Environmental life cycle assessment (LCA) for design of climate-resilient bridges – a comprehensive review and a case study

The life cycle assessment (LCA) study of a bridge and bridge network would provide the environmental profile and hotspot information including the GHG emission of different life stages, among the components. Compared with a rapid adoption of Road LCA into the procurement process in the developed countries, Bridge LCA however remains a nascent area where a few studies conducted in North America. The critical issues of environmental profile, hotspots and benchmarks of bridges remain a challenge due to the complexity of bridge structures, data collection and unfamiliarity of LCA in the bridge community. To address the challenge, this study presents a comprehensive bibliometric analysis and review regarding life cycle environmental impacts assessment of bridge projects around the world to identify the research pattern in order to capture the areas of research needed inside this theme. As a proof of concept, this study continues with conducting an LCA case study of a Bridge Replacement Project on a Canadian signature highway, demonstrating the adoption of the LCA methodology and a framework to streamline the collection of data, to develop, present, and interpret the environmental impacts, in terms of the durability and service life of the bridge asset. The study found that stainless steel rebar decks outperformed black steel decks in terms of CO2 reduction by over 10%, with transport fleet impacts being a significant part of the bridge’s overall environmental impact, highlighting the need for diverse functional units in bridge life cycle assessment studies.</p

Image_2_A PD-L1 Negative Advanced Gastric Cancer Patient With a Long Response to PD-1 Blockade After Failure of Systematic Treatment: A Case Report.pdf

BackgroundIt was widely accepted that programmed death-ligand 1 (PD-L1) positive, tumor mutational burden-high (TMB-H) or microsatellite instability-high (MSI-H) tumor are prone to have better treatment response to immune checkpoint blockade. The value of immune checkpoint blockade in PD-L1 negative gastric cancer patients has been questioned due to lower objective response rate (ORR).Case PresentationWe report an unusual case of a PD-L1 negative, proficient mismatch repair (pMMR)/microsatellite stability (MSS), tumor mutational burden-low (TMB-L) gastric cancer patient who achieved good response to immune checkpoint blockade after failure of systematic treatment. Multiple lymph nodes and bone metastases are the main characteristics of this patient. The patient survived for more than 30 months after diagnosis.ConclusionsThis case suggested that PD-L1 negative gastric cancer patient may also benefit from immune checkpoint blockade. In gastric cancer, patients with lymph node metastasis may be potential beneficiaries.</p

Image_1_A PD-L1 Negative Advanced Gastric Cancer Patient With a Long Response to PD-1 Blockade After Failure of Systematic Treatment: A Case Report.pdf

BackgroundIt was widely accepted that programmed death-ligand 1 (PD-L1) positive, tumor mutational burden-high (TMB-H) or microsatellite instability-high (MSI-H) tumor are prone to have better treatment response to immune checkpoint blockade. The value of immune checkpoint blockade in PD-L1 negative gastric cancer patients has been questioned due to lower objective response rate (ORR).Case PresentationWe report an unusual case of a PD-L1 negative, proficient mismatch repair (pMMR)/microsatellite stability (MSS), tumor mutational burden-low (TMB-L) gastric cancer patient who achieved good response to immune checkpoint blockade after failure of systematic treatment. Multiple lymph nodes and bone metastases are the main characteristics of this patient. The patient survived for more than 30 months after diagnosis.ConclusionsThis case suggested that PD-L1 negative gastric cancer patient may also benefit from immune checkpoint blockade. In gastric cancer, patients with lymph node metastasis may be potential beneficiaries.</p

DataSheet_1_Multimodal MRI-Based Radiomics-Clinical Model for Preoperatively Differentiating Concurrent Endometrial Carcinoma From Atypical Endometrial Hyperplasia.pdf

ObjectivesTo develop and validate a radiomics model based on multimodal MRI combining clinical information for preoperative distinguishing concurrent endometrial carcinoma (CEC) from atypical endometrial hyperplasia (AEH).Materials and MethodsA total of 122 patients (78 AEH and 44 CEC) who underwent preoperative MRI were enrolled in this retrospective study. Radiomics features were extracted based on T2-weighted imaging (T2WI), diffusion-weighted imaging (DWI), and apparent diffusion coefficient (ADC) maps. After feature reduction by minimum redundancy maximum relevance and least absolute shrinkage and selection operator algorithm, single-modal and multimodal radiomics signatures, clinical model, and radiomics-clinical model were constructed using logistic regression. Receiver operating characteristic (ROC) analysis, calibration curves, and decision curve analysis were used to assess the models.ResultsThe combined radiomics signature of T2WI, DWI, and ADC maps showed better discrimination ability than either alone. The radiomics-clinical model consisting of multimodal radiomics features, endometrial thickness >11mm, and nulliparity status achieved the highest area under the ROC curve (AUC) of 0.932 (95% confidential interval [CI]: 0.880-0.984), bootstrap corrected AUC of 0.922 in the training set, and AUC of 0.942 (95% CI: 0.852-1.000) in the validation set. Subgroup analysis further revealed that this model performed well for patients with preoperative endometrial biopsy consistent and inconsistent with postoperative pathologic data (consistent group, F1-score = 0.865; inconsistent group, F1-score = 0.900).ConclusionsThe radiomics model, which incorporates multimodal MRI and clinical information, might be used to preoperatively differentiate CEC from AEH, especially for patients with under- or over-estimated preoperative endometrial biopsy.</p

Arbitrary Programming of Racetrack Resonators Using Low-Loss Phase-Change Material Sb₂Se₃

