Buffer-free ozone-ferrate(VI) systems for enhanced oxidation of electron-deficient contaminants: Synergistic enhancement effects, systematic toxicity assessment, and practical applications.

The combination of ozone (O3) and ferrate (Fe(VI)) oxidation technology demonstrates substantial potential for practical applications, though it has been underreported, resulting in gaps in comprehensive activity assessments and thorough exploration of its mechanisms. This study reveals that the previous use of a borate buffer solution obscured certain synergistic reactions between O3 and Fe(VI), causing a reduction of activity by ∼40 % when oxidizing the electron-deficient pollutant atrazine. Consequently, we reassessed the activity and mechanisms using a buffer-salt-free O3/Fe(VI) system. Our findings showed that the hydroxyl radical (·OH) served as the predominant active species, responsible for an impressive 95.9 % of the oxidation activity against electron-deficient pollutants. Additional experiments demonstrated that the rapid production of neglected and really important superoxide radicals (·O2-) could facilitate the decomposition of O3 to generate ·OH and accelerate the reduction of Fe(VI) to Fe(V), reactivating O3 to produce ·OH anew. Intriguingly, as the reaction progressed, the initially depleted Fe(VI) was partially regenerated, stabilizing at over 50 %, highlighting the significant potential of this combined system. Moreover, this combined system could achieve a high mineralization efficiency of 80.4 % in treating actual coking wastewater, complemented by extensive toxicity assessments using Escherichia coli, wheat seeds, and zebrafish embryos, showcasing its robust application potential. This study revisits and amends previous research on the O3/Fe(VI) system, providing new insights into its activity and synergistic mechanisms. Such a combined technology has potential for the treatment of difficult-to-degrade industrial wastewater.

Value of Ultrasound Super-Resolution Imaging for the Assessment of Renal Microcirculation in Patients with Acute Kidney Injury: A Preliminary Study.

The present study aimed to explore the clinical applicability of ultrasound super-resolution imaging (US SRI) for assessing renal microcirculation in patients with acute kidney injury (AKI). A total of 62 patients with sepsis were enrolled in the present study-38 with AKI and 24 control patients-from whom renal ultrasounds and clinical data were obtained. SonoVue contrast (1.5 mL) was administered through the elbow vein and contrast-enhanced ultrasound (CEUS) images were obtained on a Mindray Resona A20 ultrasound unit for 2 min. The renal perfusion time-intensity curve (TIC) was analyzed and, after 15 min, additional images were obtained to create a microscopic blood flow map. Microvascular density (MVD) was calculated and its correlation with serum creatinine (Scr) levels was analyzed. There were significant differences in heart rate, Scr, blood urea nitrogen, urine volume at 24 h, and glomerular filtration rate between the two groups (p < 0.01), whereas other characteristics, such as renal morphology, did not differ significantly between the AKI group and control group (p > 0.05). The time to peak and mean transit times of the renal cortex in the AKI group were prolonged compared to those in the control group (p < 0.01), while the peak intensity and area under the TIC were lower than those in the control group (p < 0.05). The MVD of the renal cortex in the AKI group was lower than that in the control group (18.46 ± 5.90% vs. 44.93 ± 11.65%; p < 0.01) and the MVD in the AKI group showed a negative correlation with Scr (R = -0.84; p < 0.01). Based on the aforementioned results, US SRI can effectively assess renal microcirculation in patients with AKI and is a noninvasive technique for the diagnosis of AKI and quantitative evaluation of renal microcirculation.

Objective Neurophysiological Indices for the Assessment of Chronic Tinnitus Based on EEG Microstate Parameters.

