Rethinking time-lagged emissions and abatement potential of fluorocarbons in the post-Kigali Amendment era.

The Montreal Protocol has been successful in safeguarding the ozone layer and curbing climate change. However, accurately estimating and reducing the time-lagged emissions of ozone-depleting substances or their substitutes, such as produced but not-yet-emitted fluorocarbon banks, remains a significant challenge. Here, we use a dynamic material flow analysis model to characterize the global stocks and flows of two fluorocarbon categories, hydrochlorofluorocarbons (HCFCs) and hydrofluorocarbons (HFCs), from 1986 to 2060. We assess emission pathways, time-lagged emission sizes, and potential abatement measures throughout different life cycle stages while focusing on the role of banked fluorocarbons in global and regional decarbonization efforts in the post-Kigali Amendment era. Although fluorocarbon releases are expected to decline, the cumulative global warming potential (GWP)-weighted emissions of HCFCs and HFCs are significant; these will be 6.4 (±1.2) and 14.8 (±2.5) gigatons CO2-equivalent, respectively, in 2022-2060 in our business-as-usual (BAU) scenario. Scenario analysis demonstrates that implementing currently available best environmental practices in developed economies can reduce cumulative GWP-weighted emissions by up to 45% compared with the BAU scenario.

Enhancing anthocyanin extraction efficiency in vegetables and fruits: a high-speed shear homogenization technology.

BACKGROUND: To extract anthocyanins with high efficiency, a hypothesis for high-speed shear homogenization extraction (HSHE) method was established through a combination of solvent and ultrasonic-assisted extractions. The efficacy of this hypothesis was demonstrated by performing qualitative and quantitative analyses of 16 anthocyanins extracted from five northern vegetables, and five berry fruits using ultra-high-performance Q-Exactive Orbitrap tandem mass spectrometry. Single-factor experiments were conducted by varying ethanol concentration, temperature, pH and extraction cycles to determine the optimal conditions for this method. RESULTS: Optimal extraction conditions (ethanol 70-80%, 40-50 °C, pH 3-4, performed twice) were determined using an HSHE (5 min, 10 000 rpm, 25 °C) assisted shaker (60 min) and ultrasonication (40 kHz, 160 W cm-2, 30 min, 25 °C) procedure. Compared to the traditional non-HSHE method, the total anthocyanin content obtained through HSHE extraction showed a significant increase, ranging from 1.0 to 3.9 times higher, with purple cabbage exhibiting the most pronounced enhancement in content. More types of anthocyanins were detected in blueberry (9), black bean (7) and raspberry (5), of which malvidin was the major anthocyanin (0.426 g kg-1) in blueberry, having an amount five times than previously obtained. CONCLUSION: The established HSHE method has been proven to be a superior technique for anthocyanin extraction, with higher extraction efficiency and concentrations. This technique also provides a new avenue for extracting bioactive compounds from diverse food sources, with potential applications in improving the functional properties of food products. © 2024 Society of Chemical Industry.

Numerical Simulation of the Evaporation Behavior of Fe-Mn Heterogeneous Powder in Selective Laser Melting Process.

Multi-material additive manufacturing using heterogeneous powders as raw materials is one of the important development directions of metal additive manufacturing technology. The evaporation behavior of heterogeneous powders in the selective laser melting (SLM) process has a significant influence on the accuracy of chemical composition control and the quality of the final product. In this paper, the fusion process of Fe20Mn (80 wt.% Fe and 20 wt.% Mn) heterogeneous powder, Fe and Mn elemental powders, and Fe20Mn pre-alloyed powder is numerically simulated using FLOW-3D® software and partially validated through SLM experimental results. The morphology and the characteristics of the flow field and temperature field in the melt pool for four kinds of powder materials are analyzed. The influence of the elemental evaporation behavior of different powders on the mass loss of the Mn element is discussed. The results show that the excessive accumulation of heat increases the maximum temperature of the melt pool, thus increasing mass loss. The Fe20Mn heterogeneous powder has a wider heat-affected zone and a higher peak value of temperature, nearly 400 K higher than that of the Fe20Mn pre-alloyed powders, which exhibits an intensive evaporation behavior. The mass loss of the Mn element obtained from the SLM experiment for Fe20Mn heterogeneous powders forming parts is more than the Fe20Mn pre-alloyed powders' forming parts for different laser powers, up to 17 wt.% at P = 120 W. This tendency is consistent with the numerical analysis of the effect of evaporation behavior of Fe-Mn heterogeneous powder during the SLM process. This study provides the necessary theoretical reference and process guidance for realizing the precise control of the SLM composition of a heterogeneous powder in multi-material additive manufacturing caused by evaporation behavior.

