High-temperature corrosion-resistant alloy for waste-to-energy plants: Alloy designing, fabrication, and possible corrosion-resistance mechanism

This study designed a novel high-temperature corrosion-resistant alloy through thermodynamic equilibrium computations. The strength was determined by the integration of precipitation-strengthening species of nickel boride and tungsten solid solution strengthening, while high-temperature corrosion-resistant property was realized through optimized compositional design. Phase stability was enabled by the presence of a face-centered cubic structure. The alloy was fabricated and its corrosion-resistance performance was experimentally compared with other commercially available nickel- and iron-based alloys under simulated municipal solid waste combustion. The designed alloy with a composition of Ni-5B-6W-28Cr-13Al showed a low corrosion rate of ∼72 % < 13CrMo4-5TS and 1.08 % > Inconel 625. Economic analysis showed that Ni-5B-6W-28Cr-13Al has a cost-effectiveness ratio of 1:1.57 with respect to Inconel 625 and 1:0.09 with respect to 13CrMo4-5TS. Corrosion-resistance mechanism was explored using scanning electron microscopy coupled with energy dispersive spectroscopy, x-ray diffractometer, and DFT computations. The corrosion resistance occurred through the formation of a uniform tungsten-chromium-oxide film which inhibits inward diffusion of corrosive chlorine species. These findings provide insights into the development of alloys for high-temperature technologies.

circKDM1A suppresses bladder cancer progression by sponging miR-889-3p/CPEB3 and stabilizing p53 mRNA

Circular RNAs (circRNAs) play crucial biological functions in various tumors, including bladder cancer (BCa). However, the roles and underlying molecular mechanisms of circRNAs in the malignant proliferation of BCa are yet unknown. CircKDM1A was observed to be downregulated in BCa tissues and cells. Knockdown of circKDM1A promoted the proliferation of BCa cells and bladder xenograft growth, while the overexpression of circKDM1A exerts the opposite effect. The dual-luciferase reporter assay revealed that circKDM1A was directly bound to miR-889-3p, acting as its molecular sponge to downregulate CPEB3. In turn, the CPEB3 was bound to the CPE signal in p53 mRNA 3'UTR to stabilize its expression. Thus, circKDM1A-mediated CPEB3 downregulation inhibits the stability of p53 mRNA and promotes BCa malignant progression. In conclusion, circKDM1A functions as a tumor suppressor in the malignant proliferation of BCa via the miR-889-3p/CPEB3/p53 axis. CircKDM1A may be a potential prognostic biomarker and therapeutic target of BCa.

Synergistic control potential of flue gas pollutants under Ultra-Low emission standards in waste incineration plants

As the dominant waste disposal process, incineration is regarded as the main incentive for the "not-in-my-backyard" syndrome, and faces an inescapable pressures of ultra-low emissions (ULE). Establishing precise response relationships between emission factors (EFs) and full-process influencing factors can provide guidance for the synergistic mitigation of flue gas pollutants (FGPs). In this work, the multi-dimensional EFs of FGPs were identified by initially integrating FGPs concentration monitoring data of existing 1,226 processing lines in China, technologies applied and operational experience (OE), local economic and political characteristics. Significant regional imbalance performance was observed, which EFs in the coastal regions were 3.55-92.39 % lower than those of the inland areas. NOx, SO2, HCl were identified as critical components requiring further reduction under the ULE standards, with exceedance rates recorded at 73.07 %, 38.90 %, and 56.69 %, respectively. An indicative value of 20 mg/m3 for PM is recommended for the control of heavy metals of Cd + Tl and Sb + As + Pb + Cr + Co + Cu + Mn + Ni based on the correlation coefficients of r = 0.28 (p < 0.001) and r = 0.20 (p = 0.002), respectively. Waste composition and OE were quantified as the main contributors of EFs' disparities by the tree-branching controlled variable approach established in this study. Predictive models for FGPs control process and corresponding EFs were constructed. EFs of nine FGPs in 2030 would decrease by 0.97-65.42 %, due to more complex purification processes employed to meet ULE's limitations, such as the application of five-stage processes growing from 45.60 % to 58.28 %. While regional imbalance in EFs-SO2 and EFs-HCl were extended with increases from 25.83 % to 33.07 % and 9.91 % to 32.32 %, respectively, due to the consistent disparities of OE and growing heterogeneity of control policies. Enhancing interregional empirical exchanges, reducing the regional market monopolies, and formulating technical guidelines would be beneficial to synergize the reduction of FGPs emissions and alleviate regional imbalance.

Study of High-Transverse-Momentum Higgs Boson Production in Association with a Vector Boson in the qqbb Final State with the ATLAS Detector

This Letter presents the first study of Higgs boson production in association with a vector boson (V=W or Z) in the fully hadronic qqbb final state using data recorded by the ATLAS detector at the LHC in proton-proton collisions at sqrt[s]=13  TeV and corresponding to an integrated luminosity of 137  fb^{-1}. The vector bosons and Higgs bosons are each reconstructed as large-radius jets and tagged using jet substructure techniques. Dedicated tagging algorithms exploiting b-tagging properties are used to identify jets consistent with Higgs bosons decaying into bb[over ¯]. Dominant backgrounds from multijet production are determined directly from the data, and a likelihood fit to the jet mass distribution of Higgs boson candidates is used to extract the number of signal events. The VH production cross section is measured inclusively and differentially in several ranges of Higgs boson transverse momentum: 250-450, 450-650, and greater than 650 GeV. The inclusive signal yield relative to the standard model expectation is observed to be μ=1.4_{-0.9}^{+1.0} and the corresponding cross section is 3.1±1.3(stat)_{-1.4}^{+1.8}(syst)  pb.

Measurement of the Centrality Dependence of the Dijet Yield in p+Pb Collisions at sqrt[s_{NN}]=8.16 TeV with the ATLAS Detector

ATLAS measured the centrality dependence of the dijet yield using 165  nb^{-1} of p+Pb data collected at sqrt[s_{NN}]=8.16  TeV in 2016. The event centrality, which reflects the p+Pb impact parameter, is characterized by the total transverse energy registered in the Pb-going side of the forward calorimeter. The central-to-peripheral ratio of the scaled dijet yields, R_{CP}, is evaluated, and the results are presented as a function of variables that reflect the kinematics of the initial hard parton scattering process. The R_{CP} shows a scaling with the Bjorken x of the parton originating from the proton, x_{p}, while no such trend is observed as a function of x_{Pb}. This analysis provides unique input to understanding the role of small proton spatial configurations in p+Pb collisions by covering parton momentum fractions from the valence region down to x_{p}∼10^{-3} and x_{Pb}∼4×10^{-4}.

Distinguishment between high-grade gliomas and solitary brain metastases in peritumoural oedema: quantitative analysis using synthetic MRI at 3 T

AIM

To investigate the efficacy of synthetic magnetic resonance imaging (MRI) in distinguishing high-grade gliomas (HGGs) from solitary brain metastases (SBMs) in peritumoural oedema.

MATERIALS AND METHODS

Thirty-five patients with HGGs and 25 patients with SBMs were recruited and scanned using synthetic MRI using a 3 T scanner. Two radiologists measured synthetic MRI-derived relaxation values independently (T1, T2, proton density [PD]) in the peritumoural oedema, which was used to generate quantitative metrics before (T1native, T2native, and PDnative) and after (T1post, T2post, and PDpost) contrast agent injection. Student's t-test or the Mann-Whitney U-test was performed to detect statistically significant differences in the aforementioned metrics in peritumoural oedema between HGGs and SBMs. The receiver operating characteristic (ROC) curves were plotted to evaluate the efficacy of each metric in distinguishing the two groups, and the areas under the curves (AUCs) were compared pairwise by performing the Delong test.

