Surgical vs nonsurgical treatment for esophageal squamous cell carcinoma in patients older than 70 years: a propensity score matching analysis.

PURPOSE: With the rising life expectancy and an aging population, it has become increasingly important to investigate treatments suitable for older adult patients with esophageal cancer. This study investigated whether older adult patients who underwent esophagectomy had better clinical outcomes than those who were nonsurgically treated. METHODS: We retrospectively analyzed patients with esophageal squamous cell carcinoma (ESCC) who were 70 years or older and underwent esophagectomy, radiotherapy (RT), and/or chemoradiotherapy (CRT) between January 2018 and December 2019. Patients were divided into 2 groups: the surgery group (S group) and the nonsurgery group (NS group). We then compared the clinical outcomes of the 2 groups. RESULTS: After a median follow-up duration of 36.6 months, the S group showed better overall survival (OS). The 3-year OS was 59% in the S group and 27% in the NS group (hazard ratio [HR], 0.397; 95% CI, 0.278-0.549; P < .0001). In the S group, the median progression-free survival was 38.3 months (95% CI, 30.6-46.1) compared with 12.3 months in the NS group (HR, 0.511; 95% CI, 0.376-0.695; P < .0001). In addition, the number of adverse events in the NS group was higher than that in the S group (P < .001). CONCLUSION: Overall, patients with ESCC at the age of ≥70 years who underwent esophagectomy had significantly better clinical outcomes than those who underwent nonsurgical treatment with RT and/or CRT.

Mechanisms of efficient indoor formaldehyde removal via electro-Fenton: Synergy in ·OH generation and utilization through a modified carbon cathode.

Indoor formaldehyde poses a significant carcinogenic risk to human health, making its removal imperative. Electro-Fenton degradation has emerged as a promising technology for addressing this concern. In the electro-Fenton system, ·OH is identified as the primary active species responsible for formaldehyde removal. Hence, its generation and utilization are pivotal for the system's effectiveness and economy. Experimental and quantum chemical methods were employed to investigate the effects and mechanisms of nitrogen doping on various aspects influencing ·OH generation and utilization. Results indicate that nitrogen doping synergistically enhances the generation and utilization of ·OH, leading to an improved formaldehyde removal efficiency in nitrogen-doped cathodic systems. The dominant nitrogen type influencing ·OH generation and utilization varies across different stages. Pyridinic nitrogen facilitates H2O2 adsorption through hydrogen bonding, while pyrrolic and graphitic nitrogen contribute to formaldehyde adsorption and catalyze the conversion of H2O2 to ·OH. Both pyridinic nitrogen and pyrrolic nitrogen boost the degradation of formaldehyde by ·OH. In comparison to the unmodified system, the modified system with NAC-GF/700C as cathode exhibits remarkable improvements. The formaldehyde removal efficiency has increased twofold, and energy consumption reduced by 73.45%. Furthermore, the system demonstrates excellent cyclic stability. These advancements can be attributed to the activation temperature, which leads to the appropriate types and high content of nitrogen elements in NAC-GF/700C. The research represents an important step towards more economical and efficient electro-Fenton technology for indoor formaldehyde removal.

Effect of cervical paraesophageal lymph node metastasis versus supraclavicular lymph node metastasis on the overall survival of patients with thoracic esophageal squamous cell carcinoma: an observational study.

