The Global Environmental Impacts of China's Accession to the WTO: A 20-Year Review.

Robust empirical assessments of the long-term cumulative global effects of free trade and economic globalization on the environment are limited. This account fills this gap by constructing a dynamic computable general equilibrium model to estimate the environmental effects of a milestone in the recent history of trade liberalization: China's 20-year World Trade Organization (WTO) accession. The modeling shows that China's accession could have resulted in an increase in the global cumulative greenhouse gases (GHGs), sulfur dioxide (SO2), and nitrogen oxide (NOx) emissions by roughly 14,000 Mt CO2-eq, 64 Mt, and 46 Mt, respectively. The global production scale effect contributed to most of these estimated increases. The regional total output composition effect also caused higher emissions. Meanwhile, the sectoral output composition effect helped reduce total emissions to a limited extent. Fortunately, a package of emission abatement measures led to a decrease in emission factors and a drop in the global cumulative emissions of GHGs, SO2, and NOx. The findings suggest that to enjoy the free trade and economic globalization benefits and minimize the induced emission increases, it is vitally important to systemically reduce emissions across the entire economy and nurture a low-carbon trade regime.

Exploring the spatiotemporal pattern evolution of carbon emissions and air pollution in Chinese cities.

Based on data from 335 cities in China, this study employs the standard deviation ellipse method to portray unbalanced and differential spatiotemporal evolution patterns of environmental emissions and socioeconomic elements. A logarithmic mean Divisia index analysis and in-depth discussion are carried out to disclose the main driving factors and underlying reasons for the differences. Decoupling trends exist among carbon emissions, gross domestic product (GDP) and population in terms of their gravity center migrations. The standard deviation ellipse direction of carbon emissions gradually changed from 'northeast‒southwest' to 'northwest‒southeast', and the standard deviation ellipse areas of carbon emissions and air pollution continuously expanded over time; at the same time, that of GDP contracted. Economic growth has always been the main driver of carbon emissions and air pollution nationally, but its role has weakened. Moreover, decreases in the energy intensity and carbon and pollution intensities are the main factors contributing to emissions reductions. Differentiated spatiotemporal economic structure evolution, regional heterogeneities in the energy intensity and efficiency, and cross-region power energy transmissions are identified as the underlying reasons for the unbalanced spatiotemporal patterns of the environmental emissions and socioeconomic elements. Based on these findings, policy suggestions can be made to address the imbalances and promote carbon mitigation, air quality improvement and high-quality social-economic development at the city level.

Influence of Ni Contents on Microstructure and Mechanical Performance of AlSi10Mg Alloy by Selective Laser Melting.

To improve the tensile strength and wear resistance of AlSi10Mg alloys, a novel in situ synthesis method of selective laser melting (SLM) was used to fabricate the Ni-reinforced AlSi10Mg samples. The eutectic Si networks formed around the α-Al crystals by diffusion and transportation via Marangoni convection in the SLM process. Moreover, the XRD and TEM results verified that the Al3Ni nanoparticles were created by the in situ reaction of the Ni and aluminum matrix in the Ni/AlSi10Mg samples. Therefore, the microstructure of the Ni-containing alloys was constituted by the α-Al + Si network + Al3Ni phases. The dislocations accumulated at the continuous Si network boundaries and cannot transmit across the dislocation walls inside the Si network. SEM results revealed that the continuity and size of eutectic Si networks can be tailored by adjusting the Ni contents. Furthermore, the Al matrix also benefited from the Al3Ni nanoparticles against the dislocation movement due to their excellent interfacial bonding. The 3Ni-AlSi10Mg sample exhibited high mechanical properties due to the continuous Si networks and Al3Ni nanoparticles. The tensile strength, elongation, Vickers hardness, friction coefficient, and wear volumes of the 3Ni-AlSi10Mg samples were 401.15 ± 7.97 MPa, 6.23 ± 0.252%, 144.06 ± 0.81 HV, 0.608, 0.11 mm3, respectively, which outperformed the pure AlSi10Mg samples (372.05 ± 1.64 MPa, 5.84 ± 0.269%, 123.22 ± 1.18 HV, 0.66, and 0.135 mm3).

