Bioreactors;
In-vessel.
The former, including biocells, bioreactors and in-vessel composting, require higher capital and operating costs, but allow a better process monitoring. This, in turn, results in lower environmental nuisance as well as in more favorable process conditions, which usually accelerate the biodegradation, shortening the composting period [ 17 , 18 , 19 ]. Conversely, open systems, such as open windrow and aerated piles, are much less costly: they do not rely on reactors and often air supply is provided by periodically turning the material under processing. In this way, temperature and moisture are also roughly regulated. The lower monitoring extent, in this case, results in longer composting times [ 20 , 21 ] and higher land occupation is also required. In order to overcome the limits of the single composting methods, two-stage processes have also been implemented: in this case, closed systems are used to manage the first biodegradation stages that are more energy intensive and characterized by greater emissions, whereas the final maturation stage is left to open systems [ 22 , 23 ]. Among others, the choice of the composting process depends on the environmental and economic conditions, but it is clear that diverse configurations can be applied in a wide variety of contexts to pursue organic waste recovery [ 24 , 25 ]. Compost generation accounts, indeed, for the interest in composting as a material recovery process pursuing circular economy principles. Moreover, it is recognized as a key process in the food-energy-water nexus, since compost can be used as soil amendment for food production [ 7 ].
The application of compost on soil brings several benefits, enhancing its main physic-chemical properties [ 26 ]. It increases the soil essential levels of both organic matter and nutrients and enhances its bulk density, porosity, water holding capacity, and cation-exchange capacity. Moreover, as a substitute for chemical fertilizer, the use of compost contributes to the reduction of the environmental impacts associated with the production and utilization of chemical fertilizers [ 27 ]. However, undesired substances and materials can be found in compost, hindering its safe agronomic use. Compost quality and the emissions of CO 2 and other GHG are recognized as the main challenges for the sustainability of the process [ 9 ]. Both require the identification of proper solutions, and to this end the analysis of the influencing factors is fundamental.
The composition and characteristics of the organic substrate destined to composting influences the presence of undesired substances and components in compost [ 28 , 29 ]. The release of CO 2 is also influenced by the chemical composition of the substrate that drives the biochemical reaction, but little has been reported up to now. Conversely, the issue of organic waste contamination has been significantly debated [ 28 , 29 ].
Non-degradable materials, which may enter composting together with the organic waste, end up in the compost if not removed via mechanical pretreatments or during compost refining stages, with adverse effects on soil [ 30 ]. Compost physical contaminants, such as glass, plastics, and synthetic fibers, tend to be incorporated at the soil depth of cultivation, where they may either envelop or act as nucleating agents for mineral grains and organic matter, blocking some pores and potentially reducing water percolation and gas exchange [ 30 ].
The presence of physical contaminants can be properly controlled by promoting the source segregation of the organic waste destined for composting. Alvarez et al. [ 31 ] studied the correlations between the socio-economic/demographic factors and the percentage of undesirable materials present in biowaste samples to find that in separately collected streams, it ranged between 10 and 20%; conversely, in cities with poor participation in the separate collection schemes, unwanted materials may account up to the 50% of the biowaste. More recently, Echavarri-Bravo et al. [ 32 ], through an inter-laboratory trial to evaluate the presence of physical contaminants in compost, posed the issue of their proper detection. The outcomes of their work showed that physical contaminants are heterogeneously present in the source sorted organic waste of municipal origin, and they may require replicate analysis to provide a fair assessment of product quality [ 32 ].
Although the improvement of separate collection can enhance the quality of the organic waste, potential miss-sorting and the collection system itself [ 33 ] require the mechanical pretreatment of the waste destined to composting [ 34 , 35 ]. On the other hand, despite the beneficial effects of the pretreatment stage on physical contaminants reduction, such pretreatment determines losses of biodegradable materials, mainly through sieving [ 23 ], and promotes the reduction of plastic items to micro-plastics (MPs) via shredding and crushing processes. Compost is considered as one of the main sources of MPs in agricultural environments [ 36 ]; they may adversely affect the carbon cycle in soil and bring toxic elements (i.e. heavy metals) that have been reported to be associated to MPs during composting [ 37 ]. Gui et al. [ 38 ] showed the gradual increase of MPs abundance during composting, as well as the change in their shape and size distribution. Therefore, the long-term application of compost onto the soil could result in the accumulation of MPs and consequent impacts on the soil ecosystem.
Although MPs represent a pressing issue, there remains a scarcity of data about their presence, especially for the smaller fractions, due to the difficulties associated with their separation and analysis [ 39 ]. However, some attempts have already been made, and a recent study showed that the abundance of MPs tend to increase during the pretreatment of the organic waste destined to composting, whereas manual sorting had no effect on micro-plastics as it aimed at the removal of the larger plastic items, the mechanical shearing and tearing forces exerted by the crushing and pressing steps was the cause of the increase of micro-plastic abundance in the samples entering the composting process [ 38 ]. This outcome confirms the key role of source selection in preventing the generation of MPs that can end up in compost. In this regard, studying the refined compost produced from five OFMSW facilities differing for the collection systems and treatment technologies, Edo et al. [ 40 ] found that smaller plants with OFMSW door-to-door collection systems produced compost with less plastic of all sizes, whereas compost from big facilities fed by OFMSW from street bin collection displayed the highest contents of plastics. Additionally, the authors reported that no compostable plastic debris was found in the analyzed samples, suggesting that biodegradable polymers that may be present in the incoming waste do not contribute to the spreading of anthropogenic pollution [ 40 ]. Biodegradable polymers have been introduced in recent decades to overcome the issue of traditional plastic pollution. The increasing use of such new materials determines their increasing frequent presence in the waste destined to composting. Although, as mentioned, most biodegradable polymers have been found to be suitable for composting, few of them, such as polylactic acid (PLA), may negatively affect the process. More specifically, it has been found that PLA degradation generates lactic acid, which significantly reduces the pH of compost, affecting seed germination [ 41 ].
In contrast with non-degradable, physical pollutants, the pre-processing of the organic waste cannot act on the presence of persistent organic contaminants. Polycyclic aromatic hydrocarbons (PAHs), polychlorinated biphenyls (PCBs), polychlorinated dibenzo-p-dioxins and -furans (PCDD/Fs), pesticides, and phthalates have reportedly been found in compost [ 42 , 43 , 44 , 45 ], and their fate during the composting process varies depending on the molecular weight, as discussed later in this work.
The composting process aims at organic matter biostabilization, which is mainly affected by the supply of oxygen, the availability of nutrients, the temperature, and the time [ 46 ]; the optimization of these operating parameters and conditions are crucial to ensure the biodegradation of organic matter to an adequate extent, determining compost biological stability and maturity.
Compost stability refers to the degree of decomposition of the organic matter, whereas the maturity describes the suitability as soil amendment, indicating the degree of humification [ 47 ]. Relevant amounts of organic acids, free ammonia-nitrogen (NH 3 ) or other water-soluble compounds that can restrict root development and limit seed germination may be found in unstable composts, and thus the maturity further implies the absence of both phytotoxic compounds in addition to pathogens [ 47 , 48 , 49 ].
Stability and maturity are a consequence of the proper biodegradation of organic compounds in the presence of nutrients such as nitrogen (N), phosphorous (P), and potassium (K). Carbon and nitrogen are fundamental for microorganisms to gain energy and build new cells, and thus the C/N ratio is used as a process control parameter [ 50 ]. During composting, the C/N ratio decreases as a consequence of the decrease of both elements, which occurs at a rate that is higher for C than for N [ 50 ]. Several studies reported that a C/N ratio between 25–30 is optimal for proper composting, but values as high as 40 or 50 have been recommended as well [ 51 , 52 , 53 ]. The C/N ratio may be adjusted by selecting suitable bulking agents, which also play a role in affecting aeration by influencing the porosity of the substrate under composting.
Oxygen supply is the most important parameter in ensuring the proper process development, affecting the microbial activity during the process [ 54 ]. Aeration frequency was found to influence the succession of the bacterial community during the industrial food waste composting by affecting both oxygen concentration and the release of various enzymes by these bacteria [ 54 ]. Similar outcomes were obtained by Wang et al. [ 55 ], who further observed how the aeration rate influenced the leachate production and contributed to the decomposition of toxic substances in the leachate itself.
Cerda et al. [ 48 ] reported proper composting development for aeration ranging between 0.2 and 0.6 L/kg OM min, whereas Xu et al. [ 56 ], studying bacterial dynamics together with gaseous emissions and humification during the composting of food waste, found that aeration intensities higher than 0.36 L/kg OM min reduced the emissions of GHG and hydrogen sulphide and promoted the production of the humus precursor. The same authors recommended reducing the aeration intensity in the final stages of composting in order to avoid the bacterial consumption of the humus precursors.
