Search

Background: Lower urinary tract symptoms (LUTS) are common complaint in urology practice and affecting the quality of life for patients. This article aims to perform a systematic review and meta-analysis on the global prevalence of LUTS overall, and according to different patient characteristics. Methods: We searched MEDLINE and Embase for population-based epidemiological studies reporting the prevalence of LUTS from inception to 1 Jan 2021. Studies which: (1) have enough information on sample size and prevalence; (2) investigate individuals aged 15 or above; and (3) have clear diagnostic criteria for LUTS. We extracted the following information: year of publication; name of the first author; study period; region of recruitment; race; age range; sex; severity; symptoms; and criteria. We pooled rate estimates with exact binomial and test score-based confidence intervals (CIs) using proportions with a random-effects model. Results: We included 222 studies from 36 countries involving 1,692,110 samples and 632,933 patients with LUTS. The overall prevalence of any and moderate-to-severe LUTS was 63.2% (95% CI = 58.0–68.1) and 31.3% (95% CI = 28.8–33.8), respectively. The most common symptom was storage symptoms (56.7%; 95% CI = 51.0–62.4), followed by voiding symptoms (36.4%; 95% CI = 27.8–45.4) and post-micturition symptoms (30.7%; 95% CI = 19.2–43.6). A higher prevalence of moderate-to-severe LUTS was observed in male subjects (35.2%; 95% CI = 32.1–38.5) and individuals aged ≥60 (39.0%; 95% CI = 33.4–44.8; I2 = 99.9%). Its prevalence increased from 27.4% (95% CI = 24.5–30.3) in 1990–1999, to 31.9% (95% CI = 27.3–36.7) in 2000–2009 and 36.2% (95% CI = 30.7–41.9) in 2010–2019. Conclusions: This study was the first comprehensive meta-analysis examining the global prevalence of LUTS. We identified a high level of LUTS prevalence in the general population, with a higher burden in male subjects, older individuals, and the Asian population. There has been an increasing trend in the prevalence of LUTS since the 1990s.

BACKGROUND: Testicular cancer is a common malignancy among young males in western countries. OBJECTIVE: To examine the global disease burden and trends of testicular cancer incidence and mortality by age and country, and their associations with human development index (HDI), gross domestic product (GDP), lifestyle habits, and metabolic risk factors. DESIGN, SETTING, AND PARTICIPANTS: We retrieved the Global Cancer Observatory database for the testicular cancer incidence and mortality in 2020; the World Bank for GDP per capita; the United Nations for HDI; the WHO Global Health Observatory for prevalence of smoking and alcohol drinking; and the Cancer Incidence in Five Continents, WHO mortality database, Surveillance, Epidemiology, and End Results programme and Nordic Cancer Registries (NORDCAN) for trend analysis. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: We presented the testicular cancer incidence and mortality using age-standardised rates. We examined their associations with HDI, GDP, smoking, alcohol drinking, physical inactivity, overweight, obesity, and medical conditions including diabetes, hypertension, and hypercholesterolaemia by linear regression. We estimated the 10-yr trend of incidence and mortality by joinpoint regression with average annual percentage change with 95% confidence intervals in different age groups. RESULTS AND LIMITATIONS: There was a wide variation in the testicular cancer burden with the highest mortality found in low-income countries, and the regions of Central America and South America, while the highest incidence was observed in high-income countries, especially in Western and Northern Europe. We found a positive association for HDI, GDP, alcohol drinking, inactivity, overweight, obesity, and hypercholesterolaemia with testicular cancer incidence, while a negative correlation was observed between GDP and mortality of testicular cancer. Globally, there was an overall increasing incidence trend of testicular cancer for the past decade, particularly in younger males; the mortality trends of testicular cancer were relatively stable. However, we did not analyse the trend of different stages and subtypes of testicular cancer due to data unavailability. CONCLUSIONS: There was a global variation in the testicular cancer burden associated with HDI, GDP, alcohol drinking, inactivity, overweight, obesity, and hypercholesterolaemia. Testicular cancer had an increasing incidence but decreasing mortality. The increasing testicular cancer incidence in the younger population is of concern and calls for early detection and preventive interventions. PATIENT SUMMARY: Globally, testicular cancer incidence had been increasing particularly in the younger population, although its deaths rates had been decreasing. Socioeconomic indices, alcohol drinking, inactivity, overweight, obesity, and high plasma lipid levels are associated with testicular cancer incidence and mortality.

