Earth's early continental crust formed from wet and oxidizing arc magmas.

Formation of continental crust has shaped the surface and interior of our planet and generated the land and mineral resources on which we rely. However, how the early continental crust of Earth formed is still debated1-7. Modern continental crust is largely formed from wet and oxidizing arc magmas at subduction zones, in which oceanic lithosphere and water recycle into the mantle8-10. The magmatic H2O content and redox state of ancient rocks that constitute the early continental crust, however, are difficult to quantify owing to ubiquitous metamorphism. Here we combine two zircon oxybarometers11,12 to simultaneously determine magmatic oxygen fugacity (fO2) and H2O content of Archaean (4.0-2.5 billion years ago) granitoids that dominate the early continental crust. We show that most Archaean granitoid magmas were ≥1 log unit more oxidizing than Archaean ambient mantle-derived magmas13,14 and had high magmatic H2O contents (6-10 wt%) and high H2O/Ce ratios (>1,000), similar to modern arc magmas. We find that magmatic fO2, H2O contents and H2O/Ce ratios of Archaean granitoids positively correlate with depth of magma formation, requiring transport of large amounts of H2O to the lower crust and mantle. These observations can be readily explained by subduction but are difficult to reconcile with non-subduction models of crustal formation3-7. We note an increase in magmatic fO2 and H2O content between 4.0 and 3.6 billion years ago, probably indicating the onset of subduction during this period.

Signal enhancement ratio of multi-phase contrast-enhanced MRI: an imaging biomarker for survival in pancreatic adenocarcinoma.

OBJECTIVES: To evaluate signal enhancement ratio (SER) for tissue characterization and prognosis stratification in pancreatic adenocarcinoma (PDAC), with quantitative histopathological analysis (QHA) as the reference standard. METHODS: This retrospective study included 277 PDAC patients who underwent multi-phase contrast-enhanced (CE) MRI and whole-slide imaging (WSI) from three centers (2015-2021). SER is defined as (SIlt - SIpre)/(SIea - SIpre), where SIpre, SIea, and SIlt represent the signal intensity of the tumor in pre-contrast, early-, and late post-contrast images, respectively. Deep-learning algorithms were implemented to quantify the stroma, epithelium, and lumen of PDAC on WSIs. Correlation, regression, and Bland-Altman analyses were utilized to investigate the associations between SER and QHA. The prognostic significance of SER on overall survival (OS) was evaluated using Cox regression analysis and Kaplan-Meier curves. RESULTS: The internal dataset comprised 159 patients, which was further divided into training, validation, and internal test datasets (n = 60, 41, and 58, respectively). Sixty-five and 53 patients were included in two external test datasets. Excluding lumen, SER demonstrated significant correlations with stroma (r = 0.29-0.74, all p < 0.001) and epithelium (r = -0.23 to -0.71, all p < 0.001) across a wide post-injection time window (range, 25-300 s). Bland-Altman analysis revealed a small bias between SER and QHA for quantifying stroma/epithelium in individual training, validation (all within ± 2%), and three test datasets (all within ± 4%). Moreover, SER-predicted low stromal proportion was independently associated with worse OS (HR = 1.84 (1.17-2.91), p = 0.009) in training and validation datasets, which remained significant across three combined test datasets (HR = 1.73 (1.25-2.41), p = 0.001). CONCLUSION: SER of multi-phase CE-MRI allows for tissue characterization and prognosis stratification in PDAC. CLINICAL RELEVANCE STATEMENT: The signal enhancement ratio of multi-phase CE-MRI can serve as a novel imaging biomarker for characterizing tissue composition and holds the potential for improving patient stratification and therapy in PDAC. KEY POINTS: Imaging biomarkers are needed to better characterize tumor tissue in pancreatic adenocarcinoma. Signal enhancement ratio (SER)-predicted stromal/epithelial proportion showed good agreement with histopathology measurements across three distinct centers. Signal enhancement ratio (SER)-predicted stromal proportion was demonstrated to be an independent prognostic factor for OS in PDAC.

Expression of CD109 in oral squamous cell carcinoma and its clinical significance.

