Search

The Tibetan Plateau (TP), with its unique geographical and climatic conditions, holds a significant role in global climate change. Therefore, it is particularly urgent to fully understand its vegetation phenology. Herbaceous plants are widely distributed in the TP. However, previous studies have predominantly examined the impact of air temperature on the end date of the vegetation growing season (EOS), with less emphasis on the influence of land surface temperature (LST). In this study, the dynamic changes in the EOS from 2001 to 2020 were analyzed by utilizing the Normalized Difference Vegetation Index (NDVI) data published by NASA. Furthermore, the impact of climate change on the EOS was examined, and the dominant factor (air temperature, LST, or precipitation) influencing the EOS was identified. The main findings were as follows: the average annual EOS predominantly occurred between day of year (DOY) 240 and 280, with an advance from the edge of the plateau to the center. The EOS across the entire region displayed a marginal tendency towards delay, with an average rate of 0.017 days/year. Among all vegetation, shrubs showed the most pronounced delay at a rate of 0.04 days/year. In terms of precipitation, the impact of climate change increased precipitation in both summer and autumn, which could delay EOS. In terms of temperature, an increase in summer Tmin, autumn air temperatures and summer LST delayed the EOS, while an increase in autumn LST advanced the EOS. Compared to air temperature and precipitation, LST had a stronger controlling effect on the EOS (the largest pixel area dominated by LST). These results could offer new insights for enhancing the parameters of vegetation phenology models across the TP. [ABSTRACT FROM AUTHOR]

Climate change significantly impacts the livelihoods of farmer households. Particularly vulnerable areas, both economically and environmentally, face significant threats from climate change. This study developed a framework to assess household-level vulnerability to climate change by integrating the Exposure-Sensitivity-Resilience Analysis (ESRA) and Sustainable Livelihoods Analysis (SLA) frameworks. Using Gui-Zhou Province as the study area, the study examined whether livelihood vulnerability differs among various types of farmer households in economically and environmentally vulnerable areas and identified the main factors contributing to vulnerability. Results indicate significant differences in livelihood vulnerability among the three household types, with pure agricultural households (PAH) being the most vulnerable due to high exposure, sensitivity, and low adaptive capacity. Further analysis revealed minor differences in sensitivity but significant differences in adaptive capacity among the three farmer categories. In terms of sensitivity, all three farmer household categories exhibit high sensitivity to water, housing, and agricultural production. Regarding adaptive capacity, significant differences in human and financial capital exist among the three household types, with off-farm households (OFH) possessing the highest adaptive capacity due to their substantial human and financial capital. Further research identified high exposure and low adaptive capacity as the primary causes of livelihood vulnerability, noting no significant difference in the main contributing factors among the three types of farmer households. Common factors contributing to the livelihood vulnerability of farmer households include agricultural cooperatives, labor capacity, temperature changes, drought frequency changes, precipitation changes, agricultural insurance, and losses in agricultural production. Overall, the proposed livelihood vulnerability framework offers guidance for analyzing the vulnerability of farmer households in areas with both economic and environmental vulnerabilities under climate change. Concurrently, tailored measures to reduce farmer households' livelihood vulnerability should be developed for different household types, considering the local climatic, geographic, and socioeconomic conditions. [ABSTRACT FROM AUTHOR]

Climate change inevitably affects vegetation growth in the Tibetan Plateau (TP). Understanding the dynamics of vegetation phenology and the responses of vegetation phenology to climate change are crucial for evaluating the impacts of climate change on terrestrial ecosystems. Despite many relevant studies conducted in the past, there still remain research gaps concerning the dominant factors that induce changes in the start date of the vegetation growing season (SOS). In this study, the spatial and temporal variations of the SOS were investigated by using a long-term series of the Normalized Difference Vegetation Index (NDVI) spanning from 2001 to 2020, and the response of the SOS to climate change and the predominant climatic factors (air temperature, LST or precipitation) affecting the SOS were explored. The main findings were as follows: the annual mean SOS concentrated on 100 DOY–170 DOY (day of a year), with a delay from east to west. Although the SOS across the entire region exhibited an advancing trend at a rate of 0.261 days/year, there were notable differences in the advancement trends of SOS among different vegetation types. In contrast to the current advancing SOS, the trend of future SOS changes shows a delayed trend. For the impacts of climate change on the SOS, winter Tmax (maximum temperature) played the dominant role in the temporal shifting of spring phenology across the TP, and its effect on SOS was negative, meaning that an increase in winter Tmax led to an earlier SOS. Considering the different conditions required for the growth of various types of vegetation, the leading factor was different for the four vegetation types. This study contributes to the understanding of the mechanism of SOS variation in the TP. [ABSTRACT FROM AUTHOR]

