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Background: Serum Krebs von den Lungen‐6 (KL‐6) has been reported to be elevated in patients with idiopathic pulmonary fibrosis (IPF). Objective: The aim of this study was to evaluate the diagnostic value of KL‐6 and whether the expression value of KL‐6 could indicate the severity of the disease in IPF patients. To address this question, it is necessary to see whether the patients' physical characteristics and other clinical conditions could affect the baseline KL‐6 level. Design We conducted a study of 100 patients who were diagnosed with IPF. Lung function, computed tomography (CT), and serological lab tests data were analyzed. Results: The tests showed that there is a significant elevation of KL‐6 in IPF patients compared with other interstitial lung disease (ILD) and healthy controls. It was noted that serum KL‐6 is a stable biomarker not affected by lung infection and smoking, though IPF patients with antinuclear antibody (ANA) showed higher KL‐6 levels. KL‐6, in conjunction with poor pulmonary function and higher radiological fibrosis scores, indicates the severity of the disease but not poor survival. Conclusions: It is identified that serum KL‐6 is a useful noninvasive biomarker to help improve the certainty of IPF diagnosis from other interstitial lung disease and assist evaluation of disease severity and prognosis. [ABSTRACT FROM AUTHOR]

To put the brakes on global climate change, China, the world's top emitter, has established ambitious CO 2 emissions reduction targets. Industry-level emissions analysis can help policymakers determine better ways to achieve mitigation targets. This study is the first to target the total-factor carbon emission performance (TCPI) of secondary and service industries. We first compile industry-level CO 2 emission inventories of 25 Yangtze River Delta cities during 2007–2016. The TCPI of secondary and service industries is then estimated by the non-radial directional distance function. We then compare the TCPI of the two industries across levels, dynamics, and inequalities using a global metafrontier approach. The results show the TCPI of the service industry (0.563 in 2016) was significantly higher than that of secondary industry (0.256 in 2016), suggesting that the service industry was more carbon-friendly. The TCPI gap between the secondary and service industries narrowed over the study period. The TCPI of secondary industry showed a promising increase during 2007–2016 with an annual growth rate of 2.30%, reflecting the positive effects of the government's reforms and environmental regulations. By contrast, the service industry saw a downward trend in TCPI, decreasing by 1.68% annually, primarily because it is a newcomer to low-carbon development. TCPI inequality in secondary industry was much larger than in the service industry, suggesting that significant heterogeneity exists in secondary industry. Therefore, policymakers should implement targeted mitigation policies for secondary industry, and place decarbonising the service industry on the agenda to reverse its decreasing TCPI. Image 1 • Carbon emission performance of secondary and service industries is investigated. • Service industry is more carbon-friendly than secondary industry. • The gap in carbon emission performance between secondary and service industries narrows. • Secondary industry has greater heterogeneity of carbon emission performance than service industry. [ABSTRACT FROM AUTHOR]

• CO 2 emission inventories of shrinking and growing cities are compiled. • Emission patterns of various shrinking and growing cities are investigated. • CO 2 emission mitigation of shrinking cities occurred with the decline of secondary industry. • Growing cities can achieve emissions mitigation with economic growth. • Results are helpful for shrinking and growing cities' sustainable development. The implementation of CO 2 emission mitigation policies in cities is the key to China achieving its national emission mitigation targets. China is experiencing rapid urbanization and facing huge inequality in regional development and then shrinking cities generate. This study, for the first time, discusses long-term CO 2 emission patterns of shrinking cities with comparisons of growing cities. 55 cities in Northeast China and the Yangtze River Delta are selected as cases. We first categorize these cities into three groups of shrinking cities and three groups of growing cities with a population index. Each group's emission patterns in terms of energy, employment and industry structures are then examined. We find that CO 2 emissions in the rapidly shrinking group presented a continuously increasing trend, while the other five groups reached their emission peaks in 2011–2013. For slightly and moderately shrinking groups, CO 2 emission mitigation was a positive sign but occurred with the decline of secondary industry, especially for resource-based or heavy manufacturing cities, such as Daqing and Anshan in Northeast China. In the case of three types of growing cities, cities were capable of mitigating CO 2 emissions and maintaining economic growth. The slightly growing group was the optimal type among these six groups. Its CO 2 emissions experienced a decline with an annual rate of −1.47% during 2013–2015, while the economy still soared (increased by 7.27% annually). New economic growth points should be fostered to mitigate further shrinkage and achieve sustainable development for shrinking cities. The cities' categorization rules, research thinking, and results offered in this study could provide a reference for other cities or developing countries at similar industrialization/urbanization phases to abbreviate their path towards a low-carbon economy. [ABSTRACT FROM AUTHOR]