Chronic tinnitus is highly prevalent but lacks precise diagnostic or effective therapeutic standards. Its onset and treatment mechanisms remain unclear, and there is a shortage of objective assessment methods. We aim to identify abnormal neural activity and reorganization in tinnitus patients and reveal potential neurophysiological markers for objectively evaluating tinnitus. By way of analyzing EEG microstates, comparing metrics under three resting states (OE, CE, and OECEm) between tinnitus sufferers and controls, and correlating them with tinnitus symptoms. This study reflected specific changes in the EEG microstates of tinnitus patients across multiple resting states, as well as inconsistent correlations with tinnitus symptoms. Microstate parameters were significantly different when patients were in OE and CE states. Specifically, the occurrence of Microstate A and the transition probabilities (TP) from other Microstates to A increased significantly, particularly in the CE state (32-37%, p ≤ 0.05 ); and both correlated positively with the tinnitus intensity. Nevertheless, under the OECEm state, increases were mainly observed in the duration, coverage, and occurrence of Microstate B (15-47%, ), which negatively correlated with intensity ( [Formula: see text]-0.513, ). Additionally, TPx between Microstates C and D were significantly reduced and positively correlated with HDAS levels ( [Formula: see text] 0.548, ). Furthermore, parameters of Microstate D also correlated with THI grades ( [Formula: see text]-0.576, ). The findings of this study could offer compelling evidence for central neural reorganization associated with chronic tinnitus. EEG microstate parameters that correlate with tinnitus symptoms could serve as neurophysiological markers, contributing to future research on the objective assessment of tinnitus.

Accountability audit of natural resources and total factor productivity-Evidence based on Chinese listed companies.

Based on a natural event, namely a pilot accountability audit of natural resources conducted by local officials in 2014, this study empirically investigates the impact of the pilot on the total factor productivity (TFP) of enterprises. The study utilizes the Differences-in-Differences model with an observation window spanning from 2012 to 2015. The findings indicate a significant reduction in the total factor productivity of enterprises in the pilot area due to the implementation of the pilot program. The study identifies that this impact is primarily driven by increased production costs and decreased investment. Further analysis reveals heterogeneity in the effects, with regions characterized by low levels of economic development, distortions in the production element market, low competition in industries, heavy asset-intensive industries, large enterprises, and absolute holding enterprises experiencing a more pronounced impact of the audit on total factor productivity. Overall, this study sheds light on the influence of accountability audits of natural resources on the real economy and offers valuable insights for policymakers.

Assessment of geriatric and clinical domains for development and validation of a novel nomogram to predict the prognosis of older patients with breast cancer: a real-world retrospective cohort study.

Background: Breast cancer is a relatively heterogeneous disease in the older population. Survival in older breast cancer patients is not only affected by tumor-related factors, but also by geriatric assessment domains. How tumor clinical factors and geriatric factors specifically affect the survival rate of older patients and how to combine these two factors to predict the risk of death in older patients with breast cancer remain clinical questions to be addressed. Method: We used the Peking Union Medical College Hospital database to identify older patients (≥65 years) who were newly diagnosed with breast cancer between January 2013 and December 2019. Of the 641 eligible patients, we retrospectively analyzed the clinical and geriatric data of 556 patients who formed our study population. The primary outcomes were overall survival (OS) and breast cancer-specific survival (BCSS). Univariate and multivariate Cox regression analyses were conducted to identify independent prognostic factors and construct a nomogram to predict the 1-, 3-, and 5-year survival rates. The performance of the constructed nomogram was evaluated using calibration curve, receiver operating characteristic (ROC) curve, and decision curve analysis (DCA). Results: Multivariate Cox regression analysis revealed seven independent prognostic factors associated with OS in older patients with breast cancer: age, tumor stage, lymph node stage, intrinsic molecular subtype, functional status, comorbidities, and psychological state. Nomogram based on these seven factors yielded excellent performance, with area under the ROC curve (AUROC) of 0.748. Similarly, the nomogram for BCSS had an AUROC of 0.760. Moreover, the calibration curve and DCA revealed good predictive accuracy between the actual and predicted probabilities. Conclusion: Independent prognostic factors for OS and BCSS in older patients with breast cancer in China were determined in our study. A novel nomogram for predicting the 1-, 3-, and 5-year OS and BCSS in this patient population was developed and validated. The nomogram exhibited good accuracy, indicating its potential for clinical decision making and improving outcomes.

An experimental study for quantitative assessment of fatty infiltration and blood flow perfusion in quadriceps muscle of rats using IDEAL-IQ and BOLD-MRI for early diagnosis of sarcopenia.