China's urbanization has received as much attention as its economic growth in recent years. While rapid urbanization has promoted modernization and wealth creation, it has also brought many problems and challenges. So, since 2014, the Chinese government has implemented a new urbanization policy nationwide. However, few researchers have examined whether China's new urbanization policies promote sustainable urbanization. This paper evaluates the sustainable urbanization of 19 urban agglomerations in China using the elastic coefficient. The results indicate a significant increase in the number of cities achieving sustainable urbanization since the implementation of China's new urbanization policy. The number has risen from 46 in the period of 2010–2015 to 71 in the period of 2015–2021. Considering the impact of the new coronavirus on economy, there would have been even more cities entering sustainable urbanization during the latter period. This indicates that the new urbanization policy has a positive influence on the sustainable urbanization of China's urban agglomerations. The sustainable urbanization status is not static and changes with different policies that are implemented in different time periods. Therefore, it is important to find useful policies that can guide and enhance the urbanization process in these cities. In addition, cities that have a sustainable urbanization status are not perfect. To address this issue, it is important to categorize and implement targeted policies for cities experiencing both sustainable and non-sustainable urbanization. Changes in a city's size or urbanization rates are not related to the city's sustainable urbanization status. A larger city size does not indicate sustainable urbanization, and, similarly, cities with faster urbanization rates do not exhibit a higher level of urbanization sustainability. [ABSTRACT FROM AUTHOR]

Water-level fluctuation (WLF) can destroy soil aggregates and induce soil organic carbon (SOC) loss, potentially triggering impacts on the concentration of atmospheric carbon dioxide. However, responses of soil aggregate content and aggregate-associated organic carbon to WLF have not been well studied, especially in the water-level fluctuation zone (WLFZ) of the Three Gorges Reservoir (TGR). Therefore, samples from different elevations (145 m, 155 m and 165 m) in the WLFZ of the TGR were collected for experiments. The wet sieving method was used to divide soil into silt and clay (<0.053 mm), micro-aggregate (0.053–0.25 mm) and macro-aggregate (>0.25 mm). The K2Cr2O7-H2SO4 oxidation method was used to measure total SOC content in different soil aggregates. A modified Walkley and Black method was used to measure labile carbon in different soil aggregates. Results showed that macro-aggregate content substantially decreased, while micro-aggregate content remained stable and silt and clay fraction accumulated with a decrease in water-level elevations. Moreover, total SOC content and labile carbon in macro-aggregate were obviously higher than those in the micro-aggregate and the silt and clay fraction. Macro-aggregate contributed the most to SOC sequestration, while micro-aggregate contributed the least, and the contribution of macro-aggregate increased with a decrease in water-level elevations. We concluded that the macro-aggregate was the most active participant in the SOC sequestration process, and preferentially increasing the macro-aggregate content of the lowest water-level elevation was conducive to an improvement in soil carbon sequestration potential and would mitigate climate change. [ABSTRACT FROM AUTHOR]

Soft hydrogel iontronic devices, utilizing the assumed non‐Faradaic exchange of ions and electrons at the metal‐hydrogel interfaces, have been demonstrated with advantages of high stretchability, transparency, and biocompatibility. Yet, in real situation under high voltage, Faradaic reaction is inevitable, which can breakdown the device and lead to the low durability. Herein, the Faradaic breakdown behaviors of hydrogel iontronic devices under high AC voltage are systematically studied. Side reactions including electrode corrosion and water electrolysis are confirmed in the electrical double layer. Interface barrier layers are proposed to eliminate this issue. It is found that acetylene black (ACET) as modification layer can achieve the best performances, providing effective protection while maintaining the electrical performances. By leveraging ACET‐modified electrodes, long‐term durable iontronics, including electroluminescent devices and high‐output triboelectric nanogenerators, are successfully demonstrated. This work can provide insightful strategies for developing practical hydrogel iontronic devices. [ABSTRACT FROM AUTHOR]

