Accelerating Proteomics Using Broad Specificity Proteases

Trypsin is the gold-standard protease in bottom-up proteomics, but many sequence stretches of the proteome are inaccessible to trypsin and standard LC-MS approaches. Thus, multienzyme strategies are used to maximize sequence coverage in post-translational modification profiling. We present fast and robust SP3- and STRAP-based protocols for the broad-specificity proteases subtilisin, proteinase K, and thermolysin. All three enzymes are remarkably fast, producing near-complete digests in 1-5 min, and cost 200-1000× less than proteomics-grade trypsin. Using FragPipe resolved a major challenge by drastically reducing the duration of the required "unspecific" searches. In-depth analyses of proteinase K, subtilisin, and thermolysin Jurkat digests identified 7374, 8178, and 8753 unique proteins with average sequence coverages of 21, 29, and 37%, including 10,000s of amino acids not reported in PeptideAtlas' >2400 experiments. While we could not identify distinct cleavage patterns, machine learning could distinguish true protease products from random cleavages, potentially enabling the prediction of cleavage products. Finally, proteinase K, subtilisin, and thermolysin enabled label-free quantitation of 3111, 3659, and 4196 unique Jurkat proteins, which in our hands is comparable to trypsin. Our data demonstrate that broad-specificity proteases enable quantitative proteomics of uncharted areas of the proteome. Their fast kinetics may allow "on-the-fly" digestion of samples in the future.

Comparing coronary artery cross-sectional area among asymptomatic South Asian, White, and Black participants: the MASALA and CARDIA studies

BACKGROUND

South Asian individuals have high risk of atherosclerotic cardiovascular disease (ASCVD). Some investigators suggest smaller coronary artery size may be partially responsible.

METHODS

We compared the left anterior descending (LAD) artery cross-sectional area (CSA) (lumen and arterial wall) among South Asians in the Mediators of Atherosclerosis in South Asians Living in America (MASALA) study with White and Black participants in the Coronary Artery Risk Development in Young Adults (CARDIA) study, adjusting for BMI, height, and other ASCVD risk factors. We used thin-slice non-contrast cardiac computed tomography to measure LAD CSA. We used linear regression models to determine whether race/ethnicity was associated with LAD CSA after adjusting for demographic factors, BMI, height, coronary artery calcium (CAC), and traditional cardiovascular risk factors.

RESULTS

Our sample included 3,353 participants: 513 self-identified as South Asian (44.4% women), 1286 as Black (59.6% women), and 1554 as White (53.5% women). After adjusting for age, BMI, height, there was no difference in LAD CSA between South Asian men and women compared to White men and women, respectively. After full adjustment for CVD risk factors, LAD CSA values were: South Asian women (19.9 mm2, 95% CI [18.8 - 20.9]) and men (22.3 mm2, 95% CI [21.4 - 23.2]; White women (20.0 mm2, 95% CI [19.4-20.5]) and men (23.6 mm2, 95% CI [23.0-24.2]); and Black women (21.6 mm2, 95% CI [21.0 - 22.2]) and men (26.0 mm2, 95% CI [25.3 - 26.7]). Height, BMI, hypertension, CAC, and age were positively associated with LAD CSA; current and former cigarette use were inversely associated.

CONCLUSIONS

South Asian men and women have similar LAD CSA to White men and women, and smaller LAD CSA compared to Black men and women, respectively, after accounting for differences in body size. Future studies should determine whether LAD CSA is associated with future ASCVD events.

[Progress in research of rash and fever syndrome surveillance and early warning]

Objective: To introduce the progress in research of rash and fever syndrome (RFS) surveillance and early warning both at home and abroad, and provide reference for surveillance and prevention of RFS in China. Methods: The keywords "fever" "rash" and "surveillance" and others were used for a literature retrieval by using China National Knowledge Infrastructure, Wanfang Data Knowledge Service Platform, PubMed and Web of Science. The languages of literatures were limited in Chinese and English. The key information of the literatures were collected and analyzed with Excel. Results: A total of 36 study papers (21 in Chinese and 15 in English) were included. The studies mainly focused on the pathogen surveillance of RFS (n=19). The pathogens included measles virus, varicella-zoster virus, rubella virus, enterovirus, human B19 virus, dengue virus, streptococcus group A, Salmonella typhi and Salmonella paratyphoid,human herpesvirus, mumps virus and adenovirus. Eight studies were about the surveillance in major events, such as sport game, World Expo and religious gathering, or sudden natural disasters, such as earthquake and tropical storm, during 2010-2015. Eight studies focused on case or epidemic surveillance, most of which were studies from other counties. The surveillance sites were medical institutions. RFS was diagnosed according to the International Classification of Diseases, 9th (ICD-9) and symptoms descripted in chief-complaint. Only one study in Mongolia conducted RFS epidemic prediction. The analysis methods of 36 papers included simple descriptive analysis, time-based early warning models (such as regression analysis, fixed threshold method, Hugh Hart control chart method and cumulative sum control chart method) and time series analysis method. Conclusions: In the future, RFS surveillance system should cover both known pathogens and emerging pathogens. Automatic surveillance using information capture and intelligent modelling can be applied to improve the sensitivity and specificity of RFS surveillance and early warning.

[Analysis of clinical characteristics of children with adenoid hypertrophy and pharyngolaryngeal reflux]

Objectives: To explore the clinical characteristics of children with adenoid hypertrophy (AH) and laryngopharyngeal reflux (LPR) by detecting the expression of pepsin in adenoids as a standard for AH with LPR. Methods: A total of 190 children who were admitted for surgical treatment due to AH were included in the study. The main clinical symptoms of the patients were recorded, and the degree of adenoid hypertrophy was evaluated. Before the surgery, Reflux Symptom Index (RSI) and Reflux Finding Score (RFS) were used to evaluate the reflux symptoms. After the surgery, pepsin immunohistochemical staining was performed on the adenoid tissue, and according to the staining results, the patients were divided into study group (pepsin staining positive) and control group (pepsin staining negative). SPSS 19.0 software was used for statistical analysis. Quantitative data conforming to normal distribution between the two groups were tested by two-independent sample t test, and quantitative data with skewed distribution were tested by Mann-Whitney U test. Results: The positive rate of pepsin staining in the 190 AH patients was 78.4% (149/190). The study group had higher levels of preoperative symptoms such as erythema and/or congestion of the pharynx(2.1±0.7 vs. 1.8±0.6,t=2.23), vocal cord edema[1.0(0, 1.0) vs. 1.0(0, 1.0), Z=2.00], diffuse laryngeal edema[0(0, 1.0) vs. 0(0, 0), Z=2.48], posterior commissure hypertrophy[(1.4±0.6 vs. 1.1±0.5), t=2.63], and a higher total score on the RFS scale than the control group(6.2±2.7 vs. 5.0±2.6, t=2.47), with statistical differences (P<0.05). The sensitivity and specificity of RFS score in diagnosing AH with LPR were 24.8% and 80.5%, respectively. When RFS>5 was used as the positive threshold, the sensitivity and specificity of RFS score in diagnosing AH with LPR were 61.1% and 58.5%, respectively. There was a statistical difference in the number of positive cases of RFS score between the study group and the control group(91 vs. 17,χ2=5.04,P=0.032). Conclusions: LPR is common in AH children. Children with AH and LPR have specific performance in electronic laryngoscopy, such as erythema with edema in the pharynx, posterior commissure hypertrophy, and vocal cord edema.

