Simultaneous nitrification and denitrification in a hybrid activated sludge-membrane aerated biofilm reactor (H-MABR) for nitrogen removal from low COD/N interflow: A pilot-scale study.

There are a large number of simple landfills in hilly areas, and the results of previous studies have shown that pollutants in landfills can spread via interflow and cause surface source pollution. The hybrid activated sludge-membrane aerated bioreactor (H-MABR) developed in a previous study can be used for the treatment of interflow with a low chemical oxygen demand (COD)/total nitrogen (TN) ratio, and it has been shown to be effective in laboratory simulations. To investigate the effectiveness of the H-MABR in treating interflow around landfills in real-world applications, an in-situ pilot-scale evaluation of the effectiveness of H-MABR operation was conducted at a landfill. The results indicated that the removal efficiencies of COD, TN, and ammonia nitrogen in interflow by H-MABR were 87.1 ± 6.0%, 80.9 ± 7.9%, and 97.9 ± 1.4%, respectively. The removal rate of TN reached 148.6-205.6 g-N/m3·d. The concentration of each pollutant in the effluent was in accordance with China's "Standard for pollution control on the landfill site of municipal solid waste (GB16889-2008)," wherein the COD, TN, and ammonia nitrogen of effluent should be less than 100 mg/L, 40 mg/L, and 25 mg/L, respectively. The results of community composition analysis and PICRUSt analysis based on 16S rRNA gene sequencing showed that there were different dominant functional bacteria between the inner and outer rings, but functional genes involved in the nitrification-denitrification, assimilated nitrate reduction, and dissimilated nitrate reduction pathway were all detected. Furthermore, except for the nitrite oxidation gene narG, the abundance of which did not significantly differ between the inner and outer rings, the abundance of the other functional genes was higher in the outer ring than in the inner ring. An economic evaluation revealed that the operation cost of interflow treatment by the H-MABR was as low as ¥2.78/m3; thus, the H-MABR is a shock-load-resistant and cost-effective technology for interflow treatment.

Potential application of aptamers combined with DNA nanoflowers in neurodegenerative diseases.

The efficacy of neurotherapeutic drugs hinges on their ability to traverse the blood-brain barrier and access the brain, which is crucial for treating or alleviating neurodegenerative diseases (NDs). Given the absence of definitive cures for NDs, early diagnosis and intervention become paramount in impeding disease progression. However, conventional therapeutic drugs and existing diagnostic approaches must meet clinical demands. Consequently, there is a pressing need to advance drug delivery systems and early diagnostic methods tailored for NDs. Certain aptamers endowed with specific functionalities find widespread utility in the targeted therapy and diagnosis of NDs. DNA nanoflowers (DNFs), distinctive flower-shaped DNA nanomaterials, are intricately self-assembled through rolling ring amplification (RCA) of circular DNA templates. Notably, imbuing DNFs with diverse functionalities becomes seamlessly achievable by integrating aptamer sequences with specific functions into RCA templates, resulting in a novel nanomaterial, aptamer-bound DNFs (ADNFs) that amalgamates the advantageous features of both components. This article delves into the characteristics and applications of aptamers and DNFs, exploring the potential or application of ADNFs in drug-targeted delivery, direct treatment, early diagnosis, etc. The objective is to offer prospective ideas for the clinical treatment or diagnosis of NDs, thereby contributing to the ongoing efforts in this critical field.

Adverse impact of phthalate and polycyclic aromatic hydrocarbon mixtures on birth outcomes: A metabolome Exposome-Wide association study.

