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Indepth research on the impact of energy endowment on provincial green development provides a new perspective for achieving high-quality provincial economic development. Based on 30 provinces’ panel data in China from 2009 to 2020, this study first constructs an index system to analyze energy endowment and provincial green development; then it explores the mechanism by which energy endowment affects provincial green development, including the moderating role of environmental regulation and the mediating role of energy efficiency. The results show that energy endowment can significantly curb provincial green development when environmental regulations are not taken into account. Moreover, environmental regulation has moderated the process of energy endowment affecting provincial green development. Energy efficiency has mediated the process of energy endowment affecting provincial green development. From a geographical viewpoint, the moderating effect of environmental regulation has regional heterogeneity but the mediating effect of energy efficiency does not. The conclusions of this research may supply applicable recommendations for provincial green development in China.

Mobile searches have become the main channel for people to search for information, and mobile searches have received attention in the field of information-seeking behavior. Especially as users use various apps to search network information, the app-switching behaviors in mobile searches have also attracted scholars’ attention in recent years. Research on app-switching behaviors in mobile searches can help to further understand users’ search motivations, evaluate search results, and improve users’ mobile search experiences. This study recruited participants (n = 30) and conducted a 15-day user experiment. This study collected all participants’ mobile phone log data during the experiment and identified the app-switching behaviors in mobile searches through a log collection tool. This study aimed to discover the app-switching behavior paths and patterns in mobile searches. Firstly, the basic characteristics of app-switching behaviors in mobile searches were analyzed, as were the app-switching paths in mobile searches from the perspective of switching probability between apps. Then, the different behaviors in mobile search sessions were identified and app-switching behavior patterns were put forward. These behavior patterns summarize user behavior changes in mobile search sessions. This paper focused on analyzing app-switching behavior paths under different patterns and found apparent differences in app-switching behavior paths. This study examined mobile search behavior from the perspective of app-switching. The research of this paper can help to better understand the relationship between users’ mobile search behaviors and app interactions and is an excellent supplement to the analysis of mobile search behaviors.

Programmed death ligand 1 (PD-L1) immune checkpoint inhibitors are promising therapeutic agents for treating cancers but the response rate is

Background. The aim of the study was to compare the morphological distinctions of the posterior wall (PW) in different complex acetabular fractures using 3D software and fracture mapping technique and ultimately to provide for improved clinical treatment. Methods. One hundred and fourteen patients with complex acetabular fracture associated with PW were recruited. All patients were divided into two groups according to the injury mechanism of the PW: Group A (both-column and PW) and Group B (including posterior column and PW; T shape and PW; and transverse and PW). Fracture mapping was generated on the intra- and extrasurface of a standard template. The radiological parameters including spatial displacement, articular surface area, articular range, marginal impaction, and multifragments of the two groups were compared. Results. The spatial displacement, intra-/extra-articular surface area, and start and end point in Group A were 10.9 mm (IQR, 8.4-15.2), 8.2 ± 2.6 cm2, 17.9 ± 5.3 cm2, 0.8° (IQR, -6.0-16.2), and 107.5° (IQR, 97.2-116.9), respectively. The results in Group B were 30.4 mm (IQR, 16.8-48.7), 4.1 ± 2.0 cm2, 10.6 ± 4.4 cm2, 29.5° (IQR, 19.2-38.0), and 117.5° (IQR, 98.2-127.2), respectively. Marginal impaction was defined by Letournel et al. All the differences between two groups were significant ( P < 0.05 ). The fracture map in Group A showed an “L”-shaped pattern and a “cusp” on the ilium, and the PW was located at 1/5 to 1/4 of the posterosuperior part of the acetabulum. The fracture maps in Group B were scattered and lacked consistency, and the PWs were confined to 1/10 to 1/8 of the posterior acetabulum. Conclusions. Quantitative measurements and fracture mapping represented the differences in morphological characteristics of PWs associated with complex acetabular fractures.

