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Hepatocellular carcinoma (HCC) is one of the most common malignancies and is a major cause of cancer-related mortalities worldwide (Forner et al., 2018; He et al., 2023). Sarcopenia is a syndrome characterized by an accelerated loss of skeletal muscle (SM) mass that may be age-related or the result of malnutrition in cancer patients (Cruz-Jentoft and Sayer, 2019). Preoperative sarcopenia in HCC patients treated with hepatectomy or liver transplantation is an independent risk factor for poor survival (Voron et al., 2015; van Vugt et al., 2016). Previous studies have used various criteria to define sarcopenia, including muscle area and density. However, the lack of standardized diagnostic methods for sarcopenia limits their clinical use. In 2018, the European Working Group on Sarcopenia in Older People (EWGSOP) renewed a consensus on the definition of sarcopenia: low muscle strength, loss of muscle quantity, and poor physical performance (Cruz-Jentoft et al., 2019). Radiological imaging-based measurement of muscle quantity or mass is most commonly used to evaluate the degree of sarcopenia. The gold standard is to measure the SM and/or psoas muscle (PM) area using abdominal computed tomography (CT) at the third lumbar vertebra (L3), as it is linearly correlated to whole-body SM mass (van Vugt et al., 2016). According to a "North American Expert Opinion Statement on Sarcopenia," SM index (SMI) is the preferred measure of sarcopenia (Carey et al., 2019). The variability between morphometric muscle indexes revealed that they have different clinical relevance and are generally not applicable to broader populations (Esser et al., 2019).

Comparative study of different sewage sludge incineration treatments based on environmental and economic life cycle assessment.

Incineration is one of the most widely used treatments in the field of sewage sludge disposal. However, the choice of sewage sludge incineration process is still controversial. In this study, the comparative life cycle assessment of sewage sludge incineration processes, including the mono-incineration, co-incineration in coal-fired power plants and co-incineration in municipal solid waste (MSW) incineration plants, was carried out from the perspective of environment, carbon footprint and economy. The environmental assessment results show that terrestrial ecotoxicity, freshwater ecotoxicity, marine ecotoxicity, human carcinogenic toxicity and human non-carcinogenic toxicity are the most significant environmental impacts. And the environmental performance of co-incineration in coal-fired power plants is the best. Moreover, the environmental impact is most sensitive to the dehydrant, electricity and fly ash chelating agent. Co-incineration in MSW incineration plants has the lowest carbon emissions, with only 70.50% and 82% of the carbon emissions from mono-incineration and co-incineration in coal-fired power plants, respectively. Furthermore, sewage sludge mono-incineration has the highest disposal costs because of the higher depreciation and solid waste disposal costs. The comprehensive evaluation results reveal that the optimization should focus on the selection of dehydrant and fly ash chelating agent, as well as the improvement of the equipment efficiency.

Assessment of the electron-proton energy relaxation rates extracted from molecular dynamics simulations in weakly-coupled hydrogen plasmas.

Electron-proton energy relaxation rates are assessed using molecular dynamics (MD) simulations in weakly-coupled hydrogen plasmas. To this end, we use various approaches to extract the energy relaxation rate from MD-simulated temperatures, and we find that existing extracting approaches may yield results with a sizable discrepancy larger than the variance between analytical models, which is further verified by well-known case studies. Present results show that two of the extracting approaches can produce identical results, which is attributed to a proper treatment of relaxation evolution. To discriminate the use of various methods, an empirical criterion with respect to initial plasma temperatures is proposed, which can self-consistently explain the cases considered. In addition, for a transient electron-proton plasma, we show that it is possible to extrapolate the Coulomb logarithm from that derived by initial plasma parameters in a single MD calculation, which is reasonably consistent with previous MD data. Our results are helpful to obtain accurate MD-based energy relaxation rates.

Visual assessment and quantitative analysis of bone marrow edema in young and middle-aged versus elderly patients with vertebral compression fracture by spectral CT.

