Effects of straw returning combined with blended controlled-release urea fertilizer on crop yields, greenhouse gas emissions, and net ecosystem economic benefits: A nine-year field trial.

Although straw returning combined with blended controlled-release urea fertilizer (BUFS) has been shown to improve wheat-maize rotation system productivity, their effects on greenhouse gas (GHG) emissions, carbon footprints (CF), and net ecosystem economic benefits (NEEB) are still unknown. Life cycle assessment was used to investigate a long-term (2013-2022) wheat-maize rotation experiment that included straw combined with two N fertilizer types [BUFS and (conventional urea fertilizer) CUFS] and straw-free treatments (BUF and CUF). The results showed that BUFS and CUFS treatments increased the annual yield by 13.8% and 11.5%, respectively, compared to BUF and CUF treatments. The BUFS treatment increased the yearly yield by 13.8% compared to the CUFS treatment. Since BUFS and CUFS treatments increased soil organic carbon (SOC) sink sequestration by 25.0% and 27.0% compared to BUF and CUF treatments, they reduced annual GHG emissions by 7.1% and 4.7% and CF per unit of yield (CFY) by 13.7% and 9.6%, respectively. BUFS treatment also increased SOC sink sequestration by 20.3%, reduced GHG emissions by 10.7% and CFY by 23.0% compared to CUFS treatment. It is worth noting that the BUFS and CUFS treatments increased the annual ecological costs by 41.6%, 26.9%, and health costs by 70.1% and 46.7% compared to the BUF and CUF treatments, but also increased the net yield benefits by 9.8%, 6.8%, and the soil nutrient cycling values by 29.2%, 27.3%, and finally improved the NEEB by 10.1%, 7.3%, respectively. Similar results were obtained for the BUFS treatment compared to the CUFS treatment, ultimately improving the NEEB by 23.1%. Based on assessing yield, GHG emissions, CF, and NEEB indicators, the BUFS treatment is recommended as an ideal agricultural fertilization model to promote sustainable and clean production in the wheat-maize rotation system and to protect the agroecological environment.

Renewable energy consumption - financial globalization-tourism nexus with nonlinearity and cross-sectional dependence during Asia's carbon-free transition.

Adopting renewable energy consumption is one of the most important aspects of international efforts to combat climate change, improve energy security, and encourage the shift to a more robust and sustainable energy system. Therefore, the empirics and policymakers worldwide are searching for factors that can promote renewable energy consumption. This analysis intends to investigate the role of financial globalization and tourism on renewable energy consumption in Asia and sub-regions such as Central Asia, East Asia, South Asia, Southeast Asia, and West Asia. The analysis utilized the linear and nonlinear CS-ARDL methods. Long-run outcomes of the linear and nonlinear models confirm that a rise in financial globalization and tourism promotes renewable energy consumption in Asia and all sub-regions. However, the nonlinear model highlights that a fall in financial globalization hurts renewable energy consumption in Central and South Asian regions, and tourism only hurts renewable energy consumption in Asia. In addition, ICT, GDP, and GHG emissions help promote renewable energy consumption. These results suggest that Asian policymakers must increase collaboration in the financial sectors and promote sustainable tourism in the regions to promote renewable energy consumption.

Printable and low-cost perfect terahertz absorber realized by a laser-induced graphene metasurface.

Terahertz (THz) absorbers are highly desired with the rapid development of THz technology. Although metasurface-based absorbers can realize perfect absorption, their fabrication often requires complicated micro-nano-processing with a high cost. In this paper, fast printable and low-cost metasurface absorbers based on a laser-induced graphene (LIG) technique are proposed. Experimental results demonstrate that these two metasurfaces can achieve maximum absorptions of 99.3% and 99.9% at their resonant frequencies in an incident angle range of ±55°. Fabrication of a metasurface with a size of 1 × 1 cm costs only 11 s. The absorbers may be applied in THz dichroism and communications.

Multiplex Chroma Response Wearable Hydrogel Patch: Visual Monitoring of Urea in Body Fluids for Health Prognosis.

