Organic Cation Modulation in Manganese Halides to Optimize Crystallization Process and X-Ray Response Toward Large-Area Scintillator Screen.

Manganese halides are one of the most potential candidates for large-area flat-panel detection owing to their biological safety and all-solution preparation. However, reducing photon scattering and enhancing the efficient luminescence of scintillator screens remains a challenge due to their uncontrollable crystallization and serious nonradiative recombination. Herein, an organic cation modulation is reported to control the crystallization process and enhance the luminescence properties of manganese halides. Given the industrial requirements of the X-ray flat-panel detector, the large-area A2MnBr4 screen (900 cm2) with excellent uniformity is blade-coated at 60 °C. Theoretical calculations and in situ measurements reveal that organic cations with larger steric hindrance can slow down the crystallization of the screen, thus neatening the crystal arrangement and reducing the photon scattering. Moreover, larger steric hindrance can also endow the material with higher exciton binding energy, which is beneficial for restraining nonradiative recombination. Therefore, the BPP2MnBr4 (BPP = C25H22P+) screen with larger steric hindrance exhibits a superior spatial resolution (>20 lp mm-1) and ultra-low detection limit (< 250 nGyair s-1). This is the first time steric hindrance modulation is used in blade-coated scintillator screens, and it believes this study will provide some guidance for the development of high-performance manganese halide scintillators.

Construction and validation of serum Metabolic Risk Score for early warning of malignancy in esophagus.

Using noninvasive biomarkers to identify high-risk individuals prior to endoscopic examination is crucial for optimization of screening strategies for esophageal squamous cell carcinoma (ESCC). We conducted a nested case-control study based on two community-based screening cohorts to evaluate the warning value of serum metabolites for esophageal malignancy. The serum samples were collected at enrollment when the cases had not been diagnosed. We identified 74 differential metabolites and two prominent perturbed metabolic pathways, and constructed Metabolic Risk Score (MRS) based on 22 selected metabolic predictors. The MRS generated an area under the receiver operating characteristics curve (AUC) of 0.815. The model performed well for the within-1-year interval (AUC: 0.868) and 1-to-5-year interval (AUC: 0.845) from blood draw to diagnosis, but showed limited ability in predicting long-term cases (>5 years). In summary, the MRS could serve as a potential early warning and risk stratification tool for establishing a precision strategy of ESCC screening.

Circulating metabolites and coronary heart disease: a bidirectional Mendelian randomization.

Background: Numerous studies have established a link between coronary heart disease and metabolic disorders. Yet, causal evidence connecting metabolites and Coronary Heart Disease (CHD) remains scarce. To address this, we performed a bidirectional Mendelian Randomization (MR) analysis investigating the causal relationship between blood metabolites and CHD. Methods: Data were extracted from published genome-wide association studies (GWASs) on metabolite levels, focusing on 1,400 metabolite summary data as exposure measures. Primary analyses utilized the GWAS catalog database GCST90199698 (60,801 cases and 123,504 controls) and the FinnGen cohort (43,518 cases and 333,759 controls). The primary method used for causality analysis was random inverse variance weighting (IVW). Supplementary analyses included MR-Egger, weighted mode, and weighted median methods. Sensitivity analyses were conducted to evaluate heterogeneity and pleiotropy. Reverse MR analysis was employed to evaluate the direct impact of metabolites on coronary heart disease. Additionally, replication and meta-analysis were performed. We further conducted the Steiger test and colocalization analysis to reflect the causality deeply. Results: This study identified eight metabolites associated with lipids, amino acids and metabolite ratios that may influence CHD risk. Findings include: 1-oleoyl-2-arachidonoyl-GPE (18:1/20:4) levels: OR = 1.08; 95% CI 1.04-1.12; P = 8.21E-06; 1-palmitoyl-2-arachidonoyl-GPE (16:0/20:4) levels: OR = 1.07; 95% CI 1.04-1.11; P = 9.01E-05; Linoleoyl-arachidonoyl-glycerol (18:2/20:4): OR = 1.08; 95% CI 1.04-1.22; P = 0.0001; Glycocholenate sulfate: OR = 0.93; 95% CI 0.90-0.97; P = 0.0002; 1-stearoyl-2-arachidonoyl-GPE (OR = 1.07; 95% CI 1.03-1.11; P = 0.0002); N-acetylasparagine (OR = 1.04; 95% CI 1.02-1.07; P = 0.0030); Octadecenedioate (C18:1-DC) (OR = 0.93; 95% CI 0.90-0.97; P = 0.0004); Phosphate to linoleoyl-arachidonoyl-glycerol (18:2-20:4) (1) ratio (OR = 0.92; 95% CI 0.88-0.97; P = 0.0005). Conclusion: The integration of genomics and metabolomics offers novel insights into the pathogenesis of CHD and holds significant importance for the screening and prevention of CHD.