Background: We aimed to examine the global disease burden and trends of prostate cancer incidence and mortality by age, and their associations with gross domestic product (GDP), human development index (HDI), smoking, and alcohol drinking. Materials and Methods: We retrieved the Global Cancer Observatory (GLOBOCAN) database for the incidence and mortality of prostate cancer in 2020; the World Bank for GDP per capita; the United Nations for HDI; the WHO Global Health Observatory for prevalence of smoking and alcohol drinking; the Cancer Incidence in 5 Continents (CI5), WHO mortality database, for trend analysis. We presented the prostate cancer incidence and mortality using age-standardized rates. We examined their associations with GDP, HDI, smoking, and alcohol drinking by Spearman's correlations and multivariable regression. We estimated the 10-year trend of incidence and mortality by joinpoint regression analysis with average annual percent change with 95% confidence intervals in different age groups. Results: A wide variation in the burden of prostate cancer with the highest mortality found in low-income countries while the highest incidence was observed in high-income countries. We found moderate to high positive correlations for GDP, HDI, and alcohol drinking with prostate cancer incidence, whilst a low negative correlation was observed for smoking. Globally, there was an increasing incidence but decreasing mortality of prostate cancer, and such trends were particularly prominent in Europe. Notably, the incidence increase was also found in the younger population aged

The effluents of municipal wastewater treatment plant (WWTP) contain excessive nitrogen and phosphorus compared with the concentration in rivers or lakes. To reduce the pollutant load placed on aqueous environments, constructed wetland (CW) technology has been widely applied to advanced wastewater treatment. Packing substrates in CW could remove various pollutants. Steel slag, yellow earth, kaolin, volcanic rock, anthracite, and ceramsite could effectively remove phosphorus (P); volcanic rock, ceramsite, zeolite, yellow earth, manganese sand, and activated carbon have an affinity for ammonia nitrogen (NH4+-N). After 24 h reactions with the WWTP standard 1B synthetic wastewater, four packing substrates, i.e., volcanic rock and anthracite (1:1), volcanic rock and yellow earth (2:1), zeolite and yellow earth (2:1), and manganese sand and activated carbon (1:3), could remove over 56% and 30% of NH4+-N and phosphorus respectively. In addition, anthracite and volcanic rock (1:3), anthracite and activated carbon (1:40), anthracite and manganese sand (1:5), and anthracite and zeolite (1:4) effectively purified NH4+-N and phosphorus in secondary WWTP effluent, with removal efficiency exceeding 39% and 27%, respectively. A sequential experiment was performed to optimize packing substrates ratios in CW with volcanic rock and anthracite, ceramsite and yellow earth, and manganese sand and activated carbon. When the quantity of the substrate was doubled, most packing substrates adsorb more than 50% phosphorus and NH4+-N of the standard 1B WWTP synthetic wastewater. Considering the removal efficiency of packing substrates on phosphorus and NH4+-N, it is suggested that manganese sand and activated carbon (1:3), volcanic rock and anthracite (2:1), and yellow earth are appropriate substrates for CW in WWTP effluent advanced treatment.

Developing low-cost, well-performing, and resource-efficient photocatalysts with enhanced solar light utilization can contribute to the practicability of photocatalytic techniques in organic wastewater treatment. This study fabricated and characterized a novel sunlight-driven BiOBr- and acetylene black (AB)-loaded monolithic photocatalyst. The fly ash-based geopolymer acts as photocatalyst support that can also provide adsorption sites and semiconductor metal oxide (Fe