It has been well-investigating that individual phthalates (PAEs) or polycyclic aromatic hydrocarbons (PAHs) affect public health. However, there is still a gap that the mixture of PAEs and PAHs impacts birth outcomes. Through innovative methods for mixtures in epidemiology, we used a metabolome Exposome-Wide Association Study (mExWAS) to evaluate and explain the association between exposure to PAEs and PAHs mixtures and birth outcomes. Exposure to a higher level of PAEs and PAHs mixture was associated with lower birth weight (maximum cumulative effect: 143.5 g) rather than gestational age. Mono(2-ethlyhexyl) phthalate (MEHP) (posterior inclusion probability, PIP = 0.51), 9-hydroxyphenanthrene (9-OHPHE) (PIP = 0.53), and 1-hydroxypyrene (1-OHPYR) (PIP = 0.28) were identified as the most important compounds in the mixture. In mExWAS, we successfully annotated four overlapping metabolites associated with both MEHP/9-OHPHE/1-OHPYR and birth weight, including arginine, stearamide, Arg-Gln, and valine. Moreover, several lipid-related metabolism pathways, including fatty acid biosynthesis and degradation, alpha-linolenic acid, and linoleic acid metabolism, were disturbed. In summary, these findings may provide new insights into the underlying mechanisms by which PAE and PAHs affect fetal growth.

Seminal plasma S100A8/A9 as a potential biomarker of genital tract inflammation.

ABSTRACT: Infections and inflammatory reactions in the male genital tract are the leading causes of male infertility with a prevalence of 6%-10%, primarily affecting testicular and epididymal function and ultimately compromising sperm quality. However, most infertile patients with genital infection/inflammation are asymptomatic and easily overlooked. Traditional indicators, including white blood cells, elastase, and other components in semen, can reflect inflammation of the genital tract, but there is still a lack of a uniform standard method of detection. Therefore, it is necessary to explore reliable markers in semen that reflect the inflammatory status of the genital tract. Using the experimental autoimmune orchitis (EAO) model to simulate noninfectious chronic orchitis, we successfully collected ejaculated seminal fluid from EAO rats using optimized electrical stimulation devices. Proteomic analysis was performed using isobaric tags for relative and absolute quantification (iTRAQ). Compared to the control group, 55 upregulated and 105 downregulated proteins were identified in seminal plasma samples from the EAO group. In a preliminary screening, the inflammation-related protein S100A8/A9 was upregulated. We further verified that S100A8/A9 was increased in seminal plasma and highly expressed in testicular macrophages of the EAO model. In patients with oligoasthenospermia and genital tract infections, we also found that S100A8/A9 levels were remarkably increased in seminal plasma and testicular macrophages. S100A8/A9 in semen may be a potential biomarker for chronic genital inflammation. Our study provides a new potential biomarker for early diagnosis and further understanding of male infertility caused by genital inflammation.

Stereotactic radiotherapy vs whole brain radiation therapy in EGFR mutated NSCLC: Results & reflections from the prematurely closed phase III HYBRID trial.

BACKGROUND: All known randomized trials of stereotactic radiotherapy (SRT) versus whole brain radiotherapy (WBRT) for brain metastases (BMs) comprise mixed histologies. The phase III HYBRID trial (NCT02882984) attempted to evaluate the non-inferiority of SRT vs. WBRT specifically for EGFR-mutated non-small cell lung cancer (EGFRm NSCLC) BMs. METHODS: Inclusion criteria were ≤ 5 BMs (any size) from treatment-naïve EGFRm NSCLC. All patients started a first-generation tyrosine kinase inhibitor on the first day of WBRT (37.5 Gy/15 fractions) or SRT (25-40 Gy/5 fractions per tumor volume). The primary endpoint was 18-month intracranial progression-free survival (iPFS; intention-to-treat). RESULTS: The trial commenced in June 2015 and was closed in April 2021 after screening 208 patients but enrolling 85 (n = 41 WBRT, n = 44 SRT; median follow-up 31 and 36 months, respectively). Respectively, 9.5 % vs. 10.2 % of patients experienced intracranial progression at 18 months, and the median iPFS was 21.4 vs. 22.3 months (p > 0.05 for all). The SRT arm experienced higher overall survival and cognitive preservation (p < 0.05 for all). The most notable reason for low enrollment was patients not wishing to risk neurocognitive decline from WBRT. CONCLUSIONS: Although this phase III trial was underpowered, there was no evidence that SRT yielded outcome detriments compared to WBRT for EGFRm NSCLC BMs. Lessons from prematurely closed trials are valuable, as they often provide important experiential perspectives for investigators designing/executing future trials. In the current era, randomized trials involving WBRT without cognitive sparing measures may be at high risk of underaccrual; trial investigators are encouraged to carefully consider our experience when attempting to design such trials. However, trials of molecular-/biologically-stratified patients are highly recommended as the notion of "individualized medicine/oncology" continues to expand.

