Body composition and metabolic syndrome in patients with type 1 diabetes

BACKGROUND In recent years,the prevalence of obesity and metabolic syndrome in type 1 diabetes(T1DM)patients has gradually increased.Insulin resistance in T1DM deserves attention.It is necessary to clarify the relationship between body composition,metabolic syndrome and insulin resistance in T1DM to guide clinical treatment and intervention.AIM To assess body composition(BC)in T1DM patients and evaluate the relationship between BC,metabolic syndrome(MS),and insulin resistance in these indi-viduals.METHODS A total of 101 subjects with T1DM,aged 10 years or older,and with a disease duration of over 1 year were included.Bioelectrical impedance analysis using the Tsinghua-Tongfang BC Analyzer BCA-1B was employed to measure various BC parameters.Clinical and laboratory data were collected,and insulin resistance was calculated using the estimated glucose disposal rate(eGDR).RESULTS MS was diagnosed in 16/101 patients(15.84%),overweight in 16/101 patients(15.84%),obesity in 4/101(3.96%),hypertension in 34/101(33.66%%)and dyslip-idemia in 16/101 patients(15.84%).Visceral fat index(VFI)and trunk fat mass were significantly and negatively correlated with eGDR(both P<0.001).Female patients exhibited higher body fat percentage and visceral fat ratio compared to male patients.Binary logistic regression analysis revealed that significant factors for MS included eGDR[P=0.017,odds ratio(OR)=0.109],VFI(P=0.030,OR=3.529),and a family history of diabetes(P=0.004,OR=0.228).Significant factors for hypertension included eGDR(P<0.001,OR=0.488)and skeletal muscle mass(P=0.003,OR=1.111).Significant factors for dyslipidemia included trunk fat mass(P=0.033,OR=1.202)and eGDR(P=0.037,OR=0.708).CONCLUSION Visceral fat was found to be a superior predictor of MS compared to conventional measures such as body mass index and waist-to-hip ratio in Chinese individuals with T1DM.BC analysis,specifically identifying visceral fat(trunk fat),may play an important role in identifying the increased risk of MS in non-obese patients with T1DM.

Creep constitutive model considering nonlinear creep degradation of fractured rock

Stability analysis of underground constructions requires a model study of rock masses’ long-term performance. Creep tests under different stress conditions was conducted on intact granite and granite samples fractured at 30° and 45° angles. The experimental results indicate that the steady creep strain rates of intact and fractured rock present an exponential increase trend with the increase of stress level. A nonlinear creep model is developed based on the experimental results, in which the initial damage caused by fracture together with the damage caused by constant load have been taken into consideration. The fitting analysis results indicated that the model proposed is more accurate at identifying the full creep regions in fractured granite, especially the accelerated stage of creep deformation. The least-square fit error of the proposed creep model is significantly lower than that of Nishihara model by almost an order of magnitude. An analysis of the effects of elastic modulus, viscosity coefficient, and damage factors on fractured rock strain rate and creep strain is conducted. If no consideration is given to the effects of the damage, the proposed nonlinear creep model can degenerate into to the classical Nishihara model.

Managing the surge:A comprehensive review of the entire disposal framework for retired lithium-ion batteries from electric vehicles

Anticipating the imminent surge of retired lithium-ion batteries(R-LIBs)from electric vehicles,the need for safe,cost-effective and environmentally friendly disposal technologies has escalated.This paper seeks to offer a comprehensive overview of the entire disposal framework for R-LIBs,encompassing a broad spectrum of activities,including screening,repurposing and recycling.Firstly,we delve deeply into a thorough examination of current screening technologies,shifting the focus from a mere enumeration of screening methods to the exploration of the strategies for enhancing screening efficiency.Secondly,we outline battery repurposing with associated key factors,summarizing stationary applications and sizing methods for R-LIBs in their second life.A particular light is shed on available reconditioning solutions,demonstrating their great potential in facilitating battery safety and lifetime in repurposing scenarios and identifying their techno-economic issues.In the realm of battery recycling,we present an extensive survey of pre-treatment options and subsequent material recovery technologies.Particularly,we introduce several global leading recyclers to illustrate their industrial processes and technical intricacies.Furthermore,relevant challenges and evolving trends are investigated in pursuit of a sustainable end-of-life management and disposal framework.We hope that this study can serve as a valuable resource for researchers,industry professionals and policymakers in this field,ultimately facilitating the adoption of proper disposal practices.