RESILIENT Part 2: A Randomized, Open-Label Phase III Study of Liposomal Irinotecan Versus Topotecan in Adults With Relapsed Small Cell Lung Cancer.

PURPOSE: The phase III RESILIENT trial compared second-line liposomal irinotecan with topotecan in patients with small cell lung cancer (SCLC). PATIENTS AND METHODS: Patients with SCLC and progression on or after first-line platinum-based chemotherapy were randomly assigned (1:1) to intravenous (IV) liposomal irinotecan (70 mg/m2 every 2 weeks in a 6-week cycle) or IV topotecan (1.5 mg/m2 daily for 5 consecutive days, every 3 weeks in a 6-week cycle). The primary end point was overall survival (OS). Key secondary end points included progression-free survival (PFS) and objective response rate (ORR). RESULTS: Among 461 randomly assigned patients, 229 received liposomal irinotecan and 232 received topotecan. The median follow-up was 18.4 months. The median OS was 7.9 months with liposomal irinotecan versus 8.3 months with topotecan (hazard ratio [HR], 1.11 [95% CI, 0.90 to 1.37]; P = .31). The median PFS per blinded independent central review (BICR) was 4.0 months with liposomal irinotecan and 3.3 months with topotecan (HR, 0.96 [95% CI, 0.77 to 1.20]; nominal P = .71); ORR per BICR was 44.1% (95% CI, 37.6 to 50.8) and 21.6% (16.4 to 27.4), respectively. Overall, 42.0% and 83.4% of patients receiving liposomal irinotecan and topotecan, respectively, experienced grade ≥3 related treatment-emergent adverse events (TEAEs). The most common grade ≥3 related TEAEs were diarrhea (13.7%), neutropenia (8.0%), and decreased neutrophil count (4.4%) with liposomal irinotecan and neutropenia (51.6%), anemia (30.9%), and leukopenia (29.1%) with topotecan. CONCLUSION: Liposomal irinotecan and topotecan demonstrated similar median OS and PFS in patients with relapsed SCLC. Although the primary end point of OS was not met, liposomal irinotecan demonstrated a higher ORR than topotecan. The safety profile of liposomal irinotecan was consistent with its known safety profile; no new safety concerns emerged.

The relationship between social support and professional identity of health professional students from a two-way social support theory perspective: chain mediating effects of achievement motivation and meaning in life.

BACKGROUND: Studies has suggested that receiving social support improves the professional identity of health professional students. According to the two-way social support theory, social support includes receiving social support and giving social support. However, the effect of the two-way social support on health professional students' professional identity has not been clarified yet. METHODS: To explore the mechanism of how two-way social support affects health professional students' professional identity, an observational, cross-sectional study was conducted among a convenience and cluster sample of 1449 health professional students from two medical schools in western China. Measures included a short version of the two-way social support scale, a health professional students' professional identity questionnaire, an achievement motivation scale, and a meaning in life scale. Data were analyzed by use of SPSS26.0 software and PROCESSv4.0 plug-in. RESULTS: Receiving social support, giving social support, achievement motivation, meaning in life, and professional identity were positively correlated with each other. Receiving and giving social support not only directly predicted health professional students' professional identity, but also indirectly predicted health professional students' professional identity through the mediating roles of achievement motivation and meaning in life, and the chain mediating roles of achievement motivation and meaning in life, respectively. The effectiveness of predicting health professional students' professional identity varied among different types of two-way social support, which could be depicted as two-way social support > mainly giving social support > mainly receiving social support > low two-way social support. CONCLUSION: In the medical education, the awareness and ability of health professional students to receive and give social support should be strengthened. More attention should be drawn on the chain mediating effect of achievement motivation and meaning in life between two-way social support and professional identity. The current results shed new light on exploring effective ways of improving health professional students' professional identity, which suggested that more attention should be paid to the positive effects of mainly giving social support and two-way social support rather than only on the effects of receiving social support.

