Highly sensitive and simultaneous detection of ascorbic acid, dopamine, and uric acid using Pt@g-C3N4/N-CNTs nanocomposites

The detection of ascorbic acid (AA), dopamine (DA), and uric acid (UA) is crucial for understanding and managing various illnesses. In this research, Pt@g-C3N4 nanoparticles were synthesized via hydrothermal method and combined with N-doped carbon nanotubes (N-CNTs). The Pt@g-C3N4/N-CNTs-modified glassy carbon (GC) electrode was fabricated as an electrochemical sensor for the determination of AA, DA, and UA. The linear response range of AA, DA, and UA in the optimal condition was 100-3,000 μM, 1-100 μM, and 2-215 μM boasting a low detection limit (S/N = 3) of 29.44 μM (AA), 0.21 μM (UA), and 2.99 μM (DA), respectively. Additionally, the recoveries of AA, DA, and UA in serum sample were 100.4%-106.7%. These results corroborate the feasibility of the proposed method for the simultaneous, sensitive, and reliable detection of AA, DA, and UA. Our Pt@g-C3N4/N-CNTs/GC electrode can provide a potential strategy for disease diagnosis and health monitoring in clinical settings.

[Analysis of clinical epidemiological characteristics of respiratory syncytial virus in children in a hospital of pediatric in Hubei Province from 2020 to 2023]

Objective: To explore the clinical epidemiological characteristics of respiratory syncytial virus in children in Hubei Province from 2020 to 2023. Method: A single-center and cross-sectional study was used to analyze the clinical data of 3 271 children with respiratory syncytial virus infection in Wuhan Children's Hospital affiliated to Huazhong University of Science and Technology from July 1, 2020 to June 30, 2023. Nonparametric rank sum test and χ2 test were used for comparative analysis. Results: From July 1, 2020 to June 30, 2023, a total of 25 583 children were included in the analysis, of which 3 271(12.8%) children infected RSV. The detection rate was 16.3% in 2020-2021, 14.7% in 2021-2022 and 9.1% in 2022-2023. The detection rate decreased year by year (χ2=222.054, P<0.05). From 2020 to 2023, there was an anti-seasonal epidemic of RSV in spring and autumn. The detection rate of RSV in infants under 1 year old was the highest, but the median ages of RSV positive children increased (H=140.575, P<0.05). Pneumonia was the main clinical manifestation of RSV respiratory tract infection. Conclusion: The epidemiological characteristics of RSV in children in Hubei Province were different from those before. From 2020 to 2023, the detection rate of RSV decreased year by year. Besides winter, the prevalence of RSV could also be seen in spring and autumn. The median age of children infected with RSV increased after the epidemic. Pneumonia was the main clinical manifestation after RSV infection.

The water-soluble subfraction from Artemisia argyi alleviates LPS-induced inflammatory responses via multiple pathways and targets in vitro and in vivo

ETHNOPHARMACOLOGICAL RELEVANCE

As a traditional Chinese medicine, Artemisia argyi has been used medicinally and eaten for more than 2000 years in China. It is widely reported in treating inflammatory diseases such as eczema, dermatitis, arthritis, allergic asthma and colitis. Although several studies claim that its volatile oil and organic reagent extracts have certain anti-inflammatory effects, the water-soluble fractions and molecular mechanisms have not been studied.

AIM OF THE STUDY

To evaluate the therapeutic effect of A. argyi water extract (AAWE) on lipopolysaccharide (LPS)-induced inflammatory responses and to identify the most effective water-soluble subfractions. Moreover, the relevant pharmacological and molecular mechanisms by which the active subfraction mitigates inflammation were further investigated.

MATERIALS AND METHODS

Firstly, RAW 264.7 cells stimulated with LPS were treated with AAWE (50, 100, and 200 μg/mL) or the water-soluble subfractions separated by D101 macroporous resin (AAWE1-AAWE4, 100 μg/mL), and NO production and mRNA levels of inflammatory genes were evaluated to determine the most effective water-soluble subfractions. Secondly, the chemical components of the active subfraction (AAWE4) were analyzed by UPLC-QTOF-MS. Thirdly, transcriptome and network pharmacology analysis, RT-qPCR and Western blotting assays were conducted to explore the underlying anti-inflammatory mechanism and active compounds of AAWE4. Subsequently, the binding ability of the potential active components in AAWE4 to the core targets was further determined by molecular docking. Eventually, the in vivo anti-inflammatory activity of AAWE4 (1.17, 2.34 and 4.68 g/kg, administered per day for 7 d) was evaluated in mice with LPS-induced systemic inflammation.

RESULTS

In this study, AAWE showed excellent anti-inflammatory effects, and its water-soluble subfraction AAWE4 exhibited the strongest inhibitory effect on NO concentration and inflammatory gene mRNA expression after LPS stimulation, indicating that it was the most effective subfraction. Thereafter, four main compounds in AAWE4 were confirmed or tentatively identified by UPLC-QTOF-MS, including three flavonoid glycosides and one phenolic acid. Furthermore, the transcriptome and network pharmacology analysis showed that AAWE4 inhibited inflammation via multiple pathways and multiple targets. Based on the RT-qPCR and Western blotting results, AAWE4 downregulated not only the p38, PI3K, CCL5, MMP9, AP-1, and BCL3 mRNA expression levels activated by LPS but also their upstream and downstream protein expression levels and protein phosphorylation (p-AKT/AKT, p-p38/p38, p-ERK/ERK, p-JNK/JNK). Moreover, four identified compounds (isochlorogenic acid A, vicenin-2, schaftoside and isoschaftoside) could significantly inhibit NO content and the overexpression of inflammatory factors TNF-α, IL-1β, iNOS and COX-2 mRNA induced by LPS, and the molecular docking confirmed the high binding activity of four active compounds with selected core targets (p38, AKT1, MMP9, and CCL5). In addition, the mRNA expression and immunohistochemical analysis showed that AAWE44 could inhibit lung inflammation via multiple pathways and multiple targets in vivo.

CONCLUSIONS

The findings of this study suggest that the water-soluble subfraction AAWE4 from A. argyi ameliorated the inflammation caused by LPS through multiple pathways and multiple targets in vitro and in vivo, providing scientific support for the medicinal use of A. argyi. Importantly, it shows that the A. argyi subfraction AAWE4 can be developed as an anti-inflammatory drug.

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.

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.

Opportunities and challenges in enhancing the bioavailability and bioactivity of dietary flavonoids: A novel delivery system perspective

Flavonoids have multiple favorable bioactivities including antioxidant, anti-inflammatory, and antitumor. Currently, flavonoid-containing dietary supplements are widely tested in clinical trials for the prevention and/or treatment of multiple diseases. However, the clinical application of flavonoids is largely compromised by their low bioavailability and bioactivity, probably due to their poor aqueous solubility, intensive metabolism, and low systemic absorption. Therefore, formulating flavonoids into novel delivery systems is a promising approach for overcoming these drawbacks. In this review, we highlight the opportunities and challenges in the clinical use of dietary flavonoids from the perspective of novel delivery systems. First, the classification, sources, and bioactivity of dietary flavonoids are described. Second, the progress of clinical research on flavonoid-based dietary supplements is systematically summarized. Finally, novel delivery systems developed to improve the bioavailability and bioactivity of flavonoids are discussed in detail to broaden the clinical application of dietary flavonoids.

Clinical characteristics and prognostic factors of surgical treatment in children with brainstem tumor

OBJECTIVE

Brainstem tumors present a significant challenge in surgical treatment, and the prognostic factors in children are lacking. This study aimed to investigate clinical characteristics and prognostic factors of surgical treatment in children with brainstem tumors.

PATIENTS AND METHODS

50 children with brainstem tumors who underwent surgical treatment, including frameless- or frame-based stereotactic biopsy and resection, were included and followed up for clinical and biological analysis. Factors of outcomes were assessed by univariate and multivariate analysis.

RESULTS

27 cases (54.0%) underwent resection in all children with brainstem tumors. The rate of resection reached as high as 81.8% in children with non-diffuse intrinsic pontine glioma (DIPG), while in children with DIPG, biopsy was performed in the majority, and resection was obtained in the minority with focal necrosis. A rare complication was found following the surgery. Multivariate analysis considered World Health Organization (WHO) grade 3-4, with hazard ratio (HR)=4.48, 95% confidence interval (CI) of 2.84-8.69, p=0.001, H3K27M mutation (HR=2.50, 95% CI 1.73-5.69, p=0.015), and hydrocephalus (HR=2.17, 95% CI 1.08-5.32, p=0.014) as independent adverse prognostic factors. For Kaplan-Meier analysis, children with WHO grade 3-4, Ki-67 LI ≥ 20%, TP53 mutation, H3K27M mutation, DIPG, and hydrocephalus had significantly decreased overall survival (OS).