RESULTS

The mean T1native, T2native, and T1post values in the peritumoural oedema of HGGs were significantly lower compared with SBMs (all p<0.05). The T1post value had a higher AUC (0.843) in differentiating HGGs and SBMs than all other individual metrics (all p<0.05). The combined T1native, T2native, and T1post model had the best distinguishing performance with an AUC, sensitivity, and specificity of 0.987, 94.3%, and 100%, respectively.

CONCLUSIONS

Synthetic MRI may be a potential supplement to the preoperative diagnosis of HGGs and SBMs in clinical practice, as the synthetic MRI-derived tri-parametric model in the peritumoural oedema showed significantly improved diagnostic performance in distinguishing HGGs from SBMs.

Identification of lncRNA-based regulatory mechanisms of Takifugu rubripes growth traits in fast and slow-growing family lines

Family selection is an important method in fish aquaculture because growth is the most important economic trait. Fast-and slow-growing families of tiger puffer fish (Takifugu rubripes) have been established through family selection. The development of teleost fish is primarily controlled by the growth hormone (GH)-insulin-like growth factor 1 (IGF-1) axis that includes the hypothalamus-pituitary-liver. In this study, the molecular mechanisms underlying T. rubripes growth were analyzed by comparing transcriptomes from fast- and slow-growing families. The expressions of 214 lncRNAs were upregulated, and those of 226 were downregulated in the brain tissues of the fast-growing T. rubripes family compared to those of the slow-growing family. Differentially expressed lncRNAs centrally regulate mitogen-activated protein kinase (MAPK) and forkhead box O (FoxO) signaling pathways. Based on the results of lncRNA-gene network construction, we found that lncRNA3133.13, lncRNA23169.1, lncRNA23145.1, and lncRNA23141.3 regulated all four genes (igf1, mdm2, flt3, and cwf19l1). In addition, lncRNA7184.10 may be a negative regulator of rasgrp2 and a positive regulator of gadd45ga, foxo3b, and dusp5. These target genes are associated with the growth and development of organisms through the PI3K/AKT and MAPK/ERK pathways. Overall, transcriptomic analyses of fast- and slow-growing families of T. rubripes provided insights into the molecular mechanisms of teleost fish growth rates. Further, these analyses provide evidence for key genes related to growth regulation and the lncRNA expression regulatory network that will provide a framework for improving puffer fish germplasm resources.

Mechanistic exploration of polytetrafluoroethylene thermal plasma gasification through multiscale simulation coupled with experimental validation

The ever-growing quantities of persistent Polytetrafluoroethylene (PTFE) wastes, along with consequential ecological and human health concerns, stimulate the need for alternative PTFE disposal method. The central research challenge lies in elucidating the decomposition mechanism of PTFE during high-temperature waste treatment. Here, we propose the PTFE microscopic thermal decomposition pathways by integrating plasma gasification experiments with multi-scale simulations strategies. Molecular dynamic simulations reveal a pyrolysis-oxidation & chain-shortening-deep defluorination (POCD) degradation pathway in an oxygen atmosphere, and an F abstraction-hydrolysis-deep defluorination (FHD) pathway in a steam atmosphere. Density functional theory computations demonstrate the vital roles of 1O2 and ·H radicals in the scission of PTFE carbon skeleton, validating the proposed pathways. Experimental results confirm the simulation results and show that up to 80.12% of gaseous fluorine can be recovered through plasma gasification within 5 min, under the optimized operating conditions determined through response surface methodology.

Steady state engineering of a two-level system by the mixed-state inverse engineering scheme

The mixed-state inverse engineering scheme is a control scheme used for engineering the quantum state of a driven open quantum system from an initial steady state to a final steady state. In this paper, we present an analytical study of this scheme applied to the driven two-level model coupled to a heat reservoir. Typically, when the purity of the quantum state varies, incoherent control techniques are required for mixed-state engineering. However, we show that for both Markovian and non-Markovian dynamics, coherent control protocols can transfer the quantum state into the target state. This simplification comes at a cost, as the evolution of the quantum state must be limited to restricted conditions, resulting in special trajectories in its Hilbert space that connect the initial and target states.

A general nonparametric classification method for multiple strategies in cognitive diagnostic assessment

Cognitive diagnosis models (CDMs) have been used as psychometric tools in educational assessments to estimate students' strengths and weaknesses in terms of cognitive skills learned and skills that need study. In practice, it is not uncommon that questions can often be solved using more than one strategy, which requires CDMs capable of accommodating multiple strategies. However, existing parametric multi-strategy CDMs need a large sample size to produce a reliable estimation of item parameters and examinees' proficiency class memberships, which obstructs their practical applications. This article proposes a general nonparametric multi-strategy classification method with promising classification accuracy in small samples for dichotomous response data. The method can accommodate different strategy selection approaches and different condensation rules. Simulation studies showed that the proposed method outperformed the parametric CDMs when sample sizes were small. A set of real data was analyzed as well to illustrate the application of the proposed method in practice.

Achieving sustainable emissions in China: Techno-economic analysis of post-combustion carbon capture unit retrofitted to WTE plants

China's aims of achieving CO2 emissions peak by 2030 and carbon neutrality by 2060 are crucial in guiding international efforts to mitigate climate change. Amine-based solvent technologies for capturing CO2 on a large scale have been implemented as retrofits in various industrial facilities, with a particular focus on coal-fired power plants. Nonetheless, its implementation within the waste-to-energy (WTE) industry is considerably limited and non-existent in China. This work presents a technical and economic evaluation of retrofitting a generic WTE facility in China with a carbon capture system. A rate-based process simulation model of the capture plant was developed in Aspen Plus, and the effect of equipment installation factors on capital cost was evaluated via the enhanced detailed factor (EDF) method. A set of key performance indicators were evaluated. The findings indicate that the energy demand linked to the capture system caused a decrease in efficiency by 13.17%, 14.85%, and 16.56% at 85%, 90%, and 95% capture rates, respectively, and the overall exergy efficiency of the system was reduced by 5.5%, 8.27%, and 10.63%, respectively. The estimated CO2 captured costs range from €56.41/tCO2 to €58.95/tCO2, while CO2 avoided costs range from €153.33/tCO2 to €236.47/tCO2. Retrofitting a CO2 capture unit at WTE facilities has the potential to substantially contribute to achieving the country's emission reduction targets. However, the successful implementation requires a comprehensive policy structure. This work offers some insights into the prospective integration of CO2 capture technology in China's WTE industry.

Mendelian Randomization Analysis Reveals Causal Factors behind Alzheimer's Disease Risk: Evidence, Opportunities, and Challenges

Alzheimer's disease and its comorbidities pose a heavy disease burden globally, and its treatment remains a major challenge. Identifying the protective and risk factors for Alzheimer's disease, as well as its possible underlying molecular processes, can facilitate the development of interventions that can slow its progression. Observational studies and randomized controlled trials have provided some evidence regarding potential risk factors for Alzheimer's disease; however, the results of these studies vary. Mendelian randomization is a novel epidemiological methodology primarily used to infer causal relationships between exposures and outcomes. Many Mendelian randomization studies have identified potential causal relationships between Alzheimer's disease and certain diseases, lifestyle habits, and biological exposures, thus providing valuable data for further mechanistic studies and the development and implementation of clinical prevention strategies. However, the results and data from Mendelian randomization studies must be interpreted based on comprehensive evidence. Moreover, the existing Mendelian randomization studies on the epidemiology of Alzheimer's disease have some limitations that are worth exploring. Therefore, the aim of this review was to summarize the available evidence on the potential protective and risk factors for Alzheimer's disease by assessing published Mendelian randomization studies on Alzheimer's disease, and to provide new perspectives on the etiology of Alzheimer's disease.

