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To lay a solid basis for prosperity and competitiveness, countries should achieve balance in the three fundamental aspects: energy availability, energy affordability and ecological balance. Nuclear energy has attracted international interest as one of the most crucial environmental quality strategies. The objective of this study is to analyze the non-linear link between nuclear energy and environmental quality in the top-10 nuclear energy consumer countries (USA, China, Russia, France, Canada, Spain, Sweden, South Korea, Ukraine, and Germany). Earlier research employed panel data methodologies to examine the linkage between nuclear energy and the environment, despite the fact that many nations did not independently demonstrate such a correlation. On the alternative, this study uses a novel approach known as ‘Quantile-on-Quantile,’ which allows for the analysis of time-series dependence in each country by giving universal yet country-specific insights into the relationship between the variables. Estimates show that the consumption of nuclear energy improves environmental quality by lowering ecological footprint in the majority of the nations studied at certain quantiles of data. Moreover, the data demonstrate that the degree of asymmetries between our variables changes by nation, emphasizing the importance of policymakers exercising caution when adopting nuclear energy and environmental quality regulations.

A novel concept is described here that utilizes externally applied heat to a solid rod of reconstituted tobacco biomass to form a stream of aerosol under progressively oxygen-deficient atmosphere. The boundary of auto-ignition was determined at oxygen concentrations of 0%, 5%, 10%, and 21% and then the effects of these different atmospheres on various parameters were studied. Experimental results indicated that the ignition temperature decreased with the increase of oxygen concentration and a negative temperature coefficient (NTC) for atmosphere with oxygen was observed at before but close to ignition temperature. Significant differences in the yields of CO and CO2 between oxygen and oxygen-free atmosphere were observed. The mass of aerosol produced under an inert atmosphere and reduced-oxygen atmosphere were characterized with selected volatile and semi-volatile components, phenols, aldehydes, and other organic compounds of interests. In addition, higher oxygen concentration resulted in higher bulk and surface oxygen content of solid-phase residue, the reduction of carbon and hydrogen element content and related functional groups, and the content of inorganic compounds also exhibited an increase with oxygen concentration. By systematically changing oxygen concentrations of the biomass bed with increasing temperatures, an aerosol stream of controlled chemical composition and yields could be formed without leading to ignition. Key chemical markers of inhalation harm were measured and compared to each other under different degrees close to combustion. Studying reconstituted tobacco or other biomass materials in such a way could provide alternative and useful information in the design heated biomass aerosol generators.

A lit cigarette forms a positive and negative pressure zone by a puff with respect to the position of its paper burn line. Smoke aerosols generated from the two zones are then pulled through the rod under the puff to form the mainstream smoke. This phenomenon is fundamental to the thermophysics and the resultant chemical composition of the mainstream smoke. In this study, we created two different airflow pathways inside a heated tobacco rod by a puff, and investigated the differences in aerosol formation and its chemical compositions. The two different pressure-induced conditions, one through an open-ended tobacco rod (marked as HNB, a label of a designed airflow pathway of commercial heated tobacco products called heat-not-burn prior), and the other through a closed-ended tobacco rod (marked as NSC, a label of a novel-designed airflow pathway of heated tobacco products), were compared for their aerosol collected mass (ACM), the contents of nicotine, water and added aerosol agents such as propylene glycol (PG) and glycerol (VG), as well as selected aldehydes and ketones in the mainstream aerosol. Aerosol particle distribution and the heated temperature along different rod locations were also compared during a puff. The results indicated marked differences in the aerosol formation processes between the two HNB and NSC systems. The transfer ratios of the main aerosol components were significantly higher for the NSC; the levels of formaldehyde and acetaldehyde were significantly lower under the NSC than the HNB condition. There were also significant differences for the aerosol particle number concentration (APNC) and count median diameter (CMD) for the two systems. The lack of convective heat transfer in the aerosol formation under the NSC condition resulted in a relatively stable thermal aerosol generation zone, reflected by the temperature difference between the two systems in the selected locations. The NSC mode of tobacco heating thus offers a novel and enhanced aerosol generation for heat tobacco product designs.