Attention-Based Spatial-Temporal Convolution Gated Recurrent Unit for Traffic Flow Forecasting.

Accurate traffic flow forecasting is very important for urban planning and traffic management. However, this is a huge challenge due to the complex spatial-temporal relationships. Although the existing methods have researched spatial-temporal relationships, they neglect the long periodic aspects of traffic flow data, and thus cannot attain a satisfactory result. In this paper, we propose a novel model Attention-Based Spatial-Temporal Convolution Gated Recurrent Unit (ASTCG) to solve the traffic flow forecasting problem. ASTCG has two core components: the multi-input module and the STA-ConvGru module. Based on the cyclical nature of traffic flow data, the data input to the multi-input module are divided into three parts, near-neighbor data, daily-periodic data, and weekly-periodic data, thus enabling the model to better capture the time dependence. The STA-ConvGru module, formed by CNN, GRU, and attention mechanism, can capture both temporal and spatial dependencies of traffic flow. We evaluate our proposed model using real-world datasets and experiments show that the ASTCG model outperforms the state-of-the-art model.

Impact of the emergency response to COVID-19 on air quality and its policy implications: Evidence from 290 cities in China.

The emergency response to the COVID-19 pandemic had an extreme exogenous impact on society and the economy. This paper aims to explore the impacts of the national emergency response and the subsequent emergency response termination on air quality and its policy implications through regression discontinuity design (RDD) estimation by employing panel data on daily air quality from January 1, 2019, to July 31, 2020, for 290 cities in China. The empirical results showed that the emergency response resulted in a significant decrease in most of the major pollutant concentrations within a short time frame, and the average air quality index (AQI) decreased by approximately 11.0%. The concentrations of PM2.5, PM10, SO2, NO2, and CO decreased by approximately 18.8%, 13.1%, 13.5%, 11.1% and 6.7%, respectively, while the O3 concentration did not change significantly. Further causal analysis found that mandatory traffic restrictions and the shutdown of industries were two important factors that contributed greatly to air quality improvement. Moreover, since the process of returning to normal daily activities and promoting the economy were gradual, the results showed that air pollution did not rebound immediately after the government called for the "resumption of production and work" and announced the "termination of the emergency response". Our findings suggest that to achieve a substantial and sustainable improvement in air quality, it is necessary to continuously implement strict emission control routines and take co-control measures for various VOCs precursors of ozone.

Clinical characteristics of anti-AChR-MuSK-LRP4 antibody-negative myasthenia gravis in China.

INTRODUCTION/AIMS: Descriptions of the clinical characteristics of anti-AChR-MuSK-LRP4 antibody-negative myasthenia gravis (triple-negative myasthenia gravis, TNMG) are lacking in the current literature. Therefore, we investigated the clinical characteristics of TNMG in Chinese patients. METHODS: We retrospectively analyzed 925 patients with MG registered in the Department of Neuroimmunology, Henan Institute of Medical and Pharmaceutical Sciences from January 2015 to March 2021. RESULTS: One hundred six patients diagnosed with TNMG were included in the study. The average age of onset was 32.4 y, with a male-to-female ratio of 1:1. The age of onset showed a bimodal distribution: 0-9 y and 40-49 y. Adult patients were more likely to have weakness of limb and bulbar muscles (p < .05). Thymic hyperplasia was found in 20.2% of the patients. Younger patients were more likely to relapse. The rate of adult early-onset myasthenia gravis reaching complete stable remission and pharmacological remission was 47.6%, and the prognosis was better than that in juvenile-onset myasthenia gravis (p = .019). Older age of onset was the only risk factor for the development of generalized TNMG from ocular TNMG (R = 1.046, p = .002, 95% confidence interval 1.017-1.077). DISCUSSION: This study showed that the clinical characteristics of patients with TNMG varied among the different age groups. Significant findings included a bimodal distribution of onset age, coexisting thymic hyperplasia, and a generally favorable prognosis.

Fabrication of liquid cell for in situ transmission electron microscopy of electrochemical processes.