Visual wearable devices can rapid intuitively monitor biomarkers in body fluids to indicate the human health status and provide valuable reference for further medical diagnosis. However, unavoidable interference factors such as skin color, natural light, and background luminescence can interfere with the visualization accuracy of flexible wearable devices, limiting their practical sensing application. Here, we designed a wearable sensing patch via an embedded upconversion optical probe in a 3D porous polyacrylamide hydrogel, exhibiting a multiplex chroma response to urea based on the inner filter effect, which overcomes the susceptibility to external conditions due to its near-infrared excited luminescence and improves the resolution and accuracy of visual sensing. Furthermore, a highly compatible portable sensing platform combined with a smartphone was designed to achieve in situ rapid quantitative analysis of urea. The limit of detection values of the upconversion optical probe and hydrogel sensor are as low as 1.4 and 30 µM respectively, exhibiting the practicality in different scenarios. The designed sensing patch provides a convenient and accurate sensing strategy for the detection of biomarkers in body fluids and has the potential to be developed into a point-of-care device to provide disease early warning and clinical diagnosis.

Influencing factors of online products decision-making oriented to tourism economy under the guidance of consumer psychology.

This work aims to increase the consumption of online tourism products and promote the development of the tourism economy. Based on this, it first analyses the Internet market under the guidance of consumer psychology. Then, the influencing factors of online product decision-making for the tourism economy are discussed. Finally, based on the above analysis, it discusses and evaluates the main factors affecting the consumption of online travel products. The research method of this work is set based on psychology so that it can analyze the psychological state of consumers more deeply and promote the development of the consumer market. The results show that the main factors affecting the consumption of online travel products include online travel platforms and user characteristics. Specifically, approximately 80% of users consume online travel products based on platform reviews, approximately 10% of users consume online travel products based on platform recommended content, and approximately 5% of users consume online travel products based on platform search content. Users vary mainly by age, gender, and region and have different preferences for different platforms. Among the four major platforms, Ctrip occupies the most consumers. The conclusion is that the main way to develop the tourism economy is to build a better online travel platform. At the same time, it is necessary to promote online tourism according to the characteristics of users and increase the marketing of online tourism products. This work not only provides a reference for promoting online tourism product marketing but also helps to promote the development of the tourism economy.

Data leaking scandal, risks, and financial consumption behaviors in online tourism platforms: The role of trust on college students and teachers.

Given the importance of data safety for psychology, the present study investigated the influence of data leaking scandal on campus customers' financial consumption behaviors at intelligent tourism platforms in China, and explored the roles that individual characteristics play in this process by focusing on a set of participants from colleges. Data were collected through sending out an online questionnaire, where respondents were asked to finish a series of questions about their background information, their trust, future consuming intention, and defensive behaviors toward intelligent platforms. After they finished these questions, a short description about an online tourism platform leaking customers' personal information was presented to the respondents, following which they were asked to report about their future consuming intentions and defensive behaviors again. In total, 236 participants of college students and teachers were recruited. Paired samples mean comparison showed that after the stimulus was presented, the respondents had a significant decrease in future financial consumption intention, and a significant increase in defensive behaviors toward online tourism platforms due to risks perceived. Multiple regression analysis was conducted subsequently to investigate individual characteristics that may account for part of the decrease (increase) in consuming intention (defensive behaviors). Results showed that, customers with higher level of trust and monthly income, as well as older customers, tend to experience higher level of decrease in consuming intention, and increase in defensive behaviors. These findings highlighted the importance of online tourism platforms guaranteeing data security of their customers.

Prevalence of venous thromboembolism and evaluation of a modified caprini risk assessment model: a single-centre, prospective cohort study involving patients undergoing lung resections for bronchiectasis.

