Ficus awkeotsang Makino pectin in acidic environments: Insights into pectin structure, gelation behavior, and gel properties

This study demonstrated the gelation capacity, gelation behavior, and mechanism of Ficus awkeotsang Makino pectin (JFSP) in acidic media (pH 3.4-4.5). JFSP exhibited an extraordinary ability to spontaneously form a gel at a low polymer concentration (0.3 %, w/v) within the pH range of 3.75-4.05 at room temperature, without the need to introduce exogenous metal ions or co-solutes. Analysis of zeta potential and carboxyl dissociation extent revealed the protonation of free carboxyl groups within JFSP under acidic conditions. Atomic force microscopy and small angle X-ray scattering elucidated the aggregation morphology and folding conformation of JFSP. At pH 3.8, the correlation length (ξ) of JFSP chains decreased to around 1.67 nm. Rheological experiments confirmed the formation of a stronger gel network at pH 3.8 and 4.0, with good thermal and freeze-thaw stability. Isothermal Titration Calorimetry (ITC), temperature sweeps, and gelation force analyses emphasized the pivotal role of hydrogen bonds in JFSP gels at pH 3.8 and 4.0. Further reducing the pH to 3.4-3.6 disrupted the dynamic equilibrium of gel-driving forces, leading to the formation of a flocculated gel network. These findings deepen our understanding of JFSP behavior in low-acid conditions, which may be useful for further food formulations at these conditions.

Response of tree growth to nutrient addition is size dependent in a subtropical forest

Understanding how nutrient addition affects the tree growth is critical for assessing forest ecosystem function and processes, especially in the context of increased nitrogen (N) and phosphorus (P) deposition. Subtropical forests are often considered N-rich and P-poor ecosystems, but few existing studies follow the traditional "P limitation" paradigm, possibly due to differences in nutrient requirements among trees of different size classes. We conducted a three-year fertilization experiment with four treatments (Control, N-treatment, P-treatment, and NP-treatment). We measured soil nutrient availability, leaf stoichiometry, and relative growth rate (RGR) of trees across three size classes (small, medium and large) in 64 plots. We found that N and NP-treatments increased the RGR of large trees. P-treatment increased the RGR of small trees. RGR was mainly affected by N addition, the total effect of P addition was only 10 % of that of N addition. The effect of nutrient addition on RGR was mainly regulated by leaf stoichiometry. This study reveals that nutrient limitation is size dependent, indicating that continuous unbalanced N and P deposition will inhibit the growth of small trees and increase the instability of subtropical forest stand structure, but may improve the carbon sink function of large trees.

Identification of calcium chelating peptides from peanut protein hydrolysate and absorption activity of peptide-calcium complex

BACKGROUND

Peanut peptides have good chelating ability with metal ions. However, there are few studies on the chelation mechanism of peanut peptides with calcium and absorption properties of peptide-calcium complex.

RESULTS

Peptides with high calcium chelating rate were isolated and purified from peanut protein hydrolysate (PPH), and the chelation rate of component F21 was higher (81.4 ± 0.8%). Six peptides were identified from component F21 by liquid chromatography-tandem mass spectrometry, and the frequency of acidic amino acids and arginine in the amino acid sequence was higher in all six peptides. Peanut peptide-calcium complex (PPH21-Ca) was prepared by selecting component F21 (PPH21). Ultraviolet analysis indicated that the chelate reaction occurred between peanut peptide and calcium ions. Fourier transform infrared analysis showed that the chelating sites were carboxyl and amino groups on the amino acid residues of peptides. Scanning electron microscopy revealed that the surface of peanut peptide had a smooth block structure, but the surface of the complex had a granular morphology. Caco-2 cell model tests revealed that the bioavailability of PPH21-Ca was 58.4 ± 0.5%, which was significantly higher than that of inorganic calcium at 37.0 ± 0.4%.

CONCLUSION

Peanut peptides can chelate calcium ions by carboxyl and amino groups, and the peptide-calcium complex had higher bioavailability. This study provides a theoretical basis for the development of new calcium supplement products that are absorbed easily. © 2024 Society of Chemical Industry.

[Evaluation of safety of early enteral nutrition in patients with severe intra-abdominal infection and intestinal fistulas]

Objective: To evaluate the safety of early enteral nutrition (EEN) support in patients with severe intra-abdominal infection and intestinal fistulas. Methods: This was a retrospective cohort study. We collected relevant clinical data of 204 patients with severe intra-abdominal infection and intestinal fistulas who had been managed in the No. 1 Department of General Surgery, Shanghai Ninth People's Hospital, Shanghai Jiaotong University between 1 January 2017 and 1 January 2020. The patients were allocated to EEN or delayed enteral nutrition (DEN) groups depending on whether enteral nutrition had been instituted within 48 hours of admission to the intensive care unit. The primary outcome was 180-day mortality. Other outcomes included rates of intraperitoneal hemorrhage, septic shock, open abdominal cavity, bloodstream infection, mechanical ventilation, and continuous renal replacement therapy. Risk factors for mortality were analyzed by logistic regression. Results: There were no significant differences in hematological data or other baseline characteristics between the two groups at the time of admission to the intensive care unit (all P>0.05). However, septic shock (31.2% [15/48] vs. 15.4% [24/156], χ2=4.99, P=0.025), continuous renal replacement therapy (27.1% [13/48] versus 9.0% [14/156], χ2=8.96, P=0.003), and 180-day mortality (31.2% [15/48] vs. 7.7% [12/156], χ2=15.75, P<0.001) were significantly more frequent in the EEN than the DEN group (all P<0.05). Multivariate regression analysis showed that older age (OR=1.082, 95%CI:1.027-1.139,P=0.003), worse Acute Physiology and Chronic Health Evaluation (APACHE) II scores (OR=1.189, 95%CI: 1.037-1.363, P=0.013), higher C-reactive protein (OR=1.013, 95%CI:1.004-1.023, P=0.007) and EEN (OR=8.844, 95%CI:1.809- 43.240, P=0.007) were independent risk factors for death in patients with severe intra-abdominal infection and intestinal fistulas. Conclusion: EEN may lead to adverse events and increase mortality in patients with both enterocutaneous fistulas and severe abdominal infection. EEN should be implemented with caution in such patients.

Molecular mechanism of quality changes in solid endosperm of tender coconut during room temperature storage based on transcriptome and metabolome

Tender coconut (TC) is popular around the world. Postharvest storage of TC leads to a decline in its appearance quality and flavor in both liquid endosperm (LE) and solid endosperm (SE). While LE is the most consumed part and remains in a liquid state, SE is the only cellular tissue directly connected to LE and may be the main contributor to flavor deterioration during storage. This study focused on investigating SE changes during TC storage at 25 °C using computed tomographic technology, transcriptome and metabolome analyses. The results showed increased thickness and density, elevated protein and fat contents, and decreased reducing and soluble sugars in SE of TC during storage. Integrated transcriptome and metabolome analysis revealed that these changes were mainly associated with the gene transcription levels involved in amino acid, carbohydrate and lipid metabolisms, along with specific metabolites. These findings offer valuable insights for controlling TC quality during storage.

Limosilactobacillus reuteri peptidoglycan alleviates aflatoxin B1-induced toxicity through adsorbing toxins and improving growth, antioxidant status, immunity and liver pathological changes in chicks

1. The objective of this study was to investigate the protective effects of a peptidoglycan produced by Limosilactobacillus reuteri against aflatoxin B1 (AFB1) induced toxicity in vitro and in vivo in broiler chicks.2. Toxin adsorption experiments were carried out firstly in vitro. These experiments indicated that the absorption efficiency of the peptidoglycan for AFB1 was 64.3-75.9%.3. In the in vivo experiments, Hy-Line Brown chicks were fed a diet containing AFB1 at 71.43 µg/kg with and without peptidoglycan supplementation at concentrations of 100, 200, or 300 g/kg feed from 0-42 d of age.4. The peptidoglycan supplementation in AFB1-contaminated diets resulted in significant improvements in terms of average daily gain, feed intake, feed conversion ratio, white blood cell count, haemoglobin content, glutathione peroxidase activity, immunoglobulin (Ig) A, IgG, IgM and Newcastle disease virus antibody titres (p < 0.05) and diminished liver steatosis.5. In conclusion, peptidoglycan supplementation alleviated AFB1-induced toxicity through adsorbing toxins and improving growth performance, antioxidant ability, immunity and liver pathological changes in chicks. The optimal supplemental dose was 200 mg/kg in feed.

