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Introduction Postoperative pulmonary complications (PPCs) occur frequently in patients undergoing lung surgery under general anaesthesia and are strongly associated with longer postoperative hospital stays and increased mortality. The existing literature has shown that a higher level of preoperative physical activity (PA) plays a positive role in the low incidence of postoperative complications and the quality of life in patients undergoing lung surgery. However, the association between preoperative PA levels and the incidence of PPCs has rarely been studied, particularly in thoracoscopic lung surgery. This study aims to evaluate PA levels in patients undergoing thoracoscopic lung surgery using the International Physical Activity Questionnaire and to investigate the association between PA levels and the incidence of PPCs.Methods and analysis A total of 204 participants aged 18–80 years undergoing thoracoscopic lung surgery (thoracoscopic wedge resection, thoracoscopic segmentectomy and thoracoscopic lobectomy) will be included in the study. The primary outcome is the incidence of PPCs within the first 5 postoperative days. The secondary outcomes include the number of PPCs, the incidence of PPCs 1 month postoperatively, the arterial blood levels of inflammatory markers, the incidence of postoperative adverse events within the first 5 postoperative days, extubation time, unplanned admission to the intensive care unit, postoperative length of stay and mortality 1 month postoperatively.Ethics and dissemination The study was reviewed and approved by the Research Ethics Committee of the First Affiliated Hospital of Shandong First Medical University on 31 March 2022 (YXLL-KY-2022(014)) and is registered at ClinicalTrials.gov. We plan to disseminate the data and findings of this study in international and peer-reviewed journals.Trial registration number The trial has been prospectively registered at the clinicaltrials.gov registry (NCT05401253).

ObjectiveDepression and schizophrenia (SCH) were accompanied by an acute phase response (APR) that was implicated in the alterations in total protein (TP), albumin, and globulin levels. The aims of this study are to examine serum TP, albumin, globulin levels, depressive symptoms, and their associations in patients with SCH.MethodsWe recruited 34 patients with SCH and 136 healthy controls (HCs) according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). Psychiatric symptoms and biomarkers were assessed using the Chinese version of the Positive and Negative Syndrome Scale (PANSS) as well as the bromocresol green and biuret methods.ResultsSerum TP (F = 46.11, p < 0.001, η2 = 0.19), albumin (F = 31.69, p < 0.001, η2 = 0.14), and globulin (F = 12.48, p < 0.001, η2 = 0.06) levels were lower in patients than those in HCs after adjusting for covariates. Serum TP (r = −0.37, p = 0.03) and albumin (r = −0.37, p = 0.03) levels were negatively correlated with depressive score in patients. Stepwise multivariate regression analysis showed the negative associations of depressive score with serum TP (β = −0.13, t = −2.92, p = 0.007), albumin (β = −0.23, t = −2.36, p = 0.03), and globulin (β = −0.16, t = −2.40, p = 0.02) levels in patients. Serum TP, albumin, and globulin levels exhibited the accuracies of 87.1, 70.0, and 69.4% in discriminating between patients and HCs (area under the curve [AUC]: 0.78, 0.68, and 0.77; sensitivity/specificity: 52.9%/95.6%, 55.9%/73.5%, and 76.5%/67.6%).ConclusionOur data suggested that decreased serum TP, albumin, and globulin should be regarded as the SCH risk factors and were implicated in the depressive severity of SCH, which further provided the support for the hypothesis that SCH and depression were accompanied by the abnormal inflammatory cytokines with the APR.

Although the 2021 Western North America (WNA) heat wave was predicted by weather forecast models, questions remain about whether such strong events can be simulated by global climate models (GCMs) at different model resolutions. Here, we analyze sets of GCM simulations including historical and future periods to check for the occurrence of similar events. High- and low-resolution simulations both encounter challenges in reproducing events as extreme as the observed one, particularly under the present climate. Relatively stronger amplitudes are observed during the future periods. Furthermore, high- and low-resolution short initialized GCM simulations are both able to reasonably predict such strong events and their associated high-pressure ridge over the WNA with a 1 week forecast lead time. Moisture sensitivity experiments further indicate a drier atmospheric moisture condition results in substantially higher near-surface temperatures in the simulated heat events.

