Geographic Variation Research Articles

Clinical perspective and outcome of culture-negative microbial keratitis: A retrospective study.

To study the risk factors, clinical features, and treatment outcomes of patients with culture-negative keratitis (CNK). A retrospective data review of 933 patients with CNK was performed from January 2018 to December 2020. The variables such as the history of injury, visual acuity, slit-lamp findings with measurements of size and depth of ulcer, microbiological evaluation, duct patency, blood glucose levels, and treatment were considered, and clinical outcome was analyzed. Of the 933 patients with CNK, 763 (81.8%) were medically managed, with a mean treatment duration of 2.08 ± 1.7 weeks. Among them, 622 (66.7%) were both smear and culture-negative, and 311 (33.3%) showed only smear positivity. Smear-positive patients showed a positive correlation with the history of injury. A higher incidence of fungal growth on repeat culture was observed. Surgical interventions were done only in 18.2% of the patients; the rest were treated with topical medications alone. High clinical suspicion, differentiation of causative organisms based on clinical findings, and initiating empirical therapy with broad-spectrum antibiotics and antifungals improve the ultimate prognosis in patients with CNK, even though a standard protocol for empirical medical treatment may differ among institutions and surgeons based on their clinical experience and geographical variations.

Causes for Geographic Variation in Incidence of Out-Of-Hospital Cardiac Arrest in Victoria

Causes for Geographic Variation in Incidence of Out-Of-Hospital Cardiac Arrest in Victoria

Great leap forward famine exposure and urban-rural migration convolute the modern prevalence of diabetes in China

BackgroundAlthough evidence from birth cohort analysis has indicated the metabolic risk of early-life exposure to the Great Leap Forward Famine (GLFF) in China, three confounding effects, including the exposure windows, aging, and geographical variations in famine severity, have been brought to debates for a decade. This study aimed to address these confounding effects and extensively examine how GLFF exposure is associated with diabetes risk in mid-to-late life and its interaction with urban-rural migration.MethodsData from the China Health and Retirement Longitudinal Study (CHARLS) were analyzed with age-stratification and stepped wedge approaches. Weighted prevalence and multivariable logistic regression were used to investigate the effects of GLFF exposure and urban-rural migration on mid-to-late life diabetes risk and the interaction between GLFF exposure and urban-rural migration. Birth provinces were controlled as a fixed effect to account for variations in famine severity across provinces.ResultsCompared to those who were never exposed to GLFF, fetal GLFF exposure was associated with a higher risk of adult-onset diabetes after controlling for provinces, demographics, and health statuses. Yet, after adding the proxy of childhood growth environments into the model, fetal exposure to GLFF was not significantly associated with adult-onset diabetes risk (OR = 1.22, p = 0.10), compared to those who were never exposed to GLFF. Across the three age-stratification groups, static urban residents, in general, had a higher risk of diabetes compared to static rural residents. Interaction effects between GLFF exposure and urban-rural migration were insignificant across all three age-stratification groups.ConclusionFetal exposure to GLFF might have a traceable effect on adult-onset diabetes risk. Yet, the growth environment and urban lifestyle outweigh and further confound the impact of GLFF exposure on adult-onset diabetes risk.

Microbiome Analysis Revealed the Effects of Environmental Factors on the Presence of Toxigenic Fungi and Toxin Production in Rice Grains

Fungal contamination in rice and mycotoxins present significant challenges to both rice quality and food safety. However, there is a dearth of comprehensive research on the compositional and structural changes within fungal colonies in rice, particularly in typical rice-producing regions, as well as their underlying influencing factors. In this study, a comprehensive analysis of fungal taxa in rice grains was conducted using amplicon sequencing and bioinformatics methods on 99 rice samples collected in three major rice-producing regions in China: Northeast Plain (NP), Yangtze River Basin (YR), and Southeast Coastal Area (SC). A total of 6,019,722 fungal ITS sequences were obtained with an average sequence length of 235 base pairs, and effective ASVs (2014) accounted for approximately 97.58% of the total ASVs (2064). The fungal community diversity in rice grains exhibited significant variations across the three regions, with deterministic processes playing a predominant role in shaping the ecological dynamics of fungal taxa. Among the core microbiota (92 shared ASVs), the first five species (Alternaria, Fusarium, Curvularia, Epicoccum, and Ustilaginoidea) accounting for a proportion greater than 5% had been reported as potential pathogens for plants. Geographical variations in fungal community composition were evident, with a significantly higher number of shared populations observed between YR and CS regions compared to those in the NP region. Nutrient elements and climatic conditions were the internal and external driving factors of rice fungal community composition. Additionally, notable regional variations in fungal functionality were observed. The findings have significant implications for gaining a comprehensive understanding of the distribution patterns of fungal communities in the major rice-producing regions in China. Additionally, it provides valuable insights into controlling key influencing factors to effectively reduce the occurrence of toxin-producing fungi and mitigate the associated risks related to mycotoxin contamination, thereby contributing to improved risk management and assessment.