The purpose of this study was to investigate the expression of CD109 and its clinicopathological significance in oral squamous cell carcinoma. Data from TIMER2.0 and UALCAN were analyzed to assess CD109 mRNA levels in OSCC. The immunohistochemical method was used to investigate the expressions of CD109 in 20 normal oral mucosa and 75 OSCC and analyzed the relationship between the expression of CD109 and the clinical variables. The mRNA levels of CD109 in OSCC tissues were significantly higher than in adjacent normal tissues (p<0.05). Immunohistochemical analysis revealed that CD109 protein expression was increased in OSCC tissues compared to normal tissues, and this difference was statistically significant (P<0.05). The positive rate of CD109 expression was 94% (16/117) in the group with lymph node metastasis, while it was 55% (32/58) in the group without metastasis (P<0.05). Similarly, the positive rate of CD109 expression was 91% (22/23) in the low differentiation group and 59% (26/52) in the high differentiation group (P<0.05). CD109 expression is markedly higher in OSCC, contributes to the pathological grading of OSCC and predicts lymph node metastasis.

A proposal for grading the risk of lymph node metastasis after endoscopic resection of T1 colorectal cancer.

PURPOSE: At present, for patients with early colorectal cancer as long as having any one risk factor of lymph node metastasis (LNM) after endoscopic resection (ER), additional surgery will be considered, regardless of the degree of LNM risk; however, most patients are free of LNM. This study aimed to further grade these patients according to LNM risk. METHODS: We assessed 271 patients with T1 colorectal cancers treated initially with ER to analyze the correlation between LNM-associated risk factors and LNM rate. Differences in this rate between groups were estimated using the χ2 test or Fisher's exact test. RESULTS: Poorly differentiated adenocarcinoma (Por) (3.4% vs. 40%, p < 0.001) and lymphovascular infiltration (LV) (1.6% vs. 29.0%, p < 0.001) were the only parameters correlated with LNM. When we divided the cases into LV-negative (LV(-)) and LV-positive (LV(+)) groups, we found a significantly higher LNM rate in the LV(+) group (29.0% vs. 1.6%, p < 0.001). Additionally, the rate of LNM in those positive for each parameter did not differ from the control rate in the same group, except in the Por subgroup. When the cases were divided into four groups based on the presence of LV infiltration and Por, the LNM rate in each group was 2/233 cases (0.8%) in the LV(-)Por(-) group, 2/7 cases (28.5%) in the LV(-)Por(+) group, 7/28 cases (25.0%) in the LV(+)Por(-) group, and 2/3 cases (66.6%) in the LV(+)Por(+) group. CONCLUSIONS: Based on LV and histological differentiation, patients were classified into three LNM risk grades: low (LNM, 0.8%), moderate (LNM, 25.0-28.5%), and high (LNM, 66.6%).

Overexpression of Copines-1 is associated with clinicopathological parameters and poor outcome in gastric cancer.

BACKGROUND: Copines-1 (CPNE1) is a soluble membrane-binding protein that includes two tandem C2 domains at the N-terminus and a C terminal A domain. Importantly, it is associated with the prognosis of various tumors, but there are only a few studies regarding the role of CPNE1 in gastric cancer (GC). This study aimed to explore the clinicopathological significance and prognostic potential of CPNE1 expression in GC. METHODS: Data from the TIMER2.0 and UALCAN were analyzed to assess CPNE1 mRNA levels in GC. The prognostic role of CPNE1 mRNA was examined via the Kaplan-Meier plotter. CPNE1 protein expression in tumor tissues was analyzed via immunohistochemistry of clinical samples from 99 GC patients. The relationship of CPNE1 expression with clinicopathological parameters and overall survival (OS) was evaluated using Cox proportional hazards regression models and Kaplan-Meier survival curves. RESULTS: Copines-1 mRNA levels were higher in GC tissues than in adjacent normal tissue (ANT) (p < 0.05). Further, high CPNE1 mRNA expression indicated poor OS (p = 9.4 e-10) and was significantly associated with first progression (FP) (p = 1.6 e-06) and post-progression survival (PPS) (p = 1.5 e-12). In addition, CPNE1 protein expression was higher in GC tissues than in ANT (p < 0.0001). Moreover, CPNE1 high expression was significantly related to advanced tumor-node-metastasis (TNM) stage (p = 0.004), lymph node metastasis (p = 0.003), and vascular invasion (p = 0.001). Kaplan-Meier analysis showed that GC patients with high expression CPNE1 group had worse OS than low expression group (p = 0.003). Univariate analysis showed that age (hazard ratio [HR] = 1.992; 95% confidence interval [CI], 1.009-3.934; p = 0.047), advanced TNM stage (HR = 4.941; 95% CI, 2.052-11.897; p = 0.000), tumor invasion (HR = 3.472; 95% CI, 1.349-8.937; p = 0.010), lymph node metastasis (HR = 8.846; 95% CI, 2.708-28.897; p = 0.000), vascular invasion (HR = 3.237; 95% CI, 1.521-6.891; p = 0.002), nervous invasion (HR = 2.324; 95% CI, 1.205-4.479; p = 0.012), and CPNE1 expression (HR = 3.464; 95% CI, 1.440-8.334; p = 0.006) were correlated with OS. In the multivariate analysis, age (HR = 2.514; 95% CI, 1.264-4.999; p = 0.009), lymph node metastasis (HR = 8.441; 95% CI, 2.553-27.906; p < 0.05), and CPNE1 expression (HR = 2.549; 95% CI, 1.051-6.186; p = 0.039) were significant prognostic predictors for GC. CONCLUSIONS: Copines-1 overexpression in GC is significantly associated with poor prognosis. Thus, CPNE1 levels may serve as a prognostic biomarker in GC patients.