BACKGROUND AND AIMS: Despite the substantial impact of environmental factors, individuals with a family history of liver cancer have an increased risk for HCC. However, genetic factors have not been studied systematically by genome-wide approaches in large numbers of individuals from European descent populations (EDP). APPROACH AND RESULTS: We conducted a 2-stage genome-wide association study (GWAS) on HCC not affected by HBV infections. A total of 1872 HCC cases and 2907 controls were included in the discovery stage, and 1200 HCC cases and 1832 controls in the validation. We analyzed the discovery and validation samples separately and then conducted a meta-analysis. All analyses were conducted in the presence and absence of HCV. The liability-scale heritability was 24.4% for overall HCC. Five regions with significant ORs (95% CI) were identified for nonviral HCC: 3p22.1, MOBP , rs9842969, (0.51, [0.40-0.65]); 5p15.33, TERT , rs2242652, (0.70, (0.62-0.79]); 19q13.11, TM6SF2 , rs58542926, (1.49, [1.29-1.72]); 19p13.11 MAU2 , rs58489806, (1.53, (1.33-1.75]); and 22q13.31, PNPLA3 , rs738409, (1.66, [1.51-1.83]). One region was identified for HCV-induced HCC: 6p21.31, human leukocyte antigen DQ beta 1, rs9275224, (0.79, [0.74-0.84]). A combination of homozygous variants of PNPLA3 and TERT showing a 6.5-fold higher risk for nonviral-related HCC compared to individuals lacking these genotypes. This observation suggests that gene-gene interactions may identify individuals at elevated risk for developing HCC. CONCLUSIONS: Our GWAS highlights novel genetic susceptibility of nonviral HCC among European descent populations from North America with substantial heritability. Selected genetic influences were observed for HCV-positive HCC. Our findings indicate the importance of genetic susceptibility to HCC development.

The light weight and high strength-to-mass ratio of thin-walled boxed sections have incited interest in their widespread use in the construction of domes. However, the installation of these sections in forming the dome geometry has induced initial twists and curving features, to which their mechanical response has rarely been explored. Therefore, the structural performance of a structure with thin-walled twisted box sections is numerically studied in this paper, employing ANSYS, the verification of which is carried out through a comparison with experimental results. Additional components examined include the longitudinal stiffening rib, diaphragm, and web. The effects of variations in the thicknesses of these member plates on the mechanical behaviors are investigated. In general, the ultimate capacity of the structure is improved by increasing the thickness of the longitudinal stiffening rib, diaphragm, and web, but the strengthening effect of the stiffener is limited by a certain thickness enhancement. The common failure mode of the initial model is found to be an overall elastic-plastic buckling. A reduction in the thickness of the stiffener or web creates a curving deformation zone in the lower arch at the ultimate capacity, whereas the diaphragm thickness has little effect on the failure mode of the model.

Tropical cyclone (TC) projections with atmosphere-only models are associated with uncertainties due to their inability to represent TC-ocean interactions. However, global coupled models, which represent TC-ocean interactions, can produce basin-scale sea surface temperature biases in seasonal to centennial simulations that lead to challenges in representing TC activity. Therefore, focusing on recent individual major hurricane events, we investigated the influence of TC-ocean coupling on the response of TCs to anthropogenic change using atmosphere-only and coupled atmosphere-ocean regional model simulations. Under an extremely warm scenario, coupling does not influence the signs of projected TC rainfall and intensity responses. Coupling, however, does influence the magnitude of projected intensity and especially rainfall. Within a 500 km radius region of the TCs, the projected rainfall increases in coupled simulations are 3–47 % less than in the atmosphere-only simulations, driven by enhanced TC-induced sea surface temperature cooling in the former. However, the influence of coupling on the magnitude of projected rainfall could vary considerably over the regions of highest rainfall generated by TCs.

Neonicotinoid insecticides are among the most used insecticides and their residues are frequently found in surface water due to their persistence and mobility. Neonicotinoid insecticides exhibit toxicity to a wide range of aquatic invertebrates at environmentally relevant levels, and therefore their contamination in surface water is of significant concern. In this study, we investigated the spatiotemporal distribution of six neonicotinoids in a large wetland system, the Prado Wetlands, in Southern California, and further evaluated the wetlands' efficiency at removing these insecticides. Total neonicotinoid concentrations in water ranged from 3.17 to 46.9 ng L-1 at different locations within the wetlands, with imidacloprid and dinotefuran among the most detected. Removal was calculated based on concentrations as well as mass flux. The concentration-based removal values for a shallow pond (vegetation-free), moderately vegetated cells, densely vegetated cells, and the entire wetland train were 16.9%, 34.2%, 90.2%, and 61.3%, respectively. Principal component analysis revealed that pH and temperature were the primary factors affecting neonicotinoids removal. Results from this study demonstrated the ubiquitous presence of neonicotinoids in surface water impacted by urban runoff and wastewater effluent and highlighted the efficiency of wetlands in removing these trace contaminants due to concerted effects of uptake by wetland plants, photolysis, and microbial degradation.