The oxygen level is key benthic ecosystem health. In this study, a new kind of slow-release oxygen material (SROM) was developed and evaluated in a simulation experiment. The effects of SROM dose and dosing method on the pH and DO, the release of nitrogen and phosphorus, and greenhouse gas emissions were studied. The restoration of typical benthic species (Ceratophyllum represented submerged plants and Cipangopaludina cahayensis represented benthic animals) was also evaluated based on the analysis of catalase and peroxidase activities, survival rate, and biomass. The result shows that dosing SROM on mud surfaces had a better effect than dosing in mud. When dosing SROM on the surface of mud at a suitable dose, the DO of water increased from 0.5 mg/L to higher than 4 mg/L, and the pH was below 9, which would be suitable for the survival of benthos. Dosing SROM could also cause the concentrations of nutrient elements (NH

IMPORTANCEChildren exposed to a high level of prenatal alcohol exposure (PAE) are more likely to develop fetal alcohol spectrum disorder with adverse phenotypes on their faces. However, it is still poorly understood, which level of PAE is associated with facial manifestation and if such associations persist during childhood.OBJECTIVETo examine the association between PAE and children’s facial phenotype in a prospective multi-ethnic population-based study.DESIGN, SETTING, AND PARTICIPANTSThis study was based on the Generation R Study, a prospective cohort from fetal life onwards with maternal and offspring data. Children had a 3D facial image taken at ages 9 (n=3160) and 13 years (n=2492).EXPOSURESWe defined 6 levels of PAE based on the frequency and dose of alcohol consumption, and defined three tiers based on the timing of alcohol exposure of the unborn child.MAIN OUTCOMES AND MEASURESFor image analysis, we used 3D graph convolutional networks for non-linear dimensionality reduction, which compressed the high-dimensional images into 200 endophenotypes representing facial morphology. These facial endophenotypes were used as dependent variables in a linear regression analysis to search for associations with PAE. Finally, to detect specific facial components associated with PAE, we mapped statistically significant endophenotypes back to the 3D facial shape. We generated heatmaps to display the facial changes associated with PAE. PAE prediction based on facial shape was also performed; the prediction accuracy was estimated by area under the receiver operating characteristic curve (AUC).RESULTSA significant association between PAE and facial shape was found in the 9-year-old children, at all levels of alcohol exposure: the higher the level of exposure, the stronger the association. Moreover, PAE before and during pregnancy was associated with facial shape. The most common detected facial phenotypes included turned-up nose tip, shortened nose, turned-out jaw and turned-in lower-eyelid-related regions. For the 13-year-old children, the associations were weaker and the AUCs lower than those of the 9-years-old children.CONCLUSIONS AND RELEVANCEPAE before and during pregnancy, even at low level, is associated with the facial shape of children, and these associations become weaker as children grow older.Key pointsQuestionsWhich level of prenatal alcohol exposure (PAE) is associated with children’s facial shape at different lifetimes?FindingsA 3D facial phenotype analysis of 9- (N=3160) and 13- (N=2492) year-old children was conducted. PAE before and during pregnancy, even at low level, associates with the children’s facial shape; the association becomes weaker as children grow older.MeaningThe results suggest avoiding drinking alcohol at least three months before and during pregnancy is the safest option for the child. More research is needed to investigate the consequences of PAE on children; the discovered facial phenotypes could be used as a biomarker for further investigations.

This study aimed to evaluate the global distribution, associated factors, and epidemiologic trends of gallbladder cancer (GBC) by country, sex, and age groups. The Global Cancer Observatory was interrogated for the disease burden of GBC using age-standardized rates (ASR). The prevalence of different potential risk factors for each country was extracted from Global Health Observatory and their associations with GBC incidence and mortality were examined by linear regression analysis using beta coefficients (β). The Cancer Incidence in Five Continents I-XI and the WHO Mortality database were searched and Average Annual Percent Change (AAPC) was generated from joinpoint regression analysis. The incidence (ASR = 2.3) and mortality (ASR = 1.7) of GBC varied globally in 2018 and were higher in more developed countries and among females. Countries with higher incidence had higher human development index (βmale = 0.37; βfemale = 0.27), gross domestic products (βmale = 0.13) and higher prevalence of current smoking (βfemale = 0.05), overweight (βmale = 0.02), obesity (βmale = 0.03), and hypercholesterolaemia (βmale = 0.07). Similar patterns of associations were also observed for mortality with an additional association found for diabetes (βfemale = 0.07). Although there was an overall decreasing trend in mortality, an increasing trend in incidence was observed among some populations, particularly in males (AAPCs, 8.97 to 1.92) and in younger individuals aged