Fundamentally understanding the complex electrochemical reactions that are associated with energy devices (e.g., rechargeable batteries, fuel cells and electrolyzers) has attracted worldwide attention. In situ liquid cell transmission electron microscopy (TEM) offers opportunities to directly observe and analyze in-liquid specimens without the need for freezing or drying, which opens up a door for visualizing these complex electrochemical reactions at the nano scale in real time. The key to the success of this technique lies in the design and fabrication of electrochemical liquid cells with thin but strong imaging windows. This protocol describes the detailed procedures of our established technique for the fabrication of such electrochemical liquid cells (~110 h). In addition, the protocol for the in situ TEM observation of electrochemical reactions by using the nanofabricated electrochemical liquid cell is also presented (2 h). We also show and analyze experimental results relating to the electrochemical reactions captured. We believe that this protocol will shed light on strategies for fabricating high-quality TEM liquid cells for probing dynamic electrochemical reactions in high resolution, providing a powerful research tool. This protocol requires access to a clean room equipped with specialized nanofabrication setups as well as TEM characterization equipment.

Effectiveness of early glucocorticoids in myasthenia gravis: a retrospective cohort study.

Purpose: This study aimed to clarify the effect of early glucocorticoid (GC) application on achieving minimal manifestation (MM) status or better in the treatment of myasthenia gravis (MG) in the early clinical phase. Methods: A retrospective analysis was performed using data from 336 patients with MG who received GC therapy from January 2015 to September 2022 in the Zhengzhou University Henan Institute of Medical and Pharmaceutical Sciences Myasthenia Gravis Biobank (ZMB). Patients were divided into two groups: the early mono-GC group (treated with GC within 6 months of MG onset) and the delayed mono-GC group. Results: Kaplan-Meier analysis showed that the early mono-GC group achieved MM status earlier and more frequently than the delayed mono-GC group (log-rank test, p = 0.0082; hazard ratio [HR], 1.66; p = 0.011). The early mono-GC group had a lower maintenance oral GC dose than the delayed mono-GC group. In multivariate Cox regression analysis, early mono-GC (HR, 1.50; p = 0.043), early-onset MG (EOMG) (HR, 1.74; p = 0.034), and ocular MG (OMG) (HR, 1.90; p = 0.007) were associated with MM status or better. In conclusion, early mono-GC, EOMG, and OMG were positive predictors of treatment goals. In EOMG, OMG, and acetylcholine receptor antibody-positive MG (AChR-MG) subgroups, the maintenance oral GC doses in the early mono-GC group were significantly lower than the doses in the delayed mono-GC group (p < 0.05). Conclusion: Early intervention with GC led to better long-term outcomes and reduced the necessary maintenance dose of oral GC for patients with MG. EOMG and OMG were positive predictors of MM status or better with mono-GC.

The relationships between cholesterol crystals, NLRP3 inflammasome, and coronary atherosclerotic plaque vulnerability in acute coronary syndrome: An optical coherence tomography study.

Background: Cholesterol crystals (CCs) in lesions are the hallmark of advanced atherosclerotic plaque. Previous studies have demonstrated that CCs could activate NLRP3 inflammasome, which played an important role in atherosclerotic lesion progression. However, the relationship between CCs, NLRP3 inflammasome pathway, and plaque vulnerability in patients with ACS is still not elucidated. Methods: Two hundred sixty-nine consecutive acute coronary syndrome (ACS) patients with 269 culprit lesions were included in this study. CCs and other plaque characteristics within the culprit lesion segment were evaluated by optical coherence tomography (OCT) before percutaneous coronary intervention (PCI). The NLRP3 mRNA expression in peripheral blood mononuclear cells (PBMCs) and the serum levels of interleukin (IL)-1ß, IL-18, and other biological indices were measured. Results: Cholesterol crystals were observed in 105 (39%) patients with 105 culprit lesions. There were no significant differences in baseline clinical characteristics between the patients with CCs (CCs group, n = 105) and the patients without CCs (non-CCs group, n = 164) within the culprit lesion segment except for lipoprotein(a) [Lp(a)]. The CCs group had a higher level of NLRP3 mRNA expression in PBMCs and higher levels of serum cytokine IL-1ß and IL-18. OCT showed that the CCs group had longer lesion length, more severe diameter stenosis, and less minimum luminal area (MLA) than the non-CCs group (all p < 0.05). The frequency of thin-cap fibroatheroma (TCFA), thrombus, accumulation of macrophages, plaque rupture, micro-channel, calcification, spotty calcification, and layered plaque was higher in the CCs group than in the non-CCs groups (all p < 0.05). Multivariate logistic analysis revealed that the level of NLRP3 expression (OR = 10.204), IL-1ß levels (OR = 3.523), IL-18 levels (OR = 1.006), TCFA (OR = 3.593), layered plaque (OR = 5.287), MLA (OR = 1.475), macrophage accumulation (OR = 2.881), and micro-channel (OR = 3.185) were independently associated with CCs. Conclusion: Acute coronary syndrome patients with CCs in culprit lesions had a higher expression of NLRP3, IL-1ß, and IL-18, and had more vulnerable plaque characteristics than patients without CCs. CCs might have interacted with NLRP3 inflammasome activation in patients with ACS, which could contribute to plaque vulnerability in culprit lesions.