BACKGROUND: Severe sarcopenia may result in severe disability. Early diagnosis is currently the key to enhancing the treatment of sarcopenia, and there is an urgent need for a highly sensitive and dependable tool to evaluate the course of early sarcopenia in clinical practice. This study aims to investigate longitudinally the early diagnosability of magnetic resonance imaging (MRI)-based fat infiltration and blood flow perfusion technology in sarcopenia progression. METHODS: 48 Sprague-Dawley rats were randomly assigned into six groups that were based on different periods of dexamethasone (DEX) injection (0, 2, 4, 6, 8, 10 days). Multimodal MRI was scanned to assess muscle mass. Grip strength and swimming exhaustion time of rats were measured to assess muscle strength and function. Immunofluorescence staining for CD31 was employed to assess skeletal muscle capillary formation, and western blot was used to detect vascular endothelial growth factor-A (VEGF-A) and muscle ring finger-1 (MuRF-1) protein expression. Subsequently, we analyzed the correlation between imaging and histopathologic parameters. A receiver operating characteristic (ROC) analysis was conducted to assess the effectiveness of quantitative MRI parameters for discriminating diagnosis in both pre- and post-modeling of DEX-induced sarcopenic rats. RESULTS: Significant differences were found in PDFF, R2* and T2 values on day 2 of DEX-induction compared to the control group, occurring prior to the MRI-CSA values and limb grip strength on day 6 of induction and swimming exhaustion time on day 8 of induction. There is a strong correlation between MRI-CSA with HE-CSA values (r = 0.67; p < 0.001), oil red O (ORO) area with PDFF (r = 0.67; p < 0.001), microvascular density (MVD) (r = -0.79; p < 0.001) and VEGF-A (r = -0.73; p < 0.001) with R2*, MuRF-1 with MRI-CSA (r = -0.82; p < 0.001). The AUC of PDFF, R2*, and T2 values used for modeling evaluation are 0.81, 0.93, and 0.98, respectively. CONCLUSION: Imaging parameters PDFF, R2*, and T2 can be used to sensitively evaluate early pathological changes in sarcopenia. The successful construction of a sarcopenia rat model can be assessed when PDFF exceeds 1.25, R2* exceeds 53.85, and T2 exceeds 33.88.

Black-Blood Magnetization Prepared 2 Rapid Acquisition Gradient Echoes: A Fast and Three-Dimensional MR Black-Blood T1 Mapping Technique for Quantitative Assessment of Atherosclerosis and Venous Thrombosis.

BACKGROUND: Blood flow signals may be a confounder in quantifying T1 values of plaque or thrombus and how to realize black-blood T1 mapping remains a challenge task. PURPOSE: To develop a fast and three-dimensional black-blood T1 mapping technique for quantitative assessment of atherosclerosis and venous thrombosis. STUDY TYPE: Sequence development and optimization via phantoms and volunteers as well as pilot prospective. PHANTOM AND SUBJECTS: Numerical simulations, a standard phantom, 8 healthy volunteers (mean age, 22 ± 1 years; 5 males), and 19 patients (mean age, 57 ± 14 years; 13 males) with atherosclerosis or venous thrombosis. FIELD STRENGTH/SEQUENCE: 3T/inversion recovery spin-echo sequence (IR-SE), magnetization prepared 2 rapid acquisition gradient echoes (MP2RAGE), and black-blood prepared MP2RAGE (BB-MP2RAGE). ASSESSMENT: The black-blood preparation (i.e., delay alternating with nutation for tailored excitation, DANTE) was incorporated into MP2RAGE for black-blood T1 mapping. The BB-MP2RAGE was optimized numerically based on the Bloch equation, and then the phantom study was performed to verify the accuracy of T1 mapping by BB-MP2RAGE against IR-SE and MP2RAGE. Preliminary clinical validation was prospectively performed to assess the flow suppression effect and its potential application in plaque and thrombosis identification. STATISTICAL TESTS: Pearson correlation test, Bland-Altman analysis, paired t-test, and intraclass correlation coefficient. A P value <0.05 indicates a statistically significant difference. RESULTS: Phantom experiments showed comparable accuracy of T1 maps by BB-MP2RAGE with IR-SE and MP2RAGE (all r2 > 0.99); Compared to MP2RAGE, BB-MP2RAGE effectively nulled the blood flow signals, and had a significant improvement in contrast-to-noise ratio between static tissue and blood (250.5 ± 66.6 vs. 91.9 ± 35.9). BB-MP2RAGE can quantify plaque or thrombus T1 relaxation time with blood flow signal suppression. DATA CONCLUSION: Accurate T1 mapping with sufficient blood flow suppression was achieved by BB-MP2RAGE. BB-MP2RAGE has the potential to quantitatively characterize atherosclerosis and venous thrombosis. LEVEL OF EVIDENCE: 1 TECHNICAL EFFICACY: Stage 1.

