increased two- to three-fold during the last 30 years making the WHO 2025 target to halt rises in these risk factors unlikely to be achieved. More encouraging have been variable declines in hypertension, smoking, and alcohol consumption but on current trends only the reduction in smoking from 28% to 21% during the last 20 years appears sufficient for the WHO target to be achieved. The median age-standardized prevalence of major risk factors was higher in middle-income compared with high-income ESC member countries for hypertension {23.8% [interquartile range (IQR) 22.5-23.1%] vs. 15.7% (IQR 14.5-21.1%)}, diabetes [7.7% (IQR 7.1-10.1%) vs. 5.6% (IQR 4.8-7.0%)], and among males smoking [43.8% (IQR 37.4-48.0%) vs. 26.0% (IQR 20.9-31.7%)] although among females smoking was less common in middle-income countries [8.7% (IQR 3.0-10.8) vs. 16.7% (IQR 13.9-19.7%)]. There were associated inequalities in disease burden with disability-adjusted life years per 100 000 people due to CVD over three times as high in middle-income [7160 (IQR 5655-8115)] compared with high-income [2235 (IQR 1896-3602)] countries. Cardiovascular disease mortality was also higher in middle-income countries where it accounted for a greater proportion of potential years of life lost compared with high-income countries in both females (43% vs. 28%) and males (39% vs. 28%). Despite the inequalities in disease burden across ESC member countries, survey data from the National Cardiac Societies of the ESC showed that middle-income member countries remain severely under-resourced compared with high-income countries in terms of cardiological person-power and technological infrastructure. Under-resourcing in middle-income countries is associated with a severe procedural deficit compared with high-income countries in terms of coronary intervention, device implantation and cardiac surgical procedures. CONCLUSION A seemingly inexorable rise in the prevalence of obesity and diabetes currently provides the greatest challenge to achieving further reductions in CVD burden across ESC member countries. Additional challenges are provided by inequalities in disease burden that now require intensification of policy initiatives in order to reduce population risk and prioritize cardiovascular healthcare delivery, particularly in the middle-income countries of the ESC where need is greatest.

J. Dawson, Y. Béjot, L. Christensen et al.

European Stroke Journal • 2022

Recurrent stroke affects 9% to 15% of people within 1 year. This European Stroke Organisation (ESO) guideline provides evidence-based recommendations on pharmacological management of blood pressure (BP), diabetes mellitus, lipid levels and antiplatelet therapy for the prevention of recurrent stroke and other important outcomes in people with ischaemic stroke or transient ischaemic attack (TIA). It does not cover interventions for specific causes of stroke, including anticoagulation for cardioembolic stroke, which are addressed in other guidelines. This guideline was developed through ESO standard operating procedures and the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) methodology. The working group identified clinical questions, selected outcomes, performed systematic reviews, with meta-analyses where appropriate, and made evidence-based recommendations, with expert consensus statements where evidence was insufficient to support a recommendation. To reduce the long-term risk of recurrent stroke or other important outcomes after ischaemic stroke or TIA, we recommend: BP lowering treatment to a target of <130/80 mmHg, except in subgroups at increased risk of harm; HMGCoA-reductase inhibitors (statins) and targeting a low density lipoprotein level of <1.8 mmol/l (70 mg/dl); avoidance of dual antiplatelet therapy with aspirin and clopidogrel after the first 90 days; to not give direct oral anticoagulant drugs (DOACs) for embolic stroke of undetermined source and to consider pioglitazone in people with diabetes or insulin resistance, after careful consideration of potential risks. In addition to the evidence-based recommendations, all or the majority of working group members supported: out-of-office BP monitoring; use of combination treatment for BP control; consideration of ezetimibe or PCSK9 inhibitors when lipid targets are not achieved; consideration of use of low-dose DOACs in addition to an antiplatelet in selected groups of people with coronary or peripheral artery disease and aiming for an HbA1c level of <53 mmol/mol (7%) in people with diabetes mellitus. These guidelines aim to standardise long-term pharmacological treatment to reduce the burden of recurrent stroke in Europe.