Case-based learning (CBL) is a contextualized learning and teaching method that can facilitate active and reflective learning to develop critical thinking and problem-solving skills. However, nursing educators have some difficulty in creating a CBL environment that matches the diverse professional nursing curriculum and students' needs, including developing relevant cases and appropriate CBL implementation processes. To summarize the case design, implementation process, and their relationship with CBL effectiveness. Electronic databases of PubMed, Embase, Web of Science, CINAHL, China National Knowledge Infrastructure (CNKI) and Wanfang Data (a Chinese database) were searched from inception until January 2022. Study quality was assessed using the Mixed Methods Appraisal Tool. A qualitative synthesis was then conducted to summarize the study findings. The systematic mixed studies review included twenty-one quantitative studies, five qualitative studies and two mixed methods studies. The case design and implementation process were indispensable parts of each study, but the application process of CBL in each study was slightly different, basically including case design, preparation, small-group interaction and exploration, collaborative efforts, teacher summary, assignment and teacher feedback. There were three themes in this review that indicate the effect of CBL on students, namely, knowledge, competence and attitude. The present review analyzes the available literature and suggests that there is no common format for the case design and CBL implementation process, but demonstrates that they are an indispensable part of each study. This review provides conceptual procedures for nurse educators to design and implement CBL in nursing theoretical courses to improve the effectiveness of CBL. • Case-based learning (CBL) is widely used in many nursing disciplines and yields promising positive educational outcomes. • There is no common format for the case design and CBL implementation process in nursing education. • The case design and implementation process are an important part of CBL application in nursing programmes. • This review provides a conceptual procedure for nurse educators to design and implement CBL in nursing theoretical courses. [ABSTRACT FROM AUTHOR]

Synopsis: Metastatic mucinous adenocarcinoma of the lower ureter is reported in a 55‐year‐old woman presenting with gross hematuria who was treated for cervical cancer 3 years prior. [ABSTRACT FROM AUTHOR]

Soft iontronics expand the toolbox of bio‐integrated or bio‐interfaced devices, owing to their natural resemblance with living systems; however, the development for analogous integrated ionic circuits is immature due to the difficulty of fabricating fundamental ionic logic elements. Among these, ionic diodes have motivated great endeavors for their unique ionic current rectifying characteristics. Nonetheless, it is still challenging to achieve high‐performance ionic diodes; also, most reported aqueous solution‐based ionic diodes fail to work at extreme temperatures, seriously hindering their practical uses. This work reports a highly rectifying, temperature‐tolerant, and flexible hydrogel ionic diode enabled by an ethylene glycol/water binary solvent system. The ionic diodes exhibit outstanding dehydration resistance to high temperatures (100 °C) and anti‐freezing performance at low temperatures (−20 °C). Rectification ratios as high as 1201 (with 0% ethylene glycol content) and 566 (with 40% EG content) are achieved, which are distinctly advantageous over most previous reports. A flexible four‐diode bridge full‐wave rectifier circuit is then fabricated, and its integration with the triboelectric nanogenerator for effective biomechanical energy harvesting is demonstrated. This work is believed to open up new insights for the development of future bio‐interfaced applications. [ABSTRACT FROM AUTHOR]

