Improving the Performance of Si/PEDOT:PSS Hybrid Solar Cells with More Economical and Environmentally Friendly Alcohol Ether Solvents.

The photoelectric characteristics of poly(3,4-ethylenedioxythiophene):polystyrene sulfonate (PEDOT:PSS) films significantly affect the power conversion efficiency and stability of Si/PEDOT:PSS hybrid solar cells. In this paper, we investigated PEDOT:PSS modification with alcohol ether solvents (dipropylene glycol methyl ether (DPM) and propylene glycol phenyl ether (PPH)). The reduction of PSS content and the transformation of the PEDOT chain from benzene to a quinone structure in PEDOT:PSS induced by doping with DPM or PPH are the reasons for the improved conductivity of PEDOT:PSS films. DPM and PPH doping improves the quality of silicon with the PEDOT:PSS heterojunction and silicon surface passivation, thereby reducing the surface recombination of charge carriers, which improves the photovoltaic performance of Si/PEDOT:PSS solar cells. Comparing the power conversion performance (PCE) and air stability of Si/PEDOT:PSS solar cells with DPM (13.24%), DPH (13.51%), ethylene glycol (EG, 13.07%), and dimethyl sulfoxide (DMSO, 12.62%), it is suggested that doping with DPM and DPH can replace DMSO and EG to enhance the performance of Si/PEDOT:PSS solar cells. The EG and DMSO solvents not only have a certain toxicity to the human body but also are not environmentally friendly. In comparison to DMSO and EG, DPM and DPH are more economical and environmentally friendly, helping to reduce the manufacturing cost of Si/PEDOT:PSS solar cells and making them more conducive to their commercial applications.

COPD Assessment Test and risk of readmission in patients with bronchiectasis: a prospective cohort study.

Introduction: Readmission following bronchiectasis exacerbation is a common and challenging clinical problem and few simple predictive tools exist. The COPD Assessment Test (CAT) is an easy-to-use questionnaire. This study aims to evaluate the predictive value of CAT scores in determining the risk of readmission in patients with bronchiectasis exacerbation. Methods: We conducted a prospective cohort study in 106 bronchiectasis patients admitted with exacerbation. All patients completed the CAT at admission and at discharge. Patients were followed-up for 12 months to collect data on readmission. The area under the curve was used to measure the predictive value of CAT at admission, CAT at discharge and change in CAT for readmission due to bronchiectasis exacerbation. Results: 46 patients were readmitted for bronchiectasis exacerbation within 12 months. High CAT at admission was an independent risk factor for readmission within 12 months in patients with acute exacerbation of bronchiectasis (hazard ratio 3.201, 95% CI 1.065-9.624; p<0.038) after adjustment for confounding variables. The cut-off value of CAT at admission and CAT at discharge to predict 12-month readmission in patients with acute exacerbation of bronchiectasis was 23.5 (sensitivity 62.2%, specificity 83.6%) and 15.5 (sensitivity 52.2%, specificity 87.0%). Conclusions: CAT at admission is a strong predictor of readmission in patients with bronchiectasis exacerbation.

Non-targeted analysis based on quantitative prediction and toxicity assessment for emerging contaminants in tire particle leachates.

