Sustainable biochar application in anammox process: Unveiling novel pathways for enhanced nitrogen removal and efficient start-up at low temperature.

This study explored the use of biochar to accelerate the establishment of anaerobic ammonium oxidation (anammox) reactors operating at 15 ± 1℃. Incorporating 10 g/L bamboo charcoal in S1 accelerated the start-up of anammox in 87 days, which was significantly shorter than 103 days in S0 (without biochar). After 140 days, S1 exhibited a 10.9 % increase in nitrogen removal efficiency due to a 28.9 % elevation in extracellular polymeric substances, bolstering anammox bacterial resilience. Predominant anammox bacteria (Cadidatus Brocadia and Cadidatus Jettenia) showed relative abundances of 3.19 % and 0.38 % in S1, respectively, which were significantly higher than 0.40 % and 0.05 % in S0. Biochar provides favorable habitats for the enrichment of anammox bacteria and accelerates the establishment of anammox at low temperatures. This finding holds promise for enhancing the efficiency of anammox in cold climates and advancing sustainable wastewater nitrogen removal.

Construction of a Tumor-Targeting Nanobubble with Multiple Scattering Interfaces and its Enhancement of Ultrasound Imaging.

Introduction: Recently, nanobubbles (NBs) have gained significant traction in the field of tumor diagnosis and treatment owing to their distinctive advantages. However, the application of NBs is limited due to their restricted size and singular reflection section, resulting in low ultrasonic reflection. Methods: We synthesized a nano-scale ultrasound contrast agent (IR783-SiO2NPs@NB) by encapsulating SiO2 nanoparticles in an IR783-labeled lipid shell using an improved film hydration method. We characterized its physicochemical properties, examined its microscopic morphology, evaluated its stability and cytotoxicity, and assessed its contrast-enhanced ultrasound imaging capability both in vitro and in vivo. Results: The results show that IR783-SiO2NPs@NB had a "donut-type" composite microstructure, exhibited uniform particle size distribution (637.2 ± 86.4 nm), demonstrated excellent stability (30 min), high biocompatibility, remarkable tumor specific binding efficiency (99.78%), and an exceptional contrast-enhanced ultrasound imaging capability. Conclusion: Our newly developed multiple scattering NBs with tumor targeting capacity have excellent contrast-enhanced imaging capability, and they show relatively long contrast enhancement duration in solid tumors, thus providing a new approach to the structural design of NBs.

Safety and efficacy of transcatheter arterial embolization in autosomal dominant polycystic kidney patients with gross hematuria: Six case reports.

BACKGROUND: To retrospectively report the safety and efficacy of renal transcatheter arterial embolization for treating autosomal dominant polycystic kidney disease (ADPKD) patients with gross hematuria. CASE SUMMARY: The purpose of this study is to retrospectively report the safety and efficacy of renal transcatheter arterial embolization for treating ADPKD patients with gross hematuria. Materials and methods: During the period from January 2018 to December 2019, renal transcatheter arterial embolization was carried out on 6 patients with polycystic kidneys and gross hematuria. Renal arteriography was performed first, and then we determined the location of the hemorrhage and performed embolization under digital subtraction angiography monitoring. Improvements in routine blood test results, routine urine test results, urine color and postoperative reactions were observed and analyzed. Results: Renal transcatheter arterial embolization was successfully conducted in 6 patients. The indices of 5 patients and the color of gross hematuria improved after surgery compared with before surgery. No severe complication reactions occurred. CONCLUSION: For autosomal dominant polycystic kidney syndrome patients with gross hematuria, transcatheter arterial embolization was safe and effective.

Multifunctional polysaccharide/metal/polyphenol double-crosslinked hydrogel for infected wound.