The importance of geography in forecasting future fire patterns under climate change

An increasing amount of California's landscape has burned in wildfires in recent decades, in conjunction with increasing temperatures and vapor pressure deficit due to climate change. As the wildland-urban interface expands, more people are exposed to and harmed by these extensive wildfires, which are also eroding the resilience of terrestrial ecosystems. With future wildfire activity expected to increase, there is an urgent demand for solutions that sustain healthy ecosystems and wildfire-resilient human communities. Those who manage disaster response, landscapes, and biodiversity rely on mapped projections of how fire activity may respond to climate change and other human factors. California wildfire is complex, however, and climate-fire relationships vary across the state. Given known geographical variability in drivers of fire activity, we asked whether the geographical extent of fire models used to create these projections may alter the interpretation of predictions. We compared models of fire occurrence spanning the entire state of California to models developed for individual ecoregions and then projected end-of-century future fire patterns under climate change scenarios. We trained a Maximum Entropy model with fire records and hydroclimatological variables from recent decades (1981 to 2010) as well as topographic and human infrastructure predictors. Results showed substantial variation in predictors of fire probability and mapped future projections of fire depending upon geographical extents of model boundaries. Only the ecoregion models, accounting for the unique patterns of vegetation, climate, and human infrastructure, projected an increase in fire in most forested regions of the state, congruent with predictions from other studies.

Prevalence of anemia of varying severity, geographic variations, and association with metabolic factors among women of reproductive age in China: a nationwide, population-based study.

To investigate the epidemiological characteristics of anemia of varying severity among women of reproductive age, we conducted a nationwide, cross-sectional study between January 1, 2019 and December 31, 2019, including 4 184 547 nonpregnant women aged 18-49 years from all 31 provinces in the mainland of China. Anemia was defined as having hemoglobin concentration < 120.0 g/L and categorized as mild, moderate, and severe. Multivariate logistic models with cluster effect were used to explore the association of anemia and metabolic risk factors. The standardized prevalence of anemia and moderate and worse anemia among women of reproductive age in China was 15.8% (95% CI 15.1%-16.6%) and 6.6% (6.3%-7.0%), respectively. The prevalence of anemia and the proportion of moderate and worse anemia significantly increased with age. We also observed great geographic variations in the prevalence of anemia, with a high likelihood in south, central, and northwest China. Moderate and/or severe anemia was positively associated with overweight and obesity, diabetes, and impaired kidney function. In conclusion, anemia remains a significant challenge for women of reproductive age in China. Geographic variations and metabolic risk factors should be considered in the comprehensive and targeting strategy for anemia reduction.

Education legislations that equalize: a study of compulsory schooling law reforms in post-WWII United States

Compulsory schooling laws are commonly believed to be effective measures in ensuring individuals benefit from education. However, their implications for racial equality are less-apparent. Exploiting timing and geographic variation in legislation reforms among Southern U.S. states, this study evaluates the differential impact of minimum school-leaving age requirements on short- and long-term labor market outcomes between Black and White men. Results show that each additional year of compulsory schooling produces about 7.3–8.2% increase in adulthood weekly income. While there exists a substantial gap in returns to education between Black and White men at early career stages, this gap is reduced by 37 percentage points at mid-late career. Findings imply that mandating compulsory school attendance motivates both Black and White men to stay in school longer, and thus reducing racial gaps in returns to education.

