Associations of ambient temperature and total cloud cover during pregnancy with newborn vitamin D status

OBJECTIVES

We aimed to estimate the effects of temperature and total cloud cover before birth on newborn vitamin D status.

STUDY DESIGN

Prospective birth cohort.

METHODS

This study included 2055 mother-newborn pairs in Wuhan, Hubei province, China. The data of temperature and total cloud cover from 30 days before birth were collected, and cord blood 25-hydroxyvitamin D [25(OH)D] were determined. Restricted cubic spline regression models, multiple linear regression models, and logistic regression models were applied to estimate the associations.

RESULTS

A "J" shaped curve was observed between temperature and vitamin D status, and an inverse "J" shaped curve was observed between total cloud cover and vitamin D status. Compared to the fourth quartile (75-100th percentile, Q4) of average temperature (30 days before birth), the odds ratio (OR) for Q1 (0-25th percentile) associated with the vitamin D deficiency occurrence (<20 ng/mL) was 3.63 (95% CI, 1.54, 8.65). Compared to Q1 of the average total cloud cover (30 days before birth), the OR associated with the occurrence of vitamin D deficiency was 2.38 (95% CI, 1.63, 3.50) for the Q4.

CONCLUSIONS

Low temperature and high cloud cover before delivery were significantly associated with an increased probability of vitamin D deficiency in newborns. The findings suggested that pregnancy women lacking sufficient sunlight exposure still need vitamin D supplement to overcome the potential vitamin D deficiency status.

Structural characteristics and drivers of greenhouse gas emissions at county-level and long-time scales: A case study of the Anji County, China

To achieve carbon neutrality, the Chinese government needs to gain a comprehensive understanding of the sources and drivers of greenhouse gas (GHG) emissions, particularly at the county level. Anji County in eastern China is a typical example of an industrial transformation from quarrying to a low-carbon economy. This study analyzed the decoupling types and structural characteristics of GHG emissions and the driving factors of carbon dioxide (CO2) emissions in the Anji from 2006 to 2019, and explored the differences between county-level and provincial-level or city-level results. It was observed that energy-related activities are the main source of GHG emissions in Anji and that economic development is the driving factor behind the increasing CO2 emissions. However, industrial transformation and upgradation coupled with the alternative use of clean energy limit the growth of GHG emissions. This study details the GHG emissions of county during the industrial transformation stage and provides corresponding policy recommendations for county governments.

Revealing the global emission gaps for fully fluorinated greenhouse gases

In response to the global trend of climate change, it is important to accurately quantify emissions of fully fluorinated greenhouse gases (FFGHGs, referring to SF6/NF3/CF4/C2F6/C3F8/c-C4F8 here). Atmospheric observation-based top-down methods and activity-based bottom-up methods are usually used together to estimate FFGHG emissions at the global and regional levels. In this work, emission gaps at global and regional levels are discussed among top-down studies, between the top-down and bottom-up FFGHG emissions, and among bottom-up emissions. Generally, trends and magnitudes of individual FFGHG emissions among top-down estimates are close to each other within the uncertainties. However, global bottom-up inventories show discrepancies in FFGHG emissions among each other in trends and magnitudes. The differences in emission magnitudes are up to 93%, 90%, 88%, 83%, 87%, and 85% for SF6, NF3, CF4, C2F6, C3F8, and c-C4F8, respectively. Besides, we reveal the insufficient regional TD studies and the lack of atmospheric observation data/stations especially in areas with potential FFGHG emissions. We make recommendations regarding the best practices for improving our understanding of these emissions, including both top-down and bottom-up methods.

Estimate Gaps of Montreal Protocol-Regulated Potent Greenhouse Gas HFC-152a Emissions in China Have Been Explained

1,1-Difluoroethane (HFC-152a) is a hydrofluorocarbon regulated by the Montreal Protocol, and its emissions in China are of concern as China will regulate HFC-152a in 2024. However, no observation-inferred top-down estimates were undertaken after 2017, and substantial gaps existed among previous estimates of China's HFC-152a emissions. Using the atmospheric observations and inverse modeling, this study reveals China's HFC-152a emissions of 9.4 ± 1.7 Gg/yr (gigagrams per year), 10.6 ± 1.8 Gg/yr, and 9.7 ± 1.5 Gg/yr in 2018, 2019, and 2020, respectively. In addition, we display an overall increasing trend during 2011-2020, which is in contrast to the decreasing and steady trend reported by the Emission Database for Global Atmospheric Research (EDGAR) and the Chinese government, respectively. Subsequently, we establish a comprehensive bottom-up emission inventory matching with top-down estimates and thus succeed in explaining the gaps among previous estimates. Furthermore, the contribution of China's emissions to global HFC-152a emission growth increased from 15% during 2001-2010 to >100% during 2011-2020. An emission projection based on our improved inventory shows that the Kigali Amendment (KA) would assist in avoiding 1535.6-4710.6 Gg (251.8-772.5 Tg CO2-eq) HFC-152a emissions during 2024-2100. Our findings indicate relatively accurate China's HFC-152a emissions and provide scientific support for addressing climate change and implementing the KA.

CCl4 emissions in eastern China during 2021-2022 and exploration of potential new sources

According to the Montreal Protocol, the production and consumption of ozone-layer-depleting CCl4 for dispersive applications was globally phased out by 2010, including China. However, continued CCl4 emissions were disclosed, with the latest CCl4 emissions unknown in eastern China. In the current study, based on the atmospheric measurements of ~12,000 air samples taken at two sites in eastern China, the 2021-2022 CCl4 emissions are quantified as 7.6 ± 1.7 gigagrams per year. This finding indicates that CCl4 emissions continued after being phased out for dispersive uses in 2010. Subsequently, our study identifies potential industrial sources (manufacture of general purpose machinery and manufacture of raw chemical materials, and chemical products) of CCl4 emissions.

Association of cord plasma metabolites with birth weight: results from metabolomic and lipidomic studies of discovery and validation cohorts

BACKGROUND

Birth weight is a good predictor of fetal intrauterine growth and long-term health. Although several studies have evaluated the relationship between metabolites and birth weight, no prior study has comprehensively investigated the metabolomic and lipidomic and further validated and quantified meaningful metabolites.

METHODS

Firstly, a pseudotargeted metabolomics approach was applied to detect 2418 metabolites in 504 cord blood samples in the discovery set enrolled from the Wuhan Healthy Baby Cohort (HBC), China. Metabolome-wide association scan (MWAS) analysis and pathway enrichment were applied to discover metabolites and metabolic pathways that were significantly associated with birth weight for gestational age (BWGA) z-score. Logistic regression models were used to analyze the association of metabolites in the most significantly associated pathways with small for gestational age (SGA) and low birth weight (LBW). Subsequently, 350 cord blood samples in a validation cohort were subjected to targeted analysis to validate the metabolites screened from the discovery cohort.