Bacterial-infected wounds present a significant challenge in the medical field, posing a severe threat to public health. Traditional wound dressings have limited efficacy in treating bacterial-infected wounds, and antibiotics suffer from cytotoxicity and drug resistance. Consequently, an urgent requirement exists for developing multifunctional wound dressings capable of providing superior antimicrobial activity and expediting wound repair. In recent years, chitosan-based natural polysaccharide hydrogels have garnered attention for their biocompatibility, antimicrobial properties, and ability to aid in hemostasis. This study presents the development of a multi-functional, bi-dynamic network hydrogel for the treatment of wounds infected with bacteria. The hydrogel consists of a backbone of chitosan grafted with chlorogenic acid (CA-ECS), oxidized pullulan polysaccharides (OP), and zinc ions (Zn2+). The CA-ECS/OP/Zn2+ hydrogel displayed strong adhesion, good injectability, and high mechanical strength and was biodegradable and biocompatible. Furthermore, adding Zn2+ and CA enhanced the hydrogel's mechanical properties and antioxidant and antimicrobial activities. In a rat model of full-thickness skin wounds infected with S. aureus, the CA-ECS/OP/Zn2+ hydrogel demonstrated great anti-inflammatory, angiogenic, and folliculogenic properties, resulting in accelerated wound healing. The CA-ECS/OP/Zn2+ hydrogel has great potential for treating bacterial-infected wounds.

A Photo-induced Cross-Linking Enhanced A and B Combined Multi-Functional Spray Hydrogel Instantly Protects and Promotes of Irregular Dynamic Wound Healing.

Wounds in harsh environments can face long-term inflammation and persistent infection, which can slow healing. Wound spray is a product that can be rapidly applied to large and irregularly dynamic wounds, and can quickly form a protective film in situ to inhibit external environmental infection. In this study, a biodegradable A and B combined multi-functional spray hydrogel is developed with methacrylate-modified chitosan (CSMA1st ) and ferulic acid (FA) as type A raw materials and oxidized Bletilla striata polysaccharide (OBSP) as type B raw materials. The precursor CSMA1st -FA/OBSP (CSOB-FA1st ) hydrogel is formed by the self-cross-linking of dynamic Schiff base bonds, the CSMA-FA/OBSP (CSOB-FA) hydrogel is formed quickly after UV-vis light, so that the hydrogel fits with the wound. Rapid spraying and curing provide sufficient flexibility and rapidity for wounds and the hydrogel has good injectability, adhesive, and mechanical strength. In rats and miniature pigs, the A and B combined spray hydrogel can shrink wounds and promote healing of infected wounds, and promote the enrichment of fibrocyte populations. Therefore, the multifunctional spray hydrogel combined with A and B can protect irregular dynamic wounds, prevent wound infection and secondary injury, and be used for safe and effective wound treatment, which has a good prospect for development.

Prognostic Value of Macrophage Inflammatory Protein-3alpha (MIP3-Alpha) and Severity Scores in Elderly Patients with Sepsis.

Objective: This study examines the effectiveness of MIP-3alpha and severity scores in determining the prognosis of elderly sepsis patients. Methods: From October 2020 to April 2021, a total of 171 elderly sepsis patients were admitted to the Emergency Department of the Shijingshan Branch of Beijing Chaoyang Hospital, Capital Medical University. According to the 28-day mortality rate, they were divided into two groups: survivors (48 cases) and deaths (123 cases). At admission, severity scores which are the Sequential Organ Failure Assessment (SOFA) and the Acute Physiology and Chronic Health Evaluation II (APACHE II) were calculated. The logistic regression was used to analyze the independent risk factors associated with 28-day mortality in elderly sepsis patients. The receiver operating characteristic (ROC) curve and area under the curve (AUC) were used to evaluate the value of MIP-3alpha, SOFA, and APACHE II in the evaluation of 28-day mortality in elderly sepsis patients. Results: MIP-3alpha, SOFA and APACHE II of the death group were significantly higher than those of the survival group (P < 0.05). Multivariate logistic regression analysis showed that MIP-3alpha, SOFA, APACHE II, and systolic blood pressure (SBP) were independent risk factors for 28-day mortality of senile sepsis (P < 0.05). Analysis of the ROC curve revealed that MIP-3alpha, SOFA, APACHE II had predictive value for the 28-day prognosis of senile sepsis (all P < 0.01). Combing with MIP-3alpha and SOFA showed better predictive ability (Z1 = 3.733, Z2 = 2.996, both P < 0.01), compared to detecting MIP-3alpha and SOFA alone. Conclusion: In senile sepsis, MIP-3alpha, SOFA, APACHE II and SBP are independent risk factors for 28-day mortality. The combination of MIP-3alpha and SOFA can further enhance the predictive value of 28-day mortality in patients with senile sepsis and provide some reference value for the evaluation and treatment of senile sepsis.

