Technology innovations impact on carbon emission in Chinese cities: exploring the mediating role of economic growth and industrial structure transformation.

China seems ambitious to achieve a "carbon emissions peak" before 2030 and "carbon neutrality" before 2060. To deal with this emissions mitigation plan, technology innovations are regarded as a crucial factor. However, considering its rebound effect (CO2 emissions driving effect) through economic growth, technology innovations might not prove a promising contributor to CO2 reduction. Therefore, there is a need to investigate further the nexus between technology innovations and CO2 emissions for conclusive debate. Based on the data of 215 cities in China, this paper uses mediating effects model to investigate the direct and indirect impacts (through economic growth and industrial structure transformation) of technology innovations on CO2 emissions from a microeconomic perspective. The main results suggest that technology innovations generally increase CO2 emissions in China both directly and indirectly. The impact of technology innovations and economic growth on CO2 emissions indicated the EKC characteristics. Furthermore, the contributions of technology innovations to CO2 emissions are distinguished in different regions. Thus, there is an urgent need for China to promote innovations in "clean technology" and to transform industrial structure to the tertiary industry to achieve the targets of carbon neutrality and emissions peaking.

Assessment of the correlation between clinical and radiological outcomes in patients suffering from mild to moderate cervical spine dysfunction symptoms: a prospective study.

BACKGROUND: Neck pain and cervical disc degeneration (CDD) are common findings. Valid data on correlation between clinical scores and radiological grade of CDD in patients with mild to moderate clinical disability are not available. The study has been designed to investigate the correlation between clinical and radiological outcomes in these patients. METHODS: A cohort of 150 patients who suffered from mild to moderate cervical spine dysfunction symptoms from September 2020 to May 2021 was enrolled. We evaluated functional status using Japanese Orthopaedic Association scores (JOA), the visual analog scale, and the Neck Disability Index. We assessed the CDD with magnetic resonance imaging-based grading systems. We analyzed relationships between radiological grades of CDD and clinical symptoms along with demographic data. RESULTS: One hundred thirteen patients [mean age 44.78, 78 (69%) females] were finally included. CDD occurred most at the C5-C6 level, with 56.93% of higher grade III from Miyazaki. The grades of Miyazaki (P < 0.05) and the scores of Nakashima (P < 0.05) were positively correlated with the duration of symptoms, and the severity of the CDD increased with aging (P < 0.01). Moreover, we correlated patients' JOA scores with the current scoring and grading systems, especially the grades of Miyazaki (P < 0.01) and the scores of Nakashima (P < 0.01). CONCLUSION: Increasing grades of CDD paralleled decreasing JOA scores in the population studied.

Assessment of the Viability and Union Feature of Diaphysis Reconstruction Using Pasteurized Tumor Bone and Intramedullary Free Fibular After Tumor Resection.

BACKGROUND: Reconstruction using pasteurized tumor bone (PTM) and intramedullary-placed vascularized free fibular (VFG) has the combined advantages of mechanical strength and biological activity. The aims of this study were to investigate scintigraphic viability and radiographic union patterns of composite grafts after surgery, union rates, functional outcomes, and complication rates. METHODS: Seventeen patients underwent intercalary composite reconstruction using PTM and VFG (12 male, 2 female, mean age: 10.9 y). Retrospective evaluation of radiography and bone scintigraphy was performed. The most common diagnosis was osteosarcoma (12/14, 85.7%). All radiography and bone scintigraphy was reviewed for bone healing and tracer uptake semiquantitatively using the ratio of the reconstructed portion to the contralateral side. Complications and oncological and functional outcomes were recorded. RESULTS: At a mean follow-up of 33.1 months, primary union was achieved in all 28 host-graft junctions in all 14 patients. The respective mean times to proximal and distal junction bone union were 6.9 and 6.5 months. Metaphyseal junctions healed faster than diaphysis junctions (5.2 vs. 8.0 mo, P=0.02). Free fibular was integrated with surrounding bone after a mean of 10.1 months. The mean tracer uptake ratio was 1.1 after a mean of 4.8 months postoperatively. Half patients (50%) had higher uptake on bone scan than contralateral side. There was no significant correlation between uptake value and bone healing time. Five complications occurred in 4 patients (28.6%), and 1 patient (7.1%) contracted an infection. No fractures or breakages were observed. The mean Musculoskeletal Tumor Society 93 score was 87.6%. CONCLUSIONS: Reconstruction using PTM combined with VFG is associated with good short-term biological activity as indicated by bone scintigraphy, a high union rate, and an acceptable complication rate. The technique is a useful reconstruction option for large segmental bone defects after tumor resection in lower extremities. LEVEL OF EVIDENCE: Level IV-therapeutic study.