[Impact of SARS-CoV-2 infection on graft composition and early transplant outcomes following allogeneic hematopoietic stem cell transplantation]

Objective: To assess the feasibility of using donors with novel coronavirus disease 2019 (COVID-19) for allogeneic hematopoietic stem cell transplantation (allo-HSCT) when there are no other available donors and allo-HSCT cannot be delayed or discontinued. Methods: Seventy-one patients with malignant hematological diseases undergoing allo-HSCT between December 8, 2022, and January 10, 2023, were included. Of these, 16 received grafts from donors with mild COVID-19 (D-COVID(+) group) and 55 received grafts from donors without COVID-19 (D-COVID(-) group). The graft compositions were compared between the two groups. Engraftment, acute graft-versus-host disease (aGVHD), overall survival (OS), and relapse were also evaluated. Results: There were no serious side effects or adverse events in the D-COVID(+) group. The mononuclear cell dose and CD34(+) cell dose were comparable between the two groups, and no additional apheresis was required. There were no significant differences in the lymphocyte, monocyte, and T-cell subset doses between the two groups. The median natural killer cell dose in the D-COVID(+) group was significantly higher than that in the D-COVID(-) group (0.69×10(8)/kg vs. 0.53×10(8)/kg, P=0.031). The median follow-up time was 72 (33-104) days. All patients achieved primary engraftment. The 60-day platelet engraftment rates in the D-COVID(+) and D-COVID(-) groups were 100% and (96.4±0.2) %, respectively (P=0.568). There were no significant differences in neutrophil (P=0.309) and platelet (P=0.544) engraftment times. The cumulative incidence of grade 2-4 aGVHD was (37.5±1.6) % vs. (16.4±0.3) % (P=0.062), and of grade 3-4 aGVHD was 25.0% ±1.3% vs. 9.1% ±0.2% (P=0.095) in the D-COVID(+) and D-COVID(-) groups, respectively. The probabilities of 60-day OS were 100% and 98.1% ±1.8% (P=0.522) in the D-COVID(+) and D-COVID(-) groups, respectively. There was no relapse of primary disease during the study period. Conclusion: When allo-HSCT cannot be delayed or discontinued and no other donor is available, a donor with mild COVID-19 should be considered if tolerable. Larger sample sizes and longer follow-up periods are required to validate these results.

[Effects of modified proper digital artery island flap in repairing complex fingertip defects]

Objective: To investigate the surgical method and clinical effects of the modified proper digital artery island flap in repairing complex fingertip defects. Methods: A retrospective observational study was conducted. From January 2017 to December 2021, 15 patients (15 fingers) with complex fingertip defects, involving the pulp, nail bed, and lateral wall of the nail, who met the inclusion criteria were admitted into General Hospital of Northern Theater Command, including 11 males and 4 females, aged from 18 to 55 years. The area of the post debridement wound was from 2.5 cm×2.0 cm to 3.5 cm×3.5 cm, and all the wounds were repaired by using modified proper digital artery island flap (including 3 parts: main flap, tongue-shaped flap, and triangular flap), of which the main flap was used to cover the finger pulp defect, the tongue-shaped flap was used to cover the nail bed and the nail lateral wall defect, and the triangular flap was inserted into the edge of the finger pulp wound to cover the vessel pedicle. The range of the flap ranged from 3.0 cm×2.0 cm to 4.5 cm×3.0 cm. The wound at the donor site was repaired with full-thickness skin graft of the groin, and the donor site of the skin graft was sutured directly. After operation, the survival of the flap and skin graft as well as and the appearance of the affected finger were observed. During the follow-up, the fingertip morphology of the affected finger was observed, two-point discrimination distance of the affected finger pulp was measured, and the patients' satisfaction with the efficacy (including very satisfied, satisfied, and dissatisfied) was asked, and the affected finger function was evaluated by the total active movement (TAM) system evaluation standard recommended by American Academy for Surgery of Hand. Results: After operation, the main flaps and skin grafts in 15 patients all survived; but the incision at the edge of tongue-shaped flap in one patient healed poorly, and one patient developed venous stasis at the distal end of the tongue-shaped flap; the triangular flap at the pedicle was slightly bloated in the early postoperative period and became smooth after 2 to 3 months. Overall, two patients developed subcutaneous hematoma in their flaps. All the complications were healed by appropriate dressing change, suture removal, or compression bandaging. After operation, the appearance of the flap was full and formed a prominent fingertip shape. During the follow-up of 6 months to 5 years, the fingertips of the affected fingers were prominent and full; the two-point discrimination distance of the affected finger pulp was (8.6±1.4) mm; 8 patients were very satisfied with the efficacy, 6 patients were satisfied, and one patient was dissatisfied; the functional assessment of the affected fingers were all excellent. Conclusions: The modified proper digital artery island flap can repair complex fingertip defects involving the pulp, nail bed, and lateral wall of the nail. The operation is simple, and the shape and function of the fingertip are good after surgery.

3D free-assembly modular microfluidics inspired by movable type printing

Reconfigurable modular microfluidics presents an opportunity for flexibly constructing prototypes of advanced microfluidic systems. Nevertheless, the strategy of directly integrating modules cannot easily fulfill the requirements of common applications, e.g., the incorporation of materials with biochemical compatibility and optical transparency and the execution of small batch production of disposable chips for laboratory trials and initial tests. Here, we propose a manufacturing scheme inspired by the movable type printing technique to realize 3D free-assembly modular microfluidics. Double-layer 3D microfluidic structures can be produced by replicating the assembled molds. A library of modularized molds is presented for flow control, droplet generation and manipulation and cell trapping and coculture. In addition, a variety of modularized attachments, including valves, light sources and microscopic cameras, have been developed with the capability to be mounted onto chips on demand. Microfluidic systems, including those for concentration gradient generation, droplet-based microfluidics, cell trapping and drug screening, are demonstrated. This scheme enables rapid prototyping of microfluidic systems and construction of on-chip research platforms, with the intent of achieving high efficiency of proof-of-concept tests and small batch manufacturing.

Bronchoalveolar Lavage Fluid from Chronic Obstructive Pulmonary Disease Patients Increases Neutrophil Chemotaxis Measured by a Microfluidic Platform

Chronic obstructive pulmonary disease (COPD) is a persistent and progressive respiratory disorder characterized by expiratory airflow limitation caused by chronic inflammation. Evidence has shown that COPD is correlated with neutrophil chemotaxis towards the airways, resulting in neutrophilic airway inflammation. This study aimed to evaluate neutrophil chemotaxis in bronchoalveolar lavage fluid (BALF) from COPD patients using a high-throughput nine-unit microfluidic platform and explore the possible correlations between neutrophil migratory dynamics and COPD development. The results showed that BALF from COPD patients induced stronger neutrophil chemotaxis than the Control BALF. Our results also showed that the chemotactic migration of neutrophils isolated from the blood of COPD patients was not significantly different from neutrophils from healthy controls, and neutrophil migration in three known chemoattractants (fMLP, IL-8, and LTB4) was not affected by glucocorticoid treatment. Moreover, comparison with clinical data showed a trend of a negative relationship between neutrophil migration chemotactic index (C. I.) in COPD BALF and patient's spirometry data, suggesting a potential correlation between neutrophil migration and the severity of COPD. The present study demonstrated the feasibility of using the microfluidic platform to assess neutrophil chemotaxis in COPD pathogenesis, and it may serve as a potential marker for COPD evaluation in the future.

Diversity of the free helical rim flap: A case series tailoring the microsurgical technique to esthetically optimize full-thickness nasal defect reconstructions

INTRODUCTION

The free helical rim (FHR) flap offers like-with-like reconstruction for full-thickness nasal defects. A case series of nasal reconstruction using an FHR flap was presented, detailing surgical steps and refinements, as well as functional and esthetic outcomes.

METHODS AND MATERIALS

This is a retrospective cohort study of composite nasal defect reconstruction with FHR flap from August 2018 to March 2020. Descriptive data were analyzed by SPSS software.

RESULTS

Six cases were recruited, four were unilateral alar defects, one was hemi-nose, and one was ala plus tip. The average size of the defect was 2.5 × 2.8 cm2. Three FHR flaps were designed with retrograde pedicles and three with anterograde pedicles. The facial artery and veins were the recipient vessels in all cases. Vascular grafts were used in all six cases. Descending branch of the lateral circumflex femoral (DLCxF) artery and vein functioned as interposition vascular conduits in five cases. Superficial forearm vein grafts were used in one case. One patient needed flap re-exploration due to venous congestion. One patient had partial flap necrosis due to delayed infection, and one developed delayed wound dehiscence in the irradiated wound. The average follow-up was 18 months.

CONCLUSION

The FHR flap has consistent vascular anatomy. It can be raised as an anterograde or retrograde flap for a contralateral or ipsilateral inset. FHR flap can be used in extensive composite nasal defects. This case series demonstrates that interposition vascular grafts are invariably needed and the possibility of using forearm vessels as grafts instead of DLCxF artery and vein.