Biosynthesis of Cytosporones in Leotiomycetous Filamentous Fungi

Polyketides with the isochroman-3-one pharmacophore are rare among fungal natural products as their biosynthesis requires an unorthodox S-type aromatic ring cyclization. Genome mining uncovered a conserved gene cluster in select leotiomycetous fungi that encodes the biosynthesis of cytosporones, including isochroman-3-one congeners. Combinatorial biosynthesis in total biosynthetic and biocatalytic formats in Saccharomyces cerevisiae and in vitro reconstitution of key reactions with purified enzymes revealed how cytosporone structural and bioactivity diversity is generated. The S-type acyl dihydroxyphenylacetic acid (ADA) core of cytosporones is assembled by a collaborating polyketide synthase pair. Thioesterase domain-catalyzed transesterification releases ADA esters, some of which are known Nur77 modulators. Alternatively, hydrolytic release allows C6 hydroxylation by a flavin-dependent monooxygenase, yielding a trihydroxybenzene moiety. Reduction of the C9 carbonyl by a short chain dehydrogenase/reductase initiates isochroman-3-one formation, affording cytosporones with cytotoxic and antimicrobial activity. Enoyl di- or trihydroxyphenylacetic acids are generated as shunt products, while isocroman-3,4-diones are formed by autoxidation. The cytosporone pathway offers novel polyketide biosynthetic enzymes for combinatorial synthetic biology to advance the production of "unnatural" natural products for drug discovery.

Rapid and accurate identification of bacteria utilizing laser-induced breakdown spectroscopy

Timely and accurate identification of harmful bacterial species in the environment is paramount for preventing the spread of diseases and ensuring food safety. In this study, laser-induced breakdown spectroscopy technology was utilized, combined with four machine learning methods - KNN, PCA-KNN, RF, and SVM, to conduct classification and identification research on 7 different types of bacteria, adhering to various substrate materials. The experimental results showed that despite the nearly identical elemental composition of these bacteria, differences in the intensity of elemental spectral lines provide crucial information for identification of bacteria. Under conditions of high-purity aluminum substrate, the identification rates of the four modeling methods reached 74.91%, 84.05%, 85.36%, and 96.07%, respectively. In contrast, under graphite substrate conditions, the corresponding identification rates reached 96.87%, 98.11%, 98.93%, and 100%. Graphite is found to be more suitable as a substrate material for bacterial classification, attributed to the fact that more characteristic spectral lines are excited in bacteria under graphite substrate conditions. Additionally, the emission spectral lines of graphite itself are relatively scarce, resulting in less interference with other elemental spectral lines of bacteria. Meanwhile, SVM exhibited the highest precision rate and recall rate, reaching up to 1, making it the most effective classification method in this experiment. This study provides a valuable approach for the rapid and accurate identification of bacterial species based on LIBS, as well as substrate selection, enhancing efficient microbial identification capabilities in fields related to social security and military applications.

[Study based on the acetaldehyde dehydrogenase 2 gene polymorphism and acetaminophen-induced liver injury]

Objective: To explore the association between aldehyde dehydrogenase 2 (ALDH2) gene polymorphisms and abnormal liver function-induced by acetaminophen (APAP) drugs. Methods: An ALDH2 gene knockout mouse model was constructed using CRISPR/Cas9 gene editing technology. The obtained heterozygous mice were mated with opposite sex of heterozygotes. Genomic DNA was extracted from the tail of the offspring mouse. The polymerase chain reaction (PCR) method was used to determine the ALDH2 genotype. APAP was further used to induce acute drug-induced liver injury models in wild-type and ALDH2 knockout mice. Blood and liver tissues of mice were collected for liver function index, HE staining, F4/80 immunohistochemistry, and other detections. The intergroup mean was compared using a one-way ANOVA. The LSD- t test was used for pairwise comparison. Results: ALDH2 knockout mice were bred successfully. The genotyping of the offspring was segregated into the wild-type (ALDH2(+/+)), heterozygous mutant (ALDH2(+/-)), and homozygous mutant (ALDH2(-/-)), respectively. Biochemical and histological results after APAP modeling showed that the level of alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), and total bilirubin (TBil) was not significantly increased in the blank control group (P < 0.05), while the ALT, AST,ALP, and TBil were all elevated in the APAP experimental group. The levels of ALT (P  = 0.004), AST (P = 0.002), and TBil (P = 0.012) were significantly elevated among the mutant group compared to those in the wild-type group, and the expression levels of these indicators were also significantly elevated among the homozygous mutant group compared to those in the heterozygous mutant group (P = 0.003, 0 and 0.006). In addition, the ALP levels were higher in the heterozygous mutation group than those in the homozygous mutant group (P = 0.085) and wild-type group mice, but the difference was only statistically significant compared to wild-type mice (P = 0.002). HE staining results showed that mice in the APAP experimental group had hepatocyte degeneration, necrosis, and increased inflammatory cell infiltration, which was mostly evident in mutant mice. Simultaneously, the F4/80 immunohistochemical staining results showed that brown granules were visible in the liver tissue of APAP experimental group mice, and its expression levels were significantly enhanced compared to the blank control group. Conclusion: APAP-induced liver function abnormalities were associated with the ALDH2 gene polymorphism. The liver injury symptoms were increased in ALDH2 mutant mice following APAP modeling, and the ALDH2 gene defect may alleviate, to some extent, APAP-induced liver function abnormalities.

Application of the strip clear-cutting system in a running bamboo (Phyllostachys glauca McClure) forest: feasibility and sustainability assessments

Introduction

As a renewable forest resource, bamboo plays a role in sustainable forest development. However, traditional cutting systems, selection cutting (SeC) and clear-cutting (ClC), result in an unsustainable production of bamboo forests due to labor-consuming or bamboo degradation. Recently, a strip clear-cutting (StC) was theoretically proposed to promote the sustainability of bamboo production, while little is known about its application consequence.

Methods

Based on a 6-year experiment, we applied the strip clear-cutting system in a typical running bamboo (Phyllostachys glauca McClure) forest to assess its feasibility and sustainability. Using SeC and ClC as controls, we set three treatments with different strip widths (5 m, 10 m, and 20 m) for strip clear-cutting, simplified as StC-5, StC-10, and StC-20, respectively. Then, we investigated leaf physiological traits, bamboo size and productivity, population features, and economic benefits for all treatments.

Results

The stands managed by StC had high eco-physiological activities, such as net photosynthetic rate (P n), photosynthetic nitrogen use efficiency (PNUE), and photosynthetic phosphorus use efficiency (PPUE), and thus grew well, achieved a large diameter at breast height (DBH), and were tall. The stand biomass of StC (8.78 t hm-2 year-1) was 1.19-fold and 1.49-fold greater than that of SeC and ClC, respectively, and StC-10 and StC-20 were significantly higher than SeC or ClC (p< 0.05). The income and profit increased with the increase in stand density and biomass, and StC-20 and StC-10 were significantly higher than SeC or ClC (p< 0.05). Using principal components analysis and subordinate function analysis, we constructed a composite index to indicate the sustainability of bamboo forests. For the sustainability assessment, StC-10 had the highest productive sustainability (0.59 ± 0.06) and the second highest economic sustainability (0.59 ± 0.11) in all cutting treatments. StC-10 had the maximum overall sustainability, with a value of 0.53 ± 0.02, which was significantly higher than that of ClC (p< 0.05).

Conclusion

The results verified that StC for Phyllostachys glauca forests is feasible and sustainable as its sustainability index outweighs those of traditional cutting systems (SeC and ClC), and 10 m is the optimum distance for the strip width of StC. Our findings provide a new cutting system for managing other running bamboo forests sustainably.

[The emulation of clinical trials with real-world data: development and application of target trial]

Clinical trial is the gold standard for evaluating the efficacy and safety of interventions; however, it is limited by high costs and long time. Real-world data (RWD) can provide a robust data basis for comparative research, but the quality is uneven. This review introduces the target trial emulation, in which researchers, using RWD and following the design of clinical trials, define exposure and outcome in advance, set eligibility criteria, determine the time zero, estimate sample size, and plan statistical analysis, to enhance the quality of evidence for observational studies. This review preliminarily discusses the standard of evidence quality evaluation in target trial emulation. Then, the target trial emulation is shown through case interpretation.

[Perioperative experience in a case of human laryngotracheal allotransplantation]

Loss of laryngeal function is a primary problem faced by patients after total laryngectomy. Although the voice function of the larynx can be partially compensated by some methods(such as implanting a voice prosthesis, using an electrolarynx and so on), and swallowing dysfunction can be improved by postoperative rehabilitation training, patients still need to breathe through the tracheostoma for life. Laryngeal transplantation, as the only therapeutic measure that has the potential to completely restore laryngeal function, has been the focus of attention in the field of otorhinolaryngology head and neck surgery both at home and abroad. In this article, we review a case of human laryngotracheal allotransplantation that was successfully completed in West China Hospital of Sichuan University, including case presentation, preoperative evaluation and preparation, surgical procedure, and postoperative management, which will provide a reference for the future development of clinical laryngeal transplantation.