Combined Measurement of the Higgs Boson Mass from the H→γγ and H→ZZ^{*}→4ℓ Decay Channels with the ATLAS Detector Using sqrt[s]=7, 8, and 13 TeV pp Collision Data

A measurement of the mass of the Higgs boson combining the H→ZZ^{*}→4ℓ and H→γγ decay channels is presented. The result is based on 140  fb^{-1} of proton-proton collision data collected by the ATLAS detector during LHC run 2 at a center-of-mass energy of 13 TeV combined with the run 1 ATLAS mass measurement, performed at center-of-mass energies of 7 and 8 TeV, yielding a Higgs boson mass of 125.11±0.09(stat)±0.06(syst)=125.11±0.11  GeV. This corresponds to a 0.09% precision achieved on this fundamental parameter of the Standard Model of particle physics.

Assessing the suitability of municipal sewage sludge and coconut bran as breeding medium for Oryza sativa L. seedlings and developing a standardized substrate

The utilization of organic solid waste (OSW) for preparing standardized seedling substrates is a main challenge due to its temporal and spatial variability. This study aims to form models based on data from the literature and validate them through experiments to explore a standardized seedling substrate. The typical OSW in Hainan Province, including municipal sewage sludge (MSS), coconut bran (CB), seaweed mud (SM), and municipal sewage sludge biochar (MSSB), was used as raw material. A series of six mixing ratios was tested, namely: T1 (0% MSS: 90% CB), T2 (10% MSS: 80% CB), T3 (30% MSS: 60% CB), T4 (50% MSS: 40% CB), T5 (70% MSS: 20% CB), and T6 (90% MSS: 0% CB). SM and MSSB were added as amendment materials at 5% (w/w) for each treatment. The physicochemical properties of substrates, agronomic traits of rice seedlings and microbial diversity were analyzed. The results showed that the four kinds of OSW played an active role in providing rich sources of nutrients. The dry weight of the above-ground part was 2.98 times greater in T3 than that of the commercial substrate. Furthermore, the microbial analysis showed a higher abundance of Actinobacteria in T3, representing the stability of the composted products. Finally, the successful fitting of the results with the linear regression models could establish relationship equations between the physicochemical properties of the substrate and the growth characteristics of seedlings. The relevant parameters suitable for the growth of rice seedlings were as follows: pH (6.46-7.01), EC (less than 2.12 mS cm-1), DD (0.13-0.16 g cm-3), and TPS (65.68-82.73%). This study proposed relevant parameters and models for standardization of seedling substrate, which would contribute to ensuring the quality of seedlings and OSW resource utilization.

[Acceptance of pre-exposure prophylaxis and post-exposure prophylaxis against HIV and related factors in men who have sex with men in Shandong Province]

Objectives: To understand the use of pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) and related factors in men who have sex with men (MSM) in Shandong Province, and provide reference for the promotion of PrEP and PEP in MSM. Methods: From April to July in 2022, MSM were recruited from 7 sentinel surveillance sites in Shandong Province for a questionnaire survey, and the sample size of each city site was 400. The information about sociodemographic characteristics, sexual behaviors, the uses of PrEP and PEP and others were collected from the MSM, and blood samples were collected from them for HIV and syphilis testing. Results: A total of 2 815 MSM were investigated, the majority of them were aged less than 30 years (55.7%, 1 569/2 815), unmarried (68.6%, 1 931/2 815) and had education background of college and above (56.5%, 1 590/2 815). Only 9.2% (258/2 815) had used PrEP and 10.8% (305/2 815) had used PEP. Multivariate logistic regression showed that factors associated with high likelihood of PrEP use in MSM included age ≤30 years (aOR=4.04, 95%CI:1.25-13.01), self-perceived lower risk of HIV infection (aOR=1.76, 95%CI:1.16-2.68), group sex and commercial sex in the past six months (aOR=1.51, 95%CI: 1.10-2.09; aOR=1.69, 95%CI: 1.16-2.47), new-type drug use (aOR=1.53, 95%CI: 1.11-2.11), receiving peer education (aOR=1.56, 95%CI: 1.03-2.37), other people using PrEP (aOR=3.29, 95%CI: 2.48-4.36), and being HIV negative (aOR=8.40, 95%CI:1.12-63.12). Factor associated with low likelihood of PrEP use in MSM was anal sex with casual partner (aOR=0.67, 95%CI:0.49-0.90). Factors associated with high likelihood of PEP use in MSM included age under 50 years (≤30 years old: aOR=2.41, 95%CI:1.02-5.69; 31-49 years old: aOR=3.33, 95%CI:1.42-7.85), no self-perceived risk for HIV infection (aOR=1.87, 95%CI:1.12-3.11), group sex in the past six months (aOR=1.68, 95%CI:1.23-2.29), new-type drug use (aOR=3.86, 95%CI:2.94-5.07) and receiving no peer education (aOR=1.54, 95%CI:1.12-2.12). Conclusions: In Shandong, a higher proportion of MSM used PrEP and PEP. Peer education and self-perceived HIV infection risk education should be strengthened to increase the rates of PrEP and PEP use in MSM.

[A study on quality of life and related factors among HIV-infected men who have sex with men based on latent profile analysis]

Objectives: To investigate the potential classification of quality of life in HIV-infected men who have sex with men (HIV-infected MSM) and to analyze possible influencing factors of different categories. Methods: A questionnaire survey was conducted among HIV-infected MSM who received antiretroviral treatment (ART) in an infectious disease hospital in Ji'nan, Shandong Province from October to December 2020. The quality of life scores in six domains were analyzed by latent profile analysis (LPA), and possible related factors of potential classification were explored by ordinal logistic regression analysis. Results: A total of 584 HIV-infected MSM were included in this study. LPA divided their quality of life into three categories, named low score, medium score and high score groups, accounting for 34.4% (201/584), 49.8% (291/584), and 15.8% (92/584), respectively. Multivariate ordinal logistic regression analysis showed that age above 40 years (aOR=1.77, 95%CI:1.11-2.80), monthly average income of 3 000 Yuan and below (aOR=3.15, 95%CI:1.72-5.76), monthly average income of 3 001-5 000 Yuan (aOR=2.26, 95%CI:1.41-3.62), distance to the hospital to receive drugs farer than 40 kms (aOR=1.76, 95%CI:1.07-2.89), and adverse reactions after taking drugs (aOR=2.31, 95%CI:1.65-3.23) were factors associated with low level of quality of life. Conclusions: The qualities of life of HIV-infected MSM showed group heterogeneity and were at high levels. Attention should be focused on HIV-infected MSM who are at older age, with low income, and long distance to access the health facilities. The measures should be taken to reduce the adverse reactions of ART drugs and improve the quality of life.