Insect chitosan/pullulan/gallium photo-crosslinking hydrogels with multiple bioactivities promote MRSA-infected wound healing.

Methicillin-resistant Staphylococcus aureus (MRSA) and other drug-resistant bacteria have become more common in recent years, which has made it extremely difficult to treat and heal many different kinds of wounds and caused enormous financial losses. Because of its unique "Trojan horse" function, Ga3+ has been recognized as a new possible candidate for inhibiting and eradicating drug-resistant bacteria. Furthermore, natural polysaccharide materials with outstanding biological characteristics, such as insect chitosan (CS) and pullulan (PUL), have attracted significant interest. In this study, we used quaternized-catechol chitosan (QDCS-PA), methacrylate-dialdehyde pullulan (DPUL-GMA), and gallium ion (Ga) to create a multi-crosslinked photo-enhanced hydrogel (Q-D/Ga/UV) with antimicrobial, hemostatic, self-healing, and injectable properties for promoting MRSA-infected wound healing. In vitro, the Q-D/Ga/UV hydrogels demonstrated good mechanical properties, antioxidant capabilities, biocompatibility, hemostatic properties, and antibacterial activity. The addition of gallium ions enhanced the hydrogels' mechanical properties, hemostatic capabilities, antibacterial activity, and ability to induce wound healing. Q-D/Ga/UV hydrogel significantly promoted wound contraction, collagen deposition, and angiogenesis while also suppressing inflammation in a whole-skin wound model of MRSA-infected rats. In conclusion, Q-D/Ga/UV hydrogels demonstrate significant promise for healing wounds infected with drug-resistant bacteria.

Enabling Stable and Low-Strain Lithium Plating/Stripping with 2D Layered Transition Metal Carbides by Forming Li-Zipped MXenes and a Li Halide-Rich Solid Electrolyte Interphase.

Two-dimensional (2D) layered materials demonstrate prominent advantage in regulating lithium plating/stripping behavior by confining lithium diffusion/plating within interlayer gaps. However, achieving effective interlayer confined lithium diffusion/plating without compromising the stability of bulk-structural and the solid electrolyte interphase (SEI) remains a considerable challenge. This paper presents an electrochemical scissor and lithium zipper-driven protocol for realizing interlayer confined lithium plating with pretty-low strain and volume change. In this protocol, lithium serves as a "zipper" to reunite the adjacent MXene back to MAX-like phase to markedly enhance the structural stability, and a lithium halide-rich SEI is formed by electrochemically removing the terminals of halogenated MXenes to maintain the stability and rapid lithium ions diffusion of SEI. When the Ti3 C2 I2 serves as the host for lithium plating, the average coulomb efficiency exceeds 97.0 % after 320 lithium plating/stripping cycles in conventional ester electrolyte. Furthermore, a full cell comprising of LiNi0.8 Mn0.1 Co0.1 O2 and Ti3 C2 I2 @Li exhibits a capacity retention rate of 73.4 % after 200 cycles even under high cathode mass-loading (20 mg cm-2 ) and a low negative/positive capacity ratio of 1.4. Our findings advance the understanding of interlayer confined lithium plating in 2D layered materials and provide a new direction in regulating lithium and other metal plating/stripping behaviors.

Biocompatible and biodegradable Bletilla striata polysaccharides hydrogels crosslinked by BDDE for wound healing through the regulating of macrophage polarization.