[Updates on immunotherapy of gastrointestinal cancers and practical challenges]

Gastrointestinal (GI) cancers are the most common tumors of the digestive system, and their high morbidity and cancer-related mortality dramatically threaten the health of the population. With the researching progress of immunotherapy, its use in the treatment of GI cancers in the perioperative and advanced stages is becoming more and more important. Currently, immunotherapy has become the standard first-line treatment for MSI-H late-stage colorectal cancer, while in the first-line treatment of late-stage gastric cancer, immunotherapy combined with chemotherapy and HER2-targeted drugs (in HER2-positive patients) has also achieved significant efficacy and long-term survival benefits. Advances in immunotherapy in the neoadjuvant and adjuvant treatment and in the second- and later-line treatment of late-stage GI cancers have demonstrated its promising therapeutic potential. However, there is still an urgent need for future studies to explore more immunotherapy combination strategies for patients with GI cancers, especially with MSS colorectal cancers.

CRISPR/Cas9 system is a suitable gene targeting editing tool to filamentous fungus Monascus pilosus

Monascus pilosus has been used to produce lipid-lowering drugs rich in monacolin K (MK) for a long period. Genome mining reveals there are still many potential genes worth to be explored in this fungus. Thereby, efficient genetic manipulation tools will greatly accelerate this progress. In this study, we firstly developed the protocol to prepare protoplasts for recipient of CRISPR/Cas9 system. Subsequently, the vector and donor DNA were co-transformed into recipients (106 protoplasts/mL) to produce 60-80 transformants for one test. Three genes (mpclr4, mpdot1, and mplig4) related to DNA damage response (DDR) were selected to compare the gene replacement frequencies (GRFs) of Agrobacterium tumefaciens-mediated transformation (ATMT) and CRISPR/Cas9 gene editing system (CGES) in M. pilosus MS-1. The results revealed that GRF of CGES was approximately five times greater than that of ATMT, suggesting that CGES was superior to ATMT as a targeting gene editing tool in M. pilosus MS-1. The inactivation of mpclr4 promoted DDR via the non-homologous end-joining (NHEJ) and increased the tolerances to DNA damaging agents. The inactivation of mpdot1 blocked DDR and led to the reduced tolerances to DNA damaging agents. The inactivation of mplig4 mainly blocked the NHEJ pathway and led to obviously reduced tolerances to DNA damaging agents. The submerged fermentation showed that the ability to produce MK in strain Δmpclr4 was improved by 52.6% compared to the wild type. This study provides an idea for more effective exploration of gene functions in Monascus strains. KEY POINTS: • A protocol of high-quality protoplasts for CGES has been developed in M. pilosus. • The GRF of CGES was about five times that of ATMT in M. pilosus. • The yield of MK for Δmpclr4 was enhanced by 52.6% compared with the wild type.

Effects of empagliflozin on progression of chronic kidney disease: a prespecified secondary analysis from the empa-kidney trial

BACKGROUND

Sodium-glucose co-transporter-2 (SGLT2) inhibitors reduce progression of chronic kidney disease and the risk of cardiovascular morbidity and mortality in a wide range of patients. However, their effects on kidney disease progression in some patients with chronic kidney disease are unclear because few clinical kidney outcomes occurred among such patients in the completed trials. In particular, some guidelines stratify their level of recommendation about who should be treated with SGLT2 inhibitors based on diabetes status and albuminuria. We aimed to assess the effects of empagliflozin on progression of chronic kidney disease both overall and among specific types of participants in the EMPA-KIDNEY trial.

METHODS

EMPA-KIDNEY, a randomised, controlled, phase 3 trial, was conducted at 241 centres in eight countries (Canada, China, Germany, Italy, Japan, Malaysia, the UK, and the USA), and included individuals aged 18 years or older with an estimated glomerular filtration rate (eGFR) of 20 to less than 45 mL/min per 1·73 m2, or with an eGFR of 45 to less than 90 mL/min per 1·73 m2 with a urinary albumin-to-creatinine ratio (uACR) of 200 mg/g or higher. We explored the effects of 10 mg oral empagliflozin once daily versus placebo on the annualised rate of change in estimated glomerular filtration rate (eGFR slope), a tertiary outcome. We studied the acute slope (from randomisation to 2 months) and chronic slope (from 2 months onwards) separately, using shared parameter models to estimate the latter. Analyses were done in all randomly assigned participants by intention to treat. EMPA-KIDNEY is registered at ClinicalTrials.gov, NCT03594110.

FINDINGS

Between May 15, 2019, and April 16, 2021, 6609 participants were randomly assigned and then followed up for a median of 2·0 years (IQR 1·5-2·4). Prespecified subgroups of eGFR included 2282 (34·5%) participants with an eGFR of less than 30 mL/min per 1·73 m2, 2928 (44·3%) with an eGFR of 30 to less than 45 mL/min per 1·73 m2, and 1399 (21·2%) with an eGFR 45 mL/min per 1·73 m2 or higher. Prespecified subgroups of uACR included 1328 (20·1%) with a uACR of less than 30 mg/g, 1864 (28·2%) with a uACR of 30 to 300 mg/g, and 3417 (51·7%) with a uACR of more than 300 mg/g. Overall, allocation to empagliflozin caused an acute 2·12 mL/min per 1·73 m2 (95% CI 1·83-2·41) reduction in eGFR, equivalent to a 6% (5-6) dip in the first 2 months. After this, it halved the chronic slope from -2·75 to -1·37 mL/min per 1·73 m2 per year (relative difference 50%, 95% CI 42-58). The absolute and relative benefits of empagliflozin on the magnitude of the chronic slope varied significantly depending on diabetes status and baseline levels of eGFR and uACR. In particular, the absolute difference in chronic slopes was lower in patients with lower baseline uACR, but because this group progressed more slowly than those with higher uACR, this translated to a larger relative difference in chronic slopes in this group (86% [36-136] reduction in the chronic slope among those with baseline uACR <30 mg/g compared with a 29% [19-38] reduction for those with baseline uACR ≥2000 mg/g; ptrend<0·0001).

INTERPRETATION

Empagliflozin slowed the rate of progression of chronic kidney disease among all types of participant in the EMPA-KIDNEY trial, including those with little albuminuria. Albuminuria alone should not be used to determine whether to treat with an SGLT2 inhibitor.

FUNDING

Boehringer Ingelheim and Eli Lilly.

Histone lysine methyltransferases MpDot1 and MpSet9 are involved in the production of lovastatin and MonAzPs by histone crosstalk modification

Increasing data suggested that histone methylation modification plays an important role in regulating biosynthesis of secondary metabolites (SMs). Monascus spp. have been applied to produce hypolipidemic drug lovastatin (also called monacolin K, MK) and edible Monascus-type azaphilone pigments (MonAzPs). However, little is known about how histone methylation regulates MK and MonAzPs. In this study, we constructed H3K9 methyltransferase deletion strain ΔMpDot1 and H4K20 methyltransferase deletion strain ΔMpSet9 using Monascus pilosus MS-1 as the parent. The result showed that deletion of MpDot1 reduced the production of MK and MonAzPs, and deletion of MpSet9 increased MonAzPs production. Real-time quantitative PCR (RT-qPCR) showed inactivation of mpdot1 and mpset9 disturbed the expression of genes responsible for the biosynthesis of MK and MonAzPs. Western blot suggested that deletion of MpDot1 reduced H3K79me and H4K16ac, and deletion of MpSet9 decreased H4K20me3 and increased H4pan acetylation. Chromatin immunoprecipitation coupled with quantitative PCR (ChIP-qPCR) showed ΔMpDot1 strain and ΔMpSet9 strain reduced the enrichment of H3K79me2 and H4K20me3 in the promoter regions of key genes for MK and MonAzPs biosynthesis, respectively. These results suggested that MpDot1 and MpSet9 affected the synthesis of SMs by regulating gene transcription and histone crosstalk, providing alternative approach for regulation of lovastatin and MonAzPs.

Impact of primary kidney disease on the effects of empagliflozin in patients with chronic kidney disease: secondary analyses of the EMPA-KIDNEY trial

BACKGROUND

The EMPA-KIDNEY trial showed that empagliflozin reduced the risk of the primary composite outcome of kidney disease progression or cardiovascular death in patients with chronic kidney disease mainly through slowing progression. We aimed to assess how effects of empagliflozin might differ by primary kidney disease across its broad population.

METHODS

EMPA-KIDNEY, a randomised, controlled, phase 3 trial, was conducted at 241 centres in eight countries (Canada, China, Germany, Italy, Japan, Malaysia, the UK, and the USA). Patients were eligible if their estimated glomerular filtration rate (eGFR) was 20 to less than 45 mL/min per 1·73 m2, or 45 to less than 90 mL/min per 1·73 m2 with a urinary albumin-to-creatinine ratio (uACR) of 200 mg/g or higher at screening. They were randomly assigned (1:1) to 10 mg oral empagliflozin once daily or matching placebo. Effects on kidney disease progression (defined as a sustained ≥40% eGFR decline from randomisation, end-stage kidney disease, a sustained eGFR below 10 mL/min per 1·73 m2, or death from kidney failure) were assessed using prespecified Cox models, and eGFR slope analyses used shared parameter models. Subgroup comparisons were performed by including relevant interaction terms in models. EMPA-KIDNEY is registered with ClinicalTrials.gov, NCT03594110.