Sorting nexin 17 increases low-density lipoprotein receptor-related protein 4 membrane expression: A novel mechanism of acetylcholine receptor aggregation in myasthenia gravis.

Myasthenia gravis (MG) is characterized by autoimmune damage to the postsynaptic membrane of the neuromuscular junction (NMJ) with impaired postsynaptic acetylcholine receptor (AChR) aggregation. Low-density lipoprotein receptor-related protein 4 (LRP4) plays an important role in AChR aggregation at endplate membranes via the Agrin-LRP4-muscle-specific receptor tyrosine kinase (MuSK) cascade. Sorting nexin 17 (SNX17) regulates the degradation and recycling of various internalized membrane proteins. However, whether SNX17 regulates LRP4 remains unclear. Therefore, we examined the regulatory effects of SNX17 on LRP4 and its influence on AChR aggregation in MG. We selected C2C12 myotubes and induced LRP4 internalization via stimulation with anti-LRP4 antibody and confirmed intracellular interaction between SNX17 and LRP4. SNX17 knockdown and overexpression confirmed that SNX17 promoted MuSK phosphorylation and AChR aggregation by increasing cell surface LRP4 expression. By establishing experimental autoimmune MG (EAMG) mouse models, we identified that SNX17 upregulation improved fragmentation of the AChR structure at the NMJ and alleviated leg weakness in EAMG mice. Thus, these results reveal that SNX17 may be a novel target for future MG therapy.

Dairy Trade Helps to Alleviate Global Carbon Emission Pressure.

Global dairy production, consumption, and trade are growing rapidly, driven by population and per capita income growth and increasing health concerns mainly from developing countries, which has aroused concerns about the related carbon emission (mostly in the form of methane) increase. If all of the dairy products consumed were produced locally/domestically in the developing countries/economies (a counterfactual scenario), the carbon emissions in 2018 would be 28 Mt CO2-equiv higher than its status quo (a factual scenario). The present study indicates that unlike in many global trade cases in which carbon leakages are from developed to developing countries, global dairy trade is characterized by net embodied carbon flows from developed to developing countries/economies due to the fact that there is an overwhelming one-way-flow of dairy products from developed to developing countries/economies. The differences in the carbon emission factors between the developed and developing countries/economies provide an opportunity that global dairy trade and production specialization can help to reduce carbon emissions from increasing dairy product demand, and the total reduction potential is estimated to be about 414 Mt CO2-equiv from 2018 to 2030. Free trade agreements such as the Regional Comprehensive Economic Partnership will incentivize larger carbon emission reduction benefits through promoting dairy trade.

Enrichment of taste and aroma perceptions in chicken meat stewed in braised soup used repeatedly.