Influence of temperature dependent short-term storage on thermal runaway characteristics in lithium-ion batteries

In practical applications, lithium-ion batteries inevitably encounter short-term exposure to high or low temperatures due to geographical climate variations and specific usage scenarios. This study explored the impact of short-term storage at temperatures ranging from −40 to 60 °C on the thermal stability of batteries. Combustion behavior, onset time (tTR) and onset temperature (TTR) of thermal runaway (TR), flame heat flux and mass loss were measured. It demonstrates that following short-term high/low temperature storage, the amount of gas in the exhaust phase increased significantly, and the intensity of the flame jet was enhanced. The experimental results showed that the tTR and TTR initially increased and then decreased with the storage temperature decreased from 20 °C to −40 °C. High temperature storage led to earlier TR and lower TTR. Interestingly, storage at 0 °C caused a delay in the occurrence of TR. Furthermore, an analysis of the heat transfer process, spanning from the safety valve opening to the onset of TR, was performed by leveraging the characteristic time and temperature parameters observed during the TR process. The findings of this research contribute to enhancing the safety and reliability of battery applications, particularly in scenarios involving temperature variations and potential thermal risks.

Colombian ocular diseases epidemiology study (CODES): glaucoma incidence and sociodemographic characterisation 2015–2020

ABSTRACT Clinical relevance Glaucoma encompasses a group of eye diseases that progressively damage the optic nerve, leading to vision loss and blindness. Understanding the incidence and demographic distribution is vital for public health planning and patient care. Background Previous small-scale studies in Colombia have reported the prevalence of glaucoma in individuals over 40 years between 1.1% and 5.29%. These data may not fully capture the true extent of the disease. Furthermore, with the ageing population, the incidence of glaucoma is likely to increase, highlighting the need for up-to-date incidence data to guide healthcare planning. Methods Data were obtained from the Social Protection Information System, the primary health record repository of Colombia, using the International Classification of Disease 10 for glaucoma. Crude incidence rates were calculated and adjusted for sex, age, and gender. The 2020 incidence was compared with estimated rates from previous years to assess the impact of the coronavirus disease 2019 lockdown. A standardised morbidity map was created to show regional variations. Results The average incidence of glaucoma in Colombia was 17.36 per 1,000 inhabitants, increasing from 12.29 in 2015 to 24.22 in 2019. Of the 212,700 reported cases, 60.75% were females. Primary open-angle glaucoma was the most prevalent type, with significant incidence in the elderly over 70 years of age, irrespective of sex. Bogotá, Antioquia, and Valle del Cauca had the highest numbers of new cases. Conclusion The increasing incidence of glaucoma and its demographic and geographical variations necessitate the awareness of ophthalmologists and optometrists. This study emphasises the need for continuous monitoring, effective interventions, and developing healthcare strategies to address the escalating challenge of glaucoma in Colombia.

Unnecessary care in orthopaedic surgery.

Unnecessary care, where the potential for harm exceeds the potential for benefit, is widespread in medical care. Orthopaedic surgery is no exception. This has significant implications for patient safety and health care expenditure. This narrative review explores unnecessary care in orthopaedic surgery. There is wide geographic variation in orthopaedic surgical practice that cannot be explained by differences in local patient populations. Furthermore, many orthopaedic interventions lack adequate low-bias evidence to support their use. Quantifying the size of the problem is difficult, but the economic burden and morbidity associated with unnecessary care is likely to be significant. An evidence gap, evidence-practice gap, cognitive biases, and health system factors all contribute to unnecessary care in orthopaedic surgery. Unnecessary care is harming patients and incurring high costs. Solutions include increasing awareness of the problem, aligning financial incentives to high value care and away from low value care, and demanding low bias evidence where none exists.

Geographic variability in dust and temperature in climate scaling regimes over the Last Glacial Cycle

Abstract. Temperature and mineral dust records serve as valuable palaeoclimatic indicators for studying atmospheric variability across different temporal scales. In this study, we employed Haar fluctuations to analyse global spatiotemporal atmospheric variability over the Last Glacial Cycle, capturing both high- and low-frequency information within the records, regardless of uniform or non-uniform sampling. Furthermore, we utilised Haar fluctuations to compute fluctuation correlations, thereby enhancing our understanding of palaeoclimate dynamics. Our findings reveal a latitudinal dependency in the transition from macroweather to climate regimes (τc), with polar regions experiencing shorter transitions compared to the tropics and mid-latitudes. These transitions occur at approximately 1/100th of glacial cycle length scales, suggesting a dominant forcing mechanism beyond Milankovitch cycles. Additionally, our analysis shows that polar regions have larger fluctuation amplitudes than lower latitudes as a consequence of the polar amplification effect. Furthermore, fluctuation correlations demonstrate faster synchronisation between the poles themselves compared to lower-latitude sites, achieving high correlation values within 10 kyr. Therefore, our findings suggest a consistent climate signal propagating from the poles to the Equator, representing the first empirical evidence supporting the hypothesis that the poles play a pivotal role as climate change drivers, influencing the variability in climatic transitions worldwide.