FINDINGS

Between May 15, 2019, and April 16, 2021, 6609 participants were randomly assigned and followed up for a median of 2·0 years (IQR 1·5-2·4). Prespecified subgroupings by primary kidney disease included 2057 (31·1%) participants with diabetic kidney disease, 1669 (25·3%) with glomerular disease, 1445 (21·9%) with hypertensive or renovascular disease, and 1438 (21·8%) with other or unknown causes. Kidney disease progression occurred in 384 (11·6%) of 3304 patients in the empagliflozin group and 504 (15·2%) of 3305 patients in the placebo group (hazard ratio 0·71 [95% CI 0·62-0·81]), with no evidence that the relative effect size varied significantly by primary kidney disease (pheterogeneity=0·62). The between-group difference in chronic eGFR slopes (ie, from 2 months to final follow-up) was 1·37 mL/min per 1·73 m2 per year (95% CI 1·16-1·59), representing a 50% (42-58) reduction in the rate of chronic eGFR decline. This relative effect of empagliflozin on chronic eGFR slope was similar in analyses by different primary kidney diseases, including in explorations by type of glomerular disease and diabetes (p values for heterogeneity all >0·1).

INTERPRETATION

In a broad range of patients with chronic kidney disease at risk of progression, including a wide range of non-diabetic causes of chronic kidney disease, empagliflozin reduced risk of kidney disease progression. Relative effect sizes were broadly similar irrespective of the cause of primary kidney disease, suggesting that SGLT2 inhibitors should be part of a standard of care to minimise risk of kidney failure in chronic kidney disease.

FUNDING

Boehringer Ingelheim, Eli Lilly, and UK Medical Research Council.

Wheat bran arabinoxylan-soybean protein isolate emulsion-filled gels as a β-carotene delivery carrier: Effect of polysaccharide content on textural and rheological properties

This study aimed to investigate the effects of different wheat bran arabinoxylan (WBAX) concentrations (1, 2, 3, and 4 wt%) on the structural and physicochemical properties of WBAX-soybean protein isolate (SPI) emulsion-filled gels (EFGs) prepared using laccase and heat treatment. The properties of the various gels as well as their microstructure, rheology, and in vitro digestion behaviors were investigated. Results showed that WBAX-SPI EFGs with a 3 wt% WBAX concentration had a smooth and uniform appearance, high water holding capacity (98.5 ± 0.2 %), and enhanced mechanical properties. Rheological experiments suggested that a stronger and closer gel network was formed at 3 wt% WBAX concentration. Fourier transform infrared spectroscopy showed that laccase and heat treatment not only catalyzed the intramolecular crosslinking of WBAX and SPI, respectively, but also promoted the interaction between WBAX and SPI. Confocal laser scanning microscopy revealed that the WBAX gel network was interspersed within the SPI network. The interactions contributing to the gelation analysis revealed that chemical (disulfide bond) and physical (hydrogen bond and hydrophobic) interactions promoted the formation of denser EFGs. Furthermore, the WBAX-SPI EFGs provided a β-carotene bioaccessibility of 21.8 ± 0.6 %. Therefore, our study suggests that WBAX-SPI EFGs hold promising potential for industrial applications in the delivery of β-carotene.

Smart antimicrobial system based on enzyme-responsive high methoxyl pectin-whey protein isolate nanocomplex for fresh-cut apple preservation

The increase in pectin methylesterase (PME) activity on fresh-cut apple surface can smartly trigger the controlled release of bactericidal agents encapsulated within intelligent responsive Pickering emulsions. In this study, we developed a PME-responsive nanocomplex (W-H-II) to stabilize Pickering emulsion containing thyme essential oil (TEO), preserving fresh-cut apples. W-H-II, formed by heat-induced whey protein isolate (WPI) and high methoxyl pectin (HMP) (pH 4.5, 85 °C, 15 min, WPI:HMP ratio 1:2), exhibited good pH stability due to the stabilizing effects of hydrophobic, hydrogen bonding, and electrostatic interactions. The presence of PME triggered the demethylation of HMP within W-H-II, conferring PME response characteristics. Subsequently, a bacteriostasis experiment with pectinase-producing Bacillus subtilis provided evidence of PME-triggered TEO release from W-H-II-stabilized Pickering emulsion. Furthermore, microscopy techniques were employed to verify the demulsification behavior of the emulsion when PME activity ranged from 0.25 to 2.50 U mL-1. Finally, the PME-responsive TEO Pickering emulsion effectively preserved fresh-cut apples. Stored for 6 days at 5 °C and 10 °C, as the PME activity on the apple surface increased, the decay rate of the coated group was 0 %, with a total colony count below 3.0 log CFU g-1. This study introduces a novel intelligent preservation strategy for storing fresh-cut apples.

Interaction mechanisms of peanut protein isolate and high methoxyl pectin with ultrasound treatment: The effect of ultrasound parameters, biopolymer ratio, and pH

Ultrasound could effectively change molecular structure of proteins, polysaccharides, and their interactions, and was used to treat the peanut protein isolate-high methoxy pectin (PPI-HMP) complexes in this study. Effects of different ultrasound parameters, PPI-HMP mixing ratio (40:1-5:2), and pH (2.0-8.0) on the PPI-HMP interactions were investigated. Turbidity, solution appearance, and Zeta-potential analysis revealed an electrostatic interaction between PPI and HMP from pH 2.0 to pH 6.0. Ultrasound changed the tertiary structure conformation of PPI according to the surface hydrophobicity analysis. Increased ultrasound power density and pH broke the hydrogen bonds between the complexes according to Fourier transform infrared spectroscopy analysis. Apparent viscosity and confocal laser scanning microscopy analysis showed that appropriate ultrasound treatment (5.43 W/cm3, 25 min, 25 °C) reduced the viscosity of the complexes, and enhanced the electrostatic and hydrophobic interactions between PPI and HMP. These findings will contribute to the application of PPI-HMP complexes in the food industry.

[Situational analysis of periodontal disease burden for adults in China from 1990 to 2019 and its incidence trend prediction]

Objective: To analyze the burden and changing trends of periodontal disease in adults of the mainland of China from 1990 to 2019, and to predict the incidence trends of periodontal disease in the next 25 years, with a goal to provide a basis for reducing the burden of periodontal disease and formulating relevant prevention and treatment measures. Methods: Data on the incidence, prevalence, and disability adjusted life years (DALY) rate of periodontal disease among adults in the mainland of China from 1990 to 2019 were extracted from the global burden of disease study 2019 (GBD 2019) database. The estimated annual percent change (EAPC) was used to estimate the temporal trend of periodontal disease, and the age-period-cohort model (APC) was used to predict the age-standardized incidence of periodontal disease in Chinese adults from 2020 to 2044. Results: From 1990 to 2019, the incidence, prevalence, and DALY rate of adult periodontal disease in the mainland of China showed an increasing trend, with EAPCs of 0.3 (95%CI: 0.1-0.6), 0.5 (95%CI: 0.1-0.8), and 0.5 (95%CI: 0.1-0.8), respectively. The incidence and prevalence of periodontitis among the population aged 35-39 years old and 40-44 years old increased the most significantly, with EAPCs of 0.8 and 0.7, respectively, whereas the change in periodontal disease prevalence tended to be stable and the increase trend in prevalence was lower in the elderly group (EAPC=0.4). The incidence (EAPC=2.1), prevalence (EAPC=2.6) and DALY rate (EAPC=2.6) of periodontal disease in females increased more than those in males (EAPC=1.9, 2.4, and 2.4, respectively), of which the prevalence had exceeded that of males in 2019. The APC model predicted that the prevalence of periodontal disease in the period of 2020-2044 in China would still be on an upward trend, and the increase rate would be higher in females than in males. Conclusions: The burden of periodontal disease among adults in China had been increasing over the past 30 years, especially among young and middle-aged adults as well as females, and the incidence of periodontal disease will continue to increase over the next 25 years.

Primary human thyrocytes maintained the function of thyroid hormone production and secretion in vitro

PURPOSE

Thyroid cell lines are useful tools to study the physiology and pathology of the thyroid, however, they do not produce or secrete hormones in vitro. On the other hand, the detection of endogenous thyroid hormones in primary thyrocytes was often hindered by the dedifferentiation of thyrocytes ex vivo and the presence of large amounts of exogenous hormones in the culture medium. This study aimed to create a culture system that could maintain the function of thyrocytes to produce and secrete thyroid hormones in vitro.

METHODS

We established a Transwell culture system of primary human thyrocytes. Thyrocytes were seeded on a porous membrane in the inner chamber of the Transwell with top and bottom surfaces exposed to different culture components, mimicking the 'lumen-capillary' structure of the thyroid follicle. Moreover, to eliminate exogenous thyroid hormones from the culture medium, two alternatives were tried: a culture recipe using hormone-reduced serum and a serum-free culture recipe.