Unusual morphologic features of low-grade endometrial stromal sarcoma: A case report.

BACKGROUND: Endometrial stromal tumours are uncommon tumours of the uterus. They mainly occur in perimenopausal women. Tumours with typical clinicopathological features do not usually pose diagnostic problems. However, rare clinicopathological features can occur, and clinicians without significant experience may have difficulty diagnosing these tumours and managing these patients. METHODS: Herein, we report a case of endometrial stromal sarcoma that occurred in a 25-year-old woman. The pathological features, immunophenotype, treatment and prognosis were discussed. RESULTS: The tumour revealed morphological heterogeneity, and there were similar proliferative-type endometrial stromal cells, an extensive amount of mature adipose tissue, and prominent rhabdomyoblastic and smooth muscle cells. Histopathological and immunohistochemical studies confirmed low-grade endometrial stromal sarcoma with smooth muscle, adipocytic and rhabdomyoblastic differentiation (approximately 60% were differentiated tissues). The final treatment of the tumour was total abdominal hysterectomy with bilateral salpingo-oophorectomy. There was no evidence of recurrence for 109 months postoperatively. CONCLUSIONS: We found that low-grade endometrial stromal tumours with extensive adipocytic and prominent rhabdomyoblastic differentiation are misdiagnosed because they are infrequent. They must be differentiated from rhabdomyosarcoma with accurate identification of adipocytes, and long-term follow-up is needed.

Gastrointestinal Langerhans cell histiocytosis with unifocal, single-system involvement in adults: Cases report and literature review.

BACKGROUND: Langerhans cell histiocytosis (LCH) is characterized by unifocal, multifocal single-system, or multi-system disease that occurs in all age groups, while it primarily attacks pediatric patients. Solitary gastrointestinal (GI) LCH in adults is exceedingly rare, so we aimed to investigate GI LCH in adults with unifocal single-system involvement and clarified the clinicopathologic characteristics of this disease. METHODS: Two cases of solitary GI LCH in adults were presented, and the clinicopathologic features of this diagnosis in the literature were reviewed. RESULTS: The main diagnostic feature of LCH is the morphologic identification of the characteristic Langerhans cells with prominent nuclear grooves and abundant eosinophilic cytoplasm, accompanied by a variable number of lymphocytes, eosinophils, and plasma cells. The distinctive cells expressed S100, CD1a, and langerin (CD207) on immunohistochemistry. BRAF V600E mutations were detected in the two patients. CONCLUSIONS: Gastrointestinal Langerhans cell histiocytosis in adults with unifocal, single-system involvement is extremely rare. Most patients were asymptomatic and usually a small solitary polyp in GI tract can be observed under routine endoscopy. Although the overall prognosis of unifocal single-system LCH is favorable, long-term follow-up is still necessary to rule out systemic disease.