Background: Esophageal cancer (EC) is a major global health burden, with a particularly high incidence in East Asia. The authors aimed to investigate the effect of metastasis in cervical paraesophageal lymph nodes (station 101) and supraclavicular lymph nodes (station 104) on the survival of patients who underwent esophagectomy for esophageal squamous cell carcinoma (ESCC). Materials and Methods: Data were obtained from the database of the authors' hospital. The authors retrospectively analyzed the patients with EC who underwent esophagectomy from January 2010 to December 2017. These patients were allocated into two groups based on the presence of lymph node metastasis (LNM) in the cervical paraesophageal or supraclavicular regions. Clinical outcomes and survival data were compared using the TNM staging system of the 8th edition of the American Joint Committee on Cancer (AJCC). Results: After a median follow-up of 62.1 months, 122 patients with LNM in the supraclavicular region were included in the study. Among these patients, 53 showed cervical paraesophageal LNM and an overall survival (OS) of 19.9 months [95% confidence interval (CI): 16.3-23.5]. In contrast, 69 patients showed supraclavicular LNM with an OS of 34.9 months (95% CI 25.7-44.1). The OS rates at 1, 3, and 5 years were 77%, 29%, and 21%, respectively, for patients with cervical paraesophageal LNM. Moreover, patients with supraclavicular LNM demonstrated OS rates of 88%, 48%, and 34%, respectively [Hazard ratio (HR): 0.634, 95% CI: 0.402-1.000, P=0.042]. Conclusions: Patients with ESCC with cervical paraesophageal LNM had significantly worse OS than those with supraclavicular LNM. This study underscores the importance of accurately identifying and managing ESCC with cervical paraesophageal LNM, as it may require more tailored and aggressive treatment strategies to prolong patient survival.

Rapid Preparation Triggered by Visible Light for Tough Hydrogel Sensors with Low Hysteresis and High Elasticity: Mechanism, Use and Recycle-by-Design.

Hydrogels have emerged as promising candidates for flexible devices and water resource management. However, further applications of conventional hydrogels are restricted due to their limited performance and lack of a recycling strategy. Herein, a tough, flexible, and recyclable hydrogel sensor via a visible-light-triggered polymerization is rapidly created. The Zn2+ crosslinked terpolymer is in situ polymerized using g-C3N4 as the sole initiator to form in situ chain entanglements, endowing the hydrogels with low hysteresis and high elasticity. In the use phase, the hydrogel sensor exhibited high ion conductivity, excellent mechanical properties, fast responsiveness, high sensitivity, and remarkable anti-fatigue ability, making it exceptionally effective in accurately monitoring complex human movements. At the end-of-life (EOL), leveraging the synergy between the photodegradation capacity of g-C3N4 and the adsorption function of the hydrogel matrix, the post-consumer hydrogel is converted into water remediation materials, which not only promoted the rapid degradation of organic pollutants, but also facilitated collection and reuse. This innovative strategy combined in situ entangling reinforcement and tailored recycle-by-design that employed g-C3N4 as key blocks in the hydrogel to achieve high performance in the use phase and close the loop through the reutilization at EOL, highlighting the cost-effective synthesis, specialized structure, and life cycle management.

Green Fruit Detection with a Small Dataset under a Similar Color Background Based on the Improved YOLOv5-AT.

Green fruit detection is of great significance for estimating orchard yield and the allocation of water and fertilizer. However, due to the similar colors of green fruit and the background of images, the complexity of backgrounds and the difficulty in collecting green fruit datasets, there is currently no accurate and convenient green fruit detection method available for small datasets. The YOLO object detection model, a representative of the single-stage detection framework, has the advantages of a flexible structure, fast inference speed and excellent versatility. In this study, we proposed a model based on the improved YOLOv5 model that combined data augmentation methods to detect green fruit in a small dataset with a background of similar color. In the improved YOLOv5 model (YOLOv5-AT), a Conv-AT block and SA and CA blocks were designed to construct feature information from different perspectives and improve the accuracy by conveying local key information to the deeper layer. The proposed method was applied to green oranges, green tomatoes and green persimmons, and the mAPs were higher than those of other YOLO object detection models, reaching 84.6%, 98.0% and 85.1%, respectively. Furthermore, taking green oranges as an example, a mAP of 82.2% was obtained on the basis of retaining 50% of the original dataset (163 images), which was only 2.4% lower than that obtained when using 100% of the dataset (326 images) for training. Thus, the YOLOv5-AT model combined with data augmentation methods can effectively achieve accurate detection in small green fruit datasets under a similar color background. These research results could provide supportive data for improving the efficiency of agricultural production.

Longitudinal patient-reported outcomes after minimally invasive McKeown esophagectomy for patients with esophageal squamous cell carcinoma.