CONCLUSIONS

A high rate of resection has been obtained in non-DIPG, and surgical intervention is remarkably safe and efficient for children with brainstem tumors. WHO grade 3-4, H3K27M mutation, and hydrocephalus indicate poor prognosis in children with brainstem tumors.

A novel mini-open sublay hernioplasty combined with D10 mesh for primary lumbar hernia: a retrospective analysis of 48 cases

BACKGROUND

The aim of this study was to explore the safety and efficacy of a novel mini-open sublay hernioplasty with D10 mesh for primary lumbar hernias.

METHODS

This retrospective study included 48 patients with primary lumbar hernias who underwent mini-open sublay hernioplasty with D10 mesh from January 2015 to January 2022 in our hospital. Observation indicators were intraoperative measured diameter of hernia ring defect, operation time, length of hospital stay, postoperative follow-up, complications, postoperative visual analog scale (VAS) score, chronic pain.

RESULTS

The operations were completed successfully in all 48 cases. The mean diameter of hernia ring was 2.66 ± 0.57 cm (range 1.5-3.0 cm), the mean operation time was 41.54 ± 13.21 min (range 25-70 min), the intraoperative blood loss was 9.89 ± 6.16 ml (range 5-30 ml), and the mean hospital stay was 3.14 ± 1.53 days (range 1-6 days). The mean preoperative and postoperative VAS scores at 24 h were 0.29 ± 0.53 (range 0-2) and 2.52 ± 0.61 (range 2-6), respectively. All cases were followed-up for 53.4 ± 24.3 months (range 12-96 months) without seroma, hematoma, incision or mesh infection, recurrence, and obvious chronic pain.

CONCLUSION

A novel mini-open sublay hernioplasty with D10 mesh for primary lumbar hernias is safe and feasible. Its efficacy in the short term is favorable.

[Cone-beam CT imaging features of common cystic lesions associated with the impacted mandibular third molar]

Objective: To analyze the imaging features of cone-beam CT (CBCT) of ameloblastoma (AB), odontogenic keratocyst (OKC) and dentigerous cysts (DC) associated with the mandibular impacted third molars,so as to provide useful information for differential diagnosis of these lesions. Methods: The patients who were with complete clinical data, pathological diagnosis and CBCT images from AB, OKC and DC around the mandibular impacted third molars were collected in Peking University Hospital of Stomatology from August 2016 to December 2021. A total of 109 patients (14 were diagnosed as AB, 23 were diagnosed as OKC and the others were diagnosed as dental cysts) were collected, including 73 males and 36 females. The age ranged from 11 to 70. The analyzed imaging features included location and internal density of the lesions, bone expansion, root resorption of adjacent teeth and types of the impacted teeth. The Chi square test was used to compare the gender of different lesions, and the Fisher's exact test was used to compare imaging features of lesions. When P<0.05, there was a significant difference among the three. Logistic regression analysis was performed to determine the imaging features that significantly contribute to correct imaging diagnosis. Corresponding P-values were calculated for all factors from multivariate models. Results: In the 23 cases of OKC, no special location was observed for the center of the lesion, heterogeneous high-density were seen in 21.7% of the cases, 56.5% of the cases had no significant bone expansion and the impacted teeth were not specially oriented. Among the 14 AB, 7 cases (7/14) were mainly located in the ramus of the mandible, and all cases (14/14) had buccal/lingual expansion of the jaw, 8 cases (8/14) presented root resorption of the adjacent teeth, and mesial impacted mandibular third molar were seen in 6 cases (6/14). Among the 72 DC, 88.9% (64/72) of the cases were mainly limited to the crown of the impacted third molar, 72.2% (52/72) of the cases had no obvious bone expansion, inverted impacted teeth were shown in 56.9% (41/72) of the cases. There was a significant difference among the three groups (χ2=7.30, P=0.026) in gender. AB and odontogenic cyst were more common in men than in women, while the incidence of OKC was roughly equal between men and women.There were significant differences in the location (P<0.001), internal density (P=0.001) of the lesions, bone expansion (P<0.001) and types of the impacted teeth (P<0.001), while no statistical difference was found for root resorption of adjacent teeth (P=0.153). Logistics regression analysis showed that the location of the lesion, internal density, bone expansion, root resorption of adjacent teeth and the types of impacted teeth had significant effects on the accurate diagnosis of the three kinds of lesions. Conclusions: Location, internal density, bone expansion and types of the impacted teeth played an important role in the correct imaging diagnosis. Further analysis indicates that when the classification of impacted teeth and the location of lesions are considered synchronously, DC can be differentiated from AB and OKC.

Transcriptomics of Cruznema velatum (Nematoda: Rhabditidae) with a redescription of the species

Cruznema velatum isolated from soil in a chestnut orchard located at Guangdong province, China, is redescribed with morphology, molecular barcoding sequences, and transcriptome data. The morphological comparison for C. velatum and six other valid species is provided. Phylogeny analysis suggests genus Cruznema is monophyletic. The species is amphimix, can be cultured with Escherichia coli in 7-9 days from egg to egg-laying adult, and has a lifespan of 11 to 14 days at 20°C. The transcription data generated 45,366 unigenes; 29.9%, 31.3%, 24.8%, and 18.6% of unigenes were annotated in KOG, SwissProt, GO, and KEGG, respectively. Further gene function analysis demonstrated that C. velatum share the same riboflavin, lipoic acid, and vitamin B6 metabolic pathways with Caenorhabditis elegans and Pristionchus pacificus.

Complexation of Apigenin and Oxymatrine Leading to Enhanced Anti-inflammatory Activity

Apigenin (APG) is a well-known dietary flavonoid with multiple bioactivities, but its poor aqueous solubility may result in low oral bioavailability and thus compromised therapeutic effects. In the present study, APG was complexed with oxymatrine (OMT), a natural quinolizidine alkaloid, for enhanced anti-inflammatory activity, and the related mechanisms in the interaction of APG with OMT were investigated. Fourier transform-infrared spectroscopy, fluorescence spectroscopy, Raman spectroscopy, and proton nuclear magnetic resonance spectroscopy characterizations demonstrated the occurrence of an APG-OMT complex formed at a molar ratio of 1:2. Then, molecular dynamics simulations and quantum chemical calculations were utilized to elucidate that hydrogen bonding, van der Waals forces, and hydrophobic effects were the main forces acting in the formation of the APG-OMT complex. Pharmacokinetic studies in rats demonstrated that the oral bioavailability of APG in the APG-OMT complex was significantly higher than that of APG alone. Finally, bioactivity evaluation in the lipopolysaccharide-induced acute inflammatory injury mouse models showed that the APG-OMT complex exhibited more potent anti-inflammatory effects than APG alone. This study confirmed that APG and OMT exerted enhanced anti-inflammatory effects through self-complexation, which may provide a novel strategy for improving the bioavailability and bioactivity of natural product mixtures.

Electrochemical H2O2 sensor based on a Au nanoflower-graphene composite for anticancer drug evaluation

Reliable H₂O₂ sensors for in situ cellular monitoring under drug stimulation can be developed as a powerful and versatile tool for drug evaluation. Herein, a novel electrochemical biosensor capable of detecting and quantifying H₂O₂ was fabricated by graphene and shape-controlled gold nanostructures. With the help of polyelectrolytes, gold exhibited hierarchical flower-like nanostructures. This kind of nanozyme material exhibited a prominent electrochemical response for H₂O₂. Electrocatalytic activity for H₂O₂ reduction with high sensitivity (5.07◊10^-4 mA μmol L^-1 cm^-2) and good detection capability (the lowest detection limit is 4.5 μmol L^-1 (S/N = 3)) were achieved. This electrochemical biosensor was successfully used to measure the concentration of H₂O₂ released from HepG2 hepatoma cells. Ascorbic acid (AA) and Camellia nitidissima Chi saponins (CNCS) were selected as model drugs, and their anticancer activities were compared by in situ monitoring of H₂O₂. Interestingly, the electrochemical sensor showed remarkable sensitivity, accuracy, and rapidity compared with the traditional enzymatic detection kit. In brief, the as-synthesized nanostructured H₂O₂ sensors can be applied to assess the antitumor properties of candidate drugs and inspire developments for personalized health care monitoring and cancer treatment.

Gut microbiota mediated the individualized efficacy of Temozolomide via immunomodulation in glioma

BACKGROUND

Temozolomide (TMZ) is the preferred chemotherapy strategy for glioma therapy. As a second-generation alkylating agent, TMZ provides superior oral bio-availability. However, limited response rate (less than 50%) and high incidence of drug resistance seriously restricts TMZ's application, there still lack of strategies to increase the chemotherapy sensitivity.