Unequal uptake of skilled maternal health care services in Ethiopia: cross-sectional data analyses informed by the intersectionality theory

ObjectiveTo investigate intersectional inequality encompassing socioeconomic, geographical and demographic variables in the use of competent birth and postnatal care services in Ethiopia.DesignData for the study came from a series of...

Deep Learning Models for Aorta Segmentation in Computed Tomography Images: A Systematic Review And Meta-Analysis

Abstract Purpose This systematic review and meta-analysis was conducted to evaluate the usefulness of deep learning (DL) models for aorta segmentation in computed tomography (CT) images. Methods Adhering to 2020 PRISMA guidelines, we systematically searched PubMed, Embase, and Web of Science for studies published up to March 13, 2024, that used DL models for aorta segmentation in adults’ chest CT images. We excluded studies that did not use DL models, involved nonhuman subjects or aortic diseases (aneurysms and dissections), or lacked essential data for meta-analysis. Segmentation performance was evaluated primarily in terms of Dice scores. Subgroup analyses were performed to identify variations related to geographical location and methodology. Results Our review of 16 studies indicated that DL models achieve high segmentation accuracy, with a pooled Dice score of 96%. We further noted geographical variations in model performance but no significant publication bias, according to the Egger test. Conclusion DL models facilitate aorta segmentation in CT images, and they can therefore guide accurate, efficient, and standardized diagnosis and treatment planning for cardiovascular diseases. Future studies should address the current challenges to enhance model generalizability and evaluate clinical benefits and thus expand the application of DL models in clinical practice.

Variation in the Floral Morphology of Prosthechea karwinskii (Orchidaceae), a Mexican Endemic Orchid at Risk.

Prosthechea karwinskii is an orchid endemic to Mexico, threatened by the destruction of its habitat and the extraction of specimens to meet its demand for ornamental and religious use. Most of its populations, including the most locally abundant ones, are found in Oaxaca state. Variations in some floral traits have been observed in these populations. We implemented a morphometric analysis to assess their floral variation and identify the most significant characters in the morphological patterns of this orchid. Floral samples were collected from 17 populations of P. karwinskii in Oaxaca, as well as from specimens used as ornaments during Easter in an Oaxacan community (Zaachila), whose origin is unknown. Sampling of natural populations covered the environmental, geographic, and morphological variation of the species. We performed an analysis of variance (ANOVA), principal component analysis (PCA), canonical variate analysis (CVA), and cluster analysis, including 185 individuals and 45 variables (12 of them were discarded in the multivariate analyses due to high correlation). Characters of the column, lateral sepal, and labellum were most informative for the observed morphological patterns. Albarradas showed the greatest morphological differentiation, mainly due to the column. In general, individuals from the same locality tended to overlap more, especially the populations of Jaltianguis and Yahuiche, which were different from the geographically close population of Etla. Teposcolula presented the highest values in perianth characters, unlike Sola_Rancho Viejo. The specimens recovered from religious ornaments were morphologically more similar to those from Yanhuitlan and Etla. This morphometric analysis identified characters as potential taxonomic markers for P. karwinskii and related species, showing its potential to associate specimens of unknown origin with their probable geographical region. Our work encourages working on collaborative conservation strategies to ensure the long-term permanence of both the species and its traditional uses.

Geographic variation in shortfalls of dementia specialists in the United States.

Dementia specialists-neurologists, geriatricians, and geriatric psychiatrists-serve a critical clinical function in diagnosing early-stage Alzheimer's disease and determining eligibility for treatment with disease-modifying therapies. However, the availability of dementia specialists is limited and varies across the United States. Using data from the Area Health Resources Files, we found that the median density of dementia specialists across hospital referral regions in United States is 28.8 per 100 000 population aged 65 years and older (interquartile range 19.3-43.6). We derived thresholds of 33-45 dementia specialists per 100 000 population aged 65 years and older as the provider density necessary to care for older adults with mild cognitive impairment and dementia. Based on these thresholds, we estimated that 34%-59% of the population aged 65 years and older resided in areas with potential dementia specialist shortfalls. The extent of potential shortfalls varied by state and rurality. A better understanding of potential gaps in the availability of dementia specialists will inform policies and practices to ensure access to services for people with cognitive impairment and dementia.