Bletilla striata polysaccharide (BSP) is a naturally occurring polysaccharide that demonstrates notable biocompatibility and biodegradability. Additionally, BSP possesses therapeutic attributes, including anti-inflammatory and reparative actions. Herein, we report a novel BSP hydrogel prepared using 1,4-butanediol diglycidyl ether (BDDE) as a cross-linking agent. The hydrogel was synthesized via condensation of the hydroxyl group in the BSP molecule with the epoxy group in BDDE. This technique of preparation preserves BSP's natural properties while avoiding any potentially hazardous or adverse effects that may occur during the chemical alteration. Compared with BSP before crosslinking, BSP hydrogel has distinct advantages, such as a three-dimensional network structure, improved water retention, enhanced swelling capacity, greater thermal stability, and superior mechanical properties. Experiments on in vitro cytotoxicity, hemolysis, and degradation revealed that BSP hydrogel had good biocompatibility and biodegradability. Finally, we evaluated the in vivo wound repair effect of BSP hydrogel, and the results showed that BSP hydrogel had a significant wound-healing effect. Furthermore, the BSP hydrogel promoted the polarization of M1-type macrophages towards the M2-type and reduced the inflammatory response during the wound healing phase. Because of its ease of production, safety, efficacy, and environmental friendliness, BSP hydrogel is considered a highly promising material for wound dressings.

Independent and reproducible hippocampal radiomics biomarkers for multisite multiple sclerosis and neuromyelitis optica spectrum disorders.

OBJECTIVE: To investigate the abnormal radiomics features of the hippocampus in patients with multiple sclerosis (MS) and neuromyelitis optica spectrum disorders (NMOSD) and to explore the clinical implications of these features. METHODS: 752 participants were recruited in this retrospective multicenter study (7 centers), which included 236 MS, 236 NMOSD, and 280 normal controls (NC). Radiomics features of each side of the hippocampus were extracted, including intensity, shape, texture, and wavelet features (N = 431). To identify the variations in these features, two-sample t-tests were performed between the NMOSD vs. NC, MS vs. NC, and NMOSD vs. MS groups at each site. The statistical results from each site were then integrated through meta-analysis. To investigate the clinical significance of the hippocampal radiomics features, we conducted further analysis to examine the correlations between these features and clinical measures such as Expanded Disability Status Scale (EDSS), Brief Visuospatial Memory Test (BVMT), California Verbal Learning Test (CVLT), and Paced Auditory Serial Addition Task (PASAT). RESULTS: Compared with NC, patients with MS exhibited significant differences in 78 radiomics features (P < 0.05/862), with the majority of these being texture features. Patients with NMOSD showed significant differences in 137 radiomics features (P < 0.05/862), most of which were intensity features. The difference between MS and NMOSD patients was observed in 47 radiomics features (P < 0.05/862), mainly texture features. In patients with MS and NMOSD, the most significant features related to the EDSS were intensity and textural features, and the most significant features related to the PASAT were intensity features. Meanwhile, both disease groups observed a weak correlation between radiomics data and BVMT. CONCLUSION: Variations in the microstructure of the hippocampus can be detected through radiomics, offering a new approach to investigating the abnormal pattern of the hippocampus in MS and NMOSD.

Cu/NiO nanorods for efficiently promoting the electrochemical nitrate reduction to ammonia.

The electrochemical nitrate reduction reaction (ENO3RR) is a green ammonia synthesis method under ambient conditions relative to the traditional Haber-Bosch technology, which does not require high-temperature or high-pressure conditions and can convert nitrate pollutants in the environment into value-added NH3, thus achieving a dual purpose. However, more electrocatalysts with a remarkable performance towards high-efficiency ENO3RR need to be developed. In this work, a Cu/NiO-NF composite electrocatalyst with a nanorod structure on nickel foam was successfully fabricated, which contains heterogeneous interfaces between Cu and NiO toward selective electrocatalytic nitrate reduction for ammonia synthesis. The steric nanorod morphology of the catalyst can significantly increase the surface area, expose more active sites, and improve the reaction activity. Moreover, the construction of the composite and the interface effectively boosts the synergistic effect of the active species Cu and NiO, which can regulate the electronic structure of the catalyst, expose more active sites, enhance the conductivity of the material, and accelerate the interfacial electron transfer, thereby further promoting the ENO3RR performance. This Cu/NiO-NF composite exhibits a high NH3 yield of 0.6 mmol h-1 cm-2 and up to 97.81% faradaic efficiency at the optimal applied potential of -1.0 V (vs. RHE) in a concentration of 0.1 M NO3--containing 0.1 M PBS. Furthermore, it demonstrates excellent electrochemical cycle stability. This work provides insights into the rational design and fabrication of ENO3RR electrocatalysts for potential electrocatalytic applications.