The building industry currently consumes over a third of energy produced and emits 39% of greenhouse gases globally produced by human activities. The manufacturing of building materials and the construction of buildings make up 11% of those emissions within the sector. Whole-building life-cycle assessment is a holistic and scientific tool to assess multiple environmental impacts with internationally accepted inventory databases. A comparison of the building life-cycle assessment results would help to select materials and designs to reduce total environmental impacts at the early planning stage for architects and developers, and to revise the building code to improve environmental performance. The Nature Conservancy convened a group of researchers and policymakers from governments and non-profit organizations with expertise across wood product life-cycle assessment, forest carbon, and forest products market analysis to address emissions and energy consumption associated with mass timber building solutions. The study disclosed a series of detailed, comparative life-cycle assessments of pairs of buildings using both mass timber and conventional materials. The methodologies used in this study are clearly laid out in this paper for transparency and accountability. A plethora of data exists on the favorable environmental performance of wood as a building material and energy source, and many opportunities appear for research to improve on current practices.

Background: Induction chemotherapy (ICT) plus concurrent chemoradiotherapy (CCRT) and CCRT alone were the optional treatment regimens in locoregionally advanced nasopharyngeal carcinoma (NPC) patients. Currently, the choice of them remains equivocal in clinical practice. We aimed to develop a deep learning-based model for treatment decision in NPC. Methods: A total of 1872 patients with stage T3N1M0 NPC were enrolled from four Chinese centres and received either ICT+CCRT or CCRT. A nomogram was constructed for predicting the prognosis of patients with different treatment regimens using multi-task deep learning radiomics and pre-treatment MR images, based on which an optimal treatment regimen was recommended. Model performance was assessed by the concordance index (C-index) and the Kaplan-Meier estimator. Findings: The nomogram showed excellent prognostic ability for disease-free survival in both the CCRT (C-index range: 0.888-0.921) and ICT+CCRT (C-index range: 0.784-0.830) groups. According to the prognostic difference between treatments using the nomogram, patients were divided into the ICT-preferred and CCRT-preferred groups. In the ICT-preferred group, patients receiving ICT+CCRT exhibited prolonged survival over those receiving CCRT in the internal and external test cohorts (hazard ratio [HR]: 0.17, p

Global construction industry has a huge influence on world primary energy consumption, spending, and greenhouse gas (GHGs) emissions. To better understand these factors for mass timber construction, this work quantified the life cycle environmental and economic performances of a high-rise mass timber building in U.S. Pacific Northwest region through the use of life-cycle assessment (LCA) and life-cycle cost analysis (LCCA). Using the TRACI impact category method, the cradle-to-grave LCA results showed better environmental performances for the mass timber building relative to conventional concrete building, with 3153 kg CO2-eq per m2 floor area compared to 3203 CO2-eq per m2 floor area, respectively. Over 90% of GHGs emissions occur at the operational stage with a 60-year study period. The end-of-life recycling of mass timber could provide carbon offset of 364 kg CO2-eq per m2 floor that lowers the GHG emissions of the mass timber building to a total 12% lower GHGs emissions than concrete building. The LCCA results showed that mass timber building had total life cycle cost of $3976 per m2 floor area that was 9.6% higher than concrete building, driven mainly by upfront construction costs related to the mass timber material. Uncertainty analysis of mass timber product pricing provided a pathway for builders to make mass timber buildings cost competitive. The integration of LCA and LCCA on mass timber building study can contribute more information to the decision makers such as building developers and policymakers.