Surface reconstructed Fe@C1000 for enhanced Fenton-like catalysis: Sustainable ciprofloxacin degradation and toxicity reduction.

The Fe-based catalysts typically undergo severe problems such as deactivation and Fe sludge emission during the peroxymonosulfate (PMS) activation, which commonly leads to poor operation and secondary pollution. Herein, an S-doped Fe-based catalyst with a core-shell structure (Fe@CT, T = 1000°C) was synthesized, which can solve the above issues via the dynamic surface evolution during the reaction process. Specifically, the Fe0 on the surface of Fe@C1000 could be consumed rapidly, leaving numerous pores; the Fe3C from the core would subsequently migrate to the surface of Fe@C1000, replenishing the consumed active Fe species. The X-ray diffraction (XRD) and X-ray photoelectron spectroscopy (XPS) analyses demonstrated that the reaction surface reconstructed during the PMS activation, which involved the FeIII in-situ reduction by S species as well as the depletion/replenishment of effective Fe species. The reconstructed Fe@C1000 achieved near-zero Fe sludge emission (from 0.59 to 0.08-0.23 mg L-1) during 5 cycles and enabled the dynamic evolution of dominant reactive oxygen species (ROS) from SO4·- to FeIVO, sustainably improving the oxidation capacity (80.0-92.5% in following four cycles) to ciprofloxacin (CIP) and reducing the toxicity of its intermediates. Additionally, the reconstructed Fe@C1000/PMS system exhibited robust resistance to complex water matrix. This study provides a theoretical guideline for exploring surface reconstruction on catalytic activity and broadens the application of Fe-based catalysts in the contaminants elimination.

Evolution of Grain Boundaries Promoted Hydrogen Production for Industrial-Grade Current Density.

The development of efficient and durable high-current-density hydrogen production electrocatalysts is crucial for the large-scale production of green hydrogen and the early realization of hydrogen economic blueprint. Herein, the evolution of grain boundaries through Cu-mediated NiMo bimetallic oxides (MCu-BNiMo), which leading to the high efficiency of electrocatalyst for hydrogen evolution process (HER) in industrial-grade current density, is successfully driven. The optimal MCu0.10-BNiMo demonstrates ultrahigh current density (>2 A cm-2) at a smaller overpotential in 1 m KOH (572 mV), than that of BNiMo, which does not have lattice strain. Experimental and theoretical calculations reveal that MCu0.10-BNiMo with optimal lattice strain generated more electrophilic Mo sites with partial oxidation owing to accelerated charge transfer from Cu to Mo, which lowers the energy barriers for H* adsorption. These synergistic effects lead to the enhanced HER performance of MCu0.10-BNiMo. More importantly, industrial application of MCu0.10-BNiMo operated in alkaline electrolytic cell is also determined, with its current density reached 0.5 A cm-2 at 2.12 V and 0.1 A cm-2 at 1.79 V, which is nearly five-fold that of the state-of-the-art HER electrocatalyst Pt/C. The strategy provides valuable insights for achieving industrial-scale hydrogen production through a highly efficient HER electrocatalyst.

Molecular Design of Layered Hybrid Silver Bismuth Bromine Single Crystal for Ultra-Stable X-Ray Detection With Record Sensitivity.

Nowadays, weak interlayer coupling and unclear mechanism in layered hybrid silver bismuth bromine (LH-AgBiBr) are the main reasons for limiting its further enhanced X-ray detection sensitivity and stability. Herein, the design rules for LH-AgBiBr and its influence on X-ray detection performance are reported for the first time. Although shortening amine size can enhance interlayer coupling, its detection performance is severely hampered by its easier defect formation caused by enlarged micro strain. In contrast, an appropriate divalent amine design endows the material with improved interlayer coupling and released micro strain, which benefits crystal stability and mechanical hardness. Another contribution is to increase material density and dielectric constant; thus, enhancing X-ray absorption and carrier transport. Consequently, the optimized parallel device based on BDA2 AgBiBr8 achieves a record sensitivity of 2638 µC Gyair -1 cm-2 and an ultra-low detection limit of 7.4 nGyair s-1 , outperforming other reported LH-AgBiBr X-ray detectors. Moreover, the unencapsulated device displays remarkable anti-moisture, anti-thermal (>150 °C), and anti-radiation (>1000 Gyair ) endurance. Eventually, high-resolution hard X-ray imaging is demonstrated by linear detector arrays under a benign dose rate (1.63 µGyair s-1 ) and low external bias (5 V). Hence, these findings provide guidelines for future materials design and device optimization.