Non-targeted analysis (NTA) has great potential to screen emerging contaminants in the environment, and some studies have conducted in-depth investigation on environmental samples. Here, we used a NTA workflow to identify emerging contaminants in used tire particle (TP) leachates, followed by quantitative prediction and toxicity assessment based on hazard scores. Tire particles were obtained from four different types of automobiles, representing the most common tires during daily transportation. With the instrumental analysis of TP leachates, a total of 244 positive and 104 negative molecular features were extracted from the mass data. After filtering by a specialized emerging contaminants list and matching by spectral databases, a total of 51 molecular features were tentatively identified as contaminants, including benzothiazole, hexaethylene glycol, 2-hydroxybenzaldehyde, etc. Given that these contaminants have different mass spectral responses in the mass spectrometry, models for predicting the response of contaminants were constructed based on machine learning algorithms, in this case random forest and artificial neural networks. After five-fold cross-validation, the random forest algorithm model had better prediction performance (MAECV = 0.12, Q2 = 0.90), and thus it was chosen to predict the contaminant concentrations. The prediction results showed that the contaminant at the highest concentration was benzothiazole, with 4,875 µg/L in the winter tire sample. In addition, the joint toxicity assessment of four types of tires was conducted in this study. According to different hazard levels, hazard scores increasing by a factor 10 were developed, and hazard scores of all the contaminants identified in each TP leachate were summed to obtain the total hazard score. All four tires were calculated to have relatively high risks, with winter tires having the highest total hazard score of 40,751. This study extended the application of NTA research and led to the direction of subsequent targeting studies on highly concentrated and toxic contaminants.

3D-printed dosage forms for oral administration: a review.

Oral administration is the most commonly used form of treatment due to its advantages, including high patient compliance, convenient administration, and minimal preparation required. However, the traditional preparation process of oral solid preparation has many defects. Although continuous manufacturing line that combined all the unit operations has been developed and preliminarily applied in the pharmaceutical industry, most of the currently used manufacturing processes are still complicated and discontinuous. As a result, these complex production steps will lead to low production efficiency and high quality control risk of the final product. Additionally, the large-scale production mode is inappropriate for the personalized medicines, which commonly is customized with small amount. Several attractive techniques, such as hot-melt extrusion, fluidized bed pelletizing and spray drying, could effectively shorten the process flow, but still, they have inherent limitations that are challenging to address. As a novel manufacturing technique, 3D printing could greatly reduce or eliminate these disadvantages mentioned above, and could realize a desirable continuous production for small-scale personalized manufacturing. In recent years, due to the participation of 3D printing, the development of printed drugs has progressed by leaps and bounds, especially in the design of oral drug dosage forms. This review attempts to summarize the new development of 3D printing technology in oral preparation and also discusses their advantages and disadvantages as well as potential applications.

A New Assessment Method of Vitiligo by Combination of Dermoscopy and Reflectance Confocal Microscopy.

Purpose: The aim is to investigate the application value of dermoscopy combined with reflectance confocal microscopy (RCM) in assessing vitiligo disease activity and treatment response. Patients and Methods: We enrolled 279 patients with vitiligo and evaluated the disease activity by Vitiligo Disease Activity (VIDA) score, dermoscopy, RCM and dermoscopy combined with RCM respectively. The sensitivity and specificity of different assessment techniques were compared with VIDA score by the differences and consistency. The different characteristics of dermoscopy and RCM with different treatment responses were also analyzed. Results: The results showed that the sensitivity and specificity of dermoscopy combined RCM were higher than RCM or dermoscopy alone (P values less than 0.05). In the repigmentation process, leukotrichia, pigment network absent and perilesional hyperpigmentation under dermoscopy at the baseline suggested a poor treatment response, while the incompletely disappearing pigment rings under RCM and perifollicular hyperpigmentation under dermoscopy indicated a good treatment response. We also found the proportion of patients with telangiectasia, increased pigment at the lesions and around the hair follicles was significantly higher in the good treatment response group than that in the poor one by dermoscopy (χ2 = 4.423, 32.471, 4.348, P = 0.035 0.000, 0.037) and by RCM the proportion of patients with both increased pigment granules and dendritic melanocytes in the good treatment response group was higher than that in the poor one (χ2 = 38.215, 5.283, P = 0.000, 0.022, respectively). Conclusion: With the higher sensitivity and specificity than dermoscopy or RCM alone, a combination of dermoscopy and RCM may be a new more accurate measure to assess the vitiligo disease activity and the treatment response.

Blinding assessment in clinical trials of traditional Chinese medicine: Exploratory principles and protocol.

