Assessment and Discussion of Correlation Among Psychological Symptoms, Occupational Strain, and Neurotic Personality for Metro Drive

Metro driver is the prime person who is responsible for metro operation safety. The mental health of a metro driver is very important for the operation of the subway and requires the driver to keep high mental alertness to monitor the surrounding environment and also handle emergencies under uncertain or dangerous conditions. After a long-term occupational strain, a metro driver is likely to suffer from some mental health problems, such as anxiety and depression, that ultimately threaten the lives of passengers. Therefore, in this study, we focus on the psychological symptoms of metro drivers from the angle of occupational strain and neuroticism. A total of 396 metro drivers from Kunming Rail Transit Operation Co., Ltd. in China were investigated through a questionnaire survey. Symptom Checklist-90 (SCL-90), Personal Strain Questionnaire (PSQ), and NEO-Five-Factor Inventory-Neuroticism Subscale (NEO-FFI-N) were applied to evaluate the psychological symptoms, occupational strain, and neuroticism in metro drivers, respectively. The surveyed data were analyzed by SPSS software. Based on the data, a path structural equation model was established to explore the correlation among occupational strain, psychological symptoms, and neuroticism. The results show that the scores for psychological symptoms and occupational strain are higher than the Chinese adult norm among metro drivers. The occupational strain, neuroticism, and psychological symptoms are all positively correlated in the metro drivers. Occupational stress has a direct influence on the psychological symptom, while neuroticism plays a partial mediation role between occupational strain and psychological symptoms. The results of this study can be applied to optimize the employee selection system and training system for metro operation companies.

The predictive value of tumor volume reduction ratio on three-dimensional endorectal ultrasound for tumor response to chemoradiotherapy for locally advanced rectal cancer

Background

Preoperative chemoradiotherapy remains part of the standard treatment for patients with locally advanced rectal cancer. Subsequent treatment individualization requires accurate prediction of tumor response to chemoradiotherapy. Three-dimensional endorectal ultrasound (3D-ERUS) can automatically capture and store the images of the rectal wall and rectal cancer with high resolution. In this study, we aimed to assess the correlation and predictive value between tumor volume changes measured on 3D-ERUS and the histopathological tumor response after chemoradiotherapy for patients with locally advanced rectal cancer.

Methods

A total of 54 patients with locally advanced rectal cancer who underwent chemoradiotherapy and had complete 3D-ERUS data pre-and post-chemoradiotherapy were enrolled in the study. The tumor volume pre-and post-chemoradiotherapy was measured manually on 3D-ERUS, and the tumor volume reduction ratio was calculated. The histopathological tumor regression grade (TRG) was used to assess tumor response. The differences in volumetry parameters were compared between groups with varying tumor response. The diagnostic efficacy of the tumor volume reduction ratio was evaluated by the receiver operating characteristic (ROC) curve.

Results

The mean age of all patients was 55.19±12.46 years. The relative proportions of TRG 0–3 were 29.6% (16/54), 16.6% (9/54), 50% (27/54), and 3.8% (2/54), respectively. The median tumor volumes post-chemoradiotherapy in good responders (TRG 0–1, median tumor volume =3.26 cm³) and the complete response group (TRG 0, median tumor volume =2.61 cm³) were smaller than those in poor responders (TRG 2–3, median tumor volume =5.43 cm³) and the partial response group (TRG 1–3, median tumor volume =4.00 cm³), while tumor volume reduction ratios were higher than those of poor responders (79.32% vs. 59.67%) and the partial response group (82.22% vs. 61.64%), with significant differences (all P values <0.05). The ROC curves showed that the cut-off values of the tumor volume reduction ratio to predict good responders and complete response were 67.77% and 72.02%, respectively. The corresponding areas under the curve in the prediction of good responders and complete response were 0.830 and 0.829, respectively.

Conclusions

The tumor volume reduction ratio measured on 3D-ERUS might be a helpful indicator for tumor response in patients with locally advanced rectal cancer.