[The correlations between influenza and meteorological factors in 15 cities of northern China, 2008-2020]

Objective: To understand the influence of meteorological factors on the morbidity of influenza in northern cities of China and explore the differences in the influence of meteorological factors on the morbidity of influenza in 15 cities. Methods: The monthly reported morbidity of influenza and monthly meteorological data from 2008 to 2020 were collected in 15 provincial capital cities, including Xi 'an, Lanzhou, Xining, Yinchuan and Urumqi (5 northwestern cities), Beijing, Tianjin, Shijiazhuang, Taiyuan, Hohhot, Ji'nan, Zhengzhou (7 northern cities), Shenyang, Changchun and Harbin (3 northeastern cities). The panel data regression model was applied to conduct quantitative analyze on the influence of meteorological factors on influenza morbidity. Results: The univariate and multivariate panel regression analysis showed that after controlling the population density and other meteorological factors, for each 5 ℃ drop of monthly average temperature, the morbidity change percentage (MCP) of influenza was 11.35%, 34.04% and 25.04% in the 3 northeastern cities, 7 northern cities and 5 northwestern cities, respectively, and the best lag period months was 1, 0 and 1 month; When the monthly average relative humidity decreased by 10%, the MCP was 15.84% in 3 cities in northeastern China and 14.80% in 7 cities in northern China respectively, and the best lag period months was 2 and 1 months respectively; The MCP of 5 cities in northwestern China was 4.50% for each 10 mm reduction of monthly accumulated precipitation, and the best lag period months was 1 month; The MCPs of 3 cities in northeastern China and 5 cities in northwestern China were 4.19% and 5.97% respectively when the accumulated sunshine duration of each month decreased by 10 hours, the best lag period months was 1 month. Conclusions: In northern cities of China from 2008 to 2020, the temperature, relative humidity, precipitation and sunshine duration all had negatively impact on the morbidity of influenza, and temperature and relative humidity were the main sensitive meteorological factors. Temperature had a strong direct impact on the morbidity of influenza in 7 cities in northern China, and relative humidity had a strong lag effect on the morbidity of influenza in 3 cities in northeastern China. The duration of sunshine in 5 cities in northwestern China had a greater impact on the morbidity of influenza compared with 3 cities in northeastern China.

Protocol for electrotaxis of large epithelial cell sheets

Here, we present a protocol for electrotaxis of large epithelial cell sheets without compromising the integrity of cell epithelia in a high-throughput customized directed current electrotaxis chamber. We describe the fabrication and use of polydimethylsiloxane stencils to control the size and shape of human keratinocyte cell sheets. We detail cell tracking, cell sheet contour assay, and particle image velocimetry to reveal the spatial and temporal motility dynamics of cell sheets. This approach is applicable to other collective cell migration studies. For complete details on the use and execution of this protocol, please refer to Zhang et al. (2022).¹.

Electric field-guided collective motility initiation of large epidermal cell groups

Recent research has elucidated mechanochemical pathways of single cell polarization, but much less is known about collective motility initiation in adhesive cell groups. We used galvanotactic assays of zebrafish keratocyte cell groups, pharmacological perturbations, electric field switches, particle imaging velocimetry and cell tracking to show that large cell groups initiate motility in minutes towards the cathode. Interestingly, while PI3K-inhibited single cells are biased towards the anode, inhibiting PI3K does not affect the cathode-directed cell group migration. We observed that control groups had fastest cathode-migrating cell at the front, while the front cells in PI3K-inhibited groups were the slowest. Both control and PI3K-inhibited groups rapidly repolarized when the electric field direction was reversed, and the group migration continued after the electric field was switched off. Inhibiting myosin disrupted cohesiveness of keratocyte groups and abolished the collective directionality and ability to switch direction when the electric field is reversed. Our data are consistent with a model according to which cells in the group sense the electric field individually and mechanical integration of the cells results in coherent group motility. [Media: see text] [Media: see text] [Media: see text] [Media: see text] [Media: see text] [Media: see text] [Media: see text] [Media: see text] [Media: see text] [Media: see text] [Media: see text] [Media: see text] [Media: see text].

[Assessment of intensity of seasonal influenza activity in Beijing-Tianjin-Hebei region, 2019-2021]

Objective: To explore the feasibility of moving epidemic method (MEM) in the assessment of seasonal influenza (influenza) activity intensity from the perspective of urban agglomeration, assess influenza activity intensity in the Beijing-Tianjin-Hebei region from 2019 to 2021 and evaluate the reliability of surveillance data and the effectiveness of the MEM model application. Methods: The weekly reported incidence rate (IR) of influenza and the percentage of influenza-like illness (ILI%) from 2011-2021 in Beijing-Tianjin-Hebei region were collected to establish MEM models respectively. The model fitting effect and the reliability of the two data were evaluated for the purpose of establishing an optimal model to assess the influenza activity intensity in Beijing-Tianjin-Hebei region from 2019-2021. A cross-validation procedure was used to evaluate the performance of the models by calculating the Youden's index, sensitivity and specificity. Results: The MEM model fitted with weekly ILI% had a higher Youden's index compared with the model fitted with weekly IR at both Beijing-Tianjin-Hebei region level and provincial level. The MEM model based on ILI% showed that the epidemic threshold in Beijing-Tianjin-Hebei region during 2019-2020 was 4.42%, the post-epidemic threshold was 4.66%, with medium, high and very high intensity thresholds as 5.38%, 7.22% and 7.84%, respectively. The influenza season during 2019-2020 had 10 weeks (week 50 of 2019 to week 7 of 2020). The influenza season started in week 50 of 2019, and the intensity fluctuated above and below medium epidemic level for six consecutive weeks. The high intensity was observed in week 4 of 2020, the threshold of very high intensity was excessed in week 5, and the intensity gradually declined and became lower than the threshold at the end of the influenza season in week 8. The epidemic threshold was 4.29% and the post-epidemic threshold was 4.35% during 2020-2021. Influenza activity level never excessed the epidemic threshold throughout the year, and no epidemic period emerged. Conclusions: The MEM model could be applied in the assessment of influenza activity intensity in Beijing-Tianjin-Hebei region, and the use of ILI% to assess influenza activity intensity in this region was more reliable than IR data. Influenza activity intensity in Beijing-Tianjin-Hebei region was higher during 2019-2020 but significantly lower in 2020-2021.

Bioturbation in sediment cores from the Clarion-Clipperton Zone in the northeast Pacific: Evidence from excess 210Pb

Radioactivity levels of ²¹⁰Pb and ²²⁶Ra were measured to evaluate the bioturbation coefficients and mixing depths in one sediment core collected from the polymetallic nodule area inside the Clarion-Clipperton Zone (CCZ), a contract area of the China Ocean Mineral Resources Association (COMR) in the eastern Pacific Ocean. With a steady-state diffusion mode, the bioturbation coefficient and mixing depth of the sediment core were estimated to be 81.5 cm²/a and 51.3 cm, respectively, higher than that of the sediment core from the previous results from abyssal or global areas, which may be attributed to the distribution of total organic carbon (TOC) abundance. In addition, the transport flux of TOC from the surface layer to the deep layer were evaluated to be 1.15 mmol/(cm²·a), resulting in 83,200 tons of carbon buried annually into the sediment in the CCZ, indicating that a potential carbon sink will be disturbed with future exploration.

Neutrophil conversion to a tumor-killing phenotype underpins effective microbial therapy

The inflammatory microenvironment of solid tumors creates a pro-tumorigenic milieu that resembles chronic inflammation akin to a subverted wound healing response. Here we investigated the effect of converting the tumor microenvironment from a chronically inflamed state to one of acute microbial inflammation by injecting microbial bioparticles directly into tumors. Intratumoral microbial bioparticle injection led to rapid and dramatic changes in the tumor immune composition, the most striking of which was a substantial increase in the presence of activated neutrophils. In situ photoconversion and intravital microscopy indicated that tumor neutrophils transiently switched from sessile producers of vascular endothelial growth factor to highly motile neutrophils that clustered to make neutrophil-rich domains in the tumor. The neutrophil clusters remodeled tumor tissue and repressed tumor growth. Single cell transcriptional analysis of microbe-stimulated neutrophils showed a profound shift in gene expression towards heightened activation and anti-microbial effector function. Microbe-activated neutrophils also upregulated chemokines known to regulate neutrophil and CD8+ T cell recruitment. Microbial therapy also boosted CD8+ T cell function and enhanced the therapeutic benefit of checkpoint inhibitor therapy in tumor-bearing mice and provided protection in a model of tumor recurrence. These data indicate that one of the major effector mechanisms of microbial therapy is the conversion of tumor neutrophils from a wound healing to an acutely activated cytotoxic phenotype, highlighting a rationale for broader deployment of microbial therapy in the treatment of solid cancers.