Aeration is not only crucial to providing oxygen supply, as it also helps with regulating the temperature and the moisture in the mass under composting as well as in removing CO 2 [ 57 ]. The moisture, in turn, has been recently pointed out to affect GHG emissions during food and garden waste composting; increasing the moisture content of the waste under composting resulted in more pores filled with water, which determined, in turn, the creation of anaerobic zones where methane (CH 4 ) was produced; nevertheless, total nitrous oxide (N 2 O) was found to increase for decreasing moisture content [ 58 ]. This condition stands as a technical challenge to be addressed to ensure the sustainability of the process while providing proper aeration conditions. Several studies indeed report that aeration demand for temperature and moisture regulation is much higher than that of biochemical reactions [ 59 , 60 ], and thus excess oxygen is usually supplied in industrial scale plants.
Most industrialized countries have regulated composting as an OFMSW recovery process, defining specific guidelines. Beyond setting threshold limit values for some target compost parameters, these provide indications about the process operating conditions, including the definition of the waste substrates to be excluded as well as the minimum temperature to be reached to ensure the proper sanitation of the final product [ 61 ]. Composting is indeed a self-heating process and temperatures tend to increase in the initial stages as a result of the higher biochemical reaction intensity, and to decline in the final maturation steps, reaching values comparable to the environmental ones. Due to the importance of temperature during composting, this process is divided into the so-called mesophilic, thermophilic and maturation stages, where the former two (i.e. mesophilic and thermophilic) basically refer to the accelerated bio-oxidation phase. In order to produce a hygienic compost, the thermophilic stage should last one week and reach temperatures as high as 55 °C to ensure pathogen destruction [ 61 ]. The temperature of the waste under composting is influenced by the external one, so that heating methods have been developed to promote the microbial activity and increase the temperature in cold climate regions [ 62 ]. The role of high temperature is indeed fundamental not only for hygiene reasons; it promotes organic matter degradation, shortening the maturity period [ 63 ]. Additionally, it may act in controlling the presence of some contaminants. In this regard, Chen et al. [ 64 ] reported an almost 43% removal of polystyrene-MPs from sewage sludge after 45 days of hyperthermophilic composting. They concluded that this outcome was due to the excellent bio-oxidation performance exhibited by hyperthermophilic bacteria [ 64 ]. However, under thermophilic conditions, the high temperature, humidity and oxygen content could improve the degradation of MPs and increase the release of toxic elements (plasticizer, chlorine and heavy metals). In addition, such conditions could produce the reactive oxygen species that reduces the richness and biodiversity of microbial communities during the conventional composting of cow manure and sawdust [ 65 ].
The operating conditions may thus play a role in promoting the contaminant removal; besides MPs, the concentration of selected organic contaminants can be also reduced. This is the case for low molecular weight PAHs, which were observed to decrease up to 90% during composting [ 66 ]. Conversely, the concentration of high molecular weight PAHs, PCBs and pesticides was found to remain stable or to increase, likely due to the moisture content reduction during the final steps of composting [ 66 , 67 , 68 , 69 ]. Similarly, Graça et al. [ 69 ] showed that the use of wood shavings as a bulking agent promoted the proper succession of bacteria during composting, leading to the degradation of low molecular weight PAHs and phthalates, whereas Lin et al. [ 70 ] demonstrated the possibility to treat the high concentration of benzophenone during the co-composting of food waste, sawdust and mature compost, reaching a 97% removal efficiency after 35 days of incubation.
It is worth highlighting that composting has been proposed as a bioremediation practice for sites contaminated with organic pollutants, including polycyclic aromatic hydrocarbons, pesticides, and petroleum products [ 71 ], as well as polychlorinated dibenzo-p-dioxins (PCDDs) and polychlorinated di-benzofurans (PCDFs) [ 72 ]. This indicates a potential for the process to reduce the presence of some toxic compounds (which may be contained in the incoming waste) in the final compost.
In most industrialized countries where OFMSW recycling practices are well established, the characteristics of compost for its use on soil are clearly identified. Although a lack of uniformity can be observed, the agronomic value (C/N ratio, minimum carbon content) and the presence of heavy metals, inerts and pathogens are usually well established [ 73 ]. Similarly, the stability and maturity are already monitored in waste-based composts. The assessment of both biological stability and maturity during the industrial scale composting of the organic fraction of municipal solid waste showed the key role of these parameters in the process monitoring [ 74 ]. The analysis of the Dynamic Respiration Index (DRI) over time was found to provide useful indications about the development of the biological stabilization process, although it may not address the correct identification of the possible causes for unstable composts. Similarly, the sole result of phytotoxicity tests cannot provide comprehensive information given the tight link between stability and maturity [ 74 ], especially for municipal waste based-compost [ 75 ]. The proper monitoring of the selected conventional parameters of stability and maturity may provide further indication about the biodiversity in composting processes [ 76 ].
The greatest concern about the safe use of compost on soil must be ascribed to those contaminants not yet regulated, and this issue has been largely debated in the scientific literature. The presence of persistent organic contaminants has been investigated to provide a wider perspective, and it was found that they do not usually pose a severe risk. The content of compounds causing dioxin-like effects such as PAHs, PCBs and other chlorinated compounds, analyzed in compost samples collected in 16 European countries, was found to be mostly below the most restrictive limit values [ 77 ]. Similarly, Langdon et al. [ 78 ] found that many contaminants in composted municipal organic waste samples produced in New South West Australia can be considered as not posing a risk. Nevertheless, for some others, no criteria were available to assess their hazard potential. To this end, a priority ranking was proposed based on the assessment of a risk quotient (RQ) for either ecological or human receptors. This was calculated considering the maximum concentration in soil resulting in two different scenarios of compost application on soil ( Table 2 ).
Prioritization of selected contaminants based on the risk assessment conducted by Langdon et al. [ 78 ]).
Priority Group | Risk Receptor | Contaminant of Potential Concern | RQ (10 t/ha) | RQ (140 t/ha) |
---|---|---|---|---|
Very high | Ecological | Phenol | 3.5 | 45 |
Ecological | Dibutyl phthalate | 1.8 | 23 | |
Ecological | Commercial penta-BDE | 2.3 | 30 | |
Human health | Total PBDEs | 5.5 | 70 | |
High | Ecological | DEHA | 0.45 | 5.7 |
Ecological | BPA | 0.14 | 1.7 | |
Medium | Ecological | DEHP | 0.11 | 23 |
Ecological | DBT | 0.11 | 1.5 | |
Low | Ecological | Benzyl butyl phthalate | 0.0092 | 0.12 |
Human health | DEHP | 0.046 | 0.58 |
The need to further explore the adverse effects of most emerging compounds comes along with the need to verify whether the proper adjustment of the composting operating conditions may contribute to their degradation. In this regard, further research should focus on understanding the mechanisms underlying the biologically-mediated oxidation of these organic pollutants during waste composting and, based on scientific literature, similar considerations are raised for microplastics. As mentioned, the establishment of specific temperature profiles may be beneficial for the process [ 64 ]. However, further research efforts should be directed towards the understanding of its role on different plastic polymers and size range as well as toward the definition of strategies to reach high temperatures in cold climate regions. In this regard, a suitable solution would be the use of new microbial strains working at psychrophilic conditions, as suggested by Jiang et al. [ 79 ]. Generally speaking, the research on microbial communities has indicated that many compounds used for microbial inoculation help to improve the temperature, to extend the high temperature periods, and to enhance kinase activity, chemical composition and enzymes so that more studies are required in this field [ 11 ].
Depending on the chemical characteristics and concentration of contaminants, the microbial pools as well as the environmental composting conditions that they contribute to create may differently affect the fate of the contaminant itself [ 11 ]. The identification of both optimization strategies and effective monitoring represents other areas of key research to address the technical challenges related to composting.
Process optimization entails the iterative adjustment of the operating conditions to identify those ensuring the sustainable production of a high-quality compost. In this view, an approach based exclusively on an experimental campaign, especially if carried out at industrial scale, may require significant time and effort. Modelling can represent a suitable tool to better understand the composting process [ 80 ], identifying the causes of possible failures so as to take prompt action. In this regard, Onwosi et al. [ 81 ] briefly reviewed possible statistical and kinetic approaches. The former relies on the use of techniques, including the one-at-a-time approach, factorial design and the fuzzy logic model, which allow the comprehension of the effects of some variables of the process under investigation. On the other hand, the kinetic approach uses mathematical models. The development of effective models is worth studying, with the aim being to address new solutions to be adopted at larger scales.
The optimization of the composting process is also fundamental to reducing GHG emissions. Recent research advances have focused on the use of semi-permeable membranes coupled with intermittent aeration: under the optimum conditions investigated at industrial scale, a global warming potential (GWP) reduction up to 10% was observed [ 82 ] and the carbon dioxide, methane, nitrous oxide, and ammonia emissions outside the membrane during the aeration interval were decreased by 64%, 70%, 55%, and 11%, respectively, compared with that inside the membrane [ 83 ].