Oropharyngeal Probiotic ENT-K12 as an Effective Dietary Intervention for Children With Recurrent Respiratory Tract Infections During Cold Season

Recurrent respiratory tract infections (RRTi) cause a high burden of disease and lead to negative impact on quality of life, frequent school/work absenteeism, and doctor visits, which remain a great challenge to pediatricians because RRTi can increase the risk of various complications including antibiotic overuse and resistance, which is one of the biggest threats to global health, and there is no confirmed effective treatment. In this study, we aimed to assess the clinical efficacy and safety of oropharyngeal probiotic ENT-K12 as a dietary intervention or a complementary treatment along with standard medical treatment during acute respiratory infections among children with RRTi during cold season. The results of this study show that when comparing to practicing of standard medical treatment only, the complementary intake of oropharyngeal probiotic ENT-K12 can effectively reduce episodes of both acute and RRTi in school children, shorten the course of respiratory symptoms onset, reduce the use of antibiotics and antiviral drugs, and reduce the absence days from both children's school and parents' work. Using oropharyngeal probiotics as a complementary dietary intervention to stabilize oropharyngeal microflora, specifically inhibiting respiratory pathogens and enhancing host immunity, could possibly be a promising approach to reduce RRTi burden and combating antibiotic resistance in long term, more clinical studies will be needed to further confirm the clinical practicing guide to ensure its clinical benefit.

Hsian-Tsao (Mesona chinensis Benth.) Extract Improves the Thermal Tolerance of Drosophila melanogaster

Global warming has prompted scientific communities to consider how to alleviate thermal stress in humans and animals. The present study assessed the supplementation of hsian-tsao extract (HTE) on thermal stress in Drosophila melanogaster and preliminarily explicated its possible physiological and molecular mechanisms. Our results indicated that the lethal time for 50% of female flies fed on HTE was significantly longer than that of male flies at the same heat stress temperature. Under thermal stress, the survival time of females was remarkably increased in the HTE addition groups compared to the non-addition group. Thermal hardening by acute exposure to 36°C for 30 min (9:00 to 9:30 a.m.) every day could significantly prolong the longevity of females. Without thermal hardening, HTE increased the antioxidant capacity of females under heat stress, accompanied by an increment of catalase (CAT) activity, and the inhibition for hydroxyl radicals (OH⋅) and superoxide anions (⋅O2 -). Superoxide dismutase (SOD) activity and the inhibition for ⋅O2 - was significantly affected by thermal hardening in the non-HTE addition groups, and significant differences were shown in CAT and SOD activities, and the inhibition for ⋅O2 - among groups with thermal hardening. After heat exposure, heat shock protein 70 (Hsp70) was only up-regulated in the group with high levels of added HTE compared with the group without and this was similar in the thermal hardening group. It was concluded that the heat stress-relieving ability of HTE might be partly due to the enhancement of enzymatic activities of SOD and CAT, and the inhibition for OH⋅ and ⋅O2 -. However, the expression levels of Hsp70 were not well related to thermal tolerance or heat survival.

Environmentally stable MXene ink for direct writing flexible electronics

MXene inks are promising candidates for fabricating conductive circuits and flexible devices. Here, MXene inks prepared from solvent mixtures demonstrate long-term stability and can be employed in commercial rollerball pens to write electronic circuits on flexible substrates. Such circuits exhibit a fast and accurate capacitive response for touch-boards and water level measurement, indicating the excellent potential of these MXene inks in electrical device fabrication.

Tough and Fatigue Resistant Cellulose Nanocrystal Stitched Ti3 C2 Tx MXene Films

Ti₃ C₂ T_x MXene (or "MXene" for simplicity) has gained noteworthy attention for its metal-like electrical conductivity and high electrochemical capacitance - a unique blend of properties attractive towards a wide range of applications such as energy storage, healthcare monitoring and electromagnetic interference shielding. However, processing MXene architectures using conventional methods often deals with the presence of defects, voids and isotropic flake arrangements, resulting in a trade-off in properties. Here, we report a sequential bridging (SB) strategy to fabricate dense, free-standing MXene films of interconnected flakes with minimal defects, significantly enhancing its mechanical properties, specifically tensile strength (∼285 MPa) and breaking energy (∼16.1 MJ m^-3 ), while retaining substantial values of electrical conductivity (∼3,050 S cm^-1 ) and electrochemical capacitance (∼920 F cm^-3 ). This SB method first involves forming a cellulose nanocrystal (CNC)-stitched MXene framework, followed by infiltration with structure-densifying calcium cations (Ca²⁺ ), resulting in tough and fatigue resistant films with anisotropic, evenly spaced, and strongly interconnected flakes - properties essential for developing high-performance energy-storage devices. We anticipate that the knowledge gained in this work will be extended towards improving the robustness and retaining the electronic properties of 2D nanomaterial-based macroarchitectures. This article is protected by copyright. All rights reserved.

