Drugs and related goods are widely used in order to promote public health and the quality of life. One of the most serious environmental challenges affecting public health is the ongoing presence of antibiotics in the effluents generated by pharmaceutical industries and hospitals. Antibiotics cannot be entirely removed from wastewater using the traditional wastewater treatment methods. Unmetabolized antibiotics generated by humans can be found in urban and livestock effluent. The antibiotic present in effluent contributes to issues with resistance to antibiotics and the creation of superbugs. Over the recent 2 years, the coronavirus disease 2019 pandemic has substantially boosted hospital waste volume. In this situation, a detailed literature review was conducted to highlight the harmful effects of untreated hospital waste and outline the best approaches to manage it. Approximately 50 to 70% of the emerging contaminants prevalent in the hospital wastewater can be removed using traditional treatment strategies. This paper emphasizes the numerous treatment approaches for effectively eliminating emerging contaminants and antibiotics from hospital wastewater and provides an overview of global hospital wastewater legislation and guidelines on hospital wastewater administration. Around 90% of ECs might be eliminated by biological or physical treatment techniques when used in conjunction with modern oxidation techniques. According to this research, hybrid methods are the best approach for removing antibiotics and ECs from hospital wastewater. The document outlines the many features of effective hospital waste management and might be helpful during and after the coronavirus disease 2019 outbreak, when waste creation on all hospitals throughout the globe has considerably increased.

Background: There is a need for searching for biomarkers indicating patients who will benefit the most from treatment with omalizumab for chronic spontaneous urticaria (CSU). The aim of this study was to assess whether the eosinophil/neutrophil/platelet/basophil-to-lymphocyte ratio (ELR, NLR, PLR, BLR) may predict the response to omalizumab treatment of chronic spontaneous urticaria. Methods: A retrospective data analysis of CSU patients treated s-c with 300 mg of omalizumab every four weeks under the drug program was carried out. NLR, ELR, PLR and BLR, DLQI, UAS-7, CRP, anti-TPO and tIgE were assessed before (V0) and after three (V3) and six months (V6) of treatment. Results: Among 52 patients with CSU, 21 were responders, 24 were partially responders and 6 were non-responders to treatment with 300 mg omalizumab every four weeks. An amount of 18 patients had features of type I autoallergic CSU (CSUaiTI) and 34 patients had autoimmunity type IIb CSU with mast cell-directed activating autoantibodies (CSUaiTIIb). NLR, ELR, PLR and BLR indices did not change during a six-month-course of biological treatment. Initial values of ELR and BLR were significantly correlated with the initial tIgE level and anti-TPO/IgE ratio. Initial values of NLR, ELR and BLR were significantly correlated with initial CRP. Comparisons between type I autoallergic CSU (CSUaiTI) and autoimmunity type IIb CSU (CSUaiTIIb) revealed that the absolute number and percentage of eosinophils, basophils, BLR and tIgE were significantly higher in type CSUaiTI and anti-TPO and anti-TPO/IgE were significantly lower in type CSUaiTI. Conclusions: NLR, ELR, PLR and BLR do not change significantly during six months of omalizumab treatment and do not appear to be useful in predicting its efficacy.

Biological treatment represents a fundamental component of wastewater treatment plants (WWTPs). The transmission of antibiotic resistance bacteria (ARB) and resistance genes (ARGs) occurred through the continuous migration and transformation, attributed to the residual presence of antibiotics in WWTPs effluent, posing a significant threat to the entire ecosystem. It is necessary to propose novel biological strategies to address the challenge of refractory contaminants, such as antibiotics, ARGs and ARB. This review summarizes the occurrence of antibiotics in wastewater, categorized by high and low concentrations. Additionally, current biological treatments used in WWTPs, such as aerobic activated sludge, anaerobic digestion, sequencing batch reactor (SBR), constructed wetland, membrane-related bioreactors and biological aerated filter (BAF) are introduced. In particular, because microorganisms are the key to those biological treatments, the effect of high and low concentration of antibiotics on microorganisms are thoroughly discussed. Finally, solutions involving functional bacteria, partial nitrification (PN)-Anammox and lysozyme embedding are suggested from the perspective of the entire biological treatment process. Overall, this review provides valuable insights for the simultaneous removal of antibiotics and ARGs in antibiotics wastewater.

