Search

Bone and soft tissue sarcomas with complex and varied clinical, imaging, and pathological characteristics cannot be diagnosed and treated by a single discipline, as each discipline has some limitations. This study aimed to explore the role of a multidisciplinary team (MDT) in the diagnosis and treatment of bone and soft tissue sarcomas over the past four consecutive years. The subjects were 269 patients discussed during MDT meetings at a Bone and Soft Tissue Sarcomas Center in South China. The diagnosis, relapse diagnosis, unplanned resection, management of pulmonary nodules, and treatment of refractory and advanced tumors were compared to similar data provided in the literature to (i) determine whether the MDT significantly affected the diagnosis and treatment of bone and soft tissue sarcomas, and (ii) explore trends in the types of patients with bone and soft tissue sarcomas and treatment decision-making since the establishment of the MDT. Results revealed that the MDT significantly improved preoperative diagnostic accuracy for patients with bone and soft tissue sarcomas; the accuracy of diagnosis and relapse diagnosis by the MDT reached 95.42% and 100%, respectively. After an MDT discussion, the positive pathology rate for extended resection after unplanned resection was 81.2%. The overall accuracy of the MDT in determining the nature of pulmonary nodules was 87.1–91.9%. For patients presenting with pulmonary nodules in osteosarcoma, no statistically significant difference in survival was shown between cases discussed by the MDT and those without an MDT discussion (p = 0.5751). Collectively, the MDT can play a positive role in accurate preoperative diagnosis, relapse diagnosis, the decision to extend resection after an unplanned resection, and the diagnostic accuracy of pulmonary nodules. [ABSTRACT FROM AUTHOR]

• Heat transfer characteristics of closed and circulated air cavities are obtained. • Design of insulation inside the cavity is proposed for a TW in Western China. • Indoor thermal environment of a CTW room is analyzed. Integrating the design of insulation, heat storage, and solar heating can help to improve indoor thermal environment during winter in Western China. However, insulation at night is often overlooked for Trombe walls (TWs). The present study considers a panel curtain installed in the cavity to enhance the preservation of heat of TWs at night. The effects of the structural parameters related to insulation inside the cavity on the TWs were analyzed in Western China and a design approach for insulation inside the cavity was proposed. In addition, the indoor air temperature of a TW with a built-in panel curtain (CTW) room was analyzed. The results indicate that the heat efficiency in the nighttime can be significantly improved by setting a panel curtain in the air cavity. Low emissivity film should be attached to the closed cavity side. The emissivity of the panel curtain's exterior surface plays an important role in the closed cavity and the effect is more significant with low emissivity. The optimum thickness depends on the climate, i.e., 0.02–0.06 m for a large solar radiant heat loss ratio (SHLR), 0.02–0.05 m for a medium SHLR, and 0.02–0.04 m for a low SHLR. The thickness of the circulated cavity should be larger than 0.07 m, and the effect varies within a small range when the thickness exceeds 0.1 m. A panel curtain can significantly improve the indoor air temperature in a CTW room. [ABSTRACT FROM AUTHOR]

Developing rooftop photovoltaics has become an important pathway towards carbon neutrality globally, but how to rationally implement rooftop photovoltaic development has not been investigated. This study presents a technical framework for optimizing the development scale and spatial layout of rooftop solar installations based on high-resolution generation simulation and load-oriented electricity dispatch. It is demonstrated that with the gradual expansion of rooftop development, its penetration in the electric grid grows at a decelerated speed, but the accompanying curtailment increases at an accelerated rate. Both regional sub-grid integration and improved grid flexibility marginally increase the development scale under curtailment constraint, while energy storage and trans -regional power transmission allow for significantly larger scales, thus elevating the penetration of photovoltaic generation to higher levels. The analysis reveals that the development scale should be optimized to account for regional differences in load characteristics. The optimal layout that maximizes photovoltaic penetration while minimizes photovoltaic curtailment varies with the grid flexibility and storage capacity. In China, at least 90% grid flexibility and 8–12 hours of storage capacity are required to realize 2/3 photovoltaic penetration and meet a 5% curtailment constraint. This study provides guidance for rooftop photovoltaic development in China and has implications for variable energy management in the community. • A framework is established for optimizing the scale and layout of rooftop photovoltaics. • Energy storage and load shifting support significantly larger development scales. • Scale and layout should be optimized to account for regional load differences. • At least 90% grid flexibility 8–12 h of storage capacity are necessary in China. [ABSTRACT FROM AUTHOR]

