Microstructure Characteristics, Mechanical Properties and Strain Hardening Behavior of B2 Intermetallic Compound-Strengthening Fe-16Mn-9Al-0.8C-3Ni Steel Fabricated by Twin-Roll Strip Casting, Cold Rolling and Annealing

In this study, the Fe-16Mn-9Al-0.8C-3Ni (wt.%) lightweight steel was fabricated by novel twin-roll strip casting technology. The microstructure, tensile properties and strain-hardening behavior of the present steel have been investigated and compared to those of conventionally processed steels with similar chemical compositions. After annealing, a unique gradient microstructure of intermetallic compound (B2)-austenite was obtained along the thickness direction, consisting of granular B2 (average: 430 nm) and fine austenite (average: 1.82 μm) at the surface layer, blocky B2 (average: 1.03 μm) and medium austenite (average: 3.98 μm) at the quarter layer and polygonal B2 (average: 1.94 μm) and coarse austenite (average: 6.13 μm) at the center layer. The cooperative action of B2 pinning dislocation, plane slip and back stress led to stronger strain hardening, among which the strong back stress effect originated from the multistage discontinuous austenite deformation and the mechanical incompatibility between austenite and B2 is believed to be the most important reason, thereby achieving an excellent balance of strength (ultimate tensile strength: 1147 MPa) and ductility (total elongation: 43.2%). This work not only developed a new processing way to fabricate Ni-containing Fe-Mn-Al-C lightweight steel with outstanding mechanical properties, but also provided a potential solution for manufacturing some other metallic materials accompanied by brittle B2 intermetallic.

Common antibiotics, azithromycin and amoxicillin, affect gut metagenomics within a household

BACKGROUND

The microbiome of the human gut serves a role in a number of physiological processes, but can be altered through effects of age, diet, and disturbances such as antibiotics. Several studies have demonstrated that commonly used antibiotics can have sustained impacts on the diversity and the composition of the gut microbiome. The impact of the two most overused antibiotics, azithromycin, and amoxicillin, in the human microbiome has not been thoroughly described. In this study, we recruited a group of individuals and unrelated controls to decipher the effects of the commonly used antibiotics amoxicillin and azithromycin on their gut microbiomes.

RESULTS

We characterized the gut microbiomes by metagenomic sequencing followed by characterization of the resulting microbial communities. We found that there were clear and sustained effects of the antibiotics on the gut microbial community with significant alterations in the representations of Bifidobacterium species in response to azithromycin (macrolide antibiotic). These results were supported by significant increases identified in putative antibiotic resistance genes associated with macrolide resistance. Importantly, we did not identify these trends in the unrelated control individuals. There were no significant changes observed in other members of the microbial community.

CONCLUSIONS

As we continue to focus on the role that the gut microbiome plays and how disturbances induced by antibiotics might affect our overall health, elucidating members of the community most affected by their use is of critical importance to understanding the impacts of common antibiotics on those who take them. Clinical Trial Registration Number NCT05169255. This trial was retrospectively registered on 23-12-2021.

Infection density pattern of Cardinium affects the responses of bacterial communities in an invasive whitefly under heat conditions

Communities of bacteria, especially symbionts, are vital for the growth and development of insects and other arthropods, including Bemisia tabaci Mediterranean (MED), a destructive and invasive insect pest. However, the infection density patterns and influence factors of bacteria in whiteflies, which mainly include symbionts, remain largely unclear. To reveal the different density patterns of Cardinium in B. tabaci MED populations and the impacts of high temperatures on whiteflies with different Cardinium density infection patterns, 2 isofemale lines isolated from B. tabaci MED from the same geographical population of China and from B. tabaci MED collected from other countries and locations were examined using several techniques and methods, including fluorescence in situ hybridization (FISH), quantitative real-time polymerase chain reaction (qPCR), 16S rRNA gene sequencing, and 2b-RAD sequencing. The results showed that there were 2 different infection density patterns of Cardinium in B. tabaci MED (including 1 high-density pattern and 1 low-density pattern). For whiteflies with low-density Cardinium, conventional PCR could not detect Cardinium, but the other techniques confirmed that there was a low level of Cardinium within hosts. High temperature significantly decreased the diversity of bacterial communities: the relative titer of Cardinium increased but the density of Rickettsia decreased in the isofemale line with high-density Cardinium. However, high temperature did not influence the diversity and symbiont density in the line with low-density Cardinium. Moreover, high temperature influenced the functions of bacterial communities in whiteflies with high-density Cardinium but did not affect the bacterial functions in whiteflies with low-density Cardinium. Our results provide novel insights into the complex associations between symbionts and host insects.

Differences in HDL-related mortality risk between individuals with and without hypertension: a prospective cohort study in UK Biobank

BACKGROUND AND AIMS

Very high levels of high-density lipoprotein cholesterol (HDL-C) have been paradoxically linked to increased mortality risk. The present study aimed to examine associations of HDL-C and varied sizes of the HDL particle (HDL-P) with mortality risk stratified by hypertension.

METHODS AND RESULTS

This prospective cohort study included 429 792 participants (244 866 with hypertension and 184 926 without hypertension) from the UK Biobank. During a median follow-up of 12.7 years, 23 993 (9.8%) and 8142 (4.4%) deaths occurred among individuals with and without hypertension, respectively. A U-shaped association of HDL-C with all-cause mortality was observed in individuals with hypertension after multivariable adjustment, whereas an L-shape was observed in individuals without hypertension. Compared with individuals with normal HDL-C of 50-70 mg/dL, those with very high HDL-C levels (>90 mg/dL) had a significantly higher risk of all-cause mortality among individuals with hypertension (hazard ratio, 1.47; 95% confidence interval, 1.35-1.61), but not among those without hypertension (1.05, 0.91-1.22). As for HDL-P, among individuals with hypertension, a larger size of HDL-P was positively whereas smaller HDL-P was negatively associated with all-cause mortality. After additional adjustment for larger HDL-P in the model, the U-shaped association between HDL-C and mortality risk was altered to an L-shape among individuals with hypertension.

CONCLUSIONS

The increased risk of mortality associated with very high HDL-C existed only in individuals with hypertension, but not in those without hypertension. Moreover, the increased risk at high HDL-C levels in hypertension was likely driven by larger HDL-P.

[Impact of the depth of remission by induction chemotherapy on the prognosis of limited stage small cell lung cancer]

Objective: To evaluate the effect of depth of remission of induction chemotherapy on the overall prognosis of limited stage small cell lung cancer (L-SCLC). Methods: The study was a retrospective, L-SCLC patients who contained complete imaging data and underwent consecutive standardized treatments at the Department of Thoracic Radiation and Medical Oncology, Zhongnan Hospital of Wuhan University between January 2013 and June 2021 were included. To delineate the volume of tumor before and after induction chemotherapy and to calculate the depth of remission caused by the induced chemotherapy. The time receiver operating characteristic (timeROC) method was used to determine the optimal predictors for prognosis, multi-factor analysis using Cox risk proportional model. Results: A total of 104 patients were included in this study. The median PFS and OS of this cohort were 13.7 months and 20.9 months, respectively. It was observed by timeROC analysis that residual tumor volume after induction chemotherapy had the optimal predictive value of PFS at 1 year (AUC=0.86, 95% CI: 0.78~0.94) and OS at 2 years (AUC=0.76, 95% CI: 0.65~0.87). Multivariate analysis showed residual tumor volume after induction chemotherapy was the independent prognostic factor to PFS (HR=1.006, 95% CI: 1.003~1.009, P<0.01) and OS (HR=1.009, 95% CI: 1.005~1.012, P<0.001). For those whose residual tumor volume remitted to less than 10 cm(3) after induction chemotherapy, the favorable long-term outcomes could be achieved, regardless of their initial tumor load. Conclusion: The depth of remission of induction chemotherapy could be a promising prognostic predictor to the L-SCLC and provide the individualized treatment guidance.

Fabrication of High Aspect Ratio Nano-Channels by Thermal Nano-Imprinting and Parylene Deposition

A low-cost method of fabrication of high aspect ratio nano-channels by thermal nano-imprinting and Parylene deposition is proposed. SU-8 photoresist nano-channels were first manufactured by thermal nano-imprinting, and Parylene deposition was carried out to reduce the width of the nano-channels and increase the aspect ratio. During the process, the side walls of the SU-8 nano-channels were covered with the Parylene film, reducing the width of the nano-channels, and the depth of the channels increased due to the thickness of the Parylene film deposited on the surface of the SU-8 nano-channels, more so than that at the bottom. The influence of Parylene mass on the size of nano-channels was studied by theoretical analysis and experiments, and the deposition pressure of Parylene was optimized. The final high aspect ratio nano-channels are 46 nm in width and 746 nm in depth, of which the aspect ratio is 16. This simple and efficient method paves the way for the production of high aspect ratio nano-channels.