Imaging features and radiologic-pathologic correlations of inflammatory pseudotumor-like follicular dendritic cell sarcoma.

BACKGROUND: Inflammatory pseudotumor-like follicular dendritic cell sarcoma (IPT-like FDCS) is a rare tumor. This study aimed to reveal the radiological characteristics of IPT-like FDCS by radiologic-pathologic correlation. RESULTS: We analyzed two cases of IPT-like FDCS in the liver, nine in the spleen, and two in both the liver and spleen concomitantly. IPT-like FDCS presented as well-defined iso- or hypodense masses on unenhanced computed tomography (CT) images in both the liver and spleen. Hyperintensities on T1-weighted images and hypointensities on T2-weighted images with hypointense rings were characteristic features in splenic cases. "Halo signs" were observed in two out of three liver tumors. Hepatic lesions showed significant enhancement, whereas splenic lesions showed only mild enhancement. Delayed annular enhancement was observed in both liver and spleen cases. On ultrasonographic examination, IPT-like FDCS presented as hypoechoic lesions with enhancement similar to that observed on CT. Hyaline fibrous pseudocapsules, which correlated with the hypointensities on T2-weighted images, were microscopically observed at the tumor edge. IPT-like FDCS was characterized by an abundance of small blood vessels and capillaries. Capillaries were also found in the fibrous capsule of some IPT-like FDCSs, which may explain the delayed annular enhancement. CONCLUSIONS: The manifestations of IPT-like FDCS in the liver and spleen showed differences that warrant them to be approached differently during diagnosis. Characteristic radiological findings of IPT-like FDCS included different enhancement patterns between liver and spleen tumors and rim-like hypointensities on T2-weighted images, as well as annular enhancement on CT and magnetic resonance images. These imaging features correlated with tumor pathology.

Underestimated ecosystem carbon turnover time and sequestration under the steady state assumption: A perspective from long-term data assimilation.

It is critical to accurately estimate carbon (C) turnover time as it dominates the uncertainty in ecosystem C sinks and their response to future climate change. In the absence of direct observations of ecosystem C losses, C turnover times are commonly estimated under the steady state assumption (SSA), which has been applied across a large range of temporal and spatial scales including many at which the validity of the assumption is likely to be violated. However, the errors associated with improperly applying SSA to estimate C turnover time and its covariance with climate as well as ecosystem C sequestrations have yet to be fully quantified. Here, we developed a novel model-data fusion framework and systematically analyzed the SSA-induced biases using time-series data collected from 10 permanent forest plots in the eastern China monsoon region. The results showed that (a) the SSA significantly underestimated mean turnover times (MTTs) by 29%, thereby leading to a 4.83-fold underestimation of the net ecosystem productivity (NEP) in these forest ecosystems, a major C sink globally; (b) the SSA-induced bias in MTT and NEP correlates negatively with forest age, which provides a significant caveat for applying the SSA to young-aged ecosystems; and (c) the sensitivity of MTT to temperature and precipitation was 22% and 42% lower, respectively, under the SSA. Thus, under the expected climate change, spatiotemporal changes in MTT are likely to be underestimated, thereby resulting in large errors in the variability of predicted global NEP. With the development of observation technology and the accumulation of spatiotemporal data, we suggest estimating MTTs at the disequilibrium state via long-term data assimilation, thereby effectively reducing the uncertainty in ecosystem C sequestration estimations and providing a better understanding of regional or global C cycle dynamics and C-climate feedback.

CD4(+) T cells from food allergy model are resistant to TCR-dependent apoptotic induction.

BACKGROUND: CD4(+) T cell polarization plays a critical role in the pathogenesis of allergy. How to modulate the skewed CD4(+) T cell polarization is less clear. The specific immunotherapy (SIT) is the only specific remedy for the treatment of allergic diseases; the therapeutic effect is to be improved. OBJECTIVES: This study aims to investigate the role of interleukin (IL)-18 in enhancing the therapeutic effect of SIT. METHODS: A peanut allergy mouse model was developed and treated with SIT or/and IL-18. CD4(+) T cell apoptosis was assessed by flow cytometry. The expression of Fas ligand (FasL) was observed by quantitative real time RT-PCR and Western blotting. Interferon-γ in the culture medium was determined by enzyme-linked immunosorbent assay. The fasL gene promoter methylation in CD4(+) T cells was assessed by methylation specific PCR. RESULTS: The results showed that lower levels of IL-18 were detected in allergic mice; administration of IL-18 significantly enhanced the therapeutic effect of SIT on suppressing the allergic inflammation in the mouse intestine. In the cell culture studies, IL-18 increased the TCR-dependent CD4(+) T cell apoptosis, the expression of FasL in CD4(+) T cells, the production of Interferon-γ and the demethylation of the FasL promoter in CD4(+) T cells. CONCLUSIONS: Administration of IL-18 enhances the effect of SIT on suppressing allergic inflammation in the mouse intestine via enhancing the TCR-dependent CD4(+) T cell apoptosis.