BACKGROUND: Venous thromboembolism (VTE) is a common postoperative complication in general thoracic surgery, but the incidence of patients undergoing surgery for bronchiectasis was not known. The purpose of our study was to investigate the incidence of VTE in bronchiectasis patients undergoing lung resection and to evaluate the risk stratification effect of the modified caprini risk assessment model (RAM). METHODS: We prospectively enrolled patients with bronchiectasis who underwent lung resection surgery between July 2016 and July 2020.The postoperative duplex lower-extremity ultrasonography or(and) computed tomographic pulmonary angiography (CTPA) was performed to detect VTE. The clinical characteristics and caprini scores of VTE patients and non-VTE patients would be compared and analyzed. Univariate logistic regression was performed to evaluate whether higher Caprini scores were associated with postoperative VTE risk.In addition, We explored the optimal cutoff for caprini score in patients with bronchiectasis by using the receiver operating characteristic (ROC) curve. RESULTS: One hundred and seventeen patients were eligible based on the prospective study criteria. The postoperative VTE incidence was 8.5% (10/117). By comparing the clinical characteristics and Caprini scores of VTE and non-VTE patients, the median preoperative hospitalization (7 vs 5 days, P = 0.028) and Caprini score (6.5 vs 3,P < 0.001) were significantly higher in VTE patients. In univariate logistic regression, a higher Caprini score was associated with higher odds ratio (OR) for VTE of 1.7, 95% confidence interval (CI) was from 1.2 to 2.5 (P = 0.001), C-statistics was 0.815 in the modified caprini RAM for predicting VTE. In a multivariable analysis adjusting for preoperative hospitalization, a higher Caprini score was associated with higher odds OR for VTE of 1.8 (95%CI: 1.2-2.6, P = 0.002), C-statistics was 0.893 in the caprini RAM for predicting VTE. When taking the Caprini score as 5 points as the diagnostic threshold, the Youden index is the largest. CONCLUSIONS: The postoperative VTE incidence in patients undergoing lung resection for bronchiectasis was 8.5%.The modified caprini RAM effectively stratified bronchiectasis surgery patients for risk of VTE and showed excellent predictive power for VTE. The patients with postoperative caprini scores = 5, should be recommended to take positive measures to prevent postoperative VTE. TRIAL REGISTRATION: Chinese Clinical Trial Register: ChiCTR-EOC-17010577.

Establishment of Economic Forecasting Model of High-tech Industry Based on Genetic Optimization Neural Network.

Scientific and accurate prediction of high-tech industries is of great practical significance for government departments to grasp the future economic operation and formulate development strategies. In this paper, aiming at some shortcomings of neural network (NN) applied in economic forecasting, GANN was introduced to construct the economic forecasting model of high-tech industry. Genetic algorithm (GA) has simple calculation and strong robustness and can generally ensure convergence to the global optimum, which effectively overcomes the shortcomings of NN using gradient descent method. In order to verify the feasibility of the economic forecasting model in this paper, the comparative experiments of different models are carried out in this paper. Experimental results show that the proposed algorithm has faster convergence speed and greater generalization ability, and the average error rate is reduced to about 1%. The prediction accuracy of this model reached 95.14%, which was about 11.93% higher than the previous model. Applying the economic forecasting model in this paper to the economic forecasting of high-tech industries can provide the means and reference value for the government to formulate regional future economic development plans, forecast, and control the economic growth and development direction.

Three new flavonoid glycosides from the aerial parts of Allium sativum L. and their anti-platelet aggregation assessment.

Three new flavonoid glycosides, Dasuanxinoside F-H (1-3), were isolated from the aerial parts of Allium sativum, together with eight known compounds which were firstly reported in this plant, including three flavonoid glycosides (4-6) and five phenylethanoid glycosides (7-11). Their structures were identified by UV-vis, IR, 1D and 2D NMR spectra, as well as HR-ESI-MS analyses. The inhibitory effect of the isolated compounds on platelet aggregation induced by adenosine diphosphate (ADP) was evaluated in vitro. The results showed that most compounds displayed different degrees of inhibition. Among them, 2, 5, 8 and 9 exhibited the strongest activity on platelet aggregation.

Validation of a modified Caprini risk assessment model in lung cancer patients undergoing surgery: Results of a multicenter cross-sectional observational study.