A study on the influencing factors and response strategies for young teachers from Taiwan to teach in universities in China: a push-pull-mooring model perspective.

Introduction: A growing number of Taiwanese teachers are choosing to teach at universities in mainland China, but their jobs are not always stable. Therefore, this study aims to investigate the factors infuencing young teachers from Taiwan to teach in universities in China. Methods: Twenty-seven young teachers from Taiwan with master's or doctoral degrees who were willing to apply to work at universities in China and who were already teaching in China were invited to conduct in-depth interviews to collect research data.The interview data were coded and analyzed according to the Push-Pull-Mooring (PPM) Model. Results and discussion: The results showed that the understanding of mainland Chinese universities among young Taiwanese teachers is not entirely consistent. Taiwanese teachers who previously studied in mainland China have a more comprehensive understanding of mainland Chinese universities, and some teachers have gained a superfcial understanding through academic exchanges between the two sides and information shared by friends.However,still,7% of the teachers have no understanding at all. Most young Taiwanese teachers indicate that they do not understand the talent recruitment policies of mainland Chinese universities. The push factors that infuence young teachers from Taiwan to teach at mainland universities are: Oversupply of teachers in Taiwan, poor environment for higher education in Taiwan, poor articulation of the cross-strait academic system, and four aspects of teacher retirement and re-employment in Taiwan. The pull factors are: Benefcial policies, salary, living environment, educational advantages and cultural dissemination in 5 areas. Mooring factors are divided into 3 aspects: personal factors, environmental factors and social factors.

Assessment of the anti-inflammatory mechanism of quercetin 3,7-dirhamnoside using an integrated pharmacology strategy.

Pouzolzia zeylanica (L.) Benn. is a Chinese herbal medicine widely used for its anti-inflammatory and pus-removal properties. To explore its potential anti-inflammatory mechanism, quercetin 3,7-dirhamnoside (QDR), the main flavonoid component of P. zeylanica (L.) Benn., was extracted and purified. The potential anti-inflammatory targets of QDR were predicted using network analysis. These potential targets were verified using molecular docking, molecular dynamics simulations, and in vitro experiments. Consequently, 342 potential anti-inflammatory QDR targets were identified. By analyzing the intersection between the protein-protein interaction and the Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways, we identified several potential protein targets of QDR, including RAC-alpha serine/threonine-protein kinase (AKT1), Ras-related C3 botulinum toxin substrate 1 (RAC1), nitric oxide synthase 3 (NOS3), serine/threonine-protein kinase mTOR (mTOR), epidermal growth factor receptor (EGFR), growth factor receptor-bound protein 2 (GRB2), and endothelin-1 receptor (EDNRA). QDR has anti-inflammatory activity and regulates immune responses and apoptosis through chemokines, Phosphatidylinositol 3-kinase 3(PI3K)/AKT, cAMP, T-cell receptor, and Ras signaling pathways. Molecular docking analysis showed that QDR has good binding abilities with AKT1, mTOR, and NOS3. In addition, molecular dynamics simulations demonstrated that the protein-ligand complex systems formed between QDR and AKT1, mTOR, and NOS3 have high dynamic stability, and their protein-ligand complex systems possess strong binding ability. In RAW264.7 macrophages, QDR significantly inhibited lipopolysaccharides (LPS)-induced inducible nitric oxide synthase expression, nitric oxide (NO) release and the generation of proinflammatory cytokines IL-6, IL-1ß, and TNF-α. QDR downregulated the expression of p-AKT1(Ser473)/AKT1 and p-mTOR (Ser2448)/mTOR, and upregulated the expression of NOS3, Rictor, and Raptor. This indicates that the anti-inflammatory mechanisms of QDR involve regulation of AKT1 and mTOR to prevent apoptosis and of NOS3 which leads to the release of endothelial NO. Thus, our study elucidated the potential anti-inflammatory mechanism of QDR, the main flavonoid found in P. zeylanica (L.) Benn.