Geographic variations of aggregate mechanical stability controlled by inorganic cementing agents across the East Asian monsoon region

Soil aggregate mechanical properties are of vital importance for plant growth, tillage and soil erosion, and strongly conditioned by the amount and type of cementing agents that differ with soils. As most research focus at the site scale, how aggregate mechanical stability vary across different types of soils at regional scales and underlying mechanisms remain poorly understood. Herein, seven typical zonal soils in heavy textures with an increased status of soil development were collected under two land uses (arable and forest) and at three pedogenic horizons along the mid-temperate to south-subtropical climatic gradient in the East Asian monsoon region. Aggregate tensile strength (Y), specific rupture energy (Esp) and friability (FI) were measured on air-dried aggregates in a compression test, as well as soil cementing agents related to particle size distribution, organic matter and its components, metal oxides, phyllosilicates and exchangeable cations. Y and Esp were most affected by soil type (F = 37.7 and 21.4, p < 0.001), and less affected by land use and soil horizon (F < 8.2). Y and Esp were overall remarkably larger for temperate moderately (257 ∼ 700 kPa and 40 ∼ 261 J kg−1) than for subtropical highly developed soils (171 ∼ 329 kPa and 22 ∼ 52 J kg−1); FI (0.35 ∼ 1.30) showed no distinct geographic trend. Among soil properties, exchangeable polyvalent cations, crystalline Fe and Al oxides, and vermiculite had much larger and significant explanatory power (R2 = 0.33 ∼ 0.54, p < 0.01) than traditional soil properties (organic matter, soil texture and bulk density) (R2 < 0.25, p > 0.01), suggesting the predominant roles of the inorganic cementing agents in aggregate mechanical stability across soil types. Aggregate mechanical stability was increased by exchangeable polyvalent cations and vermiculite (r = 0.71 ∼ 0.81, p < 0.001), and weakened by crystalline Fe and Al oxides (r = −0.77 ∼ −0.74, p < 0.001). Additionally, mean annual precipitation and temperature were negatively correlated with aggregate mechanical stability (r = −0.80 ∼ −0.76, p < 0.001). This study demonstrates the remarkable geographic variations of aggregate mechanical stability under the influence of climate and highlights the importance of clay mineralogy (mainly swelling clay and crystalline Fe and Al oxides) and exchangeable cations at the regional scale.

Evolution of secondary metabolites, morphological structures and associated gene expression patterns in galls induced by four closely related aphid species on a host plant species.

Gall-forming insects induce various types of galls on their host plants by altering gene expression in host plant organs, and recent studies have been conducted for gene expression in galls. However, the evolutionary trajectories of gene expression patterns and the resulting phenotypes have not yet been studied using multiple related species. We investigated the speciation and the diversification process of galls induced by four closely related aphid species (Hormaphidini) on a host plant species (Hamamelis japonica) by examining the phylogenetic congruence between the geographical divergences of aphids and the host plant, and by comparing their gene expression patterns and resulting phenotypes. Phylogenetic analysis of aphids and the host plant showed that geographical isolation among host plant populations has interrupted gene flow in aphids and accelerated the speciation process. The concentration of phenolics and the complexity of the internal structure of galls were correlated with the expression levels of genes for the biosynthesis of phenolics and morphogenesis respectively. These results suggest that the expression levels of genes for the biosynthesis of phenolics and morphogenesis have evolutionarily increased in galls accelerated by the speciation process of aphids due to the distribution change of the host plant, leading to the related phenotypic evolution. Our study showed the evolutionary process of phenotypic traits in galls in the wild from both gene expression and actual phenotype levels.

Practitioner Review: Continuity of mental health care from childhood to adulthood for youths with ADHD-who, how and when?

Many youths with attention-deficit/hyperactivity disorder (ADHD) experience significant long-term impairment and may develop concurrent mental and somatic health difficulties as adults. This is associated with burden and costs for the individual and society which could be prevented through continued support in youth. Yet, only few young people transition to adult mental health services for ongoing care in different countries worldwide. We provide an overview on current transition practices, highlighting the gaps in knowledge and the barriers to effective service transitioning, while considering the large geographical variation in available guidelines and service provision. For ease of use, this review is organized in a question-and-answer format covering different aspects of the transition process and considering both service users' and clinicians' perspectives. Consensus is needed to identify those that require continued care, the optimal timing to arrange transition, and the most suitable services. Finally, we discuss cost-effectiveness of transition practices, consider examples of best practice, and propose recommendations on how to improve transitional care, including the importance of service users' input into transition planning.