METHODS

Luci-GL261 glioma orthotopic xenograft model combined bioluminescence imaging was utilized to evaluate the anti-tumor effect of TMZ and differentiate TMZ sensitive (S)/non-sensitive (NS) individuals. Integrated microbiomics and metabolomics analysis was applied to disentangle the involvement of gut bacteria in TMZ sensitivity. Spearman's correlation analysis was applied to test the association between fecal bacteria levels and pharmacodynamics indices. Antibiotics treatment combined TMZ treatment was used to confirm the involvement of gut microbiota in TMZ response. Flow cytometry analysis, ELISA and histopathology were used to explore the potential role of immunoregulation in gut microbiota mediated TMZ response.

RESULTS

Firstly, gut bacteria composition was significantly altered during glioma development and TMZ treatment. Meanwhile, in vivo anti-cancer evaluation suggested a remarkable difference in chemotherapy efficacy after TMZ administration. Moreover, 16s rRNA gene sequencing and non-targeted metabolomics analysis revealed distinct different gut microbiota and immune infiltrating state between TMZ sensitive and non-sensitive mice, while abundance of differential gut bacteria and related metabolites was significantly correlated with TMZ pharmacodynamics indices. Further verification suggested that gut microbiota deletion by antibiotics treatment could accelerate glioma development, attenuate TMZ efficacy and inhibit immune cells (macrophage and CD8α⁺ T cell) recruitment.

CONCLUSIONS

The current study confirmed the involvement of gut microbiota in glioma development and individualized TMZ efficacy via immunomodulation, hence gut bacteria may serve as a predictive biomarker as well as a therapeutic target for clinical TMZ application.

Surgical treatment of tethered cord syndrome showed promising outcome in young children with short duration

OBJECTIVE

Aside from the severity, surgical interventions for the treatment of neurological dysfunctions remain controversial. This study aimed to find factors predicting the benefits of tethered cord syndrome (TCS) surgery.

PATIENTS AND METHODS

80 children with TCS were included and followed up for pre- and post-operative factors along with neurophysiological analysis. Outcomes were assessed by univariate and multivariate analysis.

RESULTS

Surgical treatment not only improved preoperative signs and symptoms in 79% of TCS patients but it showed to be an efficient procedure for the occurrence of future neurological defects. Univariate analysis also revealed that surgical intervention in TCS children (age <1 year) can modulate filar lipoma location and cutaneous abnormalities three months after surgery. Neurophysiological assessment revealed only 5.0% of surgical complications in TCS patients. Two patients had cerebrospinal fluid leakage, and two cases of CNS infection were detected.

CONCLUSIONS

Surgical intervention is highly recommended for the prevention of neurological deficits in children with TCS. Electrophysiological monitoring revealed rare complications following the surgery.

Intraspecific variation in genome size in Artemisia argyi determined using flow cytometry and a genome survey

Different collections and accessions of Artemisia argyi (Chinese mugwort) harbour considerable diversity in morphology and bioactive compounds, but no mechanisms have been reported that explain these variations. We studied genome size in A. argyi accessions from different regions of China by flow cytometry. Genome size was significantly distinct among origins of these 42 Chinese mugwort accessions, ranging from 8.428 to 11.717 pg. There were no significant intraspecific differences among the 42 accessions from the five regions of China. The clustering analysis showed that these 42 A. argyi accessions could be divided into three groups, which had no significant relationship with geographical location. In a genome survey, the total genome size of A. argyi (A15) was estimated to be 7.852 Gb (or 8.029 pg) by K-mer analysis. This indicated that the results from the two independent methods are consistent, and that the genome survey can be used as an adjunct to flow cytometry to compensate for its deficiencies. In addition, genome survey can provide the information about heterozygosity, repeat sequences, GC content and ploidy of A. argyi genome. The nuclear DNA contents determined here provide a new reference for intraspecific variation in genome size in A. argyi, and may also be a potential resource for the study of genetic diversity and for breeding new cultivar.

Active fractions of golden-flowered tea (Camellia nitidissima Chi) inhibit epidermal growth factor receptor mutated non-small cell lung cancer via multiple pathways and targets in vitro and in vivo

As a medicine-food homology (MFH) plant, golden-flowered tea (Camellia nitidissima Chi, CNC) has many different pharmacologic activities and is known as "the queen of the tea family" and "the Panda of the Plant world". Several studies have revealed the pharmacologic effects of CNC crude extract, including anti-tumor, anti-oxidative and hepatoprotective activity. However, there are few studies on the anti-tumor active fractions and components of CNC, yet the underlying mechanism has not been investigated. Thus, we sought to verify the anti-non-small cell lung cancer (NSCLC) effects of four active fractions of CNC. Firstly, we determined the pharmacodynamic material basis of the four active fractions of CNC (Camellia. leave. saponins, Camellia. leave. polyphenols, Camellia. flower. saponins, Camellia. flower. polyphenols) by UPLC-Q-TOF-MS/MS and confirmed the differences in their specific compound contents. Then, MTT, colony formation assay and EdU incorporation assay confirmed that all fractions of CNC exhibit significant inhibitory on NSCLC, especially the Camellia. leave. saponins (CLS) fraction on EGFR mutated NSCLC cell lines. Moreover, transcriptome analysis revealed that the inhibition of NSCLC cell growth by CLS may be via three pathways, including "Cytokine-cytokine receptor interaction," "PI3K-Akt signaling pathway" and "MAPK signaling pathway." Subsequently, quantitative real-time PCR (RT-qPCR) and Western blot (WB) revealed TGFB2, INHBB, PIK3R3, ITGB8, TrkB and CACNA1D as the critical targets for the anti-tumor effects of CLS in vitro. Finally, the xenograft models confirmed that CLS treatment effectively suppressed tumor growth, and the key targets were also verified in vivo. These observations suggest that golden-flowered tea could be developed as a functional tea drink with anti-cancer ability, providing an essential molecular mechanism foundation for MFH medicine treating NSCLC.

Using a co-designed, self-delivered, Avatar-based patient discharge education application to improve acute coronary syndrome patient knowledge

Background

30-day rehospitalisation following heart event among acute coronary syndrome (ACS) patients remains high and is largely contributed by poor disease-related knowledge and self-management, especially in the disadvantaged patient groups such as those with low education levels and inadequate health literacy. Traditional patient education methods fail to address these issues.

Purpose

This study aimed to test a unique consumer co-designed discharge education application (app) on patients' knowledge and its acceptability.

Methods

ACS patients (unstable angina, non-STEMI or STEMI) were recruited from Royal Adelaide Hospital at South Australia during admission, provided with the app via tablet for one-month self-delivered education. The app has undergone a rigorous development process with the substantial engagement of consumers (Figure 1). App content includes the Heart Foundation Six Steps to Cardiac Recovery including disease-related knowledge, risk factor management, and ACS responses, assessed at baseline, followed by first use at discharge and one month later. Patients and cardiac nurses rated the acceptability of the app.

Results

Among 22 Participants 81.8% were male (n=18), with a mean age of 59.7 (10.3) years, 45.5% (n=10) had not completed high school and nearly a quarter of the participants had marginal or below marginal health literacy. The diagnosis included STEMI (n=16, 72.7%) and non-STEMI (n=5, 22.7%). The majority of participants underwent percutaneous coronary intervention (PCI) (n=21, 95.5%)

Significant improvements were observed for overall coronary artery disease knowledge at one month (p=0.003) and the exercise and nutrition domains at discharge (p=0.029; p&lt;0.001) and one month (p=0.02; p=0.003) (Figure 2). Significant improvements were also observed for ACS knowledge and beliefs at discharge (p=0.008; p=0.038) and one month (p&lt;0.001; p=0.025) when ACS response attitude was also significantly improved at one month (p=0.036). Overall acceptability was high at 7.7/10 (n=22 nurses) and 8.3/10 (patients). The participants described the app as `clear, simple, easy to understand, as well as stimulating and interactive, better than a live person'.

Conclusion

This novel, self-delivered Avatar-based ACS discharge education App has the potential to provide discharge education for ACS patients even for those who have low education levels or inadequate health literacy. Results need to be confirmed in a randomised controlled trial.

Funding Acknowledgement

Type of funding sources: Foundation. Main funding source(s): The National Heart Foundation Australia

Genome sequencing reveals chromosome fusion and extensive expansion of genes related to secondary metabolism in Artemisia argyi

Artemisia argyi, as famous as Artemisia annua, is a medicinal plant with huge economic value in the genus of Artemisia and has been widely used in the world for about 3000 years. However, a lack of the reference genome severely hinders the understanding of genetic basis for the active ingredient synthesis of A. argyi. Here, we firstly report a complex chromosome-level genome assembly of A. argyi with a large size of 8.03 Gb, with features of high heterozygosity (2.36%), high repetitive sequences (73.59%) and a huge number of protein-coding genes (279 294 in total). The assembly reveals at least three rounds of whole-genome duplication (WGD) events, including a recent WGD event in the A. argyi genome, and a recent burst of transposable element, which may contribute to its large genome size. The genomic data and karyotype analyses confirmed that A. argyi is an allotetraploid with 34 chromosomes. Intragenome synteny analysis revealed that chromosomes fusion event occurred in the A. argyi genome, which elucidates the changes in basic chromosome numbers in Artemisia genus. Significant expansion of genes related to photosynthesis, DNA replication, stress responses and secondary metabolism were identified in A. argyi, explaining the extensive environmental adaptability and rapid growth characteristics. In addition, we analysed genes involved in the biosynthesis pathways of flavonoids and terpenoids, and found that extensive gene amplification and tandem duplication contributed to the high contents of metabolites in A. argyi. Overall, the reference genome assembly provides scientific support for evolutionary biology, functional genomics and breeding in A. argyi and other Artemisia species.