Background This study aimed to evaluate the updated incidence, mortality, risk factors, and epidemiologic trends of colorectal cancer (CRC) for different regions and sex using publicly available data from 186 countries. Methods The Global Cancer Observatory (GLOBOCAN) database was retrieved for the age-standardized rates (ASR) for incidence and mortality of CRC in 2018 and 2012. The prevalence of risk factors (2008–2016) was retrieved from the Global Health Observatory database. The associations between the prevalence of risk factors and incidence and mortality of CRC and were measured using beta coefficients (β) with 95% confidence intervals (CI) generated from a univariable linear regression analysis. Results In 2018, the highest incidence and mortality of CRC were in regions of very high human development index (HDI) (ASRs, 30.6 and 11.1) with men to women ratio of 1.4 and 1.2. Population in countries with higher incidence have higher alcohol consumption (β=1.30, 95% CI 1.02 to 1.57 for men; β=0.46, CI 0.35 to 0.57 for women), higher prevalence of tobacco use (β=0.11, CI 0.02 to 0.19 for women), insufficient physical activity (β=0.59, CI 0.34 to 0.84; β=0.19, CI 0.09 to 0.29), overweight (β=0.47, CI 0.38 to 0.57; β=0.16, CI 0.12 to 0.20), obesity (β=0.24, CI 0.11 to 0.38; β=0.34, CI 0.25 to 0.43), and elevated cholesterol (β=1.80, CI 1.53 to 2.07; β=1.22, CI 1.05 to 1.38). Similar associations were also found for mortality (figure 1). From 2012 to 2018, there was an overall increase in the trend of incidence and mortality, particularly in Asia (+29.7% and +17.4%) and Africa (+24.3% and +17.6%), and among men (+14.6% and +8.0%) compared with women (+14.0% and +4.3%). Conclusions The variation in disease burden of CRC was associated with HDI and the prevalence of risk factors. There was an increasing trend in the incidence and mortality of CRC, particularly in regions with low and middle incomes and among men. More intensive lifestyle modifications and population-based screening are recommended for these populations.

The degradation of chlorpyrifos (CP) by an endophytic bacterial strain (HJY) isolated from Chinese chives (Allium tuberosum Rottl. ex Spreng) was investigated. Strain HJY was identified as Sphingomonas sp. based on morphological, physiological, and biochemical tests and a 16S rDNA sequence analysis. Approximately 96% of 20 mg L-1 CP was degraded by strain HJY over 15 days in liquid minimal salts medium (MSM). The CP degradation rate could also be increased by glucose supplementation. The optimal conditions for the removal of 20 mg L-1 CP by strain HJY in MSM were 2% inoculum density, pH 6.0, and 30-35°C. The CP degradation rate constant and half-life were 0.2136 ± 0.0063 d-1 and 3.2451 ± 0.0975 d, respectively, under these conditions, but were raised to 0.7961 ± 0.1925 d-1 and 0.8707 ± 0.3079 d with 1% glucose supplementation. The detection of metabolic products and screening for degrading genes indicated that O,O-diethyl O-3,5,6-trichloropyridinol was the major degradation product from CP, while it was likely that some functional genes were undetected and the mechanism responsible for CP degradation by strain HJY remained unknown. Strain HJY is potentially useful for the reduction of CP residues in Chinese chives and may be used for the in situ phytoremediation of CP.