Flavor enrichment of sauce-braised chicken creates a popular umami taste and aroma. In order to preliminarily reveal the enrichment of taste and aroma compounds of sauce-braised meat products processed with braised soup used repeatedly, the system containing only chicken and chicken soup was designed to simulate the process of repeated stewing. Free amino acids, 5-nucleotides, fatty acids, and volatile compounds in stewed chicken were determined, and taste and aroma profiles were evaluated using an electronic tongue (E-tongue) and an electronic nose (E-nose), respectively. As repeated stewing times increased, the total free amino acid content increased from 514.37 mg/100 g to 721.33 mg/100 g, and the contents of 5'-inosine monophosphate, 5'-guanosine monophosphate, and 5'-adenosine monophosphate increased by approximately 20%. Meanwhile, the relative content of saturated fatty acids increased, and the relative content of monounsaturated fatty acids decreased significantly. Oleic acid, linoleic acid, and palmitoleic acid accounted for more than 80% of the total fatty acid content. A total of 15 aroma-active compounds were identified during repeated stewing, and their concentrations increased by more than 40%, especially for monounsaturated alkenals. Within 10 times of repeated stewing, the taste and aroma compounds were enriched because of a decrease in the concentration difference of taste substances and an increase in the flavor-adsorption capacity of fat, which was also consistent with the results from the E-nose and E-tongue. The taste and aroma of stewed chicken tended to remain constant after 10 times of repeated stewing of braised soup. The obtained information can provide guidelines for regulating the aroma and taste of sauce-braised chicken. PRACTICAL APPLICATION: The fat level of stewed chicken and the difference in concentration between stewed meat and braised soup were important potential factors that could be employed to enhance the flavor of stewed meat.

Hypoglycemia-Exacerbated Mitochondrial Connexin 43 Accumulation Aggravates Cardiac Dysfunction in Diabetic Cardiomyopathy.

Background: Diabetic cardiomyopathy (DCM) is a complex multifaceted disease responsible for elevated heart failure (HF) morbidity and mortality in patients with diabetes mellitus (DM). Patients with DCM exhibit subclinical diastolic dysfunction, progression toward systolic impairment, and abnormal electrophysiology. Hypoglycemia events that occur spontaneously or due to excess insulin administration threaten the lives of patients with DM-with the increased risk of sudden death. However, the molecular underpinnings of this fatal disease remain to be elucidated. Methods and Results: Here, we used the established streptozotocin-induced DCM murine model to investigate how hypoglycemia aggravates DCM progression. We confirmed connexin 43 (Cx43) dissociation from cell-cell interaction and accumulation at mitochondrial inner membrane both in the cardiomyocytes of patients with DM and DCM murine. Here, we observed that cardiac diastolic function, induced by chronic hyperglycemia, was further aggravated upon hypoglycemia challenge. Similar contractile defects were recapitulated using neonatal mouse ventricular myocytes (NMVMs) under glucose fluctuation challenges. Using immunoprecipitation mass spectrometry, we identified and validated that hypoglycemia challenge activates the mitogen-activated protein kinase kinase (MAPK kinase) (MEK)/extracellular regulated protein kinase (ERK) and inhibits phosphoinositide 3-kinase (PI3K)/Akt pathways, which results in Cx43 phosphorylation by Src protein and translocation to mitochondria in cardiomyocytes. To determine causality, we overexpressed a mitochondrial targeting Cx43 (mtCx43) using adeno-associated virus serotype 2 (AAV2)/9. At normal blood glucose levels, mtCx43 overexpression recapitulated cardiac diastolic dysfunction as well as aberrant electrophysiology in vivo. Our findings give support for therapeutic targeting of MEK/ERK/Src and PI3K/Akt/Src pathways to prevent mtCx43-driven DCM. Conclusion: DCM presents compensatory adaptation of mild mtCx43 accumulation, yet acute hypoglycemia challenges result in further accumulation of mtCx43 through the MEK/ERK/Src and PI3K/Akt/Src pathways. We provide evidence that Cx43 mislocalization is present in hearts of patients with DM hearts, STZ-induced DCM murine model, and glucose fluctuation challenged NMVMs. Mechanistically, we demonstrated that mtCx43 is responsible for inducing aberrant contraction and disrupts electrophysiology in cardiomyocytes and our results support targeting of mtCx43 in treating DCM.

High-yield production of mono- or few-layer transition metal dichalcogenide nanosheets by an electrochemical lithium ion intercalation-based exfoliation method.