BACKGROUND AND OBJECTIVES: Lung cancer patients slated for surgery are at high risk of venous thromboembolism (VTE). Precise risk assessment is necessary for providing proper thromboprophylaxis and reducing morbidity and mortality of VTE. METHODS: A multicenter, observational, cross-sectional cohort study, involving patients with primary lung cancer undergoing surgery, was carried out from August 2016 to December 2019. All patients were assessed according to the Caprini risk assessment model (RAM) and a modified scoring system incorporating elevated D-dimer and new stratification of surgical time. The endpoint was confirmed VTE or patient discharge. RESULTS: Out of 1205 patients, 87 (7.2%) were diagnosed with VTE. The area under the curve of modified scores for VTE was 0.759, which was larger than that of the original one (0.589) (p < 0.05). By modified Caprini scoring system, a higher score was associated with increased VTE risk (odds ratio [OR], 1.345; 95% confidence interval [CI], 1.197-1.512; p < 0.001), and there was an increased OR of 4.090 (95% CI, 2.472-6.768, p < 0.001) for VTE in high-risk category patients. CONCLUSION: Modified Caprini RAM showed an improved prediction of high-risk patients with an elevated likelihood of postoperative VTE compared to the original one.

Human health risk assessment of groundwater nitrate at a two geomorphic units transition zone in northern China.

To assess groundwater nitrate contamination and its human health risks, 489 unconfined groundwater samples were collected and analyzed from Zhangjiakou, northern China. The spatial distribution of principle hydrogeochemical results showed that the average concentrations of ions in descend order was HCO3-, SO42-, Na+, Ca2+, Cl-, NO3-, Mg2+ and K+, among which the NO3- concentrations were between 0.25 and 536.73 mg/L with an average of 29.72 mg/L. In total, 167 out of 489 samples (~ 34%) exceeded the recommended concentration of 20 mg/L in Quality Standard for Groundwater of China. The high NO3- concentration groundwater mainly located in the northern part and near the boundary of the two geomorphic units. As revealed by statistical analysis, the groundwater chemistry was more significantly affected by anthropogenic sources than by the geogenic sources. Moreover, human health risks of groundwater nitrate through oral and dermal exposure pathways were assessed by model, the results showed that about 60%, 50%, 32% and 26% of the area exceeded the acceptable level (total health index>1) for infants, children, adult males and females, respectively. The health risks for different groups of people varied significantly, ranked: infants> children> adult males>adult females, suggesting that younger people are more susceptible to nitrate contamination, while females are more resistant to nitrate contamination than males. To ensure the drinking water safety in Zhangjiakou and its downstream areas, proper management and treatment of groundwater will be necessary to avoid the health risks associated with nitrate contamination.

Perfluorooctanoic Acid (PFOA) and Perfluorooctanesulfonic Acid (PFOS) in Surface Water of China: National Exposure Distributions and Probabilistic Risk Assessment.

This study presents a comprehensive application of the probabilistic risk assessment methodology for perfluorooctanoic acid (PFOA) and perfluorooctane sulfonate (PFOS), which are two types of perfluoroalkyl acids frequently studied in recent years. The exposure characteristics of PFOA and PFOS in Chinese surface water on a nationwide scale were summarized. Individual predicted no-effect concentration (PNEC) and the sensitivities for taxonomic groups of primary producers, invertebrates, and vertebrates were derived by the species sensitivity distributions method. Both hazard quotients (HQs) and joint probability curves were calculated to assess the risks to aquatic organisms. Among seven Chinese river basins, the mean concentrations of PFOA and PFOS in the Yangtze River Basin were the highest (58 ng/L and 22 ng/L, respectively), while the lowest concentrations (< 1 ng/L) were in the Songhua River Basin. The acute PNEC value was 2.43 mg/L for PFOA and 0.96 mg/L for PFOS, and the chronic PNEC value was 0.0067 mg/L for PFOA and 0.0012 mg/L for PFOS, respectively. The sensitivities of different taxonomic groups revealed higher sensitivity of primary producers for PFOA and higher sensitivity of invertebrates for PFOS. The acute HQs of PFOA and PFOS were less than 1. The probabilities of exposure concentrations exceeding 5th percentile toxicity value of the chronic data for all aquatic organisms were 1.65% for PFOA and 1.23% for PFOS, respectively, suggesting a low probability of effects to aquatic organisms. Compared with the risk scenarios worldwide, the ecological risks for chronic effects decreased in the order of PFOS (worldwide) > PFOA (China) > PFOS (China) > PFOA (worldwide).