Reclaimed wastewater (RW) is increasingly used to irrigate agricultural land and to alleviate agricultural water shortages worldwide. This usage has resulted in concerns about soil contamination by pharmaceuticals and personal care products (PPCPs) and the human health risks associated with dietary crop intake. In this study, we systematically analysed the occurrence and accumulation of 11 PPCPs and one active metabolite in soils and various crops (cucumber, eggplant, long bean and wheat) from realistic RW irrigation fields with different irrigation histories (20, 30 and 40 years) in Beijing and evaluated the human health risks associated with the consumption of these crops. The 11 PPCPs and one active metabolite were detected at concentrations ranging from 0.67 to 22.92 ng L−1 in RW, 0.029–28.13 μg kg−1 in irrigated soil, and 0.05). The concentrations of the studied PPCPs in the RW used for irrigation followed different patterns from the concentrations detected in the irrigated soils and crops. Although the concentrations of sulfamethoxazole, sulfisoxazole, sulfamethazine and trimethoprim in RW were higher than those of many other studied PPCPs, their respective values in the irrigated soils and crops did not display a similar tendency. The uptake and accumulation of PPCPs varied among the crop species (P

To improve the removal of pharmaceutical and personal care products (PPCPs) from contaminated water, a novel electrolysis-integrated tidal flow constructed wetland system (E-TFCW) was developed. E-TFCWs have the highest removal efficiency for the four investigated PPCPs when the electrodes are arranged at the bottom of the E-TFCWs. The removal efficiency of four PPCPs increases from 4.41% to 11.71% to 28.83%-68.32% when using electrolysis combined with tidal flow constructed wetlands. The synergy effect for the degradation of PPCPs between electrolysis and constructed wetlands on the degradation of PPCPs in E-TFCWs were significant (enhancement factor > 1), while the removal efficiency of PPCPs after the electrolysis (10 h, accounting for 14.98–44.41%) is higher than that before electrolysis (10 h, accounting for 9.62–27.14%) and electrolysis process (4 h) accounting for 42.81%-68.47%. Electrolysis can enhance the removal of PPCPs through direct oxidation. Moreover, the increase in intermediate oxidation compounds in the E-TFCWs may imply the enhanced biodegradability of PPCPs during the electrolysis process since the by-products of PPCPs were identified. The contents of Thermomonas, Microbacterium, Cloacibacterium and Acidovorax at the bottom of the E-TFCWs were significantly higher than those of other bacteria, which contributed to the removal of PPCPs. Electrolysis can enhance the biodegradability of PPCPs and the formation of anoxic/aerobic conditions for the growth of predominant bacteria, which contributes to the degradation of PPCPs in the E-TFCWs. The results illustrate that electrolysis-integrated tidal flow constructed wetlands are an effective technology for the removal of PPCPs.

With new network applications quickly appearing in power telecommunication access networks, Network traffic exhibits new abnormal behaviors. How to find out the abnormal traffic parts is very difficult. This paper bring forth a new anomaly detection approach to network traffic. Firstly, we take network traffic in power telecommunication access networks as a time series. Secondly, the factor analysis method is used to describe them. According to the factor decomposed theory, network traffic is divided into different factor components. Thirdly, the empirical mode decomposition is carried out for these two components. In this case, a quick anomaly detection algorithm is presented. Simulation results show that our approach is feasible and promising.

The temporal and spatial variations of the thermospheric mass density during a series of idealized substorms were investigated using the Global Ionosphere Thermosphere Model (GITM). The maximum mass density perturbation of an idealized substorm with a peak variation of hemispheric power (HP) of 50 GigaWatts (GW) and interplanetary magnetic field (IMF) Bz of -2 nT was ~14% about 50 min after the substorm onset in the nightside sector of the auroral zone. The mass density response to different types of energy input has a strong local time dependence, with the mass density perturbation due to only an IMF Bz variation peaking in the dusk sector and the density perturbation due to only HP variations peaks in the nightside sector. Simulations with IMF Bz changes only, and HP changes only showed that the system behaves slightly nonlinearly when both IMF and HP variations are included (a maximum of 6% of the non-linearity), and that the non-linearity grows with energy input. The neutral gas heating rate due to Joule heating was of same magnitude as the heating rate due to precipitation, but the majority of the temperature enhancement due to the heating due to precipitation occurs at lower altitude as compared to the auroral heating. About 110 min after onset, a negative mass density perturbation (~-5%) occurred in the night sector, which was consistent with the mass density measurement of the CHAMP satellite.