Tilt angle is a key parameter that affects solar photovoltaic (PV) power generation. Traditional empirical model based on latitude may fail to estimate the optimum tilt angle in regions with large climatic differences. In this study, we propose a framework that incorporates ground with satellite data to determine the optimum tilt angle at any location. We collect global solar radiation measurements of 133 stations in China and estimate the diffuse fraction through Boland–Ridley–Lauret model. Hourly PV power generation is modelled by considering photoelectric conversion process and PV system losses. The results show that the optimum tilt angles are highly correlated with latitude and diffuse fraction with an R of 0.86 and 0.80, respectively. Empirical models reconciled by diffuse fraction allow for spatial estimates of the optimum tilt angle from satellite data to reflect the climatic influence. Furthermore, we explore the benefit from periodically adjusting the tilt angle in China. PV panels fixed at the optimum tilt angle increase the annual power yield by 13.7% compared with horizontally fixed panels. Seasonal adjustment largely increases power yield in winter; additional yield gain of monthly adjustment is very limited; while tracking systems provide the option of achieving double or even triple gains. [Display omitted] [ABSTRACT FROM AUTHOR]

A letter to the editor and a reply are presented in response to the article regarding the health reforms in China by Tsung-Mei Cheng in the November 2012 issue.

Rooftop photovoltaics (PV) are playing an increasingly important role in building a clean and decarbonized energy system. For such distributed resources, formulating scientific development plans and incentives tailored to local conditions requires a comprehensive potential assessment at high spatial and temporal resolutions. Here, we evaluate the resource volume, power generation potential, economic feasibility, and market returns on electricity sales of rooftop PV in Jiangsu Province, China at hourly and 500-m resolutions by combining remote sensing survey, PV output simulation and load dispatching. The province's annual rooftop PV generation meets approximately 30% of the total social electricity consumption, and the entire region has reached both plant-side and user-side grid parity. Based on the case study, we investigate the suitable development scale of rooftop PV subject to different owners, as well as the impact of grid's system flexibility and energy storage on rooftop PV curtailment. For household use, the installation of a 3-kW rooftop PV is suitable, while for grid power supply, rooftop PV development needs to be sized to accommodate the grid. We find that increasing system flexibility significantly reduces PV curtailment for the same penetration rate, and that the use of energy storage helps increasing PV penetration under the curtailment constraint. This study represents a relatively extreme case of high penetration of variable solar PV generations, high uncertainty of PV outputs, and high variability in user-side loads, providing a reliable reference for rooftop PV development in other China's provinces. • Rooftop PV in Jiangsu can supply about 30% of the total social electricity demand. • 3-kW rooftop PV is economically and commercially suitable for individual residents. • Rooftop PV development for electric utility needs to be sized to accommodate the grid. • Flexible grid and energy storage increase PV penetration and decrease PV curtailment. [ABSTRACT FROM AUTHOR]

Phase change material (PCM) coupled with night ventilation (NV) is regarded as a promising cooling strategy. The suitability of PCM coupled with NV in transition and hot seasons of 10 cities in Western China was investigated based on a non-air-conditioned office building. The optimum phase change temperature (PCT) and the cooling potential of PCM coupled with NV in transition and hot seasons were determined by numerical investigations using EnergyPlus. The results showed that the optimum PCT for the 10 selected cities varied from 23 °C to 29 °C. PCM coupled with NV was suitable for application in all of the selected cities, but the PCM strategy was the best choice for the transition season in cities in severe cold zone. Applying PCM coupled with NV strategy could reduce the discomfort hours in the transition season by at least 16% compared with NV alone. In addition, the favorable outdoor air dry-bulb temperature (T out) for the application of PCM coupled with NV was obtained for the selected cities in Western China, which had the following characteristics: (1) the diurnal temperature difference (Δ T) exceeded 6.8 °C, (2) the average value (T ave) was close to 27 °C, (3) the minimum value (T min) was 2.7 °C lower than the optimum PCT and the maximum value (T max) was 1.7 °C higher than the optimum PCT. • Climatic and seasonal factors considered on PCEs coupled with NV. • Optimal phase change temperature obtained by considering seasonal suitability. • Quantitative advantages of PCEs coupled with NV compared with only NV or PCEs. • Climatic characteristics obtained using a performance-based inverse design method. [ABSTRACT FROM AUTHOR]

Background: The purpose of this study was to gather temporal trends on bacteria epidemiology and resistance of intraoperative bone culture from chronic ostemyelitis at an affiliated hospital in South China.Method: Records of patients with chronic osteomyelitis from 2003 to 2014 were retrospectively reviewed. The medical data were extracted using a unified protocol. Antimicrobial susceptibility testing was carried out by means of a unified protocol using the Kirby-Bauer method, results were analyzed according to Clinical and Laboratory Standards Institute definitions.Result: Four hundred eighteen cases met our inclusion criteria. For pathogen distribution, the top five strains were Staphylococcus aureus (27.9%); Pseudomonas aeruginosa (12.1%); Enterobacter cloacae (9.5%); Acinetobacter baumanii (9.0%) and Escherichia coli (7.8%). Bacterial culture positive rate was decreased significantly among different year-groups. Mutiple bacterial infection rate was 28.1%. One strain of Staphylococcus aureus was resistant to linezolid and vancomycin. Resistance of Pseudomonas aeruginosa stains to Cefazolin, Cefuroxime, Cefotaxime, and Cefoxitin were 100% nearly. Resistance of Acinetobacter baumanii stains against Cefazolin, Cefuroxime were 100%. Ciprofloxacin resistance among Escherichia coli isolates increased from 25 to 44.4%. On the contrary, resistance of Enterobacter cloacae stains to Cefotaxime and Ceftazidime were decreased from 83.3 to 36.4%.Conclusions: From 2003 to 2014, positive rate of intraoperative bone culture of chronic osteomyelitis was decreased; the proportion of Staphylococcus aureus was decreased gradually, and our results indicate the importance of bacterial surveilance studies about chronic osteomyelitis. [ABSTRACT FROM AUTHOR]