The optimization of the composting process for GHG may also entail the use of additives [ 84 , 85 ]. Yang et al. [ 50 ] proposed the addition of two mineral additives, namely phosphor-gypsum and superphosphate, to reduce gaseous emissions during kitchen waste composting. They found that additives reduced CH 4 emissions by 80.5–85.8% and decreased NH 3 emissions by 18.9–23.5%. A decrease in GHG emissions by 7.3–17.4% was also observed. The extensive data analysis carried out by Cao et al. [ 84 ] to quantify the impact of different additives on NH 3 and GHG emissions showed that it was possible to gain greater yields, reducing the loss of total nitrogen as well as the emissions of NH 3 , N 2 O and CH 4 by 46.4%, 44.5%, 44.6% and 68.5%. The corresponding reduction in the global warming potential was 54.2%. The same authors pointed out that all the additive categories (namely physical chemical and biological) significantly reduced TN loss and NH 3 emission, although, under optimal conditions, the chemical additives resulted in higher effectiveness [ 84 ].
Novel additives may thus be identified, or proper activation procedures may be developed to enhance the efficiency of traditional additives with regard to odour and gaseous emissions. It is worth highlighting that, in a circular perspective, carbon dioxide, although contributing to GHG emissions, may be more interestingly captured and recycled. Thomson et al. [ 86 ] proposed this option by approaching the composting process optimization in the view of resource recapture with the aim of using CO 2 and other composting outputs (like heat and the compost itself) within controlled environmental agriculture practices.
In view of enhancing composting sustainability in a circular perspective, its integration within anaerobic digestion facilities has been proved to be a solution. For instance, Di Maria et al. [ 87 ] compared composting with integrated anaerobic/aerobic treatments aiming at different energetic use of the biogas produced during the anaerobic stage. Their findings demonstrated that the latter was the preferred option in terms of avoided impacts, especially when considering the upgrading of biogas into biomethane instead of conventional exploitation in co-generators [ 87 ]. These results were more recently confirmed by Le Pera et al., [ 88 ] highlighting another area of further research based on LCA studies to identify the potential impact of composting and optimize the process by addressing the reduction of emissions.
The reliability of composting and its easy implementation are the main drivers for this process to be the preferred technical solution to manage the organic fraction of municipal solid waste at the European level. Nevertheless, with the shift of the paradigm towards the circular economy, some aspects have emerged as technical constraints limiting the sustainability of this process. The need to ensure the effective and safe use of compost on soil has addressed the discussion on compost quality and the presence of contaminants. Similarly, odour, ammonia and GHG emissions require proper handling to reduce the environmental burdens of the process.
The literature review highlights the central position of these aspects in the scientific debate. Different kinds of persistent organic contaminants have been detected and regarded in the view of the potential risk posed by their release into the environment; similarly, the fate of microplastics during composting has been investigated to verify which process stages contribute the most to their accumulation into the process product. Further studies are needed to unveil the hazard potential of emerging contaminants as well as to address the understanding of the mechanisms underlying their potential removal during composting and to propose novel solutions to be applied at larger scale.
Another issue of concern was found to be related to gaseous emissions: beyond odour control solutions, it is fundamental to reduce the environmental burdens associated with GHG emissions. Novel approaches rely on intermittent aeration and the use of semi-permeable membranes or that of additives, but additional efforts should be devoted to the identification of both the optimal operating conditions and the operating costs to implement these solutions within industrial plants. Moreover, in the view of a circular perspective, any solution addressing the capture and recycling of gaseous compounds may play a pivotal role in the near future. This is particularly true for GHGs such as CO 2 .
It is worth highlighting that research exclusively based on experimental campaigns may turn out to be expensive and time-consuming, so that additional approaches based on either mathematical modelling or life cycle assessment studies may be used to support the identification of the most suitable solutions. However, even though different approaches may serve diverse purposes, adopting a holistic and multidisciplinary perspective in the design of research studies dealing with the composting process may play a key role towards the definition of reliable, cost-effective and environmentally friendly strategies to enhance composting performances. Conversely, despite the essential role of research in this field, the limitation of lab-scale experimental tests has to be overcome via the validation of the most promising findings at real scale.
Alessandra Cesaro would like to thank the former Italian Ministry of Education, University and Research (MIUR) who provided financial support for her position in the frame of the research project entitled “Dipartimenti di Eccellenza” per Ingegneria Civile Edile e Ambientale -CUPE65D18000820006.
This research received no external funding.
G.P. and A.C. contributed to the study conception and design, material preparation, data collection and analysis and wrote the first draft of the manuscript. A.C. performed review and editing. All authors have read and agreed to the published version of the manuscript.
Not applicable.
Data availability statement, conflicts of interest.
The authors declare no conflict of interest.
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August 14, 2024
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by Kimbra Cutlip, University of Maryland
Urban soils often contain chemical contaminants, such as heavy metals or trace amounts of antibiotics, along with higher levels of antibiotic-resistant bacteria. New research from the University of Maryland suggests that, in some cases, boosting urban soil health with compost and treated manure may reduce the amount of "bad" bacteria. Understanding these dynamics has important implications for improving the quality and safety of fresh produce in urban agriculture.
The study was published the Journal of Food Protection.
"Urban farming brings people together and now we see that it can help clean up the environment, at least from certain antibiotic-resistant bacteria," said Ryan Blaustein, an assistant professor in the Department of Nutrition and Food Science at UMD and an author of the study. "Growing organically may promote healthier vegetable 'microbiomes' that we are exposed to as consumers."
Urban farmers and community gardeners often amend their soil with biological additives, like animal manure, or composts made from mixtures of plant material and food scraps that may include fruits and vegetables, eggs, milk, meat, or shellfish waste.
These types of soil amendments are regulated, and must be properly composted or pasteurized before application, because they carry a risk of introducing microbes like salmonella and E. coli, which cause food-borne illness. But little is known about the potential effects of using organic soil amendments on antibiotic resistance in bacteria in urban food systems.
To help fill this gap, Blaustein and his colleagues analyzed soils and leafy green vegetables like kale and lettuce from seven urban farms and community gardens around Washington, D.C. They tested for levels of total bacteria and bacteria resistant to antibiotics like ampicillin and tetracycline. At each location, they tested leafy greens as well as soil that had been treated with manure or compost and soil that had not been treated.
Their results showed that amended soils treated with manure or compost had much more total bacteria than untreated soils, but not necessarily more harmful bacteria or antibiotic-resistant strains. Meaning, the proportion of resistant bacteria and food safety indicators were actually lower in the amended soil. Further studies need to be done to determine the long-term impacts, but their results suggest that manure and compost could act like probiotics for the soil, perhaps introducing or stimulating beneficial bacteria that outcompetes and suppresses the antibiotic-resistant bacteria .
The researchers also found that the pH in soil was strongly associated with concentrations of tetracycline-resistant bacteria, suggesting that managing pH has applications for controlling associated risks. In addition, they saw large differences in bacteria levels between sites, sometimes within the same farm, depending on what amendments were used and what greens were grown. Blaustein said these results highlight the need to build a systems-level understanding of soils in urban farming environments.
This information has important implications for understanding the role of compost and manure for improving soil health and managing harmful bacteria and ensuring a healthy food supply from urban agricultural settings.
Journal information: Journal of Food Protection
Provided by University of Maryland
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Time marches on predictably, but biological aging is anything but constant, according to a new Stanford Medicine study.
August 14, 2024 - By Rachel Tompa
We undergo two periods of rapid change, averaging around age 44 and age 60, according to a Stanford Medicine study. Ratana21 /Shutterstock.com
If it’s ever felt like everything in your body is breaking down at once, that might not be your imagination. A new Stanford Medicine study shows that many of our molecules and microorganisms dramatically rise or fall in number during our 40s and 60s.
Researchers assessed many thousands of different molecules in people from age 25 to 75, as well as their microbiomes — the bacteria, viruses and fungi that live inside us and on our skin — and found that the abundance of most molecules and microbes do not shift in a gradual, chronological fashion. Rather, we undergo two periods of rapid change during our life span, averaging around age 44 and age 60. A paper describing these findings was published in the journal Nature Aging Aug. 14.
“We’re not just changing gradually over time; there are some really dramatic changes,” said Michael Snyder , PhD, professor of genetics and the study’s senior author. “It turns out the mid-40s is a time of dramatic change, as is the early 60s. And that’s true no matter what class of molecules you look at.”
Xiaotao Shen, PhD, a former Stanford Medicine postdoctoral scholar, was the first author of the study. Shen is now an assistant professor at Nanyang Technological University Singapore.