Benefits of refined NH3 emission controls on PM2.5 mitigation in Central China

Atmospheric ammonia (NH₃) is one of the most crucial precursors of secondary inorganic aerosols. However, its emission control is still weakness over China. NH₃ emission inventories of 2015 with and without considering a set of refined emission reduction strategies covering seven major NH₃ emission sources were constructed in Central China. GEOS-Chem model simulations were conducted to quantify the benefits of NH₃ emission reduction on PM_2.5 mitigation in four typical months (January, April, July and October). The results showed that these control strategies could reduce approximately 47.0% (152 Gg) of the total NH₃ emissions in Hubei Province, with the agricultural (livestock and fertilizer application) source being reduced the most (133 Gg). NH₃ had a significant nonlinear relationship with sulfate, nitrate, ammonium and PM_2.5. NH₃ emission reduction exerted less effect on sulfate mitigations (the annual average sensitivity was 4.5%), but it obviously alleviated nitrate, ammonium and thus PM_2.5, with the annual average sensitivities of 81.9%, 34.8% and 22.0%, respectively. The average provincial concentrations of PM_2.5 were alleviated by 11.2% in January, 10.6% in October, 10.2% in April and 9.3% in July through NH₃ emission reduction by 47.0%. The reduction benefits were more pronounced in high NH₃ emission areas, such as Yichang, with the PM_2.5 reduction of 14.4% in January. This research could provide scientific support for formulating NH₃ emission reduction policies to further mitigate PM_2.5 pollution.

Hourly emission estimation of black carbon and brown carbon absorption from domestic coal burning in China

Residential coal combustion (RCC) emission demonstrates obvious daily variation, while no real-time estimation of air pollutants from RCC has been reported, as the limitation of hourly activity data and emission factors. With a dilution sampling system, a high-precision electronic balance, and an Aethalometer Model AE33, a real-time monitoring platform for RCC emission was established. Hourly emission factors (EFs) of BC and absorption emission factors (AEFs) of BrC from eleven kinds of chunk coals and nine kinds of honeycomb coals burning in China were obtained. The monthly and hourly coal consumption amounts were calculated with the activity data from literature reviews and a field survey. The first hourly BC and absorption cross section of BrC emission inventories from RCC were established in China. The historical emission trends (2003-2017) indicated that the policy has rapidly controlled the emission of BC and ACS_BrC from RCC in urban area (26.7% and 31.8% decreased, respectively in 2013). While in rural areas, their emission continually increased by 1.2% ~ 5.3% until more strict law enacted in 2017. Emissions of BC and ACS_BrC in winter seasons were 60.1 Gg and 1064.1 Gm², which accounted for 54.3% and 55.1% of the total BC and ACS_BrC emissions correspondingly. The peak values of hourly emission of BC and ACS_BrC (in 370 nm) normally appeared at 19:00-23:00, accounting for 43.0% and 41.5% of their total daily emission. The low emission periods were at cooking times including 7:00, 12:00, and 17:00 of a day and the whole emission of BC and ACS_BrC for the three periods accounted for 1.8% and 2.3% of their daily emission. This high-resolution BC and ACS_BrC emission inventories can be useful for future modeling works on the formation and evolution of a haze event, the smoke aging and transportation, as well as corresponding climate and human health effects.

Molecular Mechanism Underlying the Regulatory Effect of Vine Tea on Metabolic Syndrome by Targeting Redox Balance and Gut Microbiota

Metabolic syndrome (MS) is a metabolic disorder that arises from the increasing prevalence of obesity. The pathophysiology seems to be largely attributable to the imbalance of lipid and glucose metabolism, redox signaling pathways, and gut microbiota. The increased syndromes, such as type 2 diabetes and cardiovascular disease demands natural therapeutic attention for those at high risk. Vine tea, as a traditional medicinal and edible resource rich in flavonoids, especially for dihydromyricetin (DHM), exhibits promising health benefits on the intervention of MS, but the specific molecular mechanism has not been systematically elucidated. The present article aims to summarize the regulatory effects and biological targets of vine tea or DHM on MS, and analyze the underlying potential molecular mechanisms in cells, animals, and humans, mainly by regulating the redox associated signaling pathways, such as Nrf2, NF-κB, PI3K/IRS2/AKT, AMPK-PGC1α-SIRT1, SIRT3 pathways, and the crosstalk among them, and by targeting several key biomarkers. Moreover, vine tea extract or DHM has a positive impact on the modulation of intestinal microecology by upregulating the ratio of Firmicutes/Bacteroidetes (F/B) and increasing the relative abundance of Akkermansia muciniphila. Therefore, this review updated the latest important theoretical basis and molecular evidence for the development and application of vine tea in dietary functional products or drugs against MS and also imputed the future perspectives to clarify the deep mechanism among vine tea or DHM, redox associated signaling pathways, and gut microbiota.