PURPOSE: Surgery for esophageal squamous cell carcinoma (ESCC) is characterized by a poor prognosis and high complication rate, resulting in a heavy symptom burden and poor health-related quality of life (QOL). We evaluated longitudinal patient-reported outcomes (PROs) to analyze the correlations between symptoms and QOL and their changing characteristics during postoperative rehabilitation. METHODS: We investigated patients with ESCC who underwent minimally invasive McKeown esophagectomy at Sichuan Cancer Hospital between April 2019 and December 2019. Longitudinal data of the clinical characteristics and PROs were collected. The MD Anderson Symptom Inventory and European Organization for Research and Treatment of Cancer (EORTC) QOL questionnaires were used to assess symptoms and QOL and compare the trajectories of PROs during the investigation. RESULTS: A total of 244 patients with ESCC were enrolled in this study. Regarding QOL, role and emotional functions returned to baseline at 1 month after surgery, and cognitive and social functions returned to baseline at 3 months after surgery. However, physical function and global QOL did not return to baseline at 1 year after surgery. At 7 days and 1, 3, 6, and 12 months after surgery, the main symptoms of the patients were negatively correlated with physical, role, emotional, cognitive, and social functions and the overall health status (P < 0.05). CONCLUSION: Patients with ESCC experience reduced health-related QOL and persisting symptoms after minimally invasive McKeown esophagectomy, but a recovery trend was observed within 1 month. The long-term QOL after esophagectomy is acceptable.

Laparoscopic-assisted retrieval of inferior vena cava filter: A case report and literature review.

BACKGROUND: The retrieval of inferior vena cava filters beyond the retrieval window poses challenges, requiring alternative techniques. OBJECTIVES: To discuss the laparoscopy-assisted retrieval approach for difficult inferior vena cava filters. RESEARCH DESIGN: Case report. SUBJECTS: A 57-year-old male with a retrievable inferior vena cava filter placed 8 months prior. MEASURES: Laparoscopy-assisted retrieval technique utilized after unsuccessful interventional attempts. RESULTS: Successful retrieval of the filter despite thickened intimal tissue involvement, with no postoperative complications. CONCLUSIONS: Laparoscopy-assisted retrieval offers a direct visual approach for challenging filter removal, proving minimally invasive, safe, and effective.

The potential of urban irrigation for counteracting carbon-climate feedback.

Global climate changes, especially the rise of global mean temperature due to the increased carbon dioxide (CO2) concentration, can, in turn, result in higher anthropogenic and biogenic greenhouse gas emissions. This potentially leads to a positive loop of climate-carbon feedback in the Earth's climate system, which calls for sustainable environmental strategies that can mitigate both heat and carbon emissions, such as urban greening. In this study, we investigate the impact of urban irrigation over green spaces on ambient temperatures and CO2 exchange across major cities in the contiguous United States. Our modeling results indicate that the carbon release from urban ecosystem respiration is reduced by evaporative cooling in humid climate, but promoted in arid/semi-arid regions due to increased soil moisture. The irrigation-induced environmental co-benefit in heat and carbon mitigation is, in general, positively correlated with urban greening fraction and has the potential to help counteract climate-carbon feedback in the built environment.

Trans-lesion synthesis and mismatch repair pathway crosstalk defines chemoresistance and hypermutation mechanisms in glioblastoma.

Almost all Glioblastoma (GBM) are either intrinsically resistant to the chemotherapeutical drug temozolomide (TMZ) or acquire therapy-induced mutations that cause chemoresistance and recurrence. The genome maintenance mechanisms responsible for GBM chemoresistance and hypermutation are unknown. We show that the E3 ubiquitin ligase RAD18 (a proximal regulator of TLS) is activated in a Mismatch repair (MMR)-dependent manner in TMZ-treated GBM cells, promoting post-replicative gap-filling and survival. An unbiased CRISPR screen provides an aerial map of RAD18-interacting DNA damage response (DDR) pathways deployed by GBM to tolerate TMZ genotoxicity. Analysis of mutation signatures from TMZ-treated GBM reveals a role for RAD18 in error-free bypass of O6mG (the most toxic TMZ-induced lesion), and error-prone bypass of other TMZ-induced lesions. Our analyses of recurrent GBM patient samples establishes a correlation between low RAD18 expression and hypermutation. Taken together we define molecular underpinnings for the hallmark tumorigenic phenotypes of TMZ-treated GBM.