BACKGROUND: For the diagnosis of bone marrow edema (BME), spectral computed tomography (CT) has emerged as a promising technique. PURPOSE: To study the different performances of spectral CT in the diagnosis of vertebral BME in young and middle-aged versus elderly patients. MATERIAL AND METHODS: Magnetic resonance imaging (MRI) was used as the gold standard. To determine the existence of BME, spectral CT color-coded images of the vertebral bodies of 82 patients with vertebral compression fractures (VCFs) were visually inspected. A quantitative analysis of the spectral CT vertebral water concentration in the diagnosis of BME was performed using a receiver operating characteristic (ROC) curve. Patients were divided into two groups for comparison: the young and middle-aged group; and the elderly group. RESULTS: The sensitivity and specificity for visual assessment were 83.7% and 98.3%, respectively, in the young and middle-aged group and 96.8% and 98.2%, respectively, in the elderly group. The elderly group had a higher sensitivity than the young and middle-aged group (P < 0.05). With a threshold of 1046.2 mg/cm3, the ROC curve for the young and middle-aged group displayed an area under the curve (AUC) of 0.870, sensitivity of 86.0%, and specificity of 81.4%. The threshold of 1031.4 mg/cm3 yielded a sensitivity of 95.2% and a specificity of 98.4%, and the AUC of the elderly group was 0.997. The elderly group had a higher level of specificity than the young and middle-aged group (P < 0.05). CONCLUSION: Spectral CT can reliably diagnose BME in VCFs, and it performs better in elderly people than in young and middle-aged people.

Quantitative assessment of the association of polymorphisms in the metallothionein 2A gene with cancer risk.

OBJECTIVE: The aim of the study was to quantitatively assess the association of metallothionein 2A (MT2A) polymorphisms rs28366003 and rs1610216 with cancer risk. METHODS: Crude odd ratios (OR) with 95% confidence intervals (CI) were used to estimate associations of the polymorphisms with cancer risk. RESULTS: Six eligible case-control studies with 1899 cases and 2437 controls focused on rs28366003, and three of those six studies, with 548 cases and 926 controls, additionally focused on rs1610216. Pooled analysis showed that MT2A rs28366003 and rs1610216 were associated with cancer risk: (AG + GG) vs. AA, OR = 2.67; GG vs. (AG + AA), OR = 5.97; GG vs. AA, OR = 6.80; AG vs. AA, OR = 2.46; G vs. A, OR = 2.67 for rs28366003; and CC vs. (TC+TT), OR = 2.51; CC vs. TT, OR = 2.42 for rs1610216. Subgroup analysis based on ethnicity showed a significant association of rs28366003 with cancer risk in Asian and Caucasian populations. However, a significant association of rs1610216 with cancer risk was found only in the Asian population. CONCLUSION: MT2A rs28366003 and rs1610216 polymorphisms were associated with cancer risk and might serve as genetic biomarkers for predicting cancer risk. However, larger studies are needed to confirm these findings.

Investigating the spatiotemporal differences and influencing factors of green water use efficiency of Yangtze River Economic Belt in China.

Combining freshwater consumption and wastewater emissions into a unified analysis framework and utilizing the epsilon-based measure (EBM) model with the characteristics of radial model and non-radial model, this paper evaluates green water use efficiency (GWUE) of 11 provincial-regions in the Yangtze River Economic Belt (YREB) and investigates its spatiotemporal differences during the period 2005-2014, on basis of which the contribution rate of each input-specific green water use inefficiency in the overall green water use efficiency and the potential of freshwater-saving and wastewater emissions reduction are also calculated. The Theil index is used to explore the sources of the provincial gap of green water use inefficiency, and a random-effect panel Tobit model is applied to test the impact of the influencing factors of green water use inefficiency in the YREB. It is found that green water use inefficiency of the YREB is relatively low and regional differences is significant during the sample period, indicating a large potential of water-saving and water pollution reduction, and narrowing BGAP and WGAP of the Upstream is the key for improving green water use inefficiency in the YREB. The panel Tobit regression results show that economic development, technological innovation, water use structure, water resources endowment, environmental regulation and regional differences all play positive/negative effects on green water use inefficiency in the YREB, while these factors' influencing direction, degree and significance are significantly different. The conclusions of our study can provide considerably valuable information for the YREB to reserve water resources and reduce wastewater emissions.

Quantitative assessment of the association between GRIA1 polymorphisms and migraine risk.