[Analysis of characteristics of types of primary sexual partners and related factors of not being tested for HIV among men who have sex with men]

Objective: To compare the characteristics of MSM with different types of primary sexual partners and to analyze the factors associated with MSM not being tested for HIV in the last six months. Methods: MSM were recruited in nine cities of Shandong Province from April to July 2021, and face-to-face questionnaires were conducted to collect information on sociodemographic characteristics, high-risk behaviors, and HIV testing of MSM. Blood samples were taken for serological tests of HIV and syphilis antibodies. Results: A total of 3 008 men who had anal sex with men in the last six months were divided into three groups according to the type of primary sexual partner in the last six months: the fixed sexual partner group (36.83%, 1 108/3 008), the commercial sexual partner group (3.06%, 92/3 008), and casual sexual partner group (60.11%, 1 808/3 008). There were statistically significant differences in the distribution of age, local residence time, education level, the primary place to find male sexual partners, use of new-type drugs in the last six months, consistent condom use every time during same-sex anal sex in the last six months, group sex in the last six months, no HIV testing in the last six months, having had a sexually transmitted disease in the last year, receiving peer education in the last year, and frequency of syphilis testing in the last year among different groups (P<0.05). Multivariable logistic regression analysis showed that related factors of not being tested for HIV in the last six months in MSM were those aged less than 30 years old (aOR=1.39, 95%CI: 1.06-1.83), married/cohabiting (aOR=1.74, 95%CI: 1.39-2.16), high school education or less (aOR=1.39, 95%CI: 1.15-1.67), had not used new-type drugs in the last six months (aOR=2.27, 95%CI: 1.89-2.71), had not received peer education in the last year (aOR=1.59, 95%CI: 1.28-1.98), had never been tested for syphilis (aOR=11.30, 95%CI: 8.15-15.66), had not been tested in the last year but had been previously tested for syphilis (aOR=5.65, 95%CI: 4.19-7.62), the type of primary sexual partner in the last six months being a commercial sexual partner (aOR=1.80, 95%CI: 1.01-3.20), and the type of primary sexual partner in the last six months being a casual sexual partner (aOR=1.50, 95%CI: 1.26-1.80). Conclusions: The characteristics of MSM with different types of primary sexual partners are different, and the proportion of HIV testing still needs to be improved. In the future, we should make full use of the Internet and peer education to expand the coverage of HIV testing for MSM, targeting the characteristics of MSM with different types of primary sexual partners.

Vemurafenib for BRAF V600-mutant Erdheim-Chester disease presenting with bilateral orbital involvement

ECD is considered to have rapid progression and poor prognosis. Studies have shown that vemurafenib is effective for ECD patients with orbital involvement, but not for ECD with multiple organs. The refinement of treatment approaches and the increased awareness of ECD have led to a dramatic improvement in prognosis.

Commentary on "Extending the Basic Local Independence Model to Polytomous Data" by Stefanutti, de Chiusole, Anselmi, and Spoto

The Polytomous Local Independence Model (PoLIM) by Stefanutti, de Chiusole, Anselmi, and Spoto, is an extension of the Basic Local Independence Model (BLIM) to accommodate polytomous items. BLIM, a model for analyzing responses to binary items, is based on Knowledge Space Theory, a framework developed by cognitive scientists and mathematical psychologists for modeling human knowledge acquisition and representation. The purpose of this commentary is to show that PoLIM is simply a paraphrase of a DINA model in cognitive diagnosis for polytomous items. Specifically, BLIM is shown to be equivalent to the DINA model when the BLIM-items are conceived as binary single-attribute items, each with a distinct attribute; thus, PoLIM is equivalent to the DINA for polytomous single-attribute items, each with a distinct attribute.

Hepatitis C virus genotype diversity in Ningxia Hui autonomous region, Northwestern China

Hepatitis C virus (HCV) genotypes vary greatly in different regions. The aim of this study is to investigate the distribution of HCV genotypes in HCV infected patients, in Ningxia Hui Autonomous Region. Nucleic acid extraction and amplification were performed with test kits on 153 HCV infected patients serum samples. The HCV viral load was measured using reverse transcriptase PCR (RT-PCR) and HCV genotypes were determined. Among the 153 HCV-infected patients, 56 had genotype (GT)1b (36.60%), 45 had GT2a (29.40%), 23 had GT3a (15.00%), 14 had GT3b (9.20%),13 had GT6a (8.50%), 1 had GT1g (0.70%), 1 had GT6xa (0.70%). In GT1b, 21.40% were female and 78.60% were male; in GT2a, 42.20% were female and 57.80% were male;Males were most prevalent in genotypes 1b(39.30%), while female were most prevalent in genotype 2a(46.30%). Rare GT1g and GT6xa were also detected in males. The 41-50 year age group had the highest HCV prevalence of 32.00%. HCV GT1b is the predominant HCV genotype in Ningxia Hui Autonomous Region.

A Testlet Diagnostic Classification Model with Attribute Hierarchies

In this article, a testlet hierarchical diagnostic classification model (TH-DCM) was introduced to take both attribute hierarchies and item bundles into account. The expectation-maximization algorithm with an analytic dimension reduction technique was used for parameter estimation. A simulation study was conducted to assess the parameter recovery of the proposed model under varied conditions, and to compare TH-DCM with testlet higher-order CDM (THO-DCM; Hansen, M. (2013). Hierarchical item response models for cognitive diagnosis (Unpublished doctoral dissertation). UCLA; Zhan, P., Li, X., Wang, W.-C., Bian, Y., & Wang, L. (2015). The multidimensional testlet-effect cognitive diagnostic models. Acta Psychologica Sinica, 47(5), 689. https://doi.org/10.3724/SP.J.1041.2015.00689). Results showed that (1) ignoring large testlet effects worsened parameter recovery, (2) DCMs assuming equal testlet effects within each testlet performed as well as the testlet model assuming unequal testlet effects under most conditions, (3) misspecifications in joint attribute distribution had an differential impact on parameter recovery, and (4) THO-DCM seems to be a robust alternative to TH-DCM under some hierarchical structures. A set of real data was also analyzed for illustration.

Clinical analysis of microvascular reconstruction combined with decompressive craniectomy in patients with malignant middle cerebral artery infarctions

PURPOSE

This study aimed to evaluate the safety and efficacy of microvascular reconstruction combined with decompressive craniectomy in patients with MMCA.

METHODS

We searched for patients with MMCA ,and age＜60 years old, postoperative survival of more than 3 months, consistent with decompression of bone flap removal. Patients were divided into experimental group and control group according to whether they underwent emergency vascular revascularization within 5 days after onset of ischemic stroke.

RESULTS

A total of 6 patients were included in the treatment group and 12 patients in the control group. The NIHSS score of the treatment group was lower than that of the control group 7 days after operation, but the difference was not statistically significant;3 months after surgery, mRs score in the treatment group was lower than that in the control group, the difference was statistically significant (P=0.002); mRs scores of the treatment group 3 months after surgery were significantly different from those before surgery (P<0.05), but no such difference was found in the control group.

CONCLUSION

Compared with DHC, open surgical revascularization can improve early cerebral perfusion in MMCA patients, and neurological recovery is better at 3 months after operation. By ensuring that surgeons are properly trained and hospitals are equipped, open surgical revascularization can be a treatment option for patients with MMCA.

Investigation of enhanced H2 production from municipal solid waste gasification via artificial neural network with data on tar compounds

An artificial neural network (ANN) is a biologically inspired computational technique that imitates the behavior and learning process of the human brain. In this study, ANN technique was applied to assess the gasification of municipal solid waste (MSW) with the aim of enhancing the H₂ production. The experiments were conducted using a horizontal tube reactor under different parameters: temperatures, MSW loadings, residence times, and equivalence ratios. The input and output variables (released gases) were tested and trained using back-propagation algorithm, and the data distribution by K-fold contrivance. The values of the training (80% data) and validation (20% data) dataset were found satisfactory. The values of regression coefficient (R²) for the training phase were lied between 0.9392 and 0.9991, and 0.9363 and 0.993824 for the testing phase. Whereas; the values of root mean square error (RSME) for the training phase were lied between 0.4111 and 0.8422, and between 0.1476 and 0.7320 for the testing phase. Higher H₂ production of 42.1 vol% was produced at the higher reaction temperature of 900 °C with LHV of 11.2 MJ/Nm³. According to the tar analysis, the dominant compounds were aromatics (17 compounds) followed by polycyclic aromatic, phenyl, aliphatic, aromatic heterocyclic, polycyclic, and aromatic ketone compounds.