As one of the key components of clinical trials, blinding, if successfully implemented, can help to mitigate the risks of implementation bias and measurement bias, consequently improving the validity and reliability of the trial results. However, successful blinding in clinical trials of traditional Chinese medicine (TCM) is hard to achieve, and the evaluation of blinding success through blinding assessment lacks established guidelines. Taking into account the challenges associated with blinding in the TCM field, here we present a framework for assessing blinding. Further, this study proposes a blinding assessment protocol for TCM clinical trials, building upon the framework and the existing methods. An assessment report checklist and an approach for evaluating the assessment results are presented based on the proposed protocol. It is anticipated that these improvements to blinding assessment will generate greater awareness among researchers, facilitate the standardization of blinding, and augment the blinding effectiveness. The use of this blinding assessment may further advance the quality and precision of TCM clinical trials and improve the accuracy of the trial results. The blinding assessment protocol will undergo continued optimization and refinement, drawing upon expert consensus and experience derived from clinical trials. Please cite this article as: Wang XC, Liu XY, Shi KL, Meng QG, Yu YF, Wang SY, Wang J, Qu C, Lei C, Yu XP. Blinding assessment in clinical trials of traditional Chinese medicine: Exploratory principles and protocol. J Integr Med. 2023; 21(6): 528-536.

Toward Minute-Level DNA Computing: An Ultrafast, Cost-Effective, and Universal System for Lighting Up Various Concurrent DNA Logic Nanodevices (CDLNs) and Concatenated Circuits.

DNA logic nanodevices are powerful tools for both molecular computing tasks and smart bioanalytical applications. Nevertheless, the hour-level operation time and high cost caused by the frequent redesign/reconstruction of gates, tedious strand-displacement reaction, and expensive labeled probes (or tool enzymes) in previous works are ineluctable drawbacks. Herein, we report an ultrafast and cost-effective system for engineering concurrent DNA logic nanodevices (CDLNs) by combining polythymine CuNCs with SYBR Green I (SG I) as universal dual-output producers. Particularly, benefiting from the concomitant minute-level quick response of both unlabeled illuminators and the exquisite strand-displacement-free design, all CDLNs including contrary logic pairs (YES∧NOT, OR∧NOR, and Even∧Odd number classifier), noncontrary ones (IDE∧IMP, OR∧NAND), and concatenated circuits are implemented in just 10 min via a "one-stone-two-birds" method, resulting in only 1/12 the operation time and 1/4 the cost needed in previous works, respectively. Moreover, all of them share the same threshold value, and the dual output can be easily visualized by the naked eye under a portable UV lamp, indicating the universality and practicality of this system. Furthermore, by exploiting the "positive/negative cross-verification" advantages of concurrent contrary logic, the smart in vitro analysis of the polyadenine strand and its polymerase is realized, providing novel molecular tools for the early diagnosis of cancer-related diseases.

Assessment of Carbon Sequestration Capacity of E. ulmoides in Ruyang County and Its Ecological Suitability Zoning Based on Satellite Images of GF-6.

Eucommia ulmoides Oliver. (E. ulmoides) is a species of small tree native to China. It is a valuable medicinal herb that can be used to treat Alzheimer's disease, diabetes, hypertension, and other diseases. In addition, E. ulmoides is a source of rubber. It has both medicinal and ecological value. As ecological problems become increasingly prominent, accurate information on the cultivated area of E. ulmoides is important for understanding the carbon sequestration capacity and ecological suitability zoning of E. ulmoides. In previous tree mapping studies, no studies on the spectral characteristics of E. ulmoides and its remote sensing mapping have been seen. We use Ruyang County, Henan Province, China, as the study area. Firstly, using the 2021 Gao Fen-6 (GF-6) Wide Field of View (WFV) time series images covering the different growth stages of E. ulmoides based on the participation of red-edge bands, several band combination schemes were constructed. The optimal time window to identify E. ulmoides was selected by calculating the separability of E. ulmoides from other land cover types for different schemes. Secondly, a random forest algorithm based on several band combination schemes was investigated to map the E. ulmoides planting areas in Ruyang County. Thirdly, the annual NPP values of E. ulmoides were estimated using an improved Carnegie Ames Stanford Approach (CASA) to a light energy utilization model, which, in turn, was used to assess the carbon sequestration capacity. Finally, the ecologically suitable distribution zone of E. ulmoides under near current and future (2041-2060) climatic conditions was predicted using the MaxEnt model. The results showed that the participation of the red-edge band of the GF-6 data in the classification could effectively improve the recognition accuracy of E. ulmoides, making its overall accuracy reach 96.62%; the high NPP value of E. ulmoides was mainly concentrated in the south of Ruyang County, with a total annual carbon sequestration of 540.104835 t CM-2·a-1. The ecological suitability zone of E. ulmoides can be divided into four classes: unsuitable area, low suitable area, medium suitable area, and high suitable area. The method proposed in this paper applies to the real-time monitoring of E. ulmoides, highlighting its potential ecological value and providing theoretical reference and data support for the reasonable layout of E. ulmoides.