This study extends the social influence factor in the Unified Theory of Acceptance and Use of Technology (UTAUT) model by delineating it into coercive, normative, and mimetic pressures based on institutional theory. It investigates the role of each institutional pressure in influencing the behavioural intention of accounting lecturers in Malaysia's public universities to use Information and Communications Technology (ICT)-enhanced student-centred teaching methods. Using a purposive sampling method, self-report questionnaires were distributed to accounting lecturers in Malaysia's public universities offering undergraduate accounting programmes. This resulted in 114 usable questionnaires. The hypothesized relationships were tested using structural equation modeling via Smart-PLS software. Only coercive and normative pressures were found to have a significant and positive influence on behavioural intention. Mimetic pressures had an insignificant influence on behavioural intention. The findings of this study are useful to authorities in the higher education sector and practitioners who have been encouraging the student-centred teaching movement. This study provides further enlightenment on which social factors yield the most effects at the present moment and which social factors need greater work to yield better effects on increasing lecturers' behavioural intentions as a whole.

Abstract While therapies such as chemotherapy combined with immunotherapy, sacituzumab govitecan, and PARP inhibitors are available for metastatic TNBC, on disease progression after these therapies, the mainstay of therapy is chemotherapy. Apatinib is a small-molecule tyrosine kinase inhibitor that has promising anti-angiogenesis and antitumor activity for TNBC. We aimed to evaluate the safety and efficacy of adding apatinib to chemotherapy in patients with advanced TNBC with failed first/second-line treatment. A total of 66 patients were randomly assigned, in a 1:1 ratio, to receive vinorelbine or vinorelbine with apatinib in 28-day cycles. The primary endpoint was progression-free survival (PFS). Secondary endpoints included overall survival (OS), overall response rate (ORR) and safety. 33 received apatinib plus vinorelbine and 32 received vinorelbine (1 was withdrawal). Median PFS was significantly longer in the apatinib plus vinorelbine group than in the vinorelbine group (3.9 months vs. 2.0 months; hazard ratio, 1.82; 95% confidence interval [CI], 1.06 to 3.11; P = 0.026). Median OS was 11.5 months with apatinib plus vinorelbine and 9.9 months with vinorelbine (HR,1.01; 95% CI, 0.51 to 1.97; P = 0.985). The ORR was 9.1% in the apatinib plus vinorelbine group and 6.3% in the vinorelbine group (P = 0.667). The most common treatment-related hematologic grade 3–4 adverse events in apatinib plus vinorelbine group, were leukopenia, granulocytopenia, anemia, and thrombocytopenia. no treatment-related nonhematologic grade 4 adverse events or treatment-related deaths were observed. Collectively, adding apatinib to vinorelbine shows a promising benefit in PFS compared to vinorelbine monotherapy, with an excellent toxicity profile, warranting further exploration.

Background and Aim: The development of acute pancreatitis (AP) is strongly linked to blood clotting and fibrinolysis issues. Modern clinical practices now utilize advanced blood markers like thrombin–antithrombin III complex (TAT), plasmin‐α2‐plasmin inhibitor complex, thrombomodulin (TM), and tissue plasminogen activator–inhibitor complex (t‐PAIC) to assess thrombosis risk. Our study used a highly sensitive chemiluminescence technique to measure these markers in AP patients, aiming to determine their early predictive value for AP severity. Methods: There were 173 patients with AP, all of whom developed symptoms within 72 h; 102 individuals had onset symptoms within 48 h. The biomarkers were measured upon admission before determining the severity of AP. Results: The levels of TAT, plasmin‐α2‐plasmin inhibitor complex, TM, and t‐PAIC were significantly higher in the severe acute pancreatitis (SAP) group compared with the mild acute pancreatitis and moderate severe acute pancreatitis groups. For the patients within 72 h of onset, TAT, TM, and t‐PAIC predicted the occurrence of SAP. For the patients within 48 h of onset, TAT and t‐PAIC predicted the occurrence of SAP. The area under the curve (AUC) of prediction models is similar to Bedside Index for Severity in Acute Pancreatitis (BISAP) but significantly higher than C‐reactive protein (P < 0.05). Notably, t‐PAIC had a larger AUC than TAT, BISAP, and C‐reactive protein. Conclusion: In the initial 48 h, plasma TAT and t‐PAIC levels may predict the development of SAP. Within 72 h, plasma levels of TAT, TM, and t‐PAIC may predict the development of SAP, and the TAT + TM + t‐PAIC prediction model achieved a maximum AUC of 0.915, comparable to BISAP. [ABSTRACT FROM AUTHOR]