• The overall ARG abundance in the dry season was higher than that in the wet season. • Seasonal differences in ARGs were observed in the water but not in the sediment. • The potential HGT frequency in the water was higher than that in the sediment. • Endogenous release from the sediment was the main source for the water resistome. • The potential health risk posed by the resistome was higher in the dry season. Reservoirs play a vital role in the control and management of surface water resources. However, the long water residence time in the reservoir potentially increases the storage and accumulation of antibiotic resistant genes (ARGs). The full profiles and potential health risks of antibiotic resistomes in reservoirs are largely unknown. In this study, we investigated the antibiotic resistomes of water and sediment during different seasons in the Danjiangkou Reservoir, which is one of the largest reservoirs in China, using a metagenomic sequencing approach. A total of 436 ARG subtypes belonging to 20 ARG types were detected from 24 water and 18 sediment samples, with an average abundance of 0.138 copies/cell. The overall ARG abundance in the sediment was higher than that in the water, and bacitracin and vancomycin resistance genes were the predominant ARG types in the water and sediment, respectively. The overall ARG abundance in the dry season was higher than that in the wet season, and a significant difference in ARG subtype compositions was observed in water, but not in the sediment, between the different seasons. The potential horizontal gene transfer frequency in the water was higher than that in the sediment, and the ARGs in water mainly came from the sediment upstream of the reservoir. The metagenomic assembly identified 14 contigs as ARG-carrying pathogens including Escherichia coli , Klebsiella pneumoniae and Pseudomonas aeruginosa , and 3 of 14 carried virulence factors. Overall, the potential public health risks posed by resistomes in the water of the Danjiangkou Reservoir were higher in the dry season than in the wet season. Based on these results, strategies including sediment control and pathogen monitoring are suggested for water safety management in drinking water reservoirs. [ABSTRACT FROM AUTHOR]

Both hepatitis B virus (HBV) and aflatoxin B1 (AFB1) exposure can cause liver damage as well as increase the probability of hepatocellular carcinoma (HCC). To investigate the underlying genetic changes that may influence development of HCC associated with HBV infection and AFB1 exposure, HCC patients were subdivided into 4 groups depending upon HBV and AFB1 exposure status: (HBV(+)/AFB1(+), HBV(+)/AFB1(-), HBV(-)/AFB1(+), HBV(-)/AFB1(-)). Genetic abnormalities and protein expression profiles were analyzed by array-based comparative genomic hybridization and isobaric tagging for quantitation. A total of 573 chromosomal aberrations (CNAs) including 184 increased and 389 decreased were detected in our study population. Twenty-five recurrently altered regions (RARs; chromosomal alterations observed in ≥10 patients) in chromosomes were identified. Loss of 4q13.3-q35.2, 13q12.1-q21.2 and gain of 7q11.2-q35 were observed with a higher frequency in the HBV(+)/AFB1(+), HBV(+)/AFB1(-) and HBV(-)/AFB1(+) groups compared to the HBV(-)/AFB(-) group. Loss of 8p12-p23.2 was associated with high TNM stage tumors (P = 0.038) and was an unfavorable prognostic factor for tumor-free survival (P =0.045). A total of 133 differentially expressed proteins were identified in iTRAQ proteomics analysis, 69 (51.8%) of which mapped within identified RARs. The most common biological processes affected by HBV and AFB1 status in HCC tumorigenesis were detoxification and drug metabolism pathways, antigen processing and anti-apoptosis pathways. Expression of AKR1B10 was increased significantly in the HBV(+)/AFB1(+) and HBV(-)/AFB1(+) groups. A significant correlation between the expression of AKR1B10 mRNA and protein levels as well as AKR1B10 copy number was observered, which suggest that AKR1B10 may play a role in AFB1-related hepatocarcinogenesis. In summary, a number of genetic and gene expression alterations were found to be associated with HBV and AFB1- related HCC. The possible synergistic effects of HBV and AFB1 in hepatocarcinogenesis warrant further investigations. [ABSTRACT FROM AUTHOR]