The aim of this study was to develop a widely accepted prognostic nomogram for extranodal NK/T-cell lymphoma, nasal-type (NKTCL). The clinical data from 1383 patients with NKTCL treated at 10 ...participating institutions between 2000 and 2011 were reviewed. A nomogram was developed that predicted overall survival (OS) based on the Cox proportional hazards model. To contrast the utility of the nomogram against the widely used Ann Arbor staging system, the International Prognostic Index (IPI) and the Korean Prognostic Index (KPI), we used the concordance index (C-index) and a calibration curve to determine its predictive and discriminatory capacity. The 5-year OS rate was 60.3% for the entire group. The nomogram included five important variables based on a multivariate analysis of the primary cohort: stage; age; Eastern Cooperative Oncology Group performance status; lactate dehydrogenase; and primary tumor invasion. The calibration curve showed that the nomogram was able to predict 5-year OS accurately. The C-index of the nomogram for OS prediction was 0.72 for both cohorts, which was superior to the predictive power (range, 0.56-0.64) of the Ann Arbor stage, IPI and KPI in the primary and validation cohorts. The proposed nomogram provides an individualized risk estimate of OS in patients with NKTCL.
The extension of the cosmic-ray spectrum beyond 1 petaelectronvolt (PeV; 10
electronvolts) indicates the existence of the so-called PeVatrons-cosmic-ray factories that accelerate particles to PeV ...energies. We need to locate and identify such objects to find the origin of Galactic cosmic rays
. The principal signature of both electron and proton PeVatrons is ultrahigh-energy (exceeding 100 TeV) γ radiation. Evidence of the presence of a proton PeVatron has been found in the Galactic Centre, according to the detection of a hard-spectrum radiation extending to 0.04 PeV (ref.
). Although γ-rays with energies slightly higher than 0.1 PeV have been reported from a few objects in the Galactic plane
, unbiased identification and in-depth exploration of PeVatrons requires detection of γ-rays with energies well above 0.1 PeV. Here we report the detection of more than 530 photons at energies above 100 teraelectronvolts and up to 1.4 PeV from 12 ultrahigh-energy γ-ray sources with a statistical significance greater than seven standard deviations. Despite having several potential counterparts in their proximity, including pulsar wind nebulae, supernova remnants and star-forming regions, the PeVatrons responsible for the ultrahigh-energy γ-rays have not yet been firmly localized and identified (except for the Crab Nebula), leaving open the origin of these extreme accelerators.
Studies suggest that dysfunction of brain-derived neurotrophic factor (BDNF) is a possible contributor to the pathology and symptoms of Alzheimer's disease (AD). Several studies report reduced ...peripheral blood levels of BDNF in AD, but findings are inconsistent. This study sought to quantitatively summarize the clinical BDNF data in patients with AD and mild cognitive impairment (MCI, a prodromal stage of AD) with a meta-analytical technique. A systematic search of Pubmed, PsycINFO and the Cochrane Library identified 29 articles for inclusion in the meta-analysis. Random-effects meta-analysis showed that patients with AD had significantly decreased baseline peripheral blood levels of BDNF compared with healthy control (HC) subjects (24 studies, Hedges' g=-0.339, 95% confidence interval (CI)=-0.572 to -0.106, P=0.004). MCI subjects showed a trend for decreased BDNF levels compared with HC subjects (14 studies, Hedges' g=-0.201, 95% CI=-0.413 to 0.010, P=0.062). No differences were found between AD and MCI subjects in BDNF levels (11 studies, Hedges' g=0.058, 95% CI=-0.120 to 0.236, P=0.522). Interestingly, the effective sizes and statistical significance improved after excluding studies with reported medication in patients (between AD and HC: 18 studies, Hedges' g=-0.492, P<0.001; between MCI and HC: 11 studies, Hedges' g=-0.339, P=0.003). These results strengthen the clinical evidence that AD or MCI is accompanied by reduced peripheral blood BDNF levels, supporting an association between the decreasing levels of BDNF and the progression of AD.