RESULTS

In the discovery set, 513 metabolites were significantly associated with BWGA z-score (PFDR <0.05), of which 298 KEGG-annotated metabolites were included in the pathway analysis. The primary bile acid biosynthesis pathway was the most relevant metabolic pathway associated with BWGA z-score in our study. Elevated cord plasma primary bile acids were associated with lower BWGA z-score and higher odds of SGA or LBW in the discovery and validation cohorts. In the validation set, a 2-fold increase in taurochenodeoxycholic acid (TCDCA) and taurocholic acid (TCA) was associated with 0.10 (95% CI: 0.00, 0.20) and 0.18 (95 %CI: 0.04, 0.31) decrease in BWGA z-score, respectively, after adjusting for covariates. In addition, a 2-fold increase in cord plasma TCDCA and TCA was associated with an adjusted odds ratio of 1.52 (1.00, 2.30) and 1.77 (1.05, 2.98) for SGA, respectively. The adjusted ORs for a 2-fold increase in TCDCA and TCA concentrations were 2.39 (95% CI 1.00, 5.71) and 3.21 (0.96, 10.74) for LBW, respectively.

CONCLUSIONS

The results indicate a significant association between primary bile acids and lower BWGA z-score, as well as higher risk of SGA and LBW. Abnormalities of primary bile acid metabolism may play an important role in restricted fetal development. This article is protected by copyright. All rights reserved.

18F-FDG PET/CT-based radiomics model for predicting the degree of pathological differentiation in non-small cell lung cancer: a multicentre study

AIM

To explore the value of 2-[18F]-fluoro-2-deoxy-d-glucose (FDG) positron-emission tomography (PET)/computed tomography (CT)-based radiomics model for predicting the degree of pathological differentiation in non-small-cell lung cancer (NSCLC).

MATERIALS AND METHODS

Clinical characteristics of 182 NSCLC patients from four centres were collected, and radiomics features were extracted from 18F-FDG PET/CT images. Three logistic regression prediction models were established: clinical model; radiomics model; and nomogram combining radiomics signatures and clinical features. The predictive ability of the models was assessed using receiver operating characteristics curve analysis.

RESULTS

Patients from centre 1 were assigned randomly to the training and internal validation cohorts (7:3 ratio); patients from centres 2-4 served as the external validation cohort. The area under the curve (AUC) values for the clinical model in the training, internal validation, and external validation cohort were 0.74 (95% confidence interval [CI] = 0.64-0.84), 0.64 (95% CI = 0.46-0.81), and 0.74 (95% CI = 0.60-0.88), respectively. In the training (AUC: 0.84 [95% CI = 0.77-0.92]), internal validation (AUC: 0.81 [95% CI = 0.67-0.95]), and external validation cohorts (AUC: 0.74 [95% CI = 0.58-0.89]), the radiomics model showed good predictive ability for differentiation. Compared to the clinical and radiomics models, the nomogram has relatively better diagnostic performance, and the AUC values for nomogram in the training, internal validation, and external validation cohort were 0.86 (95% CI = 0.78-0.93), 0.83 (95% CI = 0.70-0.96), and 0.77 (95% CI = 0.62-0.92), respectively.

CONCLUSIONS

The 18F-FDG PET/CT-based radiomics model showed good ability for predicting the degree of differentiation of NSCLC. The nomogram combining the radiomics signature and clinical features has relatively better diagnostic performance.

Mitigation of Fully Fluorinated Greenhouse Gas Emissions in China and Implications for Climate Change Mitigation

Fully fluorinated greenhouse gases (FFGHGs), including sulfur hexafluoride (SF6), nitrogen trifluoride (NF3), and perfluorocarbons (PFCs), have drawn attention because they have long atmospheric lifetimes (up to thousands of years) and high global warming potential. Targeting SF6, NF3, and four PFCs (CF4, C2F6, C3F8, and c-C4F8), this study projects future FFGHG emission patterns in China, explores their mitigation potential, and evaluates the effects of FFGHG emission reduction on the achievement of the country's carbon neutrality goal and climate change. FFGHG emissions are expected to increase consistently, ranging from 506 to 1356 Mt CO2-eq yr-1 in 2060 under the business-as-usual (BAU) scenario. If mitigation strategies are sufficiently employed, FFGHG emissions under three mitigation scenarios: Technologically Feasible 2030, Technologically Feasible 2050, and Technologically Feasible 2060, will eventually decrease to approximately 49-78, 70-110, and 98-164 Mt CO2-eq yr-1 in 2060, respectively, compared to the BAU scenario. Extensive implementation of FFGHG emission mitigation technologies will curb temperature rise by 0.008-0.013 °C under the slowest mitigation scenario, compared to 0.013-0.026 °C under the BAU scenario. Well-coordinated policies and reforms on FFGHG emission mitigation are recommended to prevent potential adverse effects on the climate to a certain extent.

Inverse Modeling Revealed Reversed Trends in HCFC-141b Emissions for China during 2018-2020

Having the highest ozone-depleting potential among hydrochlorofluorocarbons (HCFCs), the production and consumption of HCFC-141b (1,1-dichloro-1-fluoroethane, CH3CCl2F) are controlled by the Montreal Protocol. A renewed rise in global HCFC-141b emissions was found during 2017-2020; however, the latest changes in emissions across China are unclear for this period. This study used the FLEXible PARTicle dispersion model and the Bayesian framework to quantify HCFC-141b emissions based on atmospheric measurements from more sites across China than those used in previous studies. Results show that the estimated HCFC-141b emissions during 2018-2020 were on average 19.4 (17.3-21.6) Gg year-1, which was 3.9 (0.9-7.0) Gg year-1 higher than those in 2017 (15.5 [13.4-17.6] Gg year-1), showing a renewed rise. The proportion of global emissions that could not be exactly traced in 2020 was reduced from about 70% reported in previous studies to 46% herein. This study reconciled the global emission rise of 3.0 ± 1.2 Gg year-1 (emissions in 2020 - emissions in 2017): China's HCFC-141b emissions changed by 4.3 ± 4.5 Gg year-1, and the combined emissions from North Korea, South Korea, western Japan, Australia, northwestern Europe, and the United States changed by -2.2 ± 2.6 Gg year-1, while those from other countries/regions changed by 0.9 ± 5.3 Gg year-1.

[Topography-guided transepithelial corneal collagen cross-linking by sequential ultraviolet A irradiation in different diameters for progressive keratoconus in adults]