L. Bartalena, G. Kahaly, L. Baldeschi et al.

European Journal of Endocrinology • 2021

Graves' orbitopathy (GO) is the main extrathyroidal manifestation of Graves' disease (GD). Choice of treatment should be based on assessment of clinical activity and severity of GO. Early referral to specialized centers is fundamental for most patients with GO. Risk factors include smoking, thyroid dysfunction, high serum level of thyrotropin receptor antibodies, radioactive iodine (RAI) treatment, and hypercholesterolemia. In mild and active GO, control of risk factors, local treatments and selenium (selenium-deficient areas) are usually sufficient; if RAI treatment is selected to manage GD, low-dose oral prednisone prophylaxis is needed, especially if risk factors coexist. For both active moderate-to-severe and sight threatening GO, antithyroid drugs are preferred when managing Graves' hyperthyroidism. In moderate-to-severe and active GO, intravenous (iv) glucocorticoids are more effective and better tolerated than oral glucocorticoids. Based on current evidence and efficacy/safety profile, costs and reimbursement, drug availability, long-term effectiveness and patient choice after extensive counselling, a combination of iv methylprednisolone and mycophenolate sodium is recommended as first-line treatment. A cumulative dose of 4.5 grams (g) of iv methylprednisolone in 12 weekly infusions is the optimal regimen. Alternatively, higher cumulative doses not exceeding 8 g can be used as monotherapy in most severe cases and constant/inconstant diplopia. Second-line treatments for moderate-to-severe and active GO include: a) a second course of iv methylprednisolone (7.5 g) subsequent to careful ophthalmic and biochemical evaluation, b) oral prednisone/prednisolone combined with either cyclosporine or azathioprine; c) orbital radiotherapy combined with oral or iv glucocorticoids, d) teprotumumab; e) rituximab and f) tocilizumab. Sight threatening GO is treated with several high single doses of iv methylprednisolone per week and, if unresponsive, with urgent orbital decompression. Rehabilitative surgery (orbital decompression, squint and eyelid surgery) is indicated for inactive residual GO manifestations.

Y. Stede, A. Stoicescu, Giusi Amore et al.

EFSA Journal • 2018

Abstract This report of the European Food Safety Authority and the European Centre for Disease Prevention and Control presents the results of zoonoses monitoring activities carried out in 2017 in 37 European countries (28 Member States (MS) and nine non‐MS). Campylobacteriosis was the commonest reported zoonosis and its EU trend for confirmed human cases increasing since 2008 stabilised during 2013–2017. The decreasing EU trend for confirmed human salmonellosis cases since 2008 ended during 2013–2017, and the proportion of human Salmonella Enteritidis cases increased, mostly due to one MS starting to report serotype data. Sixteen MS met all Salmonella reduction targets for poultry, whereas 12 MS failed meeting at least one. The EU flock prevalence of target Salmonella serovars in breeding hens, laying hens, broilers and fattening turkeys decreased or remained stable compared to 2016, and slightly increased in breeding turkeys. Salmonella results on pig carcases and target Salmonella serovar results for poultry from competent authorities tended to be generally higher compared to those from food business operators. The notification rate of human listeriosis further increased in 2017, despite Listeria seldom exceeding the EU food safety limit in ready‐to‐eat food. The decreasing EU trend for confirmed yersiniosis cases since 2008 stabilised during 2013–2017. The number of confirmed shiga toxin‐producing Escherichia coli (STEC) infections in humans was stable. A total of 5,079 food‐borne (including waterborne) outbreaks were reported. Salmonella was the commonest detected agent with S. Enteritidis causing one out of seven outbreaks, followed by other bacteria, bacterial toxins and viruses. The agent was unknown in 37.6% of all outbreaks. Salmonella in eggs and Salmonella in meat and meat products were the highest risk agent/food pairs. The report further summarises trends and sources for bovine tuberculosis, Brucella, Trichinella, Echinococcus, Toxoplasma, rabies, Coxiella burnetii (Q fever), West Nile virus and tularaemia.