A novel three-plasmid packaging system for chimeric SFV/SIN VRPs derived from Semliki Forest virus and Sindbis virus as a candidate gene delivery vector.

Semliki Forest virus (SFV) viral replicon particles (VRPs) have been frequently used in various animal models and clinical trials. Chimeric replicon particles offer different advantages because of their unique biological properties. We here constructed a novel three-plasmid packaging system for chimeric SFV/SIN VRPs. The capsid and envelope of SIN structural proteins were generated using two-helper plasmids separately, and the SFV replicon contained the SFV replicase gene, packaging signal of SIN, subgenomic promoter followed by the exogenous gene, and 3' UTR of SIN. The chimeric VRPs carried luciferase or eGFP as reporter genes. The fluorescence and electron microscopy results revealed that chimeric VRPs were successfully packaged. The yield of the purified chimeric VRPs was approximately 2.5 times that of the SFV VRPs (1.38 × 107 TU/ml vs. 5.41 × 106 TU/ml) (p < 0.01). Furthermore, chimeric VRPs could be stored stably at 4°C for at least 60 days. Animal experiments revealed that mice immunized with chimeric VRPs (luciferase) had stronger luciferase expression than those immunized with equivalent amount of SFV VRPs (luciferase) (p < 0.01), and successfully expressed luciferase for approximately 12 days. Additionally, the chimeric VRPs expressed the RBD of SARS-CoV-2 efficiently and induced robust RBD-specific antibody responses in mice. In conclusion, the chimeric VRPs constructed here met the requirements of a gene delivery tool for vaccine development and cancer therapy.

SFI, a sex hormone binding globulin based nomogram for predicting non-alcoholic fatty liver disease in the Chinese population.

Background: The purpose of this study is to establish a novel nomogram model for accurate detection of non-alcoholic fatty liver disease (NAFLD) in the Chinese population based on sex hormone binding globulin (SHBG) and other routine laboratory tests. Methods: A total of 1417 participants (1003 testing and 414 validations) were enrolled into the study. Risk factors independently associated with NAFLD were identified and incorporated in the new nomogram, SFI. The performance of nomogram was assessed by analysis of receiver operating characteristic (ROC) curve, calibration curve, and decision curve. Results: We formulated a new nomogram incorporating four independent factors: SHBG, body mass index (BMI), ALT/AST, and triglycerides (TG). The nomogram achieved good indexes of area under ROC 0.898 (95% confidence interval 0.865-0.926) in predicting NAFLD, which was significantly superior to previously reported models of FLI, HSI, LFS, and LAP. The calibration curve and decision curve demonstrated high performance and clinical utility of the nomogram in predicting NAFLD. Conclusion: The nomogram SFI has high performance in predicting NAFLD in Chinese population and may be used as a cost-effective screening model to assess NAFLD in the general population.

Preoperative US Integrated Random Forest Model for Predicting Delphian Lymph Node Metastasis in Patients with Papillary Thyroid Cancer.

BACKGROUND: Delphian lymph node (DLN) has been considered to be a gate that predicts widespread lymph node involvement, higher recurrence and mortality rates of head and neck cancer. OBJECTIVE: This study aimed to establish a preoperative ultrasonography integrated machine learning prediction model to predict Delphian lymph node metastasis (DLNM) in patients with diagnosed papillary thyroid carcinoma (PTC). METHODS: Ultrasonographic and clinicopathologic variables of PTC patients from 2014 to 2021 were retrospectively analyzed. The risk factors associated with DLNM were identified and validated through a developed random forest (RF) algorithm model based on machine learning and a logistic regression (LR) model. RESULTS: A total of 316 patients with 402 thyroid lesions were enrolled for the training dataset and 280 patients with 341 lesions for the validation dataset, with 170 (28.52%) patients developed DLNM. The elastography score of ultrasonography, central lymph node metastasis, lateral lymph node metastasis, and serum calcitonin were predictive factors for DLNM in both models. The RF model has better predictive performance in the training dataset and validation dataset (AUC: 0.957 vs. 0.890) than that in the LR model (AUC: 0.908 vs. 0.833). CONCLUSION: The preoperative ultrasonography integrated RF model constructed in this study could accurately predict DLNM in PTC patients, which may provide clinicians with more personalized clinical decision-making recommendations preoperatively. Machine learning technology has the potential to improve the development of DLNM prediction models in PTC patients.