Objective: To compare the efficacy and safety of a novel customized topography-guided transepithelial corneal collagen cross-linking (TG-CXL) procedure by sequential ultraviolet A irradiation in different diameters and conventional transepithelial corneal collagen cross-linking (TE-CXL) in adult patients with progressive keratoconus. Methods: A prospective cohort study was conducted. Adult patients diagnosed with progressive keratoconus in the Affiliated Xiamen Eye Center of Xiamen University were continuously recruited and randomly assigned to receive the TG-CXL or TE-CXL procedure from March 2020 to March 2021. Patients in the TE-CXL group were irradiated in the central 9-mm zone of the cornea (total energy, 7.2 J/cm2; irradiance, 45 mW/cm2), while patients in the TG-CXL group were first irradiated with the protocol used in the TE-CXL group, and further irradiated in the central 6-mm zone (total energy, 3.6 J/cm2; irradiance, 9 mW/cm2). The subjective symptom of pain and corneal fluorescein sodium staining were scored within postoperative 3 days. Slit lamp examination, measurements of uncorrected visual acuity (UCVA) and best-corrected visual acuity (BCVA), corneal topography, anterior segment optical coherence tomography, in vivo corneal confocal microscopy, corneal endothelial cell count, and non-contact tonometry were performed before surgery and at 3, 6, and 12 months after surgery. Results: A total of 66 patients were enrolled (mean age, 23.0±3.3 years old), with 33 patients (33 eyes) in each group. No statistically significant differences were found in age, gender, and maximum keratometry (Kmax) between the two groups (P>0.05). On day 1 after surgery, the average pain score of the TG-CXL group (2.21±0.45) was significantly higher than that of the TE-CXL group (1.32±0.33) (P<0.05). The pain was rapidly alleviated in both groups on days 2 and 3. On days 1 and 2, the corneal fluorescein sodium staining scores in the TG-CXL group (4.15±0.83 and 2.21±0.60, respectively) were significantly higher than those in the TE-CXL group (1.76±0.56 and 0.85±0.51, respectively, P<0.001), while there was no significant difference between the two groups at day3 (P=0.184). The UCVA and BCVA of the TG-CXL group at 3, 6, and 12 months after surgery were significantly improved when compared with the baseline. At 3, 6, and 12 months, the BCVA (LogMAR) of the TG-CXL group (0.21±0.15, 0.22±0.16, and 0.22±0.16, respectively) were significantly improved when compared with those of the TE-CXL group(0.32±0.15, 0.34±0.15, and 0.36±0.16, respectively, P<0.01). However, there was no significant difference in UCVA between groups at any time point after surgery (P>0.05). The spherical and cylindrical power values of the TG-CXL group were improved when compared with the baseline (P<0.05). However, no significant difference in spherical power values was found between the two groups at any time point after surgery (P>0.05). Meanwhile, there were significant differences in cylindrical power values between the two groups at 6 and 12 months after surgery (P<0.05). The Kmax in the TG-CXL group was improved at all of the time points after surgery when compared with the baseline (P<0.001), while no significant difference in Kmax was found at any time point after surgery in the TE-CXL group when compared with the baseline (P>0.05). At 6 and 12 months after surgery, the Kmax values in the TG-CXL group were significantly lower than the TE-CXL group (P<0.05). No significant differences were found in flat keratomety, steep keratometry, the minimal thickness of the cornea, endothelial cell density, and intraocular pressure between the two groups at any time point after surgery (P>0.05). Within one month after surgery, optical coherence tomography revealed the increased density in the anterior stroma in both groups. In most patients in the TG-CXL group, a demarcation line was visible in the central and para-central corneal stroma, representing a clear and continuous, high-signal arc-shaped linear structure, which was deeper in the central cornea than the para-central cornea. In contrast, a demarcation line, fuzzy and focally discontinuous, was visible only in a few patients in the TE-CXL group, with an almost uniform depth in the central and the para-central cornea. Confocal microscopy demonstrated an apparent mesh-like cross-linked collagen structure in the superficial and intermediate corneal stroma at all time points after surgery in the TG-CXL group, with thickening stromal collagen fibers and an increased number of interconnections. In contrast, the mesh-like structure and number of interconnections in the superficial corneal stroma were significantly reduced at 12 months after surgery in the TE-CXL group, with no cross-linking structure in the intermediate corneal stroma at any time point after surgery. No serious complications such as corneal infection, sterile corneal ulcer, and persistent epithelial defect were observed in both groups during the follow-up of 12 months. Conclusions: The TG-CXL procedure by sequential irradiation in two different diameters with ultraviolet A light was effective and safe in the management of progressive keratoconus in adults, achieving significant refractive improvement. This might be a good technical alternative for refractive corneal cross-linking surgery.

Anthropogenic Chloroform Emissions from China Drive Changes in Global Emissions

Emissions of chloroform (CHCl3), a short-lived halogenated substance not currently controlled under the Montreal Protocol on Substances that Deplete the Ozone Layer, are offsetting some of the achievements of the Montreal Protocol. In this study, emissions of CHCl3 from China were derived by atmospheric measurement-based "top-down" inverse modeling and a sector-based "bottom-up" inventory method. Top-down CHCl3 emissions grew from 78 (72-83) Gg yr-1 in 2011 to a maximum of 193 (178-204) Gg yr-1 in 2017, followed by a decrease to 147 (138-154) Gg yr-1 in 2018, after which emissions remained relatively constant through 2020. The changes in emissions from China could explain all of the global changes during the study period. The CHCl3 emissions in China were dominated by anthropogenic sources, such as byproduct emissions during disinfection and leakage from chloromethane industries. Had emissions continued to grow at the rate observed up to 2017, a delay of several years in Antarctic ozone layer recovery could have occurred. However, this delay will be largely avoided if global CHCl3 emissions remain relatively constant in the future, as they have between 2018 and 2020.

Indoor Volatile Organic Compounds: Concentration Characteristics and Health Risk Analysis on a University Campus

Volatile organic compounds (VOCs) are major indoor air pollutants that contain several toxic substances. However, there are few studies on health risk assessments of indoor VOCs in China. This study aimed to determine the concentration characteristics of VOCs on college campuses by collecting VOC samples from different locations on campus during different seasons combined with the exposure times of college students in each location obtained from a questionnaire survey to assess the possible health risks. The highest total VOC concentration (254 ± 101 µg/m³) was in the dormitory. The seasonal variation of TVOC concentrations was related to the variation of emission sources in addition to temperature. Health risk assessments of VOCs were evaluated using non-carcinogenic and carcinogenic risk values, represented by hazard quotient (HQ) and lifetime cancer risk (LCR), respectively. The non-carcinogenic risks at all sampling sites were within the safe range (HQ < 1). Dormitories had the highest carcinogenic risk, whereas the carcinogenic risk in the other three places was low (with LCR < 1.0 × 10^-6). Moreover, 1,2-dichloroethane was identified as a possible carcinogenic risk substance in the dormitory due to its high LCR (1.95 × 10^-6). This study provides basic data on health risks in different locations on campus and a basis for formulating measures to improve people's living environments.

Pathway and Cost-Benefit Analysis to Achieve China's Zero Hydrofluorocarbon Emissions

Global hydrofluorocarbon (HFC) cumulative emissions will be more than 20 Gt CO₂-equiv during 2020-2060 and have a non-negligible impact on global warming even in full compliance with the Kigali Amendment (KA). Fluorochemical manufacturers (including multinationals) in China have accounted for about 70% of global HFC production since 2015, of which about 60% is emitted outside China. This study built an integrated model (i.e., DECAF) to estimate both territorial and exported emissions of China under three scenarios and assess the corresponding climate effects as well as abatement costs. Achieving near-zero territorial emissions by 2060 could avoid 23 ± 4 Gt CO₂-equiv of cumulative territorial emissions (compared to the 2019 Baseline scenario) during 2020-2060 at an average abatement cost of 9 ± 6 USD/t CO₂-equiv. Under the near-zero emission (including territorial and abroad) pathway, radiative forcing from HFCs will peak in 2037 (60 ± 6 mW/m²) with a 33% peak reduction and 8 years in advance compared to the path regulated by the KA, and the radiative forcing by 2060 will be lower than that in 2019. Accelerated phase-out of HFC production in China could provide a possibility for rapid global HFC abatement and achieve greater climate benefits.