Climate change and human health: Last call to arms for us

Climate change,now the foremost global health hazard,poses multifaceted challenges to human health.This editorial elucidates the extensive impact of climate change on health,emphasising the increasing burden of diseases and the exacerbation of health disparities.It highlights the critical role of the healthcare sector,particularly anaesthesia,in both contributing to and mitigating climate change.It is a call to action for the medical community to recognise and respond to the health challenges posed by climate change.

International law obligations for the disposal of Fukushima nuclear-contaminated water under the principles of nuclear safety

The disposal of contaminated water from Japan’s Fukushima nuclear power plant is a significant international nuclear safety issue with considerable cross-border implications.This matter requires compliance not only with the law of the sea but also with the principles of nuclear safety under international law.These principles serve as the overarching tenet of international and China’s domestic nuclear laws,applicable to nuclear facilities and activities.The principle of safety in nuclear activities is fully recognized in international and domestic laws,carrying broad legal binding force.Japan’s discharge of nuclear-contaminated water into the sea violates its obligations under the principle of safety in nuclear activities,including commitments to optimum protection,as low as reasonably practicable,and prevention.The Japanese government and the International Atomic Energy Agency(IAEA)have breached the obligation of optimum protection by restricting the scope of assessments,substituting core concepts,and shielding dissenting views.In the absence of clear radiation standards,they have acted unilaterally without fulfilling the obligation as low as reasonably practicable principle.The discharge of Fukushima nuclear-contaminated water poses an imminent and unpredictable risk to all countries worldwide,including Japanese residents.Japan and the IAEA should fulfill their obligations under international law regarding disposal,adhering to the principles of nuclear safety,including optimum protection,the obligation as low as reasonably practicable,and prevention through multilateral cooperation.Specifically,the obligation to provide optimum protection should be implemented by re-evaluating the most reliable disposal technologies and methods currently available and comprehensively assessing various options.The standard of the obligation as low as reasonably practicable requires that the minimization of negative impacts on human health,livelihoods,and the environment should not be subordinated to considerations of cutting costs and expenses.Multilateral cooperation should be promoted through the establishment of sound multilateral long-term monitoring mechanisms for the discharge of nuclear-contaminated water,notification and consultation obligations,and periodic assessments.These obligations under international law were fulfilled after the accidents at the Three Mile Island and Chernobyl nuclear power plants.The implications of the principles of nuclear safety align with the concept of building a community of shared future for nuclear safety advocated by China.In cases of violations of international law regarding the disposal of nuclear-contaminated water that jeopardize the concept of a community of a shared future for nuclear safety,China can also rely on its own strength to promote the implementation of due obligations through self-help.

Patients’Knowledge, Attitude and Practices on Disposal Methods of Expired and Unused Medicines: Implication for Creation of Drug Take-Back Program