Robust Fluorine-Functionalized {Ln5}-Organic Frameworks for Excellent Catalytic Performance on Cycloaddition of CO2 with Epoxides and Knoevenagel Condensation

Lanthanide-organic frameworks (LnOFs) are a class of promising catalysts on a large number of organic reactions because of the higher coordination number of Ln³⁺ ions, inspired by which exploratory preparation of cluster-based LnOFs was carried out by us. Herein, the exquisite combination of spindly [Ln₅(μ₃-OH)₆(CO₂)₆(H₂O)₆] clusters (abbreviated as {Ln₅}) and fluorine-functionalized tetratopic ligand of 2',3'-difluoro-[p-terphenyl]-3,3″,5,5″-tetracarboxylic acid (F-H₄PTTA) engendered two highly robust isomorphic nanoporous frameworks of {[Ln₅(FPTTA)₂(μ₃-OH)₆(H₂O)₆](NO₃)}_n (NUC-61, Ln = Ho and Dy). NUC-61 compounds are rarely reported {Ln₅}-based 3D frameworks with nano-caged voids (19 Å × 17 Å), which are shaped by twelve [Ln₅(μ₃-OH)₆(COO)₈] clusters and eight completely deprotonated F-PTTA^4- ligands. Activated NUC-61a compounds are characterized by plentiful coexisted Lewis acid-base sites of open Ln^III sites, capped μ₃-OH, and -F. Judged by the ideal adsorbed solution theory (IAST), activated NUC-61Ho-a had a high CO₂/CH₄ adsorptive selectivity with the value of 12.7 (CO₂/CH₄ = 50/50) and 9.1 (CO₂/CH₄ = 5/95) at 298 K, which could lead to high-purity CH₄ (≥99.9996%). Furthermore, catalytic experiments exhibited that NUC-61Ho-a, as a representative, could efficiently catalyze the cycloaddition reactions of CO₂ with epoxides as well as the Knoevenagel condensation reactions of aldehydes and malononitrile. This work proves that the {Ln₅}-based skeletons of NUC-61 with chemical stability, heterogeneity, and recyclability are an excellent acid-base bifunctional catalyst for some organic reactions.

Rhodium(III)-Picolinamide Complexes Act as Anticancer and Antimetastasis Agents via Inducing Apoptosis and Autophagy

As a continuation of our endeavors in discovering metal-based drugs with cytotoxic and antimetastatic activities, herein, we reported the syntheses of 11 new rhodium(III)-picolinamide complexes and the exploration of their potential anticancer activities. These Rh(III) complexes showed high antiproliferative activity against the tested cancer cell lines in vitro. The mechanism study indicated that Rh1 ([Rh(3a)(CH₃CN)Cl₂]) and Rh2 ([Rh(3b)(CH₃CN)Cl₂]) inhibited cell proliferation by multiple modes of action via cell cycle arrest, apoptosis, and autophagy and inhibited cell metastasis via FAK-regulated integrin β1-mediated suppression of EGFR expression. Furthermore, Rh1 and Rh2 significantly inhibited bladder cancer growth and breast cancer metastasis in a xenograft model. These rhodium(III) complexes could be developed as potential anticancer agents with antitumor growth and antimetastasis activity.

Association between circulating tumor cells in the peripheral blood and the prognosis of gastric cancer patients: a meta-analysis

Background

Research on the correlation between circulating tumor cells (CTCs) and gastric cancer (GC) has increased rapidly in recent years. However, whether CTCs are associated with GC patient prognosis is highly controversial.

Objective

This study aims to evaluate the value of CTCs to predict the prognosis of GC patients.

Design

A meta-analysis.

Data Sources and Methods

We searched the PubMed, Embase, and Cochrane Library databases for studies that reported the prognostic value of CTCs in GC patients before October 2022. The association between CTCs and overall survival (OS) and disease-free survival (DFS)/recurrence-free survival (RFS) and progression-free survival (PFS) of GC patients was assessed. Subgroup analyses were stratified by sampling times (pre-treatment and post-treatment), detection targets, detection method, treatment method, tumor stage, region, and HR (Hazard Ratio) extraction methods. Sensitivity analysis was performed by removing individual studies to assess the stability of the results. Publication bias was evaluated using funnel plots, Egger's test, and Begg's test.

Results

We initially screened 2000 studies, of which 28 were available for further analysis, involving 2383 GC patients. The pooled analysis concluded that the detection of CTCs was associated with poor OS (HR = 1.933, 95% CI 1.657-2.256, p < 0.001), DFS/RFS (HR = 3.228, 95% CI 2.475-4.211, p < 0.001), and PFS (HR = 3.272, 95% CI 1.970-5.435, p < 0.001). Furthermore, the subgroup analysis stratified by tumor stage (p < 0.01), HR extraction methods (p < 0.001), detection targets (p < 0.001), detection method (p < 0.001), sampling times (p < 0.001), and treatment method (p < 0.001) all showed that CTC detection was associated with poor OS and DFS/RFS for GC patients. Furthermore, the study showed that CTCs were associated with the poor DFS/RFS of GC when CTCs were detected for patients from Asian or No-Asian regions (p < 0.05). In addition, higher CTCs predicted poorer OS for GC patients who are from Asian regions (p < 0.001), but without statistical difference for GC patients from No-Asian regions (p = 0.490).

Conclusion

CTC detection in peripheral blood was associated with poor OS, DFS/RFS, and PFS in patients with GC.

Biomimetic hypoxia-triggered RNAi nanomedicine for synergistically mediating chemo/radiotherapy of glioblastoma

Although RNA interference (RNAi) therapy has emerged as a potential tool in cancer therapeutics, the application of RNAi to glioblastoma (GBM) remains a hurdle. Herein, to improve the therapeutic effect of RNAi on GBM, a cancer cell membrane (CCM)-disguised hypoxia-triggered RNAi nanomedicine was developed for short interfering RNA (siRNA) delivery to sensitize cells to chemotherapy and radiotherapy. Our synthesized CCM-disguised RNAi nanomedicine showed prolonged blood circulation, high BBB transcytosis and specific accumulation in GBM sites via homotypic recognition. Disruption and effective anti-GBM agents were triggered in the hypoxic region, leading to efficient tumor suppression by using phosphoglycerate kinase 1 (PGK1) silencing to enhance paclitaxel-induced chemotherapy and sensitize hypoxic GBM cells to ionizing radiation. In summary, a biomimetic intelligent RNAi nanomedicine has been developed for siRNA delivery to synergistically mediate a combined chemo/radiotherapy that presents immune-free and hypoxia-triggered properties with high survival rates for orthotopic GBM treatment.

Trends in Self-Reported Adherence to Healthy Lifestyle Behaviors Among US Adults, 1999 to March 2020

IMPORTANCE

Adherence to a healthy lifestyle is associated with lower risks of adverse outcomes. However, trends in multiple lifestyle factors and overall healthy lifestyle status among US adults in recent years are unknown.

OBJECTIVE

To examine trends in multiple lifestyle factors and overall healthy lifestyle among US adults.

DESIGN, SETTING, AND PARTICIPANTS

This serial cross-sectional study used nationally representative data from 10 National Health and Nutrition Examination Survey (NHANES) cycles (nine 2-year cycles from 1999 to 2016 and 1 combined cycle from 2017 to March 2020) among adults 20 years or older. Data were analyzed from December 10, 2021, to January 11, 2023.

EXPOSURE

Survey cycle.

MAIN OUTCOMES AND MEASURES

Five healthy lifestyle factors: never smoking, moderate or lighter alcohol consumption (for women: ≤7 drinks/wk; for men: ≤14 drinks/wk), healthy diet (Healthy Eating Index-2015 scores ≥60.0), sufficient physical activity (≥150 min/wk of equivalent moderate physical activity), and healthy weight (body mass index [calculated as weight in kilograms divided by height in meters squared] 18.5-24.9).

RESULTS

A total of 47 852 adults were included in this study. The weighted mean [SE] age was 47.3 [0.2] years; 24 539 (weighted proportion, 51.5%) were women. From the 1999-2000 cycle to the 2017 to March 2020 cycle, the estimated prevalence of the 5 lifestyle factors showed divergent trends, with increasing prevalence of never smoking (from 49.4% [95% CI, 46.4%-52.4%] to 57.7% [95% CI, 55.5%-59.9%]; difference, 8.2% [95% CI, 4.5%-12.0%]), healthy diet (from 19.3% [95% CI, 16.0%-22.6%] to 24.5% [95% CI, 21.5%-27.5%]; difference, 5.2% [95% CI, 0.8%-9.7%]), and sufficient physical activity (from 55.7% [95% CI, 51.8%-59.6%] to 69.1% [95% CI, 67.2%-71.1%]; difference, 13.4% [95% CI, 9.0%-17.8%]), while prevalence of healthy weight decreased from 33.1% (95% CI, 30.5%-35.6%) to 24.6% (95% CI, 22.6%-26.7%; difference, -8.4% [95% CI, -11.8% to -5.1%]) (all P < .001 for trend). Meanwhile, there was no significant trend in moderate or lighter alcohol consumption. Overall, the estimated prevalence of at least 4 healthy lifestyle factors increased from 15.7% (95% CI, 12.8%-18.7%) to 20.3% (95% CI, 17.8%-22.7%; difference, 4.5% [95% CI, 0.7%-8.4%]; P < .001 for trend). Disparities in healthy lifestyle were widened by age group, with little improvement among adults 65 years and older (difference, 0.04% [95% CI, -4.28% to 4.35%]). There were persistent disparities in healthy lifestyle by race and ethnicity, educational level, and income level.

CONCLUSIONS AND RELEVANCE

The findings of this cross-sectional study of NHANES data over a 22-year period suggest diverse change patterns across 5 healthy lifestyle factors and a modest improvement in overall lifestyle existed among US adults, with worsening or persistent disparities in lifestyle.