Impact of Metastatic Lymph Nodes on Survival of Patients with pN1-Category Esophageal Squamous Cell Carcinoma: A Long-Term Survival Analysis.

BACKGROUND: The morbidity and mortality rates of esophageal squamous cell carcinoma (ESCC) are high in China. The overall survival (OS) of patients with ESCC is related to lymph node (LN) metastasis (LNM). This study aimed to discuss the impact of metastasis in LN stations on the OS of patients with pathologic N1 (pN1) ESCC. METHODS: Data were obtained from the Esophageal Cancer Case Management database of Sichuan Cancer Hospital and Institute (SCCH-ECCM). Additionally, data of patients with pN1-category ESCC collected between January 2010 and December 2017 were retrospectively analyzed. RESULTS: Data from 807 patients were analyzed. The median OS of the patients with one metastatic LN (group 1) was 49.8 months (95 % confidence interval [CI], 30.8-68.9 months), whereas the OS of those with two metastatic LNs (group 2) was only 33.3 months (P = 0.0001). Moreover, group 1 did not show a significantly longer OS than group 2.1 (patients with 2 metastatic LNs in 1 LNM station; P = 0.5736), but did show a significantly longer OS than group 2.2 (patients with 2 metastatic LNs in 2 LNM stations; P < 0.0001). After propensity score-matching, the 5-year survival rate for group 1 was 28 %, whereas that for group 2 was 14 % (P = 0.0027). CONCLUSIONS: The OS for the patients with one metastatic LN in one LNM was not significantly longer than for the patients with two metastatic LNs in one LNM station. Patients with one LNM station had a significantly longer OS than those with two LNM stations. Thus, the number of LNM stations is a significant determinant of OS in pN1 ESCC.

Analgesic Effect of Exercise on Neuropathic Pain via Regulating the Complement Component 3 of Reactive Astrocytes.

BACKGROUND: Exercise has been proven to be an efficient intervention in attenuating neuropathic pain. However, the underlying mechanisms that drive exercise analgesia remain unknown. In this study, we aimed to examine the role of complement component 3 (C3) in neuropathic pain and whether antinociceptive effects are produced by exercise via regulating C3 in mice. METHODS: In this study, using a spared nerve injury (SNI)-induced neuropathic pain mice model, C57BL/6J mice were divided into 3 groups: Sham mice, SNI mice, and SNI + Exercise (Ex) mice with 30-minute low-intensity aerobic treadmill running (10 m/min, no inclination). Paw withdrawal threshold; thermal withdrawal latency; and glial fibrillary acidic protein, C3, tumor necrosis factor-α, and interlukin-1ß expression in the spinal cord were monitored. C3 knockout (KO) mice were further used to verify the role of C3 in neuropathic pain. RESULTS: von Frey test, acetone test, and CatWalk gait analysis revealed that treadmill exercise for 4 weeks reversed pain behaviors. In addition, exercise reduced astrocyte reactivity (SNI mean = 14.5, 95% confidence interval [CI], 12.7-16.3; SNI + Ex mean = 10.3, 95% CI, 8.77-11.9, P = .0003 SNI + Ex versus SNI) and inflammatory responses in the spinal cord after SNI. Moreover, it suppressed the SNI-induced upregulation of C3 expression in the spinal cord (SNI mean = 5.46, 95% CI, 3.39-7.53; SNI + Ex mean = 2.41, 95% CI, 1.42-3.41, P = .0054 SNI + Ex versus SNI in Western blot). C3 deficiency reduced SNI-induced pain and spinal astrocyte reactivity (wild type mean = 7.96, 95% CI, 6.80-9.13; C3 KO mean = 5.98, 95% CI, 5.14-6.82, P = .0052 C3 KO versus wild type). Intrathecal injection of recombinant C3 (rC3) was sufficient to produce mechanical (rC3-Ex mean = 0.77, 95% CI, 0.15-1.39; rC3 mean = 0.18, 95% CI, -0.04 to 0.41, P = .0168 rC3-Ex versus rC3) and cold (rC3-Ex mean = 1.08, 95% CI, 0.40-1.77; rC3 mean = 3.46, 95% CI, 1.45-5.47, P = .0025 rC3-Ex versus rC3) allodynia in mice. Importantly, exercise training relieved C3-induced mechanical and cold allodynia, and the analgesic effect of exercise was attenuated by a subeffective dose of intrathecal injection of C3. CONCLUSIONS: Overall, these results suggest that exercise suppresses neuropathic pain by regulating astroglial C3 expression and function, thereby providing a rationale for the analgesic effect of exercise as an acceptable alternative approach for treating neuropathic pain.