Banks, emissions, and environmental impacts of China's ozone depletion substances and hydrofluorocarbon substitutes during 1980-2020

Ozone-depleting substances (ODSs), which also contribute to global warming, have been controlled by the Montreal Protocol (MP) since 1987. China joined the MP in 1991 and began reducing production and consumption of ODSs in the country, leading to a decrease in emissions of ODSs. Based on the Intergovernmental Panel on Climate Change guidelines, the latest emission factors and actual consumption in China (MP scenario), both the historical banks and the historical emissions of ODSs and substitute hydrofluorocarbons (HFCs) during 1980-2020 were calculated. To understand the reduction in ODS and HFC emissions by implementing the MP, we also estimated China's virtual emissions (NMP, i.e., the amount of ODS emissions without the MP) over the same period. The avoided cumulative ODS consumption and emission values of 10.8 and 5.8 (4.8-6.9) million tonnes (Mt) of CFC-11-equivalent (eq), respectively, were estimated by comparing the two scenarios. Furthermore, 26 (22-33) giga tonnes (Gt) of CO₂-eq emissions, equivalent to an increase of 0.031 W m^-2 radiative forcing, were estimated to be avoided by 2020, which will prevent an additional 0.025 °C increase in temperature. The MP implemented by China has resulted in substantial environmental benefits over the last 30 years. However, owing to the massive use of HFCs as substitutes, the cumulative emissions reached 2286 Mt. CO₂-eq during 1990-2020, and it will be challenging to phase down HFCs in the environment after China ratified the Kigali Amendment in 2021.

Global methyl halide emissions from biomass burning during 2003-2021

Methyl halides (CH₃Cl, CH₃Br, and CH₃I) are ozone-depleting substances. Biomass burning (BB) is an important source of methyl halides. The temporal variations and global spatial distribution of BB methyl halide emissions are unclear. Thus, global methyl halide emissions from BB during 2003-2021 were estimated based on satellite data. A significant decreasing trend (p < 0.01) in global methyl halide emissions from BB was found between 2003 and 2021, with CH₃Cl emissions decreasing from 302 to 220 Gg yr^-1, CH₃Br emissions decreasing from 16.5 to 11.7 Gg yr^-1, and CH₃I emissions decreasing from 8.9 to 6.1 Gg yr^-1. From a latitudinal perspective, the northern high-latitude region (60-90° N) was the only latitude zone with significant increases in BB methyl halide emissions (p < 0.01). Based on an analysis of the drivers of BB methyl halide emissions, emissions from cropland, grassland, and shrubland fires were more correlated with the burned area, while BB emissions from forest fires were more correlated with the emissions per unit burned area. The non-BB emissions of CH₃Cl increased from 4749 Gg yr^-1 in 2003 to 4882 Gg yr^-1 in 2020, while those of CH₃Br decreased from 136 Gg yr^-1 in 2003 to 118 Gg yr^-1 in 2020 (global total CH₃I emissions are not available). The finding indicates that global CH₃Cl and CH₃Br emissions from sources besides BB increased and decreased during 2003-2020. Based on our findings, not only searching for unknown sources is important, but also re-evaluating known sources is necessary for addressing methyl halide emissions.

Characteristics and source apportionment of some halocarbons in Hangzhou, eastern China during 2021

In recent years, eastern China has been identified as an important contributor to national and global emissions of halocarbons, some of which are ozone depletion substances (ODSs) that delay the recovery of the stratospheric ozone layer. However, the most recent characteristics and sources of halocarbons in eastern China remain unclear. Thus, hourly atmospheric observations of halocarbons were conducted in Hangzhou throughout 2021. The results showed that methylene chloride (CH₂Cl₂) was the most abundant halocarbon (2207 (25 %-75 % quantile: 1116-2848) ppt; parts per trillion) followed by chloromethane (CH₃Cl) (912 (683-1043) ppt), and 1,2-dichloroethane (CH₂ClCH₂Cl) (596 (292-763) ppt). Then, backward trajectory and potential source contribution function (PSCF) analysis show that the emission hot spots of halocarbons were concentrated in adjacent cities in Zhejiang and neighboring provinces in eastern China. Moreover, based on positive matrix factorization (PMF) analysis, industrial emission (38.7 %), solvent usage (32.6 %), and the refrigeration sector and biomass burning (23.7 %) were the main sources of halocarbons (observed in this study). This study reveals high concentrations and potential sources of halocarbons in eastern China, which are important for studying the recovery of the ozone layer.

Pioneering observation of atmospheric volatile organic compounds in Hangzhou in eastern China and implications for upcoming 2022 Asian Games

Understanding the emission sources of volatile organic compounds (VOCs) is critical for air pollution mitigation. Continuous measurements of atmospheric VOCs were conducted from January to February in Hangzhou in 2021. The average measured concentration of total VOCs (TVOCs) was 38.2 ± 20.9 ppb, > 42% lower than that reported by previous studies at the urban center in Hangzhou. The VOC concentrations and proportions were similar between weekdays and weekends. During the long holidays of the Spring Festival in China, the concentrations of TVOCs were ∼50% lower than those during the regular days, but their profiles showed no significant difference (p > 0.05). Further, we deduced that aromatics and alkenes were the most crucial chemicals promoting the formation of O₃ and secondary organic aerosol (SOA) in Hangzhou. According to interspecies correlations, combustion processes and solvent use were inferred as major VOC emission sources. This study provides implications for air quality improvements before and during the upcoming Asian Games that will be hosted in Hangzhou in 2022.

RIB induced reactions: Studying astrophysical reactions with low-energy RI beam at CRIB

Astrophysical reactions involving radioactive isotopes (RI) often play an important role in high-temperature stellar environments. The experimental studies on the reaction rates for those are still limited mainly due to the technical difficulties in producing high-quality RI beams. A direct measurement of those reactions would be still challenging in many cases, however, we can make a reliable evaluation of the reaction rates by an indirect method or by studying the resonance prorerties. Here we ntroduce recent examples of experimental studies on such RI-involving astrophysical reactions, performed at Center for Nuclear Study, the University of Tokyo, using the low-energy RI beam separator CRIB. One is for the neutron-induced destruction reactions of 7Be in the Big-Bang nucleosynthesis, and the other is the study on the 22Mg(α, p) reaction relevant in X-ray bursts, which was performed with the resonant scattering method from the inverse reaction channel.

Historical trend of ozone-depleting substances and hydrofluorocarbon concentrations during 2004-2020 derived from satellite observations and estimates for global emissions

Global concentrations (or mole fractions) and emissions of ozone-depleting substances (ODSs) and their hydrofluorocarbon (HFCs) substitutes that are controlled by the Montreal Protocol and its Amendments and adjustments (MP) are of great interest to both the scientific community and public. Previous studies on global concentrations and emissions have mostly relied on ground-based observations. Here, we assess the global concentrations and emissions of eight MP controlled substances and methyl chloride from ACE-FTS (Atmospheric Chemistry Experiment high-resolution infrared Fourier transform spectrometer) satellite observations: CFC-11 (CFCl₃), CFC-12 (CF₂Cl₂), CCl₄, HCFC-22 (CHClF₂), HCFC-141b (C₂H₃Cl₂F), HCFC-142b (C₂H₃ClF₂), HFC-23 (CHF₃), HFC-134a (C₂H₂F₄), and CH₃Cl. Results show that the ACE-FTS satellite observations can be used to derive the concentrations and emissions of these ODSs, HFCs, and CH₃Cl, as they are consistent with those derived from the ground-based observations. Our findings imply that the changes in the concentrations and emissions of the ODSs and HFCs closely match the regulatory status of the MP, and satellite observations can be used to monitor the past and future progress of the MP.