An assessment of the analytical performance of non-invasive prenatal testing (NIPT) in detecting sex chromosome aneuploidies: 34,717-patient sample in a single prenatal diagnosis Centre in China.

OBJECTIVE: The present study aimed to evaluate the efficacy of a non-invasive prenatal test (NIPT) in the detection of the sex chromosome aneuploidies (SCAs) at our prenatal diagnosis centre. METHODS: Among a cohort of 34,717 pregnancies, maternal plasma samples from our prenatal diagnosis centre were subject to analysis of SCAs using NIPT detection. Pregnant women with NIPT positive results of SCAs were recommended to undergo an invasive prenatal diagnosis (i.e. karyotyping and fluorescence in situ hybridization) to validate the prediction value of NIPT. RESULTS: From 34,717 clinical pregnancies, 229 (0.66%) pregnancies were identified with SCAs. Of these, 78 (34.1%) cases were positive for 45,X and 151 (65.9%) cases comprised a sex chromosome trisomy. Of the 229 positive NIPT results, 193 (84.3%) cases had accepted an invasive diagnosis involving karyotyping analysis of the amniotic fluid, which confirmed 67 cases (34.7%) as true positive, as well as 126 cases (65.3%) as false positive. The positive predictive values were 23.07%, 50%, 36% and 27.27% respectively. The remaining 36 (15.7%) cases declined a prenatal diagnosis. The termination rates of 45,X, 47,XXY, 47,XXX and 47,XYY were 20.5%,46%,12.9% and 11.5% respectively. CONCLUSIONS: NIPT demonstrated a lower accuracy in predicting monosomy X than sex chromosome trisomies. After invasive testing, the fetal chromosome with 45,X and 47,XXY were terminated more often than those with 47,XXX, 47,XYY. Because NIPT is a screening test, false positive/negative cases exist, and pre- and post-test counselling is essential for informing patients about the benefits and limitations of the test. Confirmatory testing of abnormal results is recommended prenatally or after birth, and the importance of confirmatory testing and benefits of early diagnosis should be addressed.

[Interpretation of the international expert recommendations of clinical features to prompt referral for diagnostic assessment of cerebral palsy].

Under the guidance and support of national policies in recent years, the community medical system has been developed rapidly, among which primary child healthcare is carried out routinely in community hospitals, greatly alleviating the pressure of specialized pediatric hospitals and departments of pediatrics in secondary and tertiary general hospitals. However, due to the lack of professional training for primary child healthcare personnel in community medical institutions, early symptoms of children with cerebral palsy cannot be identified and so children with cerebral palsy are often unable to receive early diagnosis and intervention, which may affect their prognosis. An article about international expert consensus and recommendations on early identification and referral of cerebral palsy in community medical institutions was published in Development Medicine and Child Neurology in 2020. It proposed six clinical features that should prompt referral and two warning signs that warrant enhanced monitoring, as well as five recommendations for referral to medical experts and other healthcare professionals for the diagnosis of cerebral palsy. The recommendations may help primary child healthcare personnel in community medical institutions to early identify the children at high risk of cerebral palsy, thus reducing the delay of referral and intervention. This article gives an interpretation of the recommendations based on the actual situation in China, in order to improve the ability of primary child healthcare personnel in community medical institutions to early identify high-risk signals of cerebral palsy and conduct reasonable referral. This will help to achieve the early identification, early diagnosis, and early intervention to improve the prognosis of children with cerebral palsy.

In vivo percutaneous permeation of gold nanomaterials in consumer cosmetics: implication in dermal safety assessment of consumer nanoproducts.