Background: Handling of medicines is a day-to-day activity by patients and many health care providers. However, multiple studies have brought to light inappropriate disposal methods for expired and unused medication (EUM). Improper disposal of expired and unused medicines is hazardous both to humans and the environment. Objective: This sought to measure patients’ knowledge, attitude, and practices on disposal methods of EUM. Methods: A cross-sectional study was carried out among 384 patients at three outpatient pharmacies at the University Teaching Hospitals (UTHs). The structured questionnaire was used to collect data and STAT version 15.1 was used to analyse the data. Results: 384 respondents participated in this study and, at some point, had EUM. In this study, 356 (92.7%) of the participants reported that they had never heard of a drug take-back system. Most of the participants 285 (74.2%) and 239 (62.2%) kept and donated their unused medicine, respectively. Additionally, 244 (63.5%), 212 (55.2%), and 176 (44.8%) of the participants disposed of expired medicines in the bin or garbage, flushed them in toilets or sinks, or burned them, respectively. Occupation was significantly associated with unsafe disposal of unused medicine [P-value = 0.019]. Conclusion and Relevance: Knowledge of safe disposal methods for EUM was good amongst most participants. However, used unsafe disposal methods. The majority of the participants exhibited positive attitude concerning safe disposal methods. This study highlights the need for drug-take-back program creation in Zambia.

Study of the Management and Disposal Practices of Unused or Out-of-Date Medicines by Households in the Municipality of Ouagadougou, Burkina Faso

Introduction: Not all medicines that pass-through consumers’ hands are used, and some often expire in households. These health products can be sources of accidental risks and pollution when they are not properly disposed of. In Burkina Faso, there are as yet no guidelines for the disposal of unused medicines in households. The aim of this study was to estimate the extent of household possession of unused or expired medicines, and to describe attitudes and disposal practices. Methods: This was a descriptive cross-sectional study covering households in the Ouagadougou commune conducted from June to August 2021. Two-stage stratified sampling was used: selection of Enumeration Zones (EZs) and selection of households, with each EZ comprising several households. Data collection was based on direct interviews using a structured questionnaire. Data were processed using Epi Info software version 7.2.4.0. Results: In total, 417 household residents were surveyed out of the planned 423 households, corresponding to a completion rate of 98.58% compared with the initial sample. Among the respondents, 79.62% had unused and/or expired medicines in their household. A total of 2562 drug packaging units were counted, for a total weight of 121.90 kg. Nearly 75% were aware that improper disposal was a danger to the environment. Some respondents kept their unused medicines at home until they expired (43.41%), and disposed of them mainly by throwing them in the household garbage (75.58%). The majority (79%) were in favor of the government setting up a take-back program for these medicines. Conclusion: The introduction of a take-back program for unused or out-of-date medicines will ensure safer disposal of medicines, and better protection for households and the environment.

Levels of Polycyclic Aromatic Hydrocarbons (PAHs) in Healthcare Waste Incinerators’ Bottom Ash from Five County Hospitals in Kenya