Base MRI Imaging Characteristics of Meningioma Patients to Discuss the WHO Classification of Brain Invasion Otherwise Benign Meningiomas

PURPOSE

Compared and analyzed the MRI imaging features of brain invasion otherwise benign (BIOB) meningiomas and WHO grade 1, grade 2 meningiomas, discussed the WHO grading of BIOB from the perspective of imaging.

MATERIALS AND METHODS

A retrospective analysis was performed on 675 meningiomas patients who carried on MRI examination from January 2006 to February 2022. Setting the 2022 Central nervous system (CNS) WHO Guidelines as the gold standard for pathological diagnosis. Statistical analysis of age, gender, and MRI features of meningiomas in relation to WHO grade and brain invasion.

RESULTS

Among 675 cases meningiomas, 543 (80.4%) were WHO grade 1, 123 (18.2%) were WHO grade 2, and 9 (1.3%) were WHO grade 3. There were 108 cases meningiomas with brain invasion (BI) (16.0%) and 567 cases without BI (84.0%). Among BI cases, 67 cases were BIOB. Compared the MRI features between BIOB and WHO grade 1 meningiomas, multivariate analysis demonstrated that the most strongly factors associated with distinguish them were enhancement degree, peritumoral edema, tumor-brain interface, fingerlike protrusion, mushroom sign, and bone invasion (AUC: 0.925 (0.901∼0.945), sensitivity: 0.925, specificity: 0.801). Compared the MRI features between BIOB and WHO grade 2 meningiomas, multivariate analysis demonstrated that the most strongly factors associated with distinguish them were enhancement degree and the tumor-brain interface (AUC: 0.779 (0.686∼0.841), sensitivity: 0.746, specificity: 0.732), their efficacy was slightly weaker.

CONCLUSIONS

BIOB is more similar to WHO grade 2 meningiomas in clinical and imaging features than WHO grade 1, so we think that it may be reasonable to classify BIOB as WHO Grade 2 meningiomas in the guidelines.

Follistatin is a crucial chemoattractant for mouse decidualized endometrial stromal cell migration by JNK signalling

Follistatin (FST) and activin A as gonadal proteins exhibit opposite effects on follicle-stimulating hormone (FSH) release from pituitary gland, and activin A-FST system is involved in regulation of decidualization in reproductive biology. However, the roles of FST and activin A in migration of decidualized endometrial stromal cells are not well characterized. In this study, transwell chambers and microfluidic devices were used to assess the effects of FST and activin A on migration of decidualized mouse endometrial stromal cells (d-MESCs). We found that compared with activin A, FST exerted more significant effects on adhesion, wound healing and migration of d-MESCs. Similar results were also seen in the primary cultured decidual stromal cells (DSCs) from uterus of pregnant mouse. Simultaneously, the results revealed that FST increased calcium influx and upregulated the expression levels of the migration-related proteins MMP9 and Ezrin in d-MESCs. In addition, FST increased the level of phosphorylation of JNK in d-MESCs, and JNK inhibitor AS601245 significantly attenuated FST action on inducing migration of d-MESCs. These data suggest that FST, not activin A in activin A-FST system, is a crucial chemoattractant for migration of d-MESCs by JNK signalling to facilitate the successful uterine decidualization and tissue remodelling during pregnancy.

Double-Layered Strategy for Broadband Photomultiplication-Type Organic Photodetectors and Achieving Narrowband Response in Violet, Red, and Near-Infrared Light

Broadband photomultiplication-type organic photodetectors (PM-OPDs) were prepared with PMBBDT:PY3Se-2V (1:1, wt/wt) as the absorbing layer (AL) and PC₇₁BM:P3HT (100:5, wt/wt) as the photomultiplication layer (PML) on the basis of the sandwich structure. The incident photons from ultraviolet light to the near-infrared region can be harvested by AL. The rather less P3HT in PML can produce plenty of isolated hole traps with P3HT surrounded by PC₇₁BM; the electron tunneling injection induced by trapped holes near the Ag electrode can lead to the photomultiplication (PM) phenomenon. The performance of PM-OPDs can be effectively improved by optimizing the AL thickness. The optimal PM-OPDs exhibit a broad spectral response from 300 to 1050 nm as well as an external quantum efficiency (EQE) of 5800% at 340 nm at 10 V bias, along with a specific detectivity (D*) of 3.78 × 10¹³ Jones. The spectral response of PM-OPDs is controlled by the trapped-hole distribution near the Ag electrode, primarily originating from the photogenerated holes in AL. To further optimize the spectral response of PM-OPDs, the optical filter layer (OFL) was used to manipulate light field distribution in AL. The violet, red, and near-infrared-light PM-OPDs were developed by employing different OFLs.

T Cells Chemotaxis Migration Studies with a Multi-Channel Microfluidic Device

Immune surveillance is dependent on lymphocyte migration and targeted recruitment. This can involve different modes of cell motility ranging from random walk to highly directional environment-guided migration driven by chemotaxis. This study protocol describes a flow-based microfluidic device to perform quantitative multiplex cell migration assays with the potential to investigate in real time the migratory response of T cells at the population or single-cell level. The device also allows for subsequent in situ fixation and direct fluorescence analysis of the cells in the microchannel.

[Hepatitis C elimination among drug users in China: challenges, strategies and experiences]

The prevalence of hepatitis C among drug users in China is high, and thus it is one of the populations that needs attention to achieve hepatitis C elimination. However, due to the complexities of this population's situation, hepatitis C elimination still faces many challenges, such as difficult screening, low cure rate, poor compliance, and high reinfection rates. Therefore, the existing diagnostic and therapeutic system cannot meet the needs of this population. China has pledged to establish a unified system for drug users that will integrate drug treatment programs, education, medical care, and rehabilitation, creating favorable conditions for integrating hepatitis C diagnosis and treatment and improving the accessibility of drug users. Starting with the current situation and challenges of eliminating hepatitis C among drug users in China, in combination with cases from other countries, this paper discusses the strategy for eliminating hepatitis C and introduces what Hainan Province did to eliminate hepatitis C among drug users.

Recent advances in microfluidics-based cell migration research

Cell migration is crucial for many biological processes, including normal development, immune response, and tissue homeostasis and many pathological processes such as cancer metastasis and wound healing. Microfluidics has revolutionized the research in cell migration since its inception as it reduces the cost of studies and allows precise manipulation of different parameters that affect cell migratory response. Over the past decade, the field has made great strides in many directions, such as techniques for better control of the cellular microenvironment, application-oriented physiological-like models, and machine-assisted cell image analysis methods. Here we review recent developments in the field of microfluidic cell migration through the following aspects: 1) the co-culture models for studying host-pathogen interactions at single-cell resolution; 2) the spatiotemporal manipulation of the chemical gradients guiding cell migration; 3) the organ-on-chip models to study cell transmigration; and 4) the deep learning image processing strategies for cell migration data analysis. We further discuss the challenges, possible improvement and future perspectives of using microfluidic techniques to study cell migration.

Recent advances in acoustofluidic separation technology in biology

Acoustofluidic separation of cells and particles is an emerging technology that integrates acoustics and microfluidics. In the last decade, this technology has attracted significant attention due to its biocompatible, contactless, and label-free nature. It has been widely validated in the separation of cells and submicron bioparticles and shows great potential in different biological and biomedical applications. This review first introduces the theories and mechanisms of acoustofluidic separation. Then, various applications of this technology in the separation of biological particles such as cells, viruses, biomolecules, and exosomes are summarized. Finally, we discuss the challenges and future prospects of this field.