Extreme fire weather in Chile driven by climate change and El Niño-Southern Oscillation (ENSO).

A string of fierce fires broke out in Chile in the austral summer 2023, just six years after the record-breaking 2017 fire season. Favored by extreme weather conditions, fire activity has dramatically risen in recent years in this Andean country. A total of 1.7 million ha. burned during the last decade, tripling figures of the prior decade. Six of the seven most destructive fire seasons on record occurred since 2014. Here, we analyze the progression during the last two decades of the weather conditions associated with increased fire risk in Central Chile (30°-39° S). Fire weather conditions (including high temperatures, low humidity, dryness, and strong winds) increase the potential for wildfires, once ignited, to rapidly spread. We show that the concurrence of El Niño and climate-fueled droughts and heatwaves boost the local fire risk and have decisively contributed to the intense fire activity recently seen in Central Chile. Our results also suggest that the tropical eastern Pacific Ocean variability modulates the seasonal fire weather in the country, driving in turn the interannual fire activity. The signature of the warm anomalies in the Niño 1 + 2 region (0°-10° S, 90° W-80° W) is apparent on the burned area records seen in Central Chile in 2017 and 2023.

Multidirectional Planar Motion Transmission on a Single-Motor Actuated Robot via Microscopic Galumphing.

Insect-scale mobile robots can execute diverse arrays of tasks in confined spaces. Although most self-contained crawling robots integrate multiple actuators to ensure high flexibility, the intricate actuators restrict their miniaturization. Conversely, robots with a single actuator lack the requisite agility and precision for planar movements. Herein, a novel eccentric rotation-dependent multidirectional transmission is presented using a tilted eccentric motor and a simplistic two-legged structural configuration for planar locomotion. The speed of the eccentric motor is modulated to enable alternating microscopic jumps to propel the system, creating a mode of motion analogous to galumphing of seals. Upon modeling the motion dynamics and conducting experiments, the effectiveness of direct motion transmission is substantiated through microscopic galumphing encompassing left/right crawling and straight-forward crawling. Finally, a 1.2 g untethered robot is developed, which demonstrates enhanced straight crawling and spot turning, traverses narrow tunnels, and achieves precise movements. Therefore, the proposed motion-transmission technique provides a comprehensive set of innovative solutions of underactuated agile robots.

Discovery of Highly Selective PARP7 Inhibitors with a Novel Scaffold for Cancer Immunotherapy.

PARP7 plays a crucial role in cancer immunity. The inhibition of PARP7 has shown potential in boosting the immune response against cancer, making it an attractive target for cancer immunotherapy. Herein, we employed a rigid constraint strategy (reduction in molecular flexibility) to design and synthesize a series of novel indazole-7-carboxamide derivatives based on the structure of RBN-2397. Among these derivatives, (S)-XY-05 was identified as the most promising PARP7 inhibitor (IC50: 4.5 nM). Additionally, (S)-XY-05 showed enhanced selectivity toward PARP7 and improved pharmacokinetic properties (oral bioavailability: 94.60%) compared with RBN-2397 (oral bioavailability: 25.67%). In the CT26 syngeneic mouse model, monotherapy with (S)-XY-05 displayed a strong antitumor effect (TGI: 83%) by activating T-cell-mediated immunity within the tumor microenvironment. Collectively, we confirmed that (S)-XY-05 has profound effects on tumor immunity, which paves the way for future studies of PARP7 inhibitors that could be utilized in cancer immunotherapy.