The programmable photonic integrated circuit (PIC) is an enabling technology behind optical interconnects and quantum information processing. Conventionally, the programmability of PICs is driven by the thermo-optic effect, free carrier dispersion, or mechanical tuning. These effects afford either high speed or a large extinction ratio, but all require constant power or bias to maintain the states, which is undesirable for programmability with infrequent switching. Recent progress in programmable PICs based on nonvolatile phase-change materials (PCMs) offers an attractive solution to a truly “set-and-forget” switch that requires zero static energy. Here, we report an essential building block of large-scale programmable PICsa racetrack resonator with independent control of coupling and phase. We changed the resonance extinction ratio (ER) without perturbing the resonance wavelength, leveraging a programmable unit based on a directional coupler and a low-loss PCM Sb2Se3. The unit is only 33-μm-long and has an operating bandwidth over 50 nm, a low insertion loss (∼0.36 dB), high ER (∼15 dB), and excellent fabrication yield of over 1000 cycles endurance across nine switches. The work is a crucial step toward future large-scale energy-efficient programmable PICs

Additional file 1 of Whole-lesion apparent diffusion coefficient (ADC) histogram as a quantitative biomarker to preoperatively differentiate stage IA endometrial carcinoma from benign endometrial lesions

Additional file 1. Table S1. Comparison of ADC histogram parameters between Grade 1/2 and Grade 3 stage IA EC. Table S2. Diagnostic performance of volumetric ADC histogram parameters in differentiating Grade 3 from Grade 1/2 stage IA EC. Table S3. Correlation between ADC histogram parameters and expression of Ki-67 in stage IA EC. Table S4. Comparison of ADC histogram parameters between stage IA ECs with low- and high- Ki-67 expression

Video_4_Acupuncture for the treatment of thalamencephalic and mesencephalic injury secondary to electrical trauma: A case report.MP4

In a case of thalamencephalic and mesencephalic injury secondary to electrical trauma, a 29-year-old patient has been receiving manual acupuncture for 17 months in National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion. As a result of treatment, the patient's self-care ability and quality of life have greatly improved. In order to fully understand how acupuncture can benefit neurological sequelae resulting from electrical trauma, further research is needed. Additionally, there should be consideration given to the promotion of acupuncture therapy in the neurological sequelae of electric shock.</p

Additional file 1 of MRI-based radiomics value for predicting the survival of patients with locally advanced cervical squamous cell cancer treated with concurrent chemoradiotherapy

Additional file 1

Table_3_Therapeutic efficacy of acupuncture point stimulation for stomach cancer pain: a systematic review and meta-analysis.DOCX

PurposeIn recent years, traditional Chinese medicine has received widespread attention in the field of cancer pain treatment. This meta-analysis is the first to evaluate the effectiveness and safety of acupuncture point stimulation in the treatment of stomach cancer pain.MethodsFor this systematic review and meta-analysis, we searched PubMed, Web of Science, Cochrane Library, Embase, WANFANG, China National Knowledge Infrastructure (CNKI), and Chinese Journal of Science and Technology (VIP) databases as well as forward and backward citations to studies published between database creation to July 27, 2023. All randomized controlled trials (RCTs) on acupuncture point stimulation for the treatment of patients with stomach cancer pain were included without language restrictions. We assessed all outcome indicators of the included trials. The evidence from the randomized controlled trials was synthesized as the standardized mean difference (SMD) of symptom change. The quality of the evidence was assessed using the Cochrane Risk of Bias tool. This study is registered on PROSPERO under the number CRD42023457341.ResultsEleven RCTs were included. The study included 768 patients, split into 2 groups: acupuncture point stimulation treatment group (n = 406), medication control group (n = 372). The results showed that treatment was more effective in the acupuncture point stimulation treatment group than in the medication control group (efficacy rate, RR = 1.63, 95% CI 1.37 to 1.94, p Systematic Review Registrationhttps://clinicaltrials.gov/, identifier CRD42023457341.</p

Data_Sheet_1_Therapeutic efficacy of acupuncture point stimulation for stomach cancer pain: a systematic review and meta-analysis.DOCX

PurposeIn recent years, traditional Chinese medicine has received widespread attention in the field of cancer pain treatment. This meta-analysis is the first to evaluate the effectiveness and safety of acupuncture point stimulation in the treatment of stomach cancer pain.MethodsFor this systematic review and meta-analysis, we searched PubMed, Web of Science, Cochrane Library, Embase, WANFANG, China National Knowledge Infrastructure (CNKI), and Chinese Journal of Science and Technology (VIP) databases as well as forward and backward citations to studies published between database creation to July 27, 2023. All randomized controlled trials (RCTs) on acupuncture point stimulation for the treatment of patients with stomach cancer pain were included without language restrictions. We assessed all outcome indicators of the included trials. The evidence from the randomized controlled trials was synthesized as the standardized mean difference (SMD) of symptom change. The quality of the evidence was assessed using the Cochrane Risk of Bias tool. This study is registered on PROSPERO under the number CRD42023457341.ResultsEleven RCTs were included. The study included 768 patients, split into 2 groups: acupuncture point stimulation treatment group (n = 406), medication control group (n = 372). The results showed that treatment was more effective in the acupuncture point stimulation treatment group than in the medication control group (efficacy rate, RR = 1.63, 95% CI 1.37 to 1.94, p Systematic Review Registrationhttps://clinicaltrials.gov/, identifier CRD42023457341.</p