[Safety and efficacy of TIPS combined with iodine-125 seed strands in the treatment of patients with hepatocellular carcinoma combined with portal vein tumor thrombosis]

Objective: To study the safety and efficacy of transjugular intrahepatic portosystemic shunt (TIPS) combined with iodine-125 (¹²⁵Ⅰ) seed strands implantation in patients with hepatocellular carcinoma combined with portal vein tumor thrombosis. Methods: 25 cases with diffuse intrahepatic tumor combined with tumor thrombus type Ⅲ/Ⅳ requiring TIPS were simultaneously implanted with ¹²⁵Ⅰseed strand. Tumor thrombus was controlled with ¹²⁵I seed implantation brachytherapy to keep the TIPS pathway unobstructed, reduce the portal vein pressure, and observe the changes in the cause of death of the patients. During the same period, 30 cases without TIPS and seed strand implantation were used as controls. Data between groups were compared using t-test, Chi-Squared test or Fisher's exact test. Results: TIPS combined with ¹²⁵Ⅰ seed strand implantation was safe in patients with diffuse hepatocellular carcinoma combined with type III/IV portal vein tumor thrombus, and 92.0% (23/25) of the patients maintained unobstructed TIPS pathway. Compared with the control group, patients in the treatment group died of fewer lead-related complications, and most died from chronic liver failure (84.0% vs. 56.7%, χ² = 4.771, P=0.029). The incidence of upper gastrointestinal bleeding was significantly decreased (12.0% vs. 46.7%, χ² =7.674, P=0.006) and ascites severity was significantly improved (mild 40.0% vs. 16.7%, moderate 52.0% vs. 20.0%, severe 8.0% vs. 46.7%, χ² =13.246 , P=0.001). Conclusions: TIPS combined with ¹²⁵Ⅰ seed strand implantation is safe and feasible in patients with diffuse intrahepatic tumor combined with tumor thrombus type Ⅲ/Ⅳ. Moreover, it can effectively keep the shunt patency and reduce portal vein pressure, thereby reducing the incidence of upper gastrointestinal bleeding and improving the degree of ascites. TIPS combined with ¹²⁵Ⅰ seed strand implantation may be used as a standard treatment modality for patients requiring TIPS therapy combined with tumor thrombus type Ⅲ/Ⅳ.

[Effects of one-stop hybrid operation on the risk and prognosis of brain arteriovenous malformations with posterior feeding artery]

Objective: To explore the effect of the combination of posterior circulation embolization and micro-resection on the risk and prognosis in patients with brain arteriovenous malformations (bAVMs) supplied by posterior circulation in a one-stop hybrid operation setting. Methods: Patients with bAVMs supplied by posterior circulation who received surgical treatment in Beijing Tiantan Hospital, Capital Medical University, were enrolled from January 2016 to December 2019 from a prospective, multicentral cohort (NCT03209804). The patients were divided into the posterior circulation embolization group and the non-posterior circulation embolization group. Propensity score matching (PSM) (1∶1) was performed according to the baseline information, the morphology of bAVMs, vascular architecture, and Spetzler-Martin grade of brain lesions. The primary endpoint was the deterioration of neurological function. The secondary endpoints were perioperative complications. The differences in surgical risk and clinical prognosis between the two groups were compared. Results: Five hundred and forty-five patients were enrolled in the cohort, and 38.3% met the included criteria (n=209 cases), with 42 cases in the posterior circulation embolization group and 167 cases in the non-posterior circulation embolization group. Depending on whether the patients were posterior circulation embolized, 39 patients in the posterior circulation embolization group and 39 patients in the non-posterior circulation embolization group were finally included after performing PSM. There were 50 males and 28 females, aged 5-58 (30±13) years. The exacerbation rate of neurological dysfunction in the posterior circulation embolization group was higher than that in the non-posterior circulation embolization group three months after surgery, however there was no statistically significant difference between the two groups [15.4% (6/39) vs 2.6% (1/39), P=0.107]. The intraoperative blood loss in the embolization group was significantly less than that in the non-embolization group [650 (500, 1 500) ml vs 1 200 (800, 2 000) ml, P=0.002]. There was no significant difference in microsurgery time between the two groups [437 (374, 521) min vs 424 (359, 601) min, P=0.865]. Likewise, there were no statistically significant differences in the incidence of postoperative complications and aggravation of neurological dysfunction, including postoperative bAVMs residual [5.1%(2/39) vs 7.7%(3/39), P=1.000], hemorrhagic complications [5.1%(2/39) vs 0(0), P=0.494], postoperative ischemic complications [10.3%(4/39) vs 5.1%(2/39), P=0.675], neurological dysfunction at discharge (17.9% vs 15.4%, P=0.755), and one-year neurological dysfunction [5.1%(2/39) vs 2.6%(1/39), P=1.000]. Conclusions: Posterior circulation embolization of bAVMs in a one-stop hybrid operation can effectively reduce intraoperative bleeding and surgical risk. Embolization of the feeding artery has no significant impact on the perioperative complications and neurological outcomes.

ToTEM: A software for fast TEM image simulation

ToTEM, a multislice based image simulation software is developed for transmission electron microscope (TEM). This software implements the following major features: i) capability of assigning three-dimensional potentials of atom into multiple slices and precise introduction of phase shift caused by the sub-pixel atomic position, ii) employing CUDA coding and graphical processing units (GPU) with multi-threading parallel algorithm based on the powerful batch (inverse) fast Fourier transform (FFT), which is especially beneficial for image simulation of scanning transmission electron microscopy (STEM) or (integrated) differential phase contrast (i)DPC, iii) design for efficiently generating large batch of dataset of high resolution transmission electron microscopy (HRTEM) images. Image simulation acceleration for STEM has been verified by simulating a large-scale SrTiO₃ . Additionally, iDPC image of MFI-type zeolites with xylene molecules encapsulated in straight channels demonstrates the advantage of iDPC in detecting light molecules. This article is protected by copyright. All rights reserved.

The Molecular Ordering and Double-Channel Carrier Generation of Nonfullerene Photovoltaics within Multi-Length-Scale Morphology

The success of nonfullerene acceptor (NFA) solar cells lies in their unique physical properties beyond the extended absorption and suitable energy levels. The current study investigates the morphology and photophysical behavior of PBDB-T donor blending with ITIC, 4TIC, and 6TIC acceptors. Single-crystal study shows that the π-π stacking and side-chain interaction dictate molecular assembly, which can be carried to blended films, forming a multi-length-scale morphology. Spontaneous carrier generation is seen in ITIC, 4TIC, and 6TIC neat films and their blended thin films using the PBDB-T donor, providing a new avenue of zero-energy-loss carrier formation. The molecular packing associated with specific contacts and geometry is key in influencing the photophysics, as demonstrated by the charge transfer and carrier lifetime results. The 2D layer of 6TIC facilitates the exciton-to-polaron conversion, and the largest photogenerated polaron yield is obtained. The new mechanism, together with the highly efficient blending region carrier generation, has the prospect of the fundamental advantage for NFA solar cells, from molecular assembly to thin-film morphology.

Novel insights into heat tolerance using metabolomic and high-throughput sequencing analysis in dairy cows rumen fluid

Heat stress influences rumen fermentative processes with effects on the physiology and production of dairy cows. However, the underlying relationship between rumen microbiota and its associated metabolism with heat tolerance in cows have not been extensively described yet. Therefore, the main objective of this study was to investigate differential heat resistance in Holstein cows using rumen bacterial and metabolome analyses. We performed both principal component analysis and membership function analysis to select seven heat-tolerant (HT) and seven heat-sensitive (HS) cows. Under heat stress conditions, the HT cows had a significantly (P < 0.05) higher propionic acid content than the HS cows; while measures of the respiratory rate, acetic, and butyric acid in the HT cows were significantly (P < 0.05) lower compared with the HS cows. Also, the HT cows showed lower (P < 0.01) rectal temperature and acetic acid to propionic acid ratio than the HS group of cows. Omics sequencing revealed that the relative abundances of Muribaculaceae, Rikenellaceae, Acidaminococcaceae, Christensenellaceae, Rikenellaceae_RC9_gut_group, Succiniclasticum, Ruminococcaceae_NK4A214_group and Christensenellaceae_R-7_group were significantly (P < 0.01) higher in the HT cows; whereas Prevotellaceae, Prevotella_1, Ruminococcaceae_UCG-014, and Shuttleworthia were significantly (P < 0.01) lower in HT cows compared to HS cows. Substances mainly involved in carbohydrate metabolism, including glycerol, mannitol, and maltose, showed significantly higher content in the HT cows (P < 0.05) compared to that in the HS cows. Simultaneously, distinct metabolites were significantly correlated with differential bacteria, suggesting that glycerol, mannitol, and maltose could serve as potential biomarkers for determining heat resistance that require further study. Overall, distinct changes in the rumen microbiota and metabolomics in the HT cows may be associated with a better adaptability to heat stress. These findings suggest their use as diagnostic tools of heat tolerance in dairy cattle breeding schemes.