[Analysis of experience in diagnosis and treatment of fetal goiter in patients with Graves' disease complicated with pregnancy]

This article reported the clinical diagnosis and treatment experience of two cases of fetal goiter in Graves' disease (GD) complicated with pregnancy. Two GD patients took antithyroid drugs regularly during pregnancy and their thyroid functions were well controlled, but the levels of thyrotropin receptor antibody (TRAb) of the two cases were still above the upper limit in the second and third trimester. Two fetuses had fetal goiter in the middle and late stages of pregnancy. After continuously controlling maternal thyroid function and closely monitoring fetal ultrasound, there was no aggravation of the fetal goiter, and the delivery went smoothly. One case had neonatal hyperthyroidism. It is suggested that although the thyroid function was well controlled during pregnancy in patients with GD, the high level of serum TRAb still needs to be alert to the occurrence of fetal goiter, and fetal ultrasound is the most direct non-invasive monitoring method.

Instant Dark Tea Alleviates Hyperlipidaemia in High-Fat Diet-Fed Rat: From Molecular Evidence to Redox Balance and Beyond

Instant dark tea (IDT) is a new product gaining increasing attention because it is convenient and can endow significant health benefit to consumers, which is partially attributed to its high concentration of functional ingredients. However, the molecular mechanism underlying its regulatory effect on hyperlipidaemia is rarely studied. In this study, we performed omics and molecular verification in high-fat diet (HFD)-fed rat, aiming to reveal the mechanism and provide molecular evidence. The results showed that the major bioactive components in IDT were include 237.9 mg/g total polysaccharides, 336.6 mg/g total polyphenols, and 46.9 mg/g EGCG. Rats fed with IDT (0.27–0.54 g/kg for 12 weeks) significantly reduced the body weight and TC, TG, LDL-C, blood glucose, and MDA and induced the level of serum HDL-C and also the levels of liver SOD, CAT, GSH-Px, and Nrf2, compared to HFD group. For molecular mechanism study, HIDT feeding had significant impact on the gene expressions of biomarkers in lipogenesis (FABP, CD36, SCD1, Cyp4a1, and Kcnn2), lipid oxidation (PPARγ), and glucose glycolysis (Gck and ENO2) in liver tissue. Moreover, gut microbiome study found that rats fed with IDT dramatically modified the gut microbial species at the family level, such as suppressing the increase abundance of Proteobacteria and Firmicutes induced by HFD. HIDT significantly boosted the relative composition of beneficial bacterium Akkermansia and Rikenellaceae_RC9_gut_group and decreased the relative abundance of the harmful bacterium Ruminococcaceae_UCG-005 and Ruminiclostridium_9, compared to HFD (p &lt; 0.01). Correlation analysis between microbiome and animal indicators found that seven genera including Akkermansia, Clostridiales, Lachnospiraceae, Lachnospiraceae_UCG-010, Ruminiclostridium_9, Ruminococaceae-UCG-005, and Ruminocuccus_1 were found as potential biomarkers that were strongly correlated with oxidative stress and metabolism genes. For instance, Ruminococcaceae_UCG-005 was significantly correlated with body weight, TG, HDL-C, Nfr2, FABP3, SCD1, Cyp4a1, and Kcnn2. Collectively, the above data obtained in this study had provided the primary molecular evidence for the molecular mechanism and brought in novel insights based on omics for the regulatory effect of IDT on hyperlipidaemia.