Geographical factor dominates spatial patterns of potential nitrate reduction rates in coastal wetland sediments in Fujian Province, China

Nitrate (NO3−) reduction is a key process governing the nitrogen (N) dynamics of coastal wetland sediments. Although the effects of environmental factors on the NO3− reduction mechanism in coastal wetland sediments have been examined in various studies, the effects of spatial variation in potential NO3− reduction processes in coastal wetland sediments and the factors driving geographical variation in these processes have not been widely examined. Here, we conducted research on surface sediment samples from four different vegetation types at six coastal wetland sites across two regions. We characterized potential rates of NO3− reduction processes (including denitrification (DF), anammox (ANA), and dissimilatory nitrate reduction to ammonium (DNRA)) using a15N tracer method. Additionally, we assessed the abundances of functional genes, and microbial community structure using high-throughput sequencing, and metagenomic sequencing. In six wetland sites, the contribution ranges of DF, ANA, and DNRA to NO3− reduction were 38.43%–55.69%, 31.33%–45.65%, and 5.26%–17.11%, respectively, and potential NO3− reduction was mainly driven by N removal via gaseous N (DF+ANA). Significant spatial differences were observed in the structure of bacterial and fungal microbial communities, suggesting that geographical distance has a major effect on microbial community structure. Environmental factors and Functional gene abundances were significantly related to potential NO3− reduction processes, and physicochemical properties had a stronger effect on potential NO3− reduction processes than gene abundances. Factors showing significant differences across regions were the main drivers of variation in potential NO3− reduction processes. Overall, our study showed that sediment substrates and geographical environmental factors rather than the abundance of functional genes and vegetation types were the main indicators of potential NO3− reduction activities in coastal wetlands.

Sustainable Sludge Management in China: Quantifying GHG Emissions and Exploring Its Reduction Strategies

This study aims to evaluate the emissions of greenhouse gases (GHGs) stemming from the sludge treatment sector in China and to investigate the feasibility of novel technologies in curtailing these emissions, with the aim of fostering sustainable sludge management methodologies. Employing a life-cycle assessment (LCA) methodology, the research computed the comprehensive GHG emissions resulting from sludge treatment, taking into consideration diverse elements such as treatment techniques (e.g., landfills, incineration, and land application) and the geographical variations among China’s 660 municipalities. Findings indicate that the total amount of GHG emissions from sludge treatment amounted to 18.54 Mt CO2-eq in 2017, with incineration registering the highest emissions (10,011.53 kg CO2-eq/t dry sludge (DS)), followed by landfills (717.51 kg CO2-eq/t DS) and land application (276.41 kg CO2-eq/t DS). The geographical dispersion of emissions characteristics reveal notable regional disparities, with the top 1% of cities responsible for 34.2% of the overall emissions. The concentration of emissions in the top 1 percent of cities underscores the necessity for tailored mitigation measures that consider localized sustainable development challenges. Principal component analysis (PCA) demonstrates that economic determinants and treatment scales exert substantial influence on emissions, underscoring the imperative of aligning Sustainable Development Goals (SDGs) with economic advancement. To curtail the carbon footprint associated with sludge treatment and enhance sustainability, the study evaluated the emission mitigation potential and expenses of diverse technologies, encompassing thermal conversion, anaerobic digestion, hydrothermal treatment, and wet oxidation. These technologies have the capacity to slash GHG emissions by 0.09–0.46 t CO2-eq/t DS in comparison to traditional approaches, while concurrently advancing resource recuperation and principles of circular economy. For instance, gasification could diminish GHG emissions by 0.33–0.46 t CO2-eq/t DS, whereas anaerobic digestion could yield reductions of 0.09–0.30 t CO2-eq/t DS. The implementation of these innovative technologies across 660 Chinese municipalities could potentially curtail total GHG emissions from sludge treatment by 15–40%. Nevertheless, further enhancements are imperative to refine their environmental and economic efficiency and guarantee enduring sustainability. By deploying these technologies and embracing optimization tactics, China’s sludge treatment sector can make a substantial contribution towards attaining national carbon neutrality objectives and advancing sustainable development.