Background: Primitive neuroectodermal tumors (PNETs) constitute a rare type of malignant neuroectodermal tumors that have chromosomal translocations identical to Ewing's sarcoma (ES), and the characteristics of this disease remain unclear. Purpose: To describe the clinical, radiological, and pathological features of peripheral PNETs (pPNETs) to enhance their recognition. Material and Methods: The clinical, imaging, and pathologic findings of 35 patients with pPNETs were retrospectively reviewed, all being confirmed by biopsy or surgical pathology. All 35 patients had preoperative computed tomography (CT) examinations; 10 patients had preoperative magnetic resonance imaging (MRI) studies. Results: Of 35 pPNET patients, 54.3% had a primary tumor in soft tissue, the others in bone. On plain CT images, 33 lesions demonstrated heterogeneous hypodense masses with multiple lamellar lower density, and with osteolytic destruction if the tumor originated in bone. Calcification was only found in five lesions arising in soft tissue. All lesions enhanced heterogeneously with varying areas of cystic changes, and all lesions in bone and 52.6% of lesions in soft tissue showed ill-defined margins after contrast administration. On MRI, these tumors appeared in conjunction with osteolytic bone destruction and irregular soft tissue masses iso- to hypointense to skeletal muscle on T1-weighted images and showed heterogeneously high intensity on T2-weighted images. All lesions enhanced heterogeneously with cystic changes. Homer-Wright rosettes were observed in 15 lesions, and 97.1% lesions were positive for CD99 in histopathological results. Conclusion: pPNETs can involve any part of the body, and a large, ill-defined, aggressive soft tissue mass and heterogeneous enhancement with or without osteolytic bone destruction on CT or MR images could suggest the diagnosis. [ABSTRACT FROM AUTHOR]

The association between sarcopenia and prognosis in patients with cirrhosis remains to be determined. In this study, we aimed to quantify the association between sarcopenia and the risk of mortality in patients with cirrhosis, stratified by sex, underlying liver disease etiology, and severity of hepatic dysfunction. PubMed, Web of Science, EMBASE, and major scientific conference sessions were searched without language restriction through 13 January 2021 with an additional manual search of bibliographies of relevant articles. Cohort studies of ≥100 patients with cirrhosis and ≥12 months of follow-up that evaluated the association between sarcopenia, muscle mass and the risk of mortality were included. Twenty-two studies involving 6,965 patients with cirrhosis were included. The pooled prevalence of sarcopenia in patients with cirrhosis was 37.5% overall (95% CI 32.4%-42.8%), and was higher in male patients, those with alcohol-associated liver disease, those with Child-Pugh grade C cirrhosis, and when sarcopenia was defined by L3-SMI (third lumbar-skeletal muscle index). Sarcopenia was associated with an increased risk of mortality in patients with cirrhosis (adjusted hazard ratio [aHR] 2.30, 95% CI 2.01-2.63), with similar findings in a sensitivity analysis of patients with cirrhosis without hepatocellular carcinoma (aHR 2.35, 95% CI 1.95-2.83) and in subgroups stratified by sex, liver disease etiology, and severity of hepatic dysfunction. The association between quantitative muscle mass index and mortality further supports the association between sarcopenia and poor prognosis (aHR 0.95, 95% CI 0.93-0.98). There was no significant heterogeneity in any of our analyses. Sarcopenia was highly and independently associated with higher risk of mortality in patients with cirrhosis. The prevalence of sarcopenia and its association with death in patients with cirrhosis remain unclear. This meta-analysis indicated that sarcopenia affected about one-third of patients with cirrhosis and up to 50% of patients with alcohol-related liver disease or Child-Pugh class C cirrhosis. Sarcopenia was independently associated with an ∼2-fold higher risk of mortality in patients with cirrhosis. The mortality rate increased with greater severity or longer durations of sarcopenia. Increasing awareness about the importance of sarcopenia in patients with cirrhosis among stakeholders must be prioritized. [Display omitted] • The overall prevalence of sarcopenia among patients with cirrhosis is 37.5%, with higher prevalence in males, patients with alcohol-related liver disease, and greater severity of cirrhosis. • The 1-, 3-, and 5-year cumulative probabilities of survival in patients with sarcopenia were 76.6%, 64.3%, and 45.3%, respectively. By comparison, they were 93.4%, 82.0%, and 74.2%, respectively in patients without sarcopenia • Sarcopenia is associated with an approximately 2-fold higher risk of death in patients with cirrhosis • Every 1 cm2/m2 increase in L3-SMI and 1 mm/m increase in umbilicus-TPMT were associated with a 3% and 12% decrease in mortality risk, respectively. [ABSTRACT FROM AUTHOR]