An omics-based characterization of Wolfiporia cocos reveals three CYP450 members involved in the biosynthetic pathway of pachymic acid.

Wolfiporia cocos is a medicinal mushroom used in China. It biosynthesizes pachymic acid (PA), a main therapeutic triterpene associated with therapies. Nowadays, the unknown PA biosynthesis leads to difficulties in increasing its content in W. cocos. Herein, we report sequencing, assembling, and characterization of the genome and several transcriptomes of W. cocos. Sequence mining determined candidate genes that encode lanosterol synthase, sterol O-acyltransferase, and sterol C-24 methyltransferase likely involved in the steps from lanosterol to PA. Gene cluster analysis identified four CYP450 cDNAs likely involved in the biosynthesis of PA, namely WcCYP64-1, WcCYP64-2, WcCYP52, and WcCYP_FUM15, which were subjected to both overexpression and silencing in mycelia. The overexpression of each of WcCYP64-1, WcCYP52 and WcCYP_FUM15 increased the content of PA, 16α-hydroxytrametenolic acid, eburicoic acid, and tumulosic acid, while the silencing of each gene either significantly or slightly decreased the contents of these four compounds, indicating their involvement in the PA biosynthesis. In addition, different temperatures affected the expression of these genes and the formation of PA. By contrast, the overexpression and silencing of WcCYP64-2 did not alter the formation of these compounds. Taken together, these findings determine more potential steps in the biosynthetic pathway of PA for metabolic engineering.

Reducing cherry rain-cracking: Enhanced wetting and barrier properties of chitosan hydrochloride-based coating with dual nanoparticles.

The synergistic effects of phosphorylated zein nanoparticles (PZNP) and cellulose nanocrystals (CNC) in enhancing the wetting and barrier properties of chitosan hydrochloride (CHC)-based coating are investigated characterized by Fourier Transform Infrared Spectra (FTIR), X-ray Diffraction (XRD), atomic force microscopy and by investigating the mechanical properties, etc., with the aim of reducing cherry rain cracking. FTIR and XRD showed dual nanoparticles successfully implanted into CHC, CHC-PZNP-CNC combined moderate ductility (elongation at break: 7.8 %), maximum tensile strength (37.5 MPa). The addition of PZNP alone significantly improved wetting performance (Surface Tension, CHC: 55.3 vs. CHC-PZNP: 48.9 mN/m), while the addition of CNC alone led to a notable improvement in the water barrier properties of CHC (water vapor permeability, CHC: 6.75 × 10-10 vs. CHC-CNC: 5.76 × 10-10 gm-1 Pa-1 s-1). The final CHC-PZNP-CNC coating exhibited enhanced wettability (51.2 mN/m) and the strongest water-barrier property (5.32 × 10-10 gm-1 Pa-1 s-1), coupled with heightened surface hydrophobicity (water contact angle: 106.4°). Field testing demonstrated the efficacy of the CHC-PZNP-CNC coating in reducing cherry rain-cracking (Cracking Index, Control, 42.3 % vs. CHC-PZNP-CNC, 19.7 %; Cracking Ratio, Control, 34.6 % vs. CHC-PZNP-CNC, 15.8 %). The CHC-PZNP-CNC coating is a reliable option for preventing rain-induced cherry cracking.

Construction and characterization of Zn-WPH-COS complex nanoparticles with improved zinc bioavailability.