These big changes likely impact our health — the number of molecules related to cardiovascular disease showed significant changes at both time points, and those related to immune function changed in people in their early 60s.
Snyder, the Stanford W. Ascherman, MD, FACS Professor in Genetics, and his colleagues were inspired to look at the rate of molecular and microbial shifts by the observation that the risk of developing many age-linked diseases does not rise incrementally along with years. For example, risks for Alzheimer’s disease and cardiovascular disease rise sharply in older age, compared with a gradual increase in risk for those under 60.
The researchers used data from 108 people they’ve been following to better understand the biology of aging. Past insights from this same group of study volunteers include the discovery of four distinct “ ageotypes ,” showing that people’s kidneys, livers, metabolism and immune system age at different rates in different people.
Michael Snyder
The new study analyzed participants who donated blood and other biological samples every few months over the span of several years; the scientists tracked many different kinds of molecules in these samples, including RNA, proteins and metabolites, as well as shifts in the participants’ microbiomes. The researchers tracked age-related changes in more than 135,000 different molecules and microbes, for a total of nearly 250 billion distinct data points.
They found that thousands of molecules and microbes undergo shifts in their abundance, either increasing or decreasing — around 81% of all the molecules they studied showed non-linear fluctuations in number, meaning that they changed more at certain ages than other times. When they looked for clusters of molecules with the largest changes in amount, they found these transformations occurred the most in two time periods: when people were in their mid-40s, and when they were in their early 60s.
Although much research has focused on how different molecules increase or decrease as we age and how biological age may differ from chronological age, very few have looked at the rate of biological aging. That so many dramatic changes happen in the early 60s is perhaps not surprising, Snyder said, as many age-related disease risks and other age-related phenomena are known to increase at that point in life.
The large cluster of changes in the mid-40s was somewhat surprising to the scientists. At first, they assumed that menopause or perimenopause was driving large changes in the women in their study, skewing the whole group. But when they broke out the study group by sex, they found the shift was happening in men in their mid-40s, too.
“This suggests that while menopause or perimenopause may contribute to the changes observed in women in their mid-40s, there are likely other, more significant factors influencing these changes in both men and women. Identifying and studying these factors should be a priority for future research,” Shen said.
In people in their 40s, significant changes were seen in the number of molecules related to alcohol, caffeine and lipid metabolism; cardiovascular disease; and skin and muscle. In those in their 60s, changes were related to carbohydrate and caffeine metabolism, immune regulation, kidney function, cardiovascular disease, and skin and muscle.
It’s possible some of these changes could be tied to lifestyle or behavioral factors that cluster at these age groups, rather than being driven by biological factors, Snyder said. For example, dysfunction in alcohol metabolism could result from an uptick in alcohol consumption in people’s mid-40s, often a stressful period of life.
The team plans to explore the drivers of these clusters of change. But whatever their causes, the existence of these clusters points to the need for people to pay attention to their health, especially in their 40s and 60s, the researchers said. That could look like increasing exercise to protect your heart and maintain muscle mass at both ages or decreasing alcohol consumption in your 40s as your ability to metabolize alcohol slows.
“I’m a big believer that we should try to adjust our lifestyles while we’re still healthy,” Snyder said.
The study was funded by the National Institutes of Health (grants U54DK102556, R01 DK110186-03, R01HG008164, NIH S10OD020141, UL1 TR001085 and P30DK116074) and the Stanford Data Science Initiative.
About Stanford Medicine
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Psychiatry’s new frontiers
Due to its environmental friendliness, composting is widely used for the treatment of chicken manure and kitchen waste. However, the composting effect still needs to be improved due to the low pH of kitchen waste and low C/N of chicken manure. This paper analyzed the composting effects of chicken manure, kitchen waste, and combined chicken manure and kitchen waste. The maximum composting temperature, relative abundance of thermophilic bacteria, organic matter degradation, and water content decrease for the combined treatment were 77.00 °C, 67.04%, 15.00%, and 28.74%, respectively, which were significantly greater than those for the separate treatment of chicken manure and kitchen waste. Moreover, the results revealed that the composting products of the combined treatment had a higher degree of harmlessness and humification based on seed germination, Escherichia coli , and humification indicator, which is advantageous for the resource application of the products. In conclusion, combined treatment can enhance the composting effect due to the pH and C/N of the material being improved by mixing chicken manure and kitchen waste. This study provides a powerful assistance for understanding the composting mechanism of combined treatment of chicken manure and kitchen waste, laying the theoretical foundation for engineering application.
Combined treatment enhances composting effect by improving pH and C/N of material.
Combined treatment increases temperature and thermophilic bacterial reproduction.
Combined treatment promotes organic matter degradation and water evaporation.
Combined treatment raises harmlessness and humification of composting products.
Chicken manure is characterized by low C/N and high pH, while kitchen waste is characterized by high C/N and low pH. They are poorly composted separately, and need to add conditioners in the process. Therefore, combined treatment of chicken manure and kitchen waste was considered to achieve suitable C/N and pH, which enhances the composting effect and also reduces the use of conditioners. This study provides a novel approach to the composting of chicken manure and kitchen waste.
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This work was supported by the National Key Research and Development Program of China (No. 2020YFC1806402), the Shenyang Science and Technology Plan Project (No. 20–202–4–37). Feng Ma was financially supported by the scholarship (No. 202306080070) from China Scholarship Council (CSC). The authors would like to thank Dr. Shuichi TORII (Kumamoto University) for his helpful discussion.
This work was supported by the National Key Research and Development Program of China (No. 2020YFC1806402), the Shenyang Science and Technology Plan Project (No. 20–202–4–37).
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Institute of Process Equipment and Environmental Engineering, School of Mechanical Engineering and Automation, Northeastern University, Shenyang, 110819, China
Feng Ma, Qinghui Chen, Haoyu Quan, Chaoyue Zhao, Youzhao Wang & Tong Zhu
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All authors contributed to the study conception and design. Material preparation was performed by Feng Ma, Qinghui Chen, and Haoyu Quana. Data collection and analysis were performed by Feng Ma, Chaoyue Zhao, and Youzhao Wang. Funding Acquisition was performed by Tong Zhu. The first draft of the manuscript was written by Feng Ma and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.
Correspondence to Tong Zhu .
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Ma, F., Chen, Q., Quan, H. et al. Combined Treatment for Chicken Manure and Kitchen Waste Enhances Composting Effect by Improving pH and C/N. Waste Biomass Valor (2024). https://doi.org/10.1007/s12649-024-02676-0
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Received : 09 April 2024
Accepted : 03 August 2024
Published : 16 August 2024
DOI : https://doi.org/10.1007/s12649-024-02676-0
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Published on 16.8.2024 in Vol 26 (2024)
Authors of this article:
1 Department of Clinical Laboratory, National Center Hospital, National Center of Neurology and Psychiatry, Kodaira, Japan
2 Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Japan
3 Department of Psychiatry, The Jikei University School of Medicine, Tokyo, Japan
4 Graduate School of Nursing Science, St. Luke’s International University, Tokyo, Japan
5 Department of Neuropsychiatry, Kyorin University School of Medicine, Tokyo, Japan
6 Department of Neuropsychiatry, Akita University Graduate School of Medicine, Akita, Japan
7 Department of Neuropsychiatry, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
Yoshikazu Takaesu, MD, PhD
Department of Neuropsychiatry
Graduate School of Medicine
University of the Ryukyus
Okinawa, 903-0215
Phone: 81 98 895 3331
Email: [email protected]
Background: The screening process for systematic reviews is resource-intensive. Although previous machine learning solutions have reported reductions in workload, they risked excluding relevant papers.
Objective: We evaluated the performance of a 3-layer screening method using GPT-3.5 and GPT-4 to streamline the title and abstract-screening process for systematic reviews. Our goal is to develop a screening method that maximizes sensitivity for identifying relevant records.
Methods: We conducted screenings on 2 of our previous systematic reviews related to the treatment of bipolar disorder, with 1381 records from the first review and 3146 from the second. Screenings were conducted using GPT-3.5 (gpt-3.5-turbo-0125) and GPT-4 (gpt-4-0125-preview) across three layers: (1) research design, (2) target patients, and (3) interventions and controls. The 3-layer screening was conducted using prompts tailored to each study. During this process, information extraction according to each study’s inclusion criteria and optimization for screening were carried out using a GPT-4–based flow without manual adjustments. Records were evaluated at each layer, and those meeting the inclusion criteria at all layers were subsequently judged as included.