Incident cardiovascular events and early mortality in patients with revascularized critical limb ischemia

OBJECTIVES

Patients with critical limb ischemia (CLI) present a high risk of cardiovascular events and death. This study aimed to investigate the incidence of major adverse cardiovascular events (MACE) and one-year mortality in patients undergoing percutaneous revascularization procedure for CLI.

METHODS

This investigation is a retrospective analysis of an ongoing cohort study in patients with CLI undergoing endovascular revascularization, hospitalized in the vascular medicine department from November 2013 to December 2018. Major cardiovascular events were collected during the first year after revascularization procedure and were defined as heart failure, acute coronary syndrome, ischemic stroke and sudden death. Mortality and major limb amputations, defined as above-the-ankle amputation, were determined during the one-year follow-up period. Multivariate logistic regression analyses were performed to identify factors independently associated with the occurrence of MACE and one-year mortality after revascularization procedure. A P≤0.05 was considered as statistically significant.

RESULTS

The study included 285 consecutive patients, 157 men (55%) and 128 women (45%), with a mean age of 77.8±12 years. Treated hypertension was present in 222 (78%) patients; diabetes was present in 137 (48%) patients; 112 (39%) patients had known coronary heart disease and 20 (7%) patients were dialysis dependent. During the one-year follow-up after revascularization procedure, 75 (26.3%) patients presented an incident cardiovascular event, of whom 19 (6.7%) patients in the perioperative period. Cumulative mortality rate was 26.7% (76 patients) mostly from cardiovascular causes. Twenty-five patients (8.8%) experienced major amputation. In multivariate analysis, the occurrence of MACE was associated with an increased mortality risk (HR 6.96 (2.99-16.94), P<0.001). Other variables associated with an increased mortality were living in a nursing home and malnutrition. Decompensated heart failure and coronary heart disease were both associated with incident MACE in multivariate analysis, independently of confounders.

CONCLUSION

In the present study population, incident MACE were prevalent in the year following endovascular revascularization procedure in patients with CLI and were associated with an increased risk of mortality. Coronary heart disease and decompensated heart failure are important contributors for the occurrence of MACE. In this elderly patient population with CLI, these results should be taken into account during the multidisciplinary team meeting before consideration of revascularization procedure.

[Artificial intelligence for medical information departments : construction and evaluation of a decision-making tool to identify and prioritize stays of which the PMSI coding could be optimized, and to ensure the revenues generated by activity-based pricing]

BACKGROUND

Medical Information Departments help to optimize the hospital revenues generated by activity-based pricing. A review of medical files, selected after the targeting of coding summaries, is organized. The aim is to make any corrections to the diagnoses or coded procedures with a potential impact on the pricing of the stay. Targeting is of major importance as a means of concentrating resources on the files for which coding can be effectively improved. The tools available for targeting can be optimized. We have developed a decision-making support tool to make targeting more efficient. The objective of our study was to evaluate the performance of this tool.

METHODS

The tool combines an artificial intelligence module with a rule-based expert module. A predictive score is assigned to each coding summary that reflects the probability of a revalued stay. Evaluation of the performance of this tool was based on a sample of 400 stays of at least 3 nights of patients hospitalized at the Paris Saint-Joseph Hospital from 1^st November to 31^st December 2019. Each stay was reviewed by a coding expert, without knowledge of the score assigned and without help from expert queries. Two main assessment criteria were used: area under the ROC curve and positive predictive value (PPV).

RESULTS

The area under the ROC curve was 0.70 (CI 95% [0.64-0.76]). With a revalued coding rate of 32%, PPV was 41% for scores above 5, 65% for scores above 8, 88% for scores above 9.

CONCLUSION

The study made it possible to validate the performance of the tool. The implementation of new variables could further increase its performance. This is an area of development to be considered, particularly with in view of generalizing individual invoicing in hospitals.

Dilution effect for highly efficient multiple-component organic solar cells

Although the multiple-component (MC) blend strategy has been frequently used as a very effective way to improve the performance of organic solar cells (OSCs), there is a strong need to understand the fundamental working mechanism and material selection rule for achieving optimal MC-OSCs. Here we present the 'dilution effect' as the mechanism for MC-OSCs, where two highly miscible components are molecularly intermixed. Contrary to the aggregation-induced non-radiative decay, the dilution effect enables higher luminescence quantum efficiencies and open-circuit voltages (V_OC) in MC-OSCs via suppressed electron-vibration coupling. The continuously broadened bandgap together with reduced electron-vibration coupling also explains the composition-dependent V_OC in ternary blends well. Moreover, we show that electrons can transfer between different acceptors, depending on the energy offset between them, which contributes to the largely unperturbed charge transport and high fill factors in MC-OSCs. The discovery of the dilution effect enables the demonstration of a high power conversion efficiency of 18.31% in an MC-OSC.

A self-quenching fluorescence probe-mediated exponential isothermal amplification system for highly sensitive and specific detection of microRNAs

We designed an efficient self-quenching fluorescence probe and constructed this probe-mediated exponential isothermal amplification system for miRNA detection. Owing to the significant improvement in the detective signal-to-background ratio, a wide dynamic range of 9 orders of magnitude and a limit of detection as low as 0.08 aM can be easily achieved in a single step. Furthermore, benefiting from the additional advantages of high specificity and biocompatibility, the proposed method has been demonstrated to be capable of accurately quantifying miRNA biomarkers in serum, which will provide promising perspectives for clinical diagnosis.

Generation of flow and droplets with an ultra-long-range linear concentration gradient

In the chemical and biological fields, the creation of concentration gradient microenvironments is an important approach for many applications, such as crystal growth and drug screening. Although many concentration gradient generators have been demonstrated, current generators can hardly produce ultra-long linear concentration gradients. In this paper, we propose a concentration-gradient flow/droplet generator which consists of a microfluidic flow switch, a cavity array for stage-by-stage concentration dilution, and an optional T-junction for droplet formation. The generator can realize an ultra-long continuously-varying concentration gradient along the flow direction. Generation of a 38 mm concentration gradient was demonstrated. The length can be further extended by enlarging the capacity of the cavities and increasing the number of the stages. The concentration gradient showed high linearity in the range of 10% to 90%. Moreover, cyclic generation of a concentration gradient flow and droplets with different concentrations was realized by the generator. In a demonstration of drug screening, the generator was employed to produce paclitaxel in different concentrations. A negative correlation between the 4T1 cell viability and the paclitaxel concentration was observed after the treatment. We envision that the concentration gradient generator will be a promising candidate for various drug screening applications.