The role of binocular disparity in the neural representation of multiple moving stimuli in the visual cortex.

A fundamental process of vision is to segment visual scenes into distinct objects and surfaces. Stereoscopic depth and visual motion cues are particularly important for segmentation. However, how the primate visual system uses depth and motion cues to segment multiple surfaces in 3-dimensional space is not well understood. We investigated how neurons in the middle temporal (MT) cortex represented two overlapping surfaces located at different depths and moved simultaneously in different directions. We recorded neuronal activities in MT of three male macaque monkeys while they performed discrimination tasks under different attention conditions. We found that neuronal responses to overlapping surfaces showed a robust bias toward the horizontal disparity of one of the two surfaces. For all animals, the disparity bias in response to two surfaces was positively correlated with the disparity preference of the neurons to single surfaces. For two animals, neurons that preferred the near disparities of single surfaces (near neurons) showed a near bias to overlapping stimuli, and neurons that preferred the far disparities (far neurons) showed a far bias. For the third animal, both near and far neurons showed a near bias, although the near neurons showed a stronger near bias than the far neurons. Interestingly, for all three animals, both near and far neurons showed an initial near bias relative to the average of the responses to the individual surfaces. Although attention can modulate neuronal response to better represent the attended surface, the disparity bias was still present when attention was directed away from the visual stimuli, indicating that the disparity bias cannot be explained by an attention bias. We also found that the effect of attention modulation of MT responses was consistent with object-based rather than feature-based attention. We proposed a model in which the pool size of the neuron population that weighs the responses to individual stimulus components can be variable. Our model is a novel extension of the standard normalization model and provides a unified explanation of the disparity bias across animals. Our results revealed the neural encoding rule for multiple moving stimuli located at different depths and showed new evidence of response modulation by object-based attention in MT. The disparity bias would allow subgroups of neurons to preferentially represent individual surfaces at different depths of multiple stimuli and therefore facilitate segmentation. Attention can further select a surface and enhance its neural representation.

Angulation error assessment for the trajectory in the anteroposterior and lateral fluoroscopic views during percutaneous endoscopic transforaminal lumbar discectomy.

BACKGROUND: Anteroposterior (AP) and lateral fluoroscopies are often used to evaluate the intraoperative location and angulation of the trajectory in percutaneous endoscopic transforaminal lumbar discectomy (PETLD). Although the location of the trajectory shown in fluoroscopy is absolutely accurate, the angulation is not always reliable. This study aimed to evaluate the accuracy of the angle shown in the AP and lateral fluoroscopic views. METHODS: A technical study was performed to assess the angulation errors of PETLD trajectories shown in AP and lateral fluoroscopic views. After reconstructing a lumbar CT image, a virtual trajectory was placed into the intervertebral foramen with gradient-changing coronal angulations of the cephalad angle plane (CACAP). For each angulation, virtual AP and lateral fluoroscopies were taken, and the cephalad angles (CA) of the trajectory shown in the AP and lateral fluoroscopic views, which indicated the coronal CA and the sagittal CA, respectively, were measured. The angular relationships among the real CA, CACAP, coronal CA, and sagittal CA were further demonstrated with formulae. RESULTS: In PETLD, the coronal CA is approximately equal to the real CA, with a small angle difference and percentage error, whereas the sagittal CA shows a rather large angle difference and percentage error. CONCLUSION: The AP view is more reliable than the lateral view in determining the CA of the PETLD trajectory.

Research on the impact of digital economy on Regional Green Technology Innovation: Moderating effect of digital talent Aggregation.