Results: On each layer, both GPT-3.5 and GPT-4 were able to process about 110 records per minute, and the total time required for screening the first and second studies was approximately 1 hour and 2 hours, respectively. In the first study, the sensitivities/specificities of the GPT-3.5 and GPT-4 were 0.900/0.709 and 0.806/0.996, respectively. Both screenings by GPT-3.5 and GPT-4 judged all 6 records used for the meta-analysis as included. In the second study, the sensitivities/specificities of the GPT-3.5 and GPT-4 were 0.958/0.116 and 0.875/0.855, respectively. The sensitivities for the relevant records align with those of human evaluators: 0.867-1.000 for the first study and 0.776-0.979 for the second study. Both screenings by GPT-3.5 and GPT-4 judged all 9 records used for the meta-analysis as included. After accounting for justifiably excluded records by GPT-4, the sensitivities/specificities of the GPT-4 screening were 0.962/0.996 in the first study and 0.943/0.855 in the second study. Further investigation indicated that the cases incorrectly excluded by GPT-3.5 were due to a lack of domain knowledge, while the cases incorrectly excluded by GPT-4 were due to misinterpretations of the inclusion criteria.
Conclusions: Our 3-layer screening method with GPT-4 demonstrated acceptable level of sensitivity and specificity that supports its practical application in systematic review screenings. Future research should aim to generalize this approach and explore its effectiveness in diverse settings, both medical and nonmedical, to fully establish its use and operational feasibility.
Large language models (LLMs) with extensive parameters, honed on substantial textual data, have seen striking advancements recently. Following OpenAI’s third-generation Generative Pre-trained Transformer (GPT-3), LLMs now possess advanced competencies in various natural language processing tasks [ 1 ]. Among these, ChatGPT, which is built on GPT-3.5—an iteration that improves upon GPT-3 by integrating both supervised and reinforcement learning techniques—has received particular attention [ 2 , 3 ]. GPT-3.5 has shown exceptional performance in the medical domain, achieving remarkable results on medical licensing examinations across different regions [ 4 ]. Furthermore, GPT-4, the successor to GPT-3.5, has exhibited superior performance [ 5 ], with its contextual understanding abilities potentially exceeding those of humans [ 6 , 7 ]. Beyond its use for language editing [ 8 , 9 ], both GPT-3.5 and GPT-4 have proven to be effective tools for analyzing and comprehending the abstracts of research papers, offering potential benefits in the screening process for systematic reviews.
Systematic reviews and subsequent meta-analyses bear crucial clinical significance. The screening of titles and abstracts is a crucial step in this process [ 10 - 13 ], often involving more than 1000 papers identified via targeted keyword searches [ 14 ]. This screening process can take approximately 1 hour for every 60-120 papers [ 10 ], which is a substantial drain on human and time resources. In addition, human error is inevitable in the screening process [ 15 - 17 ], and the number of such errors can increase as the amount of paper to be screened increases possibly due to fatigue and cognitive overload [ 18 , 19 ]. To mitigate this labor-intensive task, attempts have been made to use text mining and machine learning technologies [ 17 , 20 - 29 ]. Although these methods have successfully reduced the workload, they risk omitting relevant papers, which could result in a high false-negative rate. Specifically, several studies reported the exclusion of records that should have been included in the meta-analysis [ 20 , 21 , 23 , 29 ]. Consequently, using machine learning techniques, such as natural language processing, to assist with abstract screening has not yet become widely adopted [ 14 , 30 ]. For systematic reviews, maintaining high sensitivity for studies eligible for full-text assessment, ideally at 100% [ 10 ], is crucial if they are to be fully supplanted by an automated process.
With the advanced language-processing capabilities of GPT-3.5 and GPT-4 [ 2 , 5 ], there has been an expectation of achieving higher accuracy in screening processes. Kohandel Gargari et al [ 31 ] conducted title and abstract screening using GPT-3.5, but the sensitivity for identifying relevant papers remained at a maximum of 69%, even after attempting various prompt modifications. Khraisha et al [ 32 ] explored the use of GPT-4 across different systematic review processes and found that the sensitivity for title and abstract screening ranged between 42% and 50%. Guo et al [ 33 ] have also demonstrated the use of GPT-4 in title and abstract screenings; however, the sensitivity for relevant papers was limited to 76%, highlighting the challenge of unintentionally excluding necessary records. Notably, Tran et al [ 34 ] used GPT-3.5 for title and abstract screening with rigorous prompt adjustments, achieving a high sensitivity of 97.1% for relevant papers. While this high-sensitivity level might already be suitable for practical use in the systematic review process, its specificity was limited to 37.7% [ 34 ].
The aim of this study is to develop a title- and abstract-screening method using GPT-3.5 and GPT-4 that achieves as high a sensitivity as possible. Although the method of using GPT-3.5 by Tran et al [ 34 ] achieved high sensitivity for identifying relevant papers, we aim to maintain high sensitivity while also improving specificity through a unique approach that incorporates GPT-4. To achieve this, we subdivided the process of determining inclusion for systematic reviews [ 11 ] involving 3 layers of screening. By breaking down the screening process into multiple steps, each addressing a specific aspect, we aimed to optimize the performance of the language models. In this study, we regarded the results of human screening as the gold standard and calculated the sensitivity and specificity of the GPT-3.5 and GPT-4 screening results in comparison with them. Furthermore, we carefully examined the records that were erroneously excluded by GPT-3.5/GPT-4. This examination was conducted to assess the appropriateness of their exclusion.
GPT-3.5 and GPT-4, LLMs used in this study, are accessible through ChatGPT. However, ChatGPT does not support processing multiple queries against the titles and abstracts of scholarly papers simultaneously. To address this limitation, we leveraged the application programming interfaces (APIs) of GPT-3.5 and GPT-4, known as gpt-3.5-turbo and gpt-4-turbo-preview, respectively [ 35 ].
For gpt-3.5-turbo, we used the most current model available, gpt-3.5-turbo-0125. This model could be used at a low cost of US $0.50 per 1M tokens for input and US $1.50 per 1M tokens for output, with approximately 750 tokens corresponding to 1000 words [ 36 ]. Similarly, for GPT-4, we used the latest model available, gpt-4-0125-preview, which was available at a cost of US $10.00 per 1M tokens for input and US $30.00 per 1M tokens for output [ 36 ].
In this study, we used Google Spreadsheet and Google Apps Script to interface with the GPT-3.5 and GPT-4 APIs for batch processing. Specifically, we created the “GPT35” function to call the gpt-3.5-turbo-0125 API within Google Spreadsheet. Users can invoke this function by entering “=GPT35([prompt])” into a cell, enabling the intuitive batch processing of multiple titles and abstracts. Similarly, we established the “GPT4” function to access the gpt-4-0125-preview API.
Both the gpt-3.5-turbo-0125 and gpt-4-0125-preview have a parameter called “temperature,” which introduces “variability” in the responses—the higher the temperature, the greater the randomness, with a range between 0 and 2 [ 37 ]. As described later in this study, the decision to include or exclude records was delegated to GPT-3.5 and GPT-4. At the preliminary trials, it was observed that setting the temperature above 0 resulted in varying responses from one trial to another. In addition, setting the temperature above 0 can lead to unexpected responses. When instructed to respond with either “E” (for the exclusion) or “I” (for the inclusion), if the temperature is 0, the output will be strictly “E” or “I.” However, if the temperature is above 0, even if it is only 0.1, the response might be, for example, “The answer is ‘E’.” In light of these observations, and primarily to ensure reproducibility, this study fixed the temperature at 0 for all screenings. The Apps Script used in this study is shown in Multimedia Appendix 1 .
Generally, in a systematic review, a comprehensive examination is conducted on studies that address a relevant clinical question. After a comprehensive literature search is performed to identify all potential studies for review, each record is assessed to determine whether it addresses the clinical question [ 11 ]. In this study, we used either GPT-3.5 or GPT-4 to assess the inclusion or exclusion of relevant papers at each of the following three layers: (1) research design, (2) target population, and (3) intervention and control [ 11 ]. Records not deemed for exclusion at any of these layers were classified as “included.” We present the workflow of the process we conducted in Figure 1 .
The characteristics of the 2 systematic review papers [ 38 , 39 ] used in this study are summarized in Table 1 . The first paper by Takeshima et al [ 38 ] investigated the efficacy of bright light therapy in patients with bipolar disorder. In this study, the titles and abstracts of a total of 1381 records were initially screened in duplicate, with the task being divided between 2 pairs of independent evaluators. The first pair reviewed the initial 753 records, while the second pair assessed the remaining 628 records. Of these, 30 records were targeted for a full-text assessment, and eventually 6 records (encompassing 6 studies) were selected for meta-analysis. The second paper by Maruki et al [ 39 ] verified the difference in therapeutic effects between the usage of 2 types: second-generation antipsychotics (SGAs) and mood stabilizers (MSs), versus the usage of either type alone, targeting patients with bipolar disorder. In this study, the titles and abstracts of a total of 3146 records were initially screened in duplicate, with the screening divided between 2 pairs of evaluators. The first pair reviewed the initial 1694 records, while the second pair evaluated the remaining 1452 records. Of these, 96 records were targeted for a full-text assessment, and eventually 9 records (encompassing 5 studies) were selected for meta-analysis. We used the data on the inclusion or exclusion decisions of each human evaluator made prior to reaching a consensus among evaluators.