Research Progress on the Osteogenesis-Related Regulatory Mechanisms of Human Umbilical Cord Mesenchymal Stem Cells

In recent years, research on human umbilical cord mesenchymal stem cells (hUCMSCs) derived from human umbilical cord tissue has accelerated and entered clinical application research. Compared with mesenchymal stem cells (MSCs) from other sources, hUCMSCs can be extracted from different parts of umbilical cord or from the whole umbilical cord. It has the characteristics of less ethical controversy, high differentiation potential, strong proliferation ability, efficient expansion in vitro, avoiding immune rejection and immune privilege, and avoids the limitations of lack of embryonic stem cells, heterogeneity, ethical and moral constraints. hUCMSCs avoid the need for embryonic stem cell sources, heterogeneity, and ethical and moral constraints. Bone defects are very common in clinical practice, but completely effective bone tissue regeneration treatment is challenging. Currently, autologous bone transplantation and allogeneic bone transplantation are main treatment approaches in clinical work, but each has different shortcomings, such as limited sources, invasiveness, immune rejection and insufficient osteogenic ability. Therefore, to solve the bottleneck of bone tissue regeneration and repair, a great amount of research has been carried out to explore the clinical advantages of hUCMSCs as seed cells to promote osteogenesis.However, the regulation of osteogenic differentiation of hUCMSCs is an extremely complex process. Although a large number of studies have demonstrated that the role of hUCMSCs in enhancing local bone regeneration and repair through osteogenic differentiation and transplantation into the body involves multiple signaling pathways, there is no relevant article that summarize the findings. This article discusses the osteogenesis-related regulatory mechanisms of hUCMSCs, summarizes the currently known related mechanisms, and speculates on the possible signals.

[Risk predictive models of healthcare-seeking delay among imported malaria patients in Jiangsu Province based on the machine learning]

OBJECTIVE

To create risk predictive models of healthcare-seeking delay among imported malaria patients in Jiangsu Province based on machine learning algorithms, so as to provide insights into early identification of imported malaria cases in Jiangsu Province.

METHODS

Case investigation, first symptoms and time of initial diagnosis of imported malaria patients in Jiangsu Province in 2019 were captured from Infectious Disease Report Information Management System and Parasitic Disease Prevention and Control Information Management System of Chinese Center for Disease Control and Prevention. The risk predictive models of healthcare-seeking delay among imported malaria patients were created with the back propagation (BP) neural network model, logistic regression model, random forest model and Bayesian model using thirteen factors as independent variables, including occupation, species of malaria parasite, main clinical manifestations, presence of complications, severity of disease, age, duration of residing abroad, frequency of malaria parasite infections abroad, incubation period, level of institution at initial diagnosis, country of origin, number of individuals travelling with patients and way to go abroad, and time of healthcare-seeking delay as a dependent variable. Logistic regression model was visualized using a nomogram, and the nomogram was evaluated using calibration curves. In addition, the efficiency of the four models for prediction of risk of healthcare-seeking delay among imported malaria patients was evaluated using the area under curve (AUC) of receiver operating characteristic curve (ROC). The importance of each characteristic was quantified and attributed by using SHAP to examine the positive and negative effects of the value of each characteristic on the predictive efficiency.

RESULTS

A total of 244 imported malaria patients were enrolled, including 100 cases (40.98%) with the duration from onset of first symptoms to time of initial diagnosis that exceeded 24 hours. Logistic regression analysis identified a history of malaria parasite infection [odds ratio (OR) = 3.075, 95% confidential interval (CI): (1.597, 5.923)], long incubation period [OR = 1.010, 95% CI: (1.001, 1.018)] and seeking healthcare in provincial or municipal medical facilities [OR = 12.550, 95% CI: (1.158, 135.963)] as risk factors for delay in seeking healthcare among imported malaria cases. BP neural network modeling showed that duration of residing abroad, incubation period and age posed great impacts on delay in healthcare-seek among imported malaria patients. Random forest modeling showed that the top five factors with the greatest impact on healthcare-seeking delay included main clinical manifestations, the way to go abroad, incubation period, duration of residing abroad and age among imported malaria patients, and Bayesian modeling revealed that the top five factors affecting healthcare-seeking delay among imported malaria patients included level of institutions at initial diagnosis, age, country of origin, history of malaria parasite infection and individuals travelling with imported malaria patients. ROC curve analysis showed higher overall performance of the BP neural network model and the logistic regression model for prediction of the risk of healthcare-seeking delay among imported malaria patients (Z = 2.700 to 4.641, all P values < 0.01), with no statistically significant difference in the AUC among four models (Z = 1.209, P > 0.05). The sensitivity (71.00%) and Youden index (43.92%) of the logistic regression model was higher than those of the BP neural network (63.00% and 36.61%, respectively), and the specificity of the BP neural network model (73.61%) was higher than that of the logistic regression model (72.92%).

CONCLUSIONS

Imported malaria cases with long duration of residing abroad, a history of malaria parasite infection, long incubation period, advanced age and seeking healthcare in provincial or municipal medical institutions have a high likelihood of delay in healthcare-seeking in Jiangsu Province. The models created based on the logistic regression and BP neural network show a high efficiency for prediction of the risk of healthcare-seeking among imported malaria patients in Jiangsu Province, which may provide insights into health management of imported malaria patients.

Self-Powered, Non-Toxic, Recyclable Thermogalvanic Hydrogel Sensor for Temperature Monitoring of Edibles

Thermogalvanic hydrogel, an environmentally friendly power source, enable the conversion of low-grade thermal energy to electrical energy and powers microelectronic devices in a variety of scenarios without the need for additional batteries. Its toxicity, mechanical fragility and low output performance are a hindrance to its wide application. Here, we demonstrate thermoelectric gels with safe non-toxic, recyclable, highly transparent and flexible stretchable properties by introducing gelatin as a polymer network and SO3/42- as a redox electric pair. When the temperature difference is 10 K, the gel-based thermogalvanic cell achieves an open-circuit voltage of about 16.2 mV with a maximum short-circuit current of 39 μA. Furthermore, we extended the application of the Gel-SO3/42- gel to monitor the temperature of hot or cold food, enabling self-powered sensing for food temperature detection. This research provides a novel concept for harvesting low-grade thermal energy and achieving safe and harmless self-driven temperature monitoring.

[The value of cardiac MRI in the risk stratification in patients with hypertrophic cardiomyopathy]

Objective: To explore the value of cardiac magnetic resonance imaging (CMR) in the risk stratification of hypertrophic cardiomyopathy (HCM). Methods: HCM patients who underwent CMR examination in Fuwai Hospital between March 2012 and May 2013 were retrospectively enrolled. Baseline clinical and CMR data were collected and patient follow-up was performed using telephone contact and medical record. The primary composite endpoint was sudden cardiac death (SCD) or and equivalent event. The secondary composite endpoint was all-cause death and heart transplant. Patients were divided into SCD and non-SCD groups. Cox regression was used to explore risk factors of adverse events. Receiver operating characteristic (ROC) curve analysis was used to assess the performance and the optimal cut-off of late gadolinium enhancement percentage (LGE%) for the prediction of endpoints. Kaplan-Meier and log-rank tests were used to compare survival differences between groups. Results: A total of 442 patients were enrolled. Mean age was (48.5±12.4) years and 143(32.4%) were female. At (7.6±2.5) years of follow-up, 30 (6.8%) patients met the primary endpoint including 23 SCD and 7 SCD equivalent events, and 36 (8.1%) patients met the secondary endpoint including 33 all-cause death and 3 heart transplant. In multivariate Cox regression, syncope(HR=4.531, 95%CI 2.033-10.099, P<0.001), LGE% (HR=1.075, 95%CI 1.032-1.120, P=0.001) and left ventricular ejection fraction (LVEF) (HR=0.956, 95%CI 0.923-0.991, P=0.013) were independent risk factors for primary endpoint; Age (HR=1.032, 95%CI 1.001-1.064, P=0.046), atrial fibrillation (HR=2.977, 95%CI 1.446-6.131, P=0.003),LGE% (HR=1.075, 95%CI 1.035-1.116, P<0.001) and LVEF (HR=0.968, 95%CI 0.937-1.000, P=0.047) were independent risk factors for secondary endpoint. ROC curve showed the optimal LGE% cut-offs were 5.1% and 5.8% for the prediction of primary and secondary endpoint, respectively. Patients were further divided into LGE%=0, 0<LGE%<5%, 5%≤LGE%<15% and LGE%≥15% groups. There were significant survival differences between these 4 groups whether for primary endpoint or secondary endpoint (all P<0.001) and the accumulated incidence of primary endpoint was 1.2% (2/161), 2.2% (2/89), 10.5% (16/152) and 25.0% (10/40), respectively. Conclusion: LGE is an independent risk factor for SCD events as well as all-cause death and heart transplant. LGE is of important value in the risk stratification in patients with HCM.

Interface Coordination Engineering of P-Fe3O4/Fe@C Derived from an Iron-Based Metal Organic Framework for pH-Universal Water Splitting

Developing electrocatalysts with high energy conversion efficiency is urgently needed. In this work, P-Fe₃O₄/Fe@C electrodes with rich under-coordinated Fe atom interfaces are constructed for efficient pH-universal water splitting. The introduction of under-coordinated Fe atoms into the P-Fe₃O₄/Fe@C interface can increase the local charge density and polarize the 3d orbital lone electrons, which promotes water adsorption and activation to release more H^*, thus elevating electrocatalytic activity. As a donor-like catalyst, P-Fe₃O₄/Fe@C displays excellent electrocatalytic performance with overpotentials of 160 mV and 214 mV in acidic and alkaline electrolytes at 10 mA cm^-2, in addition to pH-universal long-term stability.