Health-care waste contains potentially harmful microorganisms and compounds which can infect and affect hospital patients, healthcare workers, the general public and environment. Therefore, management of health care waste requires safe handling, treatment and disposal procedures. While incineration reduces the volume and quantity of waste for final disposal, it leads to the production of fly and bottom ashes laden with toxic incomplete combustion products such as Polycyclic Aromatic Hydrocarbons (PAHs), dioxins, furans and heavy metals. This exposes workers who handle and dispose the bottom ashes, hospital patients, the general public and environment. The goal of this study was to determine the total and individual levels of 16 most prevalent and toxic PAHs. Bottom ash samples were collected from incinerators in five county hospitals in Kenya, namely;Moi-Voi, Narok, Kitale, Makindu and Isiolo. Bottom ash samples were collected over a period of six months from the five hospitals. The samples were then sieved, homogenised and stored at 4°C in amber coloured glass containers. The PAHs were extracted using 30 ml of a hexane-acetone solvent (1:1) mixture by ultrasonication at room temperature (23°C) for 45 minutes. The PAHs were then analyzed with a GC-MS spectrophotometer model (Shimadzu GCMS-QP2010 SE) connected to a computer work station was used for the PAHs analysis. The GC-MS was equipped with an SGE BPX5 GC capillary column (30 m × 0.25 mm × 0.25 μm) for the separation of compounds. Helium was used as the carrier gas at a flow rate of 15.5 ml/minute and 14.5 psi. 1 μl of the sample was injected at 280°C, split mode (10:1). The oven programming was set for a total runtime of 40 minutes, which included: 100°C (2-minute hold);10°C /min rise to 200°C;7°C /min rise to 249°C;3°C /min rise to 300°C (2-minute hold). The interface temperature was set at 290°C. Analysis was done in Selected Ion Monitoring (SIM) mode and the peak areas of each of the PAHs were collected from the chromatograph and used for quantification of the 16 PAHs listed by the U.S. Environmental Protection Agency (EPA) which included, BaA (benz[a]anthracene: 4 rings), BaP (benzo[a]pyrene: 5 rings), BbF (benzo [b]fluoranthene: 5 rings), BkF (benzo[k]fluoranthene: 5 rings), Chr (chrysene: 4 rings), DbA (dibenz[a,h]anthracene: 5 rings), InP (indeno[1,2,3 - cd] pyrene: 6 rings) and Acp (acenaphthene: 3 rings), Acpy (acenaphthylene: 3 rings), Ant (anthracene: 3 rings), BghiP (benzo[g,h,i]perylene: 6 rings), Flu (fluorene: 3 rings), FluA (fluoranthene: 4 rings), Nap (naphthalene: 2 rings), PhA (phenanthrene: 3 rings) and Pyr (pyrene: 4 rings). Ion source-interface temperature was set at 200°C - 250°C. Internal standards from Sigma Aldrich were used in the analysis and the acquired mass spectra data were then matched against the NIST 2014 library [1] [2]. The mean PAHs concentration in the bottom ashes of each hospital varied broadly from 0.001 mg/kg to 0.4845 mg/kg, and the mean total concentration levels of individual PAHs ranged from 0.0072 mg/kg to 1.171 mg/kg. Low molecular weight PAHs (Phenanthrene, Naphthalene and Fluorene) were predominant in all the hospital wastes whereas Kitale and Narok presented the lowest PAHs concentrations and the lowest number of individual PAHs. Moi/Voi recorded the highest total PAHs concentration at 1.3129 ± 0.0023 mg/kg from a total of 11 PAHs being detected from the bottom ash samples. Narok had only three PAHs being detected at very low concentrations of 0.0041 ± 0.00 mg/kg, 0.0076 ± 0.00 mg/kg and 0.012 ± 0.00 mg/kg for phenanthrene, anthracene and chrysene respectively. This study presents hospital incinerator bottom ash as containing detectable levels of both carcinogenic and non-carcinogenic PAHs. Continued unprotected exposure of hospital workers (waste handlers) to the bottom ash PAHs could be hazardous to their health because of their cumulative effect. Preventive measures e.g. the use of Personal protective equipment (PPE) should be prioritised to minimise direct contact with the bottom ash. The study recommends an upgrade on incinerator technology for efficient combustion processes thus for better pollution control.

Current Situation Analysis and Suggestions for Solid Waste Management Practices among Households in Freetown

Freetown which is the capital city of Sierra Leone is facing challenges with population growth, urbanization, and industrialization, leading to an increase in municipal solid waste (MSW) generation. The study aims to evaluate MSW generation, composition, and disposal methods, as well as the impact of collection fees, policy implementation, and women’s participation in municipal solid waste management (MSWM). The study used both qualitative and quantitative methods for data collection and analysis. The study administered 393 structured questionnaires in three selected sections to collect data on variables such as family size, education, level of knowledge, etc. The study used door-to-door data collection to determine the rate of solid waste generation, composition, and disposal in 66 households from two of the selected sections and 34 households from the other section to evaluate the current situation of MSWM practices among households in Freetown. The study used a descriptive statistic to analyze the data collected using Origin-Pro9 and MS Excel software. The findings showed that with a 4.2% urban growth rate, Freetown had a population of 1,467,543 in 2023, generating 851 tons of MSW per day, with organic waste accounting for 78% of the total MSW generated. Plastic waste generation also increased from 7.6% in 2020 to 13% in 2023. The study emphasizes the need to sustain the MSWM system by prioritizing solid waste collection fees, policy enforcement, and women’s participation in the MSWM sector. It further suggests and provides recommendations for developing an efficient and sustainable MSWM system in Sierra Leone, including knowledge transfer from countries like China and the US.