Clinical value of folate receptor-positive circulating tumor cells in patients with esophageal squamous cell carcinomas: a retrospective study.

BACKGROUND: The aim of the study is to explore the role of preoperative folate receptor-positive circulating tumor cell (FR+CTC) levels in predicting disease-free survival (DFS) and overall survival (OS) in patients with esophageal squamous cell carcinomas (ESCC). METHODS: Three ml blood samples were prospectively drawn from ESCC patients, and ligand-targeted polymerase chain reaction (LT-PCR) was used for the quantification of FR+CTCs. Other serum indicators were measured by traditional methods. Clinicopathological characteristics were obtained from the hospital medical record system, DFS and OS data were obtained by follow-up. The correlation between clinico-pathological characteristics, DFS, and OS and FR+CTCs were analyzed, respectively. Risk factors potentially affecting DFS and OS were explored by Cox regression analysis. RESULTS: there were no significant correlations between FR+CTCs and patient age, sex, albumin, pre-albumin, C-reactive protein (CRP), ferritin and CRP/Albumin ratio, tumor size, grade of differentiation, lymph node metastasis, TNM stage, perineural invasion/vessel invasion (all P > 0.05). Nevertheless, preoperative FR+CTCs were an independent prognostic factor for DFS (HR 2.7; 95% CI 1.31-, P = 0.007) and OS (HR 3.37; 95% CI 1.06-, P = 0.04). DFS was significantly shorter for patients with post-operative FR+CTCs ≥ 17.42 FU/3ml compared with patients < 17.42 FU/3ml (P = 0.0012). For OS, it was shorter for patients with FR+CTCs ≥ 17.42 FU/3ml compared with patients < 17.42 FU/3ml, however, the difference did not reach statistical significance (P = 0.51). CONCLUSIONS: ESCC patients with high FR+CTCs tend to have a worse prognosis. FR+CTCs may monitor the recurrence of cancers in time, accurately assess patient prognosis, and guide clinical decision-making. TRIAL REGISTRATION: The study was approved by the Sichuan Cancer Hospital & Institute Ethics Committee (No. SCCHEC-02-2022-050).

Circular polarization-resolved ultraviolet photonic artificial synapse based on chiral perovskite.

Circularly polarized light (CPL) adds a unique dimension to optical information processing and communication. Integrating CPL sensitivity with light learning and memory in a photonic artificial synapse (PAS) device holds significant value for advanced neuromorphic vision systems. However, the development of such systems has been impeded by the scarcity of suitable CPL active optoelectronic materials. In this work, we employ a helical chiral perovskite hybrid combined with single-wall carbon nanotubes to achieve circularly polarized ultraviolet neuromorphic vision sensing and imaging. The heterostructure demonstrates long-term charge storage as evidenced by multiple-pulsed transient absorption measurements and highly sensitive circular polarization-dependent photodetection, thereby enabling efficient CPL-resolved synaptic and neuromorphic behaviors. Significantly, our PAS sensor arrays adeptly visualize, discriminate, and memorize distinct circularly polarized images with up to 93% recognition accuracy in spiking neural network simulations. These findings underscore the pivotal role of chiral perovskites in advancing PAS technology and circular polarization-enhanced ultraviolet neuromorphic vision systems.

Trans-Lesion Synthesis and Mismatch Repair Pathway Crosstalk Defines Chemoresistance and Hypermutation Mechanisms in Glioblastoma.