Identifying the fate of nitrogenous species during sewage sludge pyrolysis via in-situ tracing of protein-sludge inherent components interactions

The effect of interactions between different components in sewage sludge on the thermochemical transformation of nitrogenous species is usually neglected, which is important to explain the generation mechanism of some key nitrogenous by-products. Here, we investigated the distribution, form, and chemical properties of the products from sludge-extracted protein (PR) under different pyrolysis scenarios using several in-situ probe techniques, to elucidate the critical role of typical sludge organics/inorganics on the evolution of nitrogenous intermediates and by-products. The results suggested that Ca/Fe/Si/Al-containing inorganics significantly affected the pyrolytic behavior of PR and the thermal transformation of nitrogenous species, while sludge organics, including humic acids and polysaccharides, had limited effects on the temperature-dependent evolution of nitrogenous species in PR. Among them, calcium oxide catalyzed the ring-opening reaction of heterocyclic-N with aromatic-like structures, resulting in a 21.1 %-68.8 % reduction in nitrogen fixation efficiency in the char. At lower temperatures (350-450 °C), calcium oxide caused more nitrogen to be transferred to the gas/tar phases in the form of NH₃ and heterocyclic-N, and it also enhanced the conversion of nitrile-N → HCN → NO at temperatures above 450 °C. In contrast, polyferric salts inhibited the devolatilization of mono-heterocyclic-N and enhanced the thermal stability of poly-heterocyclic-N, resulting in a maximum increase of 18.5 mg·g^-1 of nitrogen content in the char, while reducing the release of NH₃ and HCN by 71.1 % and 32.0 %. This work elucidated the interaction between PR and inherent components in sludge, providing key information for the control of nitrogenous volatiles and NO_x.

[Gasless submental approach endoscopic removal of thyroglossal cyst]

Objective: To explore the safety and feasibility of gasless submental approach endoscopic removal of thyroglossal cyst. Methods: This work prospectively included the clinical data of 13 patients who underwent the gasless submental approach endoscopic removal of thyroglossal cyst at the Department of Otolaryngology, the First Affiliated Hospital of Chongqing Medical University from August 2021 to February 2022. The operative time, bleeding volumes, postoperative complications, subjective pain levels, satisfaction with incisional scars, neck and facial deformities, and recurrences were prospectively evaluated by visual analogue scale(VAS) score. Results: All of 13 patients were successfully treated using this new technique. The patients had a median age of 38 years, ranging from 24 to 59 years, comprising of 3 males and 10 females. The length of the submental incision was about 3 cm and the median of operation time was 135 minutes. Postoperative complications were minimal. The median volume of blood loss was 10 ml. Surgical site swelling existed in 1 case and dysphagia for more than 1 week occurred in 2 cases. Patients were discharged from the hospital with a median of 3 days after surgery. On a VAS of 0-10 scores, the pain had a median of 2 on the first day after surgery, and the satisfaction with incision scars and neck and facial deformities showed a median of 8 at 6 months after surgery. There were no recurrences during the follow-up period of 9-15 months. Conclusion: Gasless submental approach endoscopic removal of thyroglossal cyst may be a reliable new surgical method that is safe and has cosmetic advantages.

Inhalation health risk assessment of incineration and landfill in the Bohai Rim, China

An inhalation health risks assessment of 96 waste to energy (WtE) plants and 178 landfills in the Bohai Rim, located in northeast China, has been conducted. Based on the latest emission inventories in 2020, WRF/CALPUFF was used to simulate the diffusion of pollutants. Population-weighted hazard index (HI) and carcinogenic risk (CR) of incineration and landfill for each pollutant and each target organ impacted were calculated. The health risks of incineration and landfill were correlated with per capita municipal solid waste (MSW) disposal quantity, emission factors, pollutant toxic effects and local migration and diffusion conditions. The HI of incineration and landfill in the Bohai Rim were 4.07 × 10^-3 and 4.79 × 10^-3, respectively, which was lower than the acceptable level (HI < 1), while the CR of incineration and landfill were 4.72 × 10^-7 and 2.58 × 10^-7, respectively, which was also lower than the acceptable level (CR < 1 × 10^-6). The non-carcinogenic risks of incineration mainly targeted respiratory system and development system, while the non-carcinogenic risks of landfill mainly targeted nervous system and respiratory system. The carcinogenic risks of incineration mainly targeted respiratory system and digestive system, while the carcinogenic risks of landfill mainly targeted hepatic system and respiratory system. With the trend that incineration phase in, while landfill phase out, the number of patients for 15 target organ diseases caused by the disposal of unit mass MSW would decrease in the Bohai Rim, ranging from 1.8 × 10^-8 - 1.8 × 10^-2 (pop/t)，especially in developed provinces, such as Beijing and Tianjin. However, the number of patients for 4 target organ diseases caused by the disposal of unit mass MSW would increase, ranging from 1.18 × 10^-6 - 5.28 × 10^-3 (pop/t). Based on pollutants' pathogenic mechanisms, this study innovatively accessed and compared incineration and landfill's health risks of target organs, and provide technical and policy suggestions based on the changing trend of MSW disposal methods in the future.

Predictive value of peritumour radiomics in the diagnosis of benign and malignant pulmonary nodules with halo sign

AIM

To evaluate peritumour radiomics in predicting benign and malignant pulmonary nodules with halo sign.

MATERIALS AND METHODS

In this retrospective study, 305 pulmonary nodules with halo sign (benign, 120; adenocarcinoma, 185) were collected. Manual segmentation was used to mark the gross tumour volume (GTV) and the peritumour volume (PTV) was established by uniform dilation (1 cm) of the tumour area in three dimensions. The GTV and PTV radiomic features were combined to produce the gross tumour and peritumour volume (GPTV). The minimum-redundancy maximum-relevance (mRMR) feature ranking method and least absolute shrinkage and selection operator (LASSO) algorithm were used to eliminate redundant radiomic features. Predictive models combined with clinical features and radiomic signatures were established. Multivarible logistic regression analysis was used to establish the combined model and develop a nomogram. Receiver operating characteristic (ROC) curve analysis was used to evaluate the predictive performance of the model.

RESULTS

In the testing cohort, the area under the ROC curve (AUC) of the GTV, PTV, and GPTV radiomic models was 0.701 (95% CI: 0.589-0.814), 0.674 (95% CI: 0.557-0.791) and 0.755 (95% CI: 0.643-0.867), respectively. The AUC of the nomogram model based on clinical and GPTV radiomic signatures was 0.804 (95% CI: 0.707-0.901).

CONCLUSION

The nomogram model based on clinical and GPTV radiomic signatures can better predict benign and malignant pulmonary nodules with halo signs, demonstrating that the model has potential as a convenient and effective auxiliary diagnostic tool for radiologists.

Mitochondria-targeted fluorescent probe for imaging viscosity in hepatic ischemia-reperfusion injury cell model

The viscosity of the cell microenvironment is a parameter that affects cell physiological processes. A fluorescent probe X-V was designed to detect the viscosity changes of a hepatic ischemia-reperfusion injury (HIRI) cell model with high selectivity and sensitivity. The fluorescence emission wavelength is 615 nm and the Stokes shift can be up to 125 nm, which can be used not only for intracellular viscosity changes stimulated by different drugs but also for the detection of cell viscosity changes in the HIRI cell model. Probe X-V provides a useful tool to study the relationship between mitochondrial viscosity and related diseases.