Identification of Potential Gene Targets for Suppressing Oviposition in Holotrichia parallela Using Comparative Transcriptome Analysis.

Holotrichia parallela is an important plant pest. Comparative feeding experiments showed that the egg production, oviposition duration and survival rate of H. parallela beetles were significantly higher when they fed on elm leaves than when they fed on willow or purpus privet leaves. RNA sequencing was used to determine transcriptomic changes associated with oviposition. Comparative transcriptome analysis revealed that the beetles that fed on elm and willow had a total of 171 genes with differential expression. When the beetles fed on elm and purpus privet, 3568 genes had differential expression. The vitellogenesis, ovarian serine protease, odorant-binding proteins, acyl-CoA synthetase and follicle cell proteins were commonly upregulated genes in elm-fed beetles compared with those fed on willow/purpus privet leaves. The involvement of the follicle cell protein 3C gene in the regulation of oviposition was confirmed using RNA interference. The results provide insights into the molecular mechanisms underlying oviposition in H. parallela feeding on different host plants. This study also describes a method for identifying potentially effective genes for pest control.

[Difference in Brain Age Between Alzheimer's Disease and Mild Cognitive Impairment].

Objective To investigate the brain age differences between Alzheimer's disease(AD)and mild cognitive impairment(MCI)patients,and further explore the correlations between brain age gap(BAG)and clinical features.Methods The clinical data and radiologic findings of 132 probable AD and AD-derived MCI patients diagnosed at Beijing Tiantan Hospital,Capital Medical University from December 2018 to July 2021 were retrospectively analyzed.According to the diagnostic criteria for AD and MCI,the patients were assigned into AD and MCI groups.In addition,156 volunteers without neurological diseases and other severe diseases were recruited as the control group.The general data,Montreal cognitive assessment(MoCA)score,and mini-mental state examination(MMSE)score were compared among the three groups.The deep learning-based brain age prediction model was employed to calculate the BAGs of the three groups.Spearman correlation analysis was conducted to explore the correlations between BAG and clinical features.Results The 132 patients included 106 patients in the AD group and 26 patients in the MCI group.The MoCA and MMSE scores followed an ascending trend of AD group

Exogenous spraying of 4-chlorophenoxyacetic acid sodium salt promotes growth and flavonoid biosynthesis of mulberry leaves (Morus alba L.).

Mulberry (Morus alba L.) leaves are known as an ideal vegetable with good antioxidant effect, which can bring delicious taste and multiple health benefits. In the present study, the effects of 4-Chlorophenoxyacetic acid sodium salt (4-CPANa) treatment on growth and content of flavonoid compounds in mulberry leaves were investigated. Moreover, the changes in the expression levels of genes involved in flavonoid biosynthetic pathways, and the accumulation of important secondary metabolites including rutin (Rut), chlorogenic acid (ChA), isoquercitrin (IQ) and astragalin (Ast), were investigated in mulberry leaves. The results showed that 4-CPANa treatment could significantly promote the differentiation and growth of mulberry, increased shoot number, bud number, leaf fresh weight and leaf area of mulberry compared with control. Besides, the contents of ChA, Rut, IQ and Ast were significantly increased after 4-CPANa (5 mg/L) treatment. Further analysis revealed that 5 mg/L 4-CPANa strongly induced the expression of flavonoid biosynthesis-related genes including flavonoid 3-O-glucosyltransferase (F3GT) gene, chalcone synthase (CHS) gene, 4-xoumarate-CoA ligase (4CL) and phenylalanine ammonia lyase (PAL) gene. In conclusion, exogenous spraying of 4-CPANa provides a new way to improve the medicinal quality and development of mulberry leaf food with high value. Supplementary Information: The online version contains supplementary material available at 10.1007/s12298-023-01339-z.