Research progresses on VOCs emission investigations via surface and satellite observations in China

Volatile organic compounds (VOCs) are important precursors of severe pollution of ozone (O₃) and secondary organic aerosols in China. Fully understanding the VOCs emission is crucial for making regulations to improve air quality. This study reviews the published studies on atmospheric VOCs concentration observations in China and observation-based estimation of China's VOCs emission strengths and emission source structures. The results reveal that direct sampling and stainless-steel-tank sampling are the most commonly used methods for online and offline observations in China, respectively. The GC-MS/FID is the most commonly used VOCs measuring instrument in China (in 60.8% of the studies we summarized). Numerous studies conducted observation campaigns in urban areas (76.2%) than in suburban (17.1%), rural (18.1%), and background areas (14.3%) in China. Moreover, observation sites are largely set in eastern China (83.8%). Though there are published studies reporting observation-based China's VOCs emission investigation, these kinds of studies are still limited, and gaps are found between the results of top-down investigation and bottom-up inventories of VOCs emissions in China. In order to enhance the observation-based VOCs emission investigations in China, this study suggests future improvements including: (1) development of VOCs detection techniques, (2) strengthening of atmospheric VOCs observations, (3) improvement of the accuracy of observation-based VOCs emission estimations, and (4) facilitation of better VOCs emission inventories in China.

Substantial methane emissions from abandoned coal mines in China

China has shut down and abandoned a substantial number of coal mines since 1999, which have been releasing methane (CH₄) for many years. However, the characteristics of China's abandoned mine methane (AMM) emissions are still unclear; this is a concerning knowledge gap because coal mines are the largest contributor to China's anthropogenic CH₄ emissions. This study used two methods to estimate China's historical AMM emissions over the past 40 years (1980-2020) and to project its AMM emissions to 2060 which is the target year for China's carbon neutrality goal. The results show that China's AMM emissions increased substantially from 0.11 ± 0.03 million tons per year (Mt/yr) (3.1 ± 0.84 Mt/yr CO₂-eq) in 1980 to 4.7 ± 0.94 Mt/yr (131 ± 26 Mt/yr CO₂-eq) in 2020. An accelerated growth rate was found during 1998-2005, with AMM emissions rapidly increasing by approximately three times, which was consistent with the high number of mine shutdowns. In 2019, we found that AMM emissions had become the fourth largest anthropogenic source in China, higher than the national anthropogenic CH₄ emissions of individual United Nations Framework Convention on Climate Change Annex I countries excluding the United States of America and the Russian Federation. If unabated, China's AMM emissions are projected to peak at 8.7 ± 2.6 Mt/yr in 2040 and reach approximately one-third of China's anthropogenic carbon dioxide emissions in 2060. This study reveals that understanding AMM emissions can help more accurately quantify China's total CH₄ emissions and guide their future mitigation.

How the Air Clean Plan and carbon mitigation measures co-benefited China in PM2.5 reduction and health from 2014 to 2020

China implemented a stringent Air Clean Plan (ACP) since 2013 to address environmental and health risks caused by ambient fine particulate matter (PM_2.5). However, the policy effectiveness of ACP and co-benefits of carbon mitigation measures to environment and health are still largely unknown. Using satellite-based PM_2.5 products produced in our previous study, concentration-response functions, and the logarithmic mean Divisia index (LMDI) method, we analyzed the spatiotemporal dynamics of premature deaths attributable to PM_2.5 exposure, and quantitatively estimated the policy benefits of ACP and carbon mitigation measures. We found the annual PM_2.5 concentrations in China decreased by 33.65 % (13.41 μg m^-3) from 2014 to 2020, accompanied by a decrease in PM_2.5-attributable premature deaths of 0.23 million (95 % confidence interval (CI): 0.22-0.27), indicating the huge benefits of China ACP for human health and environment. However, there were still 1.12 million (95 % CI: 0.79-1.56) premature deaths caused by the exposure of PM_2.5 in mainland China in 2020. Among all ACP measures, clean production (contributed 55.98 % and 51.14 % to decrease in PM_2.5 and premature deaths attributable to PM_2.5) and energy consumption control (contributed 32.58 % and 29.54 % to decrease in PM_2.5 and premature deaths attributable to PM_2.5) made the largest contribution during the past seven years. Nevertheless, the environmental and health benefits of ACP are not fully synergistic in different regions, and the effectiveness of ACP measures reduced from 2018 to 2020. The co-effects of CO₂ and PM_2.5 has become one of the major drivers for PM_2.5 and premature deaths reduction since 2018, confirming the clear environment and health co-benefits of carbon mitigation measures. Our study suggests, with the saturation of clean production and source control, more targeted region-specific strategies and synergistic air pollution-carbon mitigation measures are critical to achieving the WHO's Air Quality Guideline target and the UN's Sustainable Development Goal Target in China.

Anthropogenic emissions of ozone-depleting substance CH3Cl during 2000-2020 in China

Methyl Chloride (CH₃Cl) is the largest source of stratospheric chlorine, which has a significant impact on the depletion of the stratospheric ozone layer. Detailed information on anthropogenic CH₃Cl emissions in China is still lacking. This study establishes a comprehensive bottom-up inventory of anthropogenic CH₃Cl emissions in China during 2000-2020. Results show that China's anthropogenic CH₃Cl emissions have increased significantly, from 34.1 ± 11.6 Gg/yr (gigagrams per year) in 2000 to 128.5 ± 26.5 Gg/yr in 2018 with a slight decrease to 124.9 ± 26.0 Gg/yr in 2020. The main sources of anthropogenic emissions of CH₃Cl in China are chemical production (37.1%), solvent use (35.4%), and coal combustion (13.6%) in 2020. China's contribution to global anthropogenic emissions of CH₃Cl reached almost 50%. Moreover, the ratios of CH₃Cl CFC-11-eq emissions relative to emissions of ozone-depleting substances (ODSs) controlled under the Montreal Protocol in China have increased from 0.8% in 2000 to 11.6% in 2020 and are estimated to continue increasing in the future. In summary, China's anthropogenic CH₃Cl emissions have shown an increasing trend in the past two decades, made a huge contribution to the total global anthropogenic emissions, and presented a potential increasing impact on the depletion of the ozone layer and global warming.

Deep Underground Laboratory Measurement of ^{13}C(α,n)^{16}O in the Gamow Windows of the s and i Processes

The ^{13}C(α,n)^{16}O reaction is the main neutron source for the slow-neutron-capture process in asymptotic giant branch stars and for the intermediate process. Direct measurements at astrophysical energies in above-ground laboratories are hindered by the extremely small cross sections and vast cosmic-ray-induced background. We performed the first consistent direct measurement in the range of E_{c.m.}=0.24 to 1.9 MeV using the accelerators at the China Jinping Underground Laboratory and Sichuan University. Our measurement covers almost the entire intermediate process Gamow window in which the large uncertainty of the previous experiments has been reduced from 60% down to 15%, eliminates the large systematic uncertainty in the extrapolation arising from the inconsistency of existing datasets, and provides a more reliable reaction rate for the studies of the slow-neutron-capture and intermediate processes along with the first direct determination of the alpha strength for the near-threshold state.

