We assessed the distribution of site-specific metastases in patients with renal cell carcinoma (RCC) according to age. Moreover, we evaluated recommendations proposed by guidelines and focused ...specifically on bone and brain metastases.
Patients with metastatic RCC (mRCC) were abstracted from the Nationwide Inpatient Sample (1998–2007). Age was stratified into four groups: <55, 55–64, 65–74 and ≥75 years. Cochran–Armitage trend test and multivariable logistic regression analysis tested the relationship between age and the rate of multiple metastatic sites. Finally, we examined the rates of brain or bone metastases according to the presence of other metastatic sites.
In 11 157 mRCC patients, the rate of multiple metastatic sites decreased with increasing age (P < 0.001). This phenomenon was confirmed in patients with lung, bone, liver and brain metastases (all P ≤ 0.01). The rate of bone metastases was 10% in patients with exclusive abdominal metastases and 49% in patients with abdominal, thoracic and brain metastases. The rate of brain metastases was 2% in patients with exclusive abdominal metastases and 16% in patients with thoracic and bone metastases.
The proportion of patients with multiple metastatic sites is higher in young patients. The rates of bone (10%–49%) and brain (2%–16%) metastases are nonnegligible in mRCC patients.
Because of its ultrasensitivity, fluorescence offers a noninvasive means to investigate biomolecular mechanisms, pathways, and regulations in living cells, tissues, and animals. However, real-world ...applications of fluorescence technologies encounter many practical challenges. For example, the intrinsic heterogeneity of biological samples always generates optical interferences. High background such as autofluorescence can often obscure the desired signals. Finally, the wave properties of light limit the spatial resolution of optical microscopy. The key to solving these problems involves using chemical structures that can modulate the fluorescence output. Photoswitchable fluorescent molecules that alternate their emissions between two colors or between bright-and-dark states in response to external light stimulation form the core of these technologies. For example, molecular fluorescence modulation can switch fluorophores on and off. This feature supports super-resolution, which enhances resolution by an order of magnitude greater than the longstanding diffraction-limit barrier. The reversible modulation of such probes at a particular frequency significantly amplifies the frequency-bearing target signal while suppressing interferences and autofluorescence. In this Account, we outline the fundamental connection between constant excitation and oscillating fluorescence. To create molecules that will convert a constant excitation into oscillating emission, we have synthesized photoswitchable probes and demonstrated them as proofs of concept in super-resolution imaging and frequency-domain imaging. First, we introduce the design of molecules that can convert constant excitation into oscillating emission, the key step in fluorescence modulation. Then we discuss various technologies that use fluorescence modulation: super-resolution imaging, dual-color imaging, phase-sensitive lock-in detection, and frequency-domain imaging. Finally, we present two biological applications to demonstrate the power of photoswitching-enabled fluorescence imaging. Because synthetic photoswitchable probes can be much smaller, more versatile, and more efficient at high-performance modulation experiments, they provide a complement to photoswitchable fluorescent proteins. Although new challenges remain, we foresee a bright future for photoswitching-enabled imaging and detection.
Floral organs are specified by the combinatorial action of MADSdomain transcription factors, yet the mechanisms by which MADSdomain proteins activate or repress the expression of their target genes ...and the nature of their cofactors are still largely unknown. Here, we show using affinity purification and mass spectrometry that five major floral homeotic MADS-domain proteins (AP1, AP3, PI, AG, and SEP3) interact in floral tissues as proposed in the "floral quartet" model. In vitro studies confirmed a flexible composition of MADSdomain protein complexes depending on relative protein concentrations and DNA sequence. In situ bimolecular fluorescent complementation assays demonstrate that MADS-domain proteins interact during meristematic stages of flower development. By applying a targeted proteomics approach we were able to establish a MADS-domain protein interactome that strongly supports a mechanistic link between MADS-domain proteins and chromatin remodeling factors. Furthermore, members of other transcription factor families were identified as interaction partners of floral MADS-domain proteins suggesting various specific combinatorial modes of action.