Prophage-encoded gene VpaChn25_0734 amplifies ecological persistence of Vibrio parahaemolyticus CHN25

Vibrio parahaemolyticus is a waterborne pathogen that can cause acute gastroenteritis, wound infection, and septicemia in humans. The molecular basis of its pathogenicity is not yet fully understood. Phages are found most abundantly in aquatic environments and play a critical role in horizontal gene transfer. Nevertheless, current literature on biological roles of prophage-encoded genes remaining in V. parahaemolyticus is rare. In this study, we characterized one such gene VpaChn25_0734 (543-bp) in V. parahaemolyticus CHN25 genome. A deletion mutant ΔVpaChn25_0734 (543-bp) was obtained by homologous recombination, and a revertant ΔVpaChn25_0734-com (543-bp) was also constructed. The ΔVpaChn25_0734 (543-bp) mutant was defective in growth and swimming mobility particularly at lower temperatures and/or pH 7.0–8.5. Cell surface hydrophobicity and biofilm formation were significantly decreased in the ΔVpaChn25_0734 (543-bp) mutant (p < 0.05). Based on the in vitro Caco-2 cell model, the deletion of VpaChn25_0734 (543-bp) gene significantly reduced the cytotoxicity of V. parahaemolyticus CHN25 to human intestinal epithelial cells (p < 0.05). Comparative secretomic and transcriptomic analyses revealed a slightly increased extracellular proteins, and thirteen significantly changed metabolic pathways in the ΔVpaChn25_0734 (543-bp) mutant, showing down-regulated carbon source transport and utilization, biofilm formation, and type II secretion system (p < 0.05), consistent with the observed defective phenotypes. Taken, the prophage-encoded gene VpaChn25_0734 (543-bp) enhanced V. parahaemolyticus CHN25 fitness for survival in the environment and the host. The results in this study facilitate better understanding of pathogenesis and genome evolution of V. parahaemolyticus, the leading sea foodborne pathogen worldwide.

Identification of Antibacterial Components in the Methanol-Phase Extract from Edible Herbaceous Plant Rumex madaio Makino and Their Antibacterial Action Modes

Outbreaks and prevalence of infectious diseases worldwide are some of the major contributors to morbidity and morbidity in humans. Pharmacophageous plants are the best source for searching antibacterial compounds with low toxicity to humans. In this study, we identified, for the first time, antibacterial components and action modes of methanol-phase extract from such one edible herbaceous plant Rumex madaio Makino. The bacteriostatic rate of the extract was 75% against 23 species of common pathogenic bacteria. The extract was further purified using the preparative high-performance liquid chromatography (Prep-HPLC) technique, and five separated componential complexes (CC) were obtained. Among these, the CC 1 significantly increased cell surface hydrophobicity and membrane permeability and decreased membrane fluidity, which damaged cell structure integrity of Gram-positive and -negative pathogens tested. A total of 58 different compounds in the extract were identified using ultra-HPLC and mass spectrometry (UHPLC-MS) techniques. Comparative transcriptomic analyses revealed a number of differentially expressed genes and various changed metabolic pathways mediated by the CC1 action, such as down-regulated carbohydrate transport and/or utilization and energy metabolism in four pathogenic strains tested. Overall, the results in this study demonstrated that the CC1 from R. madaio Makino are promising candidates for antibacterial medicine and human health care products.

Highly stable lithium anodes from recycled hemp textile

Three-dimensional lithium (Li) hosts have been shown to suppress the growth of Li dendrites for next generation Li metal batteries. Here, we report a cost-effective and scalable approach to produce highly stable Li composite anodes from industrial hemp textile waste. The hemp@Li composite anodes demonstrate stable cycling both in half and full cells.

A prognostic nomogram for intrahepatic progression-free survival in patients with colorectal liver metastases after ultrasound-guided percutaneous microwave ablation

PURPOSE

The present study identified predictors of intrahepatic progression-free survival (ihPFS) after ultrasound (US)-guided percutaneous microwave ablation (MWA) for colorectal liver metastases (CRLMs) and developed a nomogram to predict ihPFS.

METHODS

From January 2013 to December 2018, a total of 314 patients (224 men and 90 women; mean age, 57.1 ± 11.8 years; range, 23-86 years) with 645 CRLMs (mean diameter, 16.6 ± 6.5 mm; range, 6.0-45.0 mm) treated with US-guided percutaneous MWA were included and analyzed. The average number of CRLMs per patient treated was 2 (range, 1-8). A nomogram to predict ihPFS was developed based on a multivariable Cox model. Validation of the nomogram was performed using the concordance index (C-index), calibration curves, and decision curve analyses.