Does energy-consuming right trading have double dividend effect on firm's economic performance and carbon emission?

Whether the market-based environmental regulation policy can achieve a win-win situation of economic growth and carbon emission reduction has always been an academic controversial topic. Taking the pilot policy of energy-consuming right trading (ECRT) of China in 2016 as a quasi-natural experiment, this paper uses the difference-in-differences (DID) method to investigate the policy impact of ECRT on the economic performance and carbon emissions of firms. An economy-environment composite index has been conducted for testing double dividend effect of ECRT. The empirical results show that ECRT can improve the economic performance and reduce carbon emissions of firms significantly. The double dividend effect is more significant in high-carbon emission firms, non-state-owned firms and prior to COVID-19 pandemic. ECRT policy has Porter innovation mechanism, in which innovation input is the main contribution of economic dividend effect and green technology innovation is the main contribution of environmental dividend effect. The conclusions of this paper provide empirical evidence and policy implications for realizing the common development of economy and environment, accelerating the process of emission reduction and building a national energy trading market.

The effect of entrepreneurship education on the entrepreneurial intention of different college students: Gender, household registration, school type, and poverty status.

Entrepreneurship education (EE) is a crucial link to promoting college students' entrepreneurship, which reduces unemployment, economic development, and poverty. Based on a sample of Chinese college students, this study uses a logistic model to investigate the effect of EE on entrepreneurial intention (EI). It focuses on evaluating the impact of EE on the EI of different groups of college students from the perspectives of gender, household registration, school type, and poverty status. Benchmark regression results show that EE has a significant positive impact on the EI of students. The heterogeneity analysis has the following findings. First, EE has a more significant impact on women's EI, which can reduce the entrepreneurial gap between women and men. Second, EE is more effective in improving the EI of urban students, which will further widen the gap between urban and rural students in entrepreneurship. Third, EE has increased the EI of students from private universities, which represent application-oriented universities. This shows that public universities, which represent research-oriented universities, need to increase the training of talent in practical applications to narrow the gap with private universities in entrepreneurship. Fourth, after receiving EE, the EI of nonpoor students improved more than that of poor students. Equal EE increases the gap between poor and nonpoor students, which can easily lead to an intergenerational cycle of poverty in entrepreneurship. This study provides empirical evidence from college students' entrepreneurship in relatively underdeveloped western China, which supports the development of EE and entrepreneurial activities.

Exploring the effect of city size on carbon emissions: Evidence from 259 prefecture-level cities in China.