Background Intensity‐modulated radiotherapy (IMRT) provides excellent local control in nasopharyngeal carcinoma (NPC). We investigated whether simplifying 8th American Joint Committee on Cancer staging system T categories improves prognostic value. Methods We used 2191 NPC patients as a training set and 414 patients separately as an independent, external validation cohort. Results In the training set, local relapse‐free survival (LRFS), disease‐free survival (DFS), and overall survival (OS) were not significantly different between the 8th edition T2/T3 (P = 0.610, 0.380 and 0.353, respectively). Merging T2 and T3 to proposed T2 (proT2) provided significant differences in LRFS, DFS, and OS between proposed T categories. Proposed T categories had similar c‐indices for LRFS, DFS, and OS (vs the 8th edition), which was validated in the external cohorts. Moreover, for DFS, the adjusted HRs of the proT2N0 (3.8), proT1N1 (3.8), and proT2N1 (6.0) subsets were similar; the adjusted HRs of the proT3N0 (7.0), proT3N1 (11.4), proT1N2 (11.0), proT2N2 (11.6), and proT3N2 (13.3) subsets were similar; the adjusted HRs of the proT1N3 (17.8), proT2N3 (15.3), and proT3N3 (26.4) subsets were similar; the results of the adjusted HRs for OS had the same rule. Defining proT1N0 as stage I; proT1N1/proT2N0‐1 as stage II; proT3N0‐2/proT1‐2N2 as stage III; and proT1‐3N3 as stage IVa generated orderly, significant differences in DFS and OS between stages in the training set and external validation cohort. Conclusions In the IMRT era, three T categories are more reasonable (merging T2/T3 into T2) and proT3N0‐2 (the 8th edition T4N0‐2) should be down‐staged to stage III.

Buildings consume large amounts of materials and energy, making them one of the highest environmental impactors. Quantifying the impact of building materials can be critical to developing an effective greenhouse gas mitigation strategy. Using Athena Impact Estimator for Buildings (IE4B), this paper compares cradle-to-grave life-cycle assessment (LCA) results for a 12-story building constructed from cross-laminated timber (CLT) and a functionally equivalent reinforced concrete (RC) building. Following EN 15978 framework, environmental impacts for stages A1&ndash, A5 (product to construction), B2, B4, and B6 (use), C1&ndash, C4 (end of life), and D (beyond the building life) were evaluated in detail along resource efficiency. For material resource efficiency, total mass of the CLT building was 33.2% less than the alternative RC building. For modules A to C and not considering operational energy use (B6), LCA results show a 20.6% reduction in embodied carbon achieved for the CLT building, compared to the RC building. For modules A to D and not considering B6, the embodied carbon assessment revealed that for the CLT building, 6.57 &times, 105 kg CO2 eq was emitted, whereas for the equivalent RC building, 2.16 &times, 106 kg CO2 eq was emitted, and emissions from CLT building was 70% lower than that from RC building. Additionally, 1.84 &times, 106 kg of CO2 eq was stored in the wood material used in the CLT building during its lifetime. Building material selection should be considered for the urgent need to reduce global climate change impacts.

Distant metastasis is among the main reasons for treatment failure in nasopharyngeal carcinoma (NPC) patients. To identify patients with a high risk of distant metastasis is important to guide posttreatment surveillance, appropriate time treatments, and prolonging their long-term survival. In this study, we systematically examined the associations between a series of nodal-related characteristics and distant metastasis-free survival (DMFS) by detailed MRI reading and established a nomogram for DMFS in NPC patients. T-stage, age group, Epstein-Barr virus (EBV) level, central nodal necrosis, and nodal number were identified as independent risk factors for distant metastasis and were included into the final nomogram. The calibration plot showed a high agreement between the prediction by the nomogram and actual observations. Our established nomogram achieved a high C-index in predicting distant metastasis in both of the training cohort (0.737) and the validation cohort (0.718). This nomogram incorporated several readily available nodal features from the MR images, and it might be useful for guiding clinical decision and NPC patients' posttreatment surveillance. It also provides cues for how to redefine N-stage. Additional research is needed to confirm our conclusions.

Background The skeletal system is the most common site of distant metastasis in nasopharyngeal carcinoma (NPC); various prognostic factors have been reported for skeletal metastasis, though most studies have focused on a single factor. We aimed to establish nomograms to effectively predict skeletal metastasis at initial diagnosis (SMAD) and skeletal metastasis-free survival (SMFS) in NPC. Methods A total of 2685 patients with NPC who received bone scintigraphy (BS) and/or 18F–deoxyglucose positron emission tomography/computed tomography (18F–FDG PET/CT) and 2496 patients without skeletal metastasis were retrospectively assessed to develop individual nomograms for SMAD and SMFS. The models were validated externally using separate cohorts of 1329 and 1231 patients treated at two other institutions. Results Five independent prognostic factors were included in each nomogram. The SMAD nomogram had a significantly higher c-index than the TNM staging system (training cohort, P = 0.005; validation cohort, P