RESULTS

The 1-, 2-, and 3-year cumulative ihPFS rates were 59.0%, 38.9%, and 30.8%, respectively. Maximal CRLM size, number of CRLMs, ablative margin, primary tumor lymph node status, and chemotherapy were five independent prognostic factors for ihPFS. The C-index of the nomogram was 0.702 (CI: 0.681-0.723). A risk classification system that perfectly classified the patients into three risk groups was constructed. The median ihPFS of patients in the low-, intermediate-, and high-risk groups was 36.3 months (95% CI: 21.4-51.1), 13.4 months (95% CI: 12.1-14.6), and 3.8 months (95% CI: 2.3-5.3), respectively.

CONCLUSION

The nomogram and risk classification system will facilitate the personalized assessment of ihPFS for patients receiving US-guided percutaneous MWA for CRLMs.

[Analysis on prevalence and epidemic risk of animal plague in different ecological plague foci in Inner Mongolia Autonomous Region]

The risk of plague epidemics and relapse of various types of plague foci persists in Inner Mongolia Autonomous Region. For Marmota sibirica plague foci, the animal plague has not been found but antibody has been detected positive. Nowadays, Marmota sibirica has been increasing in population and distribution in China. In bordering countries Mongolia and Russia, the animal plague has been continuously prevalent. For Spermophilus dauricus plague foci, the animal plague has been taken place now and then. Compared to the above foci, the animal plague is most prevalent in Meriones unguiculatus plague foci and frequently spread to humans. Due to higher strain virulence and historical disaster in Marmota sibirica plague foci and Spermophilus dauricus plague foci, plague prevention and control should be strengthened on these foci. In addition to routine surveillance, epidemic dynamics need to be further monitored in these two foci, in order to prevent their relapse and spread to humans.

Efficacy and safety of recombinant human endostatin during peri-radiotherapy period in advanced non-small-cell lung cancer

Background: This study aimed to retrospectively investigate the efficacy and safety of recombinant human endostatin (Rh-endostatin) combined with radiotherapy in advanced non-small-cell lung cancer (NSCLC). Methods: Patients with unresectable stage III and IV NSCLC who treated with radiotherapy were enrolled. Patients who received Rh-endostatin infusion throughout the whole peri-radiotherapy period formed the Endostar group, and those who received no Rh-endostatin infusion were the control group. Results: The median progression-free survival was 8.0 and 4.4 months (hazard ratio: 0.53; 95% CI: 0.32-0.90; p = 0.019) and median overall survival was 40.0 and 13.1 months (hazard ratio: 0.53; 95% CI: 0.28-0.98; p = 0.045) for the Endostar and control groups, respectively. The Endostar group exhibited a numerically lower rate of radiation pneumonitis relapse, radiation pneumonitis death and pulmonary fibrosis. Conclusion: Rh-endostatin infusion throughout the peri-radiotherapy period enhanced radiosensitivity and showed better survival outcomes and a tendency toward fewer radiation-related pulmonary events in patients with NSCLC.

Emission and spatialized health risks for trace elements from domestic coal burning in China

Residential coal combustion (RCC) emission exhibited obvious daily variation, while no real-time estimation of air pollutants from RCC has been reported, as the shortages of corresponding activity dataset and emission factors with high time resolution. A real-time monitoring platform for RCC emission was established. Hourly emission factors of 18 typed of TEs from eleven kinds of chunk coals and nine kinds of honeycomb coals burning in China were obtained. The monthly and hourly coal consumption amounts were calculated with reference and our field survey. Then the hourly TEs emission inventories from RCC were established in China. GEOS-Chem and Risk Quotients Models were utilized to map the spatialized health risks of hazardous elements, including the gridded hazard index and carcinogenic risk. The result indicated that the EFs of TEs would be underestimated if the tests only consider flaming conditions. Cu, K, Ca, Zn, and Co were the top five elements from RCC, with corresponding emission amounts as 1397.7, 1054.0, 676.0, 623.5 and 420 tons in 2017, respectively. K, Ti, Fe, Sn, and Sb showed hourly peak values under flaming dominated periods, accounting for 48.2%, 45.9%, 31.8%, 42.8%, and 33.8% of their daily emissions. Other elements (e.g., V, Co, As, Hg and Pb) exhibited higher emissions under smoldering dominated period in nighttime, accounting for 22.2%, 32.9%, 27.6%, 34.7%, and 28.4% of their daily emissions. TEs emission from RCC closely follows the habits of human daily cooking and heating activity. The national HI were lower than the acceptable level (HI ≤ 1) except Sichuan Province (up to 1.2). Higher carcinogenic risks (≥1 × 10^-6) occurred in parts of Sichuan, Shanxi, Hunan and Hubei, which were up to 2.0 × 10^-5. The high-resolution TEs emission inventories could be useful for future modeling works on the formation and evolution of air pollution and are helpful for human exposure assessment.