Revisiting Frictional Characteristics of Graphene: Effect of In-Plane Straining

Supreme mechanical performance and tribological properties render graphene a promising candidate as a surface friction modifier. Recently, it has been demonstrated that applying in-plane strain can effectively tune friction of suspended graphene in a reversible manner. However, since graphene is deposited on solid surfaces in most tribological applications, whether such operation will result in a similar modulation effect becomes a critical question to be answered. Herein, by depositing graphene onto a stretchable substrate, the frictional characteristics of supported graphene under a wide range of strain are examined with an in situ tensile loading platform. The experimental results show that friction of supported graphene decreases with increasing graphene strain, similar to the suspended system. However, depending on the adherence state of the graphene/substrate interface, the system exhibits two distinct friction regimes with significantly different strain dependences. Assisted by detailed atomic force microscopy imaging, we attribute the unique behavior to the transition between two friction modulation modes, i.e., contact-quality-dominated friction and puckering-dominated friction. This work provides a more comprehensive view of the influence of strain on surface friction of graphene, which is beneficial for active modulation of graphene friction through strain engineering.

Evaluating the usability of a co-designed interactive web application for cardiac rehabilitation

Funding Acknowledgements

Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): Novartis

Background/significance

The rapid development of information technology is driving the evolution of choices of modes of delivery of healthcare services. The internet is an extremely powerful tool for accessing information, and communication. However, involvement of patients in the assessment of such an intervention is crucial, and can be achieved through a person-centred approach, utilising a co-design process with the aim to increase intervention usability.

Purpose

To assess the usability of the Country Access to Cardiac Health (CATCH) Web, an interactive web application for cardiac rehabilitation (CR), co-designed with rural and remote Australians, following the co-design development phase.

Methods

The User Experience (UX) Design framework was used to co-design the web portal with CR patients through two rounds of six co-design workshops pre (n=39), and post (n=35). Participants and family members living in rural and remote areas of Australia were invited to participate based on their eligibility for CR as outlined by the National Heart Foundation of Australia. As part of the UX Design Framework the System Usability Scale (SUS) was used to measure objective feedback from participants on the website design. The SUS assesses the three core components of a products usability: effectiveness, efficiency and satisfaction using a 10 question Likert scale. Mean scores were compared between the two rounds of workshops using an independent T-Test. The mean SUS score is categorised into poor to moderate (&lt;68), good (68-80.3) and excellent (&gt;=80.3) and categories were compared between the two rounds of workshops through Chi-Square tests.

Results

The 35 participants in the usability workshops had a mean age of 68.6 (SD 11.2) years and 16 (47%) were female (Table 1). The majority had experienced a myocardial infarction (15, 42.8%) and had hyperlipidemia (17, 50%), heart failure (15, 44%), hypertension (14, 41%), and Type II diabetes (7, 21%). Of these participants 20 (59%) used a smart phone, 18 (58%) had access to the National Broadband Network and 20 (59%) engaged with Facebook. From the first to the second round of workshops, there was an improvement in the mean SUS scores from 66.7 (SD16.8) to 73.6 (SD 21.0); p=0.26. The proportion of participants rating it as good or excellent increased from 48.7 to 65.8%; p=0.11 (Figure1).

Conclusion

The usability testing of the interactive CATCH web application showed an improvement in the SUS rating from poor to moderate in the co-design development phase to good or excellent by most of the participants in the usability testing phase. Usability is closely related to engagement with a digital health intervention. Upcoming evaluation of this intervention will report on clinical outcomes.

Invasive pulmonary fungal infections in children with severe human adenovirus type 7 pneumonia: A retrospective study

BACKGROUND

There has been a rapid increase in the number of human adenovirus type 7 (HAdV-7) and invasive pulmonary fungal infections (IPFIs) co-infection.

METHODS

In this study, we included patients with confirmed HAdV-7 infection during the period from 2018 to 2019 to explore clinical characteristics of severe HAdV-7 pneumonia combined with IPFIs.

RESULTS

Among the 143 patients, 35 cases were co-infected with IPFIs. Others were assigned to the control group (n Z 108). Patients wereprone to be complicated with respiratory failure, heart failure and hemophagocytic syndromein IPFIs group. Thirty-one species of fungi were detected in the IPFIs group, among whichAspergillus was the most common species. Compared to control group, patients had lowerlevels of WBC, CD3þ T lymphocyte counts and CD19þ B lymphocyte counts in IPFIs group.

CONCLUSION

Aspergillus is the most common species in IPFIs combined with severe HAdV-7 pneumonia. For children with severe HAdV-7 pneumonia who are younger, have a long course of disease, and have been admitted to the ICU, we should predict the occurrence of IPFIs when there is multi-system dysfunction and the reduction of CD3+ T lymphocyte counts and CD19+ B lymphocyte counts in course of their disease.

POS0015 BULLOUS SYSTEMIC LUPUS ERYTHEMATOSUS SUCCESSFULLY TREATED WITH MYCOPHENOLATE MOFETIL COMBINED WITH GLUCOCORTICOID: A CASE REPORT

Background:

Bullous systemic lupus erythematosus (BSLE) is a rare subtype of systemic lupus erythematosus, accounting for less than 1% of systemic lupus erythematosus (SLE) [1]. It is common in adults aged 20 to 40, with female predominace [2]. Its skin manifestations are mainly tensive blisters, especially involving oral and genital mucosa, Nissl’s sign is mostly negative, blisters break and heal to form pigmentation of varying degrees, leaving no scar. At present, the main treatment is systemic application of corticosteroids combined with immunosuppressants. Here, we report a BSLE who successfully treated with mycophenolate mofetil (MMF) combined with glucocorticoid.

Objectives

To be vigilant in the early identification of BSLE, and through the treatment experience of this case, it can provide a basis for the use of Mycophanol ester as the preferred drug for the treatment of BSLE in the future.

Methods

The clinical manifestation, laboratory test, treatment, and outcome were described.

Results

A 50-year-old female patient with systemic lupus erythematosus presented with wandering joint pain for 1 year and sporadic patchy erythema on eyelid, hands, and neck for 7 months. There are blisters on part of her erythema and normal skin, about 1mm-15mm in diameter, the blister fluid is cool, fusion is broken, and Nissl’s sign is negative. She suffered from anemia, albuminuria, polyserous effusion and other system damage. Skin histopathology showed mild hyperkeratosis of epidermis, formation of subepidermal blisters and accumulation of a large number of neutrophils; direct immunofluorescence showed that the positive expressions of IgA, IgG and C3 were found in the basement membrane of the skin, leading to a diagnosis of BSLE. In the initial stage, patients were treated with high-dose glucocorticoid (160 mg, qd) combined with immunosuppressants (thalidomide and hydroxychloroquine), but the number of blisters increased. After treatment with MMF (1 g, bid), the skin lesions disappeared, joint pain relieved, anemia was corrected, and polyserous effusion was absorbed. She was followed up for half a year and there was no recurrence.

Conclusion

Patients with BSLE are often accompanied by multiple system damage [2], so it is critical to correctly identify BSLE and provide appropriate treatment as soon as possible. For patients who do not respond to single glucocorticoid therapy, combined with MMF can be used as the preferred drug for the treatment of BSLE in the future.

References:

[1] L. Duan et al., Treatment of Bullous Systemic Lupus Erythematosus. Journal of immunology research 2015, 167064 (2015).

[2] K. Chanprapaph, S. Sawatwarakul, V. Vachiramon, A 12-year retrospective review of bullous systemic lupus erythematosus in cutaneous and systemic lupus erythematosus patients. Lupus 26, 1278-1284 (2017).

Figure 1.

BSLE. Blisters can be seen on the face, neck, armpits and arms.

BSLE = bullous systemic lupus erythematous.

Disclosure of Interests

None declared

AB0390 COST-EFFECTIVENESS OF IGURATIMOD IN PATIENTS WITH RHEUMATOID ARTHRITIS (RA) BY USING A CLAIMS-BASED ALGORITHM: RETROSPECTIVE ANALYSIS OF REAL‑WORLD DATA

Background

Iguratimod (IGU), as one of the conventional synthetic disease-modifying antirheumatic drugs (csDMARDs), has been approved by National Medical Products Administration (NMPA) to treat Rheumatoid arthritis (RA).