The overexpression and clinical significance of TBX15 in human gliomas

T-box transcription factor 15 (TBX15) is upregulated in a variety of tumors and has been reported to promote uncontrolled proliferation of tumor cells and induce tumor cells to avoid apoptosis, thus accelerating the malignant transformation of malignant tumors. However, the prognostic value of TBX15 in glioma and its relationship with immune infiltration remain unknown. In this study, we intended to explore the prognostic value of TBX15 and its link to glioma immune infiltration and examine TBX15 expression in pan-cancer using RNAseq data in TPM format from TCGA and GTEx. TBX15 mRNA and protein expressions in glioma cells and adjacent normal tissue were detected and compared by RT-qPCR and Western blot. The effect of TBX15 on survival was assessed by Kaplan-Meier Method. The correlation between TBX15 upregulation and the clinicopathological characteristics of glioma patients was assessed by using TCGA databases, and the relationship between TBX15 and other genes in glioma was evaluated by using TCGA data. The top 300 genes most significantly associated with TBX15 were selected to establish a PPI network through the STRING database. The relationship between TBX15 mRNA expression and immune cell infiltration was explored by using ssGSEA and the TIMER Database. It was found that TBX15 mRNA expression in glioma tissues was significantly higher than that in the adjacent normal tissues, and this difference was most obvious in high-grade gliomas. TBX15 expression was increased in human gliomas and associated with worse clinicopathological characteristics and poorer survival prognosis in glioma patients. In addition, elevated TBX15 expression was linked to a collection of genes involved in immunosuppression. In conclusion, TBX15 played an important role in immune cell infiltration in glioma and may prove to be a predictor of the prognosis in glioma patients.

Robust vessel segmentation in laser speckle contrast images based on semi-weakly supervised learning

OBJECTIVE

The goal of this study is to develop a robust semi-weakly supervised learning strategy for vessel segmentation in laser speckle contrast imaging (LSCI), addressing the challenges associated with the low signal-to-noise ratio, small vessel size, and irregular vascular aberration in diseased regions, while improving the performance and robustness of the segmentation method.

APPROACH

For the training dataset, the healthy vascular images denoted as normal-vessel samples were manually labeled, while the diseased LSCI images involving tumor or embolism were denoted as abnormal-vessel samples and annotated as pseudo labels by the traditional semantic segmentation methods. In the training phase, the pseudo labels were constantly updated to improve the segmentation accuracy based on DeepLabv3+. Objective evaluation was conducted on the normal-vessel test set, while subjective evaluation was performed on the abnormal-vessel test set.

MAIN RESULTS

The proposed method achieved an IOU of 0.8671, a Dice of 0.9288, and a mean relative percentage difference (mRPD) with supervised learning of 0.5% in the objective evaluation. In the subjective evaluation, our method significantly outperformed other methods in main vessel segmentation, tiny vessel segmentation, and blood vessel connection. Additionally, our method exhibited robustness when abnormal-vessel style noise was added to normal-vessel samples using a style translation network.

SIGNIFICANCE

The proposed semi-weakly supervised learning strategy demonstrates high efficiency and excellent robustness for vascular segmentation in LSCI, providing a potential tool for assessing the morphological and structural features of vessels in clinical applications.

Bioinspired Additive Manufacturing of Hierarchical Materials: From Biostructures to Functions

Throughout billions of years, biological systems have evolved sophisticated, multiscale hierarchical structures to adapt to changing environments. Biomaterials are synthesized under mild conditions through a bottom-up self-assembly process, utilizing substances from the surrounding environment, and meanwhile are regulated by genes and proteins. Additive manufacturing, which mimics this natural process, provides a promising approach to developing new materials with advantageous properties similar to natural biological materials. This review presents an overview of natural biomaterials, emphasizing their chemical and structural compositions at various scales, from the nanoscale to the macroscale, and the key mechanisms underlying their properties. Additionally, this review describes the designs, preparations, and applications of bioinspired multifunctional materials produced through additive manufacturing at different scales, including nano, micro, micro-macro, and macro levels. The review highlights the potential of bioinspired additive manufacturing to develop new functional materials and insights into future directions and prospects in this field. By summarizing the characteristics of natural biomaterials and their synthetic counterparts, this review inspires the development of new materials that can be utilized in various applications.

A new species of Siphlonurus Eaton, 1868 (Ephemeroptera, Siphlonuridae) from Yunnan, China

Siphlonurusdongxi Li & Tong, sp. nov. from Shangri-La City, Yunnan Province, China, is described based on egg, nymph, and winged stages. The new species is closely related to S.davidi (Navás, 1932), and can be distinguished by the colour of the imago, the forking point of MP, the penis, posterolateral spines of tergum IX of imagoes, and first abdominal terga nymph, as well as the structure of the egg. The new species and S.davidi have the same morphological and structural characteristics, such as the long cubital area with many intercalaries, cross veins between C, Sc, RA, and RSa₁ surrounded with distinct pigments, the strong curvature of vein CuP in the forewing, the broad expansion of the hindwing, the membranous penis lobes fused without teeth, supporting the proposition of a new species complex, the Siphlonurusdavidi group. The structures of the penis and the egg of the new species could help understand the origin and evolution of the genus Siphlonurus.

A primary Rosai-Dorfman-Destombes disease of the scalp: case report and literature review

Background

Rosai-Dorfman-Destombes disease (RDD) was first described in 1965 as a benign histiocytic proliferative disorder of unknown cause. Cases of RDD limited to cutaneous tissue have been reported over the past few decades, but single cutaneous RDD of the scalp is rare.

Case presentation

We report a 31-year-old male with a lump on the parietal scalp without extranodal lesion lasting 1 month with gradual enlargement. The surgical incision ruptured with purulent after the first resection. Then the patient was treated with plastic surgery after disinfection and antibiotic treatment. Finally, he recovered well and discharged after 20 days.

Conclusions

RDD of the scalp is rare. Surgical incision can cure the lesion but it may become infected because of increased lymphocytic infiltration. Early diagnosis and differential diagnosis of RDD are necessary. For treatment, individualized therapy is critical to patient prognosis.

Mode of innovative green production for concrete engineering: life cycle assessment of accelerators prepared from aluminum mud wastes

In this study, two types of liquid alkali-free accelerators were prepared by aluminum sulfate (AF₁) and aluminum mud wastes (AF₂), and the life cycle assessment (LCA) in the preparation of AF₁ and AF₂ was compared. The LCA was considered from cradle to gate including raw materials used, transportation, and accelerator preparation based on the method ReCiPe2016. The results indicated that AF₁ had a higher environmental impact in all midpoint impact categories and endpoint indicators than that of AF₂, and AF₂ reduced 43.59% emission of CO₂, 59.09% emission of SO₂, 71% consumption of mineral resources, and 46.67% consumption of fossil resources than that of AF₁ respectively. As an environment-friendly accelerator, AF₂ had a better application performance than traditional accelerator AF_1. When the dosage of accelerators was 7%, the initial setting times of cement pastes containing AF₁ and AF₂ were 4 min 57 s and 4 min 04 s respectively, the final setting times of cement pastes containing AF₁ and AF₂ were 11 min 49 s and 9 min 53 s respectively, and the compressive strengths at 1 d of mortars containing AF₁ and AF₂ were 7.35 MPa and 8.33 MPa respectively. This study aims to provide technical feasibility and environmental impact assessment for exploring new avenues of preparing environment-friendly liquid alkali-free accelerators with aluminum mud solid wastes. It has great potential in reducing carbon and pollution emissions and has a greater competitive advantage due to great application performance.

Clinicopathological Features of Hepatocellular Carcinoma with Metabolic Risk Factors

Objective

This study aims to explore the pathological characteristics of metabolic-related hepatocellular carcinoma (HCC) and its correlation with metabolic factors.

Methods

Fifty-one patients with liver cancer of unknown causes were enrolled. Biopsy of the liver and staining of the liver tissues with hematoxylin-eosin as well as special and immunohistochemical stains were performed. The histological subtypes of HCC were diagnosed based on the WHO Classification of Malignant Hepatocellular Tumors. The NAFLD activity score system was adopted for assessing the surrounding non-neoplastic liver tissues.

Results

Of the total, 42 (82.4%) patients were diagnosed with HCC, 32 had metabolic risk factors, 20 patients met the diagnostic criteria of the metabolic-associated fatty liver disease (MAFLD)-related HCC, and 40.6% (13/32) had liver cirrhosis. The incidence of cirrhosis (p = 0.033) and diabetes mellitus type 2 (p = 0.036) in patients with MAFLD-related HCC was notably higher than that in HCC patients with only metabolic risk factors. Among the 32 HCC cases with metabolic risk factors, trabecular type was the most prevalent, followed by steatohepatitis type, scirrhous type, solid type, pseudoglandular type, clear-cell type, and macrotrabecular type. The degree of tumor cells' swelling and ballooning was found to be positively related to the degree of fibrosis in the surrounding liver tissues (p = 0.011) as well as the proportion of cirrhosis (p = 0.004). Moreover, the degree of fibrosis in the surrounding liver tissues showed a negative correlation with the levels of serum cholesterol (p = 0.002), low-density lipoprotein (p = 0.002), ApoA1 (p = 0.009), ApoB (p = 0.022), total protein (p = 0.015), WBC count (p = 0.006), and PLT count (p = 0.015).