The increasing emergence of nano-cosmetics in the marketplace provokes safety concerns with respect to percutaneous permeation and toxicity of nanomaterials inside the human body. In this study, in vivo percutaneous permeation and dermal safety of cosmetic cream containing Au nanosheets and extracted Au nanosheets from cosmetic creams are investigated with guinea pigs. Quantitative percutaneous permeation data suggests that Au nanosheets in cosmetic creams permeate into the skin epidermis, dermis, and subcutaneous layer after 10 d cutaneous exposure, but cannot enter the systemic circulation. However, more Au nanosheets are accumulated in the skin and the permeation of Au nanosheets increased after embedded into the cream matrix. Synchrotron radiation X-ray fluorescence (SRXRF) imaging reveals that Au nanosheets in cosmetics penetrate mainly through hair follicles in a time-dependent manner. Cosmetic creams rather than extracted Au nanosheets decrease the cell viability of keratinocytes and slightly induce apoptosis/necrosis of keratinocytes and skin dermal fibroblasts. Intriguingly, the growth of hair is inhibited by the cosmetic cream and the extracted Au nanosheets revealed by HE staining and immunohistochemistry (IHC) assay. Altogether this study provides insights into the comprehensive understanding of percutaneous permeation and dermal safety of cosmetic creams containing Au nanosheets. This work provides reliable methods to study the skin permeation, biodistribution, and dermal safety of nano-cosmetics and reminds the community of the crucial need to combine the assays at molecular, cellular, and organ levels in nanotoxicology research.

A public website for the automated assessment and validation of SARS-CoV-2 diagnostic PCR assays.

SUMMARY: Polymerase chain reaction-based assays are the current gold standard for detecting and diagnosing SARS-CoV-2. However, as SARS-CoV-2 mutates, we need to constantly assess whether existing PCR-based assays will continue to detect all known viral strains. To enable the continuous monitoring of SARS-CoV-2 assays, we have developed a web-based assay validation algorithm that checks existing PCR-based assays against the ever-expanding genome databases for SARS-CoV-2 using both thermodynamic and edit-distance metrics. The assay-screening results are displayed as a heatmap, showing the number of mismatches between each detection and each SARS-CoV-2 genome sequence. Using a mismatch threshold to define detection failure, assay performance is summarized with the true-positive rate (recall) to simplify assay comparisons. AVAILABILITY AND IMPLEMENTATION: The assay evaluation website and supporting software are Open Source and freely available at https://covid19.edgebioinformatics.org/#/assayValidation, https://github.com/jgans/thermonucleotide BLAST and https://github.com/LANL-Bioinformatics/assay_validation. SUPPLEMENTARY INFORMATION: Supplementary data are available at Bioinformatics online.

In situ experimental measurement of mercury by combining PGNAA and characteristic X-ray fluorescence.

In our previous research, a new detection method was proposed to measure Hg and Pb simultaneously by combining Prompt Gamma-ray Neutron Activation Analysis (PGNAA) and X-ray Fluorescence (XRF) and proved by the Monte Carlo N-Particle (MCNP) simulation code. For further experimental verification, a combined measurement experimental facility, comprising an 241Am-Be neutron source, SAINT-GOBAIN Bismuth Germanate (BGO) as the γ-ray detector, and an NaI detector with 25 µm Be window as the X-ray detector, was presented. Specifically, the characteristic X-ray fluorescence of the Hg directly induced in this experimental facility was utilized to improve the limits of detection (LOD) of Hg instead of traditional excitation sources. The simulation and experiment results indicated that LOD for Hg by the combined measurement instrument was 19.4 mg kg-1. The empirical formula of the calibration curve in this method was given based on the aforementioned calculations.

Groundwater pollution and risk assessment based on source apportionment in a typical cold agricultural region in Northeastern China.

Increasing anthropogenic contamination poses a significant threat to groundwater security. Identifying potential contamination sources and apportioning their corresponding contributions are of vital importance for the prevention of contamination and management of groundwater resources. In this study, principal component analysis (PCA), modified grey relational analysis (MGRA), absolute principal component score-multiple linear regression (APCS-MLR), and positive matrix factorization (PMF) receptor modeling technologies were employed to evaluate the groundwater quality and apportion the potential contamination sources in the Lalin river basin, a main grain production district in the northeast of China. The contamination assessment with PCA and MGRA suggested that the groundwater in Lalin river basin was polluted due to human activities. The PCA method identified five and four potential contamination sources in wet and dry seasons, respectively, and the main sources were basically same. The APCS-MLR and PMF methods apportioned the source contributions to each groundwater quality variable. The final results showed that agricultural sources including waste water, agrochemicals and fertilizers were identified as the main sources of groundwater contamination both in wet and dry seasons. In addition, groundwater management strategies learned from the advanced experiences were discussed to protect the groundwater system in that region.