Precipitation was an important obstacle to improving zinc's bioavailability. Therefore, zinc-whey protein hydrolysate-chitosan oligosaccharide (Zn-WPH-COS) complexes (167 nm) were prepared by linking Zn-WPH (zinc: 18.4%) with COS (1:1, 2 h) to enhance zinc's bioaccessibility. Fourier-transform infrared showed Zn-WPH formed with zinc replaced hydrogen (from 3274 to 3279 cm-1) and reacted with COO- (C-N: from 1394 to 1402 cm-1), a new peak at 1025 cm-1 proved COS can be successful cross-linked (Zn-WPH-COS). Fluorescence spectra showed zinc and COS reduced WPH hydrophobicity (28.0 and 39.0%, respectively). Circular dichroism showed zinc decreased WPH α-helix (from 13.7 to 11.5%), in contrast with COS to Zn-WPH. Zinc solubility and dialyzability were increased (64.5/ 54.2% vs 50.2/ 41.2% vs 29.5/ 21.7%) in Zn-WPH-COS, compared with Zn-WPH and ZnSO4·7H2O, respectively, due to the smallest size (167 nm) and COS protection on Zn-WPH (gastric digestion). These results indicate Zn-WPH-COS could significantly improve the digestion and absorption of zinc.

Microstructure analysis, tribological correlation properties and strengthening mechanism of graphene reinforced aluminum matrix composites.

In this paper, graphene reinforced aluminum matrix composites are successfully prepared by high-energy ball milling. The results show that no graphene agglomeration is found in the mixed powder. The complex composites prepared by high energy ball milling and powder metallurgy have approximately 4-5 layers of graphene and the thickness of single-layer graphene is approximately 0.334 nm. The final experimental results confirm the formation of compound AlC3 in the microstructure, and its diffraction spot index is ([Formula: see text]00), ([Formula: see text]1[Formula: see text]) and (11[Formula: see text]). The maximum friction coefficient is 0.126, and the average friction coefficient is 0.027, suggesting good wear resistance and corrosion resistance. Additionally, the friction corrosion mechanism of the material is deeply analyzed. The results of strengthening mechanism analysis show that the main strengthening mechanism of the materials designed in this experiment is thermal mismatch strengthening. It can be concluded that the yield strength of the material calculated by the modified model is 227.75 MPa. This value is slightly lower than the calculated value of the general shear lag model (237.68 MPa). However, it is closer to the yield strength value of the actual material (211 MPa).

[Chemical analysis of classical prescription Qianghuo Shengshi Standard Decoction by UHPLC-Q Exactive Orbitrap MS].

A UHPLC-Q Exactive Orbitrap MS method was used to analyze the chemical constituents of the classical prescription Qianghuo Shengshi Standard Decoction(QHSS). UHPL conditions were as follows: Waters~(TM) UPLC~(TM) HSS T3 C_(18) column(2.1 mm×100 mm, 1.7 µm) and mobile phase of acetonitrile-0.1% formic acid aqueous solution. Mass spectrometry data of QHSS, each herb extract, and negative sample were collected in both positive and negative ion modes. The chemical constituents of QHSS were identified or tentatively identified based on the accurate molecular weight, retention time, MS fragmentation, comparison with reference substances, and literature reports. A total of 141 compounds were identified, including 18 amino acids, oligosaccharides, oligopeptides, and their derivatives, 19 phenolic acids, 44 coumarins, 18 flavonoids and chromones, 13 saponins, 17 phthalides, and 12 other components. This study comprehensively characterized the chemical constituents of QHSS, laying an experimental basis for the in-depth research on the material basis and quality control of QHSS.

The Epidemiological Analysis of HIV/AIDS Patients: Sexually Transmitted Diseases Department vs. other Departments in A General Hospital of Shanghai, China.