Conclusion

Pathological characteristics of the tumor and adjacent non-neoplastic liver tissues of HCC with metabolic risk factors were found to be correlated with metabolic abnormalities.

nZVI decreases N2O emission from pesticide-contaminated paddy soil

The abundance and speciation of iron in farmland soils may affect the environmental fate of residual pesticides and their effects on soil N-cycling, which remains unclear. Herein, the roles of nanoscale zero-valent iron (nZVI) and iron oxidates (α-Fe₂O₃, γ-Fe₂O₃, and Fe₃O₄) as exogenous iron in reducing the adverse effect of pesticide pollution on soil N-cycling were firstly studied. It was found that the iron-based nanomaterials, especially nZVI, effectively reduced the N₂O emission by 32.4-69.7 % at 5 g kg^-1 from pentachlorophenol (PCP, as a representative pesticide, 100 mg kg^-1) contaminated paddy soil, and remarkable N₂O reduction (86.9 %) and PCP removal (60.9 %) were simultaneously achieved by applying 10 g kg^-1 nZVI. Moreover, nZVI significantly mitigated the PCP-induced soil NO₃^--N accumulation and increased soil NH₄⁺-N. Mechanistically, the nZVI restored the activities and abundances of nitrate- and N₂O- reductases and reduced microorganisms in the PCP-contaminated soil. Moreover, the nZVI suppressed N₂O-producing fungi while promoting soil bacteria (especially nosZ-II bacteria) to increase N₂O consumption in the soil. This study provides a strategy for adding iron-based nanomaterials to mitigate the adverse effects of pesticide residues on soil N-cycling and provides basic data for subsequent understanding of the effects of iron cycling in paddy soils on pesticide residues and N-cycling.

URNet: System for recommending referrals for community screening of diabetic retinopathy based on deep learning

Diabetic retinopathy (DR) will cause blindness if the detection and treatment are not carried out in the early stages. To create an effective treatment strategy, the severity of the disease must first be divided into referral-warranted diabetic retinopathy (RWDR) and non-referral diabetic retinopathy (NRDR). However, there are usually no sufficient fundus examinations due to lack of professional service in the communities, particularly in the developing countries. In this study, we introduce UGAN_Resnet_CBAM (URNet; UGAN is a generative adversarial network that uses Unet for feature extraction), a two-stage end-to-end deep learning technique for the automatic detection of diabetic retinopathy. The characteristics of DDR fundus data set were used to design an adaptive image preprocessing module in the first stage. Gradient-weighted Class Activation Mapping (Grad-CAM) and t-distribution and stochastic neighbor embedding (t-SNE) were used as the evaluation indices to analyze the preprocessing results. In the second stage, we enhanced the performance of the Resnet50 network by integrating the convolutional block attention module (CBAM). The outcomes demonstrate that our proposed solution outperformed other current structures, achieving 94.5% and 94.4% precisions, and 96.2% and 91.9% recall for NRDR and RWDR, respectively.

Reaction mechanism and electronic properties of host-guest energetic material CL-20/HA under high pressure by quantum-based molecular dynamics simulations

The novel host-guest material 2,4,6,8,10,12-hexanitro-2,4,6,8,10,12-hexaazaisowurtzitane (CL-20)/hydroxylamine (HA) improves the detonation energy of CL-20 explosives without compromising its safety. However, the reaction mechanism of CL-20/HA under high pressure is not yet fully understood for the complex host-guest structure. A multiscale shock simulation technique by quantum-based molecular dynamics was performed to investigate the reaction mechanism of CL-20/HA under shock with different velocities along different directions, focusing on charge transfer, electronic properties, reaction path and product evolution. The structural changes caused by both insertion of HA and charge overlap between CL-20 and HA are responsible for the electronic changes and gap decrease. Directional charge transfer was observed between CL-20 and HA molecular fragments during shock in all shock loading directions, causing the CL-20 molecular group to become electrically non-neutral. The C-N bond in the CL-20 cage then broke, leading to the release of nitro and nitrous oxide at high temperatures and pressures. The HA molecules or free H atoms from HA could bond with the O atom in the nitro group, leading to the N-O bond cleavage. Some free H atoms could act as an intermediary, connecting two CL-20 molecules and forming dimeric molecules briefly. Compared with the pure CL-20 system, HA can inhibit the reaction of CL-20 in the CL-20/HA system to some extent during the initial shock stage. A further understanding of the chemical reaction mechanism and energy release in dense host-guest materials can be advanced by focusing on the microscopic internal effects of the guest molecule on the host molecule reactions.

Different types of percutaneous endovascular interventions for acute ischemic stroke

BACKGROUND

Acute ischemic stroke (AIS) is the abrupt reduction of blood flow to a certain area of the brain which causes neurologic dysfunction. Different types of percutaneous arterial endovascular interventions have been developed, but as yet there is no consensus on the optimal therapy for people with AIS.

OBJECTIVES

To compare the safety and efficacy of different types of percutaneous arterial endovascular interventions for treating people with AIS.

SEARCH METHODS

We searched the Cochrane Central Register of Controlled Trials (CENTRAL; Issue 4 of 12, 2022), MEDLINE Ovid (1946 to 13 May 2022), Embase (1947 to 15 May 2022), Science Citation Index Web of Science (1900 to 15 May 2022), Scopus (1960 to 15 May 2022), and China Biological Medicine Database (CBM; 1978 to 16 May 2022). We also searched the ClinicalTrials.gov trials register and the World Health Organization (WHO) International Clinical Trials Registry Platform to 16 May 2022.

SELECTION CRITERIA

Randomized controlled trials (RCTs) comparing one percutaneous arterial endovascular intervention with another in treating adult patients who have a clinical diagnosis of AIS due to large vessel occlusion and confirmed by imaging evidence, including thrombo-aspiration, stent-retrieval thrombectomy, aspiration-retriever combined technique, and thrombus mechanical fragmentation.

DATA COLLECTION AND ANALYSIS

Two review authors independently performed the literature searches, identified eligible trials, and extracted data. A third review author participated in discussions to reach consensus decisions when any disputes occurred. We assessed risk of bias and applied the GRADE approach to evaluate the quality of the evidence. The primary outcome was rate of modified Rankin Scale (mRS) of 0 to 2 at three months. Secondary outcomes included the rate of modified Thrombolysis In Cerebral Infarction (mTICI) of 2b to 3 postprocedure, all-cause mortality within three months, rate of intracranial hemorrhage on imaging at 24 hours, rate of symptomatic intracranial hemorrhage at 24 hours, and rate of procedure-related adverse events within three months.

MAIN RESULTS

Four RCTs were eligible. The current meta-analysis included two trials with 651 participants comparing thrombo-aspiration with stent-retrieval thrombectomy. We judged the quality of evidence to be high in both trials according to Cochrane's risk of bias tool RoB 2. There were no significant differences between thrombo-aspiration and stent-retrieval thrombectomy in rate of mRS of 0 to 2 at three months (risk ratio [RR] 0.97, 95% confidence interval [CI] 0.82 to 1.13; P = 0.68; 633 participants; 2 RCTs); rate of mTICI of 2b to 3 postprocedure (RR 1.01, 95% CI 0.95 to 1.07; P = 0.77; 650 participants; 2 RCTs); all-cause mortality within three months (RR 1.01, 95% CI 0.74 to 1.37; P = 0.95; 633 participants; 2 RCTs); rate of intracranial hemorrhage on imaging at 24 hours (RR 1.03, 95% CI 0.86 to 1.24; P = 0.73; 645 participants; 2 RCTs); rate of symptomatic intracranial hemorrhage at 24 hours (RR 0.90, 95% CI 0.49 to 1.68; P = 0.75; 645 participants; 2 RCTs); and rate of procedure-related adverse events within three months (RR 0.98, 95% CI 0.68 to 1.41; P = 0.90; 651 participants; 2 RCTs). Another two included studies reported no differences for the comparisons of combined therapy versus stent-retrieval thrombectomy or thrombo-aspiration. One RCT is ongoing.

AUTHORS' CONCLUSIONS

This review did not establish any difference in safety and effectiveness between the thrombo-aspiration approach and stent-retrieval thrombectomy for treating people with AIS. Furthermore, the combined group did not show any obvious advantage over either intervention applied alone.

Development and verification of a combined diagnostic model for primary Sjögren's syndrome by integrated bioinformatics analysis and machine learning

Primary Sjögren's syndrome (pSS) is a chronic, systemic autoimmune disease mostly affecting the exocrine glands. This debilitating condition is complex and specific treatments remain unavailable. There is a need for the development of novel diagnostic models for early screening. Four gene profiling datasets were downloaded from the Gene Expression Omnibus database. The 'limma' software package was used to identify differentially expressed genes (DEGs). A random forest-supervised classification algorithm was used to screen disease-specific genes, and three machine learning algorithms, including artificial neural networks (ANN), random forest (RF), and support vector machines (SVM), were used to build a pSS diagnostic model. The performance of the model was measured using its area under the receiver operating characteristic curve. Immune cell infiltration was investigated using the CIBERSORT algorithm. A total of 96 DEGs were identified. By utilizing a RF classifier, a set of 14 signature genes that are pivotal in transcription regulation and disease progression in pSS were identified. Through the utilization of training and testing datasets, diagnostic models for pSS were successfully designed using ANN, RF, and SVM, resulting in AUCs of 0.972, 1.00, and 0.9742, respectively. The validation set yielded AUCs of 0.766, 0.8321, and 0.8223. It was the RF model that produced the best prediction performance out of the three models tested. As a result, an early predictive model for pSS was successfully developed with high diagnostic performance, providing a valuable resource for the screening and early diagnosis of pSS.