A novel risk assessment model for venous thromboembolism after major thoracic surgery: a Chinese single-center study.

BACKGROUND: Venous thromboembolism (VTE) is an insidious disease with significant morbidity and mortality. We conducted a retrospective single-center study on patients who underwent thoracic surgery and developed a novel VTE risk assessment model (RAM). METHODS: Patients who underwent thoracic surgery between July 2016 and December 2017 (n=533) at the Beijing Chao-Yang Hospital were enrolled in this study. None of the patients received any prophylaxis perioperatively. Lower limbs Doppler ultrasonography was performed before and after surgery for deep venous thrombosis (DVT) confirmation. Patients with new postoperative DVT, typical symptoms of pulmonary embolism (PE), or high Caprini score (≥9) underwent further computer tomography pulmonary angiography (CTPA) examination for PE. Caprini, Rogers, Padua, and Khorana RAM were used for all of the patients. A novel RAM of VTE, which we called Chao-Yang VTE RAM, was developed according to the logistic regression analysis. RESULTS: The overall incidence of VTE after thoracic surgery was 8.4% (45 of 533). Among the 45 VTE patients, 86.7% have DVT and 13.3% have DVT + PE. Age ≥60 (OR 4.51, 95% CI: 2.09-9.71, P=0.000) has an independent risk factor for VTE. The areas under the receiver operating characteristic (ROC) curve of Caprini, Rogers, Padua, Khorana, and Chao-Yang models were 0.74 (P<0.0001), 0.52 (P=0.62), 0.69 (P<0.0001), 0.64 (P=0.0017), and 0.80 (P<0.0001), respectively. The VTE incidence in the low-, moderate-, and high-risk groups predicted with Chao-Yang scores was 1.3% (3 of 230), 8.4% (14 of 166), and 20.4% (28 of 137); these were 1.6% (3 of 192), 11.9% (38 of 318), and 17.4% (4 of 23), respectively, when using the Caprini criteria. The high-risk group had a significantly higher incidence than the low- and moderate-risk groups (P=0.000). Additionally, as the number of risk factors increased, the incidence of VTE increased from 1.2% to 50.0%. CONCLUSIONS: The incidence of VTE in patients who underwent major thoracic surgery was high in our series. Based on a retrospective single-center population study, we developed a novel prediction model to identify patients receiving thoracic surgery with different risks for VTE events.

Assessment of non-lobe-specific lymph node metastasis in clinical stage IA non-small cell lung cancer.

BACKGROUND: The rationality of selective mediastinal lymph node dissection based on lobe-specific metastasis is still controversial. The correlation of lymph node metastasis in lobe-specific lymphatic drainage regions (LSDRs) and non-LSDRs has not been widely reported. The purpose of this study was to investigate the variables affecting nodal metastasis in non-LSDRs and to further evaluate the rationality of selective lymphadenectomy in clinical stage IA non-small cell lung cancer (NSCLC) patients. METHODS: The clinicopathological information of 316 patients with clinical stage IA NSCLC who underwent lobectomy with systematic lymph node dissection between June 2014 and June 2018 was retrospectively collected for analysis. RESULTS: The overall lymph node metastasis rate was 19.3%. For 35 patients with positive LSDR lymph nodes, the non-LSDR lymph node metastasis rate was 31.4%. Only one patient (0.4%) among 281 patients with negative LSDR lymph nodes had nodal spread in non-LSDRs. Univariate analysis identified that solid consistency, worse differentiation, and positive status in LSDRs were unfavorable predictive variables of lymph node metastasis in non-LSDRs. Multivariate analysis showed that nodal metastasis in LSDRs was the only independent predictor of nodal involvement in non-LSDRs (P < 0.001). CONCLUSION: For patients with clinical stage IA NSCLC, non-LSDR lymph node metastasis mainly depends on the involvement of the LSDR lymph node. Our observations may indicate the potential implications for the reasonable management of lymphadenectomy in stage IA NSCLC patients.