BACKGROUND: Hospital is an important place for HIV/AIDS screening, and a general hospital is composed of multiple departments. Different departments have different levels of understanding of HIV/AIDS, especially the sexually transmitted diseases (STD) department is the main place for HIV/AIDS screening. OBJECTIVE: The study aims to validate the common knowledge that the STD department is an important place for HIV/AIDS screening by comparing the epidemiological characteristics of HIV/AIDS patients in the STD department and other departments in Tongji Hospital, which can provide a theoretical basis for the precise and differentiated control of HIV/AIDS. METHODS: A total of 283,525 HIV screening cases were analyzed from January 1st 2006 to December 31st 2018 in the STD department and other departments. The epidemiological data of 226 HIV/AIDS cases were retrospectively analyzed. RESULTS: Firstly, the incidence of HIV/AIDS in the population served by Tongji Hospital was higher than that in Shanghai and China. Secondly, the positive rate of HIV screening test in the STD department was ten times higher than that of other departments. Thirdly, the social-demographic characteristics of HIV/AIDS patients in the STD department were different from those in other departments. Fourthly, there were differences in age, education, marital status and number of sex partners between men who have sex with men (MSM) and men who have sex with women (MSW). Fifthly, there was no difference except age in social-demographic characteristics of MSM between the STD department and other departments. Sixthly, compared with other departments, the majority of HIV/AIDS patients in the STD department were MSM. Seventhly, syphilis and HIV co-infection were not statistically significant in HIV/AIDS patients between the STD department and other departments. CONCLUSION: Firstly, the significantly higher positive rate of an HIV screening test in the STD department emphasizes its importance as a place for screening HIV/AIDS patients. Secondly, HIV/AIDS patients diagnosed in the general hospital were mainly transmitted by sexual contact, and MSM accounted for the most part of these patients. More attention should be paid to screen outpatients, especially in the STD department and young men.

Analysis of the Coptis chinensis genome reveals the diversification of protoberberine-type alkaloids.

Chinese goldthread (Coptis chinensis Franch.), a member of the Ranunculales, represents an important early-diverging eudicot lineage with diverse medicinal applications. Here, we present a high-quality chromosome-scale genome assembly and annotation of C. chinensis. Phylogenetic and comparative genomic analyses reveal the phylogenetic placement of this species and identify a single round of ancient whole-genome duplication (WGD) shared by the Ranunculaceae. We characterize genes involved in the biosynthesis of protoberberine-type alkaloids in C. chinensis. In particular, local genomic tandem duplications contribute to member amplification of a Ranunculales clade-specific gene family of the cytochrome P450 (CYP) 719. The functional versatility of a key CYP719 gene that encodes the (S)-canadine synthase enzyme involved in the berberine biosynthesis pathway may play critical roles in the diversification of other berberine-related alkaloids in C. chinensis. Our study provides insights into the genomic landscape of early-diverging eudicots and provides a valuable model genome for genetic and applied studies of Ranunculales.

HBO1 overexpression is important for hepatocellular carcinoma cell growth.

Hepatocellular carcinoma (HCC) is a common primary liver malignancy lacking effective molecularly-targeted therapies. HBO1 (lysine acetyltransferase 7/KAT7) is a member of MYST histone acetyltransferase family. Its expression and potential function in HCC are studied. We show that HBO1 mRNA and protein expression is elevated in human HCC tissues and HCC cells. HBO1 expression is however low in cancer-surrounding normal liver tissues and hepatocytes. In HepG2 and primary human HCC cells, shRNA-induced HBO1 silencing or CRISPR/Cas9-induced HBO1 knockout potently inhibited cell viability, proliferation, migration, and invasion, while provoking mitochondrial depolarization and apoptosis induction. Conversely, ectopic overexpression of HBO1 by a lentiviral construct augmented HCC cell proliferation, migration and invasion. In vivo, xenografts-bearing HBO1-KO HCC cells grew significantly slower than xenografts with control HCC cells in severe combined immunodeficient mice. These results suggest HBO1 overexpression is important for HCC cell progression.

Exploration of D022-Type Al3TM(TM = Sc, Ti, V, Zr, Nb, Hf, Ta): Elastic Anisotropy, Electronic Structures, Work Function and Experimental Design.