Trigeminal Nerve Isolation Application in Microvascular Decompression for Treating Trigeminal Neuralgia: A Retrospective Study

This study aimed to compare the outcomes of trigeminal nerve isolation (TNI) with conventional microvascular decompression (CMVD) in cases of trigeminal neuralgia (TN). We retrospectively reviewed 143 TN cases who underwent microvascular decompression from January 2017 to January 2020. The surgical management of TNI or CMVD in all patients was randomized. The cases were divided into two groups, one group underwent a TNI and the other one received CMVD. The general data, postoperative outcomes, and complications were reviewed retrospectively. Cases with a narrow cistern of cerebellopontine, short trigeminal nerve root, and arachnoid adhesion were defined as difficult cases. All of the cases were followed up for at least 1 year. Surgical outcomes were assessed and compared between the two groups. In results, we found no significant differences in the general data, duration of hospitalization and blood loss between the two procedures. However, of the 143 cases, 12 cases (17.1%) recurred after surgery in the CMVD group, and four cases (5.5%) recurred after TNI operation. The rates of pain relief were 69 (94.5%) in the CMVD group, and 58 (82.9%) for TNI (P=0.027). In the TNI group, there was only one difficult case among four no pain-relief cases, while in the CMVD group, 10 difficult cases were found among the 12 no pain-relief cases (P=0.008). In conclusion, the TNI technique is more effective than the CMVD procedure and could also be performed on patients with classical TN. Future double-blind and randomized controlled trials are necessary to confirm this result.

[Clinicopathological characteristics and prognosis of patients with small bowel tumors: A single center analysis of 220 cases]

Objective: To analyze the clinicopathological characteristics and prognosis of patients with small bowel tumors. Methods: This was a retrospective, observational study. We collected clinicopathological data of patients with primary jejunal or ileal tumors who had undergone small bowel resection in the Department of Gastrointestinal Surgery, West China Hospital, Sichuan University between January 2012 and September 2017. The inclusion criteria included: (1) older than 18 years; (2) had undergone small bowel resection; (3) primary location at jejunum or ileum; (4) postoperative pathological examination confirmed malignancy or malignant potential; and (5) complete clinicopathological and follow-up data. Patients with a history of previous or other concomitant malignancies and those who had undergone exploratory laparotomy with biopsy but no resection were excluded. The clinicopathological characteristics and prognoses of included patients were analyzed. Results: The study cohort comprised 220 patients with small bowel tumors, 136 of which were classified as gastrointestinal stromal tumors (GISTs), 47 as adenocarcinomas, and 35 as lymphomas. The median follow-up for all patient was 81.0 months (75.9-86.1). GISTs frequently manifested as gastrointestinal bleeding (61.0%, 83/136) and abdominal pain (38.2%, 52/136). In the patients with GISTs, the rates of lymph node and distant metastasis were 0.7% (1/136) and 11.8% (16/136), respectively. The median follow-up time was 81.0 (75.9-86.1) months. The 3-year overall survival (OS) rate was 96.3%. Multivariate Cox regression-analysis results showed that distant metastasis was the only factor associated with OS of patients with GISTs (HR=23.639, 95% CI: 4.564-122.430, P<0.001). The main clinical manifestations of small bowel adenocarcinoma were abdominal pain (85.1%, 40/47), constipation/diarrhea (61.7%, 29/47), and weight loss (61.7%, 29/47). Rates of lymph node and distant metastasis in patients with small bowel adenocarcinoma were 53.2% (25/47) and 23.4% (11/47), respectively. The 3-year OS rate of patients with small bowel adenocarcinoma was 44.7%. Multivariate Cox regression-analysis results showed that distant metastasis (HR=4.018, 95%CI: 2.108-10.331, P<0.001) and adjuvant chemotherapy (HR=0.291, 95% CI: 0.140-0.609, P=0.001) were independently associated with OS of patients with small bowel adenocarcinoma. Small bowel lymphoma frequently manifested as abdominal pain (68.6%, 24/35) and constipation/diarrhea (31.4%, 11/35); 77.1% (27/35) of small bowel lymphomas were of B-cell origin. The 3-year OS rate of patients with small bowel lymphomas was 60.0%. T/NK cell lymphomas (HR= 6.598, 95% CI: 2.172-20.041, P<0.001) and adjuvant chemotherapy (HR=0.119, 95% CI: 0.015-0.925, P=0.042) were independently associated with OS of patients with small bowel lymphoma. Small bowel GISTs have a better prognosis than small intestinal adenocarcinomas (P<0.001) or lymphomas (P<0.001), and small bowel lymphomas have a better prognosis than small bowel adenocarcinomas (P=0.035). Conclusions: The clinical manifestations of small intestinal tumor are non-specific. Small bowel GISTs are relatively indolent and have a good prognosis, whereas adenocarcinomas and lymphomas (especially T/NK-cell lymphomas) are highly malignant and have a poor prognosis. Adjuvant chemotherapy would likely improve the prognosis of patients with small bowel adenocarcinomas or lymphomas.

A glycometabolic gene signature associating with immune infiltration and chemosensitivity and predicting the prognosis of patients with osteosarcoma

Background

Accumulating evidence has suggested that glycometabolism plays an important role in the pathogenesis of tumorigenesis. However, few studies have investigated the prognostic values of glycometabolic genes in patients with osteosarcoma (OS). This study aimed to recognize and establish a glycometabolic gene signature to forecast the prognosis, and provide therapeutic options for patients with OS.

Methods

Univariate and multivariate Cox regression, LASSO Cox regression, overall survival analysis, receiver operating characteristic curve, and nomogram were adopted to develop the glycometabolic gene signature, and further evaluate the prognostic values of this signature. Functional analyses including Gene Ontology (GO), kyoto encyclopedia of genes and genomes analyses (KEGG), gene set enrichment analysis, single-sample gene set enrichment analysis (ssGSEA), and competing endogenous RNA (ceRNA) network, were used to explore the molecular mechanisms of OS and the correlation between immune infiltration and gene signature. Moreover, these prognostic genes were further validated by immunohistochemical staining.

Results

A total of four genes including PRKACB, SEPHS2, GPX7, and PFKFB3 were identified for constructing a glycometabolic gene signature which had a favorable performance in predicting the prognosis of patients with OS. Univariate and multivariate Cox regression analyses revealed that the risk score was an independent prognostic factor. Functional analyses indicated that multiple immune associated biological processes and pathways were enriched in the low-risk group, while 26 immunocytes were down-regulated in the high-risk group. The patients in high-risk group showed elevated sensitivity to doxorubicin. Furthermore, these prognostic genes could directly or indirectly interact with other 50 genes. A ceRNA regulatory network based on these prognostic genes was also constructed. The results of immunohistochemical staining showed that SEPHS2, GPX7, and PFKFB3 were differentially expressed between OS tissues and adjacent normal tissues.

Conclusion

The preset study constructed and validated a novel glycometabolic gene signature which could predict the prognosis of patients with OS, identify the degree of immune infiltration in tumor microenvironment, and provide guidance for the selection of chemotherapeutic drugs. These findings may shed new light on the investigation of molecular mechanisms and comprehensive treatments for OS.

Heterologous expression and characterization of novel GH12 β-glucanase and AA10 lytic polysaccharide monooxygenase from Streptomyces megaspores and their synergistic action in cellulose saccharification

BACKGROUND

The combination of cellulase and lytic polysaccharide monooxygenase (LPMO) is known to boost enzymatic saccharification of cellulose. Although the synergy between cellulases (GH5, 6 or 7) and LPMOs (AA9) has been extensively studied, the interplay between other glycoside hydrolase and LPMO families remains poorly understood.

RESULTS

In this study, two cellulolytic enzyme-encoding genes SmBglu12A and SmLpmo10A from Streptomyces megaspores were identified and heterologously expressed in Escherichia coli. The recombinant SmBglu12A is a non-typical endo-β-1,4-glucanase that preferentially hydrolyzed β-1,3-1,4-glucans and slightly hydrolyzed β-1,4-glucans and belongs to GH12 family. The recombinant SmLpmo10A belongs to a C1-oxidizing cellulose-active LPMO that catalyzed the oxidation of phosphoric acid swollen cellulose to produce celloaldonic acids. Moreover, individual SmBglu12A and SmLpmo10A were both active on barley β-1,3-1,4-glucan, lichenan, sodium carboxymethyl cellulose, phosphoric acid swollen cellulose, as well as Avicel. Furthermore, the combination of SmBglu12A and SmLpmo10A enhanced enzymatic saccharification of phosphoric acid swollen cellulose by improving the native and oxidized cello-oligosaccharides yields.

CONCLUSIONS

These results proved for the first time that the AA10 LPMO was able to boost the catalytic efficiency of GH12 glycoside hydrolases on cellulosic substrates, providing another novel combination of glycoside hydrolase and LPMO for cellulose enzymatic saccharification.

Corrigendum: Integration: gospel for immune bioinformatician on epitope-based therapy

[This corrects the article DOI: 10.3389/fimmu.2023.1075419.].

Yam Bean (Pachyrhizus erosus L. Urban) Powder Improves Grass Carp Myofibrillar Protein Gel by Forming Disulfide Bonds, Hydrogen Bonds, and Proper Microstructure

This study aimed to analyze the impact of different additions (0-1.25%) of yam bean powder (YBP) on myofibrillar protein (MP) gel characteristics such as the structure, water-holding capacity (WHC), chemical interaction strength of grass carp MP, and texture. The results showed that the YBP exhibited a strong water absorption capacity and filled in the protein heat-induced polymerization gel network well, which enabled the gel network to capture and retain water effectively, resulting in MP gels containing YBP with excellent WHC and gel strength (0.75%). In addition, YBP induced the formation of hydrogen and disulfide bonds in proteins and inhibited the conversion of α-helices to β-sheets and β-turn structures, facilitating the formation of high-strength gel networks (p < 0.05). In conclusion, YBP can significantly improve the thermally induced gelling properties of grass carp MP. In particular, the addition of 0.75% YBP had the best effect in terms of filling the gel network of grass carp MP, resulting in the formation of a continuous and dense protein network, leading to the composite gel with the best WHC and texture.