Design of an efficient single photon source from a metallic nanorod dimer: a quasi-normal mode finite-difference time-domain approach.

We describe how the finite-difference time-domain (FDTD) technique can be used to compute the quasi-normal mode (QNM) for metallic nano-resonators, which is important for describing and understanding light-matter interactions in nanoplasmonics. We use the QNM to model the enhanced spontaneous emission rate for dipole emitters near a gold nanorod dimer structure using a newly developed QNM expansion technique. Enhanced single photon emission factors of around 1500 and output ß-factors of around 60% are found near the localized plasmon resonance.

Case report: Fibroadenomas associated with atypical ductal hyperplasia and infiltrating epitheliosis mimicking invasive carcinoma.

Infiltrating epitheliosis (IE) is an uncommon type of complex sclerosing lesion in the breast. This condition is characterized by the infiltration of ducts into a scleroelastotic stroma, along with the presence of cells that display architectural and cytological patterns similar to those observed in usual ductal hyperplasia. We herein report a case of a 24-year-old woman who presented with bilateral breast nodules, which were initially identified as multiple fibroadenomas based on ultrasound findings. The patient underwent Mammotome system and regional mastectomy procedures, and subsequent pathological analysis confirmed the presence of multiple fibroadenomas with atypical ductal hyperplasia and infiltrating epitheliosis. This case discusses the challenges faced in diagnosing malignancy in a patient with multiple fibroadenomas accompanied by atypical ductal hyperplasia and infiltrating epitheliosis.

Exploring the prognostic potential of m6A methylation regulators in low-grade glioma: implications for tumor microenvironment modulation.

BACKGROUND: The biological behavior of low-grade glioma (LGG) is significantly affected by N6-methyladenosine (m6A) methylation, an essential epigenetic alteration. Therefore, it is crucial to create a prognostic model for LGG by utilizing genes that regulate m6A methylation. METHODS: Using TCGA and GTEx databases. We examined m6A modulator levels in LGG and normal tissues, and investigated PD-L1 and PD-1 expression, immune scores, immune cell infiltration, tumor immune microenvironment (TIME) and potential underlying mechanisms in different LGG clusters. We also performed immunohistochemistry and RT-qPCR to identify essential m6A adjustment factor. RESULTS: The results showed that m6A regulatory element expression was significantly increased in LGG tissues and was significantly associated with TMIE. A substantial increase in PD-L1 and PD-1 levels in LGG tissues and high-risk cohorts was observed. PD-L1 expression was positively correlated with FTO, ZCCHC4, and HNRNPD, whereas PD-1 expression was negatively correlated with FTO, ZC3H7B, and HNRNPD. The prognostic signature created using regulators of m6A RNA methylation was shown to be strongly associated with the overall survival of LGG patients, and FTO and ZCCHC4 were confirmed as independent prognostic markers by clinical samples. Furthermore, the results revealed different TIME characteristics between the two groups of patients, indicating disrupted signaling pathways associated with LGG. CONCLUSION: Our results present that the m6A regulators play vital role in regulating PD-L1/PD-1 expression and the infiltration of immune cells, thereby exerting a sizable impact on the TIME of LGG. Therefore, m6A regulators have precise predictive value in the prognosis of LGG.

Undifferentiated carcinoma of the liver with osteoclast-like giant cells: a case report and literature review.