The structural properties, elastic anisotropy, electronic structures and work function of D022-type Al3TM (TM = Sc, Ti, V, Y, Zr, Nb, La, Hf, Ta) are studied using the first-principles calculations. The results indicate that the obtained formation enthalpy and cohesive energy of these compounds are in accordance with the other calculated values. It is found that the Al3Zr is the most thermodynamic stable compound. The mechanical property indexes, such as elastic constants, bulk modulus, shear modulus, Young's modulus, Poisson's ratio, and Vickers hardness are systematically explored. Moreover, the calculated universal anisotropic index, percent anisotropy and shear anisotropic factors of D022-type Al3TM are analyzed carefully. It demonstrates that the shear modulus anisotropy of Al3La is the strongest, while that of Al3Ta is the weakest. In particular, the density of states at Fermi level is not zero, suggesting that these phases have metal properties and electrical conductivity. More importantly, the mechanisms of correlation between hardness and Young's modulus are further explained by the work function. Finally, the experimental design proves that D022-Al3Ta has an excellent strengthening effect.

The efficacy and safety of the combination of axitinib and pembrolizumab-activated autologous DC-CIK cell immunotherapy for patients with advanced renal cell carcinoma: a phase 2 study.

OBJECTIVES: Although axitinib has achieved a preferable response rate for advanced renal cell carcinoma (RCC), patient survival remains unsatisfactory. In this study, we evaluated the efficacy and safety of a combination treatment of axitinib and a low dose of pembrolizumab-activated autologous dendritic cells-co-cultured cytokine-induced killer cells in patients with advanced RCC. METHODS: All adult patients, including treatment-naive or pretreated with VEGF-targeted agents, were enrolled from May 2016 to March 2019. Patients received axitinib 5 mg twice daily and pembrolizumab-activated dendritic cells-co-cultured cytokine-induced killer cells intravenously weekly for the first four cycles, every 2 weeks for the next four cycles, and every month thereafter. RESULTS: The 43 patients (22 untreated and 21 previously treated) showed a median progression-free survival (mPFS) of 14.7 months (95% CI, 11.16-18.30). mPFS in treatment-naive patients was 18.2 months, as compared with 14.4 months in pretreated patients (log-rank P-value = 0.07). Overall response rates were 25.6% (95% CI, 13.5-41.2%). Grade 3 or higher adverse events occurred in 5% of patients included hypertension (11.6%) and palmar-plantar erythrodysesthesia (7.0%). Peripheral blood lymphocyte immunophenotype and serum cytokine profile analyses demonstrated increased antitumor immunity after combination treatment particularly in patients with a long-term survival benefit, while those with a minimal survival benefit demonstrated an elevated proportion of peripheral CD8+TIM3+ T cells and lower serum-level immunostimulatory cytokine profile. CONCLUSIONS: The combination therapy was active and well tolerated for treatment of advanced RCC, either as first- or second-line treatment following other targeted agents. Changes in immunophenotype and serum cytokine profile may be used as prognostic biomarkers.

Functional Analysis of Sterol O-Acyltransferase Involved in the Biosynthetic Pathway of Pachymic Acid in Wolfiporia cocos.

Pachymic acid from Wolfiporia cocos possesses important medicinal values including anti-bacterial, anti-inflammatory, anti-viral, invigorating, anti-rejection, anti-tumor, and antioxidant activities. However, little is known about the biosynthetic pathway from lanostane to pachymic acid. In particular, the associated genes in the biosynthetic pathway have not been characterized, which limits the high-efficiency obtaining and application of pachymic acid. To characterize the synthetic pathway and genes involved in pachymic acid synthesis, in this study, we identified 11 triterpenoids in W. cocos using liquid chromatography tandem mass spectrometry (LC-MS/MS), and inferred the putative biosynthetic pathway from lanostane to pachymic acid based on analyzing the chemical structure of triterpenoids and the transcriptome data. In addition, we identified a key gene in the biosynthetic pathway encoding W. cocos sterol O-acyltransferase (WcSOAT), which catalyzes tumolusic acid to pachymic acid. The results show that silence of WcSOAT gene in W. cocos strain led to reduction of pachymic acid production, whereas overexpression of this gene increased pachymic acid production, indicating that WcSOAT is involved in pachymic acid synthesis in W. cocos and the biosynthesis of W. cocos pachymic acid is closely dependent on the expression of WcSOAT gene. In summary, the biosynthetic pathway of pachymic acid and the associated genes complement our knowledge on the biosynthesis of W. cocos pachymic acid and other triterpenoids, and also provides a reference for target genes modification for exploring high-efficiency obtaining of active components.