This paper examines the causal relationships between carbon dioxide emissions, energy consumption and real economic output using panel cointegration and panel vector error correction modeling ...techniques based on the panel data for 28 provinces in China over the period 1995–2007. Our empirical results show that CO2 emissions, energy consumption and economic growth have appeared to be cointegrated. Moreover, there exists bidirectional causality between CO2 emissions and energy consumption, and also between energy consumption and economic growth. It has also been found that energy consumption and economic growth are the long-run causes for CO2 emissions and CO2 emissions and economic growth are the long-run causes for energy consumption. The results indicate that China's CO2 emissions will not decrease in a long period of time and reducing CO2 emissions may handicap China's economic growth to some degree. Some policy implications of the empirical results have finally been proposed.
► We conduct a panel data analysis of the energy–CO2–economy nexus in China. ► CO2 emissions, energy use and economic growth appear to be cointegrated. ► There exists bidirectional causality between energy consumption and economic growth. ► Energy consumption and economic growth are the long-run causes for CO2 emissions.
Abstract
Topological superconductors (TSCs) are unconventional superconductors with bulk superconducting gap and in-gap Majorana states on the boundary that may be used as topological qubits for ...quantum computation. Despite their importance in both fundamental research and applications, natural TSCs are very rare. Here, combining state of the art synchrotron and laser-based angle-resolved photoemission spectroscopy, we investigated a stoichiometric transition metal dichalcogenide (TMD), 2M-WS
2
with a superconducting transition temperature of 8.8 K (the highest among all TMDs in the natural form up to date) and observed distinctive topological surface states (TSSs). Furthermore, in the superconducting state, we found that the TSSs acquired a nodeless superconducting gap with similar magnitude as that of the bulk states. These discoveries not only evidence 2M-WS
2
as an intrinsic TSC without the need of sensitive composition tuning or sophisticated heterostructures fabrication, but also provide an ideal platform for device applications thanks to its van der Waals layered structure.
Most supermassive black holes (SMBHs) are accreting at very low levels and are difficult to distinguish from the galaxy centers where they reside. Our own Galaxy's SMBH provides an instructive ...exception, and we present a close-up view of its quiescent x-ray emission based on 3 megaseconds of Chandra observations. Although the x-ray emission is elongated and aligns well with a surrounding disk of massive stars, we can rule out a concentration of low-mass coronally active stars as the origin of the emission on the basis of the lack of predicted iron (Fe) Kα emission. The extremely weak hydrogen (H)—like Fe Kα line further suggests the presence of an outflow from the accretion flow onto the SMBH. These results provide important constraints for models of the prevalent radiatively inefficient accretion state.
Background
A critical appraisal of the benefits of minimally invasive surgery (MIS) is needed, but is lacking. This study examined the associations between MIS and 30‐day postoperative outcomes ...including complications graded according to the Clavien–Dindo classification, unplanned readmissions, hospital stay and mortality for five common surgical procedures.
Methods
Patients undergoing appendicectomy, colectomy, inguinal hernia repair, hysterectomy and prostatectomy were identified in the American College of Surgeons National Surgical Quality Improvement Program database. Non‐parsimonious propensity score methods were used to construct procedure‐specific matched‐pair cohorts that reduced baseline differences between patients who underwent MIS and those who did not. Bonferroni correction for multiple comparisons was applied and P < 0·006 was considered significant.
Results
Of the 532 287 patients identified, 53·8 per cent underwent MIS. Propensity score matching yielded an overall sample of 327 736 patients (appendicectomy 46 688, colectomy 152 114, inguinal hernia repair 59 066, hysterectomy 59 066, prostatectomy 10 802). Within the procedure‐specific matched pairs, MIS was associated with significantly lower odds of Clavien–Dindo grade I–II, III and IV complications (P ≤ 0·004), unplanned readmissions (P < 0·001) and reduced hospital stay (P < 0·001) in four of the five procedures studied, with the exception of inguinal hernia repair. The odds of death were lower in patients undergoing MIS colectomy (P < 0·001), hysterectomy (P = 0·002) and appendicectomy (P = 0·002).