As energy security has been an increasingly hot topic in research, a reliable and sound framework for allaying energy security is necessary. In this paper, it establishes a methodological framework based on quantitative and qualitative approaches for measuring and improving energy security from a broad sense. Firstly, it interprets the conceptual framework of energy security composed by seven dimensions, and 28 indicators are designed for its assessment. Then, Fuzzy AHP is used to indicate the importance of the dimensions and indicators, and the hybrid model of GRA-TOPSIS is introduced to evaluate energy security performance. Further, a qualitative root cause analysis is conducted with Why-Why Diagram to identify the possible causes affecting energy security. After that, a case study is conducted to investigate energy security of Henan province in China within the period of 2005–2017. The results indicate that, energy security is no longer a single-dimensional concept, but a synthetic term, and the technological, environmental, social, even political aspects can be improved to enhance energy security. The methodological framework with quantitative and qualitative techniques can help achieve an all-around understanding of energy security. • Comprehensive criteria for assessing reginal energy security were developed. • Both quantitative and qualitative analysis for regional energy security were carried out. • Fuzzy AHP was employed to determine the weights of the criteria for energy security. • GRA-TOPSIS was used for security quantitative assessment. • Why-Why Diagram was used to identify the critical factors affecting regional energy security. [ABSTRACT FROM AUTHOR]

The liver is essential for the regulation of energy, protein and amino acids, as well as in other aspects of metabolism. To identify efficient indexes for evaluation of nutritional status and metabolic characteristics during different Child-Pugh stages of hepatitis B cirrhosis, 83 patients and 35 healthy individuals were enrolled in our study. We found that grip strength, triceps skinfold thickness (TSF), body fat and skeletal muscle of the patients were reduced compared to the control group (P<0.05). Ultra-high-performance liquid chromatography data combined with mass spectrometry (UPLC-MS) showed that levels of a variety of metabolites, including lysophosphatidylcholines (LysoPCs), glycerophosphocholine, ornithine and glucuronic acid were reduced in the serum of patients with hepatitis B cirrhosis (P<0.001). However, glycerophosphoserine and taurocholic acid levels were higher than in the control group (P<0.001). Moreover, grip strength was correlated with the Child-Pugh score (P<0.05). Serum albumin, total cholesterol, LDL, LysoPCs, glycerophosphocholine, ornithine, glucuronic acid, glycerophosphoserine and taurocholic acid were correlated with the Child-Pugh score (P<0.01). These findings suggested that grip strength and the above small molecular substances might be considered as sensitive and important indexes for evaluating nutritional status and metabolic characteristics of patients with hepatitis B cirrhosis, which may help assess prognosis and adjust nutritional treatment. [ABSTRACT FROM AUTHOR]

This study provided a new idea for the preparation of magnetic nanoparticles using organic rectorite as a carrier, and a novel magnetic adsorbent, chitosan/organic rectorite-Fe 3 O 4 composite microspheres (CS/χOREC-Fe 3 O 4 ), was synthesized. The structure and physical properties of CS/χOREC-Fe 3 O 4 were characterized by XRD, SEM, TEM, FT-IR, TG, M s and XPS and its adsorption properties for removal of 3 mg/L heavy metal ions under different conditions were also investigated. The results showed that the CS/χOREC-Fe 3 O 4 microspheres exhibited excellent adsorption capacity for removing metal ions compared with the corresponding OREC-Fe 3 O 4 or chitosan alone. The adsorption process was fitted to Langmuir model and pseudo-second-order kinetic model. The E a and ΔG revealed that the adsorption of Cu (II) and Cd (II) proceeded with a low potential energy and all the adsorption processes were spontaneous. Further recycle experiments exhibited the adsorption capacity of adsorbent still maintained above 55% after the 4th cycle. All results implied that CS/χOREC-Fe 3 O 4 could be used as a promising adsorbent. [ABSTRACT FROM AUTHOR]