Lung Cancer Prediction Using Electronic Claims Records: A Transformer-Based Approach.

Electronic claims records (ECRs) are large scale and longitudinal collections of individual's medical service seeking actions. Compared to in-hospital medical records (EMRs), ECRs are more standardized and cross-sites. Recently, there has been studies showing promising results on modeling claims data for a wide range of medical applications. However, few of them address the exclusion criteria on cohort selection to extract new incidence without prior signs and also often lack of emphasis on predicting cancer in early stages. In this work, we aim to design a lung cancer prediction framework using ECRs with rigorous exclusion design using state-of-the-art sequence-based transformer. Furthermore, this work presents one of the first results by applying disease prediction model to the entire population in Taiwan. The result shows over 2.1 predictive power, 5 average positive predictive value (PPV), and 0.668 area under curve (AUC) in all-stage lung cancer and around 2.0 predictive power, 1 average PPV and 0.645 AUC in early-stage in our dataset. Sub-cohort analysis could funnel high precision selective group into prioritized clinical examination. Onset analysis validates the effect of our exclusion criteria. This work presents comprehensive analyses on lung cancer prediction, and the proposed approach can serve as a state-of-the-art disease risk prediction framework on claims data.

NALIRIFOX versus nab-paclitaxel and gemcitabine in treatment-naive patients with metastatic pancreatic ductal adenocarcinoma (NAPOLI 3): a randomised, open-label, phase 3 trial.

BACKGROUND: Pancreatic ductal adenocarcinoma remains one of the most lethal malignancies, with few treatment options. NAPOLI 3 aimed to compare the efficacy and safety of NALIRIFOX versus nab-paclitaxel and gemcitabine as first-line therapy for metastatic pancreatic ductal adenocarcinoma (mPDAC). METHODS: NAPOLI 3 was a randomised, open-label, phase 3 study conducted at 187 community and academic sites in 18 countries worldwide across Europe, North America, South America, Asia, and Australia. Patients with mPDAC and Eastern Cooperative Oncology Group performance status score 0 or 1 were randomly assigned (1:1) to receive NALIRIFOX (liposomal irinotecan 50 mg/m2, oxaliplatin 60 mg/m2, leucovorin 400 mg/m2, and fluorouracil 2400 mg/m2, administered sequentially as a continuous intravenous infusion over 46 h) on days 1 and 15 of a 28-day cycle or nab-paclitaxel 125 mg/m2 and gemcitabine 1000 mg/m2, administered intravenously, on days 1, 8, and 15 of a 28-day cycle. Balanced block randomisation was stratified by geographical region, performance status, and liver metastases, managed through an interactive web response system. The primary endpoint was overall survival in the intention-to-treat population, evaluated when at least 543 events were observed across the two treatment groups. Safety was evaluated in all patients who received at least one dose of study treatment. This completed trial is registered with ClinicalTrials.gov, NCT04083235. FINDINGS: Between Feb 19, 2020 and Aug 17, 2021, 770 patients were randomly assigned (NALIRIFOX, 383; nab-paclitaxel-gemcitabine, 387; median follow-up 16·1 months [IQR 13·4-19·1]). Median overall survival was 11·1 months (95% CI 10·0-12·1) with NALIRIFOX versus 9·2 months (8·3-10·6) with nab-paclitaxel-gemcitabine (hazard ratio 0·83; 95% CI 0·70-0·99; p=0·036). Grade 3 or higher treatment-emergent adverse events occurred in 322 (87%) of 370 patients receiving NALIRIFOX and 326 (86%) of 379 patients receiving nab-paclitaxel-gemcitabine; treatment-related deaths occurred in six (2%) patients in the NALIRIFOX group and eight (2%) patients in the nab-paclitaxel-gemcitabine group. INTERPRETATION: Our findings support use of the NALIRIFOX regimen as a possible reference regimen for first-line treatment of mPDAC. FUNDING: Ipsen. TRANSLATION: For the plain language summary see Supplementary Materials section.

Absence of Lugol staining indicates initiation of esophageal squamous cell carcinoma: A combined genomic and epidemiologic study.