Estimate of hydrochlorofluorocarbon emissions during 2011-2018 in the Yangtze River Delta, China

Hydrochlorofluorocarbons (HCFCs) are used as temporary substitutes for chlorofluorocarbons and other ozone-depleting substances because they have reduced ozone depletion and global warming potentials. The consumption and production of HCFCs are regulated via the Montreal Protocol and its amendments till 2013, with a complete phase-out being scheduled by 2030 for Article 5 parties (developing countries). To better understand the characteristics and emissions of HCFCs in the Yangtze River Delta (YRD), which is the largest metropolitan area in China, weekly flask samples were collected at the Lin'an regional background station located in the YRD from 2011 to 2018 and measured for four HCFCs (HCFC-22, HCFC-141b, HCFC-142b, and HCFC-124). The HCFC-132b and HCFC-133a measurements began in 2018. The ambient mixing ratios of the HCFCs exhibited higher concentrations and larger variabilities than those at the Shangri-la regional background station at similar latitudes in southwest China. The HCFC emissions in the YRD were estimated based on the tracer ratio method using CO and HFC-134a as tracers, and were comparable within the uncertainties. Our results are generally consistent with previous estimates obtained using top-down approaches. HCFC-22 and HCFC-141b contributed 52% ± 23% and 41% ± 24% of the total ODP-weighted (CFC-11-equivalent) HCFC emissions from the YRD, respectively, whereas HCFC-22 contributed the most (83% ± 36%) to the total CO₂-equivalent HCFC emissions from the YRD. The cumulative ODP-weighted and CO₂-equivalent emissions of HCFCs from the YRD accounted for 25% ± 15% and 20% ± 11% of the national corresponding totals, respectively, for 2011-2017. The HCFC-141b emissions from the YRD contributed approximately half of the total Chinese emissions. HCFC-133a emissions in the YRD accounted for approximately one-fifth of the global total in 2018. Thus, the YRD is an important contributor of HCFC emissions on national and global scales.

[Clinical validation of the 2020 diagnostic approach for pediatric autoimmune encephalitis in a single center]

Objective: To evaluate the value of the 2020 diagnostic criteria (Cellucci criteria) for pediatric autoimmune encephalitis (AE) in children with suspected AE in a single center. Methods: The clinical data of 121 children hospitalized at the First Affiliated Hospital of Zhengzhou University from October 2019 to October 2021, with a diagnosis of suspected AE, were retrospectively collected and analyzed. The children were divided into definite antibody-positive AE (dAPAE), probable antibody-negative AE (prANAE), possible AE (pAE) and non-AE groups according to the Chinese expert consensus and the Graus criteria. A new diagnosis was made according to the Cellucci criteria which was compared with the clinical diagnosis to evaluate the diagnostic value of the Cellucci criteria. The Mann-Whitney U test, Kruskal-Wallis test, and χ² test were used to compare the differences among groups. The sensitivity and specificity were used to evaluate efficacy of the Cellucci criteria. Results: Among the 121 children, 72 were males and 49 were females, with an age of 10.3 (6.5, 14.0) years at disease onset. There were 99 cases diagnosed as AE according the clinical diagnosis (58 males and 41 females), of which 43 cases were diagnosed as dAPAE, 14 cases as prANAE and 42 cases as pAE, and the other 22 cases were not AE (14 males and 8 females). The top 2 initial symptoms in the 99 children with AE were seizures (53 cases, 53.5%) and abnormal mental behaviors (35 cases, 35.4%). And the most common symptoms during the course of the disease were abnormal mental behaviors (77 cases, 77.8%) and seizures (64 cases, 64.6%). There were statistically differences in the incidence of consciousness disorders, autonomic dysfunctions during the course of the disease and the length of hospitalization among the 4 groups (χ²=21.63, 13.74, H=22.60, all P<0.05). Ninety-six of the 121 children were tested for AE-related antibodies, of which 45 cases (46.9%) were antibody-positive. According to the Cellucci criteria, 42 cases were diagnosed as dAPAE, 34 cases as prANAE and 14 cases as pAE. Compared with the clinical diagnosis, the sensitivity of the Cellucci criteria for the diagnosis of the 3 types of AE were 93.02%, 92.86% and 87.88%, and the specificity were 96.23%, 74.39% and 86.36%, respectively. Conclusions: The Cellucci criteria has a high sensitivity and specificity for the diagnosis of pAE and dAPAE in the clinical management of children with suspected AE, while a high sensitivity but low specificity for the diagnosis of prANAE. Therefore, it is recommended to apply the Cellucci criteria selectively in clinical practice according to the actual situation, especially in the diagnosis of prANAE.

Spin in the Abstracts of Randomized Controlled Trials in Operative Dentistry: A Cross-sectional Analysis

OBJECTIVE

To assess the presence and characteristics of spin in recently published RCT abstracts in operative dentistry and to investigate potential factors associated with the presence of spin.

METHODS AND MATERIALS

The PubMed database was searched to identify parallel-group RCTs published between 2015 and 2019 in the field of operative dentistry, which compared two or more groups and had nonsignificant results for the primary outcome. Two authors evaluated independently the presence and characteristics of spin among these abstracts. Multivariable logistic regression analyses were conducted to identify factors associated with the presence of spin in the Results and the Conclusions sections, respectively.

RESULTS

A total of 77 RCT abstracts were included, among which 58 (75.3%) showed at least one type of spin. Spin was identified in the Results and Conclusions sections of 32 (41.6%) and 45 (58.4%) abstracts, respectively. 19 RCTs (24.7%) presented spin in both the Results and the Conclusions section of abstracts. The presence of spin in the Results section of abstracts was significantly associated with source of funding (OR=8.10; p=0.025) and number of treatment arms was associated with the presence of spin in the Conclusions section of abstracts (OR=5.66; p=0.005).

CONCLUSION

The occurrence rate of spin in the sample of operative dentistry RCTs abstracts is high.

The Drivers of the Martian Bow Shock Location: A Statistical Analysis of Mars Atmosphere and Volatile EvolutioN and Mars Express Observations

The Martian interaction with the solar wind leads to the formation of a bow shock upstream of the planet. The shock dynamics appear complex, due to the combined influence of external and internal drivers. The extreme ultraviolet fluxes and magnetosonic Mach number are known major drivers of the shock location, while the influence of other possible drivers is less constrained or unknown such as crustal magnetic fields, solar wind dynamic pressure, or the Interplanetary Magnetic Field (IMF) intensity, and orientation. In this study, we compare the influence of the main drivers of the Martian shock location, based on several methods and published datasets from Mars Express (MEX) and Mars Atmosphere Volatile EvolutioN (MAVEN) missions. We include here the influence of the crustal fields, extreme ultraviolet fluxes, solar wind dynamic pressure, as well as (for MAVEN, thanks to magnetic field measurements) magnetosonic Mach number and Interplanetary Magnetic Field parameters (intensity and orientation angles). The bias due to the cross-correlations among the possible drivers is investigated with a partial correlations analysis. Several model selection methods (Akaike Information Criterion and Least Absolute Shrinkage Selection Operator regression) are also used to rank the relative importance of the physical parameters. We conclude that the major drivers of the shock location are extreme ultraviolet fluxes and magnetosonic Mach number, while crustal fields and solar wind dynamic pressure are secondary drivers at a similar level. The IMF orientation also plays a significant role, with larger distances for perpendicular shocks rather than parallel shocks.