Background : The bones are the most common site of distant metastasis in nasopharyngeal carcinoma (NPC). Few prognostic markers are available to guide treatment and sub-classify patients with bone metastasis. We aimed to identify the prognostic value of pretreatment serum alkaline phosphatase (ALP) and plasma Epstein-Barr virus DNA (EBV DNA) in patients with bone-only metastasis. Methods : A total of 272 patients who developed bone-only metastases after therapy were retrospectively analyzed. Patients were categorized according to pretreatment serum ALP (< or ≥ 110 U/L) and pretreatment plasma EBV DNA (< or ≥ 6,750 copies ml-1). Univariate and multivariate analyses of clinical variables were performed using Cox proportional hazards regression models. Overall survival (OS) was analyzed using the Kaplan-Meier method and compared using the log-rank test. Results : Median OS for the cohort was 34.06 months (range, 2.53-143.87 months). Multivariate Cox proportional hazard analysis verified pretreatment serum ALP and pretreatment plasma EBV DNA were independent prognostic factors for OS. In stratified survival analysis of patients with elevated pretreatment serum ALP and/or plasma EBV DNA, delivery of radiotherapy (RT) to bone metastases provided a significant OS benefit compared to other therapeutic methods (P < 0.05). Conclusions : This study demonstrates two important points: firstly, pretreatment serum ALP and plasma EBV DNA have prognostic value at the first diagnosis of bone-only metastasis in NPC. Secondly, radiotherapy of bone metastasis improves the prognosis of patients with elevated pretreatment serum ALP and plasma EBV DNA.

Background: The C-reactive protein/albumin (CRP/ALB) ratio has recently been associated with clinical outcomes in patients suffering various types of cancer. In this retrospective study, we investigated the prognostic value of the pre-treatment CRP/ALB ratio (CAR) in non-metastatic nasopharyngeal carcinoma (NPC) patients. Methods: The cohort included 2685 patients with non-metastatic NPC. Univariate and multivariate COX proportional hazards analyses were applied to evaluate the associations of CAR with overall survival (OS), distant metastasis-free survival (DMFS), disease-free survival (DFS), and locoregional recurrence-free survival (LRRFS) in patients with NPC. Kaplan-Meier survival analyses was used to compare groups classified by CAR. Results: Patients were categorised by the CAR using a cut-off value of 0.064. Multivariate Cox proportional hazard analysis verified that high CAR level was a significant predictor for inferior OS (P = 0.003), DMFS (P = 0.035), and LRRFS (P = 0.024), but not for DFS (P = 0.093). CAR was also an independent prognostic factor for OS when stratified by Epstein-Barr virus DNA level ( ≥ 2560 or < 2560 copies ml-1). Conclusions: High CAR provides prognostication regarding OS, DMFS, DFS, and LRRFS in patients with NPC. CAR is a valuable coadjutant for Epstein-Barr virus DNA levels for identifying survival differences.

Climate change, environmental degradation, and limited resources are motivations for sustainable forest management. Forests, the most abundant renewable resource on earth, used to make a wide variety of forest-based products for human consumption. To provide a scientific measure of a product’s sustainability and environmental performance, the life cycle assessment (LCA) method is used. This article provides a comprehensive review of environmental performances of forest-based products including traditional building products, emerging (mass-timber) building products and nanomaterials using attributional LCA. Across the supply chain, the product manufacturing life-cycle stage tends to have the largest environmental impacts. However, forest management activities and logistics tend to have the greatest economic impact. In addition, environmental trade-offs exist when regulating emissions as indicated by the latest traditional wood building product LCAs. Interpretation of these LCA results can guide new product development using biomaterials, future (mass) building systems and policy-making on mitigating climate change. Key challenges include handling of uncertainties in the supply chain and complex interactions of environment, material conversion, resource use for product production and quantifying the emissions released.