Diagnostic value of peripheral TiM-3, NT proBNP, and Sestrin2 testing in left-to-right shunt congenital heart disease with heart failure.

BACKGROUND: Left-to-right shunt congenital heart disease is more likely to induce recurrent respiratory infections in the patients which exacerbate pulmonary hypertension and thereby impairs cardiac function. It is urgent to explore a non-invasive and accurate diagnostic method that can show the cardiac anatomy and associated malformations in clinical research. OBJECTIVE: To determine the diagnostic value of peripheral mucin domain protein-3 (Tim-3), N-terminal pro-brain natriuretic peptide (NT proBNP), sestrin2 testing in patients with the left-to-right shunt congenital heart disease and heart failure. METHODS: Fifty-two neonates with with left to right shunt congenital heart disease and 30 healthy neonates were enrolled. Blood samples were collected within 24 h of admission from newborns for determining the content of TiM-3, NT proBNP, and Sestrin2. Analyzing the ROC curve provided insight into the diagnostic accuracy. Both a Spearman's rank correlation test and a logistic regression analysis were carried out. RESULTS: TiM-3, NT proBNP, and Sestrin2 levels in peripheral blood were statistically different in the three groups (P < 0.05). There were significant differences in LVEF and LVFS among the three groups (P < 0.05). When used to diagnose heart failure in conjunction with left-to-right shunt congenital heart disease, TiM-3, NT proBNP, and Sestrin2 exhibited sensitivity of 58.3, 58.3, and 83.3%, respectively, and specificity of 85.0, 72.5, and 70.0%. ROC curve analysis showed that the AUCs of Tim-3, NT proBNP, and sestrin2 in predicting the outcome of left-to-right shunted congenital heart disease combined with heart failure were 0.744 (95% CI, 0.580 to 0.908), 0.608 (95% CI, 0.359 to 0.857), respectively 0.744 (95% CI 0.592 to 0.896). CONCLUSION: Tim-3, NT proBNP, and sestrin2 can accurately differentiate heart failure from non-combined heart failure from left-to-right shunt congenital heart disease.

Exploring the environmental properties and resource utilization of construction waste in Beijing-Tianjin-Hebei region.

Beijing-Tianjin-Hebei region is a capital economic circle for the future. Promoting the coordinated development of its population, economy, resources and environment is a major national strategy. And as towns and cities continue to expand, the volume of construction waste is gradually expanding, posing a major challenge to the sustainable development of the construction industry. In order to solve this problem, this paper used portable X-ray fluorescence spectrometry to realize the on-site rapid monitoring of heavy metals in construction waste, and the correlation analysis result was R2 = 0.9908. The visualization of enrichment factor evaluation results was realized through ArcGIS. The Beijing-Tianjin-Hebei region is mainly polluted by heavy metal elements Cr, Zn, Pb and Hg, showing regional pollution characteristics, and the results of mercury morphology analysis show that all are inorganic mercury pollution, and methylmercury is not detected, and the cause can be traced to heavy industrial production in Tangshan City, which is consistent with industrial ecology. The results of leaching toxicity and cation anion analysis showed that the construction waste in Beijing-Tianjin-Hebei region had environmental risks to the surrounding surface water and groundwater. The resource treatment and disposal path were determined by means of XRD, ternary phase diagram and oxide composition analysis to avoid secondary pollution. This study explores the environmental properties and resource utilization pathways of construction waste in the Beijing-Tianjin-Hebei region, laying the foundation for research work on construction waste in the development of national urban agglomerations, effectively solving regional environmental pollution problems and promoting the sustainable development of the construction industry.

N-Doped Biochar from Lignocellulosic Biomass for Preparation of Adsorbent: Characterization, Kinetics and Application.