As a gathering place for human production activities, cities are the main places where energy consumption and carbon dioxide emissions occur. How to accurately measure city size and test the impact mechanism of city size on carbon emissions of different city levels is still controversial. This study uses the global nighttime light data to identify urban bright areas and built-up areas, and accordingly constructs the city size index of 259 prefecture level cities in China from 2003 to 2019. It avoids the problem of only considering the single index of population size or space size, and makes the measurement of city size more reasonable. We use a dynamic panel model to study the impact of city size on urban carbon emissions per capita, and discuss the heterogeneity of various cities under different population levels and economic development levels. The empirical results indicate that in the scale of cities in China showed a fluctuating growth trend in recent years. The city size index of most cities is clustered at medium and high values. The city size index of cities with different economic development levels and different population-scale levels shows obvious gradient differences but maintains an upward trend. The expansion of supercities (with a population of more than 5 million) introduces a drastic increase in carbon emissions. The carbon emissions growth caused by the expansion of cities that are classified as third tier and below is the smallest, while that caused by the expansion of cities that are classified as first-tier is the largest. The findings suggest differentiated emissions reduction suggestions for cities with different sizes.

TSR: A User-Friendly R Shiny Application for Assessment of Optimal Blood Product Selection in ABO-Incompatible Hematopoietic Stem Cell Transplantation.

OBJECTIVE: Patients undergoing hematopoietic stem cell transplant (HSCT) need frequent transfusions, until their red blood cells (RBCs) and platelets start to recover. The safe transfusion for patients who receive ABO-incompatible HSCT is essential to the transplant process. To date, there is no user-friendly tool to choose the right blood product for transfusion treatment, despite the number of guidelines and expert advice on the subject. METHODS: R/shiny is a powerful programming language for clinical data analysis and visualization. It can create interactive web applications that work in real-time. The web application named TSR was built using R programming, simplifying blood transfusion practice for ABO-incompatible HSCT with a one-click solution. RESULTS: The TSR is divided into four main tabs. The home tab provides an overview of the application, while RBC, plasma and platelet transfusion tabs offer tailored suggestions for blood product selection in each category. Unlike traditional methods that rely on treatment guidelines and specialist consensus, TSR leverages the power of the R/Shiny interface to extract critical content based on user-specified parameters, providing an innovative approach to improve transfusion support. CONCLUSION: The present study highlights that the TSR enables real-time analysis, and promotes transfusion practice by offering a unique and efficient one-key output for blood product selection to ABO-incompatible HSCT. TSR has the potential to become a widely-utilized tool for transfusion services, providing a reliable and user-friendly solution that enhances transfusion safety in clinical practice.

The river chief system and the total factor productivity in China: Evidence from the industrial enterprises database.

Balancing water environmental protection and economic growth is a priority for the local governments. Many literature analyses found that the reform of the River Chief System (RCS) had a significant effect on water quality improvement in China; however, it is important and necessary to comprehensively assess the impact of the RCS on the total factor productivity (TFP) of industrial enterprises, which provides a realistic basis for the decisions of local governments. This paper uses the quasi-natural experiment of the RCS in China and data from Chinese industrial enterprises to analyze the impact of the policy reform on the total factor productivity (TFP) of enterprises and the influence mechanism. The empirical analysis finds that the TFP of industrial enterprises in the reformed areas of the RCS is significantly lower than that in the non-reformed areas. This indicates that the implementation of the RCS is not conducive to the improvement of TFP of industrial enterprises. And this effect is mainly generated by reducing the output level and capital allocation efficiency of industrial enterprises. Meanwhile, the impact of the RCS on the TFP of industrial enterprises exists heterogeneity.

Effects of different fertilizers on nutrient quality and mineral elements in different economic forage groups in Qilian Mountain alpine meadows.