[Outcomes of 1 000 cases of robotic thyroidectomy by bilateral axillo-breast approach: a retrospective study in a single center]

Objective: To examine the surgical outcome, completeness and safety of robotic thyroidectomy by bilateral axillo-breast approach (BABA). Methods: From February 2014 to May 2019, 1 000 cases of robotic thyroidectomy via BABA at the Department of Thyroid and Breast Surgery, the 960^th Hospital of People's Liberation Army were performed. The clinicopathologic characteristics, operation times, perioperative complications, and oncologic outcomes of patients underwent robotic thyroidectomy were collected and reviewed retrospectively. There were 216 males and 784 females, aging (42.3±11.5) years (range: 7 to 75 years). There were 270 cases with benign tumors, and 730 cases with malignant cancers (the tumor diameter was (7.9±6.7) mm (range: 0.1 to 60.0 mm)). Results: There were 999 patients received robotic thyroidectomy using BABA approach successfully, while only 1 case conversed to open operation. The postoperative hospital stay was (7.5±2.5) days (range: 2 to 30 days). Among the 730 patients with thyroid cancers, 725 cases (99.3%) were papillary thyroid carcinoma, 579(79.3%) cases were with papillary thyroid microcarcinoma. Lymph node metastasis was observed in 371(50.8%) cases. The retrieved central lymph node number was 11.2±6.1 (range: 1 to 44),and the retrieved lateral lymph node number was 14.0±8.8 (range: 1 to 52). Postoperative transient hypoparathyroidism and vocal cord palsy occurred in 247(24.70%) and 56(5.60%) cases. Both of permanent hypoparathyroidism and vocal cord palsy occurred in 2 (0.20%) cases. Other surgical complications included chyle leakage (6.1%, 28/460), trachea injury (0.40%, 4/1 000), carotid artery injury (0.10%, 1/1 000). Local regional lymph node recurrence was developed in 4 patients. All patients were satisfied with the postoperative cosmetic outcomes. Conclusions: Robotic thyroidectomy by BABA is safe and effective, suitable for large benign tumors and early thyroid cancers with central or lateral lymph node metastasis. It could obtain superior cosmetic results.

Selenium-Containing Organic Photovoltaic Materials

ConspectusOrganic photovoltaics (OPVs) with a photoactive layer containing a blend of organic donor and acceptor species are considered to be a promising technology for clean energy owing to their unique flexible form factor and good solution processability that can potentially address the scalability challenges. The delicate designs of both donors and acceptors have significantly enhanced the power conversion efficiency of OPVs to more than 18%. Nonfullerene small-molecule acceptors (NFAs) have played a critical role in enhancing the short-circuit current density (J_SC) by efficiently harvesting near-infrared (NIR) sunlight. To take full advantage of the abundant NIR photons, the optical band gap of NFAs should be further reduced to improve the performance of OPVs. Incorporating highly polarizable selenium atoms onto the backbone of organic conjugated materials has been proven to be an effective way to decrease their optical band gap. For example, a selenium-substituted NFA recently developed by our group has attained a J_SC of approximate 27.5 mA cm^-2 in OPV devices, surpassing those of most emerging photovoltaic systems. Inspired by this advance, we concentrate on the topic of selenium-containing materials in this Account to incite readers' interest in further exploring this series of materials.In this Account, we first compare the differences among chalcogen heterocycles and discuss the influence of fundamental electronic behavior on the collective photoelectrical properties of the resulting materials. The superior features of selenium-substituted materials are summarized as follows: (1) The large covalent radius of selenium can diminish the π-orbital overlap, rendering enhanced quinoidal resonance character and a narrowed optical band gap of resulting materials. (2) The selenium atom is more polarizable than sulfur owing to its larger and looser outermost electron cloud, enabling enhanced intermolecular Se-Se interaction and increased charge carrier mobility of relevant materials in the solid state. We then focus on summarizing the design rules for various categories of selenium-containing materials including polymer donors, small-molecule acceptors, and polymer acceptors, especially those composed of ladder-type polycyclic units. The motivation for incorporating selenium atoms into these materials and the structure-property relationships were thoroughly elucidated. Specifically, we discuss the changes in the optical band gap, charge carrier mobility, and molecular packing induced by selenium substitution and correlate the effects of these changes with the exciton behaviors, energy loss, and nanoscale film morphology of corresponding OPV devices. Furthermore, we point out the intrinsic stability of selenium-containing materials under maximum-power-point tracking and long-term photo- or thermostress and indicate their potential use in semitransparent and tandem solar cells. At the end, the prospect of future research focuses and the possible applications of selenium-containing materials in the OPV field are discussed.

Characteristics and outcomes of octogenarians with revascularized critical limb ischemia: Impact of altered cardiac function for early mortality

OBJECTIVE

Patients with critical limb ischemia (CLI) present with advanced age and end-stage organ damage, in particular heart failure. The aim of the present study is to describe clinical and biological characteristics in octogenarian patients with CLI compared to their younger counterparts and to determine the peri-procedural risk and early mortality after endovascular procedure.

METHODS

From November 2013 to May 2019, 315 consecutive patients were retrospectively included. Clinical and biological parameters were recorded at baseline before endovascular revascularization. The main outcome was total 1-year mortality.

RESULTS

The study included 170 octogenarians and 145 non-octogenarians. The mean age of octogenarian patients was 86.9±4.8 years, almost 20 years higher than that registered in non-octagenarians patients (67.4±8.6 years). Octogenarian patients were mostly women (59.4%), presented with lower body mass index (23.8±4.4kg/m²), lower serum albumin level (31.5±5.4g/L) and lower creatinine clearance (66.1±24.5mL/mn) than younger counterparts. They were more likely to be institutionalized in a nursing home (27.1%). In the peri-procedural period, major bleeding occurred in 40 patients (12.7%), without statistical significance between the two age groups. Peri-procedural mortality occurred in 12 patients (3.8%), of whom 10 patients (83%) were octogenarians. Cumulative mortality rate was 25.4% (80 patients) during the one-year follow-up period: 58 octogenarians died (34.1%) compared to 22 non-octogenarian patients (15.2%), P<0.001. Cardiovascular events were highly prevalent, accounting for 40% of overall mortality. Twenty-five patients (8%) experienced major amputation, without significant difference between the two age groups. In octogenarian population, institutionalized status (P=0.004) and BNP level (P=0.001) were positively correlated with mortality whereas systolic blood pressure (P<0.001), left ventricular ejection fraction (P=0.003), serum albumin (P=0.020), C-Reactive protein (P=0.020) and renin-angiotensin system inhibitors at hospital discharge were negatively correlated with mortality. In multivariate analysis for mortality, only BNP level≥500pg/mL (HR 3.27; 95% CI 1.04-10.97; P=0.04), was correlated with mortality, independently of other confounders.

CONCLUSION

In the present study population, octogenarians represent a rather distinct CLI population, 20 years of age older as compared to non-octogenarians, with prevalent malnutrition and institutionalized status. The present results underline a substantial one-year mortality rate of 34.1% in this elderly population following revascularization procedure with a 6% peri-procedural mortality. Decompensated heart failure is an important contributor for mortality.

Regulating the Aggregation of Unfused Non-Fullerene Acceptors via Molecular Engineering towards Efficient Polymer Solar Cells

Tuning molecular aggregation via structure design to manipulate the film morphology still remains as a challenge for polymer solar cells based on unfused non-fullerene acceptors (UF-NFAs). Herein, a strategy was developed to modulate the aggregation patterns of UF-NFAs by systematically varying the π-bridge (D) unit and central core (A') unit in A-D-A'-D-A framework (A and D refer to electron-withdrawing and electron-donating moieties, respectively). Specifically, the quantified contents of H- or J-aggregation and crystallite disorder of three UF-NFAs (BDIC2F, BCIC2F, and TCIC2F) were analyzed via UV/Vis spectrometry and grazing incidence X-ray scattering. The results showed that the H-aggregate-dominated BCIC2F with less crystallite disorder exhibited a more favorable blend morphology with polymer donor PBDB-T (poly[(2,6-(4,8-bis(5-(2-ethylhexyl)thiophen-2-yl)benzo[1,2-b:4,5-b']dithiophene)-co-(1,3-di(5-thiophene-2-yl)-5,7-bis(2-ethylhexyl)benzo[1,2-c:4,5-c']dithiophene-4,8-dione)]) relative the other two UF-NFAs, resulting in improved exciton dissociation and charge tranport. Consequently, photovoltaic devices based on BCIC2F delivered a promising power conversion efficiency of 12.4 % with an exceptionally high short-circuit current density of 22.1 mA cm^-2 .