BACKGROUND: Plant viruses are transmitted mainly by piercing‐sucking herbivores, and viral disease management relies on chemical control of vectors. Southern rice black‐streaked dwarf virus (SRBSDV) is transmitted by the white‐backed planthopper (WBPH), Sogatella furcifera. This study aimed to evaluate the potential of silicon (Si) amendment for reducing SRBSDV transmission. RESULTS: The settling and ovipositional preferences of WBPH females decreased significantly by 14.6–43.7% for plants treated with either 0.16 g or 0.32 g SiO2 kg−1 soil during SRBSDV acquisition and by 26.2–28.3% for plants treated with 0.32 g SiO2 kg−1 soil during SRBSDV inoculation, compared with controls. Adding either 0.16 or 0.32 g SiO2 kg−1 soil significantly reduced SRBSDV inoculation rate by 31.3% and 45.3%, respectively, and acquisition rate by 25.5% and 66.0%, respectively. Silicification was intensified more in plants treated with 0.32 g SiO2 kg−1 soil than in controls. The nonprobing (np) duration increased, and the phloem sap ingestion (N4‐b) duration decreased significantly in the WBPHs feeding on high‐rate‐Si‐supplemented plants compared with control plants during both inoculation and acquisition access. CONCLUSION: This study showed that Si amendment to rice plants decreased the WBPH settling and ovipositional preference and the SRBSDV acquisition and inoculation rates, thereby reducing SRBSDV transmission. The intensified plant silicification and the altered WBPH feeding behaviors (i.e. prolonged np and shortened N4‐b) may explain the reduced SRBSDV transmission in Si‐amended plants. © 2021 Society of Chemical Industry. [ABSTRACT FROM AUTHOR]

Aim Design Methods Reporting Method Results Conclusions Implications for the Profession and/or Patient Care Impact Protocol Registration Patient or Public Contribution To evaluate the effectiveness and safety of nutritional interventions (i.e. nutritional support, dietary patterns and dietary supplements) on cognitive function in cancer survivors.Systematic review.A systematic and comprehensive search of PubMed, Web of Science, the Cochrane Library, Embase, and CINAHL was conducted from the inception until March 10, 2023. The last search was conducted on December 10, 2023.PRISMA.A total of 59 randomized controlled trials were included for analysis. Nutritional support, dietary patterns and dietary supplements improved cognitive function in cancer survivors with no apparent safety concerns. The anti‐inflammatory diet, the fasting‐mimicking diet and the web‐based diet significantly improved cognitive function. Whereas the ketogenic diet or dietary advice to consume more soluble dietary fibres and less insoluble dietary fibres and lactose could not. There was evidence from dietary supplements to support the beneficial effects of polyunsaturated fatty acid supplements, traditional herbal medicines and other supplements.Nutritional interventions have great promise for improving cognitive function in adult cancer survivors. Further validation of the nutritional interventions supported in this study in other survivors and exploration of more effective nutritional interventions are needed.This work can support the construction of nutritional support interventions and dietary guidance programs to prevent cancer‐related cognitive decline.This work filled a gap in preventive strategies for cancer‐related cognitive decline from a nutritional perspective. Nutritional support, dietary patterns, and dietary supplements can prevent cancer‐related cognitive decline without serious safety concerns. This work highlighted nutritional interventions that have the potential to improve cognitive function in cancer survivors, benefiting the further construction of evidence‐based nutritional intervention programs.PROSPERO.No patient or public contribution. [ABSTRACT FROM AUTHOR]

The degradation of three micropollutants (i.e., atrazine (ATZ), sulfamethoxazole (SMX) and metoprolol (MET)) was comprehensively investigated in flow-through UV/chlorine reactors. Results showed that the micropollutants degradation fitted well with pseudo-first-order kinetics (R2 > 0.92) with the order of rate constants following SMX > MET > ATZ. The developed steady-state approximation (SSA) model was roughly applicable in flow-through UV/chlorine reactors with the predictions deviated within 44%. UV photolysis here stood as the major degradation pathway for ATZ while the contribution of non-radical processes (UV photolysis and chlorination) to SMX degradation increased as the reactor internal diameter enlarged. The degradation rates were reduced to varying extents with complex water matrices (chloride, bicarbonate and dissolved organic matter (DOM)) where the inhibition from the DOM was most prominent (up to 73.6%). Although reactors with a larger internal diameter resulted in reduced degradation rate constants, the energy requirements were also lowered. The E EO values of micropollutants degradation by UV/chlorine fell mostly within 1.0 kWh m−3 order−1 in deionized water and under different water matrices. The acute toxicity was observed to be higher after UV/chlorine treatment in tap water, but still stayed low in general. This study revealed the different kinetics and mechanisms of micropollutants degradation in flow-through reactors and demonstrated the potential of the UV/chlorine process in terms of low energy consumption and acute toxicity. [Display omitted] • Micropollutants were efficiently degraded in flow-through UV/chlorine reactors. • A steady-state approximation model was developed and found approximately applicable. • Effects of reactor internal diameter and water matrices were investigated. • Variations of solution acute toxicity during UV/chlorine treatment were evaluated. [ABSTRACT FROM AUTHOR]