PURPOSE: The association between GRIA1 rs548294 G>A and rs2195450 C>T polymorphisms and migraine risk has been reported in several case-control studies. However, the results of studies are inconsistent. Thus, we conducted a meta-analysis to more precisely estimate the association of the two polymorphisms with migraine risk. METHODS: Eligible studies were retrieved and screened from the online databases (EMBASE, PubMed, Web of Science, Wanfang, and Chinese National Knowledge Infrastructure). The pooled odds ratio (OR) with corresponding 95.0% confidence intervals (CIs) was assessed using random- or fixed-effects model. RESULTS: A total of 1233 cases and 1374 controls from four eligible studies were included. The pooled analysis showed that GRIA1 rs548294 G>A polymorphism was not significantly associated with migraine risk. GRIA1 rs2195450 C>T polymorphism was significantly associated with migraine risk under heterozygous model (CT vs. CC, OR = 1.23, 95%CI = 1.02-1.48, PZ = 0.03). Further subgroup analysis based on ethnicity showed a significant association of GRIA1 rs2195450 C>T polymorphism with migraine risk in Asian population, but not in Caucasian population. CONCLUSIONS: Our results indicates that GRIA1 rs2195450 C>T polymorphism is significantly associated with migraine risk. However, the number of studies included in the meta-analysis was small. Thus, more high quality case-control studies with a large sample size are still required to confirm these findings.

Diagnostic Value of Preoperative Needle Biopsy for Tumor Grading Assessment in Hepatocellular Carcinoma.

BACKGROUND: Needle core biopsy (NCB) is one of the most widely used and accepted methods for the diagnosis of focal hepatic lesions. Although many studies have assessed the diagnostic accuracy of NCB in predicting the tumor grade, it is still under debate. OBJECTIVE: To identify the influence of number of biopsies on NCB diagnostic accuracy. METHODS: 153 patients with HCC were selected from patients who received preoperative NCB under the guidance of ultrasonography in our hospital. The diagnostic reference standard was the surgical pathologic diagnosis. RESULTS: Using a 3-tier grading scheme (well, moderate and poor), the accuracy of NCB has no significant differences among different number of passes in HCC ≤5 cm. For HCC >5≤8 cm, the increasing number of passes could increase the diagnostic accuracy (63.3%, 81.8%, and 84.8% for passes one, two, and three, respectively). While in HCC>8 cm, the diagnostic accuracy of passes one, two, and three were 62.1%, 69%, and 75.8%, respectively. CONCLUSIONS: The accuracy of NCB in assessing tumor grading associated with tumor size and number of passes. Meanwhile, a minimum of two passes should be performed to get better accuracy in patients with HCC >5 cm.

Management of choledocholithiasis: comparison between laparoscopic common bile duct exploration and intraoperative endoscopic sphincterotomy.

AIM: Choledocholithiasis is present in 5 to 10 percent of patients who have cholelithiasis. In the area of laparoscopic cholecystectomy (LC), laparoscopic common bile duct exploration (LCBDE) and intraoperative endoscopic sphincterotomy (IOES) have been used to treat choledocholithiasis. The purpose of this study was to compare the clinical outcomes and hospital costs of LCBDE with IOES. METHODS: Between November 1999 and October 2002, patients with choledocholithiasis undergoing LC plus LCBDE (Group A, n=45) were retrospectively compared to those undergoing LC plus IOES (Group B, n=57) at a single institution. RESULTS: Ductal stone clearance rates were equivalent for the two groups (88% versus 89%, P=0.436). The conversion rate was higher for Group B (8.8% versus 4.4%, P=0.381), as was the morbidity (12.3% versus 6.7%, P=0.336). There were no other significant differences between the two groups. The complications were mainly related to endoscopic sphincterotomy (ES), and the hospital costs were significantly increased in this subset of Group B (median, 23,910 versus 14,955 RMB yuan, P=0.03). Although hospital stay was longer in Group A (median, 7 versus 6 days, P=0.041), the patients in Group A had a significantly decreased cost of hospitalization compared with those in Group B (median, 11,362 versus 15,466 RMB yuan, P=0.000). CONCLUSION: The results demonstrate equivalent ductal stone clearance rates for the two groups. LCBDE management appears safer, and is associated with a significantly decreased hospital cost. The findings suggest LCBDE for choledocholithiasis is a better option.