Objectives

This study aimed to compare the cost-effectiveness of well-established RA therapies using a claims-based algorithm in RA patients.

Methods

An electronic medical record (EMR) database from Zhujiang Hospital was utilized to estimate the cost-effectiveness of medication for RA patients, including IGU with MTX, biological DMARDs (bDMARDs) with MTX, and MTX alone for more than 6 months from 2014 to 2020. Patients who were deemed effective must meet all the following criteria according to the algorithm, high adherence; no bDMARDs or IGU switch or addition; no prescription of new csDMARDs; no increase in dose or frequency of index drug; no new use of chronic glucocorticoids or increase in glucocorticoid dose; and no more than one glucocorticoid injection. Average cost was calculated by summing total cost of effective treatment and dividing by number of patients achieving efficacy in each group.

Results

A total of 263 patients were included in the analysis. Based on a claims-based algorithm, the effective rate was 27.1 % (26/96) for IGU with MTX group, 11.2% (7/62) for bDMARDs with MTX group, and 13.3% (14/105) for MTX alone group, respectively. Average cost of effective treatment was $833.46 for IGU with MTX therapy, $2554.57 for bDMARDs with MTX therapy, and $171.48 for MTX alone (Table 1).

Table 1.

Effectiveness and Cost per Effectively Treated Patient with RA

CriteriaAll patients (n=263)IGU with MTX group(n=96)bDMARDs with MTX group (n=62)MTX (n=105)Effectiveness:no. of patients (%)a47(17.87%)26 (27.1%)7 (11.2/%)14 (13.3%)Cost of all RA-related medication per effectively treated patient(SD)$892.75(911.57)$833.46 (252.67)$2554.5 (1273.13)$171.4 (110.33)Average cost of all RA medications postindex (excluding biologic DMARDs) per patient (SD)b$146.38(114.60)$148.81 (123.12)$86.90 (74.53)$171.4 (110.33)Average cost of only biologicDMARDs postindex per patient (SD)b$746.38(926.35)$684.27(188.67)$2468.67(1285.91)/

a χ2showed significant difference in percentage effectiveness for the original algorithm (p<0.05).

bMedication cost was 2020 U.S. dollars.

Conclusion

IGU with MTX therapy was revealed to be both effective and modestly priced, which seemed to be a cost-effective strategy for RA therapy and warranted further cost-effectiveness investigation.

References

[1](2018) [2018 Chinese guideline for the diagnosis and treatment of rheumatoid arthritis]. Zhonghua Nei Ke Za Zhi 57 (4), 242-251. https://doi.org/10.3760/cma.j.issn.0578-1426.2018.04.004

[2]Hitchon, C. A., & El-Gabalawy, H. S. (2011). The synovium in rheumatoid arthritis. The open rheumatology journal, 5, 107–114. https://doi.org/10.2174/1874312901105010107

[3]Smolen, J. S., Landewé, R., Bijlsma, J., Burmester, G. R., Dougados, M., Kerschbaumer, A., McInnes, I. B., Sepriano, A., van Vollenhoven, R. F., de Wit, M., Aletaha, D., Aringer, M., Askling, J., Balsa, A., Boers, M., den Broeder, A. A., Buch, M. H., Buttgereit, F., Caporali, R., Cardiel, M. H., … van der Heijde, D. (2020). EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2019 update. Annals of the rheumatic diseases, 79(6), 685–699. https://doi.org/10.1136/annrheumdis-2019-216655

[4]Fraenkel, L., Bathon, J. M., England, B. R., St Clair, E. W., Arayssi, T., Carandang, K., Deane, K. D., Genovese, M., Huston, K. K., Kerr, G., Kremer, J., Nakamura, M. C., Russell, L. A., Singh, J. A., Smith, B. J., Sparks, J. A., Venkatachalam, S., Weinblatt, M. E., Al-Gibbawi, M., Baker, J. F., … Akl, E. A. (2021). 2021 American College of Rheumatology Guideline for the Treatment of Rheumatoid Arthritis. Arthritis care & research, 73(7), 924–939. https://doi.org/10.1002/acr.24596

Disclosure of Interests

None declared

Berberine Attenuates Cell Motility via Inhibiting Inflammation-Mediated Lysyl Hydroxylase-2 and Glycolysis

Lysyl hydroxylase-2 (LH2) involves in the hydroxylation of telopeptide lysine residues during collagen deposition. Recent studies indicate that interleukin (IL)-6 generated by the chronic inflammation disease may trigger the LH2 expression to accelerate cell motility. Berberine is the alkaloid derived from the traditional Chinese medicine Coptis chinensis, which displays potential anti-inflammatory activity in multiple diseases. The anti-inflammatory activity of berberine has been confirmed by reducing proinflammatory cytokines such as IL-6, IL-8, and IFN-γ. However, whether and how berberine inhibits cellular motility against metastatic spread in triple-negative breast cancer (TNBC) has not been demonstrated, and the underlying mechanism remains unclear. We investigated the effects of berberine on the inflammatory cytokine secretion, cell proliferation, and migration in vitro and further explored the effect of berberine on growth and metastasis in vivo. Berberine restrained TNBC cell proliferation, motility, and glycolysis process in a dose-dependent way. The secretion of IL-6 was abrogated by berberine in TNBC cells, and IL-6-stimulated cell migration was inhibited by berberine. Mechanistically, berberine remarkably suppressed LH2 expression at both mRNA and protein levels. LH2 depletion led to decreasing the antimotility effect of berberine, and this phenomenon was related to the suppressed glycolysis after LH2 inhibition. Conversely, ectopic restoration of LH2 could further increase the antimotility effect of berberine. Moreover, berberine was confirmed to inhibit cell growth and motility in vivo, and the expression of LH2 and glycolytic enzymes was also blocked by berberine in vivo. Collectively, this study indicated that berberine could be a promising therapeutic drug via regulating LH2 for TNBC.

Novel Functional Food from an invasive species Polygonum cuspidatum: Safety evaluation, Chemical Composition, and Hepatoprotective Effects

Accidentally, we found that the shoots of Polygonum cuspidatum (SPC) have been consumed for centuries as a traditional vegetable in the Shennongjia region of China. Local residents believe that SPC has biological effects such as antibacterial, anti-aging, and antioxidant. To provide scientific support for the use of SPC as a functional food, SPC was evaluated in terms of safety, chemical composition, antioxidant activity both in vivo and in vitro. In the first, SPC exhibited no adverse cytotoxic effects or acute toxicity in mice. Then the chemical composition of SPC was determined by UHPLC-ESI-QTOF-MS/MS. 22 compounds were identified from the SPC extracts, including phenolic, flavonoid, stilbene, and anthraquinone. Finally, an acute ethanol-induced oxidative stress model in mice showed hepatoprotective effects. In brief, our study indicated that SPC is a safe, multi-functional food with antioxidant and hepatoprotective activities. Importantly, the consumption of SPC as a functional food provides a novel strategy of efficient utilization of the invasive plant.

Apigenin-oxymatrine binary co-amorphous mixture: Enhanced solubility, bioavailability, and anti-inflammatory effect

Apigenin (APG) is a functional ingredient in many foods, but its poor water solubility results in low bioavailability. This study aimed at delivering APG and improving bioavailability by a food-friendly co-amorphous formulation of APG with oxymatrine (OMT). After preparation of co-amorphous mixture (CM), characterized by powder x-ray diffraction and thermal analysis. Then, the presence of hydrogen bonds was confirmed by vibrational spectroscopy and molecular dynamics simulation. Furthermore, phase solubility and solubility studies, as well as dissolution test indicated that complexation occurred between APG and OMT in solution, which significantly improved the solubility and dissolution of APG-OMT CM. Additionally, pharmacokinetics and biological activity indicated that APG-OMT CM exhibited higher oral bioavailability and anti-inflammatory effect than pure APG. These results suggest that APG-OMT CM may be great potential for application in functional food. Importantly, the study provides a promising delivery system to improve the bioavailability of hydrophobic food ingredients.

Opportunities and challenges of patient-derived models in cancer research: patient-derived xenografts, patient-derived organoid and patient-derived cells

Background

As reported, preclinical animal models differ greatly from the human body. The evaluation model may be the colossal obstacle for scientific research and anticancer drug development. Therefore, it is essential to propose efficient evaluation systems similar to clinical practice for cancer research.

Main body

While it has emerged for decades, the development of patient-derived xenografts, patient-derived organoid and patient-derived cell used to be limited. As the requirements for anticancer drug evaluation increases, patient-derived models developed rapidly recently, which is widely applied in basic research, drug development, and clinical application and achieved remarkable progress. However, there still lack systematic comparison and summarize reports for patient-derived models. In the current review, the development, applications, strengths, and challenges of patient-derived models in cancer research were characterized.