Research on the impact of digital economy on Regional Green Technology Innovation: Moderating effect of digital talent Aggregation

The digital economy is crucial to promoting green technology innovation and development. However, there needs to be more research on the relationship between the digital economy, digital talent aggregation (DTA), and green technology innovation (GTI). Therefore, based on the data from 30 provinces, municipalities, and autonomous regions in mainland China (excluding Tibet) from 2011 to 2020, this paper uses fixed effect, threshold effect, moderating effect model, and spatial econometric model to make an empirical analysis of this research direction. The results show that (1) there is a nonlinear relationship between the digital economy and green technology innovation (GTI). This effect has regional heterogeneity effects. In the central and western regions, the digital economy is more prominent in promoting green technology innovation (GTI). (2) Digital talent aggregation (DTA) has a negative moderating effect on the influence of the digital economy on promoting green technology innovation (GTI). (3) The negative spillover effect of the digital economy on local green technology innovation (GTI) will be intensified at the spatial level due to the accumulation of digital talents. Therefore, this paper suggests that the government should actively and reasonably develop the digital economy to promote green technology innovation (GTI). In addition, the government can implement a flexible talent introduction policy, strengthen talent quality education and talent service station construction.

Insights into the H2O2-Driven Lytic Polysaccharide Monooxygenase Activity on Efficient Cellulose Degradation in the White Rot Fungus Irpex lacteus

In contrast to O₂, H₂O₂ as the cosubstrate for lytic polysaccharide monooxygenases (LPMOs) exhibits great advantages in industrial settings for cellulose degradation. However, H₂O₂-driven LPMO reactions from natural microorganisms have not been fully explored and understood. Herein, secretome analysis unraveled the H₂O₂-driven LPMO reaction in the efficient lignocellulose-degrading fungus Irpex lacteus, including LPMOs with different oxidative regioselectivities and various H₂O₂-generating oxidases. Biochemical characterization of H₂O₂-driven LPMO catalysis showed orders of magnitude improvement in catalytic efficiency compared to that of O₂-driven LPMO catalysis for cellulose degradation. Significantly, H₂O₂ tolerance of LPMO catalysis in I. lacteus was an order of magnitude higher than that in other filamentous fungi. In addition, natural reductants, gallic acid, in particular, presented in lignocellulosic biomass could sufficiently maintain LPMO catalytic reactions. Moreover, the H₂O₂-driven LPMO catalysis exhibited synergy with canonical endoglucanases for efficient cellulose degradation. Taken together, these findings demonstrate the great application potential of the H₂O₂-driven LPMO catalysis for upgrading cellulase cocktails to further improve cellulose degradation efficiency.

Porous Hydrogel Photothermal Conversion Membrane to Facilitate Water Purification

Solar water purification technology is one of the most potent methods to obtain freshwater due to its low cost and non-polluting characteristics. However, the purification efficiency is limited by the high ion concentration, organic pollution, and biological pollution during the actual water purification process. Here, we report a porous hydrogel membrane (Fe/TA-TPAM) for the purification of high ion concentration and contaminated water. The hydrogel membrane exhibits good light absorption and photothermal conversion ability, which shows high evaporation rates (1.4 kg m^-2 h^-1) and high solar efficiency for seawater. Furthermore, with the introduction of tannic acid (TA) and Ti₃C₂ MXenes, the Fe/TA-TPAM hydrogel membrane exhibits satisfied purification properties for organic-contaminated and biologically contaminated water. The excellent purification effect of Fe/TA-TPAM under light not only confirms the rationality of the hydrogel porous design and in situ generation of photosensitizer in improving the photothermal performance but also provides a novel strategy for designing advanced photothermal conversion membranes for water purification.

Synthesis and Excision Repair of Site-Specific 3'-End DNA-Histone Cross-Links Derived from Abasic Sites

Histones catalyze the DNA strand incision at apurinic/apyrimidinic (AP) sites accompanied by formation of reversible but long-lived DNA-protein cross-links (DPCs) at 3'-DNA termini within single-strand breaks. These DPCs need to be removed because 3'-hydroxyl is required for gap-filling DNA repair synthesis but are challenging to study because of their reversible nature. Here we report a chemical approach to synthesize stable and site-specific 3'-histone-DPCs and their repair by three nucleases, human AP endonuclease 1, tyrosyl-DNA phosphodiesterase 1, and three-prime repair exonuclease 1. Our method employs oxime ligation to install an alkyne to 3'-DNA terminus, genetic incorporation of an azidohomoalanine to histone H4 at a defined position, and click reaction to conjugate DNA to H4 site-specifically. Using these model DPC substrates, we demonstrated that the DPC repair efficiency is highly affected by the local protein environment, and prior DPC proteolysis facilitates the repair.

Adsorption and desorption of polychlorinated biphenyls on biochar colloids with different pyrolysis temperatures: the effect of solution chemistry

Biochar releases colloidal particles into the environment during applications and aging which can become carriers of pollutants and influence on the environmental risk of pollutants due to the excellent adsorption and migration properties of biochar colloids (BCCs). The adsorption and desorption behaviors of BCCs can be different from their bulk ones due to the colloidal size, which merits specific studies. Herein, the adsorption and desorption of 2,4,4'-trichlorobiphenyl (PCB28) as a representative on BCCs released from bulk biochars prepared from bamboo chips at 300, 500, and 700 C and the effects of solution properties were specifically investigated. Results show that the adsorption was dominated by pore filling and π-π interaction, and thus, BCCs prepared at higher temperature with greater pore volume and aromaticity had higher adsorption of PCB28. Results show that the adsorption was dominated by pore filling and π-π interaction, and thus, BCCs prepared at higher temperature with greater pore volume and aromaticity had higher adsorption of PCB28. The saturation adsorption amounts of PCB28 on BCC300, BCC500, and BCC700 were 21.9, 40.3, and 62.4 mg/g, respectively. It is noteworthy that PCB28 possessed a significant desorption hysteresis from BCCs, with the hysteresis index (Ce = 80 μg/L) increased from 0.380 to 0.661 as the preparation temperature of BCCs rising from 300 to 700 ℃. High concentration of NaCl (100 mmol/L) was unfavorable for the adsorption and desorption. The presence of humic acid or fulvic acid (FA), especially the smaller FA, could inhibit the adsorption and desorption of PCB28 on BCCs due to micropore blocking. In seawater, groundwater, surface water, and soil solution samples, the PCB28 adsorption of BCCs was inhibited to varying degrees in comparison with that in deionized water, and the desorption was noticeably inhibited in the groundwater sample. These findings provide valuable information for the understanding of interactions between BCCs and organic contaminants in natural waters and for the environmental application of biochars as well.

Role of the gut microbiota in anticancer therapy: from molecular mechanisms to clinical applications

In the past period, due to the rapid development of next-generation sequencing technology, accumulating evidence has clarified the complex role of the human microbiota in the development of cancer and the therapeutic response. More importantly, available evidence seems to indicate that modulating the composition of the gut microbiota to improve the efficacy of anti-cancer drugs may be feasible. However, intricate complexities exist, and a deep and comprehensive understanding of how the human microbiota interacts with cancer is critical to realize its full potential in cancer treatment. The purpose of this review is to summarize the initial clues on molecular mechanisms regarding the mutual effects between the gut microbiota and cancer development, and to highlight the relationship between gut microbes and the efficacy of immunotherapy, chemotherapy, radiation therapy and cancer surgery, which may provide insights into the formulation of individualized therapeutic strategies for cancer management. In addition, the current and emerging microbial interventions for cancer therapy as well as their clinical applications are summarized. Although many challenges remain for now, the great importance and full potential of the gut microbiota cannot be overstated for the development of individualized anti-cancer strategies, and it is necessary to explore a holistic approach that incorporates microbial modulation therapy in cancer.

The m6A/m5C/m1A regulator genes signature reveals the prognosis and is related with immune microenvironment for hepatocellular carcinoma

BACKGROUND

RNA methylation is a crucial in many biological functions, and its aberrant regulation is associated with cancer progression. N6-Methyladenosine (m6A), 5-Methylcytosine (m5C), N1-methyladenosine (m1A) are common modifications of RNA methylation. However, the effect of methylation of m6A/m5C/m1A in hepatocellular carcinoma (HCC) remains unclear.

METHOD

The transcriptome datasets, clinic information, and mutational data of 48 m6A/m5C/m1A regulator genes were acquired from the TCGA database, and the prognostic hazard model was established by univariate and Least absolute shrinkage and selection operator (Lasso) regression. The multivariate regression was performed to determine whether the risk score was an independent prognostic indicator. Kaplan-Meier survival analysis and ROC curve analysis were used to evaluate the predictive ability of the risk model. Decision curve analysis（DCA）analysis was conducted to estimate the clinical utility of the risk model. We further analyzed the association between risk score and functional enrichment, tumor immune microenvironment, and somatic mutation.

RESULT

The four-gene (YTHDF1, YBX1, TRMT10C, TRMT61A) risk signature was constructed. The high-risk group had shorter overall survival (OS) than the low-risk group. Univariate and multivariate regression analysis indicated that risk score was an independent prognostic indicator. Risk scores in male group, T3 + T4 group and Stage III + IV group were higher in female group, T1 + T2 group and stage I + II group. The AUC values for 1-, 2-, and 3-year OS in the TCGA dataset were 0.764, 0.693, and 0.689, respectively. DCA analysis showed that the risk score had a higher clinical net benefit in 1- and 2-year OS than other clinical features.The risk score was positively related to some immune cell infiltration and most immune checkpoints.