Assessment of patient experiences following total sacrectomy for primary malignant sacral tumors: A qualitative study.

BACKGROUND AND OBJECTIVES: Few reports have investigated patient experiences following total en bloc sacrectomy. The aims of this study were to obtain a deeper understanding of patients' personal experiences, needs, and satisfaction with the treatment to reveal areas in which perioperative and long-term patient care can be improved. METHODS: A qualitative design was applied to examine patient experiences and supportive care needs. Patients treated between 2007 and 2017 were identified from our institutional database. RESULTS: A total of 28 survivors were interviewed (13 females, age 13-75 years). Eight themes were identified: the effect of surgery on patients' (a) daily lives, (b) social activities, (c) work or school activities, (d) and family lives; (e) acceptance of ostomy surgery; (f) need for guidance regarding long-term rehabilitation; (g) satisfaction with the medical services provided in the hospital; and (h) satisfaction with the treatment outcomes. CONCLUSION: Total en bloc sacrectomy can yield satisfactory oncological outcomes; however, the procedure is a life-changing event for patients and their families. Physicians must provide long-term support and guidance after surgery to enable patients to fully understand and cope with the changes in their lives.

The fate of 4-hydroxycarbazole metabolite: metabolism and carcinogenicity assessment of a ß-adrenergic receptor modulator containing carbazole structure.

LY377604 has a potential to form 4-hydroxycarbazole, which was reported in the literature as a mutagen. This safety concern led to our investigation of the metabolism and carcinogenicity of LY377604. In in vitro studies with LY377604, 4-hydroxycarbazole was detected in the presence of liver microsomes prepared from different species. When incubated with liver slices, only the conjugate of 4-hydroxycarbazole was detected. Subsequent in vivo radio-labelled studies were conducted to characterise the formation of 4-hydroxycarbazole from LY377604. Free 4-hydroxycarbazole was not detected in vivo, but the O-glucuronide conjugate was identified as a minor metabolite in urine samples, representing 0.2% and 0.9% of the radioactive dose in rats and monkeys. The low level of circulating 4-hydroxycarbazole glucuronide conjugate was also detected in plasma. LY377604 was negative in all genetic toxicology assays and was not associated with tumour induction in a 6-month carcinogenicity study using RasH2+/- mouse model. The exposure to free 4-hydroxycarbazole was not measurable after one dose and was about 0.1%-0.2% of the parent exposure at the end of the 6-month study. These data suggested that 4-hydroxycarbazole was formed as a minor metabolite in vivo, but it was primarily conjugated and excreted in urine as the glucuronide conjugate. The absence of tumours in the carcinogenicity study combined with the exposure data suggested that the low level of free 4-hydroxycarbazole did not represent a carcinogenic risk.

Approach of technical decision-making by element flow analysis and Monte-Carlo simulation of municipal solid waste stream.

This paper deals with the procedure and methodology which can be used to select the optimal treatment and disposal technology of municipal solid waste (MSW), and to provide practical and effective technical support to policy-making, on the basis of study on solid waste management status and development trend in China and abroad. Focusing on various treatment and disposal technologies and processes of MSW, this study established a Monte-Carlo mathematical model of cost minimization for MSW handling subjected to environmental constraints. A new method of element stream (such as C, H, O, N, S) analysis in combination with economic stream analysis of MSW was developed. By following the streams of different treatment processes consisting of various techniques from generation, separation, transfer, transport, treatment, recycling and disposal of the wastes, the element constitution as well as its economic distribution in terms of possibility functions was identified. Every technique step was evaluated economically. The Mont-Carlo method was then conducted for model calibration. Sensitivity analysis was also carried out to identify the most sensitive factors. Model calibration indicated that landfill with power generation of landfill gas was economically the optimal technology at the present stage under the condition of more than 58% of C, H, O, N, S going to landfill. Whether or not to generate electricity was the most sensitive factor. If landfilling cost increases, MSW separation treatment was recommended by screening first followed with incinerating partially and composting partially with residue landfilling. The possibility of incineration model selection as the optimal technology was affected by the city scale. For big cities and metropolitans with large MSW generation, possibility for constructing large-scale incineration facilities increases, whereas, for middle and small cities, the effectiveness of incinerating waste decreases.