Predicted decrease in water availability for crop production and uncertainty in climatic conditions require devising the irrigation strategies to increase water use efficiency (WUE) for sustainable crop production. The development of crop cultivars with higher WUE is a pre-requisite for such strategies, particularly in developing countries, including Pakistan, who face stern food security challenges. A two-year field study was conducted following a split-plot randomized complete block design to understand the effects of wheat cultivars (hybrid cultivars, 18A-1 and 18A-2, and local cultivar Ghaneemat IBGE-2016), sowing dates (15th November, 30th November, and 15th December), and irrigation regimes [I (103 mm), II (175 mm), III (254 mm), and IV (330 mm)] at four different growth stages of tillering, booting, anthesis and grain filling on wheat productivity, biomass production and grain yield, and crop-water relations. Early sown hybrid cultivars 18A-1 and 18A-2 showed significantly higher biological and grain yields compared to the local cultivar (59% and 69% higher than the local cultivar). Trends in biomass production and grain yield were also similar at later sowing dates of 30th November and 15th December. However, biological and grain yields decreased with delay in sowing for each cultivar. The data also revealed that hybrid cultivars were better suited to deficient irrigation and generally produced significantly higher biological and grain yields under each moisture regime. Cultivars, sowing dates, and irrigation regime differed significantly for their effects on the Soil Plant Analysis Development (SPAD) values, chlorophyll a and b contents but not for carotenoids. Sowing dates and irrigation regimes had significant effects on relative water content (RWC), water saturation deficit (WSD), water uptake capacity (WUC), and water retention capacity (WRC); however, only WUC varied significantly between the cultivars. The phenological data show that hybrid cultivars took more days to maturity and grain filling than the local cultivar, and days decreased with delayed sowing. The biological and grain yields show significant positive correlations with SPAD values (p < 0.001) and days to maturity (p < 0.001). Our study shows that hybrid wheat cultivars can be opted for higher biomass production and grain yields under deficit irrigation scenarios of semi-arid climatic conditions in Pakistan. Moreover, the hybrid wheat cultivars can perform better than the indigenous cultivar even for delayed sowing dates of 30th November and 15th December.

Brain metastasis (BM) has been universally recognized as a poor prognostic factor in non-small cell lung cancer (NSCLC). Epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) have shown efficacy in treating BM with an EGFR mutation. This paper reports a case of BM patient with EGFR-mutated NSCLC. According to the findings, a complete remission (CR) of the BM was achieved by icotinib treatment without conducting a radiotherapy, which was followed by a resection of the primary lung cancer lesion and lymph nodes. After one-year follow-up, the disease progressed to liver metastasis and liver lesion biopsy showed a T790M mutation. The patient responded well to the combination treatment of AZD9291 and icotinib after the failure of transcatheter arterial chemoembolization (TACE). This case report suggests that icotinib has a sustainable anticancer response to BM and the combination with icotinib and AZD9291 is effective for liver metastasis with T790M.

Nanomaterials based colorimetric detection is an area of vital importance in the field of sensing applications. The nanoparticles are the main component of colorimetric sensor in replacing the natural enzyme based sensor. In this context, zero valent nanoparticles have revolutionized the field of optical sensing especially due to easily shift of electron, facile and low cost of preparation, and ease of surface modification. In this work, zero valent manganese nanoparticles (ZV-Mn NPs) are prepared through a simple and very quick method and modulated with new type of ionic liquid (IL). As-prepared materials were characterized through FE-SEM, HR-TEM, BET, FTIR, and XRD. Subsequently, the peroxidase like catalytic activity of pure and modified ZV-Mn NPs to catalyze oxidation of N,N′,N,N′-tetramethylbenzidine (TMB) in the presence of hydrogen peroxide (H _2 O _2 ) investigated. Moreover, the absorbance peak is observed at wavelength 652 nm. The enhanced catalytic activity of ZV-Mn NPs was attributed to the fast transfer of electron mechanism in between substrate and H _2 O _2 . The coating of IL on ZV-Mn NPs permitted a low limit of detection 0.2 μ M with a linear range of 10–280 μ M. This work can find wide spread interest in the colorimetric sensing applications. In order to verify the successful demonstration of H _2 O _2 sensor, we have applied it in the dairy milk products with satisfactory results.

This paper provides an improved decision making approach based on fuzzy numbers and the compositional rule of inference by Yao and Yao (2001). They claimed to have created a new method that combines statistical methods and fuzzy theory for medical diagnosis. Currently, numerous papers have cited that work. In this study, we show that if we follow their matrix multiplication operation approach, we will obtain the same result as the original method proposed by Klir and Yuan (1995). Owing to a wellknown property of (row) stochastic matrices, if the multiplication is closed, the fuzzy and defuzzy procedure of Yao and Yao (2001) is redundant. Therefore, we advise researchers to think twice before applying this approach to medical diagnosis.