Production Practice of Solid Waste Desulfurizer Disposal in European Metallurgical Furnace

In order to realize the OY Smelting Furnace disposal of solid waste,municipal waste,form a model of steel enterprises and urban integration,through the production practice of smelting furnace,analyzes the mechanism of solid waste disposal,and proposed the disposal of solid waste desulfurization agent and disposal method:According to the theory to guide the actual production process,the test ton of iron with 10-15kg of desulfurizer in the production process does not affect the quality of molten iron and slag quality.

铜冶炼过程中的砷反应行为及其处理技术的回顾

砷作为五大有毒元素之一,其对生物体和生态环境的健康威胁已引起公众的广泛关注。有色金属冶炼,特别是铜冶炼,是砷的重要人为来源,应被列为重点关注对象。因此,明确砷在铜冶炼过程中的行为,对铜冶炼企业的正常生产和环境保护具有重要意义。本工作简要介绍了冶炼用工业铜矿物和铜矿中砷的赋存形式,以及铜冶炼工艺的演变。此外,还分析了砷在有代表性的铜冶炼过程中的挥发、转化和分布行为,明确了其流向和富集规律。研究了其他矿物成分(Cu、Pb、Zn、Fe、Ca、Si)与砷在冶炼副产品(铜渣和烟尘)形成过程中的相互作用,阐明了砷污染物的形成机制。最后,分析了冶炼烟气、烟尘和铜渣中砷的控制技术,提出了未来通过将砷污染物转化为金属砷来回收砷的可能策略。

Single-use flexible ureteroscopes: Comparative in vitro analysis of four scopes

Objective:Single-use flexible ureteroscopes(fURSs)have recently been introduced by different companies.Goal of this in-vitro study was to compare four fURSs.Methods:We performed in vitro analysis of Uscope 7.5 Fr and Uscope 9.5 Fr(Pusen Ltd.,Zhuhai,China),LithoVue 9.5 Fr(LithoVue
,Boston Scientific,MA,USA),and Indoscope 9.5 Fr(Bioradmedisys
,Pune,India).Optical characteristics(image resolution,color representation,and luminosity)were compared at various distances of 10 mm,20 mm,and 50 mm.Deflection and irrigation were evaluated with and without accessories.Results:Color perception was comparable for all scopes at 10 mm(p<0.05),while Lithovue 9.5 Fr was comparable with Indoscope 9.5 Fr at the distances of 20 mm and 50 mm.Both scopes were statistically better than both Uscopes at the distances of 20 mm and 50 mm.Image resolution powers were comparable amongst all fURSs at the distances of 10 mm and 20 mm(3.56 line pairs per millimeter[lp/mm]).However,Indoscope(3.56 lp/mm)was superior to LithoVue and Uscope scopes(3.17 lp/mm)at the distance of 50 mm.Luminosity at the distance of 10 mm was comparable for LithoVue and Uscope 9.5 Fr.However,at the distances of 20 mm and 50 mm,LithoVue had the highest luminosity while Uscope 7.5 Fr had the lowest one.Indoscope had lower luminosity than other 9.5 Fr scopes at all distances.With empty working channel and 200 mm laser fiber,Indoscope had the maximum deflection(285
).With basket,Uscope 7.5 Fr had the maximum loss of deflection(30
)while Indoscope had no deflection loss.With empty working channel,all scopes had comparable irrigation flow rates in both deflected and undeflected state.Similarly,with 200 mm laser or basket,irrigation flow rates were comparable in all scopes.Conclusion:Color representation was equivalent for Indoscope and LithoVue,while being better than Uscope 7.5 Fr and Uscope 9.5 Fr.Image resolution was comparable in all scopes at the distances of 10 mm and 20 mm.Beyond the distance of 10 mm,luminosity of LithoVue was the highest and that of Uscope 7.5 Fr was the lowest.Deflection loss was the minimum with Indoscope and the maximum with 7.5 Fr Uscope.Under all scenarios,irrigation flow rates were comparable in all scopes.