Medulla tetrapanacis is composed of a lignocellulosic biopolymer and has a regular porous structure, which makes it a potential biomass material for preparing porous N-doped biochar. Herewith, N-doped Medulla tetrapanacis biochar (UBC) was successfully prepared by modification with urea and NaHCO3 under pyrolysis at 700 °C. The nitrogen-containing groups were efficiently introduced into biochar, and the micro-pore structures of the UBC were developed with sizeable specific surface area, which was loaded with massive adsorption sites. The adsorption kinetics and isotherms of the UBC conformed to pseudo-second-order and Langmuir model. The superior adsorption capacities of the UBC for methylene blue (MB) and congo red (CR) were 923.0 mg/g and 728.0 mg/g, and the capacities for Cu2+ and Pb2+ were 468.5 mg/g and 1466.5 mg/g, respectively. Moreover, the UBC had a stronger affinity for Cr3+ and Fe3+ in multiple metal ions and retained at a preferable adsorption performance for dyes and heavy metals after five cycles. Precipitation, complexation, and physical adsorption were the main mechanisms of the UBC-adsorbing metal ions and dyes. Thus, lignocellulosic biochar has great potential for removing dyes and heavy metals in aqueous solutions.

Incision pressing, a simple and effective intervention to reduce colorectal surgical site infection: A propensity score-matched study.

Background: Colorectal surgery is associated with a high risk of surgical site infection (SSI). In March 2017, we developed an intervention, called "PRESS", with the aim of reducing colorectal superficial SSI. This study assessed the effect of the new intervention in reducing the rates of superficial SSI in colorectal surgery. Methods: This study was a retrospective review of 312 PRESS+ patients compared to 171 historical control PRESS- patients who were 18 years of age or older and underwent elective colorectal surgery with clean-contaminated wounds from January 2015 to June 2020. In the PRESS+ groups, we pressed the incision downward hard with clean gauze after the interrupted suturing of the skin. Propensity score matching with 15 variables was performed in a 1:1 ratio to reduce selection bias. Univariate analysis and multivariate analysis were performed to identify risk factors associated with SSI. Results: The characteristics of the PRESS+ (n = 160) and PRESS- (n = 160) groups were well balanced after propensity score matching. The PRESS+ group had a lower superficial SSI rate (1.9% vs. 6.9%, P = 0.029) and a lower overall SSI rate (2.5% vs. 10.0%, P = 0.006) than the PRESS- group. Furthermore, multivariate analysis showed that the incisional press was an effective protective factor for superficial SSI (adjusted odds ratio = 0.215, 95% confidence interval = 0.057-0.818, P = 0.024). In addition, female sex (P = 0.048) and blood transfusion (P = 0.011) were demonstrated to be independent risk factors for superficial SSI. Conclusion: The incisional press after suturing is a simple, costless, and effective intervention in reducing superficial incisional SSI.

Nitrogen removal from low COD/N interflow using a hybrid activated sludge membrane-aerated biofilm reactor (H-MABR).

A hybrid activated sludge membrane-aerated biofilm reactor based on a two-stage simultaneous nitrification-denitrification (SND) process was built, and its utility for treating interflow with low chemical oxygen demand (COD)/total nitrogen (TN) (COD/N) was explored. The operating performance, functional microbial communities, and functional genes for nitrogen metabolism were evaluated at low COD/N (4-1.3). The reactor could achieve stable operation at COD/N = 4-1.5, and the removal efficiency of COD, TN, and ammonia nitrogen was stable at 90.30 ± 2.36 %, 85.69 ± 2.22 %, and 89.52 ± 6.06 %, respectively. The SND rates were 70.89 % and 50.75 % when influent COD/N was 2.0 and 1.7, respectively, indicating that SND makes an important contribution to nitrogen removal under these two COD/N conditions. Microbial analysis revealed that the sampling sites with a high abundance of denitrification genes in the outer ring experienced aerobic conditions, inferring that aerobic denitrification also plays an important role in denitrification.

Synthesis and Biological Evaluation of Novel Allobetulon/Allobetulin-Nucleoside Conjugates as AntitumorAgents.