We have found that consideration of neutral helium as a major species leads to a more complete physics-based modeling description of the Earth's upper thermosphere. An augmented version of the composition equation employed by the Thermosphere-Ionosphere-Electrodynamic General Circulation Model (TIE-GCM) is presented, enabling the inclusion of helium as the fourth major neutral constituent. Exospheric transport acting above the upper boundary of the model is considered, further improving the local time and latitudinal distributions of helium. The new model successfully simulates a previously observed phenomenon known as the “winter helium bulge,” yielding behavior very similar to that of an empirical model based on mass spectrometer observations. This inclusion has direct consequence on the study of atmospheric drag for low-Earth-orbiting satellites, as well as potential implications on exospheric and topside ionospheric research.

The Global Ionosphere Thermosphere Model (GITM) is a relatively new model that describes the new-Earth space environment in a different way than many of the other existing coupled models. First, it uses an altitude grid that stretches from 100 km to 500–800 km depending on F10.7, with roughly 1/3 scale-height resolution. Second, it solves the more-complete momentum equation in the vertical direction of the thermosphere, allowing non-hydrostatic solutions to form. Third, the code is parallel in such a way that the number of grid cells in the latitude and longitude direction can be specified at run-time, so that the resolution is highly adjustable. The ionosphere within GITM is treated in spherical coordinates, so is limited in altitude. Recently, the ionosphere has been modified in three ways: (1) the ion and electron temperatures have been improved; (2) a nightside EUV flux was implemented in the code; and (3) the Eddy diffusion has been modified to allow a more realistic electron density.

Accelerometer data from coplanar orbits of Challenging Minisatellite Payload (CHAMP) and Gravity Recovery and Climate Experiment (GRACE) satellites were used to study the complex altitude and latitude variations of the thermosphere mass density response to geomagnetic activity during 1–10 December 2008 near 09 LT. Helium number densities near 500 km altitude were extracted from the CHAMP and GRACE measurements and clearly show the presence of a winter hemisphere helium bulge. This recent extreme solar minimum indicates that wintertime helium concentrations exceed NRLMSISE-00 model estimates by 30%–70% during quiet geomagnetic activity after adjusting F10.7 input into MSIS. The perturbation in mass density from quiet to active conditions is found to be less enhanced in the winter hemisphere at the higher GRACE altitudes (25%) than at the lower CHAMP altitudes (60%) and is attributed to dynamic behavior in the helium/oxygen transition. The investigation revealed the maximum storm time density perturbation to occur near the He/O transition region with a much weaker maximum near the O/N2 transition region. The altitude of maximum density perturbation occurs where the perturbation in the weighted pressure scale height is equal and opposite to the perturbation in the weighted mean molecular weight scale height. The altitude structure of density scale height perturbation is significantly influenced by the changes in the molecular weight scale height and can account for 50% of the change in mass density scale height in a region correspondingly close to the He/O transition during the 2008 solar minimum period.

[1] High-resolution mass density observations inferred from accelerometer measurements on the CHAMP and GRACE satellites are employed to investigate the thermosphere mass density response with latitude and altitude to geomagnetic activity during the recent solar minimum. Coplanar orbital periods in February 2007 and December 2008 revealed the altitude and latitude response in thermosphere mass density for their respective winter hemispheres was influenced by the relative amount of helium and oxygen present. The CHAMP-to-GRACE (C/G) mass density ratio depends on two terms; the first proportional to the ratio of the mean molecular weight to temperature and the second proportional to the vertical gradient of the logarithmic mean molecular weight. For the relative levels of helium and oxygen in February 2007, the winter hemisphere C/G mass density response to geomagnetic activity, although similar to the summer hemisphere, was caused predominantly by changes in the vertical gradient of the logarithmic mean molecular weight. In December 2008, the significant presence of helium caused the mean molecular weight changes to exceed temperature changes in the winter hemisphere leading to an increase in the C/G ratio with increasing geomagnetic activity, in opposition to the decrease observed in the summer hemisphere that was caused primarily by temperature changes. The observed behavior is indicative of composition effects influencing the mass density response and the dynamic action of the oxygen to helium transition region in both latitude and altitude will lead to complex behaviors in the mass density at GRACE altitudes throughout the extended solar minimum from 2007 to 2010.