There have been growing concerns regarding the health and environmental impacts of trace organic pollutants (TOPs). However, fresh leachate from municipal solid waste (MSW) has been overlooked as a potential reservoir of TOPs. Therefore, we investigated 90 legacy and emerging TOPs in fresh leachate from 14 provinces and municipalities in China. Additionally, the fate and final discharge impacts of TOPs in 14 leachate treatment systems were analyzed. The results revealed that the detection rate of 90 TOPs was over 50 % in all samples. Notably, polychlorinated biphenyls, banned for 40 years, were frequently detected in fresh leachate. The concentration of pseudo-persistent TOPs (105-107 ng/L) is significantly higher than that of persistent TOPs (102-104 ng/L). Spatial distribution patterns of TOPs in fresh leachate suggest that economy, population, climate, and policies impact TOPs discharge from MSW. For example, economically developed and densely populated areas displayed higher TOPs concentrations, whereas warmer climates facilitate TOPs leaching from MSW. We confirmed that waste classification policies were a key driver of the decline in multiple TOPs in leachate. Mass balance analysis shows that the final effluent and sludge from current dominant leachate treatment systems contain refractory TOPs, especially perfluoroalkyl acids, which must be prioritized for control. This paper was the first comprehensive investigation of multiple TOPs in fresh leachate at a large geographic scale. The factors affecting the occurrence, spatial distribution, and fate of TOPs in fresh leachate were revealed. It provides a valuable reference for the establishment of policies for the management of TOPs in MSW and the associated leachate.

Interleukin-5 functions as a B-cell differentiation factor, but more importantly, in the context of this review, it plays a variety of roles in eosinophil biology, including eosinophil differentiation and maturation in the bone marrow, and facilitates eosinophil migration to tissue sites, usually in the context of an allergic reaction. Given the availability of selective anti-IL-5 drugs such as mepolizumab and reslizumab, as well as the IL-5 receptor antagonist benralizumab, it is worth investigating whether they could be used in some cases of allergic disease. Asthma has a well-documented involvement of IL-5 in its pathophysiology and has clear benefits in the case of anti-IL-5 therapy; therefore, current knowledge is presented to provide a reference point for the study of less-described diseases such as atopic dermatitis, chronic rhinosinusitis, chronic spontaneous urticaria, and its association with both IL-5 and anti-IL-5 treatment options. We then review the current literature on these diseases, explain where appropriate potential reasons why anti-IL-5 treatments are ineffective, and then point out possible future directions for further research.

UNASSIGNED: Rheumatoid arthritis (RA) is a chronic autoimmune disease that significantly impacts patients\' quality of life. While treatment options have expanded over the years, including the introduction of tumor necrosis factor-alpha (TNFα) inhibitors (TNFi), optimizing withdrawal strategies for these agents remains a challenge.
UNASSIGNED: This review examines the current evidence on TNFi withdrawal strategies in RA, focusing on factors influencing withdrawal decisions such as disease activity monitoring, treatment response, patient characteristics, and biomarkers. A comprehensive literature search was conducted, including randomized controlled trials, observational studies, and expert guidelines. The pathophysiology of RA, current pharmacological agents, and the treat-to-target strategy are discussed to provide a holistic understanding of RA management.
UNASSIGNED: Withdrawal strategies could be suitable for certain patients, keeping in mind that several factors influence withdrawal decisions, including treatment response, disease activity and monitoring, and patient characteristics. The decision to withdraw TNFi must balance the benefits against the potential risks of disease flare and long-term treatment-related adverse effects. Combining DMARDs and TNFi early improves outcomes, supporting tapering strategies for cost-effectiveness and flare prevention. Future directions, including precision medicine approaches, patient-centered care models, and health economics analyses, are proposed to further optimize RA management and improve patient outcomes.

Amidst growing global demand for leather goods, the efficient conversion of rawhide and skins into durable leather is crucial, yet approximately 80 % of these materials become solid and liquid waste during tannery operations. Improper management of tannery solid waste poses significant environmental risks, contaminating soil, groundwater, and surface water. This review explores thermochemical, biological, and phytoremediation methods for treating tannery solid waste, emphasizing their role in resource recovery and environmental sustainability. Thermochemical techniques like pyrolysis and gasification convert tannery solid waste into biochar, bio-oil, and syngas, which serve as soil amendments, renewable energy sources, or industrial feedstocks. Biological methods such as composting and anaerobic digestion decompose organic tannery solid waste components into nutrient-rich compost and biogas. Phytoremediation uses plants to remediate contaminants, including heavy metals, from tannery solid waste. These methods mitigate environmental pollution and support the leather industry\'s transition to sustainable practices, crucial for compliance with global regulations. Moreover, the review offers insights into current efforts and perspectives aimed at achieving a zero-waste policy, emphasizing the importance of a circular economy to alleviate the environmental burden associated with tannery operations and ensure their continued sustainability. Finally, a detailed discussion on the current challenges in terms of technology accessibility and economic feasibility was also discussed.