The genomic characteristics during the carcinogenic process of esophageal squamous cell carcinoma (ESCC) remain largely unknown. We report here the genomic characteristics of 106 esophageal tissues of various stages from a population-based screening cohort in China ("Endoscopic Screening for Esophageal Cancer in China" trial) and 57 ESCC tissues from a local hospital. A significant increase in somatic mutation and copy number alterations is observed in the non-dysplastic Lugol unstaining lesions (ND-LULs). Extensive clonal expansion has emerged in the ND-LULs to an extent similar to that in higher-stage lesions. The burden of genomic alterations correlates with the size of LULs in the ND-LULs. 8-year follow-up shows that ND-LULs harbor an increased risk of progression to ESCC (adjusted IRR6-10 mm vs. none = 4.66, adjusted IRR>10 mm vs. none = 40.70), and the risk is correlated with LUL size for both non-dysplastic and dysplastic lesions. Lugol unstaining can be the initial stage in the carcinogenic process of ESCC.

Predictive value of intratumoral-metabolic heterogeneity derived from 18F-FDG PET/CT in distinguishing microsatellite instability status of colorectal carcinoma.

Purpose/background: Microsatellite instability (MSI) status is a significant biomarker for the response to immune checkpoint inhibitors, response to 5-fluorouracil-based adjuvant chemotherapy, and prognosis in colorectal carcinoma (CRC). This study investigated the predictive value of intratumoral-metabolic heterogeneity (IMH) and conventional metabolic parameters derived from 18F-FDG PET/CT for MSI in patients with stage I-III CRC. Methods: This study was a retrospective analysis of 152 CRC patients with pathologically proven MSI who underwent 18F-FDG PET/CT examination from January 2016 to May 2022. Intratumoral-metabolic heterogeneity (including heterogeneity index [HI] and heterogeneity factor [HF]) and conventional metabolic parameters (standardized uptake value [SUV], metabolic tumor volume [MTV], and total lesion glycolysis [TLG]) of the primary lesions were determined. MTV and SUVmean were calculated on the basis of the percentage threshold of SUVs at 30%-70%. TLG, HI, and HF were obtained on the basis of the above corresponding thresholds. MSI was determined by immunohistochemical evaluation. Differences in clinicopathologic and various metabolic parameters between MSI-High (MSI-H) and microsatellite stability (MSS) groups were assessed. Potential risk factors for MSI were assessed by logistic regression analyses and used for construction of the mathematical model. Area under the curve (AUC) were used to evaluate the predictive ability of factors for MSI. Results: This study included 88 patients with CRC in stages I-III, including 19 (21.6%) patients with MSI-H and 69 (78.4%) patients with MSS. Poor differentiation, mucinous component, and various metabolic parameters including MTV30%, MTV40%, MTV50%, and MTV60%, as well as HI50%, HI60%, HI70%, and HF in the MSI-H group were significantly higher than those in the MSS group (all P < 0.05). In multivariate logistic regression analyses, post-standardized HI60% by Z-score (P = 0.037, OR: 2.107) and mucinous component (P < 0.001, OR:11.394) were independently correlated with MSI. AUC of HI60% and our model of the HI60% + mucinous component was 0.685 and 0.850, respectively (P = 0.019), and the AUC of HI30% in predicting the mucinous component was 0.663. Conclusions: Intratumoral-metabolic heterogeneity derived from 18F-FDG PET/CT was higher in MSI-H CRC and predicted MSI in stage I-III CRC patients preoperatively. HI60% and mucinous component were independent risk factors for MSI. These findings provide new methods to predict the MSI and mucinous component for patients with CRC.

Quantitative assessment of renal functions using 68Ga-EDTA dynamic PET imaging in renal injury in mice of different origins.