Assessing the drinking water quality in the Inner Mongolia Autonomous Region from 2014 to 2018

The objective of this study was to understand the drinking water quality state in the Inner Mongolia Autonomous Region from 2014 to 2018 and to derive information that will provide a basis for improving the drinking water quality in the region. Monitoring data for drinking water from the Inner Mongolia Autonomous Region for 2014 to 2018 were analyzed and the results were compared with GB 5749-2006, the Standard Test Method for Drinking Water, and GB 5749-2006, the Drinking Water Quality Standards. Data for a total of 30,613 water samples were assessed. Of the data for the microbiological index, sensory trait and general chemical index, and toxicological index, 89, 80, and 69% were qualified, respectively. For the toxicological index, the fluoride and nitrate nitrogen data were the least compliant. The water quality in all the cities was generally very suitable for drinking. However, there were marked differences in the qualified rates of drinking water in different areas and the qualified rates of the data for the three indexes were lower in rural areas than in urban areas. Given the varied issues with the drinking water quality, the relevant departments of League cities should implement appropriate and effective treatment measures to improve the drinking water quality and ensure it is safe for residents.

Discrete Aurora at Mars: Dependence on Upstream Solar Wind Conditions

Discrete aurora at Mars, characterized by their small spatial scale and tendency to form near strong crustal magnetic fields, are emissions produced by particle precipitation into the Martian upper atmosphere. Since 2014, Mars Atmosphere and Volatile EvolutioN's (MAVEN's) Imaging Ultraviolet Spectrograph (IUVS) has obtained a large collection of UV discrete aurora observations during its routine periapsis nightside limb scans. Initial analysis of these observations has shown that, near the strongest crustal magnetic fields in the southern hemisphere, the IUVS discrete aurora detection frequency is highly sensitive to the interplanetary magnetic field (IMF) clock angle. However, the role of other solar wind properties in controlling the discrete aurora detection frequency has not yet been determined. In this work, we use the IUVS discrete aurora observations, along with MAVEN observations of the upstream solar wind, to determine how the discrete aurora detection frequency varies with solar wind dynamic pressure, IMF strength, and IMF cone angle. We find that, outside of the strong crustal field region (SCFR) in the southern hemisphere, the aurora detection frequency is relatively insensitive to the IMF orientation, but significantly increases with solar wind dynamic pressure, and moderately increases with IMF strength. Interestingly however, although high solar wind dynamic pressures cause more aurora to form, they have little impact on the brightness of the auroral emissions. Alternatively, inside the SCFR, the detection frequency is only moderately dependent on the solar wind dynamic pressure, and is much more sensitive to the IMF clock and cone angles. In the SCFR, aurora are unlikely to occur when the IMF points near the radial or anti-radial directions when the cone angle (arccos(B x /|B|)) is less than 30° or between 120° and 150°. Together, these results provide the first comprehensive characterization of how upstream solar wind conditions affect the formation of discrete aurora at Mars.

First measurement of 25Al+p resonant scattering relevant to the astrophysical reaction 22Mg(α,p)25Al

Type I X-ray bursts (XRBs) are the most frequently observed thermonuclear explosions in nature. The 22Mg(α,p)25Al reaction plays a critical role in XRB models. However, experimental information is insufficient to deduce a precise 22Mg(α,p)25Al reaction rate for the respective XRB temperature range. A new measurement of 25Al+p resonant scattring was performed up to the astrophysically interested energy region of 22Mg(α,p)25Al. Several resonances were observed in the excitation functions, and their level properties have been determined based on an R-matrix analysis. In particular, proton widths and spin-parities of four natural-parity resonances above the α threshold of 26Si, which can contribute the reaction rate of 22Mg(α,p)25Al, were first experimentally determined.

Experimental studies on astrophysical reactions at the low-energy RI beam separator CRIB

Experimental studies on astrophysical reactions involving radioactive isotopes (RI) often accompany technical challenges. Studies on such nuclear reactions have been conducted at the low-energy RI beam separator CRIB, operated by Center for Nuclear Study, the University of Tokyo. We discuss two cases of astrophysical reaction studies at CRIB; one is for the 7Be+n reactions which may affect the primordial 7Li abundance in the Big-Bang nucleosynthesis, and the other is for the 22Mg(α, p) reaction relevantin X-raybursts.

Sequence Variant in the TRIM39-RPP21 Gene Readthrough is Shared Across a Cohort of Arabian Foals Diagnosed with Juvenile Idiopathic Epilepsy

Juvenile idiopathic epilepsy (JIE) is a self-limiting neurological disorder with a suspected genetic predisposition affecting young Arabian foals of the Egyptian lineage. The condition is characterized by tonic-clonic seizures with intermittent post-ictal blindness, in which most incidents are sporadic and unrecognized. This study aimed to identify genetic components shared across a local cohort of Arabian foals diagnosed with JIE via a combined whole genome and targeted resequencing approach: Initial whole genome comparisons between a small cohort of nine diagnosed foals (cases) and 27 controls from other horse breeds identified variants uniquely shared amongst the case cohort. Further validation via targeted resequencing of these variants, that pertain to non-intergenic regions, on additional eleven case individuals revealed a single 19bp deletion coupled with a triple-C insertion (Δ19InsCCC) within the TRIM39-RPP21 gene readthrough that was uniquely shared across all case individuals, and absent from three additional Arabian controls. Furthermore, we have confirmed recent findings refuting potential linkage between JIE and other inherited diseases in the Arabian lineage, and refuted the potential linkage between JIE and genes predisposing a similar disorder in human newborns. This is the first study to report a genetic variant to be shared in a sub-population cohort of Arabian foals diagnosed with JIE. Further evaluation of the sensitivity and specificity of the Δ19InsCCC allele within additional cohorts of the Arabian horse is warranted in order to validate its credibility as a marker for JIE, and to ascertain whether it has been introduced into other horse breeds by Arabian ancestry.

Association of Homocysteine and Risks of Long-Term Cardiovascular Events and All-Cause Death among Older Patients with Obstructive Sleep Apnea: A Prospective Study

OBJECTIVES

This study aimed to assess whether raised baseline plasma tHcy concentrations increased the risks of major adverse cardiovascular events (MACE) and all-cause death outcomes in older patients with obstructive sleep apnea (OSA).

DESIGN

A multicenter, prospective, observational study.

SETTING

Beijing, Shandong Province, Gansu Province of China.

PARTICIPANTS

A total of 1, 290 OSA patients aged 60 to 96 years from sleep centers of six hospitals in China consecutively recruited between January 2015 and October 2017.

MEASUREMENTS

Cox proportional models assessed the association between tHcy and the risk of new-onset all events among Chinese older OSA patients.