Almost all Glioblastoma (GBM) are either intrinsically resistant to the chemotherapeutical drug temozolomide (TMZ) or acquire therapy-induced mutations that cause chemoresistance and recurrence. The genome maintenance mechanisms responsible for GBM chemoresistance and hypermutation are unknown. We show that the E3 ubiquitin ligase RAD18 (a proximal regulator of TLS) is activated in a Mismatch repair (MMR)-dependent manner in TMZ-treated GBM cells, promoting post-replicative gap-filling and survival. An unbiased CRISPR screen provides a new aerial map of RAD18-interacting DNA damage response (DDR) pathways deployed by GBM to tolerate TMZ genotoxicity. Analysis of mutation signatures from TMZ-treated GBM reveals a role for RAD18 in error-free bypass of O6mG (the most toxic TMZ-induced lesion), and error-prone bypass of other TMZ-induced lesions. Our analyses of recurrent GBM patient samples establishes a correlation between low RAD18 expression and hypermutation. Taken together we define novel molecular underpinnings for the hallmark tumorigenic phenotypes of TMZ-treated GBM.

Trans-Lesion Synthesis and Mismatch Repair Pathway Crosstalk Defines Chemoresistance and Hypermutation Mechanisms in Glioblastoma.

Almost all Glioblastoma (GBM) are either intrinsically resistant to the chemotherapeutical drug temozolomide (TMZ) or acquire therapy-induced mutations that cause chemoresistance and recurrence. The genome maintenance mechanisms responsible for GBM chemoresistance and hypermutation are unknown. We show that the E3 ubiquitin ligase RAD18 (a proximal regulator of TLS) is activated in a Mismatch repair (MMR)-dependent manner in TMZ-treated GBM cells, promoting post-replicative gap-filling and survival. An unbiased CRISPR screen provides a new aerial map of RAD18-interacting DNA damage response (DDR) pathways deployed by GBM to tolerate TMZ genotoxicity. Analysis of mutation signatures from TMZ-treated GBM reveals a role for RAD18 in error-free bypass of O6mG (the most toxic TMZ-induced lesion), and error-prone bypass of other TMZ-induced lesions. Our analyses of recurrent GBM patient samples establishes a correlation between low RAD18 expression and hypermutation. Taken together we define novel molecular underpinnings for the hallmark tumorigenic phenotypes of TMZ-treated GBM.

Impacts of climate change, population growth, and power sector decarbonization on urban building energy use.

Climate, technologies, and socio-economic changes will influence future building energy use in cities. However, current low-resolution regional and state-level analyses are insufficient to reliably assist city-level decision-making. Here we estimate mid-century hourly building energy consumption in 277 U.S. urban areas using a bottom-up approach. The projected future climate change results in heterogeneous changes in energy use intensity (EUI) among urban areas, particularly under higher warming scenarios, with on average 10.1-37.7% increases in the frequency of peak building electricity EUI but over 110% increases in some cities. For each 1 °C of warming, the mean city-scale space-conditioning EUI experiences an average increase/decrease of ~14%/ ~ 10% for space cooling/heating. Heterogeneous city-scale building source energy use changes are primarily driven by population and power sector changes, on average ranging from -9% to 40% with consistent south-north gradients under different scenarios. Across the scenarios considered here, the changes in city-scale building source energy use, when averaged over all urban areas, are as follows: -2.5% to -2.0% due to climate change, 7.3% to 52.2% due to population growth, and -17.1% to -8.9% due to power sector decarbonization. Our findings underscore the necessity of considering intercity heterogeneity when developing sustainable and resilient urban energy systems.

[Research progress of caput femoris posterior tilt and its impact on prognosis in nondisplaced femoral neck fractures].

There are still many unresolved problems in the treatment and prognosis of nondisplaced femoral neck fractures, such as nonunion and avascular necrosis of the caput femoris .In order to reduce the risk of various complications after non-displaced femoral neck fractures, the caput femoris posterior tilt of femoral neck fractures and its impact on prognosis have attracted more and more attention. A large number of scholars' studies have found that when the posterior tilt exceeds 20°, the risk of internal fixation failure increases significantly. Based on this concept, we can choose to use primary artificial joint replacement instead of three-screw internal fixation according to the different posterior tilt angles of patients to reduce the incidence of postoperative complications. At the same time, our analysis found that comminution of the posterior segment of the femoral neck would lead to an increase in the posterior inclination angles. The purpose of this review was to investigate the relationship between caput femoris posterior tilt of femoral neck fractures and surgical outcome, and to introduce a new method for measuring caput femoris posterior tilt of the femoral neck.