Objectives: To compare the accuracy of transvaginal ultrasound (TVUS) with laparoscopy in detecting and characterizing uterosacral ligament (USL) nodules of deep infiltrative endometriosis (DIE) between patients with and without pouch of Douglas (POD) fluid., Methods: This prospective study was conducted between June 2021 and July 2023. We included patients from the Second People's Hospital of Shenzhen with two TVUS tests: no POD fluid on the first TVUS test and POD fluid on the second TVUS test. POD fluid was obtained in two ways: naturally occurring fluid during the luteal phase of the menstrual cycle and SonoPODography. Laparoscopic results are the gold standard. To compare the diagnostic performance of TVUS in the diagnosis of DIE on USLs with and without POD fluid., Results: We included 42 patients with a mean age of 36.4 ± 5.4 years. The maximum length diameter for DIE nodules on USLs with and without POD fluid was 13.3 ± 3.3 mm and 10.2 ± 2.5 mm (P < .001), respectively, while the depth of infiltration was 8.1 ± 2.4 mm and 6.1 ± 1.4 mm (P < .001), respectively. When compared to laparoscopic findings, TVUS findings with and without POD fluid resulted in a sensitivity, specificity, accuracy, positive predictive value, negative predictive value area under the curve, and Cohen kappa of 92.3%, 93.8%, 92.9%, 96.0%, 88.2%, 0.930, and 0.850 and 61.5%, 93.8%, 73.8%, 94.1%, 50.0%, 0.766, and 0.499, respectively. Laparoscopy showed USL involvement in up to 59.5% of patients. With or without fluid, the most common ultrasound features of DIE lesions were USL thickening, irregular morphology, clear boundaries, low echo, and no blood flow signal., Conclusions: For patients with clinical suspicion of DIE, TVUS with POD fluid has a higher accuracy for diagnosing USL DIE than TVUS without POD fluid., (© 2024 American Institute of Ultrasound in Medicine.)

The limitations and complexity of traditional noncontact sensors in terms of sensitivity and threshold settings pose great challenges to extend the traditional five human senses. Here, we propose tele-perception to enhance human perception and cognition beyond these conventional noncontact sensors. Our bionic multi-receptor skin employs structured doping of inorganic nanoparticles to enhance the local electric field, coupled with advanced deep learning algorithms, achieving a Δ V /Δ d sensitivity of 14.2, surpassing benchmarks. This enables precise remote control of surveillance systems and robotic manipulators. Our long short-term memory-based adaptive pulse identification achieves 99.56% accuracy in material identification with accelerated processing speeds. In addition, we demonstrate the feasibility of using a two-dimensional (2D) sensor matrix to integrate real object scan data into a convolutional neural network to accurately discriminate the shape and material of 3D objects. This promises transformative advances in human-computer interaction and neuromorphic computing.

Background: Locoregional treatment combined with systemic therapy is expected to play a synergistic anticancer role. We conducted this systemic meta-analysis to examine the efficacy and safety of transarterial chemoembolization (TACE) plus lenvatinib with or without programmed cell death protein-1 (PD-1) inhibitors (TLP group) compared with TACE + lenvatinib (TL group) for unresectable hepatocellular carcinoma (uHCC)., Methods: From the inception date to April 2024, the data from PubMed, EMBASE, the Cochrane Library, Ovid, Web of Science, and Clinical Trials. gov were used for meta-analysis. All clinical outcomes of interest included overall survival (OS), progression-free survival (PFS), objective response rate (ORR), disease control rate (DCR), and adverse events (AEs). The hazard ratio (HR) and risk ratio (RR) with 95% confidence intervals (CI) were used to measure the pooled effect., Results: This study included 10 retrospective cohort studies, including 1128 patients. The OS (HR=0.51; 95% CI: 0.43-0.60, P <  0.05), PFS (HR=0.52; 95% CI: 0.45-0.61, P <  0.05), ORR (RR = 1.58; 95% CI: 1.37-1.83; P < 0.05) and DCR (RR = 1.31; 95% CI: 1.20-1.43; P < 0.05) were significantly higher in TLP group than in the TL group. The incidence of AEs was acceptable. Prognostic factor analysis identified that ECOG PS (1/0), Child-Pugh class (B/A), BCLC stage (C/B) and main portal vein invasion (yes/no) were independent prognostic factors for OS. BCLC stage (C/B) and main portal vein invasion (yes/no) were independent prognostic factors for PFS., Conclusion: The TLP group had better efficacy for uHCC than that of the TL group, with acceptable safety., Systematic Review Registration: PROSPERO, identifier (CRD42023420093)., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Chen, Jia, Li, Cui, Wang, Zhang, Bian and Luo.)