Background: Early detection of kidney diseases can be challenging as conventional methods such as blood tests or imaging techniques (computed tomography (CT), magnetic resonance imaging (MRI), or ultrasonography) may be insufficient to assess renal function. A single-photon emission CT (SPECT) renal scan provides a means of measuring glomerular filtration rates (GFRs), but its diagnostic accuracy is limited due to its planar imaging modality and semi-quantification property. In this study, we aimed to improve the accuracy of GFR measurement by preparing a positron emission tonometry (PET) tracer 68Ga-Ethylenediaminetetraacetic acid (68Ga-EDTA) and comprehensively evaluating its performance in healthy mice and murine models of renal dysfunction. Methods: Dynamic PET scans were performed in healthy C57BL/6 mice and in models of renal injury, including acute kidney injury (AKI) and unilateral ureter obstruction (UUO) using 68Ga-EDTA. In a 30-min dynamic scan, PET images and time-activity curves (TACs) were acquired. Renal function and GFR values were measured using renograms and validated through serum renal function parameters, biodistribution results, and pathological staining. Results: 68Ga-EDTA dynamic PET imaging quantitatively captured the tracer elimination process. The calculated GFR values were 0.25 ± 0.02 ml/min in healthy mice, 0.01 ± 0.00 ml/min in AKI mice, and 0.25 ± 0.04, 0.29 ± 0.03 and 0.24 ± 0.01 ml/min in UUO mice, respectively. Furthermore, 68Ga-EDTA dynamic PET imaging and GFRPET were able to differentiate mild renal impairment before serum parameters indicated any changes. Conclusions: Our findings demonstrate that 68Ga-EDTA dynamic PET provides a reliable and precise means of evaluating renal function in two murine models of renal injury. These results hold promise for the widespread clinical application of 68Ga-EDTA dynamic PET in the near future.

Enhanced Desulfurization by Tannin Extract Absorption Assisted by Binuclear Sulfonated Phthalocyanine Cobalt Polymer: Performance and Mechanism.

Removal of hydrogen sulfide (H2S) from coke oven gas has attracted increasing attention due to economic and environmental concerns. In this study, tannin extract (TE) absorption combined with binuclear sulfonated phthalocyanine cobalt organic polymer (OTS) and binuclear sulfonated phthalocyanine cobalt (PDS) with a fixed bed reactor is used for removal of H2S. The effect of gas flow rate, concentration of H2S, co-existence of organic sulfide compounds and O2 were investigated. Then, the effect of total alkalinity content of TE, NaVO3, OTS and PDS was studied in detail. The experimental results demonstrated that 100% H2S conversion could maintain for 13 h at a total alkalinity of 5.0 g/L, TE concentration of 4.0 g/L, NaVO3 concentration of 5 g/L, and OTS and PDS concentration of 0.2 g/L and 0.2 g/L, respectively. The OTS and PDS showed synergistic effect on boosting TE desulfurization efficiency. The results provide a new route for the investigation of liquid catalyzed oxidation desulfurization in an efficient and low-cost way.

Is Adjuvant Therapy a Better Option for Esophageal Squamous Cell Carcinoma Patients Treated With Esophagectomy? A Prognosis Prediction Model Based on Multicenter Real-World Data.

OBJECTIVE: To construct a prediction model for more precise evaluation of prognosis which will allow personalized treatment recommendations for adjuvant therapy in patients following resection of ESCC. BACKGROUND: Marked heterogeneity of patient prognosis and limited evidence regarding survival benefit of various adjuvant therapy regimens pose challenges in the clinical treatment of ESCC. METHODS: Based on comprehensive clinical data obtained from 4129 consecutive patients with resected ESCC in a high-risk region in China, we identified predictors for overall survival through a 2-phase selection based on Cox proportional hazard regression and minimization of Akaike information criterion. The model was internally validated using bootstrapping and externally validated in 1815 patients from a non-high-risk region in China. RESULTS: The final model incorporates 9 variables: age, sex, primary site, T stage, N stage, number of lymph nodes harvested, tumor size, adjuvant treatment, and hemoglobin level. A significant interaction was also observed between N stage and adjuvant treatment. N1+ stage patients were likely to benefit from addition of adjuvant therapy as opposed to surgery alone, but adjuvant therapy did not improve overall survival for N0 stage patients. The C -index of the model was 0.729 in the training cohort, 0.723 after bootstrapping, and 0.695 in the external validation cohort. This model outperformed the seventh edition American Joint Committee on Cancer staging system in prognostic prediction and risk stratification. CONCLUSIONS: The prediction model constructed in this study may facilitate precise prediction of survival and inform decision-making about adjuvant therapy according to N stage.

Minimally Invasive or Open Esophagectomy for Treatment of Resectable Esophageal Squamous Cell Carcinoma? Answer From a Real-world Multicenter Study.

