Development and validation of an intraoperative hypothermia nomograph model for patients undergoing video-assisted thoracoscopic lobectomy: a retrospective study.

This study aimed to develop and internally validate a nomogram model for assessing the risk of intraoperative hypothermia in patients undergoing video-assisted thoracoscopic (VATS) lobectomy. This study is a retrospective study. A total of 530 patients who undergoing VATS lobectomy from January 2022 to December 2023 in a tertiary hospital in Wuhan were selected. Patients were divided into hypothermia group (n = 346) and non-hypothermia group (n = 184) according to whether hypothermia occurred during the operation. Lasso regression was used to screen the independent variables. Logistic regression was used to analyze the risk factors of hypothermia during operation, and a nomogram model was established. Bootstrap method was used to internally verify the nomogram model. Receiver operating characteristic (ROC) curve was used to evaluate the discrimination of the model. Calibration curve and Hosmer Lemeshow test were used to evaluate the accuracy of the model. Decision curve analysis (DCA) was used to evaluate the clinical utility of the model. Intraoperative hypothermia occurred in 346 of 530 patients undergoing VATS lobectomy (65.28%). Logistic regression analysis showed that age, serum total bilirubin, inhaled desflurane, anesthesia duration, intraoperative infusion volume, intraoperative blood loss and body mass index were risk factors for intraoperative hypothermia in patients undergoing VATS lobectomy (P < 0.05). The area under ROC curve was 0.757, 95% CI (0.714-0.799). The optimal cutoff value was 0.635, the sensitivity was 0.717, and the specificity was 0.658. These results suggested that the model was well discriminated. Calibration curve has shown that the actual values are generally in agreement with the predicted values. Hosmer-Lemeshow test showed that χ2 = 5.588, P = 0.693, indicating that the model has a good accuracy. The DCA results confirmed that the model had high clinical utility. The nomogram model constructed in this study showed good discrimination, accuracy and clinical utility in predicting patients with intraoperative hypothermia, which can provide reference for medical staff to screen high-risk of intraoperative hypothermia in patients undergoing VATS lobectomy.

Provenance of Aerosol Black Carbon over Northeast Indian Ocean and South China Sea and Implications for Oceanic Black Carbon Cycling.

Aerosol black carbon (BC) is a short-lived climate pollutant. The poorly constrained provenance of tropical marine aerosol BC hinders the mechanistic understanding of extreme climate events and oceanic carbon cycling. Here, we collected PM2.5 samples during research cruise NORC2016-10 through South China Sea (SCS) and Northeast Indian Ocean (NEIO) and measured the dual-carbon isotope compositions (δ13C-Δ14C) of BC using hydrogen pyrolysis technique. Aerosol BC exhibits six different δ13C-Δ14C isotopic spaces (i.e., isotope provinces). Liquid fossil fuel combustion, from shipping emissions and adjacent land, is the predominant source of BC over isotope provinces "SCS close to Chinese Mainland" (53.5%), "Malacca Strait" (53.4%), and "Open NEIO" (40.7%). C3 biomass burning is the major contributor to BC over isotope provinces "NEIO close to Southeast Asia" (55.8%), "Open NEIO" (41.3%), and "Open SCS" (40.0%). Coal combustion and C4 biomass burning show higher contributions to BC over "Sunda Strait" and "Open SCS" than the others. Overall, NEIO near the Bay of Bengal, Malacca Strait, and north SCS are three hot spots of fossil fuel-derived BC; the first two areas are also hot spots of biomass-derived BC. The comparable δ13C-Δ14C between BC in aerosol and dissolved BC in surface seawater may suggest atmospheric BC deposition as a potential source of oceanic dissolved BC.

Quantitative evaluation for the sources and aging processes of organic aerosols in urban Guangzhou: Insights from a comprehensive method of dual­carbon isotopes and macro tracers.

Organic carbon aerosol (OC) is a pivotal component of PM2.5 in the atmospheric environment, yet its emission sources and atmospheric behaviors remain poorly constrained in many regions. In this study, a comprehensive method based on the combination of dual­carbon isotopes (13C and 14C) and macro tracers was employed in the PRDAIO campaign performed in the megacity of Guangzhou, China. The 14C analysis showed that 60 ± 9 % of OC during the sampling campaign was associated with non-fossil sources such as biomass burning activities and biogenic emissions. It should be noted that this non-fossil contribution in OC would significantly decrease when the air masses came from the eastern cities. Overall, we found that non-fossil secondary OC (SOCNF) was the largest contributor (39 ± 10 %) to OC, followed by fossil secondary OC (SOCFF: 26 ± 5 %), fossil primary OC (POCFF: 14 ± 6 %), biomass burning OC (OCbb: 13 ± 6 %) and cooking OC (OCck: 8 ± 5 %). Also, we established the dynamic variation of 13C as a function of aged OC and the volatile organic compounds (VOCs) oxidized OC to explore the impact of aging processes on OC. Our pilot results showed that atmospheric aging was highly sensitive to the emission sources of seed OC particles, with a higher aging degree (86 ± 4 %) when more non-fossil OC particles were transferred from the northern PRD.