Corn straw is one kind of agricultural by-product containing 70-80% insoluble dietary fiber (IDF). In order to develop corn straw dietary fiber, this study was conducted to increase soluble dietary fiber (SDF) yield and improve the structure, functional and prebiotic properties of IDF and SDF from corn straw treated by alkali oxidation treatment, enzymatic hydrolysis, microbial fermentation and the combination of these methods. The results demonstrated that the yield of SDF was significantly increased from 2.64% to 17.15% after corn straw was treated by alkali oxidation treatment + Aspergillus niger fermentation + cellulase hydrolysis, compared with untreated corn straw. The SDF extracted from corn straw treated by alkali oxidation treatment + Aspergillus niger fermentation + cellulase hydrolysis (F-SDF) exhibited a honeycomb structure, low crystallinity (11.97%), good antioxidant capacity and high capacities of water holding, water solubility and cholesterol absorption and promoted short-chain fatty acids production by chicken cecal microbial fermentation in vitro. F-SDF enhanced the antibacterial activity against Escherichia coli and Staphylococcus aureus proliferations of Lactobacillus plantarum when it was used as a substrate for Lactobacillus plantarum fermentation. It could be concluded that the combined treatments could increase SDF yield from corn straw and improve its functional and prebiotic properties.

Semi-aerobic aged refuse biofilters (SAARB) are commonly-used biotechnologies for treating landfill leachate. In actual operation, SAARB often faces harsh conditions characterized by high concentrations of chemical oxygen demand (COD) and Cl-, as well as a low carbon-to-nitrogen ratio (C/N), which can disrupt the microbial community within SAARB, leading to operational instability. Maintaining the stable operation of SAARB is crucial for the efficient treatment of landfill leachate. However, the destabilization mechanism of SAARB under harsh conditions remains unclear. To address this, the study simulated the operation of SAARB under three harsh conditions, namely, high COD loading (H-COD), high chloride ion (Cl-) concentration environment (H-Cl-), and low C/N ratio environment (L-C/N). The aim is to reveal the destabilization mechanism of SAARB under harsh conditions by analyzing the fluorescence characteristics of effluent DOM and the microbial community in aged refuse. The results indicate that three harsh conditions have different effects on SAARB. H-COD leads to the accumulation of proteins; H-Cl- impedes the reduction of nitrite nitrogen; L-C/N inhibits the degradation of humic substances. These outcomes are attributed to the specific effects of different factors on the microbial communities in different zones of SAARB. H-COD and L-C/N mainly affect the degradation of organic matter in aerobic zone, while H-Cl- primarily impedes the denitrification process in the anaerobic zone. The abnormal enrichment of Corynebacterium, Castellaniella, and Sporosarcina can indicate the instability of SAARB under three harsh conditions, respectively. To maintain the steady operation of SAARB, targeted acclimation of the microbial community in SAARB should be carried out to cope with potentially harsh operating conditions. Besides, timely mitigation of loads should be implemented when instability characteristics emerge, and carbon sources and electron donors should be provided to restore treatment performance effectively.

Pemphigus vulgaris (PV) stands as a rare autoimmune disorder characterized by blistering and erosion of mucocutaneous membranes. The pathogenesis of PV implicates both B and T cells, which target cell-to-cell adhesion molecules within the epithelia of the skin and oral mucosa, leading to acantholysis. Typically, the presentation involves blistering of the oral mucosa, often followed by cutaneous lesions. Given the considerable risk of morbidity and mortality associated with PV, early diagnosis is crucial, typically relying on a combination of clinical features, histopathology, and direct immunofluorescence. Bruton tyrosine kinase (BTK) plays a significant role in the pathophysiology of autoimmune diseases and inflammation. Herein, we present a case of PV that demonstrated resistance to first-line therapy with steroids. Subsequently, treatment with the BTK inhibitor ibrutinib was initiated, yielding favorable outcomes. This case underscores the potential of targeted therapies, such as BTK inhibitors, in managing PV refractory to conventional treatment modalities.