Allobetulin is structurally similar tobetulinic acid, inducing the apoptosis of cancer cells with low toxicity. However, both of them exhibited weak antiproliferation against several tumor cell lines. Therefore, the new series of allobetulon/allobetulin-nucleoside conjugates 9a-10i were designed and synthesized for potency improvement. Compounds 9b, 9e, 10a, and 10d showed promising antiproliferative activity toward six tested cell lines, compared to zidovudine, cisplatin, and oxaliplatin based on their antitumor activity results. Among them, compound 10d exhibited much more potent antiproliferative activity against SMMC-7721, HepG2, MNK-45, SW620, and A549 human cancer cell lines than cisplatin and oxaliplatin. In the preliminary study for the mechanism of action, compound 10d induced cell apoptosis and autophagy in SMMC cells, resulting in antiproliferation and G0/G1 cell cycle arrest by regulating protein expression levels of Bax, Bcl-2, and LC3. Consequently, the nucleoside-conjugated allobetulin (10d) evidenced that nucleoside substitution was a viable strategy to improve allobetulin/allobetulon's antitumor activity based on our present study.

Fracture Behavior of Steel Slag Powder-Cement-Based Concrete with Different Steel-Slag-Powder Replacement Ratios.

The influence of different replacement ratios of steel-slag powder as cement-replacement material on the fracture performance of concrete is studied in this paper. A three-point bending fracture test is carried out on slag powder-cement-based concrete (SPC)-notched beams with steel-slag powder as cementitious materials, partially replacing cement (0%, 5%, 10%, 15%, and 20%). Load-deflection curves and load-crack-opening displacement curves of SPC-notched beams with five different replacement ratios of steel-slag powder were obtained. The effects of different steel-slag-powder replacement ratios on the fracture properties (fracture energy, fracture toughness, and double-K fracture parameters) of the SPC were analyzed and discussed. The results showed that the incorporation of appropriate steel-slag powder can affect the fracture performance of SPC. Compared with concrete without steel-slag powder, adding appropriate steel-slag powder can effectively improve the bond performance between aggregate and matrix because the steel-slag powder contains hydration activity substances such as calcium oxide and aluminium trioxide. The fracture energy and fracture toughness of SPC increased and then decreased with the increase in steel-slag-powder replacement ratios, and the SPC concrete showed best fracture performance with a 5% steel slag powder replacement ratio. Its fracture energy increases by 13.63% and fracture toughness increases by 53.22% compared with NC.

Pollution in the interflow from a simple landfill in a mountainous and hilly area in Southwest China.

Simple landfills lack pollution prevention measures and therefore continuously release pollutants into the surrounding environment. There are a large number of simple landfills in the mountainous and hilly areas in China, and the interflow accounts for a large proportion of runoff. However, the pollution in the interflow stemming from the simple landfill has not been extensively studied. Here, the pollution of the interflow caused by the simple landfill near the Yunxi Town Landfill in the mountainous and hilly region in Southwest China was studied. The composition and pollution release potential of aged refuse in the landfill were determined, and the water quality of interflow around the landfill was monitored for five months. Seasonal changes in water quality of the interflow were observed, and the concentration of pollutants in the interflow around the simple landfill greatly exceeded the water quality standard for the local water function zoning throughout the sampling period. Specifically, the chemical oxygen demand concentrations of the interflow were 247.90 ± 81.57 mg/L, and more than 50 types of refractory organics were detected, with as many as 10 types of polycyclic aromatic hydrocarbons and Environmental Protection Agency priority pollutants. The total nitrogen concentration of the interflow was 132.45 ± 108.68 mg/L; organic nitrogen (53.27%) was the main component, followed by nitrate nitrogen (32.28%) and nitrous nitrogen and ammonia nitrogen (14.45%). The results highlight the need for the remediation of interflow around simple landfills in mountainous and hilly areas. Generally, the basic data could be used to aid the development of remediation technology.

Association between R1 resection and oncological outcome in resectable gastrointestinal stromal tumors without tumor rupture: A systematic review and meta-analysis.