Photothermal-photocatalytic thin-layer flow system for synergistic treatment of wastewater

The integration of the photocatalytic effect into solar steam is highly desirable for addressing freshwater shortages and water pollution.Here,a ternary film structure for the adsorption and photothermal and photocatalytic treatment of wastewater was designed by combining the technique of self-assembled carbon nano paper with a nitrogen composite titanium dioxide(N-TiO_(2))deposited on the surface of carbon nanotubes(CNT)using polyvinylidene fluoride(PVDF)as a substrate.The photogeneration of reactive oxygen species can be promoted by rapid oxygen diffusion at the three-phase interface,whereas the interfacial photothermal effect promotes subsequent free radical reactions for the degradation of rhodamine B(93%).The freshwater evaporation rate is 1.35 kg·m^(-2)·h^(-1)and the solar-to-water evaporation efficiency is 94%.Importantly,the N-TiO_(2)/CNT/PVDF(N-TCP)film not only effectively resists mechanical damage from the environment and maintains structural integrity,but can also be made into a large film for outdoor experiments in a large solar energy conversion device to collect fresh water from polluted water and degrade organic dyes in source water simultaneously,opening the way for applications in energy conversion and storage.

Earthquake-induced fracture displacements and transmissivity changes in a 3D fracture network of crystalline rock for spent nuclear fuel disposal

During the long service period of a nuclear waste repository in crystalline rock,large earthquake(s)may occur nearby the repository site and coseismically alter the local stress field around pre-existing fractures within the geological formation.The resulting fracture normal/shear displacements may lead to fracture opening and further promote the transport of leaked radionuclides into the groundwater system.Thus,it is of central importance to analyze the consequences of potential future earthquake(s)on the hydrogeological properties of a repository site for spent nuclear fuel disposal.Based on the detailed site characterization data of the repository site at Forsmark,Sweden,we conduct a three-dimensional(3D)seismo-hydro-mechanical simulation using the 3Dimensional Distinct Element Code(3DEC).We explicitly represent a primary seismogenic fault zone and its surrounding secondary fracture network associated with a power-law size scaling and a Fisher orientation distribution.An earthquake with a magnitude of M_(w)=5.6 caused by the reactivation of the primary fault zone is modeled by simulating its transient rupture propagating radially outwards from a predefined hypocenter at a specified rupture speed,with the faulting dynamics controlled by a strength weakening law.We model the coseismic response of the off-fault fracture network subject to both static and dynamic triggering effects.We further diagnose the distribution of fracture hydro-mechanical properties(e.g.mechanical/hydraulic aperture,hydraulic transmissivity)before and after the earthquake in order to quantify earthquakeinduced hydraulic changes in the fracture network.It is found that earthquake-induced fracture transmissivity changes tend to follow a power-law decay with the distance to the earthquake fault.Our simulation results and insights obtained have important implications for the long-term performance assessment of nuclear waste repositories in fractured crystalline rocks.

Research on revision of relevant provisions of high-speed railway emergency disposal in the regulations on railway technical management(RRTM)