Air Pollutant Emission Inventory of Waste-to-Energy Plants in China and Prediction by the Artificial Neural Network Approach

The waste-to-energy (WTE) plant has been deployed in 205 cities in China. However, it always faces public resistance to be built because of the great concerns on flue gas pollutants (FGPs). There are limited studies on the socioeconomic heterogeneity analysis and prediction models of WTE capacity/ FGP emission inventories (EIs) based on big data. In this study, the incinerator level emission factors (EFs) in 2020 of PM, SO₂, NO_x, CO, HCl, dioxins, Hg, Cd + Tl, and Sb + As+ Pb + Cr + Co + Cu + Mn + Ni were calculated based on 322,926 monitoring values of all the 481 WTE plants (1140 processing lines) operating in China, with uncertainties in the range of ±34.70%. The EFs were significantly 45-96% lower than the national standard (GB18485-2014) and had negative relationships with local socioeconomic elements, while WTE capacity and FGP EIs had significantly positive correlations. Gross domestic product, area of built district, and municipal solid waste generation were the main driving forces of WTE capacity. The WTE capacity increased by 150% from 2015 to 2020, while the total emission of PM, SO₂, CO, dioxins, Hg, and Sb + As + Pb + Cr + Co + Cu + Mn + Ni decreased by 42.46-88.24%. The artificial neural network models were established to predict WTE capacity and FGP EIs in the city level, with the mean square errors ranging from 0.003 to 0.19 within the model validation limits. This study provides data and model support for the formulation of appropriate WTE plans and a pollutant emission control scheme in different economic regions.

A Nanocomposite of Bismuth Clusters and Bi2 O2 CO3 Sheets for Highly Efficient Electrocatalytic Reduction of CO2 to Formate

The renewable-electricity-driven CO₂ reduction to formic acid would contribute to establishing a carbon-neutral society. The current catalyst suffers from limited activity and stability under high selectivity and the ambiguous nature of active sites. Herein, we report a powerful Bi₂ S₃ -derived catalyst that demonstrates a current density of 2.0 A cm^-2 with a formate Faradaic efficiency of 93 % at -0.95 V versus the reversible hydrogen electrode. The energy conversion efficiency and single-pass yield of formate reach 80 % and 67 %, respectively, and the durability reaches 100 h at an industrial-relevant current density. Pure formic acid with a concentration of 3.5 mol L^-1 has been produced continuously. Our operando spectroscopic and theoretical studies reveal the dynamic evolution of the catalyst into a nanocomposite composed of Bi⁰ clusters and Bi₂ O₂ CO₃ nanosheets and the pivotal role of Bi⁰ -Bi₂ O₂ CO₃ interface in CO₂ activation and conversion.

[Tajectories of the self-efficacy of HIV testing among MSM based on latent class growth model]

Objective: To analyze the trajectories of HIV testing self-efficacy among men who have sex with men (MSM) based on latent class growth model. Methods: From August 2019 to May 2021, 404 MSM were recruited in Shandong Province and subjected to a 1-year follow-up study with individual intervention (pushing intervention pictures and videos in WeChat and follow-up questionnaires) and community intervention (forwarding to friends and sharing and discussing HIV testing-related information in WeChat groups). The level of HIV testing self-efficacy among MSM was measured. The long-term trend of HIV testing self-efficacy was analyzed using the latent class growth model (LCGM), and the influencing factors of the trend were analyzed. Results: A total of 404 MSM were (28.25±8.95) years old, with the oldest being 58 and the youngest being 18. The scores of HIV testing self-efficacy M(Q₁, Q₃) at baseline and 4 follow-ups were 18.00 (17.00, 21.00), 19.00 (18.00, 22.00), 19.00 (18.00, 22.00), 19.00 (18.00, 22.00) and 19.00 (18.00, 22.00). The results of the freely estimated two-category LCGM model showed that the trend of HIV testing self-efficacy among MSM could be divided into two classes, "intervention response group" [255(63.1%)] and "intervention non-response group" [149(36.9%)]. The former had a higher level of HIV testing self-efficacy which tended to increase at first and then decrease over time, while the latter had a lower and more stable level. The results of the multifactorial logistic regression analysis showed that the OR values of MSM in business or service and jobless or unemployed were 0.261 (95%CI: 0.108-0.633) and 0.186 (95%CI: 0.057-0.610), respectively, using the students as the reference group. Conclusion: There is a group heterogeneity in the trend of HIV testing self-efficacy in the intervention conditions among MSM, and occupation may be an influencing factor.

Environmental, economic, and energy analysis of municipal solid waste incineration under anoxic environment in Tibet Plateau

The first Municipal solid waste incineration (MSWI) plant in Lhasa, Tibet, the plateau region of China, started its operation in 2018. Considering the elevation and extreme climate (low pressure and low oxygen content) in Tibet, noticeable differences may be envisaged compared to MSWI elsewhere. The aim of this study is to evaluate the environmental impacts, economic benefits, and energy efficiency of this MSWI project with three representative MSWI case in plain region using Life cycle assessment (LCA), Cost-benefit analysis (CBA), and energy analysis methods. The result showed that enhancing blast volume and cross-sectional area of the boiler help adapt to the oxygen-deficient environment. GaBi model was employed based on the CML 2001 methodology to perform LCA. LCA shows that the Lhasa MSWI project has lower positive environment impacts than the projects in plain region. More attention is needed for the deficiencies in flue gas emissions of MSWI in the plateau region. CBA shows that the payback period is 11.97 years and the internal rate of return is 8.75%. The energy analysis indicates that the boiler energy efficiency is up to 81.92%. MSWI subject to minor changes seems suitable to Tibetan plateau, and can be deployed further.

Fast Screening for Copper-Based Bimetallic Electrocatalysts: Efficient Electrocatalytic Reduction of CO2 to C2+ Products on Magnesium-Modified Copper

Electroreduction of CO₂ (CO₂ RR) into high value-added chemicals is an attractive route to achieve carbon neutrality. However, the development of an efficient catalyst for CO₂ RR is still largely by trial-and-error and is very time-consuming. Herein, we built an electrocatalyst testing platform featuring a home-built automatic flow cell to accelerate the discovery of efficient catalysts. A fast screening of 109 Cu-based bimetallic catalysts in only 55 h identifies Mg combined with Cu as the best electrocatalyst for CO₂ to C₂₊ products. The thus designed Mg-Cu catalyst achieves a Faradaic efficiency (FE) of C₂₊ products up to 80 % with a current density of 1.0 A cm^-2 at -0.77 V versus reversible hydrogen electrode (RHE). Systematic experiments with in situ spectroelectrochemistry analyses show that Mg²⁺ species stabilize Cu⁺ sites during CO₂ RR and promote the CO₂ activation, thus enhancing the *CO coverage to promote C-C coupling.