Source Diversity of Intermediate Volatility n-Alkanes Revealed by Compound-Specific δ13C-δD Isotopes.

Intermediate volatility organic compounds (IVOCs) are important precursors of secondary organic aerosols, and their sources remain poorly defined. N-alkanes represent a considerable portion of IVOCs in atmosphere, which can be well identified and quantified out of the complex IVOC pool. To investigate the potential source diversity of intermediate volatility n-alkanes (IVnAs, nC12-nC20), we apportioned the sources of IVnAs in the atmosphere of four North China cities, based on their compound-specific δ13C-δD isotope compositions and Bayesian model analysis. The concentration level of IVnAs reached 1195 ± 594 ng/m3. The δ13C values of IVnAs ranged -32.3 to -27.6‰ and δD values -161 to -90‰. The δD values showed a general increasing trend toward higher carbon number alkanes, albeit a zigzag odd-even prevalence. Bayesian MixSIAR model using δ13C and δD compositions revealed that the source patterns of individual IVnAs were inconsistent; the relative contributions of liquid fossil combustion were higher for lighter IVnAs (e.g., nC12-nC13), while those of coal combustion were higher for heavier IVnAs (e.g., nC17-nC20). This result agrees with principal component analysis of the dual isotope data. Overall, coal combustion, liquid fossil fuel combustion, and biomass burning contributed about 47.8 ± 0.1, 35.7 ± 4.0, and 16.3 ± 4.2% to the total IVnAs, respectively, highlighting the importance of coal combustion as an IVnA source in North China. Our study demonstrates that the dual-isotope approach is a powerful tool for source apportionment of atmospheric IVOCs.

Large contribution of fossil-derived components to aqueous secondary organic aerosols in China.

Incomplete understanding of the sources of secondary organic aerosol (SOA) leads to large uncertainty in both air quality management and in climate change assessment. Chemical reactions occurring in the atmospheric aqueous phase represent an important source of SOA mass, yet, the effects of anthropogenic emissions on the aqueous SOA (aqSOA) are not well constrained. Here we use compound-specific dual-carbon isotopic fingerprints (δ13C and Δ14C) of dominant aqSOA molecules, such as oxalic acid, to track the precursor sources and formation mechanisms of aqSOA. Substantial stable carbon isotope fractionation of aqSOA molecules provides robust evidence for extensive aqueous-phase processing. Contrary to the paradigm that these aqSOA compounds are largely biogenic, radiocarbon-based source apportionments show that fossil precursors produced over one-half of the aqSOA molecules. Large fractions of fossil-derived aqSOA contribute substantially to the total water-soluble organic aerosol load and hence impact projections of both air quality and anthropogenic radiative forcing. Our findings reveal the importance of fossil emissions for aqSOA with effects on climate and air quality.

Dual-carbon isotope constraints on source apportionment of black carbon in the megacity Guangzhou of the Pearl River Delta region, China for 2018 autumn season.

Black carbon (BC) aerosol negatively affects air quality and contributes to climate warming globally. However, little is known about the relative contributions of different source control measures to BC reduction owing to the lack of powerful source-diagnostic tools. We combine the fingerprints of dual-carbon isotope using an optimized Bayesian Markov chain Monte Carlo (MCMC) scheme and for the first time to study the key sources of BC in megacity Guangzhou of the Pearl River Delta (PRD) region, China in 2018 autumn season. The MCMC model-derived source apportionment of BC shows that the dominant contributor is petroleum combustion (39%), followed by coal combustion (34%) and biomass burning (27%). It should be noted that the BC source pattern is highly sensitive to the variations of air masses transported with an enhanced contribution of fossil source from the eastern area, suggesting the important impact of regional atmospheric transportation on the BC source profile in the PRD region. Also, we further found that fossil fuel combustion BC contributed 84% to the total BC reduction during 2013-2018. The response of PM2.5 concentration to the 14C-derived BC source apportionment is successfully fitted (r = 0.90) and the results predicted that it would take ∼6 years to reach the WHO PM2.5 guideline value (10 µg m-3) for the PRD region if the emission control measures keep same as they are at present. Taken together, our findings suggest that dual-carbon isotope is a powerful tool in constraining the source apportionment of BC for the evaluations of air pollution control and carbon emission measures.

Biomass burning organic aerosols significantly influence the light absorption properties of polarity-dependent organic compounds in the Pearl River Delta Region, China.