Background: The triple combination of programmed cell death protein-1 (PD-1) inhibitors plus anti-angiogenesis tyrosine kinase inhibitors (TKIs) with or without transarterial chemoembolization (TACE) or hepatic arterial infusion chemotherapy (HAIC) enhance the effect of treatment for unresectable hepatocellular carcinoma (uHCC). The present study compared the efficacy and safety of PD-1 plus TKI with or without transarterial chemo(embolization) for uHCC., Methods: The meta-analysis was conducted using data acquired from PubMed, EMBASE, the Cochrane Library, Ovid, Web of Science, and Clinical Trials.gov from the inception date to December 2023. All clinical outcomes of interest included overall survival (OS), progression-free survival (PFS), objective response rate (ORR), and adverse events (AEs). The hazard ratio (HR) and risk ratio (RR) with 95% confidence intervals (CIs) were used to measure the pooled effect. In addition, subgroup analysis was conducted to determine the specific patient population that benefited., Results: The OS (HR = 0.47; 95% CI: 0.39-0.56, P <  0.05), PFS (HR = 0.52; 95% CI: 0.45-0.60, P <  0.05), and ORR (RR = 1.94; 95% CI: 1.60-2.35, P < 0.05) were significantly better in TACE/HAIC+TKI+PD-1(TACE/HAIC TP) group than TKI+PD-1(TP) group. The incidence of AEs was acceptable., Conclusion: The triple therapy of TACE/HAIC TP had better efficacy for uHCC than TP, with acceptable security., Systematic Review Registration: PROSPERO, identifier CRD42023475953., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Chen, Jia, Li, Cui, Wang, Zhang, Bian and Luo.)

Personal thermal management (PTM) of fabrics is vital for human health; the ever-changing location of the human body poses a big challenge for fabrics to maintain a favorable metabolic temperature. Herein, a dual-mode thermal management fabric is designed to achieve both cooling and heating functions by regulating simultaneously solar and body radiations. The cooling or heating mode can be exchanged by flipping the fabric without an external energy supply. The passive cooling side consists of an electrospun polyacrylonitrile (PAN) fabric with a hierarchical porous structure, exhibiting high sunlight reflectance (91.42%) and an ∼14 °C temperature decrease under direct sunlight irradiation. The co-existence of nanoscale and microscale pores is proven to be essential for improved cooling performances. The other heating side, coated with an MXene layer, shows high photothermal conversion efficiency (37.5%) and outstanding heating capability outdoors. Furthermore, the contrary mid-infrared emissivity of the two sides (high emissivity of the cooling side while low emissivity of the heating side) leads to the dual-mode passive regulation of body thermal energy. Besides, this fabric demonstrates satisfactory wearability and excellent stability. Our work proposes an energy-saving and cost-effective approach for PTM fabrics potentially suitable for various scenarios ( e.g. , indoors/outdoors, summer/winter, low/high latitude areas).