The digital economy is crucial to promoting green technology innovation and development. However, there needs to be more research on the relationship between the digital economy, digital talent aggregation (DTA), and green technology innovation (GTI). Therefore, based on the data from 30 provinces, municipalities, and autonomous regions in mainland China (excluding Tibet) from 2011 to 2020, this paper uses fixed effect, threshold effect, moderating effect model, and spatial econometric model to make an empirical analysis of this research direction. The results show that (1) there is a nonlinear relationship between the digital economy and green technology innovation (GTI). This effect has regional heterogeneity effects. In the central and western regions, the digital economy is more prominent in promoting green technology innovation (GTI). (2) Digital talent aggregation (DTA) has a negative moderating effect on the influence of the digital economy on promoting green technology innovation (GTI). (3) The negative spillover effect of the digital economy on local green technology innovation (GTI) will be intensified at the spatial level due to the accumulation of digital talents. Therefore, this paper suggests that the government should actively and reasonably develop the digital economy to promote green technology innovation (GTI). In addition, the government can implement a flexible talent introduction policy, strengthen talent quality education and talent service station construction.

The application of augmented reality in plastic surgery training and education: A narrative review.

Continuing problems with fewer training opportunities and a greater awareness of patient safety have led to a constant search for an alternative technique to bridge the existing theory-practice gap in plastic surgery training and education. The current COVID-19 epidemic has aggravated the situation, making it urgent to implement breakthrough technological initiatives currently underway to improve surgical education. The cutting edge of technological development, augmented reality (AR), has already been applied in numerous facets of plastic surgery training, and it is capable of realizing the aims of education and training in this field. In this article, we will take a look at some of the most important ways that AR is now being used in plastic surgery education and training, as well as offer an exciting glimpse into the potential future of this field thanks to technological advancements.

Global, regional and national burden of endocrine, metabolic, blood and immune disorders 1990-2019: a systematic analysis of the Global Burden of Disease study 2019.

Background: Endocrine, metabolic, blood and immune disorders (EMBID) is a vital public health problem globally, but the study on its burden and global trends was scarce. We aimed to evaluate the global burden of disease and trends in EMBID from 1990 to 2019. Methods: We extracted the data of EMBID-related on death cases, Age-standardized death rates (ASDRs), disability-adjusted life-years (DALYs), Age-standardized DALY rates, years of life lost (YLLs), Age-standardized YLL rates, years lived with disability (YLDs) and Age-standardized YLD rates between 1990 and 2019 from the Global Burden of Disease 2019, by sex, age, and year at the global and geographical region levels. The Annual rate of change was directly extracted from Global Health Data Exchange (GHDx) and we also calculated the age-related age-standardized rate (ASR) to quantify trends in EMBID-related deaths, DALYs, YLLs and YLDs. Result: Globally, the EMBID-related ASDRs showed an increasing trend, whereas the DALYs ASR, YLLs ASR and YLDs ASR were decreased between 1990 to 2019. Furthermore, High-income North America and Southern Sub-Saharan Africa had the highest both ASDRs and DALYs ASR, and Southern Sub-Saharan Africa and Caribbean had the highest both YLDs ASR and YLLs ASR in 2019. Males had a higher EMBID-related ASDRs than females, but the DALYs ASR in females were higher than males. The burden of EMBID was higher in older-aged compared to other age groups, especially in developed regions. Conclusion: Although EMBID-related ASRs for DALYs-, YLLs- and YLDs declined at the global level from 1990 to 2019, but the ASDRs was increasing. This implied high healthcare costs and more burden of ASDRs due to EMBID in the future. Therefore, there was an urgent need to adopt geographic targets, age-specific targets, prevention strategies and treatments for EMBID to reduce negative health outcomes globally.

Geriatric assessment for older patients with breast cancer: A single-institution study.