Transition metal dichalcogenide (TMD) nanomaterials, especially the mono- or few-layer ones, have received extensive research interest owing to their versatile properties, ranging from true metals (e.g., NbS2 and VSe2) and semimetals (e.g., WTe2 and TiSe2) to semiconductors (e.g., MoS2 and We2) and insulators (e.g., HfS2). Therefore, the reliable production of these nanomaterials with atomically thin thickness and laterally uniform dimension is essential for their promising applications in transistors, photodetectors, electroluminescent devices, catalysis, energy conversion, environment remediation, biosensing, bioimaging, and so on. Recently, the electrochemical lithium ion intercalation-based exfoliation method has emerged as a mature, efficient and promising strategy for the high-yield production of mono- or few-layer TMD nanosheets; monolayer MoS2 (yield of 92%), monolayer TaS2 (yield of 93%) and bilayer TiS2 (yield of 93%) with lateral dimensions of ~1 µm (refs. 1-3). This Protocol describes the details of experimental procedures for the high-yield synthesis of mono- or few-layer TMDs and other inorganic nanosheets such as MoS2, WS2, TiS2, TaS2, ZrS2, graphene, h-BN, NbSe2, WSe2, Sb2Se3 and Bi2Te3 by using the electrochemical lithium ion intercalation-based exfoliation method, which involves the electrochemical intercalation of lithium ions into layered inorganic crystals and a mild sonication process. The whole protocol takes 26-38 h for the successful production of ultrathin inorganic nanosheets.

Antibodies to Full-Length Agrin Protein in Chinese Patients With Myasthenia Gravis.

This study aimed to establish a cell-based assay (CBA) for the detection of agrin antibodies (Agrin-Ab) to explore the clinical features of agrin antibody-positive Chinese patients with myasthenia gravis (Agrin-MG). We developed a CBA based on the human full-length agrin protein expressed in HEK293T cells for the reliable and efficient detection of Agrin-Ab. Clinical data and serum samples were collected from 1948 MG patients in 26 provinces in China. The demographic and clinical features of Agrin-MG patients were compared with those of other MG patient subsets. Eighteen Agrin-MG cases were identified from 1948 MG patients. Nine patients were Agrin-Ab positive, and nine were AChR-Ab and Agrin-Ab double-positive (Agrin/AChR-MG). Eleven (61.11%) patients were males older than 40 years of age. The initial symptom in 13 (81.25%) cases was ocular weakness. Occasionally, the initial symptom was limb-girdle weakness (two cases) or bulbar muscle weakness (one case). Agrin-MG patients demonstrated slight improvement following treatment with either acetylcholinesterase inhibitor or prednisone; however, the combination of the two drugs could effectively relieve MG symptoms. In China, Agrin-MG demonstrated seropositivity rates of 0.92%. These patients were commonly middle-aged or elderly men. The patients usually presented weakness in the ocular, bulbar, and limb muscles, which may be combined with thymoma. These patients have more severe diseases, although the combination of pyridostigmine and prednisone was usually effective in relieving symptoms.

ZnIn2 S4 -Based Photocatalysts for Energy and Environmental Applications.

As a fascinating visible-light-responsive photocatalyst, zinc indium sulfide (ZnIn2 S4 ) has attracted extensive interdisciplinary interest and is expected to become a new research hotspot in the near future, due to its nontoxicity, suitable band gap, high physicochemical stability and durability, ease of synthesis, and appealing catalytic activity. This review provides an overview on the recent advances in ZnIn2 S4 -based photocatalysts. First, the crystal structures and band structures of ZnIn2 S4 are briefly introduced. Then, various modulation strategies of ZnIn2 S4 are outlined for better photocatalytic performance, which includes morphology and structure engineering, vacancy engineering, doping engineering, hydrogenation engineering, and the construction of ZnIn2 S4 -based composites. Thereafter, the potential applications in the energy and environmental area of ZnIn2 S4 -based photocatalysts are summarized. Finally, some personal perspectives about the promises and prospects of this emerging material are provided.

No correlation between acetylcholine receptor antibody concentration and individual clinical symptoms of myasthenia gravis: A systematic retrospective study involving 67 patients.