RESULTS

The results showed that primary human thyrocytes expressed thyroid-specific genes at higher levels in the Transwell system than in the monolayer culture. Hormones were detected in the Transwell system even in the absence of serum. The age of the donor was negatively related to the hormone production of thyrocytes in vitro. Intriguingly, primary human thyrocytes cultured without serum secreted higher levels of free triiodothyronine (FT3) than free thyroxine (FT4).

CONCLUSION

This study confirmed that primary human thyrocytes could maintain the function of hormone production and secretion in the Transwell system, thus providing a useful tool to study thyroid function in vitro.

Effects of Roasting Temperatures on Peanut Oil and Protein Yield Extracted via Aqueous Enzymatic Extraction and Stability of the Oil Body Emulsion

Oil body emulsions (OBEs) affect the final oil yield as an intermediate in the concurrent peanut oil and protein extraction process using an aqueous enzyme extraction (AEE) method. Roasting temperature promotes peanut cell structure breakdown, affecting OBE composition and stability and improving peanut oil and protein extraction rates. Therefore, this study aimed to investigate the effects of pretreatment at different roasting temperatures on peanut oil and protein yield extracted through AEE. The results showed that peanut oil and protein extraction rates peaked at 90 °C, 92.21%, and 77.02%, respectively. The roasting temperature did not change OBE composition but affected its stability. The OBE average particle size increased significantly with increasing temperature, while at 90 °C, the zeta potential peaked, and the interfacial protein concentration hit its lowest, indicating OBE stability was the lowest. Optical microscopy and confocal laser scanning microscopy confirmed the average particle size findings. The oil quality obtained after roasting treatment at 90 °C did not differ significantly from that at 50 °C. The protein composition remained unaffected by the roasting temperature. Conclusively, the 90 °C roasting treatment effectively improved the yield of peanut oil extracted using AEE, providing a theoretical basis for choosing a suitable pretreatment roasting temperature.

Correlationship between self-assembly behavior and emulsion stabilization of pea protein-high methoxyl pectin complexes treated with ultrasound at pH 2.0

This study investigated the effects of ultrasound on the self-assembly behavior of pea protein (PP)-high methoxyl pectin (HMP) complexes at pH 2.0 through transmission electron microscopy (TEM), Fourier transform infrared spectroscopy (FTIR), and intrinsic fluorescence analysis. The emulsion stabilization mechanism of PP-HMP treated with ultrasound (PP-HMP-US) was also elucidated. The results indicated that ultrasound increased the emulsifying activity index (EAI) and emulsifying stability index (ESI) of PP-HMP. Moreover, PP-HMP-US-based emulsions formed small, dispersed oil drops, which were stable during storage. PP-HMP- and PP-HMP-US-based emulsions did not demonstrate any creaming. The TEM results revealed that ultrasound can regulate the self-assembly behavior of PP and HMP to form spherical particles with a core-shell structure. This structure possessed low turbidity, a small particle size, and high absolute zeta potential values. The FTIR and intrinsic fluorescence spectra demonstrated that ultrasound increased the α-helix and β-sheet contents and exposed the tryptophan groups to more hydrophilic environments. Ultrasound also promoted the PP-HMP self-assembly through electrostatic interaction and improved its oil-water interfacial behavior, as indicated by the EAI and ESI values of PP-HMP-US-based emulsions. The current results provide a reference for the development of an innovative emulsifier prepared by ultrasound-treated protein-pectin complexes at low pH.

[Standardized nomenclature of oral microorganisms in Chinese: the 2023 update]

Oral microbial community, as an important part of human microbial community, is closely related to oral and general health. Oral microbiological research has become the forefront of international microbiological research. Standardized and unified nomenclature for oral microorganisms in Chinese is of great significance to support the development of oral medicine research. Standardized translation of microbial names is the basis for writing canonical and authoritative professional textbooks and reference books, which helps students to accurately acquire the characteristics and classifications of oral microbes. Unified translation of oral microorganisms is also conducive to academic communication and cooperation, and plays an important role in oral health education and science popularization, which enables oral microbiology knowledge to be accurately disseminated to the public. Therefore, in order to standardize the words in scientific research, funding application, publications, academic exchanges and science popularization within the field of oral medicine, we have fully discussed and revised the Chinese names of oral microorganisms in 2017 edition and ones of newly discovered oral microbes, finally reaching a consensus to form the 2023 edition of Chinese names of oral microorganisms.

Interpretable Deep Learning Identified the Significance of 1 Gy Volume on Lymphopenia after Radiotherapy in Breast Cancer

PURPOSE/OBJECTIVE(S)

Lymphopenia is common after radiotherapy (RT) and is known for its significance on poor survival outcomes in patients with breast cancer. Previous work has demonstrated the significance of point dosimetric factors like the volume receiving 5 Gy. Considering the full dosimetric data together, this study aimed to develop and validate predictive models for lymphopenia after RT in breast cancer.

MATERIALS/METHODS

Patients with breast cancer treated with radiation therapy in adjuvant setting and with complete dosimetric data were eligible. Combining dose-volume histogram (DVH) dosimetric and clinical factors, dense neural network (DNN) models were developed to predict both the reduction in lymphocyte counts and the graded lymphopenia in breast cancer patients after adjuvant RT. A Shapley additive explanation was applied to explain each feature's directional contributions. The generalization of DNN models was validated in both internal and independent external validation cohorts. P<0.05 was considered to be significant.

RESULTS

A total of 928 consecutive patients with invasive breast cancer were eligible for this study. Treatment volumes of nearly all irradiation dose levels of DVH were significant predictors for lymphopenia after RT, including volumes at very low-dose 1 Gy (V1) of all structures considered including the lung, heart and body. DNN models using full DVH dosimetric and clinical factors were built and a simplified model was further established and validated in both internal and external validation cohorts. This simplified DNN AI model, combining full DVH dosimetric parameters of all OARs and five key clinical factors including baseline lymphocyte counts, tumor stage, RT technique, RT fields and RT fractionation, showed a predictive accuracy of 77% and above.

CONCLUSION

This study demonstrated and externally validated the significance of an AI model of combining clinical and full dosimetric data, especially the volume of low dose at as low as 1 Gy of all critical structures on lymphopenia after RT in patients with breast cancer. The significance of V1 deserves special attention, as modern arc RT technology often has relatively high value of this parameter. Further study warranted for breast cancer RT plan optimization.

Multidetector CT-derived tricuspid annulus measurements predict tricuspid regurgitation reduction after transcatheter aortic valve replacement

AIM

To use multidetector row computed tomography (MDCT)-derived tricuspid annulus (TA) measurements to identify predictors for tricuspid regurgitation (TR) reduction after transcatheter aortic valve replacement (TAVR), and to investigate the impact of TR change on prognosis.

MATERIALS AND METHODS

A retrospective, single-centre study was conducted on consecutive patients who underwent TAVR with concomitant baseline mild or more severe TR from April 2012 to April 2022. TA parameters were measured using MDCT.

RESULTS

The study comprised 266 patients (mean age 74.2 ± 7.6 years, 147 men) and 45.1% had more than one grade of TR reduction at follow-up. Independent predictors of TR reduction at follow-up were distance between TA centroid and antero-septal commissure (odd ratio [OR] 0.776; 95% confidence interval [CI]: 0.672-0.896, p=0.001), baseline TR of moderate or worse (OR 4.599; 95% CI: 2.193-9.648, p<0.001), systolic pulmonary artery pressure (OR 1.018; 95% CI: 1.002-1.035, p=0.027), age (OR 0.955; 95% CI: 0.920-0.993, p=0.019), and pre-existing atrial fibrillation (OR 0.209; 95% CI: 0.101-0.433, p<0.001). Patients without TR reduction had higher rates of rehospitalisation (hazard ratio [HR] 0.642; 95% CI: 0.413-0.998, p=0.049).

CONCLUSIONS

The MDCT-derived TA parameter was predictive of TR reduction after TAVR. Persistent TR after TAVR was associated with higher rates of rehospitalisation.

Outcomes of recurrent incisional hernia repair by open and laparoscopic approaches: a propensity score-matched comparison

PURPOSE

Recurrent incisional hernias are challenging, and their surgical outcomes have not been well studied. We aimed to analyze the outcomes of recurrent incisional hernia repair in a propensity score-matched cohort study on laparoscopic intra-peritoneal onlay mesh repair (lap. IPOM) versus open sublay repair.

METHODS

All consecutive patients who had undergone open sublay repair and lap. IPOM of recurrent incisional hernia between January 2015 and December 2021 at a tertiary hernia center was identified. One-to-one propensity score matching was used to achieve a balanced exposure groups at baseline.