Non-Hermitian systems generically have complex energies, which may host topological structures, such as links or knots. While there has been great progress in experimentally engineering non-Hermitian ...models in quantum simulators, it remains a significant challenge to experimentally probe complex energies in these systems, thereby making it difficult to directly diagnose complex-energy topology. Here, we experimentally realize a two-band non-Hermitian model with a single trapped ion whose complex eigenenergies exhibit the unlink, unknot, or Hopf link topological structures. Based on non-Hermitian absorption spectroscopy, we couple one system level to an auxiliary level through a laser beam and then experimentally measure the population of the ion on the auxiliary level after a long period of time. Complex eigenenergies are then extracted, illustrating the unlink, unknot, or Hopf link topological structure. Our work demonstrates that complex energies can be experimentally measured in quantum simulators via non-Hermitian absorption spectroscopy, thereby opening the door for exploring various complex-energy properties in non-Hermitian quantum systems, such as trapped ions, cold atoms, superconducting circuits, or solid-state spin systems.
We simulated elemental carbon (EC) and organic carbon (OC) aerosols in China and compared model results to surface measurements at Chinese rural and background sites, with the goal of deriving ..."top-down" emission estimates of EC and OC, as well as better quantifying the secondary sources of OC. We included in the model state-of-the-science Chinese "bottom-up" emission inventories for EC (1.92 TgC yr−1) and OC (3.95 TgC yr−1), as well as updated secondary OC formation pathways. The average simulated annual mean EC concentration at rural and background sites was 1.1 μgC m−3, 56% lower than the observed 2.5 μgC m−3. The average simulated annual mean OC concentration at rural and background sites was 3.4 μgC m−3, 76% lower than the observed 14 μgC m−3. Multiple regression to fit surface monthly mean EC observations at rural and background sites yielded the best estimate of Chinese EC source of 3.05 ± 0.78 TgC yr−1. Based on the top-down EC emission estimate and observed seasonal primary OC/EC ratios, we estimated Chinese OC emissions to be 6.67 ± 1.30 TgC yr−1. Using these top-down estimates, the simulated average annual mean EC concentration at rural and background sites was significantly improved to 1.9 μgC m−3. However, the model still significantly underestimated observed OC in all seasons (simulated average annual mean OC at rural and background sites was 5.4 μgC m−3), with little skill in capturing the spatiotemporal variability. Secondary formation accounts for 21% of Chinese annual mean surface OC in the model, with isoprene being the most important precursor. In summer, as high as 62% of the observed surface OC may be due to secondary formation in eastern China. Our analysis points to four shortcomings in the current bottom-up inventories of Chinese carbonaceous aerosols: (1) the anthropogenic source is underestimated on a national scale, particularly for OC; (2) the spatiotemporal distributions of emissions are misrepresented; (3) there is a missing source in western China, likely associated with the use of biofuels or other low-quality fuels for heating; and (4) sources in fall are not well represented, either because the seasonal shifting of emissions and/or secondary formation are poorly captured or because specific fall emission events are missing. In addition, secondary production of OC in China is severely underestimated. More regional measurements with better spatiotemporal coverage are needed to resolve these shortcomings.
The choice of general anaesthetics may affect postoperative cognitive outcomes. This study was designed to compare the potential impact of propofol-based vs sevoflurane-based general anaesthesia on ...the development of delayed neurocognitive recovery in older adults early after major cancer surgery.
Older adults (aged ≥65 and <90 yr) who were scheduled to undergo major cancer surgery (≥2 h) were randomised to receive either propofol- or sevoflurane-based general anaesthesia. Cognitive function was assessed before and 1 week after surgery with a battery of neuropsychological tests. Age- and education-matched non-surgical controls were recruited, and their cognitive functions were tested at comparable time intervals in order to adjust for learning effects from repeated tests. Delayed neurocognitive recovery was diagnosed according to the International Study of Postoperative Cognitive Dysfunction 1 definition.