OBJECTIVE: To investigate the correlation between acetylcholine receptor antibodies (AChR-Ab) concentration levels and individualized clinical symptoms in patients with AChR myasthenia gravis (AChR-MG) in China. METHODS: ELISA was used to determine the concentration of AChR-Ab in patients with MG. The Myasthenia Gravis Foundation of America (MGFA) Clinical Classification, Quantitative Myasthenia Gravis (QMG) score, and MG-specific activities of daily living (MG-ADL) scoring systems were used to evaluate the clinical status of patients. Spearman correlation analysis was used to determine the correlation between the AChR-Ab concentration and clinical score. The changes in the antibody concentration and clinical score are shown in MGFA-antibody concentration-treatment plots. RESULTS: Autoantibody detection tests were performed in 67 patients, and their clinical scores were recorded. Forty-nine patients received immunosuppressive therapy, 17 patients received pyridostigmine only, and 1 patient under thymectomy without any medication. The AChR-Ab concentration correlated with the MGFA Classification in 5 (29.4%) patients in the pyridostigmine-only group and 15 (30.6%) patients in the immunosuppressive drug group. The changes in the MGFA Classification preceded the changes in the AChR-Ab concentration in 4 (23.5%) patients treated with pyridostigmine and 10 (20.4%) patients on immunosuppressive drugs. In patients on oral non-steroidal immunosuppressants, the AChR-Ab concentration changed by more than 50%, whereas the MGFA Classification did not increase. The AChR-Ab concentration decreased in 17/32 (53.1%) patients after thymectomy, and then increased, whereas the AChR-Ab concentration increased in 15/32 (46.9%) patients and the MGFA Classification decreased in 27/32 (81.8%) patients after thymectomy. The AChR-Ab concentration presented a slight correlation with the corresponding MGFA, QMG, and MG-ADL in patients with thymoma. DISCUSSION: In the Chinese AChR-MG population, the Changes in the AChR-Ab concentration in individuals with AChR-MG did not consistently correlate with the severity of clinical symptoms.

A Safe Flexible Self-Powered Wristband System by Integrating Defective MnO2-x Nanosheet-Based Zinc-Ion Batteries with Perovskite Solar Cells.

The booming market of portable and wearable electronics has aroused the requests for advanced flexible self-powered energy systems featuring both excellent performance and high safety. Herein, we report a safe, flexible, self-powered wristband system by integrating high-performance zinc-ion batteries (ZIBs) with perovskite solar cells (PSCs). ZIBs were first fabricated on the basis of a defective MnO2-x nanosheet-grown carbon cloth (MnO2-x@CC), which was obtained via the simple lithium treatment of the MnO2 nanosheets to slightly expand the interlayer spacing and generate rich oxygen vacancies. When used as a ZIB cathode, the MnO2-x@CC with a ultrahigh mass loading (up to 25.5 mg cm-2) exhibits a much enhanced specific capacity (3.63 mAh cm-2 at current density of 3.93 mA cm-2), rate performance, and long cycle stability (no obvious degradation after 5000 cycles) than those of the MnO2@CC. Importantly, the MnO2-x@CC-based quasi-solid-state ZIB not only achieves excellent flexibility and an ultrahigh energy density of 5.11 mWh cm-2 (59.42 mWh cm-3) but also presents a high safety under a wide temperature range and various severe conditions. More importantly, the flexible ZIBs can be integrated with flexible PSCs to construct a safe, self-powered wristband, which is able to harvest light energy and power a commercial smart bracelet. This work sheds light on the development of high-performance ZIB cathodes and thus offers a good strategy to construct wearable self-powered energy systems for wearable electronics.

Size-selective synthesis of platinum nanoparticles on transition-metal dichalcogenides for the hydrogen evolution reaction.

We report a micellar system to prepare Pt-TMDs composites with tunable Pt nanoparticles (NPs, 2-6 nm in size) on single-layer TMDs (MoS2, TiS2, TaS2) nanosheets. The Pt-MoS2 composites have shown excellent performance for the hydrogen evolution reaction (HER) with the Pt NPs exhibiting a volcano-type size effect toward HER activity due to the synergistic effects between the Pt NPs and MoS2.