The incidence and prognostic effect of Fms-like tyrosine kinase 3 gene internal tandem and nucleolar phosphoprotein 1 genes in acute myeloid leukaemia: A PRISMA-compliant systematic review and meta-analysis.

BACKGROUND: Molecular genotyping is an important prognostic role in acute myeloid leukemia (AML) patients. We aimed to design this meta-analysis to discuss the incidence and prognostic effect of nucleolar phosphoprotein 1 (NPM1) and Fms-like tyrosine kinase 3 gene internal tandem (FLT3-ITD) gene in AML patients. METHODS: PubMed, Embase, Medline, and Cochrane library were systematically searched due to May 15, 2020. Four combinations of genotypes (FLT3-ITDneg/NPM1mut, FLT3-ITDpos/NPM1mut, FLT3-ITDneg/NPM1wt, FLT3-ITDpos/NPM1wt) were compared in association with the overall survival (OS) and leukemia-free survival (LFS) outcome, which expressed as pooled hazard ratio (HR) and 95% confidence intervals (CIs). RESULTS: Twenty-eight studies were included in our study. The incidence of FLT3-ITDneg/NPM1mut, FLT3-ITDpos/NPM1mut, FLT3-ITDneg/NPM1wt, and FLT3-ITDpos/NPM1wt was 16%, 13%, 50%, and 10%, respectively. The patients with FLT3-ITDneg/NPM1mut gene may have the best OS and LFS when comparing with FLT3-ITDpos/NPM1mut (HR = 1.94 and 1.70, P < .01), FLT3-ITDneg/NPM1wt (HR = 1.57 and 2.09, P < .01), and FLT3-ITDpos/NPM1wt (HR = 2.25 and 2.84, P < .001). CONCLUSION: AML patients with FLT3-ITDneg/NPM1mut gene type have the best survival outcome than the other 3 gene types, which should be an independent genotyping in AML classification.

Severe delayed pulmonary toxicity following PD-L1-specific CAR-T cell therapy for non-small cell lung cancer.

OBJECTIVES: This phase I study aimed to evaluate the antitumor effect and safety of programmed death-ligand-1 (PD-L1)-targeting autologous chimeric antigen receptor T (CAR-T) cells for patients with non-small cell lung cancer (NSCLC). METHODS: Programmed death-ligand-1-specific CAR-T cells were generated using lentiviral transduction. Four patients with NSCLC were recruited, but only one patient was finally involved. CAR-T cells were infused on three different days (total dose during therapy, 1 × 106 CAR-T cells kg-1 body weight). The date on which the patient received the first CAR-T cell infusion was designated as Day 0. RESULTS: Circulating CAR-T cells accounted for 3.30% of the patient's peripheral blood T cells detected by FACS analysis during the first follow-up (Day +29). The chest CT scan showed subtle tumor shrinkage (stable disease). On Day +43, the patient developed pyrexia without any known causes and dyspnoea that rapidly deteriorated to respiratory failure in 3 days. The chest X-ray and CT scan showed bilateral extensive pulmonary infiltration in addition to the tumor silhouette on the left upper lung. The interleukin (IL)-6 levels in serum dramatically increased (> 100-fold). The patient was immediately transferred to the ICU where he received oxygen and intravenous infusions of tocilizumab and methylprednisolone. His symptoms rapidly improved and the pulmonary inflammation gradually resolved. CONCLUSION: The clinical manifestations and test findings for this patient with NSCLC might represent unique clinical manifestations of solitary organ damage secondary to PD-L1-specific CAR-T cell therapy. The differential diagnosis, underlying mechanism and prevention and treatment strategies for such complications have also been discussed.

Accelerated dryland expansion regulates future variability in dryland gross primary production.

Drylands cover 41% of Earth's surface and are the largest source of interannual variability in the global carbon sink. Drylands are projected to experience accelerated expansion over the next century, but the implications of this expansion on variability in gross primary production (GPP) remain elusive. Here we show that by 2100 total dryland GPP will increase by 12 ± 3% relative to the 2000-2014 baseline. Because drylands will largely expand into formerly productive ecosystems, this increase in dryland GPP may not increase global GPP. Further, GPP per unit dryland area will decrease as degradation of historical drylands outpaces the higher GPP of expanded drylands. Dryland expansion and climate-induced conversions among sub-humid, semi-arid, arid, and hyper-arid subtypes will lead to substantial changes in regional and subtype contributions to global dryland GPP variability. Our results highlight the vulnerability of dryland subtypes to more frequent and severe climate extremes and suggest that regional variations will require different mitigation strategies.