Hepatocellular carcinoma (HCC) is the most common primary malignant tumor of the liver. Osteoclast-like giant cells (OGCs) are relatively more common in pancreatic cancer, but extremely rare in HCC. Currently, there have been only a few reported cases of OGCs in HCC, and their presence indicates an aggressive clinical course. Here, we present a case of primary undifferentiated carcinoma of the liver with OGCs in a 49-year-old male patient, and through a literature review, we summarize 20 similar cases to further understand the diagnosis, treatment, and clinical course of this disease entity.

Clinicopathological Analysis of Densely and Sparsely Granulated Somatotroph Tumors of Pituitary.

OBJECTIVE: Somatotroph tumors are the second most common type of pituitary neuroendocrine tumors, which can be further classified into 2 subtypes-densely granulated somatotroph tumors (DGSTs) and sparsely granulated somatotroph tumors (SGSTs). The aim of this study was to investigate the clinical significance of the 2 subtypes in a retrospective analysis. METHODS: From the database of the Ningbo Clinical Pathology Diagnosis Center, we collected patients diagnosed with pituitary somatotroph tumors. We then compiled pertinent clinical and radiological data and proceeded with histopathological examination involving hematoxylin-eosin staining and immunohistochemical staining. Subsequent analysis compared the 2 subtypes using either χ2 test or Fisher exact test. RESULTS: We analyzed 40 cases of somatotroph tumors, 18 cases DGSTs and 22 SGSTs. Male-to-female ratio was 5:4 for DGSTs and 4:7 for SGSTs. Mean age was 52.83 years for DGSTs and 47.18 years for SGSTs. Statistically significant differences were observed between the DGST and SGST groups in invasiveness (P = 0.0267) and postoperative remission (P = 0.007). Cells of both DGSTs and SGSTs exhibited coexpression of PIT1, growth hormone, and CAM5.2, although the patterns of CAM5.2 expression differed between the 2 subtypes. CONCLUSIONS: The efficacy of CAM5.2 staining in distinguishing between DGSTs and SGSTs was demonstrated. SGSTs, with their increased invasiveness and lower remission rate, are a high-risk subtype. The histological subtype of somatotroph tumors plays a crucial role in guiding treatment decisions and prognostic evaluation in affected patients.

Electrosurgical enucleation versus bipolar transurethral resection for prostates larger than 70 ml: a prospective, randomized trial with 5-year followup.

PURPOSE: We compared the perioperative and postoperative characteristics of prostate PlasmaKinetic™ enucleation and bipolar transurethral resection for large volume benign prostatic hyperplasia. MATERIALS AND METHODS: In this prospective, randomized, controlled trial 80 patients with benign prostatic hyperplasia and a prostate of larger than 70 ml were randomly assigned to prostate bipolar transurethral resection or PlasmaKinetic enucleation. Operative time, resected adenoma weight, changes in hemoglobin, catheterization time and postoperative hospital stay were recorded and compared. Patients were followed 1, 6, 12, 24, 36, 48 and 60 months after surgery. RESULTS: Greater resected prostate weight (mean ± SD 64.2 ± 19.0 vs 50.6 ± 20.0 gm, p = 0.03), less blood loss (mean 0.87 ± 0.42 vs 1.74 ± 0.63 gm, p <0.01), and shorter catheterization time (mean 35.5 ± 5.8 vs 60.1 ± 5.8 hours, p <0.01) and postoperative hospital stay (mean 3 vs 4 days, [corrected] p <0.01) were recorded in the enucleation group than in the resection group. The postoperative improvement in International Prostate Symptom Score, quality of life, maximal flow rate and post-void residual urine volume was similar in the 2 groups at 1, 6, 12 and 24 months but significantly better in the enucleation group at 36, 48 and 60 months. During the 5-year followup no patient in the enucleation group but 2 in the resection group experienced recurrence. CONCLUSIONS: For large volume benign prostatic hyperplasia PlasmaKinetic enucleation of the prostate is associated with less blood loss, shorter hospital stay and catheterization time than bipolar transurethral resection of the prostate. Moreover, PlasmaKinetic enucleation seems to be superior at long-term followup with fewer reoperations necessary.

Mollow quintuplets from coherently excited quantum dots.