RESULTS

Of 255 patients, 85/95 with open sublay repair were matched to 85/160 with lap. IPOM. Before matching, the open sublay group had significantly larger hernia defects (6.3 cm vs. 5.0 cm) than the lap. IPOM group. Other major baseline imbalances were also found in body mass index (BMI), obesity and European Hernia Society (EHS) width classification. The pre-match results showed that the lap. IPOM group had significantly shorter operative time (median 75 vs. 95 min) and shorter postoperative hospital stay (median 8 vs. 11 days) compared with the open sublay group. Wound infection (8.4% vs. 1.9%) and hematoma (5.3% vs. 0.6%) occurred more frequently after open sublay repair. After matching, baseline characteristics were well balanced. The recurrence rate and incidence of complications were comparable between the two groups. However, the post-match analysis still showed that lap. IPOM was associated with decreased length of postoperative stay.

CONCLUSION

The outcomes of recurrent incisional hernia surgery after lap. IPOM and open sublay repair appear similar, except that the former had shorter length of postoperative stay. However, the poor outcomes were more likely associated with the unfavorable risk profiles, such as larger defect size, rather than the procedure technique itself.

Combining the triglyceride-glucose index and glycated hemoglobin A1c to assess the risk of preeclampsia in women with normal glucose tolerance: a cross-sectional study

OBJECTIVE

This study aimed to explore the relationship between the triglyceride-glucose (TyG) index, glycated hemoglobin A1c (HbA1c), and preeclampsia in pregnant women without gestational diabetes mellitus (GDM).

PATIENTS AND METHODS

This retrospective study included pregnancies with normal oral glucose tolerance tests (OGTTs) from March 2018 to February 2019. During the second trimester, serum lipids, fasting plasma glucose (FPG), and HbA1c were measured, and OGTTs were performed. Participants were classified into four groups based on their TyG index and HbA1c levels. Logistic regression analysis was done to determine the odds ratios (ORs), and receiver operating characteristic (ROC) curve analysis was used to evaluate the ability of the TyG index and HbA1c to predict the risks of preeclampsia.

RESULTS

Patients with preeclampsia exhibited higher TyG index and HbA1c levels (all p < 0.001). The incidence of preeclampsia increased with elevated TyG index and HbA1c levels individually. Furthermore, the highest incidence of preeclampsia was observed when both the TyG index and HbA1c levels were elevated. ROC curve analysis revealed that the combined TyG index and HbA1c displayed an area under the curve (AUC) of 0.689 in predicting the risk of preeclampsia. Even after adjusting for potential confounding factors, the risk of developing preeclampsia remained significantly higher. These associations were especially prominent in women aged ≥ 35 years or those with a normal BMI.

CONCLUSIONS

The findings of this study indicate that increased TyG index and HbA1c levels are associated with a higher incidence and risk of preeclampsia in women with normal glucose tolerance during pregnancy. The TyG index and HbA1c levels may serve as potential markers for preeclampsia in individuals with normal OGTT results.

[The status of patient-reported outcomes and their correlation with the number of hospitalizations within 1 year in patients with atrial fibrillation]

Objective: To observe the status of patient-reported outcomes (PROs) and their correlation with the number of hospitalizations within 1 year in patients with atrial fibrillation(AF). Methods: This study is a prospective investigation. Patients with non-valvular atrial fibrillation treated in the Department of Cardiology of the Third People's Hospital of Yancheng from May 2020 to April 2021 were selected. General information and AF6 questionnaire were used to define PROs. The number of hospitalizations within 1 year after discharge was obtained. Spearman correlation analysis was used to analyze the correlation between PROs and the New York Heart Association (NYHA) classification. The logistic regression model was used to analyze the number of hospitalizations in AF patients within 1 year. Results: A total of 197 patients were enrolled, the mean age was (74.1±9.0) years, 106 (53.8%) patients were female. The mean AF6 score was (24.3±8.3). The proportion of patients with 6 entries≥1 point exceeded 50%. There was a positive correlation between NYHA classification and PROs (r=0.360, P<0.001). Logistic regression analysis showed that the older age (OR=1.058, P=0.004) and the AF6 scores≥24(OR=4.082, P<0.001) were the risk factors of rehospitalization within 1 year for AF patients. Conclusions: The PROs of AF patients are at the medium level and poor levels of PROs are associated with increased risk of rehospitalization within 1 year.

Study on the Stability Mechanism of Peanut OBs Extracted with the Aqueous Enzymatic Method

In this study, the internal relationships among oil bodies (OBs), the protein-phospholipid interactions in aqueous phase, oil-water interface behavior, and the stability of reconstituted OBs were analyzed from the bulk phase, interface, and macro perspectives, and the stability mechanism of OBs was discussed. OB proteins and phospholipids were combined through hydrophobic and electrostatic interactions, resulting in the stretching of protein conformation. OB proteins and phospholipids act synergistically to increase interface pressure and the rate of increase in interface pressure with relatively stable elastic behavior, which is beneficial to the formation and stability of interfacial films. When OBs were reconstituted by an OB protein-phospholipid complex system, phospholipids bound to OB proteins through hydrophobic and electrostatic interactions. OB proteins and phospholipids uniformly covered the oil droplet surface of reconstituted OBs to form a stable interfacial film, which maintained the stability of OBs. The addition of phospholipids significantly reduced the particle size of OBs prepared by OB proteins in a dose-dependent manner, and particle size decreased with the increase in phospholipid content (p < 0.05). Phospholipids increased the net surface charge, enhanced electrostatic repulsion, and improved the physicochemical stability of reconstituted OBs. The stability mechanism elucidated in this study provides a theoretical basis for the demulsification of peanut OBs.

Born small-for-gestational age: not just smaller

Linked article: This Correspondence comments on Paz y Miño et al. Click here to view the article.

Spontaneous gelation behaviors and mechanism of Ficus awkeotsang Makino pectin

Ficus awkeotsang Makino (jelly fig) can produce edible gels by rubbing its seeds in water at room temperature in which pectin is considered as the main gelling component. However, the spontaneous gelation mechanism of Ficus awkeotsang Makino (jelly fig) pectin (JFSP) is still unclear. This study aimed to reveal the structure, physicochemical properties, and spontaneous gelation behaviors and mechanism of JFSP. JFSP was first obtained by water extraction and alcohol precipitation method, with a pectin yield of 13.25 ± 0.42 % (w/w), weight-average molar mass (Mw) of 111.26 kDa, and methoxylation degree (DM) of 26.8 %. Analysis of monosaccharide compositions showed that JFSP was composed of 87.8 % galactose acid, indicating a high percentage of galacturonic acid blocks. Measurement on the gelling capacity suggested that JFSP gels can be easily formed by simply dispersing the pectin in water at room temperature without adding any co-solutes or metal ions. Gelation force analysis indicated that hydrogen bonding, hydrophobic interactions, and electrostatic interactions were the main factors contributing to gel formation. At 1.0 % (w/v) of pectin concentration, JFSP gels exhibited relatively high gel hardness (72.75 ± 1.15 g) and good thermal and freeze-thawing stability. Overall, these findings highlight the potential application of JFSP as a promising commercial pectin resource.

A Novel Strategy for the Demulsification of Peanut Oil Body by Caproic Acid

The aqueous enzymatic method is a form of green oil extraction technology with limited industrial application, owing to the need for the demulsification of the oil body intermediate product. Existing demulsification methods have problems, including low demulsification rates and high costs, such that new methods are needed. The free fatty acids produced by lipid hydrolysis can affect the stability of peanut oil body (POB) at a certain concentration. After screening even-carbon fatty acids with carbon chain lengths below ten, caproic acid was selected for the demulsification of POB using response surface methodology and a Box-Behnken design. Under the optimal conditions (caproic acid concentration, 0.22%; solid-to-liquid ratio, 1:4.7 (w/v); time, 61 min; and temperature, 79 °C), a demulsification rate of 97.87% was achieved. Caproic acid not only adjusted the reaction system pH to cause the aggregation of the POB interfacial proteins, but also decreased the interfacial tension and viscoelasticity of the interfacial film with an increasing caproic acid concentration to realize POB demulsification. Compared to pressed oil and soxhlet-extracted oil, the acid value and peroxide value of the caproic acid demulsified oil were increased, while the unsaturated fatty acid content and oxidation induction time were decreased. However, the tocopherol and tocotrienol contents were higher than those of the soxhlet-extracted oil. This study provides a new method for the demulsification of POB.