Management of university solid waste in China through gasification technology: An analysis of waste composition and energy potential

This study explored the composition and energy potential of university solid waste (USW) in China. Five combustible components, namely hard plastics (HP), paper (PP), soft plastics (SP), biomass (BM), and rubber (RB), were screened with the compositions 51%, 29%, 9%, 4%, and 3%, respectively. Each USW sample was gasified using a thermogravimetric analyzer (TGA) coupled with mass spectrometry (MS) at the heating rates of 5, 10, and 15 ℃/min and a final process temperature of 900 ℃. Thermal weight loss (TG) curves exposed the degradation in the order HP > SP > RB > BM > PP. Derivative thermogravimetric (DTG) peaks revealed that HP, PP, BM, and SP were degraded in three temperature-oriented phases in the range 172-731 ℃. The RB took an additional phase in the range 584-660 ℃. Major released gases, H₂, CH₄, CO, and CO₂, were detected using MS via mass-to-charge (m/z) ratios. Higher H₂ and total gas yield produced in the case of the HP dominated other materials at the lower heating rate of 5 ℃/min. Validation of data was assessed by equating experimental and calculated curves; therefore, the regression coefficient (R²) ranged between 0.884 and 0.997. The kinetics of the process were estimated by applying the Flynn-Wall-Ozawa (FWO) model at the conversion rates (α) of 0.2, 0.5, and 0.8, which presented reasonable results. Overall, the lower heating rates supported higher thermal conversion and a high quantity of gaseous products for all the components.

How do environmental protection expenditure and green technology innovation affect synergistically the financial performance of heavy polluting enterprises? Evidence from China

In recent years, economic growth has caused an increasing number of environmental problems in China. In order to achieve the goal of carbon peak on schedule, enterprises need to accelerate green transformation and upgrading. Environmental protection expenditure and green technology innovation are important means of corporate environmental governance strategy, but it is unknown whether they can promote the sustainable development of enterprises. Therefore, this article will analyze the effect of enterprise environmental protection expenditure and green technology innovation on financial performance. Based on relevant theories, this study builds a theoretical model to demonstrate how enterprise environmental protection expenditure and green technology innovation can affect the financial performance of heavy polluting enterprises. Empirical tests are carried out using 293 heavy polluting enterprises in China as the sample. The results reveal that: (i) Enterprise environmental protection expenditure has significant negative effects on current enterprise financial performance, while green technology innovation can significantly promote enterprise financial performance. (ii) When the lag period is two periods, the enterprise environmental protection expenditure and green technology innovation have positive effects on enterprise financial performance respectively, and the effects are the most significant. (iii) Enterprise environmental protection expenditure and green technology innovation synergistically promote enterprise financial performance in the current period, and the impact has a lag effect. (iv) In state-owned enterprises and enterprises with higher corporate governance level, the synergetic promotion effect of environmental protection expenditure and green technology innovation on enterprise financial performance is more significant. Finally, this study provides suggestions for promoting the transformation and upgrading of heavy polluting enterprises and achieving sustainable development from the perspectives of the government, enterprises and the public.

A Phase IB Trial of Autologous Cytokine-Induced Killer Cells in Combination with Sintilimab, Monoclonal Antibody Against Programmed Cell Death-1, plus Chemotherapy in Patients with Advanced Non-Small-Cell Lung Cancer

INTRODUCTION

Can the Cytokine-induced killer (CIK) cells in combination with immune checkpoint inhibitor further improve the efficacy of chemotherapy in non-small cell lung cancer (NSCLC) patients? What are the adverse reactions of this combination therapy? But these problems are not clear. Therefore, we conducted a phase 1b trial to evaluate the safety and efficacy of autologous CIK cells therapy combined with Sintilimab, antibody against programmed cell death-1, plus chemotherapy in untreated, advanced NSCLC patients.

PATIENTS AND METHODS

Patients with stage IIIB/IIIC/IV NSCLC received Sintilimab, platinum-based doublet chemotherapy, and CIK cells every 3 weeks for 4 cycles, then maintenance treatment with Sintilimab in squamous and with Sintilimab plus pemetrexed in non-squamous NSCLC until disease progression or unacceptable toxicity or 2 years. The primary endpoints were safety and objective response rate (ORR).

RESULTS

Thirty-four patients received the treatment. 94.1% of patients experienced treatment-related adverse events (TRAEs). Grade 3 or greater TRAEs occurred in 64.7% of patients. One (2.9%) patient died of grade 5 immune-related pneumonia. The ORR and DCR were 82.4% (95% CI, 65.5%-93.2%) and 100.0% (95% CI, 89.7%-100.0%), respectively. Objective responses were evaluated in 14 of 15 non-squamous patients (93.3%; 95% CI, 68.1%-99.8%) and in 14 of 19 squamous patients (73.7%; 95% CI, 48.8%-90.9%). Median PFS was 19.3 months (95% CI, 8.3 months to not available).

CONCLUSION

Autologous CIK cells immunotherapy in combination with Sintilimab plus chemotherapy was well tolerable and showed encouraging efficacy in patients with previously untreated, advanced NSCLC (ClinicalTrials.gov number, NCT03987867).

[A preliminary exploration into the efficacy of personalized surgical schemes in the repair of maxillary sinus perforation and maxillary sinus fistula]

To explore the efficacy and value of personalized surgical schemes in the repair of maxillary sinus perforation and maxillary sinus fistula based on the size of the maxillary sinus perforation and maxillary sinus fistula. A total of 28 patients with maxillary sinus perforation and maxillary sinus fistula who were admitted to the Department of Oral and Maxillofacial Surgery, Stomatology Hospital of Kunming Medical University from July 2017 to May 2020 were included to conduct a prospective case clinical study. After the inflammation in the maxillary sinus was controlled, a proper surgical repair method was selected according to the size of the perforation and fistula based on the double-layer closure technique. The diameter of the perforation and fistula was measured with the assistance of cone-beam CT. After that, the platelet rich fibrin (PRF) repair was performed on the perforation and fistula with 3 mm≤diameter<7 mm in size in 14 patients. The PRF repair and buccal flap repair were performed on the perforation and fistula with 7 mm ≤diameter<15 mm in size in 7 patients. The adjacent buccal pad repair, palatine flap repair, and buccal flap repair were performed on the perforation and fistula with 15 mm≤ diameter<25 mm in size in 4 patients. The nasolabial axial flap repair and nasolabial free flap repair were performed on the perforation and fistula with a diameter ≥25 mm in size in 3 patients. The medical follow-up was conducted in all patients in the 1st, 2nd, and 4th week after surgery, with an overall success rate reaching 96.4% (27/28) after the initial intervention. The relapse of disease occurred in one patient (4.6%) with diabetes and a smoking history in the 2nd week after surgery. Identifying a proper surgical repair method according to the size of the oral and maxillary sinus perforation and maxillary sinus fistula based on the double-layer closure technique can improve the one-time cure rate in these patients under the premise that the inflammation in the maxillary sinus can be controlled.

[Is pre-oxygenation with high-flow nasal oxygen safe? randomized control trial of 56 cases of elderly patients during induction of general anesthesia with endotracheal intubation]

OBJECTIVE

To evaluate the safety of preoxygenation with high-flow nasal oxygenation in elderly patients during induction of general anesthesia with endotracheal intubation.

METHODS

Fifty-six elderly patients without difficult airway were randomized equally into high-flow nasal oxygen group (HF group) and conventional mask oxygen group (M group). Preoxygenation was performed for 5 min before induction of general anesthesia and endotracheal intubation. Oxygenation was maintained during laryngoscopy in HF group, and ventilation lasted until laryngoscopy in M group. For all the patients, the general data, cross-sectional area (CSA) of the gastric antrum measured by ultrasonography, arterial partial pressure of oxygen (PaO₂), arterial partial pressure of carbon dioxide (PaCO₂) and arterial oxygen saturation (cSO₂) were recorded before preoxygenation (T1), at 5 min of preoxygenation (T2) and immediately after intubation (T3). The safety time of asphyxia, intubation time, times of mask ventilation and postoperative complications were compared between the two groups.