Introduction: Although geriatric assessment (GA) has been used for a long time in the field of geriatrics and internal medicine, there are few studies on its application in the field of breast surgery. Therefore, the utility of specific GA domains for the assessment of older patients with breast cancer remains unclear. The aim of the present study was to evaluate the association between specific GA domains and the survival rate of older patients with breast cancer. Methods: We used the database of Peking Union Medical College Hospital to identify older patients who were newly diagnosed with breast cancer between 2012 and 2018 and retrospectively analysed the data of 541 patients aged ≥65 years. Patients with metastatic cancer and those with missing vital status data were excluded. The primary outcomes were overall survival (OS) and breast cancer-specific survival. The GA domains used in this study included functional status, comorbidities, and psychological state. Multivariate regression analysis was used to estimate hazard ratios for these three domains. Results: After a median follow-up of 72 months, we observed a significant relationship between functional impairment and mortality (adjusted HR: 3.06, 95% confidence interval [CI]: 1.83-5.10, P<0.001). Similarly, patients with severe comorbidities (adjusted HR: 2.35; 95% CI: 1.16-4.75, P=0.017) and an impaired psychological state (adjusted HR: 2.82, 95% CI: 1.45-5.50, P=0.002) showed worse OS rates. Accordingly, addition of the three GA domains to the basic model, which included age, tumour stage, lymph node stage, and intrinsic molecular subtype as baseline variables, yielded higher C-statistics for mortality analysis (from 0.713 to 0.740). Conclusion: To our knowledge, this is the first study to include specific GA domains in a prognostic model for older patients with breast cancer in China. Three domains, namely functional status, comorbidities, and psychological state, should be considered for survival analyses in this particular population. The full model including these three GA domains may be more accurate in predicting the survival of older patients with breast cancer.

Rapid decline of carbon monoxide emissions in the Fenwei Plain in China during the three-year Action Plan on defending the blue sky.

The Fenwei Plain is one of China's most polluted regions, with poor atmospheric dispersion conditions and an outdated energy structure. After implementing multiple policies in recent years, significant reductions in air pollutant concentrations were observed. In this study, based on the Lagrangian-Bayesian inversion framework FLEXINVERT, we constructed a variable resolution inversion system focusing on the Fenwei Plain and inferred the carbon monoxide (CO) emissions using in-situ atmospheric CO observations from April 2014 to March 2020. We analyzed the spatiotemporal variations of the CO emissions and discussed their causes, especially the effect of the "Three-year Action Plan on Defending the Blue Sky" (TAPDBS). Before the policy, CO emissions temporarily increased, and the overall decrease in CO emissions per unit of Gross Domestic Product (GDP) slowed down. When the policy was implemented, CO emission fluxes declined sharply, with an average drop of 28%, accompanied by an even higher 37% decrease of CO emission per GDP. The reasons for the decline in CO emissions in Shanxi, Shaanxi and Henan are diverse. The decrease in energy intensity is the reason for CO emission reduction in Shannxi and Henan province but not in Shanxi province. This research fills the gap in emission information in recent years and confirms that TAPDBS has brought a breakthrough in both economic development and air quality protection in the Fenwei Plain.

Transboundary watershed pollution control analysis for pollution abatement and ecological compensation.

The effect of watershed environmental management is closely related to the cooperation modes of upstream and downstream regions pollution control, but the existing literature rarely considers it. Additionally, based on the cumulative and cross-border impacts of pollution discharge in different regions, it is appropriate to use dynamic game theory to study pollution control problems. Therefore, this paper develops a dynamic multi game model to analyze the pollution control game behavior between the upstream and downstream regions along the basin in three scenarios: non-cooperation, pollution abatement cooperation, and ecological compensation. By using the optimal control method, we get the dynamic equilibrium strategies of the government and enterprises and pollution stock trajectories under different cooperation modes. The results show that pollution abatement cooperation can improve the environment, but may not improve social welfare; the eco-compensation mechanism is not always conducive to the improvement of the environment and welfare of the basin, and the effective conditions of implementing ecological compensation is put forward. In addition, we also analyzed the impact of consumer preferences, pollution treatment efficiency, and other parameters on governments and enterprises decision-making and the social welfare. These conclusions provide a theoretical basis for cooperative governance scheme for transboundary pollution in river basin.

Oil-based drilling cuttings pyrolysis residues at a typical shale gas drilling field in Chongqing: pollution characteristics and environmental risk assessment.