Background: Individualized decisions are required in early-stage breast cancer patients. We aimed to establish a novel model for predicting non-sentinel lymph node (SLN) metastases in patients with positive SLNs, using preoperative and intraoperative characteristics and inflammatory indicators., Methods: The data of 489 patients with invasive breast cancer were retrospectively collected from Xuanwu Hospital between 2014 and 2021. Among them, 96 patients with at least one positive SLN were used to build the predictive model. Univariate and multivariate analyses were performed to identify the risk factors of non-SLN metastases. A nomogram was developed using these risk factors and was validated by calibration curves. The area under the receiver operating characteristics curve (AUC) and decision curve analyses (DCA) were used to compare our novel nomogram with the Memorial Sloan Kettering Cancer Center (MSKCC) nomogram. Cross-validation was performed for further internal validation of the predictive model. External validation was conducted using another treatment group (n=46 patients) in Xuanwu Hospital., Results: Non-SLN metastases occurred in 42 of the 83 patients with positive SLNs (50.6%). Multivariate stepwise logistic regression indicated that the risk factors were age (P=0.032), number of positive SLNs (P=0.020), number of negative SLNs (P=0.011), resected tumor size (P=0.038), and monocyte count (P=0.012). A predictive model was developed and virtualized by nomogram using these five risk factors. The AUC of our nomogram was 0.867, which was significantly higher than that of the MSKCC model. DCA also showed a superior clinical value for our novel nomogram. After 10-fold cross-validation with 400 times repetitions, the AUC of our model was still 0.830. External validation of our model showed an AUC of 0.727. The model was well-calibrated in the internal and external validation series., Conclusions: A five-factor nomogram was developed for predicting non-SLN metastases in early-stage breast cancer patients. This novel tool exhibited good accuracy and could assist clinicians with intraoperative decisions in breast cancer patients with positive SLNs., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://gs.amegroups.com/article/view/10.21037/gs-22-585/coif). The authors have no conflicts of interest to declare., (2023 Gland Surgery. All rights reserved.)

Purpose: Under the umbrella of social cognitive theory, we examined the influences of personal, environmental, and behavioral factors on adherence to healthy eating behaviors among colorectal cancer survivors., Methods: Based on Pluye and Hong's framework, a systematic mixed studies review was conducted. An extensive search strategy was applied in PubMed, Web of Science, Embase, CINAHL, and PsycINFO (from date of record to 2022 January 22). The pillar integration process was employed to integrate the extracted data. The Mixed Methods Appraisal Tool was used to appraise the quality of all retained studies., Results: Twenty-eight studies with a total sample size of 5106 were included in the analysis, with 15 quantitative studies, 12 qualitative studies, and 1 mixed method study. The critical appraisal showed that 22 of the 28 studies (79%) were rated with five stars, while 6 (21%) were rated with four stars. The personal factors influencing adherence to healthy eating behaviors among colorectal cancer survivors included outcome expectancies, self-efficacy, psychological factors, knowledge about healthy eating, demographic and disease characteristics, environmental factors incorporated outside information on healthy eating, power of surrounding people, social activities, cultural milieus, socioeconomic status, and education. The behavioral factors included self-regulation of diet, goals, and other behaviors closely related to healthy eating behaviors., Conclusions: Adherence to healthy eating behaviors among colorectal cancer survivors was influenced collectively by personal factors, environmental factors and behavioral factors., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Artificial haptic sensors form the basis of touch-based human-interfaced applications. However, they are unable to respond to remote events before physical contact. Some elasmobranch fishes, such as seawater sharks, use electroreception somatosensory system for remote environmental perception. Inspired by this ability, we design a soft artificial electroreceptor for sensing approaching targets. The electroreceptor, enabled by an elastomeric electret, is capable of encoding environmental precontact information into a series of voltage pulses functioning as unique precontact human interfaces. Electroceptor applications are demonstrated in a prewarning system, robotic control, game operation, and three-dimensional object recognition. These capabilities in perceiving proximal precontact events can lenrich the functionalities and applications of human-interfaced electronics.

The electric double layer (EDL) at liquid-solid interfaces is fundamental to many research areas ranging from electrochemistry and microfluidics to colloidal chemistry. Here, we demonstrate the electricity generation by mechanically modulating the EDL at the hydrogel-dielectric polymer interfaces. It is found that contact electrification between the hydrogel and the dielectric polymer could charge the dielectric polymer surface at first; the mechanical deformation of the pyramid-shaped hydrogel results in the periodic variation of the EDL area and capacitance, which then induces an alternative current in the external circuits. This mechano-to-electrical energy conversion mechanism is then utilized to construct soft stretchable self-powered pressure sensors by designing dynamic EDL at hydrogel-dielectric elastomer interfaces. The sensitivity is optimized to 1.40 kPa -1 in the low-pressure range of 31-300 Pa by increasing the elastomer roughness. Its antifreeze performance is also improved by adding ethylene glycol into the hydrogel. The capability in detecting subtle human activities is further demonstrated. This mechano-electrical energy conversion and the corresponding self-powered sensor can be widely applied in future soft electronics.