From April 1, 2015 to October 15, 2016, 392 patients were enrolled and randomised. Of these patients, 387 completed the intervention and 30-day follow-up, and 379 completed 1-week neuropsychological tests. Fifty-nine control subjects were enrolled and completed repeated neuropsychological tests. The incidence of delayed neurocognitive recovery at 1 week was significantly lower in the propofol group 14.8% (28/189) than in the sevoflurane group 23.2% (44/190); odds ratio=0.577; 95% confidence interval, 0.342–0.975; P=0.038. Safety outcomes did not differ between the two groups.
When compared with sevoflurane-based general anaesthesia, propofol-based general anaesthesia might decrease the incidence of delayed neurocognitive recovery in older adults after major cancer surgery.
NCT02662257; Chinese Clinical Trial Registry (identifier: ChiCTR-IPR-15006209).
Heat stress limits wheat production and trehalose can improve stress tolerance. How trehalose affects wheat respiration is unclear. In this study, we investigated the effects of exogenous trehalose ...on the respiration of wheat seedlings during heat stress and the subsequent recovery period. Trehalose pretreatment significantly increased the expression of the alternative oxidase genes AOX1a and AOX1c under heat stress, indicating that trehalose pretreatment increased the capacity of the alternative respiration pathway (AP) in response to heat stress. Trehalose pretreatment also enhanced the activity of the malate-oxaloacetate (Mal-OAA) shuttle and ameliorated the decrease in photosynthetic activity caused by heat stress. However, when the AP was inhibited by salicylhydroxamic acid under heat stress, both Mal-OAA shuttle activity and photosynthetic efficiency were substantially reduced in the control and trehalose pretreatment groups. In addition, trehalose pretreatment helped to maintain inner mitochondrial respiratory activity and the activity of Complex II during heat stress, particularly the coupling of oxidative phosphorylation with the Complex II electron transport chain, thereby mitigating heat-related damage to the cytochrome pathway (CP). Taken together, these results suggest that exogenous trehalose enhanced the AP and reduced damage to the CP under heat stress in wheat seedlings, thus maintaining cellular energy metabolism. Up-regulation of the AP by trehalose pretreatment may improve the heat tolerance of wheat seedlings by dissipating excess reducing equivalents transported through the Mal-OAA shuttle, thereby protecting photosynthetic performance.
The impact of central Asian aridification on the low latitude North Pacific Ocean since the late Miocene remains unclear. To address this question, we systematically studied an abyssal manganese ...nodule from the northwestern Pacific Ocean, which is expected to be sensitive to eolian dust sourced from central Asia. Geochemical variations and the fossilized remains of magnetotactic bacteria within the studied nodule manifest two prominent Asian aridification events at ∼8–7 Ma and 3.6–0 Ma. These results suggest that central Asian aridification impacted both primary productivity and abyssal microbial activity in the NW Pacific Ocean via eolian dust inputs. In contrast to the Pliocene aridification event, the late Miocene event was associated with a primary productivity bloom that is not evident in coeval global primary productivity records, which indicates that the ∼8–7 Asian aridification event was likely due to NE Tibetan Plateau uplift rather than to global cooling.
Plain Language Summary
Central Asian aridification since the late Miocene has had a significant influence on climate, temperature, and North Pacific Ocean productivity through eolian dust inputs transported by westerlies. However, it is unclear whether the low latitude of NW Pacific Ocean responded to this aridification. We systematically analyzed the geochemistry and magnetism of a NW Pacific manganese nodule, and find that Asian aridification since, the late Miocene impacted biogeochemical cycling and abyssal microbial activity in the NW Pacific Ocean via eolian dust input. Our results imply that these two prominent Asian aridification events at around 8–7 Ma and ca. 3.6 Ma can be attributed to the NE Tibetan Plateau uplift and global cooling, respectively.
Key Points
A manganese nodule from the NW Pacific carries a paleoclimatic record of Asian aridification since the Late Miocene
Asian aridification impacted biogeochemical cycling and abyssal microbial activity in the NW Pacific Ocean
Major Asian aridification events at ∼8–7 Ma and ∼3.6–0 Ma may be attributed to NE Tibetan Plateau uplift and global cooling, respectively
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