Takeshima et al (2020) [ ] | Maruki et al (2022) [ ] | |
Clinical question | Is bright light therapy an effective and safe treatment for managing manic and depressive symptoms in patients with bipolar disorder, and can it also be used as a preventive measure for recurrent mood episodes? | Does the use of second-generation antipsychotics (SGA) or mood stabilizers (MS) as adjunctive therapy improve the efficacy and safety outcomes compared to their use as monotherapy in the treatment of bipolar depression? |
Databases | Ovid MEDLINE, Cochrane Central Register of Controlled Trials, Embase, PsycINFO, and ClinicalTrials.gov | PubMed, Cochrane Central Register of Controlled Trials, and Embase |
Number of records screened | 1381 | 3146 |
Number of records for full-text assessment | 30 | 96 |
Number of records (studies) included in quantitative synthesis | 6 (6) | 9 (5) |
The screening process was divided into three layers: (1) research design, (2) target population, and (3) intervention and control. The prompts for each layer must be specifically tailored to each systematic review. At this point, manual prompt adjustments could lead to issues with reproducibility in future research. Therefore, in this study, we used GPT-4 (gpt-4-0125-preview, temperature=0) to automatically extract the information and generate the content for the prompts related to “research design,” “target population,” “intervention,” and “control.” The prompts used for extraction, along with the content defined for “research design,” “target population,” “intervention,” and “control,” are detailed in Textbox 1 . In this study, we extracted information by inserting the text from the “inclusion criteria” paragraph of the Methods section of each paper into the specified location in the prompt ( Textbox 1 ).
The structure of the prompts for each of the 3 layers is shown in Textbox 2 . Within these prompts, we specified that if a decision cannot be made, records should be considered potentially eligible for full-text assessment and not excluded. In this study, the information supplied to GPT-3.5 and GPT-4 was limited to the titles and abstracts of the records; details such as authors, their affiliations, or journal names were not included in the prompts.
In the screening process using GPT-3.5 or GPT-4, we initially verified whether the research design of all records satisfied the inclusion criteria. For records not excluded in the first layer, we subsequently confirmed whether the target population aligned with the inclusion criteria. Moreover, for records that were not excluded in the first and second layers, we assessed whether both the intervention and control groups met the inclusion criteria ( Figure 1 ).
In this study, we analyzed the results from human evaluators of systematic review papers, comparing these with the records identified by GPT-3.5 or GPT-4. We considered the records included in the full-text assessment to be correct. We assessed the inclusion or exclusion decisions made by each human evaluator (before consensus was reached) against those determined by GPT-3.5 or GPT-4, focusing on sensitivity and specificity. Sensitivity was defined as the proportion of correctly identified eligible records for full-text assessment by human evaluators, GPT-3.5, or GPT-4. Formally, sensitivity is calculated as follows:
Sensitivity = True positives / (True positives + False negatives)
True positives = Number of records correctly identified as eligible
False negatives = Number of records incorrectly identified as ineligible.
Similarly, specificity was defined as the proportion of correctly identified ineligible records (for full-text assessment) by human evaluators, GPT-3.5, or GPT-4. Formally, specificity is calculated as follows:
Specificity = True negatives / (True negatives + False positives)
True negatives = Number of records correctly identified as ineligible
False Positives = Number of records incorrectly identified as eligible.
For records eligible for full-text assessment but excluded by either GPT-3.5 or GPT-4, we reviewed the title and the abstract to assess whether the exclusion decision was justified. Following this review, we recalculated sensitivity and specificity after adjusting for these justified exclusions. Furthermore, for records that were incorrectly excluded by GPT-3.5 or GPT-4, we conducted a narrative verification of the erroneous judgments by asking each LLM to explain the reasons behind their decisions. We modified the prompt used for screening ( Textbox 2 ) by replacing the “#Rules” statement with “Specify the reason for your answer.” This modification allowed GPT-3.5 or GPT-4 to provide their judgment results along with the underlying reasons.
This study used only publicly available data from research papers and does not involve human subjects or personal data. Therefore, it does not require a human subject ethics review or exemption.
Figure 2 [ 38 ] shows the number of records excluded by GPT-3.5 and GPT-4 at each layer of research design, target population, and intervention and control, applied to records in the paper by Takeshima et al [ 38 ].
GPT-3.5 excluded 84 records at the research design layer, 877 records at the target population layer, and 0 record at the intervention and control layer, ultimately determining 420 out of 1382 records for inclusion. None of the 6 records (including 6 papers) that were included in the meta-analysis were excluded by GPT-3.5. The sensitivity for included records was 0.900 and the specificity was 0.709. Among the eligible records for full-text assessment, GPT-3.5 classified 3 (10.0%) records as excluded. Of these, the exclusion of 2 records by GPT-3.5 was justified, while the remaining 1 (3.3%) record was deemed to require full-text assessment ( Table 2 ). After adjustments for these justified judgments ( Multimedia Appendix 2 ), the sensitivity improved to 0.966 and the specificity remained at 0.710. For the one record that GPT-3.5 determined to be excluded at the target population layer, it was suggested that GPT-3.5 concluded that the record “included both bipolar disorder and unipolar mood disorder, which did not match the selection criteria.”
Number of excluded records on each layer (number of those not justified) | ||||
Research design | Target population | Intervention and control | ||
Excluded by GPT-3.5 | 0 | 3 (1) | 0 | |
Excluded by GPT-4 | 4 (1) | 2 (0) | 0 |
a Number of records for which exclusion was not justified.
GPT-4 excluded 589 records at the research design layer, 760 records at the target population layer, and 1 record at the intervention and control layer, ultimately determining 31 out of 1381 records for inclusion. None of the 6 records (including 6 papers) that were included in the meta-analysis were excluded by GPT-4. The sensitivity for included records was 0.806 and the specificity was 0.996. Among the eligible records for full-text assessment, GPT-4 classified 6 (20.0%) records as excluded. Of these, the exclusion of 5 records by GPT-4 was justified, while the remaining 1 (3.3%) record was considered to require full-text assessment ( Table 2 ). After adjustments for these justified judgments ( Multimedia Appendix 2 ), the sensitivity improved to 0.962 and the specificity remained at 0.996. GPT-4 included all 6 records (including 6 papers) that were included in the meta-analysis. For the one record that GPT-4 judged to be excluded at the research design layer, it was revealed that GPT-4 deduced that “although this study mentioned registration in an RCT, it investigated the associations between sleep, physical activity, and circadian rhythm indicators” (from the perspective of whether to include the study in the meta-analysis, GPT-4’s judgment is likely to be correct; however, considering the purpose of the initial screening, we determined that it would be appropriate to include the study).
Figure 3 [ 39 ] shows the number of records excluded by GPT-3.5 and GPT-4 at each layer of research design, target population, and intervention and control, applied to records in the Maruki et al [ 39 ] paper.
GPT-3.5 excluded 220 records at the research design layer, 126 records at the target population layer, and 10 records at the intervention and control layer, ultimately determining 2790 out of 3146 records for inclusion. None of the 9 records (including 9 papers) that were included in the meta-analysis were excluded by GPT-3.5. The sensitivity for included records was 0.958 and the specificity was 0.116. Among the eligible records for full-text assessment, GPT-3.5 classified 4 (4.2%) records as excluded. None of these records’ exclusion by GPT-3.5 was justified, and all were considered to require full-text assessment ( Table 3 and Multimedia Appendix 2 ). For the 2 records that GPT-3.5 inferred to be excluded at the research design layer, it was revealed that GPT-3.5 determined that “although they were RCTs, either the individual or cluster level was not specified” for both records. For the 2 records that GPT-3.5 deemed to be excluded at the target population layer, it was suggested that GPT-3.5 surmised that “although the records involved bipolar disorder, they did not match the selection criteria due to the presence of comorbidities (one record had generalized anxiety disorder, and the other had alcohol dependence).”
Number of excluded records on each layer (number of those not justified) | ||||
Research design | Target population | Intervention and control | ||
Excluded by GPT-3.5 | 2 (2) | 2 (2) | 0 | |
Excluded by GPT-4 | 5 (0) | 2 (1) | 5 (3) |
GPT-4 excluded 1287 records at the research design layer, 503 records at the target population layer, and 830 records at the intervention and control layer, ultimately determining 526 out of 3146 records for inclusion. None of the 9 records (including 9 papers) that were included in the meta-analysis were excluded by GPT-4. The sensitivity for included records was 0.875 and the specificity was 0.855. Among the eligible records for full-text assessment, GPT-4 classified 12 (12.5%) records as excluded. Of these, the exclusion of 8 records by GPT-4 was justified, while the remaining 4 (4.2%) records were considered to require full-text assessment ( Table 3 ). After adjustments for these justified judgments ( Multimedia Appendix 2 ), the sensitivity improved to 0.943 and the specificity remained at 0.855. “For the one record that GPT-4 determined to be excluded at the target population layer, it was suggested that GPT-4 inferred that ‘although the record involved bipolar disorder, it did not match the selection criteria due to the presence of a comorbidity (alcohol dependence).’ For the three records that GPT-4 judged to be excluded at the Intervention and control layer, in each case, GPT-4 cited the reason for exclusion as ‘the intervention criteria are the addition of either SGA or MS to SGA or MS, but this study does not mention the use of SGA.’”