With the rapid development of unconventional natural gas such as shale gas, many oil-based drilling cuttings and their pyrolysis residues are produced, which are defined as hazardous wastes. In this paper, the pollution status of petroleum hydrocarbons and the leaching toxicity of eight heavy metals (Pb, Cr, Zn, Mn, Cu, Cd, Ni, and Hg) in the pyrolysis residues were studied. The ecological risk and human health risk were evaluated in the scenario where pyrolytic residues were used for paving as building materials. The results showed that the content of petroleum hydrocarbons in the pyrolysis residues was 7643.16 ± 169.67 mg/kg. Zn in the pyrolysis residues was extremely polluted, Pb was moderately polluted, Cr, Cu, As were slightly polluted, and the leaching toxicity was far below the standard value. In the ecological risk assessment, the comprehensive potential ecological risk of multiple heavy metals in the pyrolysis residues was low. On the other hand, the pyrolysis residues had no non-carcinogenic risk to adults under the condition of paving, but there was an obvious non-carcinogenic risk to children, and the carcinogenic risk of adults and children was within an acceptable range. In addition, aiming at reducing the health risk of the population, suggestions were put forward to reduce the exposure risk of the population and the content of heavy metals in the pyrolysis residue, which provided a scientific reference for the standardized management of the pyrolysis residue of oil-based drilling cuttings and the research on the corresponding treatment process.

Association between sociodemographic status and the T2DM-related risks in China: implication for reducing T2DM disease burden.

Objective: Analyzing the association between sociodemographic status and the type 2 diabetes mellitus (T2DM)-related risks in China to reduce the disease burden of T2DM. Methods: We downloaded data from the Global Burden of Disease Study 2019 to estimate the disease burden of T2DM in China. Secondary analyses were performed by year, age, gender, summary exposure value (SEV), and sociodemographic index (SDI). Results: In China, it is estimated that 3.74 (3.44-4.10) million incidence, 90.0 (82.3-98.5) million prevalence, 168.4 (143.2-194.0) thousand deaths, and 9.6 (7.6-11.9) million DALYs occurred in 2019, showing an increase of 96.8, 156.7, 162.8, and 145.4% compared to 1990. An inverse U-shaped curve was observed for the correlations between T2DM-related burden and SDI. A heavier burden was found in males. The top four risk factors were high body mass index (HBMI), dietary risks, air pollution and tobacco. HBMI, as the key risk, accounted for half of the disease burden of T2DM in China. Lower degree of SEV and higher level of attributable T2DM-related burden could be found in main risks, meaning their critical role of them in the development and progression of T2DM. An inverse U-shaped curve could be found in the association between age-standardized incidence, mortality, DALYs rate, and SDI. Conclusion: The disease burden of T2DM has rapidly increased in China. Gender disparities, different age distributions and inconsistent socioeconomic levels all played an important role in it. The key risk was HBMI. With the improvement of socioeconomic level, the main risk factors for T2DM have changed from environmental factors to lifestyle factors. Targeted control and preventative strategies to address adjustable risk factors could put an end to this soaring burden.

Using machine learning to aid treatment decision and risk assessment for severe three-vessel coronary artery disease.

BACKGROUND: Three-vessel disease (TVD) with a SYNergy between PCI with TAXus and cardiac surgery (SYNTAX) score of ≥ 23 is one of the most severe types of coronary artery disease. We aimed to take advantage of machine learning to help in decision-making and prognostic evaluation in such patients. METHODS: We analyzed 3786 patients who had TVD with a SYNTAX score of ≥ 23, had no history of previous revascularization, and underwent either coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI) after enrollment. The patients were randomly assigned to a training group and testing group. The C4.5 decision tree algorithm was applied in the training group, and all-cause death after a median follow-up of 6.6 years was regarded as the class label. RESULTS: The decision tree algorithm selected age and left ventricular end-diastolic diameter (LVEDD) as splitting features and divided the patients into three subgroups: subgroup 1 (age of ≤ 67 years and LVEDD of ≤ 53 mm), subgroup 2 (age of ≤ 67 years and LVEDD of > 53 mm), and subgroup 3 (age of > 67 years). PCI conferred a patient survival benefit over CABG in subgroup 2. There was no significant difference in the risk of all-cause death between PCI and CABG in subgroup 1 and subgroup 3 in both the training data and testing data. Among the total study population, the multivariable analysis revealed significant differences in the risk of all-cause death among patients in three subgroups. CONCLUSIONS: The combination of age and LVEDD identified by machine learning can contribute to decision-making and risk assessment of death in patients with severe TVD. The present results suggest that PCI is a better choice for young patients with severe TVD characterized by left ventricular dilation.