Pembrolizumab versus chemotherapy for patients with esophageal squamous cell carcinoma enrolled in the randomized KEYNOTE-181 trial in Asia

BACKGROUND

In the randomized phase III KEYNOTE-181 study, pembrolizumab prolonged overall survival (OS) compared with chemotherapy as second-line therapy in patients with advanced esophageal cancer and programmed death-ligand 1 (PD-L1) combined positive score (CPS) ≥10. We report a post hoc subgroup analysis of patients with esophageal squamous cell carcinoma (ESCC) enrolled in KEYNOTE-181 in Asia, including patients from the KEYNOTE-181 China extension study.

PATIENTS AND METHODS

Three hundred and forty Asian patients with advanced/metastatic ESCC were enrolled in KEYNOTE-181, including the China cohort. Patients were randomly assigned 1 : 1 to receive pembrolizumab 200 mg every 3 weeks for ≤2 years or investigator's choice of paclitaxel, docetaxel, or irinotecan. OS, progression-free survival, response, and safety were analyzed without formal comparisons. OS was evaluated based on PD-L1 CPS expression level.

RESULTS

In Asian patients with ESCC, median OS was 10.0 months with pembrolizumab and 6.5 months with chemotherapy [hazard ratio (HR), 0.63; 95% CI 0.50-0.80; nominal P < 0.0001]. Median progression-free survival was 2.3 months with pembrolizumab and 3.1 months with chemotherapy (HR, 0.79; 95% CI 0.63-0.99; nominal P = 0.020). Objective response rate was 17.1% with pembrolizumab and 7.1% with chemotherapy; median duration of response was 10.5 months and 7.7 months, respectively. In patients with PD-L1 CPS <1 tumors (pembrolizumab versus chemotherapy), the HR was 0.99 (95% CI 0.56-1.72); the HR (95% CI) for death was better for patients with PD-L1 CPS cut-offs >1 [CPS ≥1, 0.57 (0.44-0.75); CPS ≥5, 0.56 (0.41-0.76); CPS ≥10, 0.53 (0.37-0.75)]. Treatment-related adverse events were reported in 71.8% of patients in the pembrolizumab group and 89.8% in the chemotherapy group; grade 3-5 events were reported in 20.0% and 44.6%, respectively.

CONCLUSIONS

Pembrolizumab monotherapy demonstrated promising efficacy in Asian patients with ESCC, with fewer treatment-related adverse events than chemotherapy. PD-L1 CPS ≥1 is an appropriate cut-off and a predictive marker of pembrolizumab efficacy in Asian patients with ESCC.

Toughening Wet-Spun Silk Fibers by Silk Nanofiber Templating

Regenerated silk fibers typically fall short of silkworm cocoon fibers in mechanical properties due to reduced fiber crystal structure and alignment. One approach to address this has been to employ inorganic materials as reinforcing agents. The present study avoids the need for synthetic additives, demonstrating the first use of exfoliated silk nanofibers to control silk solution crystallization, resulting in all-silk pseudocomposite fibers with remarkable mechanical properties. Incorporating only 0.06 wt. % silk nanofibers led to a ∼44% increase in tensile strength (over 600 MPa) and ∼33% increase in toughness (over 200 kJ/kg) compared with fibers without silk nanofibers. These remarkable properties can be attributed to nanofiber crystal seeding in conjunction with fiber draw. The crystallinity nearly doubled from ∼17% for fiber spun from pure silk solution to ∼30% for the silk nanofiber reinforced sample. The latter fiber also shows a high degree of crystal orientation with a Herman's orientation factor of 0.93, a value which approaches that of natural degummed B. mori silk cocoon fiber (0.96). This study provides a strong foundation to guide the development of simple, eco-friendly methods to spin regenerated silk with excellent properties and a hierarchical structure that mimics natural silk. This article is protected by copyright. All rights reserved.