Conclusion

Patient-derived models are an indispensable approach for cancer research and human health.

Weed Suppression and Molecular Mechanisms of Isochlorogenic Acid A Isolated from Artemisia argyi Extract via an Activity-Guided Method

Allelopathy is considered an environmentally friendly and resource-conserving approach to weed control because allelochemicals degrade easily and cause less pollution than traditional chemical herbicides. In this study, the allelopathic active constituents of Artemisia argyi were elucidated by activity-guided isolation and ultraperformance liquid chromatography-quadrupole time-of-flight mass spectrometry (UPLC-QTOF-MS). First, a crude extract prepared in water was fractionated using macroporous resin D101 to obtain three fractions (Fr.A-C). Combined with the allelopathic activity assay on Setaria viridis and Portulaca oleracea, Fr.C was determined to be the most active fraction. We identified 14 compounds in the active fraction (Fr.C) using UPLC-QTOF-MS, including 13 phenolic compounds. Accordingly, phenolic components have been suggested as the main allelochemicals in A. argyi. Thereafter, Fr.C was further isolated by octadecylsilyl (ODS) chromatography to obtain eight subfractions (Fr.C-1-Fr.C-8). Finally, isochlorogenic acid A (ICGAA) was purified from Fr.C-3 by semipreparative liquid chromatography, which was detected in the growth environment of A. argyi. Furthermore, we evaluated the allelopathic effects of ICGAA on six weeds from different families and genera for the first time. The results showed that ICGAA is a novel allelochemical with broad herbicidal activity. In addition, we analyzed the inhibitory effect and molecular mechanism of ICGAA on the growth of S. viridis seedlings. Optical microscopy and transmission electron microscopy (TEM) revealed the degradation of membrane structures and organelles after ICGAA treatment. Transcriptome and real-time polymerase chain reaction (RT-qPCR) analysis showed that ICGAA inhibited the growth of weeds mainly by inhibiting the diterpenoid biosynthesis pathway (especially gibberellins, GAs). The decrease of gibberellin (GA) contents after ICGAA treatment also confirmed these results. In brief, this study provides new material sources and theoretical support for developing biological herbicides for agroecosystems.

A new approach for contralateral C7 nerve transfer via retrospinal route

Anterior and posterior approaches exist for the treatment of spinal pathologies. Anatomically, the 7th cervical spinal nerve(C7)crosses the C6-C7 intervertebral foramen bilaterally, allowing contralateral prevertebral or posterior C7 nerve transfer to be used. The advantage of the posterior rather than the anterior spinal approach is that it does not require retraction of important blood vessels, nerves, or other structures. In this paper, we describe transfer of the contralateral C7 nerve using a posterior approach.

Caffeic Acid, an Allelochemical in Artemisia argyi, Inhibits Weed Growth via Suppression of Mitogen-Activated Protein Kinase Signaling Pathway and the Biosynthesis of Gibberellin and Phytoalexin

Artemisia argyi is widely distributed in Asia, and it often becomes the dominant population in the field because of its strong ecological niche competitiveness. Allelochemicals secreted by plants are generally considered an important reason for their dominance in ecological competition. In this study, the allelochemicals in A. argyi were screened by a series of experiments and their mechanisms were explored via transcriptomics. First, the inhibitory effects of A. argyi on Echinochloa crusgalli, Setaria viridis, Portulaca oleracea and Amaranthus retroflexus were evaluated. Then, we carried out a qualitative and quantitative analysis of the chemical composition of the aqueous extract of A. argyi to screen for potential allelochemicals that can inhibit weed growth. Four potential allelochemicals were quantified: neochlorogenic acid (5-CQA), chlorogenic acid (3-CQA), cryptochlorogenic acid (4-CQA), and caffeic acid (CA). Coincidentally, their allelopathic effects on weeds seemed to be identical to their content, in the order CA>4-CQA>5-CQA>3-CQA. These findings suggested that CA might be the main allelopathic compound in the aqueous extract of A. argyi. Subsequently, the allelopathic effect and molecular mechanism of CA on S. viridis leaves were investigated. The physiological results showed that CA significantly induced reactive oxygen species (ROS) production, led to malondialdehyde (MDA) accumulation, and disrupted enzyme activities (POD, SOD, CAT) in S. viridis leaves. Moreover, transcriptome results revealed that CA inhibited S. viridis growth by downregulating multiple genes involved in gibberellin (GA) and phytoalexin biosynthesis and Mitogen-activated protein kinase (MAPK) signaling pathways. In addition, differentially expressed genes (DEGs) related to the biosynthesis and signaling pathways of phytohormones were verified by Quantitative Real-Time PCR (RT-qPCR). Taken together, this study may be the first to identify allelochemicals and explore their molecular mechanism about A. argyi. Importantly, the ecological advantages of A. argyi could be applied to ecological regulation and the development of botanical herbicides.

Phytochemical composition and anti-aging activity of n-butanol extract of Hedyotis diffusa in Caenorhabditis elegans

Hedyotis diffusa Willd. ( H. diffusa ), a kind of traditional Chinese medicine, has been evaluated to potential display antioxidant and anti-aging effects in vitro experiments. In this work, we investigated the effects on lifespan and stress resistance of the N-butanol extract from H. diffusa (NHD) in vivo using a Caenorhabditis elegans ( C. elegans ) model. The phytochemicals of NHD were identified by UPLC-ESI-qTOF-MS/MS method. NHD-treated wild-type N2 worms showed an increase in survival time under both normal and stress conditions. Meanwhile, NHD promoted the healthspan of nematodes by stimulating growth and development, reducing the deposition of age pigment, increasing the activities of superoxide dismutase (SOD) and glutathione peroxidase dismutase (GSH-Px), and decreasing the level of ROS without impairing fertility. Moreover, the upregulating of the expression of daf-16 , gst-4 , sod-3 , hsp12.6 genes and the downregulating of the expression of daf-2 were involved in the NHD-mediated lifespan extension. Finally, the increasing of the expression of GST-4::GFP in CL2166 transgenic nematodes and the life-span-extending activity of NHD was completely abolished in daf-2 and daf-16 mutants further revealed that the potential roles for these genes in NHD-induced longevity in C. elegans . Collectively, our findings suggest that NHD may have an active effect in healthy aging and age-related diseases.

[A case of microvascular anomalies in myopic retinoschisis]

It is a case found during routine reexamination one year after implantable Collamer lens (ICL) implantation. The patient had no complaints. The naked eye visual acuity of the left eye was 1.0, and abnormal blood vessels were seen in the supranasal retina. After fluorescein fundus angiography and sweep source OCTA, it was finally diagnosed as retinoschisis with microvascular anomalies of the left eye. This case suggests that the fundus of patients with high myopia without complaint should also be examined in detail and comprehensively. In addition to paying attention to peripheral retinopathy, the posterior pole and middle peripheral retina should be carefully examined, especially the areas that cannot be covered by conventional OCT.(Chin J Ophthalmol, 2021, 57: 944-945).

[Analysis of the detection of metals and metalloids in the bronchoalveolar lavage fluid for the etiological diagnosis value of pneumoconiosis]

Objective: To analyze the differences of the concentrations of metals and metalloids in bronchoalveolar lavage fluid (BALF) of patients with pneumoconiosis, so as to provide reference for the etiological diagnosis of pneumoconiosis. Methods: From September 2019 to August 2020, 47 pneumoconiosis patients hospitalized in Chongqing Prevention and Treatment Center for Occupational Diseases and undergoing bronchoalveolar lavage were selected as the research objects using cluster sampling method. The general situation and occupational history of patients were investigated by questionnaire, The BALF of 47 pneumoconiosis patients was collected, and the concentrations of metals and metalloids in BALF were detected by inductively coupled plasma mass spectrometry (ICP-MS) , the differences among patients with different types of pneumoconiosis, different stages of silicosis and different occupational history were analyzed by one-way ANOVA. Results: The concentrations of 50 metals and metalloids in BALF were detected, and 21 of them were analyzed. Compared with different types of pneumoconiosis, the concentrations of Zn, Mn and Sn in BALF were statistically significant (F=9.959, 3.635, 9.488, P<0.05) . The concentrations of K, Mg, Fe, Zn, Cu and Ni in BALF were significantly different in different stages of silicosis (F=4.271, 4.334, 3.588, 5.120, 7.340, 3.905, P<0.05) . The concentrations of Zn and Sn in pneumoconiosis patients with different types of work and types of exposed dust were significantly different (P<0.05) . Conclusion: The detection of Zn, Mn, Sn, and other metals in BALF can provide reference basis for the etiological diagnosis of pneumoconiosis and provide a new idea for the diagnostic method of pneumoconiosis.