[Evaluation of the efficacy and safety of Nocardia rubra cell wall skeleton immunotherapy for cervical high-risk HPV persistent infection]

Objective: To evaluate the efficacy and safety of Nocardia rubra cell wall skeleton (Nr-CWS) in the treatment of persistent cervical high-risk human papillomavirus (HR-HPV) infection. Methods: A randomized, double blind, multi-center trial was conducted. A total of 688 patients with clinically and pathologically confirmed HR-HPV infection of the cervix diagnosed in 13 hispital nationwide were recruited and divided into: (1) patients with simple HR-HPV infection lasting for 12 months or more; (2) patients with cervical intraepithelial neoplasia (CIN) Ⅰ and HR-HPV infection lasting for 12 months or more; (3) patients with the same HR-HPV subtype with no CINⅡ and more lesions after treatment with CINⅡ or CIN Ⅲ (CINⅡ/CIN Ⅲ). All participants were randomly divided into the test group and the control group at a ratio of 2∶1. The test group was locally treated with Nr-CWS freeze-dried powder and the control group was treated with freeze-dried powder without Nr-CWS. The efficacy and negative conversion rate of various subtypes of HR-HPV were evaluated at 1, 4, 8, and 12 months after treatment. The safety indicators of initial diagnosis and treatment were observed. Results: (1) This study included 555 patients with HR-HPV infection in the cervix (included 368 in the test group and 187 in the control group), with an age of (44.1±10.0) years. The baseline characteristics of the two groups of subjects, including age, proportion of Han people, weight, composition of HR-HPV subtypes, and proportion of each subgroup, were compared with no statistically significant differences (all P>0.05). (2) After 12 months of treatment, the effective rates of the test group and the control group were 91.0% (335/368) and 44.9% (84/187), respectively. The difference between the two groups was statistically significant (χ²=142.520, P<0.001). After 12 months of treatment, the negative conversion rates of HPV 16, 18, 52, and 58 infection in the test group were 79.2% (84/106), 73.3% (22/30), 83.1% (54/65), and 77.4% (48/62), respectively. The control group were 21.6% (11/51), 1/9, 35.1% (13/37), and 20.0% (8/40), respectively. The differences between the two groups were statistically significant (all P<0.001). (3) There were no statistically significant differences in vital signs (body weight, body temperature, respiration, pulse rate, systolic blood pressure, diastolic blood pressure, etc.) and laboratory routine indicators (blood cell analysis, urine routine examination) between the test group and the control group before treatment and at 1, 4, 8, and 12 months after treatment (all P>0.05); there was no statistically significant difference in the incidence of adverse reactions related to the investigational drug between the two groups of subjects [8.7% (32/368) vs 8.0% (15/187), respectively; χ²=0.073, P=0.787]. Conclusion: External use of Nr-CWS has good efficacy and safety in the treatment of high-risk HPV persistent infection in the cervix.

Impact of shield location on staff and caregiver dose rates for I-131 radiopharmaceutical therapy patients

The goal of this study is to investigate the effect of the location and width of a single lead shield on the dose rate of staff and caregivers in a hospital room with an I-131 patient. The best orientation of the patient and caregiver relative to the shield was determined based on minimizing staff and caregiver radiation dose rates. Shielded and unshielded dose rates were simulated using a Monte Carlo computer simulation and validated using real-world ionisation chamber measurements. Based on a radiation transport analysis using an adult voxel phantom published by the International Commission on Radiological Protection, placing the shield near the caregiver yielded the lowest dose rates. However, this strategy reduced the dose rate in only a tiny area of the room. Furthermore, positioning the shield near the patient in the caudal direction provided a modest dose rate reduction while shielding a large room area. Finally, increased shield width was associated with decreasing dose rates, but only a four-fold dose-rate reduction was observed for standard width shields. The recommendations of this case study may be considered as potential candidate room configurations where radiation dose rates are minimized, however these findings must be weighed against additional clinical, safety, and comfort considerations.

Generation of genuine entanglement up to 51 superconducting qubits

Scalable generation of genuine multipartite entanglement with an increasing number of qubits is important for both fundamental interest and practical use in quantum-information technologies^1,2. On the one hand, multipartite entanglement shows a strong contradiction between the prediction of quantum mechanics and local realization and can be used for the study of quantum-to-classical transition^3,4. On the other hand, realizing large-scale entanglement is a benchmark for the quality and controllability of the quantum system and is essential for realizing universal quantum computing^5-8. However, scalable generation of genuine multipartite entanglement on a state-of-the-art quantum device can be challenging, requiring accurate quantum gates and efficient verification protocols. Here we show a scalable approach for preparing and verifying intermediate-scale genuine entanglement on a 66-qubit superconducting quantum processor. We used high-fidelity parallel quantum gates and optimized the fidelitites of parallel single- and two-qubit gates to be 99.91% and 99.05%, respectively. With efficient randomized fidelity estimation⁹, we realized 51-qubit one-dimensional and 30-qubit two-dimensional cluster states and achieved fidelities of 0.637 ± 0.030 and 0.671 ± 0.006, respectively. On the basis of high-fidelity cluster states, we further show a proof-of-principle realization of measurement-based variational quantum eigensolver¹⁰ for perturbed planar codes. Our work provides a feasible approach for preparing and verifying entanglement with a few hundred qubits, enabling medium-scale quantum computing with superconducting quantum systems.

[Statistical methods of unmeasured confounder control based on negative control theory]

Controlling unmeasured confounders in non-randomized controlled studies is challenging. Negative control theory is based on the theoretical concept that the test result of negative controls must be negative. Setting appropriate negative control incorporates the specificity of association into population studies for the identification and control of unmeasured confounders. This paper explains the principles to control unmeasured confounders using negative control theory from a statistical perspective. A detailed introduction of derived methods based on negative control theory is also introduced, including adjusted standardized mortality ratio method, calibrating P-value method, generalized difference-in-difference model and double negative control method. The reasonable application of those derived methods is also comprehensively summarized based on representative case studies. Negative control is an important statistical design to identify, revise and control unmeasured confounders and a valuable method for comparative effectiveness research based on real-world data.

[HbA1c comparison and diagnostic efficacy analysis of multi center different glycosylated hemoglobin detection systems]

Objective: Compare and analyze the results of the domestic Lanyi AH600 glycated hemoglobin analyzer and other different detection systems to understand the comparability of the detection results of different detectors, and establish the best cut point of Lanyi AH600 determination of haemoglobin A1c (HbA1c) in the diagnosis of diabetes. Methods: Multi center cohort study was adopted. The clinical laboratory departments of 18 medical institutions independently collected test samples from their respective hospitals from March to April 2022, and independently completed comparative analysis of the evaluated instrument (Lanyi AH600) and the reference instrument HbA1c. The reference instruments include four different brands of glycosylated hemoglobin meters, including Arkray, Bio-Rad, DOSOH, and Huizhong. Scatter plot was used to calculate the correlation between the results of different detection systems, and the regression equation was calculated. The consistency analysis between the results of different detection systems was evaluated by Bland Altman method. Consistency judgment principles: (1) When the 95% limits of agreement (95% LoA) of the measurement difference was within 0.4% HbA1c and the measurement score was≥80 points, the comparison consistency was good; (2) When the measurement difference of 95% LoA exceeded 0.4% HbA1c, and the measurement score was≥80 points, the comparison consistency was relatively good; (3) The measurement score was less than 80 points, the comparison consistency was poor. The difference between the results of different detection systems was tested by paired sample T test or Wilcoxon paired sign rank sum test; The best cut-off point of diabetes was analyzed by receiver operating characteristic curve (ROC). Results: The correlation coefficient R² of results between Lanyi AH600 and the reference instrument in 16 hospitals is≥0.99; The Bland Altman consistency analysis showed that the difference of 95% LoA in Nanjing Maternity and Child Health Care Hospital in Jiangsu Province (reference instrument: Arkray HA8180) was -0.486%-0.325%, and the measurement score was 94.6 points (473/500); The difference of 95% LoA in the Tibetan Traditional Medical Hospital of TAR (reference instrument: Bio-Rad Variant II) was -0.727%-0.612%, and the measurement score was 89.8 points; The difference of 95% LoA in the People's Hospital of Chongqing Liang Jiang New Area (reference instrument: Huizhong MQ-2000PT) was -0.231%-0.461%, and the measurement score was 96.6 points; The difference of 95% LoA in the Taihe Hospital of traditional Chinese Medicine in Anhui Province (reference instrument: Huizhong MQ-2000PT) was -0.469%-0.479%, and the measurement score was 91.9 points. The other 14 hospitals, Lanyi AH600, were compared with 4 reference instrument brands, the difference of 95% LoA was less than 0.4% HbA1c, and the scores were all greater than 95 points. The results of paired sample T test or Wilcoxon paired sign rank sum test showed that there was no statistically significant difference between Lanyi AH600 and the reference instrument Arkray HA8180 (Z=1.665,P=0.096), with no statistical difference. The mean difference between the measured values of the two instruments was 0.004%. The comparison data of Lanyi AH600 and the reference instrument of all other institutions had significant differences (all P<0.001), however, it was necessary to consider whether it was within the clinical acceptable range in combination with the results of the Bland-Altman consistency analysis. The ROC curve of HbA1c detected by Lanyi AH600 in 985 patients with diabetes and 3 423 patients with non-diabetes was analyzed, the area under curve (AUC) was 0.877, the standard error was 0.007, and the 95% confidence interval 95%CI was (0.864, 0.891), which was statistically significant (P<0.001). The maximum value of Youden index was 0.634, and the corresponding HbA1c cut point was 6.235%. The sensitivity and specificity of diabetes diagnosis were 76.2% and 87.2%, respectively. Conclusion: Among the hospitals and instruments currently included in this study, among these four hospitals included Nanjing Maternity and Child Health Care Hospital in Jiangsu Province (reference instrument: Arkray HA8180), Tibetan Traditional Medical Hospital of TAR (reference instrument: Bio-Rad Variant Ⅱ), the People's Hospital of Chongqing Liang Jiang New Area (reference instrument: Huizhong MQ-2000PT), and the Taihe Hospital of traditional Chinese Medicine in Anhui Province (reference instrument: Huizhong MQ-2000PT), the comparison between Lanyi AH600 and the reference instruments showed relatively good consistency, while the other 14 hospitals involved four different brands of reference instruments: Arkray, Bio-Rad, DOSOH, and Huizhong, Lanyi AH600 had good consistency with its comparison. The best cut point of the domestic Lanyi AH600 for detecting HbA1c in the diagnosis of diabetes is 6.235%.