Influence of obesity on in-hospital and postoperative outcomes of hepatic resection for malignancy: a 10-year retrospective analysis from the US National Inpatient Sample.

OBJECTIVES: The influence of obesity on the outcomes of curative liver resection for malignancies remains controversial. We aimed to compare the in-hospital outcomes of liver resection for malignancy between obese and non-obese patients. DESIGN: This was a population-based, retrospective, observational study using data from the Nationwide Inpatient Sample (NIS), the largest all-payer US inpatient care database. SETTING: Hospitalisations of adults ≥18 years old with diagnoses of primary hepatobiliary malignancy or secondary malignant neoplasms of liver in the USA were identified from the NIS database between 2005 and 2014. PARTICIPANTS: Data of 18 398 patients ≥18 years old and underwent liver resection without pancreatic resection in the NIS were extracted. All included subjects had primary hepatobiliary malignancy or secondary malignant neoplasms of the liver. Patients were divided into obese and non-obese groups. These groups were compared with respect to postoperative complications, length of hospital stay and hospital cost according to surgical extent and approach. INTERVENTIONS: Patients were undergoing lobectomy of liver or partial hepatectomy. PRIMARY AND SECONDARY OUTCOME MEASURES: The primary endpoints of this study were postoperative complications, length of hospital stay and hospital cost. RESULTS: After adjustment, obese patients were significantly more likely to experience postoperative complications than were non-obese patients (adjusted OR 1.25, 95% CI 1.10 to 1.42), regardless of whether lobectomy or partial hepatectomy was performed. Furthermore, obesity was significantly associated with increased risk of postoperative complications in patients who underwent open liver resection, but not laparoscopic resection. No significant difference was observed in length of hospital stay or total hospital costs between obese and non-obese patients. CONCLUSIONS: After adjustment for preoperative comorbidities and other potential confounders, obesity is significantly associated with greater risk of complications in patients undergoing open liver resection for malignancy, but not laparoscopic resection.

Assessment of future flash flood inundations in coastal regions under climate change scenarios-A case study of Hadahe River basin in northeastern China.

Climate change may considerably influence flash floods by increasing extreme precipitation. Coastal regions in eastern and southern China may experience especially negative effects because of the frequent occurrence of tropical cyclones (TCs). This study presented a hazard assessment framework for TCs-induced flash floods under climate change scenarios and assessed future inundations in Hadahe River basin, which is in northeastern China. From 1965 to 2014, there were twenty-four TCs ranging from severe tropical storm to super typhoon over Hadahe River basin in twenty years. General Circulation Models (GCMs) are too coarse to depict the impact of TCs on extreme precipitation; therefore, hourly precipitation data from two gauges and the tracks of TCs were used to assess the impact of TCs. An extreme precipitation event on 3-4 August 2012 and the same 600-year future probabilistic extreme rainfall were utilized to investigate the impact of climate change. Daily precipitation data from eight climate models from the NEX-GDDP dataset during 1965-2005 and 2050-2099 represented historical and future simulation conditions, respectively. The hydrologic model HEC-HMS was integrated with the hydraulic model FLO-2D to simulate discharges and inundations of past and future TCs episodes. The results showed that flooded area is projected to increase by 6.6% and 7.8% for inundation depth between 1.0 and 3.0 m under RCP 4.5 and RCP 8.5 scenarios, respectively. For inundation depth over 3.0 m, flooded area is projected to increase by 17.6% and 22.0%. Relative change of flash flood extent increases as inundation depth increases, indicating that climate change is likely to increase the risk of flash floods. Additional adaptation measures are needed to make the Hadahe River basin and other similar coastal basins more resilient. The results also indicated that considering the impact of TCs produces a more reliable assessment of future flash floods in coastal regions.