Subcellular localization of nucleolar protein 14 and its proliferative function mediated by miR-17-5p and E2F4 in pancreatic cancer.

Pancreatic cancer is one of the most lethal malignancies worldwide. Acquiring infinite proliferation ability is a key hallmark and basis of tumorigenesis. NOP14 is an identified ribosome biogenesis protein that plays potential roles in cell proliferation. However, the function and molecular mechanism of NOP14 remain ambiguous in most human cancers. In this study, we first investigated the subcellular localization and expression of NOP14 by multiple quantitative assays in pancreatic cancer. We confirmed that NOP14 was mainly localized in nucleolus in human pancreatic cancer cells. Then we studied the regulatory effects of this nucleolus protein on tumor cell proliferation in vitro. NOP14 was demonstrated to play a dominant pro-proliferation role in pancreatic cancer. Furthermore, we identified miR17-5p as a downstream target of NOP14. Transfection of miR17-5p mimics or inhibitors rescued the down- or upregulated effect of NOP14 on cell proliferation by regulating expression of P130. In addition, NOP14 induced expression of transcription factor E2F4 independent of miR17-5p/P130 signaling, which simultaneously activated a set of targeted genes, such as CCNE1, PIM1, AKT1 etc., to promote tumor proliferation. These findings might provide novel insights for better understanding the diverse function of NOP14 in human malignancies to develop new strategies for targeted therapy.

Life table study of Spodoptera frugiperda at different wheat stages and the effect of larval population density on wheat yield.

BACKGROUND: Spodoptera frugiperda is an invasive, widespread agricultural pest in China. However, there have been no reports assessing feeding damage on wheat caused by S. frugiperda. To clarify the fitness and potential damage of S. frugiperda to wheat, this study analyzed the population parameters of S. frugiperda fed on wheat in a laboratory and simulated the potential damage in field conditions. RESULTS: The population parameters of S. frugiperda were compared using life tables on wheat at the seedling and adult plant stages. The adult female longevity of S. frugiperda varied from 12.29 days on seedling plants to 16.60 days on adult plants. Egg production was significantly higher when fed on wheat at the seedling stage (646.34 eggs) than when fed on adult plants (495.86 eggs). On wheat at the seedling and adult plant stages, the mean generation times were 35.42 and 38.34 days, respectively, and the intrinsic rates of increase were 0.15 and 0.14, respectively. Spodoptera frugiperda completed development and increased its population in wheat at both plant growth stages. In the field, the effect of different larval densities on the 1000-kernel weight of wheat was significantly different. An action threshold of 40 larvae per m2 was estimated, and the higher population densities caused a yield loss of 17.7%. CONCLUSION: Spodoptera frugiperda can complete its life cycle on wheat at different stages. Wheat can serve as an alternative host for S. frugiperda. If S. frugiperda reaches 320 larvae per m2 density during wheat growth, it will cause yield loss exceeding 17%. © 2023 Society of Chemical Industry.

Ultrasonic features of superficial angiomyxoma in the scrotum: A case image.

Superficial angiomyxoma in the scrotum is a well-circumscribed, ovoid-shaped, heterogeneously echogenic mass in the ultrasonography. On Doppler ultrasonography, vascular flow signals are visible in and around the mass(M).

Laparoscopic and open liver resection for hepatocellular carcinoma with type 2 diabetes mellitus: multicenter propensity score-matched study.