RESULTS

The final analysis (60.1% male; median age, 66 years) used data from 1, 100 subjects during a median follow-up of 42 months, a total of 105 (9.5%) patients developed MACE and 42 (3.8%) patients died. Multivariable Cox regression analysis showed higher adjusted hazard ratios (aHRs) of MACE, myocardial infarction (MI), hospitalization for unstable angina, and composite of all events with tHcy levels in the 4th quartile (HR=5.93, 95% CI: 2.79-12.59; HR=4.72, 95% CI:1.36-4.61; HR=4.26, 95% CI:1.62-5.71; HR=4.17, 95% CI:2.23-7.81) and the 3rd quartile (HR=3.79, 95% CI:1.76-8.20; HR=3.65, 95% CI:1.04-2.98; HR=2.75, 95% CI:1.08-3.76; HR=2.51, 95% CI:1.31-4.83) compared to reference tHcy levels in quartile 1, respectively, while the aHRs (95% CIs) of all-cause death showed significantly higher only in the highest tHcy level quartile than in the lowest quartile (HR=3.20, 95% CI=1.16-8.84, P=0.025) with no significant differences in risks of cardiovascular death and hospitalisation for heart failure among groups (P>0.05).

CONCLUSIONS

tHcy, a marker of prognosis for older OSA patients, was significantly associated with the increased risk of MACE and all-cause death in this population independent of BMI, smoking status, and other potential risk factors, but not all clinical components events of MACE. New therapeutic approaches for older patients with OSA should mitigate tHcy-associated risks of MACE, and even all-cause death.

A comprehensive review on anthropogenic volatile organic compounds (VOCs) emission estimates in China: Comparison and outlook

Accurate measurement and estimation on the trends and spatial distributions of VOCs emissions in China are critical to establishing efficient local or regional pollution control measures, while less is known about the discrepancies on VOCs emissions estimated by previous studies. In this study, two of the estimation approaches including the bottom-up and top-down methods have been reviewed with the data collected from many studies. The approaches demonstrated that the total anthropogenic VOCs emissions in China have been increasing since 1949. The contributions of industrial and solvent use to total VOCs emissions have been increasing since 2000, whereas the contributions of transportation sector have shown a decreasing trend since 2000. The contributions of fuel combustion have also been decreasing since 1950. The gaps of emission estimates for the industry and solvent use were 99.3 ± 22.7% and 81.5 ± 41.8%, respectively, which distributed in much wider ranges than other sources (e.g. 28.9 ± 16.7% for fuel combustion). In comparison to the top-down method, larger variations on the annual VOCs emission estimates were seen using the bottom-up method that comprised different data sources. For the view of spatial pattern, most hot emission estimate spots were concentrated in the eastern China, consistent to their relatively stronger strengths in the industrialization and urbanization. Although the total VOCs emission in China has been continuously increasing during 2008-2016, the VOCs emissions per gross domestic production (GDP) showed a decreasing trend. As for individual compounds, large discrepancy was seen on formaldehyde, with the coefficient of variation (CV) ranged from 37% to 128% over the years. In overall of view, the importance of industrial process and solvent use is increasing. More focuses must be made to these two sources. Emissions of individual compound, particularly those of oxygenated VOCs, were not completely determined and should be better quantified.

Advancement of Photospheric Radius Expansion and Clocked Type-I X-Ray Burst Models with the New ^{22}Mg(α,p)^{25}Al Reaction Rate Determined at the Gamow Energy

We report the first (in)elastic scattering measurement of ^{25}Al+p with the capability to select and measure in a broad energy range the proton resonances in ^{26}Si contributing to the ^{22}Mg(α,p) reaction at type I x-ray burst energies. We measured spin-parities of four resonances above the α threshold of ^{26}Si that are found to strongly impact the ^{22}Mg(α,p) rate. The new rate advances a state-of-the-art model to remarkably reproduce light curves of the GS 1826-24 clocked burster with mean deviation <9% and permits us to discover a strong correlation between the He abundance in the accreting envelope of the photospheric radius expansion burster and the dominance of ^{22}Mg(α,p) branch.

The atmospheric concentrations and emissions of major halocarbons in China during 2009-2019

Due to the characteristics of ozone-depleting and high global warming potential, chlorofluorocarbons (CFCs), hydrochlorofluorocarbons (HCFCs) and hydrofluorocarbons (HFCs) have been restricted by the Montreal Protocol and its amendments over the world. Considering that China is one of the main contributors to the emission of halocarbons, a long-term atmospheric observation on major substances including CFC-11 (CCl₃F), CFC-12 (CCl₂F₂), HCFC-22 (CHClF₂), HCFC-141b (CH₃CCl₂F), HCFC-142b (CH₃CClF₂) and HFC-134a (CH₂FCF₃) was conducted in five cities (Beijing, Hangzhou, Guangzhou, Lanzhou and Chengdu) of China during 2009-2019. The atmospheric concentrations of CFC-11, CFC-12, HCFC-141b and HCFC-142b all showed declining trends on the whole while those of HCFC-22 and HFC-134a were opposite. A paired sample t-test showed that the ambient mixing ratios of HCFC-22 and HFC-134a in cities were 41.9% and 25.7% higher on average than those in suburban areas, respectively, while the other substances did not show significant regional differences. The annual emissions of halocarbons were calculated using an interspecies correlation method and the results were generally consistent with the published estimates. Discrepancies between bottom-up inventories and the estimates in this study for CFCs emissions were found. Among the most consumed ozone depleting substances (ODSs) in China, CFCs accounted for 75.1% of the ozone depletion potential (ODP)-weighted emissions while HCFCs contributed a larger proportion (58.6%) of CO₂-equivalent emissions in 2019. China's emissions of HCFC-141b and HCFC-142b contributed the most to the global emission (17.8%-48.0%). The elimination of HCFCs in China will have a crucial impact on the HCFCs phase-out in the world.

Salvage mandibular reconstruction: multi-institutional analysis of 17 patients

Unsuccessful mandibular reconstruction occasionally occurs, leaving the patient with undesirable function and contours. In such cases, second- or third-time corrective operations are challenging. However, published studies on the complicated retreatment of such patients are scarce. A retrospective analysis covering the years 2015-2019 was conducted in three centers. All 17 patients included had undergone prior failed mandibular reconstructions in other institutions. Salvage secondary or tertiary reconstructive surgeries were attempted and the results are presented. Major factors for these failed reconstructions included exposed non-vascularized bone grafts (n = 7, 41.2%), flap loss (n = 4, 23.5%), exposed artificial joint (n = 3, 17.6%), skewed occlusion with deformity (n = 1, 5.9%), non-union (n = 1, 5.9%), and recurrence (n = 1, 5.9%). Fibula flaps were transferred in 15 patients, while iliac flaps were used in two patients for mandibular re-do reconstructions. Virtual surgical designs were conducted in nine (52.9%) patients, with navigation-guided approaches performed in three cases. Postoperative functions were relatively favorable in these complicated mandibular re-do reconstruction cases. Mandibular symmetry (mandibular length and height; P = 0.002) and condylar position (P < 0.001) were regained after these re-do attempts. Secondary or tertiary mandibular re-do reconstruction can still achieve good functional outcomes with appropriate preoperative selection and well-conceived designs, especially with the aid of virtual surgery and navigation.