Antioxidant capacity of flavonoids from Folium Artemisiae Argyi and the molecular mechanism in Caenorhabditis elegans

ETHNOPHARMACOLOGICAL RELEVANCE

Folium Artemisiae Argyi (FAA) is one kind of Chinese herbal medicine with a long history. It has widespread pharmacological activities such as antibacterial, anti-inflammatory, antioxidative, and hemostatic, among others. FAA is traditionally used for the treatment of eczema, respiratory diseases and gynecological diseases for hundreds of years. Flavonoids are reported as the main components of them. Recent studies focused on the antioxidant effect of its flavonoids in vitro, while few studies focused on the antioxidant effect in vivo, and the underlying mechanisms have not yet been elucidated.

AIM OF THE STUDY

The aim of this study was to evaluate the antioxidant activity of Folium Artemisia Argyi flavonoids (FAAF) and explore its possible molecular mechanism in Caenorhabditis elegans. The research and development of its medicinal value will beneficial to the resource utilization of FAA.

MATERIALS AND METHODS

Firstly, FAAF was prepared, purified and then qualitatively and quantitatively analyzed using LC-DAD-MS. Then, 1,1-diphenyl-2-trinitrophenylhydrazine (DPPH), 2,2-azino-bis-(3-ethylbenzothiazoline-6-sulfonic acid (ABTS), hydroxyl radical and ferric reducing antioxidant power (FRAP) assays were applied to investigate the antioxidant effect of FAAF in vitro. Meanwhile, a stress resistance assay was carried out to evaluate the antioxidant effect of FAAF in vivo. Moreover, superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) activities and reactive oxygen species (ROS) accumulation were determined to ascertain whether FAAF can increase the oxidant defense system of nematodes and reduce the accumulation of ROS. Lipofuscin and protein carbonylation assays were employed to test whether FAAF can increase the antioxidant capacity of nematodes to resist the growth health indicators related to antioxidation. At last, quantitative real-time polymerase chain reaction (qRT-PCR) was performed to evaluate the expression of genes related to antioxidation. The expression of green fluorescent protein (GFP) was further investigated using a fluorescence microscope in transgenic strains (SOD-3::GFP, GST-4::GFP, and HSP-16.2::GFP).

RESULTS

FAAF exhibited a strong antioxidant capacity and enhanced stress resistance in C. elegans. FAAF reduced ROS accumulation and improved the antioxidant defense system under acute stress. Moreover, FAAF prevented the accumulation of lipofuscin and protein carbonylation in C. elegans. FAAF also upregulated the gene expression levels of hsp-16.2, gst-4, sod-3, skn-1, daf-16, ctl-2, hsf-1 and increased SOD-3::GFP and GST-4::GFP expression.

CONCLUSION

These results demonstrated that FAAF exerted antioxidant activity in C. elegans. It was perhaps regulated by the insulin/insulin-like growth factor-1(IGF-1) signaling pathway.

Study into the spread of heat from thermo-optic silicon photonic elements

Phase modulators based upon the thermo-optic effect are used widely in silicon photonics for low speed applications such as switching and tuning. The dissipation of the heat produced to drive the device to the surrounding silicon is a concern as it can dictate how compact and tightly packed components can be without concerns over thermal crosstalk. In this paper we study through modelling and experiment, on various silicon on insulator photonic platforms, how close waveguides can be placed together without significant thermal crosstalk from adjacent devices.

Inter-relationships of different electrocardiographic indicators of left ventricular hypertrophy in 25,000 Chinese adults

Background

Several electrocardiographic (ECG) indices have previously been proposed to diagnose left ventricular hypertrophy (LVH). Such indices utilize different criteria, including increased QRS voltage, prolonged QRS duration, left axis deviation, and LAFB and LBBB-like patterns in varying combinations. However, the inter-relationships of these different electrocardiographic indices of LVH with each otherare not fully understood.

The purpose of this study is to estimate the relationships between the different LVH indices.

Methods

Electronic tracings of 12-lead ECGs recorded in 24,786 adult participants in the China Kadoorie Biobank recorded in 2014 were accessed to detect presence of LVH. ECG parameters of LVH, including individual and combinations of such parameters (voltage-only criteria such as Sokolov-Lyon, Cornell, Gubner as well as scores such as Romhilt-Estes point score) were estimated using customized computer software (Cardiolyse Oy, Finland) and compared proprietary LVH point score algorithms (Mortara, USA). Relationships between the different indices were assessed using a correlation matrix to explore associations between individual parameters and combined indices of such parameters. The matrices were used to construct heat maps and identify clustering of individual parameters.

Results

Overall, approximately 10% of the population had LVH assessed by Mortara algorithms. This graph shows that along with the free standing peaks, the rest are divided into two clusters of interconnected individual parameters. In the center of the largest cluster is the parameter, reflecting R-peak magnitude in aVL lead. In the center of another cluster was the left ventricular strain pattern, as described in Romhilt-Estes point score system. Overall, the Sokolov-Lyon index and LVH point score in Veritas algorithm had the strongest relationships with each other, but the Gubner and Cornell indices had relatively weak correlations with the other indices (Table 1). The mean correlation coefficient between five combined LVH indices was as follows: Veritas (Mortara) – 0.58, Sokolov-Lyon – 0.56, Romhilt-Estes – 0.45, Gubner – 0,32, Cornell – 0,3.

Conclusions

Parameters such as R-peak magnitude in aVL and left ventricular strain pattern were the most strongly related with each other. Aggregate indices, such as the Sokolov-Lyon index and LVH point score in Veritas algorithm were the most strongly related with all other indices, but the Gubner and Cornell indices were only weakly correlated. The results reinforce the utility of Sokolov-Lyon index and Mortara algorithms as the optimum measures of LVH.

Funding Acknowledgement

Type of funding sources: None.

Dairy intake and risk of major cardiovascular events: a prospective cohort study of 0.5 million Chinese adults

Background

Evidence on the association between dairy consumption and risk of cardiovascular disease has been highly inconsistent, with findings suggesting either harmful, neutral or beneficial effects. In addition, a very large majority of the previous studies on this topic were conducted among populations in Europe and North America who usually consume a higher amount of dairy products and very few data, particularly prospective data, come from China where the dairy consumption level is low.

Purpose

We therefore investigated the associations between intake of dairy products and incidence of several major types of cardiovascular diseases in Chinese adults.

Methods

During 2004–2008, the prospective China Kadoorie Biobank Study recruited slightly over 0.5 million adults from ten diverse regions (five urban and five rural) across China. Information on the consumption frequency of dairy products was collected at baseline and periodic resurveys, using a validated interviewer-administered laptop-based questionnaire. Over a mean follow-up of 10.9 years, there were 47,128 incident ischaemic heart disease events, 43,481 ischaemic strokes and 9749 intracerebral haemorrhages among 489,595 study participants, who did not report a prior history of cardiovascular disease at baseline. Cox regression analyses were performed to estimate multivariable-adjusted hazard ratios (HRs) for incident events associated with dairy intake.

Results

Overall, 69.3% of participants reported never or rare consumption (i.e. non-consumers) and 11.3% of them reported regular consumption (i.e. ≥4 days/week) of dairy products, with milk accounting for the largest proportion of total dairy intake (∼77%). Male and female regular dairy consumers had 2.1/1.5 and 1.7/1.1 mmHg lower systolic/diastolic blood pressure, respectively compared to non-consumers. In a subset (∼18,000) of participants with blood lipid levels measured, regular dairy consumers had ∼0.1 mmol/L higher LDL levels than non-consumers. After adjusting for a range of potential confounders, including sociodemographic and lifestyle factors, BMI and other dietary factors, dairy consumption was positively and significantly associated with risk of ischaemic heart disease, with the adjusted HR per 50 g/day increase in usual dairy consumption being 1.11 (95% confidence interval [CI] 1.09–1.14). Dairy consumption was not significantly associated with risk of ischemic stroke but was inversely associated with risk of intracerebral haemorrhage, with each 50 g/day increase in usual dairy consumption being associated with 17% lower risk (HR 0.83, 0.78–0.88). These associations remained significant after additional adjustment for systolic blood pressure.

Conclusion

In this large study of Chinese adults, higher intake of dairy products was associated with a higher risk of ischaemic heart disease but a lower risk of intracerebral haemorrhage. The exact mechanisms underlying such associations require further investigation.

Funding Acknowledgement

Type of funding sources: Public Institution(s). Main funding source(s): The CKB baseline survey and the first re-survey were supported by the Kadoorie Charitable Foundation in Hong Kong. The long-term follow-up has been supported by Wellcome grants to Oxford University (212946/Z/18/Z, 202922/Z/16/Z, 104085/Z/14/Z, 088158/Z/09/Z) and grants from the National Key Research and Development Program of China (2016YFC0900500, 2016YFC0900501, 2016YFC0900504, 2016YFC1303904) and from the National Natural Science Foundation of China (91843302). The UK Medical Research Council (MC_UU_00017/1,MC_UU_12026/2 MC_U137686851), Cancer Research UK (C16077/A29186; C500/A16896) and the British Heart Foundation (CH/1996001/9454), provide core funding to the Clinical Trial Service Unit and Epidemiological Studies Unit at Oxford University for the project.