In the list used in the paper by Maruki et al [ 39 ], there were a total of 355 records where part of the title and abstract were corrupted into irrelevant Chinese characters (eg, “This was an eight窶陣eek, open窶人abel, prospective study”). Despite these errors, all cases could be appropriately discerned, likely due to the context-sensitive judgment capability of GPT-3.5 and GPT-4.
Both the study by Takeshima et al [ 38 ] and the study by Maruki et al [ 39 ] involved 2 individuals conducting screening for the initial segment, while a different set of 2 individuals was responsible for the screening of the latter segment. The sensitivity and specificity of human evaluators and GPT-3.5 and GPT-4 for each segment are shown in Table 4 . The adjusted results, in cases where the exclusion of GPT-3.5 or GPT-4 was justified, are shown in the numbers within parentheses ( Table 4 ).
Screenings on Takeshima et al (2020) [ ] | Human evaluators | LLMs | ||||||
1A | 2A | 3A | 4A | GPT-3.5 | GPT-4 | |||
Sensitivity | 1.000 | 0.867 | — | — | 0.800 (0.929) | 0.688 (1.000) | ||
Specificity | 0.995 | 0.996 | — | — | 0.702 (0.704) | 0.997 (0.997) | ||
Sensitivity | — | — | 1.000 | 1.000 | 1.000 (1.000) | 0.933 (0.933) | ||
Specificity | — | — | 1.000 | 0.997 | 0.718 (0.718) | 0.993 (0.993) | ||
Screenings on Maruki et al (2022) [ ] | Human evaluators | Human evaluators | Human evaluators | Human evaluators | LLMs | LLMs | ||
Screenings on Maruki et al (2022) [ ] | 1B | 2B | 3B | 4B | GPT-3.5 | GPT-4 | ||
Sensitivity | 0.766 | 0.979 | — | — | 0.936 | 0.872 (0.952) | ||
Specificity | 0.998 | 0.998 | — | — | 0.129 | 0.886 (0.886) | ||
Sensitivity | — | — | 0.776 | 0.939 | 0.980 | 0.878 (0.935) | ||
Specificity | — | — | 0.999 | 0.999 | 0.100 | 0.818 (0.819) |
a LLMs: large language models.
b Not applicable.
c Values after adjusting for cases where exclusion was justified.
In our Google Spreadsheet setup, both GPT-3.5 and GPT-4 managed to process approximately 110 records per minute across each of the 3 layers. Consequently, the estimated ideal completion time was between 20 and 30 minutes for the study by Takeshima et al [ 38 ], and between 60 and 80 minutes for the study by Maruki et al [ 39 ]. However, in practice, due to errors with the Google Spreadsheet and API, the screening process took about 1 hour for the study by Takeshima et al [ 38 ] and about 2 hours in total for the study by Maruki et al [ 39 ]. Furthermore, due to daily API call limits, the work had to be spread out over 3 days. The screening for these 2 studies incurred a total cost of US $59, with US $4 for calls to GPT-3.5 and US $55 for calls to GPT-4.
This study demonstrates the use of a 3-layer screening method using GPT-3.5 and GPT-4 for title and abstract screenings in systematic reviews, highlighting its remarkable speed and sensitivity comparable with that of human evaluators. However, GPT-3.5 demonstrated low specificity for relevant records, rendering it less practical. In contrast, the use of GPT-4 showed both high sensitivity and specificity, particularly where adjustments for justified exclusions led to an improvement in sensitivity. Although achieving 100% sensitivity remained unattainable, a 3-layer screening method with GPT-4 may potentially be practical for use in the systematic review process and can reduce human labor.
Previous research demonstrating the effectiveness of automated screening using text mining has encountered sensitivity issues [ 20 - 29 ]. Specifically, the exclusion of important studies that should have been included in their meta-analysis [ 20 , 21 , 23 , 29 ], a limitation not observed in our approach, hampered their application to clinical practice. False negatives in machine learning–based screening can arise from several factors: complexity in research design, characteristics of the target demographic, types of interventions, complexity in selection criteria, a significant scarcity of relevant records within the data set (leading to data imbalance), and inconsistency in the terminology used for judgment [ 21 , 23 , 29 ]. Our method using GPT-3.5 or GPT-4 was able to address issues related to data set imbalance and terminology inconsistency, as we used the same prompt across records, and assess the inclusion or exclusion one by one. In addition, previous text mining screenings may not have effectively addressed garbled text, such as “open-label” mistakenly appearing as “open窶人abel” [ 40 ], an issue that LLMs can potentially mitigate through their attention mechanisms [ 41 ]. Moreover, the outstanding knowledge base of GPT-4 [ 6 , 7 ] likely helped address the complexity in research design, target demographics, and intervention, as well as selection criteria—areas where GPT-3.5 might have fallen short. These distinctions possibly account for the notable differences in specificity observed between GPT-3.5 and GPT-4. Recently, Guo et al [ 33 ] conducted title and abstract screening using GPT-4. Their approach diverges from our 3-layer method; it integrated inclusion and exclusion criteria within the context, generating decisions and reasoning through a single prompt. While we believe that our 3-layer method could potentially offer greater sensitivity than theirs, it remains difficult to definitively assert a significant improvement in sensitivity over the method by Guo et al [ 33 ], given the limited sample size and the differences in data sets. Tran and colleagues’ approach [ 34 ], despite using GPT-3.5, demonstrated remarkable sensitivity. It is important to note, however, that the manual creation of their highly effective prompt raises questions regarding its replicability and broader applicability.
Both human-conducted and LLM-conducted systematic reviews have their inherent pitfalls. Errors made by humans are inevitable, with their accuracy estimated to be around 10% [ 15 ], and slightly higher for false exclusions, at approximately 13%-14% [ 16 , 17 ]. These values represent the performance of experts in the relevant field, and the accuracy may be lower for individuals with less expertise or shallow screening experience; therefore, guidelines have recommended piloting and training the abstract screening team [ 12 ]. In this study, we observed that human evaluation in the paper by Takeshima et al [ 38 ] exhibited slightly more false negatives than that in the paper by Maruki et al [ 39 ]. Although the reasons for the judgment discrepancies were not investigated in this study’s data set, they may be attributed to the larger volume of records screened [ 14 ] and the potentially more complex and challenging research question in the paper by Maruki et al [ 39 ]. Using 2 reviewers to screen records can significantly lower the likelihood of false negatives [ 16 ] and has been recommended [ 11 , 13 ]. Yet, simultaneously, there has been a case that the systematic review screenings, albeit rare, are conducted by a single reviewer, because of time constraints [ 13 , 42 ]. Hence, the unavoidable errors and substantial time and effort required for screening represent significant drawbacks of human screening in systematic reviews [ 10 , 13 ].
Conversely, methods using LLMs also present several drawbacks. One primary concern is their susceptibility to misinformation and quality issues inherent in their training data [ 43 ]. Notably, in this study, the specificity of the GPT-3.5 screenings in Maruki et al [ 39 ] paper was markedly low. While the causes are not definitive, this may be attributed to an insufficient understanding of bipolar disorder, MSs, and second-generation antipsychotics. Tran and colleagues [ 34 ] incorporated relevant knowledge into their manually created prompts; it might have enhanced sensitivity but not specificity; and this could also be due to GPT-3.5’s knowledge limitations. Furthermore, the decision-making processes of LLMs lack transparency, making them difficult to interpret [ 43 ]. This lack of interpretability is compounded by the “grounding problem,” where LLMs struggle to grasp concrete facts and real-world scenarios due to their lack of real-world experiences and sensory input [ 1 , 44 ]. We attempted to verify incorrectly excluded records by querying GPT-3.5 and GPT-4 with the original screening prompts, their responses, and justifications. Our findings revealed that GPT-3.5’s lower accuracy was primarily due to a lack of knowledge about the target domain, while GPT-4’s incorrect exclusions were mainly due to misinterpretations of the inclusion criteria. These findings highlight the ongoing challenges in understanding and interpreting the decision-making processes of LLMs. Although GPT-4 demonstrates advancements in comprehension, factuality, specificity, and inference, it is still more susceptible to factual errors [ 45 ]. In addition, it has been suggested that LLMs’ accuracy diminishes with longer prompts [ 46 ]; lengthy abstracts might have contributed to decreased accuracy in decision-making. A potential future risk is that the normalization of AI-based judgments could result in the oversight of human expert verification, potentially diminishing the quality of systematic reviews.