RESULTS

The general data were comparable between the two groups. After 5 min of preoxygenation, PaO₂ and cSO₂ were significantly increased in both groups, and PaO₂ was significantly higher in HF group than in M group (F=118.108 vs 9.511, P < 0.05). Both PaO₂ and cSO₂ decreased after intubation, but PaO₂ decreased more slowly in HF group and still remained higher than that at T1; cSO₂ decreased significantly in M group to a lower level than that at T1. Compared with those in M group, the patients in HF group showed a significantly longer safety time of asphyxia (t=5.305, P < 0.05) with fewer times of mask ventilation (χ²= 6.720, P < 0.05). PaCO₂ increased after intubation in both groups but was comparable between the two groups (F=3.138, P > 0.05).

CONCLUSION

High-flow nasal oxygen is safe, simple and effective for pre-oxygenation, which, as compared with the conventional oxygen mask, improves arterial oxygen partial pressure and prolongs the safety time of asphyxia to ensure the safety of airway management during induction of general anesthesia in elderly patients with endotracheal intubation.

Preoperative prediction of the degree of differentiation of lung adenocarcinoma presenting as sub-solid or solid nodules with a radiomics nomogram

AIM

To develop and validate a radiomics nomogram for prediction of degree of differentiation in lung adenocarcinoma presenting as sub-solid or solid nodules.

MATERIALS AND METHODS

A total of 438 patients with histopathologically confirmed adenocarcinoma (248 non-poorly differentiated and 190 poorly differentiated) were divided into training cohort (n=235) and internal validation cohort (n=203) according to surgery sequence. Sixty patients form public TCIA dataset were selected for external validation. One thousand, two hundred and eighteen radiomics features were extracted from each volumetric region of interest and a least absolute shrinkage and selection operator logistic regression was applied to select meaningful radiomic features for building a radiomics score (Rad-score) model. A nomogram model incorporating the Rad-score and type was established after multivariable logistic regression. The discrimination efficiency, calibration efficacy, and clinical utility value of the nomogram were evaluated.

RESULTS

The Rad-score model could predict the differentiation degree of lung adenocarcinoma with an area under the curve (AUC) of 0.83 (95% confidence interval [CI]: 0.78-0.89) in the internal validation cohort. The AUC of the nomogram and radiographic model was 0.86 (95% CI: 0.80-0.91), 0.78 (95% CI: 0.72-0.84) in the internal validation cohort respectively. The AUC of the nomogram in the external validation cohort was 0.73 (95% CI: 0.58-0.88). Delong's test showed that the nomogram performed better than radiographic features alone (p=0.001).

CONCLUSIONS

The proposed radiomics nomogram has the potential to predict the differentiation degree of lung adenocarcinoma preoperatively.

Systematic understanding of char-volatile evolution and interaction mechanism during sewage sludge pyrolysis through in-situ tracking solid-state reaction and products fate

The complexity of sludge components and the heterogeneity of pyrolysis products make it challenging to trace char-volatile evolutions and interaction mechanisms during pyrolysis. Herein, we systematically dissected the solid-state reactions and volatile dynamic variations via in-situ infrared/mass spectral probes coupled signal amplification techniques. The identification of hidden reactions was further enhanced by comparing the discrepancies in the pyrolysis of three systems: raw sludge, sludge-extracted organics, and pseudo-components of organics. A three-stage sludge pyrolysis of bond cleavage (α = 0.2-0.5), intermediates diffusion (α = 0.5-0.7), and interface interaction (α = 0.7-0.8) was proposed through solid-state reaction tracing, and the pyrolysis reaction was found to be dominated by the first two stages. The generation of reactive intermediates accelerated the collision frequency between reactants, which increased the order of solid-state reactions and raised the energy barrier from 148 to 180-261-297 kJ/mol. The temperature-response sequence of the major pyrolysis volatiles was H₂O/CO₂/furans/alcohols (<250 °C), amine-N/acids/ketones/esters (250-350 °C), heterocyclic-N/phenols/C_2-3 (300-400 °C), CH₄/aromatics/nitrile-N (350-450 °C), and CO/HCN (>450 °C). The temperature-dependent evolution of these volatiles was consistent with the variations of chars in terms of pyrolysis behaviors, reaction models, and surface characteristics. The comprehensive understanding of the staged pyrolysis pathways and the char-volatile interaction mechanisms may provide critical information for pyrolysis procedure design and product targeted regulation.

LncRNA DACH1 protects against pulmonary fibrosis by binding to SRSF1 to suppress CTNNB1 accumulation

Idiopathic pulmonary fibrosis (IPF) is a progressive disease with unknown etiology and limited therapeutic options. Activation of fibroblasts is a prominent feature of pulmonary fibrosis. Here we report that lncRNA DACH1 (dachshund homolog 1) is downregulated in the lungs of IPF patients and in an experimental mouse model of lung fibrosis. LncDACH1 knockout mice develop spontaneous pulmonary fibrosis, whereas overexpression of LncDACH1 attenuated TGF-β1-induced aberrant activation, collagen deposition and differentiation of mouse lung fibroblasts. Similarly, forced expression of LncDACH1 not only prevented bleomycin (BLM)-induced lung fibrosis, but also reversed established lung fibrosis in a BLM model. Mechanistically, LncDACH1 binding to the serine/arginine-rich splicing factor 1 (SRSF1) protein decreases its activity and inhibits the accumulation of Ctnnb1. Enhanced expression of SRSF1 blocked the anti-fibrotic effect of LncDACH1 in lung fibroblasts. Furthermore, loss of LncDACH1 promoted proliferation, differentiation, and extracellular matrix (ECM) deposition in mouse lung fibroblasts, whereas such effects were abolished by silencing of Ctnnb1. In addition, a conserved fragment of LncDACH1 alleviated hyperproliferation, ECM deposition and differentiation of MRC-5 cells driven by TGF-β1. Collectively, LncDACH1 inhibits lung fibrosis by interacting with SRSF1 to suppress CTNNB1 accumulation, suggesting that LncDACH1 might be a potential therapeutic target for pulmonary fibrosis.

A Study on the Impact of Institutional Pressure on Carbon Information Disclosure: The Mediating Effect of Enterprise Peer Influence

Enterprises should bear the main responsibility for greenhouse gas emissions. Disclosing carbon emission information is one of the important ways for enterprises to deal with climate change. Taking China's A-share listed companies from 2014 to 2018 as the research sample, we study the impact of external explicit institutional pressure and implicit institutional pressure on corporate carbon information disclosure and analyze the mediating effect of enterprise peer influence in carbon disclosure. The empirical results show that external institutional pressure, namely environmental regulation and Confucian culture, has a significant positive impact on enterprise carbon information disclosure. Enterprise peer influence has a certain mediating effect between external institutional pressure and carbon information disclosure. The government should formulate and improve the carbon information disclosure institution and strengthen external supervision through the joint participation of all sectors of society.

A Higher-Order Cognitive Diagnosis Model with Ordinal Attributes for Dichotomous Response Data

Most existing cognitive diagnosis models (CDMs) assume attributes are binary latent variables, which may be oversimplified in practice. This article introduces a higher-order CDM with ordinal attributes for dichotomous response data. The proposed model can either incorporate domain experts' knowledge or learn from the data empirically by regularizing model parameters. A sequential item response model was employed for joint attribute distribution to accommodate the sequential mastery mechanism. The expectation-maximization algorithm was employed for model estimation, and a simulation study was conducted to assess the recovery of model parameters. A set of real data was also analyzed to assess the viability of the proposed model in practice.