The objective of this study was to examine the responses of nutrient quality and mineral elements of forages in different economic groups forages in the Qilian Mountains alpine meadows to different fertilization treatments. Eight fertilization treatments, potassium (K), nitrogen (N), zinc (Z), boric (B), copper (Cu), phosphorus (P), molybdenum (Mo), and selenium (Se), were sprayed onto forage roots, and no fertilizer was applied as a blank control (CK), with four replicates in each group. The forage trace element contents and nutritional quality of each economic group in to different treatments were determined in mid-August, and the trace element surplus and deficiency were analyzed. Compared with that in the control, the forage crude protein (CP) content in different economic groups under different fertilization treatments increased and fluctuated within the range of 7.7%-23.94%. The dry matter digestibility (DMD) ranged from 38.78% to 77.34% and showed no significant differences in DMD among treatments (P > 0.05). The DMD of legume forages was significantly higher than those of Gramineae grasses and sedges; there were no significant differences in forage acid detergent fiber (ADF) between any treatments and the control (P > 0.05), but ADF showed a decreasing trend in the treatments compared with that in the control. The P content increased by 81.81% in legumes (P < 0.05); however, it decreased by 38.46% and 61.29% in wilted grass and forbs (P < 0.05) and increased in Gramineae grasses and legumes under N treatment by 92.86% and 50% (P < 0.05), respectively. The Cu content under Cu, N, Zn, B and Se treatments increased significantly by 33.81%∼346.49% compared with that in the control. There were no significant differences in Zn content among the economic groups under different treatments (P > 0.05), but legumes showed better absorption of Zn. Consequently, the forages in this study were evaluated as having medium Cu (8.1-20 mg/kg), medium Se (0.11-1.0 mg/kg), and medium (30.1-60 mg/kg) to high (60.1-100 mg/kg) Zn contents. Comprehensive analysis showed that the application of different fertilizers could increase the CP and DMD of various forages, reduce ADF, and effectively improve the nutritional quality of pastures. The contents of N, Cu, Zn, and Se in forages increased under all treatments, and the contents of all forage elements were at appropriate levels. Applying K, N, P, Cu and Mo is beneficial to dominant species in Qilian Mountains alpine meadows.

ESBLs-producing Escherichia coli from sheep-origin: Genome-wide virulence genes identification and in vivo virulence assessment in mice and Galleria mellonella.

The worldwide spread of pathogenic Escherichia coli, together with the multidrug resistant linked with extended-spectrum ß-lactamases (blaCTX-M , blaTEM and blaOXA ), not only affect the health of animals and humans but also bring huge economic losses to animal husbandry. Despite the high levels of virulence present in many extended-spectrum beta-lactamases (ESBLs)-producing E. coli isolates, however, few studies have comprehensively assessed the pathogenicity of ESBLs-producing E. coli isolates. Thus, the aim of the present study was to investigate the presence of virulence genes in third-generation cephalosporin-resistant E. coli and to assess their pathogenicity and zoonotic potential. Previously, we identified 67 ESBLs-producing E. coli strains from sheep anal swabs in northwest China. In this study, we genotypically and phenotypically characterized isolates of E. coli that produce ESBLs. According to the VirulenceFinder and virulence factors database, all ESBLs-producing E. coli strains harboured a wide range of virulence genes. The ColV plasmid-related genes (hlyF, ompT, iss, iutA and cvaC) were present in 52 (77.6%) ESBLs-producing E. coli isolates. Surprisingly, quite a number of extraintestinal pathogenic E. coli virulence-related genes were detected in 62 (92.5%) of 67 isolates. A total of 33 serotypes and 37 sequence types (STs) were found in 67 ESBLs-producing isolates. ST10 is the most prevalent ST, which is represented by five strains. The cluster analysis showed that CC10 and CC23 were the common clonal complexes (CCs). Predominant serotypes were O8 (10%) and O9 (9%) followed by 6% each of O89, O101 and O185. Most sheep-origin ESBLs-producing E. coli held the highly pathogenic to human and displayed moderate-to-vigorous-intensity motor capacity. The ESBLs-producing E. coli isolates with numerous virulence-related genes were able to cause multiple infectious diseases in animal models (mice, neonatal rats and Galleria mellonella). To our knowledge, this study represents an important first step for a comprehensive characterization of pathogenicity and zoonotic potential of sheep-origin ESBLs-producing E. coli isolates. These findings may be of significant value for the identification of pathogenicity and zoonotic potential risks associated with sheep-origin ESBLs-producing E. coli.

A Smart Nanoreactor Based on an O2-Economized Dual Energy Inhibition Strategy Armed with Dual Multi-stimuli-Responsive "Doorkeepers" for Enhanced CDT/PTT of Rheumatoid Arthritis.