Atmospheric brown carbon (BrC) is an important constituent of light-absorbing organic aerosols with many unclear issues. Here, the light-absorption properties of BrC with different polarity characteristics at a regional site of Pearl River Delta Region during 2016-2017, influenced by sources and molecular compositions, were revealed using radiocarbon analysis and Fourier transform ion cyclotron resonance mass spectrometry. Humic-like substance (HULIS), middle polar (MP), and low polar (LP) carbon fractions constitute 46 ± 17%, 30 ± 7%, and 7 ± 3% of total absorption coefficient from bulk extracts, respectively. Our results show that the absorption proportions of HULIS and MP to the total BrC absorption are higher than their mass proportions to organic carbon mass, indicating that HULIS and MP are the main light-absorbing components in water-soluble and water-insoluble organic carbon fractions, respectively. With decreases in non-fossil HULIS, MP, and LP carbon fractions (66 ± 2%, 52 ± 2%, and 36 ± 3%, respectively), the abundances of unsaturated compounds and mass absorption efficiency at 365 nm of three fractions decreased synchronously. Increases in both non-fossil carbon and levoglucosan in winter imply that the enhanced light-absorption could be attributed to elevated levels of biomass burning organic aerosols (BBOA), which increases the number of light-absorbing nitrogen-containing compounds. Moreover, the major type of potential BrC in HULIS and MP carbon fractions are oxidized BBOA, but the potential BrC chromophores in LP are mainly associated with primary BBOA. This study reveals that biomass burning has adverse effects on radiative forcing and air quality, and probably indicates the significant influences of atmospheric oxidation reactions on the forms of chromophores.

Isotope constraints of the strong influence of biomass burning to climate-forcing Black Carbon aerosols over Southeast Asia.

Black Carbon (BC) deteriorates air quality and contributes to climate warming, yet its regionally- and seasonally-varying emission sources are poorly constrained. Here we employ natural abundance radiocarbon (14C) measurements of BC intercepted at a northern Malaysia regional receptor site, Bachok, to quantify the relative biomass vs. fossil source contributions of atmospheric BC, in a first year-round study for SE Asia (December 2015-December 2016). The annual average 14C signature suggests as large contributions from biomass burning as from fossil fuel combustion. This is similar to findings from analogous measurements at S Asian receptors sites (~50% biomass burning), while E Asia sites are dominated by fossil emission (~20% biomass burning). The 14C-based source fingerprinting of BC in the dry spring season in SE Asia signals an even more elevated biomass burning contribution (~70% or even higher), presumably from forest, shrub and agricultural fires. This is consistent with this period showing also elevated ratio of organic carbon to BC (up from ~5 to 30) and estimates of BC emissions from satellite fire data. Hence, the present study emphasizes the importance of mitigating dry season vegetation fires in SE Asia.

Triple Isotopes (δ13C, δ2H, and Δ14C) Compositions and Source Apportionment of Atmospheric Naphthalene: A Key Surrogate of Intermediate-Volatility Organic Compounds (IVOCs).

Naphthalene (NAP), as a surrogate of intermediate-volatility organic compounds (IVOCs), has been proposed to be an important precursor of secondary organic aerosol (SOA). However, the relative contribution of its emission sources is still not explicit. This study firstly conducted the source apportionment of atmospheric NAP using a triple-isotope (δ13C, δ2H, and Δ14C) technique combined with a Bayesian model in the Beijing-Tianjin-Hebei (BTH) region of China. At the urban sites, stable carbon (-27.7 ± 0.7‰, δ13C) and radiocarbon (-944.0 ± 20.4‰, Δ14C) isotope compositions of NAP did not exhibit significant seasonal variation, but the deuterium system showed a relatively more 2H depleted signature in winter (-86.7 ± 8.9‰, δ2H) in comparison to that in summer (-56.4 ± 3.9‰, δ2H). Radiocarbon signatures indicated that 95.1 ± 1.8% of NAP was emitted from fossil sources in these cities. The Bayesian model results indicated that the emission source compositions in the BTH urban sites had a similar pattern. The contribution of liquid fossil combustion was highest (46.7 ± 2.6%), followed by coal high-temperature combustion (26.8 ± 7.1%), coal low-temperature combustion (18.9 ± 6.4%), and biomass burning (7.6 ± 3.1%). At the suburban site, the contribution of coal low-temperature combustion could reach 70.1 ± 6.4%. The triple-isotope based approach provides a top-down constraint on the sources of atmospheric NAP and could be further applied to other IVOCs in the ambient atmosphere.

Occurrence and sources of PCBs, PCNs, and HCB in the atmosphere at a regional background site in east China: Implications for combustion sources.

Multiple types of persistent organic pollutants (POPs), such as polychlorinated biphenyls (PCBs), polychlorinated naphthalenes (PCNs), and hexachlorobenzene (HCB), can be unintentionally released from combustion or thermal industrial processes, which are speculated to be the main sources of these contaminants, as they were banned on production and use since several decades ago. In this study, concentrations and sources of 40 PCBs, 39 PCNs, and HCB were analyzed in air samples collected during the period 2012-2015 at a background site in east China. ΣPCBs, ΣPCNs, and HCB were in the range of 9-341 pg/m3, 6-143 pg/m3, and 14-522 pg/m3, respectively. Seasonal characteristics with high levels in winter and low levels in summer were observed for PCNs and HCB. PCBs also exhibited slightly higher levels in winter. Source apportionment was conducted, using polycyclic aromatic hydrocarbons (PAHs) as combustion sources indicator, combined with principal component analysis (PCA) and positive matrix factorization (PMF) model. The results indicated that the legacy of past produced and used commercial PCBs was the dominant contributor (∼56%) to the selected PCBs in the atmosphere in east China. PCNs were mainly emitted from combustion sources (∼64%), whereas HCB almost entirely originated from combustion process (>90%).