BACKGROUND: Deep vein thrombosis (DVT) of the lower limbs is a venous reflux disorder caused by abnormal coagulation of blood components, primarily characterised by swelling and pain in the lower limbs. Key risk factors include prolonged immobility due to bed rest, pregnancy, postpartum or postoperative states, traumas, malignant tumours and long-term contraceptive use. OBJECTIVE: To investigate the application of real-time shear wave elastography (SWE) in diagnosing lower-limb deep vein thrombosis (DVT). METHODS: A total of 91 patients with DVT were selected and divided into three groups: acute phase (n = 29), subacute phase (n = 30) and chronic phase (n = 32). The Young's modulus of the patients was measured using real-time SWE. The diagnostic efficacy of Young's modulus was evaluated by ROC curves. The hardness differences in Young's modulus across different parts of the same thrombus (head, body and tail) were measured using SWE. RESULTS: Before treatment, significant differences were observed in Young's modulus among patients with DVT (P < 0.001). Following anticoagulant therapy, catheter-directed thrombolysis and systemic thrombolysis, significant differences were noted in Young's modulus among patients at the same stage but receiving different treatments (acute phase: P = 0.003; subacute phase: P = 0.014; chronic phase: P = 0.004). Catheter-directed thrombolysis had greater efficacy than anticoagulant therapy. The area under the curve for SWE in staging patients was 0.917, with a sensitivity of 92.36% and specificity of 93.81%. Significant differences in Young's modulus were found between the thrombus head and thrombus body and tail but not between the thrombus body and thrombus tail. CONCLUSION: Measurement of Young's modulus using SWE can serve as an auxiliary means of evaluating staging, predicting pulmonary embolism and selecting treatment in patients with DVT. [ABSTRACT FROM AUTHOR]

Objective: We aimed to investigate the association between the angular trajectory of the vestibular aqueduct (ATVA) with other radiological parameters of temporal bone and clinical characteristics in patients with Ménière's disease (MD). Methods: A total of 125 unilateral MD patients and 118 controls were enrolled. Computer tomography (CT)-based radiological parameters included ATVA, vestibular aqueduct (VA) visibility, VA morphology, the vertical part of the posterior semicircular canal—the posterior fossa distance (PPD), and peri-VA pneumatization. The clinical characteristics of MD patients included gender, age of diagnosis/onset, disease duration, migraine history, clinical staging, and the results of audio-vestibular tests. The radiological parameters and clinical characteristics in MD patients were compared. Results: Compared with control ears, ATVA ≥ 140° was more prevalent and ATVA ≤ 120° was less frequent in the MD-affected side. For the MD-affected side, MD patients with ATVA ≥ 140° exhibited more severe VA invisibility and obliteration and higher male preponderance than those with ATVA ≤ 120°. Other radio-clinical features did not differ between these two subgroups. Conclusion: In the current study, ATVA ≥ 140°, an indicator of a hypoplastic endolymphatic sac, was found in approximately one-third of the affected and unaffected ears of patients with MD, as well as in a minority of controls. This suggests that the indices may be a predisposing factor rather than a specific marker for the MD ear. The male preponderance in MD patients with hypoplastic ES suggests a gender difference in the anatomical factors for MD pathogenesis. [ABSTRACT FROM AUTHOR]

To understand the coloring mechanism in black radish, the integrated metabolome and transcriptome analyses of root skin from a black recombinant inbred line (RIL 1901) and a white RIL (RIL 1911) were carried out. A total of 172 flavonoids were detected, and the analysis results revealed that there were 12 flavonoid metabolites in radish root skin, including flavonols, flavones, and anthocyanins. The relative concentrations of most flavonoids in RIL 1901 were higher than those in RIL 1911. Meanwhile, the radish root skin also contained 16 types of anthocyanins, 12 of which were cyanidin and its derivatives, and the concentration of cyanidin 3-o-glucoside was very high at different development stages of black radish. Therefore, the accumulation of cyanidin and its derivatives resulted in the black root skin of radish. In addition, a module positively related to anthocyanin accumulation and candidate genes that regulate anthocyanin synthesis was identified by the weighted gene co-expression network analysis (WGCNA). Among them, structural genes (RsCHS, RsCHI, RsDFR, and RsUGT75C1) and transcription factors (TFs) (RsTT8, RsWRKY44L, RsMYB114, and RsMYB308L) may be crucial for the anthocyanin synthesis in the root skin of black radish. The anthocyanin biosynthesis pathway in the root skin of black radish was constructed based on the expression of genes related to flavonoid and anthocyanin biosynthesis pathways (Ko00941 and Ko00942) and the relative expressions of metabolites. In conclusion, this study not only casts new light on the synthesis and accumulation of anthocyanins in the root skin of black radish but also provides a molecular basis for accelerating the cultivation of new black radish varieties.