OBJECTIVE: To evaluate the long-term and short-term outcomes of MIE compared with OE in localized ESCC patients in real-world settings. BACKGROUND: MIE is an alternative to OE, despite the limited evidence regarding its effect on long-term survival. METHODS: We recruited 5822 consecutive patients with resectable ESCC in 2 typical high-volume centers in southern and northern China, 1453 of whom underwent MIE. Propensity score-based overlap weighted regression adjusted for multifaceted confounding factors was used to compare outcomes in the MIE and OE groups. RESULTS: Five-year OS was 62.7% in the MIE group and 57.7% in the OE group. The overlap weighted Cox regression showed slightly better OS in the MIE group (hazard ratio 0.93, 95% confidence interval: 0.82-1.06). Although duration of surgery was longer and treatment cost higher in the MIE group than in the OE group, the number of lymph nodes harvested was larger, the proportion of intraoperative blood transfusions lower, and postoperative complications less in the MIE group. 30-day (risk ratio [RR] 0.77, 0.381.55) and 90-day (RR 0.79, 0.46-1.35) mortality were lower in the MIE group versus the OE group, although not statistically significant. These findings were consistent across different analytic approaches and subgroups, notably in the subset of ESCC patients with large tumors. CONCLUSIONS: MIE can be performed safely with OS comparable to OE for patients with localized ESCC, indicating MIE may be recommended as the primary surgical approach for resectable ESCC in health facilities with requisite technical capacity.

Factor decomposition for ecological pressure of the whole industrial energy carbon footprint: a case study of China.

The purpose of this paper is to study the influencing factors of the ecological pressure of the energy carbon footprint (EPECF) of China's whole industry from 2000 to 2018. First, the EPECF of 48 sub industries is calculated, then divides 48 sub-industries into high-, medium-, and low-pressure industries, and uses the logarithmic mean Divisia index (LMDI) method to analyze and summarize the main driving forces of China's industrial EPECF changes. Finally, policy suggestions for the future industrial decompression are put forward. The main results are as follows: (1) Economic development is the most important factor to promote the growth of EPECF of the three major industries. (2) At present, the population pressure factors of forest and grassland have little effect, and the effect of returning farmland to forest and grassland has not been truly played. (3) The adjustment of industrial structure has gradually become a key factor in reducing EPECF of the three industries. (4) The gradual stability of energy intensity has a certain inhibitory effect on the increase of EPECF in high-pressure industry. (5) The adjustment of energy structure in low-pressure industry has gradually worked. Therefore, the government should establish an economic sustainable development system, vigorously develop clean energy, and realize the green transformation of various industries. This provides an empirical example for other countries in the world to reduce the EPECF.

Decoupling trend and emission reduction potential of CO2 emissions from China's petrochemical industry.

This paper aims to study the decoupling status and emission reduction potential of China's petrochemical industry from 1996 to 2019. Firstly, the IPCC method is used to calculate the CO2 emissions of the petrochemical industry in China, then the logarithmic mean Divisia index (LMDI) method is used to identify the influencing factors of CO2 emissions, then the decoupling index is constructed to analyze the dependence of economic development on CO2 emissions, and finally the emission reduction potential model is established by using the influencing factors to reflect the CO2 emission reduction potential of the petrochemical industry. The results reveal that (1) the CO2 emissions can be divided into two stages of slow decline (1996-2000), (2015-2019), and one stage of rapid growth (2000-2015). (2) The energy intensity effect is the most effective factor to restrain CO2 emission, the economic growth effect is the key factor to promote CO2 emission. (3) From 1996 to 2019, there was a weak decoupling relationship between CO2 emission of petrochemical industry and economic development. Strong decoupling only occurred in 1996-2000 and 2015-2019. The CO2 emissions show only three decoupling score: I, II, and III. (4) CO2 mitigation occurred in four sub periods: 1996-2000, 2005-2010, 2010-2015, and 2015-2019. Therefore, the government should establish an energy-saving and environment-friendly industrial production system, intensify the use of clean energy, and optimize the labor force structure. It not only effectively strengthens the decoupling between the petrochemical industry and economic development, but also provides an empirical example for the carbon emission reduction and economic sustainable development of the petrochemical industry in other countries in the world.

Corrigendum: Predictive value of intratumoral-metabolic heterogeneity derived from 18F-FDG PET/CT in distinguishing microsatellite instability status of colorectal carcinoma.

[This corrects the article DOI: 10.3389/fonc.2023.1065744.].