PURPOSE: This study aimed at analyzing and comparing the perioperative results and long-term oncological outcomes of hepatocellular carcinoma (HCC) patients with type 2 diabetes mellitus (T2DM) treated with laparoscopic (LLR) versus open liver resection (OLR). METHODS: Clinicopathological data of HCC patients with T2DM who underwent LLR or OLR as initial treatment from four medical centers were retrospectively reviewed. The survival outcomes of patients who underwent laparoscopic liver resection (LLR) were compared with those of patients who underwent open liver resection (OLR). Using the Kaplan-Meier method, survival curves for the two groups of patients were generated, and the log-rank test was used to compare survival differences. Propensity score matching (PSM) analysis was used to match patients of the LLR and OLR groups in a 1:1 ratio. RESULTS: 230 HCC patients with T2DM were enrolled, including 101 patients in the LLR group and 129 patients in the OLR group. After PSM, 90 patients were matched in each of the study group. Compared with the OLR group, the LLR group had less blood loss, a shorter hospitalization and fewer postoperative complications. The LLR group had a significantly better overall survival (OS) and recurrence-free survival (RFS) than the OLR group before and after PSM. Subgroup analysis demonstrated that HCC patients with T2DM had survival benefits from LLR regardless of the course of T2DM. CONCLUSIONS: Laparoscopic liver resection for HCC patients with T2DM can be safely performed with favorable perioperative and long-term oncological outcomes at high-volume liver cancer centers, regardless of the course of T2DM.

Retrospective analysis of risk factors for distant metastasis of early-onset gastric cancer during the perioperative period.

Background: Although the overall global incidence of gastric cancer has been declining, the number of new cases in people under the age of 50 is increasing, which is related to metastasis, late pathological stages, and poor prognosis. There is a scarcity of large-scale studies to evaluate and predict distant metastasis in patients with early-onset gastric cancer. Methods: From January 2010 to December 2019, data on early-onset GC patients undergoing surgery were gathered from the Surveillance, Epidemiology, and End Results (SEER) database. We investigated the independent risk factors for distant metastasis in patients with early-onset gastric cancer. Based on these risk factors, we developed a nomogram to predict distant metastasis. The model underwent internal validation on the test set and external validation on 205 patients from the First Affiliated Hospital of Sun Yat-sen University and the seventh Affiliated Hospital of Sun Yat-sen University. The novel nomogram model was then evaluated using the receiver operating characteristic (ROC) curve, calibration, the area under the curve (AUC), and decision curve analysis (DCA). The training set nomogram score was used to classify the different risk clusters of distant metastasis. Results: Our study enrolled 2217 patients after establishing the inclusion and exclusion criteria, with 1873 having no distant metastasis and 344 having distant metastasis. The tumor size, total lymph nodes, whether or not receiving radiotherapy and chemotherapy, T stage, and N stage were significant predictors of advanced distant metastasis (p < 0.05). The AUC of the ROC analysis demonstrated our model's high accuracy. Simultaneously, the prediction model shows high stability and clinical practicability in the calibration curve and DCA analysis. Conclusions: We developed an innovative nomogram containing clinical and pathological characteristics to predict distant metastasis in patients younger than 50 years old with gastric cancer. The tool can alert clinicians about distant metastasis and help them develop more effective clinical treatment plans.

Investigating the Impact of Fly Ash on the Strength and Micro-Structure of Concrete during Steam Curing and Subsequent Stages.

Steam curing, a common way of curing precast concrete, can greatly improve its 1-day strength. However, the thermal effect of prolonged high-temperature curing can negatively impact the concrete's performance, thus compromising production of precast products in cold regions. Fly ash (FA) is used as a supplementary cementitious material to improve part of the properties of concrete. In this paper, we investigated the effect of FA (10~30%) on the compressive strength and microstructure of manufactured sand concrete at the steam curing and later stages. Specifically, we analyzed the behavior of FA in the constant temperature phase under steam curing. Results indicated that the pozzolanic reaction of FA started to occur at 24 h of constant temperature curing. Early hydration under steam curing produces a large amount of Ca(OH)2, causing the pozzolanic reaction of FA to occur significantly earlier, and the high pH value of the solution and the fibrous mesh structure of the FA surface promote the pozzolanic reaction. The addition of 30% FA to manufactured sand concrete causes a significant reduction in early strength under steam curing, which is not beneficial to the formwork removal and tensioning of precast members. Notably, manufactured sand concrete with 20% FA under steam curing had the highest late strength. The filling effect of FA and the additional gel produced by the pozzolanic reaction would result in the reduction in large pore content, refinement of pore size, improvement of microstructural compactness, and increase in gel system strength. Therefore, the addition of 20% FA to the manufactured sand concrete can improve the long-term strength, which is beneficial to the production of precast beams in cold regions.