[Feasibility and safety of transseptal transcatheter mitral valve replacement for severe mitral regurgitation]

A prospective, single-center, single-arm, and open-design study was performed to evaluate the feasibility and safety of transseptal transcatheter mitral valve replacement in the treatment of severe mitral regurgitation. Patients with symptomatic moderate-severe or severe mitral regurgitation at high-surgical risk and anatomically appropriate for the HighLife transseptal mitral valve replacement (TSMVR) system in West China Hospital, Sichuan University from December 2021 to August 2022 were enrolled. Four patients (1 male and 3 females) with severe mitral regurgitation were included, with a median age of 68.5 (64.0-77.0) years and a median Society of Thoracic Surgeons (STS) score of 8.1% (6.4%-8.9%). Technical success was achieved in all the patients. There was no residual mitral regurgitation, paravalvular leakage, or left ventricular outflow tract obstruction. Three major cardiovascular and cerebrovascular adverse events occurred within 30 days after the procedure, including ventricular tachycardia, iatrogenic atrial septal defect closure, and heart failure readmission. The current study preliminarily demonstrates that transcatheter mitral valve replacement using the HighLife system via the transseptal approach for severe mitral regurgitation is feasible and relatively safe.

Potential of Near-Infrared Spectroscopy (NIRS) for Efficient Classification Based on Postharvest Storage Time, Cultivar and Maturity in Coconut Water

Coconut water (CW) is a popular and healthful beverage, and ensuring its quality is crucial for consumer satisfaction. This study aimed to explore the potential of near-infrared spectroscopy (NIRS) and chemometric methods for analyzing CW quality and distinguishing samples based on postharvest storage time, cultivar, and maturity. CW from nuts of Wenye No. 2 and Wenye No. 4 cultivars in China, with varying postharvest storage time and maturities, were subjected to NIRS analysis. Partial least squares regression (PLSR) models were developed to predict reducing sugar and soluble sugar contents, revealing moderate applicability but lacking accuracy, with the residual prediction deviation (RPD) values ranging from 1.54 to 1.83. Models for TSS, pH, and TSS/pH exhibited poor performance with RPD values below 1.4, indicating limited predictability. However, the study achieved a total correct classification rate exceeding 95% through orthogonal partial least squares discriminant analysis (OPLS-DA) models, effectively discriminating CW samples based on postharvest storage time, cultivar, and maturity. These findings highlight the potential of NIRS combined with appropriate chemometric methods as a valuable tool for analyzing CW quality and efficiently distinguishing samples. NIRS and chemometric techniques enhance quality control in coconut water, ensuring consumer satisfaction and product integrity.

Effects of forest management practices on carbon dynamics of China's boreal forests under changing climates

Climate change and forest management practices influence forest productivity and carbon budgets, and understanding their interactions is necessary to develop accurate predictions of carbon dynamics as many countries in the world strive towards carbon neutrality. Here, we developed a model-coupling framework to simulate the carbon dynamics of boreal forests in China. The expected dynamics of forest recovery and change following intense timber harvesting in the recent past and projected carbon dynamics into the future under different climate change scenarios and forest management practices (e.g., restoration, afforestation, tending, and fuel management). We predict that under current management strategies, climate change would lead to increased fire frequency and intensity, eventually shifting these forests from carbon sinks towards being carbon sources. This study suggests that future boreal forest management should be altered to reduce the probability of fire occurrence and carbon losses caused by catastrophic fires through planting deciduous species, mechanical removal, and prescribed fire.

Effect of Soybean Protein Concentrate Preparation on Copy Numbers and Structural Characteristics of DNA from Genetically Modified Soybean

To regulate the degradation of transgenic DNA and lay theoretical foundations for the rational utilization of genetically modified (GM) products, variations in copy numbers and structural characteristics of DNA from GM soybean event GTS 40-3-2 during soybean protein concentrate (SPC) preparation were evaluated. Results showed that defatting and the first ethanol extraction were key procedures inducing DNA degradation. After these two procedures, copy numbers of the lectin and cp4 epsps targets decreased by more than 4 × 10⁸, occupying 36.88-49.30% of the total copy numbers from raw soybean. Atomic force microscopy images visually revealed the degradation of DNA that thinned and shortened during SPC preparation. Circular dichroism spectra suggested a lower helicity of DNA from defatted soybean kernel flour and a conformation transition of DNA from B-type to A-type after ethanol extraction. The fluorescence intensity of DNA decreased during SPC preparation, verifying the DNA damage along this preparation chain.

Identification and molecular interactions of novel ACE inhibitory peptides from rapeseed protein

Plant-derived bioactive peptides have drawn much attention because of their physiological functions. This study aimed to evaluate bioactive peptides in rapeseed protein and identify novel angiotensin Ⅰ-converting enzyme (ACE) inhibitory peptides using bioinformatics methods. A total of 24 kinds of bioactive peptides were encrypted in the 12 selected rapeseed proteins by analysis in BIOPEP-UWM, with higher occurrence frequency of dipeptidyl peptidase Ⅳ (DPP-Ⅳ) inhibitory peptides (0.5727-0.7487) and ACE inhibitory peptides (0.3500-0.5364). Novel ACE inhibitory peptides FQW, FRW and CPF were identified by in silico proteolysis, and they had strong inhibitory effects on ACE in vitro, showing IC₅₀ values of 44.84 ± 1.48 μM, 46.30 ± 1.39 μM and 131.35 ± 3.87 μM, respectively. Molecular docking results displayed that these three peptides were able to interact with ACE active site via hydrogen bonds and hydrophobic interactions, and coordinate with Zn²⁺. It suggested that rapeseed protein could be a good source for the production of ACE inhibitory peptides.

Quality of long standing radiographs assessment of the patella position

BACKGROUND

The gold standard for evaluating leg alignment is a long leg standing radiograph (LSR). The research states that a correct LSR should have a patella that is centered and facing forward as well as a fibula head superimposition (FHS) with a tibia that is 1/3 larger than the fibula. The purpose of this study was to determine levels of quality for LSR by quantifying and correlating the patella position and fibular head superimposition.

METHOD

741 lower limbs were included using two distinct measurement techniques, we calculated the patella position's (PD) departure from the center of the knee joint (M1 and M2). To measure the inter-rater dependability in assessing PD and FHS, intraclass correlation coefficients were determined. The Bland-Altman approach was used to compare M1 with M2's performance. We created three quality groups based on the average quantity of PD.

RESULTS

The mean PD was 3.5 mm for M1 and 4.1 mm for M2, respectively. Three quality categories were created: group A for PD ≤ 5 mm, group B for PD 5-10 mm, and group C for PD of ≥10 mm. Group A takes up 70.9% of the LSR. Interestingly, group A's FHS was 21.3% than the typical value of 1/3.

CONCLUSIONS

The patella's center should be centered within a 5 mm range and the fibular head should be 1/5 covered from the tibia. This study is the first to define quantitative metrics based on LSR analysis.

LEVEL OF EVIDENCE

Level IV (diagnostic retrospective case series).

Quantum neuronal sensing of quantum many-body states on a 61-qubit programmable superconducting processor

Classifying many-body quantum states with distinct properties and phases of matter is one of the most fundamental tasks in quantum many-body physics. However, due to the exponential complexity that emerges from the enormous numbers of interacting particles, classifying large-scale quantum states has been extremely challenging for classical approaches. Here, we propose a new approach called quantum neuronal sensing. Utilizing a 61-qubit superconducting quantum processor, we show that our scheme can efficiently classify two different types of many-body phenomena: namely the ergodic and localized phases of matter. Our quantum neuronal sensing process allows us to extract the necessary information coming from the statistical characteristics of the eigenspectrum to distinguish these phases of matter by measuring only one qubit and offers better phase resolution than conventional methods, such as measuring the imbalance. Our work demonstrates the feasibility and scalability of quantum neuronal sensing for near-term quantum processors and opens new avenues for exploring quantum many-body phenomena in larger-scale systems.