Chitosan/rectorie (CTS/REC) nano-hybrid composite microsphere was prepared by changing the proportion of CTS/REC with 2:1, 3:1 and 4:1. Compared with the pure cross-linking chitosan microsphere, the nano-hybrid composite microsphere was proved to have better sorption capacity of Cd(II), Cu(II) and Ni(II), especially 2:1(CTS/REC-1). The adsorption behavior of the microsphere of Cd(II), Cu(II) and Ni(II) was investigated in single and binary metal systems. In single system, the equilibrium studies showed that the adsorption of Cd(II), Cu(II) and Ni(II) followed the Langmuir model and the pseudo-second-order kinetic model. The negative values of (Δ G ) suggested that the adsorption process was spontaneous. In binary system, the combined action of the metals was found to be antagonistic and the metal sorption followed the order of Cu(II) > Cd(II) > Ni(II). The regeneration studies indicated that EDTA desorbed Cd(II), Cu(II) and Ni(II) from cross-linking microspheres better than HCl. The FT-IR and XPS spectra showed that coordination bonds were formed between Cd(II), Cu(II) and Ni(II) and the nitrogen atoms of cross-linking CTS/REC nano-hybrid composite microspheres. [ABSTRACT FROM AUTHOR]

In this study, magnetic particles were prepared using organic rectorite as a carrier, and then a novel magnetic adsorbent named chitosan/organic rectorite-Fe 3 O 4 intercalated composite microspheres (CS/Mt-OREC microspheres) was synthesized. The microspheres were characterized by XRD, FT-IR, TEM, SEM and VSM. The effects of adsorbent dosage, initial pH, contact time, temperatures, initial concentrations of methylene blue (MB) and methyl orange (MO) were studied. The adsorption process followed the pseudo-second-order kinetics, and the intra-particle diffusion was one but not the only rate-limiting step. The adsorption equilibrium data can be well described by Langmuir model. Thermodynamic parameters such as Δ G , Δ H , and Δ S were estimated to understand the adsorption mechanism of dyes. Moreover, CS/Mt-OREC microspheres were successfully regenerated using NaOH and HCl, and could be easily separated from aqueous solution in magnetic field. [ABSTRACT FROM AUTHOR]

Esophageal squamous cell carcinoma (ESCC) is prevalent in Yanting (YT) country located in southwestern China. Residents in the YT region have an unusual diet pattern and the role of the YT diet on the risk of ESCC is still uncertain. The present study was to examine the possible effects of sera from rats fed with the YT diet on proliferation of human esophageal cancer cell line Eca-109 by means of a sero-physiology approach. Firstly, two feasibilities were assessed to set up the sero-physiology method. We found that rats fed with a human adult diet in Chengdu region (ESCC-low-risk-area) for 30d had very close body weight gains in comparison with the control rats fed with the conventional diet, confirming the feasibility of feeding rats with a human diet without affecting their normal growth. Cell growth results showed that 5% non-deactivated rat serum had exactly the same effect on the proliferation of Eca-109 cells compared with the fetal bovine sera (FBS) control, confirming the feasibility of cultivating Eca-109 cells with the rat serum instead of FBS. Subsequently, cell proliferation results indicated that rats' sera fed with the YT diet significantly promoted Eca-109 cells proliferation but inhibited human normal liver epithelial cell line control HL7702 proliferation, whereas rats' sera fed with the Chengdu diet didn't have these effects on the two cell lines. The different effects of the two human diets on proliferation of Eca-109 cells demonstrated that the sero-physiology method is effective in studying the relationship between diet and cancer, and there maybe exist cancer-promoting factors in the YT diet. [ABSTRACT FROM AUTHOR]

As the basis of urban social-economic development, water and energy resources are indivisible and interrelated in the production and consumption activities of cities. The frequent intercity trade of energy-related goods aggravates water withdrawal in neighboring cities and causes the spatial transfer of resources. The spatial correlation of water withdrawal and energy consumption is rarely considered in the city-level water-energy nexus. As one of China's most serious water shortage regions, Hebei Province is the third-largest energy consumer in China and is a major supplier of mineral resources, industrial raw materials, water resources, electricity, and agricultural products to Beijing and Tianjin. The spatial Durbin model with the two-way fixed effects is applied to explore spatial effects of water-energy nexus in cities of Heibei province. Seven influencing factors, including energy consumption, energy structure, population, GDP, water withdrawal intensity, urbanization, and agriculture structure were considered. Results showed that all factors had positive impacts on water withdrawal except energy structure. Water withdrawal intensity made the most considerable contribution to water withdrawal, followed by urbanization, energy consumption, GDP, industrial structure, and population. The urbanization level of neighboring cities exerted the most significant positive spatial spillover impact on local water withdrawal, whereas the energy consumption showed a negative impact. The exploration of city-level spatial correlation regarding water withdrawal and energy consumption provides a reference for regional cooperation to improve resource utilization efficiency, establishing sustainable energy and water systems, and promoting sustainable development. [ABSTRACT FROM AUTHOR]