Activated fibroblast-like synovial (FLS) cells are regarded as an important target for rheumatoid arthritis (RA) treatment via starvation therapy mediated by glucose oxidase (GOx). However, the hypoxic RA-FLS environment greatly reduces the oxidation process of glucose and leads to a poor therapeutic effect of the GOx-based starvation therapy. In this work, we designed a hollow mesoporous copper sulfide nanoparticles (CuS NPs)-based smart GOx/atovaquone (ATO) codelivery system (named as V-HAGC) targeting RA-FLS cells to realize a O2-economized dual energy inhibition strategy to solve the limitation of GOx-based starvation therapy. V-HAGC armed with dual multi-stimuli-responsive "doorkeepers" can guard drugs intelligently. Once under the stimulation of photothermal and acidic conditions at the targeted area, the dual intelligent responsive "doors" would orderly open to realize the controllable release of drugs. Besides, the efficacy of V-HAGC would be much improved by the additional chemodynamic therapy (CDT) and photothermal therapy (PTT) stimulated by CuS NPs. Meanwhile, the upregulated H2O2 and acid levels by starvation therapy would promote the Fenton-like reaction of CuS NPs under O2-economized dual energy inhibition, which could enhance the PTT and CDT efficacy as well. In vitro and in vivo evaluations revealed V-HAGC with much improved efficacy of this combination therapy for RA. In general, the smart V-HAGC based on the O2-economized dual energy inhibition strategy combined with enhanced CDT and PTT has the potential to be an alternative methodology in the treatment of RA.

External Assessment of the Anti-N-Methyl-D-Aspartate Receptor Encephalitis One-Year Functional Status Score in Chinese Pediatric Patients.

Objective: to assess the performance of the Anti-N-Methyl-D-Aspartate Receptor encephalitis (NMDAR) One-Year Functional Status (NEOS) score in predicting one-year functional outcome in Chinese children with anti-NMDAR encephalitis. Methods: children with anti-NMDAR encephalitis at the Children's Hospital of Chongqing Medical University were retrospectively enrolled from January 2014 to December 2020. Patients were categorized into two groups based on the modified Rankin Scale (mRS) at one-year follow-up. Discrimination of the NEOS score was assessed by the area under curve (AUC) of the receiver operating characteristic curve. Calibration of the NEOS score was assessed by comparing predicted probabilities with observed probabilities using a calibration curve and the Hosmer-Lemeshow test. The clinical practicability of the NEOS score was evaluated by performing a decision curve analysis. Results: one hundred seventy-five children (101 females and 74 males) with anti-NMDAR encephalitis and a median age of 7.7 years were enrolled. Of those, 149 (85.1%) had a good outcome at 1 year (mRS ≤ 2), and the remaining 26 (14.9%) had a poor outcome (mRS > 2). Patients with a higher NEOS score had a significantly higher mRS at one-year follow-up [Spearman r = 0.3878, 95% confidence interval (CI): 0.2500-0.5103, P < 0.001]. The AUC of the NEOS score was 0.870 (95% CI: 0.801-0.938, P < 0.001). The observed probability and predicted probability showed moderate consistency in the calibration curve and the Hosmer-Lemeshow test (P = 0.912). The decision curve analysis showed that using the NEOS score to predict one-year outcomes could provide additional net benefit during clinical practice. Conclusions: the NEOS score is a potentially reliable model to predict the one-year functional outcome in Chinese children with anti-NMDAR encephalitis.

A nexus study of carbon emissions and financial development in China using the decoupling analysis.