On the positive side, compared with the human screening time reported in previous studies [ 10 ], our method enabled remarkably faster screening. Although our approach uses a 3-layer structure, which might seem time-consuming at first glance, by limiting GPT-3.5/GPT-4 responses to “E” (Exclude) or “I” (Include), we efficiently screened a large volume of records in batch. Unlike humans, LLMs do not experience fatigue and subsequent decline in performance; moreover, they are presumed to have better reproducibility in their judgments. While using GPT-4’s API comes with associated costs [ 36 ], the increased efficiency compared with human effort more than compensates for these expenses. Using LLMs for title and abstract screening could also enable screening a much larger number of records, previously deemed impractical due to time limitations. Our 3-layer method using GPT-4 exhibits high sensitivity and a useful level of specificity and yet opportunities for further refinement exist. Future studies could enhance accuracy through methods such as optimizing prompts [ 47 ] and integrating multiple LLMs for decision assessment [ 48 ], which may contribute to higher precision. In the meantime, swift advancements in LLM technology are set to continuously evolve; future breakthroughs in LLMs may readily overcome our current challenges—possibly, only by a simple prompt.
This study has some limitations. First, the 2 systematic reviews used in this investigation [ 38 , 39 ] were confined to clinical studies within psychiatry, limiting the generalizability of our findings. In addition, the sample size was small, and the investigation remained exploratory, with the results lacking statistical substantiation. Future studies should aim to replicate these findings across a broader range of medical fields and specialized domains to enhance their applicability and reliability. Second, the artificial intelligence industry is progressing rapidly, with information becoming obsolete within a matter of months or even weeks. The models we used in this study, gpt-3.5-turbo-0125 and gpt-4-0125-preview, are currently the most up-to-date. However, updates to these models might alter screening outcomes. Third, to ensure consistency in our findings, we set the temperature parameter to 0. However, a temperature of 0 does not always guarantee absolute uniformity in output sentences [ 35 ]. However, our observations indicate no variation in results across multiple tests with the same model in this study. Fourth, this study did not investigate the discrepancies in screening results between GPT-3.5 and GPT-4, nor did it examine the impact of prompt variations on performance. In addition, this research did not directly compare the performance of the proposed approach with existing systematic literature review strategies. Furthermore, this study was not designed to explore the risks associated with using LLMs for screening purposes. Finally, gpt-3.5-turbo-0125’s training data include information up to September 2021, whereas gpt-4-0125-preview’s training data extend to December 2023 [ 35 ]. Consequently, the systematic review paper by Takeshima et al [ 38 ] might have been incorporated into GPT-3.5’s training data set, with both systematic review papers possibly included in GPT-4’s data set. Nevertheless, as the study’s prompts did not explicitly reference these reviews, we consider that their impact is minimal.
We developed a practical screening method using GPT-3.5 and GPT-4 in the title- and abstract-screening process of systematic reviews. Our 3-layer method not only achieved better sensitivity for relevant records than previous machine learning–based screening methods [ 20 , 21 , 23 , 29 ] but also demonstrated a remarkable potential to reduce human reviewers’ workload significantly. Although GPT-3.5 showed lower specificity, which may limit its applicability, the use of GPT-4 within our method yielded sensitivity comparable with human evaluators, making it suitable for use in systematic review screenings. Despite the focus on psychiatric fields and the small sample size of our study, our findings highlight the potential for broader application. We emphasize the importance of further validation across multiple domains to establish a universal screening methodology. Concurrently, developing more effective approaches in response to the advancing capabilities of LLMs is warranted in future research.
This work was supported by the Japan Society for the Promotion of Science (JSPS) KAKENHI (grant 22K15778). During the preparation of this work, the authors used ChatGPT (GPT-4 and GPT-4o, by OpenAI), Claude (Claude 3 Opus, by Anthropic), and Gemini (Gemini 1.5 Pro, by Google) to enhance the readability and proofread the English text. After using these services, the authors reviewed and edited the content as needed and took full responsibility for the content of the publication.
None declared.
Script for the Google Spreadsheet.
Records eligible for full paper screening but excluded by GPT-3.5 or GPT-4.
application programming interface |
Generative Pre-trained Transformer |
large language model |
mood stabilizers |
second-generation antipsychotics |
Edited by S Ma; submitted 14.09.23; peer-reviewed by D Fraile Navarro, T Nguyen, A Nakhostin-Ansari; comments to author 23.01.24; revised version received 10.03.24; accepted 25.06.24; published 16.08.24.
©Kentaro Matsui, Tomohiro Utsumi, Yumi Aoki, Taku Maruki, Masahiro Takeshima, Yoshikazu Takaesu. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 16.08.2024.
This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research (ISSN 1438-8871), is properly cited. The complete bibliographic information, a link to the original publication on https://www.jmir.org/, as well as this copyright and license information must be included.
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Due to the ecological and health concerns of human wastes, extensive research has been conducted to study the composting process and to evaluate methods to describe the stability, maturity and sanitation of compost prior to its agricultural use (Brewer and Sullivan 2003; Zmora-Nahum et al. 2005).
2.3. The history and current state of the composting process. Composting has a long history that evolved alongside human settlements and the practice of agriculture. Diaz and De Bertoldi present an exhaustive history of composting from the Neolithic period to the 20 th century. Research on the composting process and influencing factors can be ...
Purpose A novel composting process suitable for handling food waste in an island community is developed. Food waste collection exhibits substantial variation in quantities over the year and is based on the separate disposal of food waste by residents and shops at the source. Methods The food waste is properly mixed with recycled compost and bulking material, consisting of a mixture of prunings ...
To foster a circular economy in line with compost quality assessment, a deep understanding of the fates of nutrients and carbon in the composting process is essential to achieve the co-benefits of value-added and environmentally friendly objectives. This paper is a review aiming to fill in the knowledge gap about the composting process. Firstly, a systematic screening search and a descriptive ...
the initial moisture content should be between 40 and 65%. The optimal values of pore space in the pile are between 30. and 36% for an efficient aeration in a composting process. (Rynk 1992 ...
2.3. The history and current state of the composting process. Composting has a long history that evolved alongside human settlements and the practice of agriculture. Diaz and De Bertoldi [Citation 50] present an exhaustive history of composting from the Neolithic period to the 20 th century. Research on the composting process and influencing ...
2.1. Main Features of the Industrial Composting Process. As shown in Figure 2, the composting process begins as soon as the raw organic materials are mixed together: During the initial stage (organic matter degradation), oxygen and the easily available compounds are consumed by the microorganisms. The temperature of the composting materials ...
New research from the University of Maryland suggests that, in some cases, boosting urban soil health with compost and treated manure may reduce the amount of "bad" bacteria.
Identifying and studying these factors should be a priority for future research," Shen said. Changes may influence health and disease risk In people in their 40s, significant changes were seen in the number of molecules related to alcohol, caffeine and lipid metabolism; cardiovascular disease; and skin and muscle.
conclusion is simple, if the composting process is correctly performed and compost is stable and mature, compost is a supply of ma cro- and micronutrients, which can substitute chemical fertilizers.
Due to its environmental friendliness, composting is widely used for the treatment of chicken manure and kitchen waste. However, the composting effect still needs to be improved due to the low pH of kitchen waste and low C/N of chicken manure. This paper analyzed the composting effects of chicken manure, kitchen waste, and combined chicken manure and kitchen waste. The maximum composting ...
Application Process. Draw Results & Odds. License Fee List. Leftover Licenses. ... It can be obtained as a paper copy or electronically via a mobile device. A screenshot or downloaded PDF of the permit on a mobile device is acceptable in the field. ... Sybille Wildlife Research Center working on CWD composting study. Cheyenne Region News Apply ...
Background: The screening process for systematic reviews is resource-intensive. Although previous machine learning solutions have reported reductions in workload, they risked excluding relevant papers. Objective: We evaluated the performance of a 3-layer screening method using GPT-3.5 and GPT-4 to streamline the title and abstract-screening process for systematic reviews.
Composting is a fundamental process in agriculture and helps in the recycling of farm wastes. The long duration of composting is a challenge; this is due to the presence of materials that take a ...
Breaking made its debut as an Olympic sport Friday, and among the competitors was Dr. Rachael Gunn, also known as B-girl Raygun, a 36-year-old professor from Sydney, Australia, who stood out in ...
The household waste composition indicated a 77% organic fraction, 11.60% plastic, 7.66% paper, and 3.74% textiles and cardboard. Ho wever, the aver-. age value of all ten zones had a waste ...