[Expression of microRNA-296 in rabbit hypertrophic scars and its role to human fibroblasts]

Objective: To investigate the expression of microRNA-296 (miR-296) in rabbit hypertrophic scars and its role in human fibroblasts (HFbs). Methods: The experimental method was used. Twelve healthy adult New Zealand long-eared rabbits regardless gender were randomly divided into normal control group and scar group, with 6 rabbits in each group. The rabbit ear hypertrophic scar model was created in scar group according to the literature, and the rabbits in normal control group did not receive any treatment. On 60 days after setting up the models in scar group, hematoxylin-eosin staining was performed to observe the growth and arrangement of fibroblasts (Fbs) in the ear scars and skin tissue of rabbits in the two groups. The mRNA expressions of miR-296 and transforming growth factor-β₁ (TGF-β₁) in ear scars and skin tissue of rabbits in the two groups were detected by real-time fluorescent quantitative reverse transcription polymerase chain reaction, and the correlation of mRNA between miR-296 and TGF-β₁ was performed with Pearson regression analysis. Two batches of HFbs were used and transfected respectively with corresponding sequences, with the 1st batch being divided into TGF-β₁ wild type+miR-296 negative control group and TGF-β₁ wild type+miR-296 mimic group and the 2nd batch being divided into TGF-β₁ mutant type+miR-296 negative control group and TGF-β₁ mutant type+miR-296 mimic group. At 48 h after transfection, luciferase reporter gene detection kit was used to detect the luciferase and renal luciferase expression of TGF-β₁ in the cells of each group, with their ratio being used to reflect the gene expression level. Two batches of HFbs were used, and each batch of cells were divided into miR-296 negative control group and miR-296 mimic group, being transfected with the corresponding sequences. At 0 (immediately), 12, 24, 36, and 48 h after transfecting the first batch of cells, the cell proliferation was detected by thiazolyl blue method. At 24 h after transfecting the second batch of cells, the expression of TGF-β₁ and collagen type Ⅰ was detected by Western blotting. The number of samples in cell experiments was 3. Data were statistically analyzed with analysis of variance for factorial design, independent sample t test. Results: On 60 days after setting up the models in scar group, the Fbs of rabbit ear scar tissue in scar group proliferated and arranged disorderly, while the growth and arrangement of Fbs in rabbit ear skin tissue in normal control group were normal. The mRNA expression of miR-296 of rabbit scar tissue in scar group (0.65±0.11) was significantly lower than 1.19±0.12 of rabbit ear skin tissue in normal control group (t=5.175, P<0.01). The mRNA expression of TGF-β₁ of rabbit ear scar tissue in scar group (1.47±0.06) was significantly higher than 1.10±0.03 of rabbit ear skin tissue in normal control group (t=12.410, P<0.01). Pearson regression analysis showed that there was a negative correlation between the mRNA expression of miR-296 and TGF-β₁ in the ear scars and skin tissue of 12 rabbits (F=7.278, P<0.05). At 48 h after transfection, the gene expression of TGF-β₁ of cells in TGF-β₁ wild type+miR-296 mimic group was significantly lower than that in TGF-β₁ wild type+miR-296 negative control group (t=35.190, P<0.01), while the gene expression of TGF-β₁ of cells in the two TGF-β₁ mutant type groups were close (P>0.05). The HFbs proliferation ability in miR-296 mimic group was significantly lower than that in miR-296 negative control group at 12, 24, 36, and 48 h after transfection(t=3.275, 11.980, 10.460, 17.260, P<0.05 or P<0.01). At 24 h after transfection, the protein expressions of TGF-β₁ and type Ⅰ collagen of cells in miR-296 negative control group were significantly higher than those in miR-296 mimic group (t=3.758, 29.390, P<0.05 or P<0.01). Conclusions: The miR-296 expression in rabbit hypertrophic scars is down-regulated; miR-296 can inhibit the proliferation of HFbs and the expression of type Ⅰ collagen by down regulating the expression of TGF-β₁.

[A real-world study of sofosbuvir-based drug treatment for hepatitis C virus genotype 6 infection in Hainan region of China]

Objective: To explore the real-world effectiveness and safety of sofosbuvir-based regimen for patients with chronic hepatitis C virus (HCV) genotype 6 infection in Hainan Island. Methods: Fifty-three cases with chronic hepatitis C virus (HCV) genotype 6 infection who were initially treated with a sofosbuvir (SOF)-based regimen [sofosbuvir/velpatasvir (SOF/VEL) for 12 weeks or sofosbuvir combined with ribavirin (SOF+RBV) for 24 weeks], followed by 24 weeks of follow-up after discontinuation of the drug from January 2018 to March 2020 were selected. The primary outcome measures were incidence of sustained virological response at 12 weeks (SVR12) after the drug withdrawal. The secondary outcome measures were adverse drug events with sustained virological response at the end of treatment and 24 weeks after the end of treatment. The occurrence of adverse events was observed during the treatment. An intragroup comparison was performed by t-test. Intention-to-treat and modified intention-to-treat analysis was used for sustained virological respons. Results: The subtype distribution of chronic hepatitis C virus (HCV) genotype 6 in 53 cases of chronic hepatitis C infection were as follows: 22 cases of type 6a, 5 cases of type 6w, 5 cases of type 6xa, 3 cases of type 6v, 2 cases of type 6e, 2 cases of type 6r, 1 case of type 6xh, and 13 cases of special virus strains with undetermined genotype. The overall sustained virological response rate at 12 weeks after the drug withdrawal was 100%. Furthermore, HCV RNA was undetectable during the treatment period (4 weeks), at the end of treatment and after the treatment (24 weeks). There were seven cases of adverse events, mainly including fatigue, anorexia, and mild anemia; however, no serious adverse events were reported. Conclusion: Sofosbuvir-based regimen combined with ribavirin or velpatasvir cannot only achieve high response rate to HCV subtype 6a, but also obtain a good sustained virological response to the rare prevalent sub-genotypes and special virus strains of HCV genotype 6, with mild adverse reactions and acceptable safety profile.

Synergistical Dipole-Dipole Interaction Induced Self-Assembly of Phenoxazine-Based Hole-Transporting Materials for Efficient and Stable Inverted Perovskite Solar Cells

Delicately designed dopant-free hole-transporting materials (HTMs) with ordered structure have become one of the major strategies to achieve high-performance perovskite solar cells (PSCs). In this work, we report two donor-π linker-donor (D-π-D) HTMs, N01 and N02, which consist of facilely synthesized 4,8-di(n-hexyloxy)-benzo[1,2-b:4,5-b']dithiophene as a π linker, with 10-bromohexyl-10H-phenoxazine and 10-hexyl-10H-phenoxazine as donors, respectively. The N01 molecules form a two-dimensional conjugated network governed by C-H⋅⋅⋅O and C-H⋅⋅⋅Br interaction between phenoxazine donors, and synchronously construct a three-dimension lamellar structure with the aid of interlaminar π-π interaction. Consequently, N01 as a dopant-free small-molecule HTM exhibits a higher intrinsic hole mobility and more favorable interfacial properties for hole transport, hole extraction and perovskite growth, enabling an inverted PSC to achieve a very impressive power conversion efficiency of 21.85 %.

Boron rich nanotube drug carrier system is suited for boron neutron capture therapy

Boron neutron capture therapy (BNCT) is a two-step therapeutic process that utilizes Boron-10 in combination with low energy neutrons to effectively eliminate targeted cells. This therapy is primarily used for difficult to treat head and neck carcinomas; recent advances have expanded this method to cover a broader range of carcinomas. However, it still remains an unconventional therapy where one of the barriers for widespread adoption is the adequate delivery of Boron-10 to target cells. In an effort to address this issue, we examined a unique nanoparticle drug delivery system based on a highly stable and modular proteinaceous nanotube. Initially, we confirmed and structurally analyzed ortho-carborane binding into the cavities of the nanotube. The high ratio of Boron to proteinaceous mass and excellent thermal stability suggest the nanotube system as a suitable candidate for drug delivery into cancer cells. The full physicochemical characterization of the nanotube then allowed for further mechanistic molecular dynamic studies of the ortho-carborane uptake and calculations of corresponding energy profiles. Visualization of the binding event highlighted the protein dynamics and the importance of the interhelical channel formation to allow movement of the boron cluster into the nanotube. Additionally, cell assays showed that the nanotube can penetrate outer membranes of cancer cells followed by localization around the cells' nuclei. This work uses an integrative approach combining experimental data from structural, molecular dynamics simulations and biological experiments to thoroughly present an alternative drug delivery device for BNCT which offers additional benefits over current delivery methods.