Investigating the linkage between financial development (FD) and carbon emissions is important for mitigating climate change. Nevertheless, there is a scarcity of studies investigating how carbon emissions decouple from FD. Here, we investigate the relationship between FD and carbon emissions by using the decoupling model based on cross-province data of China during 2000-2019. Then, we use the decomposition method to analyze the nine drivers of decoupling elasticity of FD and CO2 emissions. We found that China experienced weak decoupling and strong negative decoupling in most years. Only the finance develops at a very high level; the FD had spare capacities to promote the reduction in the carbon emissions. For example, several developed provinces (e.g., Tianjin, Zhejiang, Guangdong) realized strong decoupling after 2012. The reduction in energy intensity and the increase of foreign direct investment promoted the decoupling of FD from carbon emissions. During the financial recession period, developing a bank-based financial market helped the emissions reduction. Once financial crisis is overcome, developing a market-based financial market promoted the decoupling of FD from emissions. This is because that with the fast FD, the development of stock market contributed to emission reductions through technological improvement, while the bank loans inhibited the decoupling process through the expansion of capital-labor inputs. Overall, these results help in the assessment of the emissions impacts of FD and in addressing climate change problems.

Ecological Risk Assessment of Trace Metal in Pacific Sector of Arctic Ocean and Bering Strait Surface Sediments.

The arctic region is a remote area with relatively few anthropogenic inputs, but there is increasing concern over toxic trace metal contamination in the Arctic Ocean. In this study, distribution characteristics of eight trace metals in the surface sediment of the Pacific Sector of the Arctic Ocean and Bering Strait are analyzed. The geochemical baseline value of each metal element is explored using the relative cumulative frequency curve method; the enrichment factor (EF), geo-accumulation index (Igeo) and potential ecological risk index (RI) are applied to assess the ecological risk level of the trace metals. According to the results, Cu, As and Hg had a little more content variation, and their contents in some areas were significantly higher than the previous reports. EF values show an obvious enrichment of element As, followed by Cr element with the moderate enrichment; the enrichment of the other six elements are not related to human activity. The Igeo value shows a moderately contaminated to heavily contaminated level of As and a moderately contaminated level of Cr. According to the potential ecological risk indexes in each site, most sites are at a low ecological risk level except five sites with RI/baseline values exceeding 150 which are at a moderate ecological risk level.

Effect of Combining Operating Room Nursing Based on Clinical Quantitative Assessment with WeChat Health Education on Postoperative Complications and Quality of Life of Femoral Fracture Patients Undergoing Internal Fixation.

OBJECTIVE: To explore the effect of combining operating room nursing based on clinical quantitative assessment with WeChat health education on postoperative complications and quality of life (QOL) of femoral fracture patients undergoing internal fixation. METHODS: Ninety femoral fracture patients treated in our hospital (July 2018 to July 2021) were chosen as the research objects and split into the control group (routine intervention) and the study group (combination of operating room nursing based on clinical quantitative assessment and WeChat health education) according to the nursing intervention modes, with 45 cases each. After nursing, the postoperative complications and QOL of patients were compared between the two groups. RESULTS: No statistical between-group differences in general data were observed (P > 0.05); the hospital stay, weight-bearing time, and fracture healing time were obviously shorter in the study group than in the control group (P < 0.05); 1 d after surgery, the VAS pain status was not significantly different between the two groups (P > 0.05), and 2 d and 3 d after surgery, the VAS scores were significantly lower in the study group than in the control group (P < 0.05); 1 d after surgery, the Harris scores of patients in the two groups were close and did not present statistical difference (P > 0.05), and 8 weeks after surgery, the Harris score was significantly higher in the study group than in the control group (P < 0.05); the scores on self-care agency such as self-concept, self-care skills, sense of self-care responsibility, and health knowledge level were significantly higher in the study group than in the control group (P < 0.05); compared with the control group, the probability of occurring incision infection, lung infection, pressure sore, swelling and pain, and other complications was significantly lower in the study group (P < 0.05). CONCLUSION: Implementing operating room nursing based on clinical quantitative assessment combined with WeChat health education to femoral fracture patients undergoing internal fixation can effectively improve their postoperative clinical indicators, reduce their postoperative pain sensation and complication incidence, and effectively promote the joint motion range, which is conducive to enhancing their self-care agency and QOL.