Purpose–This study aims to improve the rules and regulations system of high-speed rail emergency disposal.Design/methodology/approach–Based on the analysis of the demands,rules and regulations of China concerning on-site high-speed rail emergency disposal,basic principles for revising the regulations on railway technical management(RRTM)are proposed and suggestions and evaluation methods according to the main clauses are put forward.Findings–Basic principles for revising the RRTM are proposed,namely“to meet the actual needs of on-site high-speed railway emergency disposal,standardize the emergency disposal process,improve the efficiency of emergency disposal and keep the consistency between provisions of emergency disposal”.Existing provisions related to emergency disposal efficiency,scenarios,safety and service quality are made up for the deficiencies.To make up for the deficiencies of the existing provisions related to emergency disposal efficiency,improvement of emergency disposal scenarios and guarantee of emergency disposal safety and quality,this paper puts forward suggestions on revising 15 emergency disposal provisions of the RRTM with regard to earthquake monitoring and warning,in-station foreign body invasion warning,air conditioning failure of EMU trains and forced parking of trains in sections.A fuzzy comprehensive evaluation model based on the analytic hierarchy process(AHP)is constructed to evaluate the proposed revision scheme and suggestions,which has been highly recognized by experts.Originality/value–This study implements the goal of high-quality railway development.

传染病流行期间定点收治医院医疗废弃物的“闭环式”管理

介绍传染病流行期间定点收治医院医疗废弃物的“闭环式”收、储、运模式,以及气化式回转窑无害化处理的工艺特点,为其他医院的医疗废弃物处理提供参考。

E-Borwein真有效解的刻画

基于Borwein真有效解的思想,利用free disposal集提出了向量优化问题的一类近似Borwein真有效解概念,建立了其与E-Benson真有效解间的等价关系.

向量优化中Free Disposal集的某些对偶性质

在分离局部凸空间中考虑free disposal集的对偶性质,其中free disposal集是指与凸锥的代数和仍是其本身的集合.在E_1或E_2是free disposal集的条件下,证明了(E_1∩E_2)^+=E_1^++E_2^+和E_1^+∩E_2^+=(E_1+E_2)^+等对偶结果.

Greenhouse Gas Emissions and Cost Analyses for the Treatment Options of Food Waste and Human Excrement

This study suggested environmental and economic evaluations by developing a scenario according to the various treatment options of food waste in Korea. In particular, the study evaluated the possibility about the combined treatment of food waste and human excrement after using food waste disposers (FWDs). The scenario including only composting (133 kg CO2 equiv./ton-household organic waste) or only FWDs (125 kg CO2 equiv./ton-household organic waste) was superior to the other scenarios in the environmental aspect and the scenario including only composting (101 USD/ton-household organic waste) was superior to the other scenarios in the economic aspect. However, the study discovered that 52% of greenhouse gas emission was reduced when sewage pretreatment was conducted in houses after using FWDs and also when biogas was collected on site and utilized in the private power station. Furthermore, the energy saving effect due to recovery of biogas has found to be larger in the environment aspect than in the economic aspect.

Disposable circumcision suture device： clinical effect and patient satisfaction

In our experience patients undergoing circumcision are mostly concerned about pain and penile appearances. We conducted a prospective randomized trial to assess the benefits of a new disposable circumcision suture device （DCSD）. A total of 942 patients were equally divided into three groups （conventional circumcision, Shang ring and disposable suture device group）. Patients in the DCSD group were anesthetized with compound 5% lidocaine cream, the others with a 2% lidocaine penile block. Operation time, intra-operative blood loss, incision healing time, intra-operative and post-operative pain, the penile appearance and overall satisfaction degree were measured. Operation time and intra-operative blood loss were significantly lower in the Shang ring and suture device groups compared to the conventional group （P 〈 0.001）. Intra-operative pain was less in the suture device group compared With the other two groups （P 〈 0.001）; whereas post-operative pain was higher in the conventional group compared to the other two groups （P 〈 0.001）. Patients in the suture device （80.57%） and Shang ring （73,57%） groups were more satisfied with penile appearances compared with the conventional circumcision group （20.06%, P 〈 0.05）. Patients in suture device group also healed markedly faster than the conventional group （P 〈 0.01）. The overall satisfaction rate was better in the suture device group （78.66%） compared with the conventional （47.13%） and Shang ring （50.00%） groups （P 〈 0.05）. The combination of DCSD and lidocaine cream resulted in shorter operation and incision healing times, reduced intra-operative and post-operative pain and improved patient satisfaction with the cosmetic appearances.