Charge-neutral excitons in semiconductor quantum dots (QDs) have a small finite energy separation caused by the anisotropic exchange splitting. Coherent excitation of neutral excitons will generally excite both exciton components, unless the excitation is parallel to one of the dipole axes. We present a polaron master equation model to describe two-exciton pumping using a coherent continuous wave pump field in the presence of a realistic anisotropic exchange splitting. We predict a five-peak incoherent spectrum, namely a Mollow quintuplet under general excitation conditions. We experimentally confirm such spectral quintuplets for In(Ga)As QDs and obtain very good agreement with theory.

Case report: Meningioma associated with meningioangiomatosis mimicking invasive meningioma.

Meningioangiomatosis (MA) is a rare malformation or hamartomatous lesion in the central nervous system, characterized by a plaque-like mass within the leptomeninges and cerebral cortex. An even rarer condition is MA complicated with meningiomas. We herein report a case of meningioma associated with MA that might be erroneously interpreted as a higher-grade lesion or an invasion by preoperative radiologic and postoperative histological examinations.

An artificial intelligence prediction model outperforms conventional guidelines in predicting lymph node metastasis of T1 colorectal cancer.

Background: According to guidelines, a lot of patients with T1 colorectal cancers (CRCs) undergo additional surgery with lymph node dissection after being treated by endoscopic resection (ER) despite the low incidence of lymph node metastasis (LNM). Aim: The aim of this study was to develop an artificial intelligence (AI) model to more effectively identify T1 CRCs at risk for LNM and reduce the rate of unnecessary additional surgery. Methods: We retrospectively analyzed 651 patients with T1 CRCs. The patient cohort was randomly divided into a training set (546 patients) and a test set (105 patients) (ratio 5:1), and a classification and regression tree (CART) algorithm was trained on the training set to develop a predictive AI model for LNM. The model used 12 clinicopathological factors to predict positivity or negativity for LNM. To compare the performance of the AI model with the conventional guidelines, the test set was evaluated according to the Japanese Society for Cancer of the Colon and Rectum (JSCCR) and National Comprehensive Cancer Network (NCCN) guidelines. Finally, we tested the performance of the AI model using the test set and compared it with the JSCCR and NCCN guidelines. Results: The AI model had better predictive performance (AUC=0.960) than the JSCCR (AUC=0.588) and NCCN guidelines (AUC=0.850). The specificity (85.8% vs. 17.5%, p<0.001), balanced accuracy (92.9% vs. 58.7%, p=0.001), and the positive predictive value (36.3% vs. 9.0%, p=0.001) of the AI model were significantly better than those of the JSCCR guidelines and reduced the percentage of the high-risk group for LNM from 83.8% (JSCCR) to 20.9%. The specificity of the AI model was higher than that of the NCCN guidelines (85.8% vs. 82.4%, p=0.557), but there was no significant difference between the two. The sensitivity of the NCCN guidelines was lower than that of our AI model (87.5% vs. 100%, p=0.301), and according to the NCCN guidelines, 1.2% of the 105 test set patients had missed diagnoses. Conclusion: The AI model has better performance than conventional guidelines for predicting LNM in T1 CRCs and therefore could significantly reduce unnecessary additional surgery.

Effects of air environmental audit on reducing air pollutant emissions: evidence from China.

In order to mitigate air pollution, governments have implemented various active measures for air pollution prevention and control, among which the air environmental audit is an essential supervision initiative of air environmental regulation policy. This study aims to focus on and investigate the role of air environmental audit in national governance systems by collecting panel data on air environmental audits and air pollutant emissions from 261 prefecture-level cities across China between 2004 and 2018. Using difference-in-differences (DID) models, we empirically analyzed the policy effects of air environmental audits on reducing air pollutant emissions. The results indicate that air environmental audits have a significant impact on reducing air pollutant emissions, which is robust under multiple scenarios, including propensity score matching and placebo tests. The effect of air environmental audits varies significantly among different air pollutants, with the most significant and rapid effect observed on PM2.5 concentration, while industrial sulfur dioxide and industrial smoke (dust) emissions exhibit a time lag. Moreover, the promotion effect of air environmental audits on air pollution control displays strong heterogeneity based on local economic levels, initial environmental quality, and government competition. Therefore, it is of great significance to intensify the implementation of air environmental audits for air pollution control and to promote and improve the audit work according to pollutant classification and local conditions, thereby fully leveraging the audit's role and further improving air quality continuously.