Background: There is still no reasonably accurate method of preoperatively predicting central lymph node metastasis (LNM), and it is essential to develop an effective evaluation model for predicting LNM in papillary thyroid carcinoma (PTC) patients., Methods: PTC samples were collected from The Cancer Genome Atlas database. Candidate genes were identified as continuously upregulated or downregulated genes in the process of N0 to N1a and N1a to N1b. The least absolute shrinkage and selection operator (LASSO) regression analysis was used to construct the predictive model for LNM. Multivariate logistic regression analysis was performed to screen the potential factors related to LNM, and a nomogram was established. The risk score of the gene signature model for predicting disease-free survival (DFS) was evaluated by Kaplan-Meier analysis., Results: A 14-gene signature was developed by LASSO regression for predicting LNM based on 69 differential expression genes (DEGs) that were continuously upregulated or downregulated in the progress of PTC. The receiver operating characteristic (ROC) curves of the 14-gene signature predicting LNM, central LNM and lateral LNM were generated. The area under the ROC (AUC) values were 0.806 [95% confidence interval (CI): 0.7608-0.8815], 0.755 (95% CI: 0.6839-0.8263) and 0.821 (95% CI: 0.7608-0.8815). The nomogram's C-index value, including the 14-gene signature and other potential risk factors, was 0.786 (95% CI: 0.7296-0.8425), and the calibration exhibited fairly good consistency with the perfect prediction. Based on the 14-gene risk score, high-risk PTC patients had a worse DFS., Conclusions: A novel 14-gene signature was developed for predicting LNM in PTC patients. The risk score also correlated with DFS in PTC patients., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://dx.doi.org/10.21037/gs-21-361). The authors have no conflicts of interest to declare., (2021 Gland Surgery. All rights reserved.)

Background: The lymph nodes in the right central compartment can be divided into 2 parts by the right recurrent laryngeal nerve (RLN), and there is a lack of an accurate and convenient method for assessing metastases in the lymph node posterior to the right recurrent laryngeal nerve (LN-prRLN) in cN0 thyroid papillary carcinoma patients., Methods: Patients diagnosed with cN0 thyroid papillary carcinoma and underwent intraoperative carbon nanoparticle-guided lymph node biopsy from January 2017 to November 2020 at the Center for Thyroid and Breast Surgery of Xuanwu Hospital were retrospectively analyzed. The intraoperative frozen section examination and postoperative LN-prRLN status should have been comprehensively recorded. The participants were divided into the LN-prRLN positive group and LN-prRLN negative group according to their recorded LN-prRLN status., Results: In total, 189 cases (LN-prRLN positive group, n=30; LN-prRLN negative group, n=159) were included in the analysis. The univariate and multivariate regression analyses revealed that the number of metastatic lymph nodes during intraoperative lymph node biopsy was the potential predictor for LN-prRLN metastasis [odds ratio (OR): 1.320, 95% confidence interval (CI): 1.057 to 1.649, P=0.014]. The receiver operating characteristic (ROC) curve showed that the area under the curve (AUC) reached 0.7 upon a combined analysis of multiple lymph node statuses located at pre-laryngeal (Delphian), pre-tracheal, and para-tracheal lymph nodes ipsilateral to the tumor in predicting the metastasis of LN-prRLN, and the cut-off value was 0.5., Conclusions: Number of metastatic lymph nodes in intraoperative biopsy was an indicator of LN-prRLN metastasis in cN0 thyroid carcinoma patients. Patients staging in cN0 with negative intraoperative lymph node status might be considered not to require LN-prRLN dissection during central lymph nodes dissection., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/gs-20-920). The authors have no conflicts of interest to declare., (2021 Gland Surgery. All rights reserved.)