Conclusion
MIS was associated with significantly fewer 30‐day postoperative complications, unplanned readmissions and deaths, as well as shorter hospital stay, in patients undergoing colectomy, prostatectomy, hysterectomy or appendicectomy. No benefits were noted for inguinal hernia repair.
Generally better outcomes after laparoscopic surgery
Intravitreal injection of anti-vascular endothelial growth factor (VEGF) agents is increasingly used for the treatment of a wide variety of retinal diseases, including age-related macular ...degeneration, diabetic retinopathy and retinal vascular occlusions, and retinopathy of prematurity. Despite encouraging results in halting the disease and improving the vision, intravitreal injection of anti-VEGF agents may be associated with systemic adverse events and devastating ocular complications. In this review, we provide an overview of safety data for intravitreal injection of common anti-VEGF agents.
Perfluoroalkyl and polyfluoroalkyl substances (PFASs) have gained increasingly global attention in recent years. Due to their unique amphiphilic properties and stability, PFASs are recognized as ...highly persistent, toxic, and environmentally bioaccumulative. Among several physicochemical technologies, adsorption has been extensively used and proved to be an effective method for removing PFASs from aqueous environment. In this review article, the technical feasibility of the use of different adsorbents, such as activated carbon, ion exchange resins, minerals, molecularly imprinted polymer (MIP), carbon nanotubes (CNTs), and a wide range of potentially low-cost biosorbents, for PFASs removal from water or wastewater is critically reviewed. The evaluation and comparison of their PFASs sorption behavior in terms of kinetics and isotherms is presented. The mechanisms involved in PFASs adsorption processes, such as diffusion, electrostatic interaction, hydrophobic interaction, ion exchange and hydrogen bond, are discussed. The effects of the parameters variability on sorption process are highlighted. Based on the literature reviewed, a few recommendations for future research on PFASs adsorption are also elaborated.
Capsule: The adsorption behavior and mechanisms of perfluoroalkyl and polyfluoroalkyl substances (PFASs) on various adsorbents are reviewed.
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•Resins and CNTs exhibit higher adsorption capacity than other adsorbents.•Biosorbents have great potential for efficient PFAS removal with cost-effectiveness.•Adsorption mechanisms involve electrostatic interaction, hydrophobic interaction and ion exchange.•The environmental parameters can influence PFASs adoption performance.
Time reversal symmetry (TRS) protects the metallic surface modes of topological insulators (TIs). The transport signature of such surface states is a plateau that arrests the exponential divergence ...of the insulating bulk with decreasing temperature. This universal behaviour is observed in all TI candidates ranging from Bi2Te2Se to SmB6. Recently, extreme magnetoresistance (XMR) has been reported in several topological semimetals which exhibit TI universal resistivity behaviour only when breaking time reversal symmetry, a regime where TIs theoretically cease to exist. Among these materials, TaAs and NbP are nominated as Weyl semimetals owing to their lack of inversion symmetry, Cd3As2 is known as a Dirac semimetal owing to its linear band crossing at the Fermi level, and WTe2 is termed a resonant compensated semimetal owing to its perfect electronhole symmetry. Here we introduce LaSb, a simple rock-salt structure material that lacks broken inversion symmetry, perfect linear band crossing, and perfect electronhole symmetry yet exhibits all the exotic eld-induced behaviours of these more complex semimetals. It shows a eld-induced universal TI resistivity with a plateau at roughly 15 K, ultrahigh mobility of carriers in the plateau region, quantum oscillations with the angle dependence of a two-dimensional Fermi surface, and XMR of about one million percent at 9 T. Owing to its structural simplicity, LaSb represents an ideal model system to formulate a theoretical understanding of the exotic consequences of breaking time reversal symmetry in topological semimetals.
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