CONCLUSION

We developed a novel m6A/m5C/m1A regulator genes' prognostic model, which could be applied as a latent prognostic tool for HCC and might guide the choice of immunotherapies.

θ-[Mo8O26]4--based multifunctional hybrid material for high catalytic performance on the cycloaddition of CO2, esterification and knoevenagel condensation

Developing materials with excellent properties has become the norm in the field of basic research, prompting us to explore highly robust hybrid materials based on electron-rich POMs and electron-deficient MOFs. Herein, a θ-[Mo₈O₂₆]^4--based hybrid material of [Cu₂(BPPP)₂]{θ-[Mo₈O₂₆]} (NUC-62) with excellent physicochemical stability was self-assembled under acidic solvothermal conditions from Na₂MoO₄ and CuCl₂ in the presence of a designed chelated ligand of 1,3-bis(3-(2-pyridyl)pyrazol-1-yl)propane (BPPP), which has sufficient coordination sites, spatial self-regulation and great deformation ability. In NUC-62, each of two tetra-coordinated Cu^II ions and two BPPP are unified into one dinuclear unit serving as the cation, which is interactively linked to θ-[Mo₈O₂₆]^4- anions via rich hydrogen bonds of C-H⋯O. Because of the unsaturated Lewis acidic Cu^II sites, NUC-62 exhibits high catalytic performance on the cycloaddition reactions of CO₂ with epoxides under mild conditions with a high turnover number and turnover frequency. Furthermore, NUC-62, as a recyclable heterogeneous catalyst, shows high catalytic activity for the esterification of aromatic acid under refluxing, which is much better than the inorganic acid catalyst of H₂SO₄ in terms of turnover number and turnover frequency. Moreover, because of open metal sites and rich terminal oxygen atoms, NUC-62 shows high catalytic activity for Knoevenagel condensation reactions of aldehydes and malononitrile. Hence, this study lays the groundwork for constructing heterometallic cluster-based microporous MOFs with excellent Lewis acidic catalysis and chemical stability. Therefore, this study lays a foundation for the construction of functional polyoxometalate complexes.

α-Cyano Triaryl[3]radialene: Unsymmetrical Stereo-configuration, Clustering-enhanced Excimer Emission, and Radical-involved Multimodal Information Switching

[3]Radialene has a peculiar topology and cross-conjugation system, representing a unique molecular scaffold in organic materials. Herein, we report a special class of stereoisomeric α-cyano triaryl[3]radialenes (CTRs) that show concentration-caused quenching in solution but emit red-shifted and enhanced luminescence in the crystalline state. Clustering of multiple cyano groups and their through-space interactions with the [3]radialene ring significantly extend π-electron communication meanwhile rigidifying the propeller conformation multivalently, thus playing a key role behind the state-dependent luminescence. These radialenes with a substantial electron affinity undergo a reversible electron transfer transition to anionic radicals with good stability, showing switching of photoabsorption, photoluminescence and electron spin resonance (ESR) signal. We also established proof-of-concept applications of CTRs for multimodal information encryption and chemical sensing.

Curcumin suppressed the proliferation and apoptosis of HPV-positive cervical cancer cells by directly targeting the E6 protein

Most human papillomavirus (HPV) types, including HPV16 and HPV18, are closely related to the occurrence of cervical cancer, predominantly through the action of viral oncoproteins E6 and E7. Curcumin, the active ingredient of the turmeric plant, has been gaining attention over the past two decades as an antioxidant, anti-inflammatory, and anticancer agent. In the present study, the HPV-positive cervical cancer cells HeLa and CaSki were treated with curcumin, and the results showed that curcumin has a dose-dependent and time-dependent inhibitory effect on cell viability. In addition, apoptosis induction was further quantitatively confirmed through flow cytometric analysis. Furthermore, the influence of different concentrations of curcumin on the mitochondrial membrane potential was evaluated through JC-1 staining and found to dramatically decrease the membrane potential in treated HeLa and CaSki cells, suggesting the critical role of the mitochondrial pathway in their apoptosis-inducing effect. This study also demonstrated the wound-healing potential of curcumin, and the results of transwell assays showed that curcumin treatment inhibited HeLa and CaSki cell invasion and migration in a dose-dependent manner compared with the control treatment. Curcumin also downregulated the expression of Bcl-2, N-cadherin, and Vimentin and upregulated the expression of Bax, C-caspase-3, and E-cadherin in both cell lines. Further research showed that curcumin also selectively inhibited the expression of the viral oncoproteins E6 and E7, as demonstrated by western blot analysis; moreover, the downregulation of E6 was more significant than that of E7. Our research also showed that coculture with cells infected with siE6 lentivirus (siE6 cells) can inhibit the proliferation, invasion, and metastasis of HPV-positive cells. While the siE6 cells were also treated with curcumin, the effect of curcumin monotherapy was offset. In summary, our research shows that curcumin regulates the apoptosis, migration, and invasion of cervical cancer cells, and the mechanism may be related to its ability to downregulate E6. This study provides a foundation for future research on the prevention and treatment of cervical cancer.

Efficient degradation of Congo red by persulfate activated with different particle sizes of zero-valent copper: performance and mechanism

In this study, Congo red (CR) was degraded by different particle sizes of zero-valent copper (ZVC) activated persulfate (PS) under mild temperature. The CR removal by 50 nm, 500 nm, 15 μm of ZVC activated PS was 97%, 72%, and 16%, respectively. The co-existence of SO₄^2- and Cl^- promoted the degradation of CR, and HCO₃^- and H₂PO₄^- were detrimental to the degradation. With the reduction of ZVC particle size, the effect of coexisting anions on degradation grew stronger. The high degradation efficiency of 50 nm and 500 nm ZVC was achieved at pH=7.0, while the high degradation of 15 μm ZVC was achieved at pH=3.0. It was more favorable to leach copper ions for activating PS to generate reactive oxygen species (ROS) with the smaller particle size of ZVC. The radical quenching experiment and electron paramagnetic resonance (EPR) analysis indicated that SO₄^-•, •OH and •O₂^- existed in the reaction. The mineralization of CR reached 80% and three possible paths were suggested for the degradation. Moreover, the degradation of 50 nm ZVC can still reach 96% in the 5th cycle, indicating promising application potential in dyeing wastewater treatment.

Comparison of long-term quality of life between Billroth-I and Roux-en-Y anastomosis after distal gastrectomy for gastric cancer: a randomized controlled trial

BACKGROUND

The results of studies comparing Billroth-I (B-I) with Roux-en-Y (R-Y) reconstruction on the quality of life (QoL) are still inconsistent. The aim of this trial was to compare the long-term QoL of B-I with R-Y anastomosis after curative distal gastrectomy for gastric cancer.

METHODS

A total of 140 patients undergoing curative distal gastrectomy with D2 lymphadenectomy in West China Hospital, Sichuan University from May 2011 to May 2014 were randomly assigned to the B-I group ( N  = 70) and R-Y group ( N  = 70). The follow-up time points were 1, 3, 6, 9, 12, 24, 36, 48, and 60 months after the operation. The final follow-up time was May 2019. The clinicopathological features, operative safety, postoperative recovery, long-term survival as well as QoL were compared, among which QoL score was the primary outcome. An intention-to-treat analysis was applied.

RESULTS

The baseline characteristics were comparable between the two groups. There were no statistically significant differences in terms of postoperative morbidity and mortality rates, and postoperative recovery between the two groups. Less estimated blood loss and shorter surgical duration were found in the B-I group. There were no statistically significant differences in 5-year overall survival (79% [55/70] of the B-I group vs. 80% [56/70] of the R-Y group, P  = 0.966) and recurrence-free survival rates (79% [55/70] of the B-I group vs. 78% [55/70] of the R-Y group, P  = 0.979) between the two groups. The scores of the global health status of the R-Y group were higher than those of the B-I group with statistically significant differences (postoperative 1 year: 85.4 ± 13.1 vs . 88.8 ± 16.1, P  = 0.033; postoperative 3 year: 87.3 ± 15.2 vs . 92.8 ± 11.3, P  = 0.028; postoperative 5 year: 90.9 ± 13.7 vs . 96.4 ± 5.6, P  = 0.010), and the reflux (postoperative 3 year: 8.8 ± 12.9 vs . 2.8 ± 5.3, P  = 0.001; postoperative 5 year: 5.1 ± 9.8 vs . 1.8 ± 4.7, P  = 0.033) and epigastric pain (postoperative 1 year: 11.8 ± 12.7 vs. 6.1 ± 8.8, P  = 0.008; postoperative 3 year: 9.4 ± 10.6 vs. 4.6 ± 7.9, P  = 0.006; postoperative 5 year: 6.0 ± 8.9 vs . 2.7 ± 4.6, P  = 0.022) were milder in the R-Y group than those of the B-I group at the postoperative 1, 3, and 5-year time points.

CONCLUSIONS

Compared with B-I group, R-Y reconstruction was associated with better long-term QoL by reducing reflux and epigastric pain, without changing survival outcomes.

TRIAL REGISTRATION

ChiCTR.org.cn, ChiCTR-TRC-10001434.

Bilayer STING goes head to head to stay put

In this issue, Liu et al.¹ provide structural insights into how STING remains inactive. Apo-STING adopts a bilayer conformation exhibiting head-to-head and side-to-side interactions in its autoinhibitory state on the ER. The apo-STING oligomer differs from the activated STING oligomer in its biochemical stability, protein domain contact, and membrane curvature.