Fang Wang,1 Shaobo Liang,2 Xiaowei Liu,1 Lei Han,1 Junye Wang,1 Qin Du1 1Department of Oncology, Affiliated Hospital of Jining Medical College, Jining 272029, China; 2Department of Gastroenterology, Central Hospital of Shanxian County, Heze, 274399, China Background: Increasing evidence has shown that long non-coding RNAs (lncRNAs) play important roles in the occurrence and development of human cancers. LINC00460, a novel tumor-related lncRNA, has been reported to be involved in several types of human malignancies. However, the role of LINC00460 in gastric cancer (GC) is still unclear. The present study aimed at exploring the biological role of LINC00460 in GC and illuminating the potential molecular mechanisms. Methods: In this study, qRT-PCR, western blotting, MTT assay, and Transwell invasion assay were used to conduct relevant experimental analysis. Results: Here, we found that LINC00460 was highly expressed in GC tissues and cell lines. Moreover, LINC00460 over-expression was found to promote GC cell proliferation, migration and invasion, whereas LINC00460 down-regulation significantly inhibited these processes. Notably, we confirmed that LINC00460 could up-regulate KDM2A expression by competitively binding to miR-342-3p in GC cells. Furthermore, the suppressive effects of LINC00460 down-regulation on GC cell proliferation, migration and invasion were partially reversed by a miR-342-3p inhibitor. Conclusion: In summary, our findings provide evidence for LINC00460 as a potential therapeutic target in GC. Keywords: LINC00460, KDM2A, miR-342-3p, gastric cancer

The distant metastasis free survival (DMFS) and overall survival (OS) differ significantly among individuals even within the same clinical stages. The purpose of this retrospective study was to build nomograms incorporating plasma EBV DNA for predicting DMFS and OS of nasopharyngeal carcinoma (NPC) patients after definitive radiotherapy. A total of 1168 non-metastatic NPC patients from two institutions were included to develop the nomograms. Seven and six independent prognostic factors were identified to build the nomograms for OS and DMFS, respectively. The models were externally validated by a separate cohort of 756 NPC patients from the third institutions. For predicting OS, the c-index of the nomogram was significantly better than that of the TNM staging system (Training cohort, P = 0.005; validation cohort, P = 0.03). The c-index of nomogram for DMFS in the training and validation set were both higher than that of TNM classification with marginal significance (P = 0.048 and P = 0.057, respectively). The probability of 1-, 3- and 5-year OS and DMFS showed optimal agreement between nomogram prediction and actual observation. The proposed stratification of risk groups based on the nomograms allowed significant distinction between Kaplan-Meier curves for survival outcomes. The prognostic nomograms could better stratify patients into different risk groups.

Background Intensity-modulated radiation therapy (IMRT) has represented a technical milestone that has facilitated the clinical implementation. The purpose of this study was to evaluate the prognostic value of maximum primary tumor diameter (MPTD) in patients with nasopharyngeal carcinoma (NPC) treated using IMRT. Methods Five-hundred and sixty-six patients with non-metastatic, histologically-confirmed NPC were retrospectively reviewed. MPTD was measured using magnetic resonance imaging (MRI). All patients were treated using IMRT; 87.5% (456/521) of patients with Stage T3-T4/N1-N3 disease also received cisplatin-based chemotherapy. Receiver operating characteristic (ROC) curves were used to identify the optimal MPTD cut-off point and examine the prognostic value of combining MPTD with the current T classification criteria. Results Median follow-up for all patients was 36 months (range, 1–52 months). The 3-year overall survival (OS), failure-free survival (FFS), distant metastasis-free survival (DMFS), and local relapse-free survival (LRFS) rates for patients with a MPTD ≤41 vs. >41 mm were 96.1% vs. 85.4%, 93.7% vs. 74.7%, 96.1% vs. 79.7%, and 98.1% vs. 92.9%, respectively (all P 41 mm were 96.9% vs. 84.5%, 95.4% vs. 73.5%, 96.1% vs. 79.2%, and 99.3% vs. 92.6%, respectively (all P