BACKGROUND: The influence of positive microscopic margin (R1) resection on the prognosis of gastrointestinal stromal tumors (GISTs) is controversial. Tumor rupture is significantly associated with the occurrence of R1 resection and may be a confounder of R1 resection in GISTs. The present meta-analysis evaluated the real influence of R1 resection on the prognosis of GISTs by excluding the confounding effect of tumor rupture. METHODS: The PubMed, Embase, Web of Science, Cochrane Central Register of Controlled Trials (CENTRAL), and ClinicalTrials.gov databases were searched. Studies that compared R1 with negative microscopic margin (R0) resection in GIST patients and reported the time-to-event data of recurrence-free survival (RFS) or disease-free survival (DFS) were eligible for inclusion. The quality of the observational studies was assessed using the Newcastle-Ottawa scale. RESULTS: Of the 4896 records screened, 23 retrospective studies with 6248 participants were selected. In the overall analysis, R1 resection resulted in a significantly shorter RFS/DFS than R0 resection for GISTs (HR = 1.80, 95% CI = 1.54-2.10, P < 0.001, I2 = 14%). However, the inferior RFS/DFS vanished when tumor rupture cases were excluded (HR = 1.34, 95% CI = 0.98-1.83, P = 0.07, I2 = 33%). Sensitivity analysis by high-quality studies brought about a more robust HR of 1.15 (95% CI = 0.88-1.50, P = 0.29), with low heterogeneity (I2 = 0%). The qualities of evidence for the outcomes were high. CONCLUSIONS: This meta-analysis shows that R1 resection did not influence the survival outcome of GISTs. Reresection may not be necessary when positive microscopic margins exist. This analysis could provide high-quality evidence for the development of guidelines.

Experimental Study on Axial Compressive Performance of Polyvinyl Alcohol Fibers Reinforced Fly Ash-Slag Geopolymer Composites.

Geopolymer concrete (GC) has been gaining attention in research and engineering circles; however, it is a brittle material with poor tensile performance and crack resistance. To address these problems, we introduced fibers into GC. In this study, axial compression and scanning electron microscope (SEM) tests were carried out on polyvinyl alcohol (PVA) short fiber reinforced low-calcium fly ash-slag-based geopolymer concrete (PFRGC). The ratio of PVA short fibers and low-calcium fly ash on the compression behavior of fiber reinforced geopolymer concrete (FRGC) were investigated and discussed. The test results show that PVA fibers play a bridging role in the cracks of the specimen and bear the load together with the matrix, so the addition of PVA fibers delayed the crack propagation of GC under axial compression. However, with the increase of low-calcium fly ash/PVA fibers, the number of unreacted fly ash particles in PFRGCs increases. Too many unreacted fly ash particles make GC more prone to micro-cracks during loading, adversely affecting compressive properties. Therefore, the axial compressive strength, elastic modulus, and Poisson's ratio of GC decrease with the increasing low-calcium fly ash/PVA fibers.

Eye movement especially vertical oculomotor impairment as an aid to assess Parkinson's disease.

AIMS: To detect abnormal eye movements in Parkinson's disease and explore its correlation with clinical characteristics and their value for diagnosis. METHODS: We recruited forty-nine Parkinson's disease patients, including 35 early Parkinson's disease patients (Hoehn-Yahr: 1 to 2 stage) and 14 advanced Parkinson's disease patients (Hoehn-Yahr: 3 to 5 stage) and 23 healthy controls. Clinical manifestations in Parkinson's disease patients were recorded. Oculomotor performances including fixation, gaze, saccade in horizontal and vertical direction, and smooth pursuit in horizontal and vertical direction were measured by video-oculography. RESULTS: We found that five oculomotor parameters, namely square wave jerk frequency, latency of downward saccade, latency of upward saccade, accuracy of upward saccade, and gain of horizontal smooth pursuit were significantly different in Parkinson's disease patients and controls. When combining all these five parameters, we got the diagnostic sensitivity of 78.3% and specificity of 95.2%. More deficits in upward saccade than in other directions were associated with disease duration and progression of Parkinson's disease. CONCLUSION: Our primary study suggests that oculomotor examination might serve as an aid in the clinical assessment of Parkinson's disease patients and differentiating between early Parkinson's disease and normal controls.