Associations of red meat, poultry, fish and egg intake with risk of cardiovascular disease: an 11-year prospective study of the China Kadoorie Biobank

Background

Higher red meat intake and lower fish intake have been associated with increased risk of cardiovascular disease (CVD), while the relevance of poultry and egg intake for CVD incidence remains inconclusive. Furthermore, most of the prospective evidence comes from studies in the Western populations, with limited data from China where the CVD patterns are largely different.

Purpose

We therefore investigated the associations of red meat, poultry, fish and egg intake with risks of several major types of CVD in Chinese adults.

Methods

The China Kadoorie Biobank is a prospective study which recruited ∼512,000 adult participants from ten diverse localities during 2004–08. At baseline and periodic resurveys, information on the consumption frequency of major food groups was collected using a validated interviewer-administered laptop-based questionnaire, together with medical history, socio-demographic and other lifestyle factors. During an average follow-up of 10.9 years, 47,128 incident ischaemic heart disease events, 43,481 ischaemic strokes and 9749 intracerebral haemorrhages were recorded among 489,595 participants, who did not have a prior history of CVD at baseline. Cox regression was used to calculate adjusted hazard ratios (HRs) relating dietary exposures to CVD risk.

Results

There were 47.2%, 1.4%, 9.0% and 24.1% of participants at baseline who regularly consumed (i.e. ≥4 days/week) red meat, poultry, fish and eggs, respectively. After adjusting for potential confounders, including body mass index and other dietary factors under study, egg consumption was significantly associated with lower risks of ischaemic heart disease and ischaemic stroke, with each 50 g/day increase in estimated habitual egg consumption being associated with 18% (HR 0.82, 95% confidence interval [CI] 0.75–0.90) and 24% lower risks (HR 0.76, 95% CI 0.69–0.84), respectively. Inverse associations were also observed between intakes of red meat, fish and eggs and risk of intracerebral haemorrhage, with adjusted HRs for 50 g/day higher intake being 0.84 (95% CI 0.74–0.97), 0.86 (95% CI 0.74–0.99) and 0.42 (95% CI 0.34–0.51), respectively.

Conclusion

This large prospective study of Chinese adults showed that higher intake of eggs was associated with lower risks of ischaemic heart disease and ischaemic stroke. Moreover, higher intakes of red meat, fish and eggs were each associated with a lower risk of intracerebral haemorrhage. Further investigation of the potential mechanisms that underlie the observed associations is required.

Funding Acknowledgement

Type of funding sources: Other. Main funding source(s): The CKB baseline survey and the first re-survey were supported by the Kadoorie Charitable Foundation in Hong Kong. The long-term follow-up has been supported by Wellcome grants to Oxford University (212946/Z/18/Z, 202922/Z/16/Z, 104085/Z/14/Z, 088158/Z/09/Z) and grants from the National Key Research and Development Program of China (2016YFC0900500, 2016YFC0900501, 2016YFC0900504, 2016YFC1303904) and from the National Natural Science Foundation of China (91843302). The UK Medical Research Council (MC_UU_00017/1,MC_UU_12026/2 MC_U137686851), Cancer Research UK (C16077/A29186; C500/A16896) and the British Heart Foundation (CH/1996001/9454), provide core funding to the Clinical Trial Service Unit and Epidemiological Studies Unit at Oxford University for the project. MG. Kakkoura is supported by the Wellcome Trust, Our Planet Our Health (Livestock, Environment and People - LEAP) (205212/Z/16/Z).

Akkermansia Muciniphila Potentiates the Antitumor Efficacy of FOLFOX in Colon Cancer

FOLFOX (oxaliplatin, fluorouracil and calcium folinate) is the first-line chemotherapy regimen for colon cancer therapy in the clinic. It provides superior efficacy than oxaliplatin alone, but the underlying mechanism remains unclear. In the present study, pharmacomicrobiomics integrated with metabolomics was conducted to uncover the role of the gut microbiome behind this. First, in vivo study demonstrated that FOLFOX exhibited better efficacy than oxaliplatin alone in colon cancer animal models. Second, 16S rDNA gene sequencing analysis showed that the abundance of Akkermansia muciniphila (A. muciniphila) remarkably increased in the FOLFOX treated individuals and positively correlated with the therapeutic effect. Third, further exploration confirmed A. muciniphila colonization significantly enhanced the anti-cancer efficacy of FOLFOX. Last, metabolomics analysis suggested dipeptides containing branched-chain amino acid (BCAA) might be responsible for gut bacteria mediated FOLFOX efficacy. In conclusion, our study revealed the key role of A. muciniphila in mediating FOLFOX efficacy, and manipulating A. muciniphila might serve as a novel strategy for colon cancer therapy.

Micromagnetic simulation of microstructure effect for binary-main-phase Nd-Ce-Fe-B magnets

We investigate the magnetic properties of a chemically heterogeneous binary-main-phase (BMP) Nd-Ce-Fe-B magnet with a core-shell structure via micromagnetic simulation. It is found that the coercivity strongly depends on the shell thickness. The BMP magnet's coercivity initially increases and then decreases with increasing Nd-rich shell thickness, and so there is the optimal shell thickness which shows the maximum coercivity for any given Ce concentration. The simulation shows the significant difference in coercivity and maximum energy product between the BMP and single-main-phase magnets. Notably, the magnetization reversal mechanism of the BMP magnet is revealed in the simulation. Local reversals in the BMP magnet first occur in the Ce-rich shells, followed by the Nd-rich cores. Then, the magnetization in Ce-rich core/Nd-rich shell typed grains is switched after reversed magnetization of all the Nd-rich core/Ce-rich shell typed grains. The BMP magnet represents a further increased coercivity for a larger GB thickness, which can be well explained by a maximum stray field.

[Evaluation of the fresh air purification system in the classroom under heavy pollution weather]

Evaluate the effect of the fresh air purification system on the improvement of indoor PM_2.5 levels in a primary school classroom in Jinan City, Shandong Province. Our purpose is to explore the optimal operating time of the fresh air system and the main factors that affect the fresh air purification system to improve indoor air quality. From December 9, 2019 to December 10, 2019, two classrooms of the same area on the third floor of a primary school building in Jinan City, Shandong Province were selected as monitoring points. During the operation of the fresh air purification system, the PM_2.5 concentration in the classroom is reduced by an average of 48.1%-61.5% compared to the outdoor PM_2.5 concentration. After running for about 2 hours, the indoor PM_2.5 concentration decreased to a relatively stable concentration level. The operating time of the fresh air purification system, student activities between classes, indoor temperature, indoor relative humidity, and outdoor PM_2.5 concentration are important factors that affect the indoor particulate removal rate. In the case of a certain amount of fresh air and indoor area, closing doors and windows and appropriately extending the operation time of the fresh air purification system can improve the air quality in the classroom to a certain extent and protect the health of students.

Co-designing digital cardiac rehabilitation with patients living in rural and remote australia - the country heart attack prevention project

Funding Acknowledgements

Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): Co-sponsored National health Medical Partnership Grant

OnBehalf

the country heart attack prevention project

Background/significance. Cardiac rehabilitation (CR) significantly reduces death, reoccurring cardiac events, hospital admissions while improving quality of life. However, it is still poorly attended with participation rates worldwide between 20-50%, worsened for rural and remote patients by the tyranny of distance, work responsibilities and transportation. Web-based CR can provide an alternative, patient centred, flexible delivery option. Co-design with consumers and clinicians is recommended to tailor web-based CR to their needs and preferences as a means of increasing attendance.

Purpose. The objective of this study is to describe how patient-generated data through workshops on desired content and features informs technology and implementation specifications for the patient portal of a CR website.

Methods. UX Design theoretical framework, using a co-design workshop, with thematic analysis, a survey, and the System Usability Scale was used to report outcomes.

Results. Based on the feedback from participants in rural and remote SA, desired content and features were updated for improving user experience. We recruited 27 participants across 4 regional Local health Networks in SA. The median age of participants was 71.0 (IQR 58-78), 14 (51.9%) were female and 27 (100%) had completed a cardiac rehabilitation program. More than half used a smart phone (16; 59.3%) and Facebook (21; 77.8%). Overall usability remains low based on a mean SUS score of 63.4 (SD 21.1), however there was a tendency to usability improving over time.

Conclusion. The co-design process has contributed to the development of the CR website, improving desired content and features. Improved usability scores can be achieved through further incorporating consumer feedback into the development of the CR website.

Adverse events associated with mirabegron 50mg versus placebo: A systematic review and meta-analysis

PURPOSE

The safety of mirabegron 50mg monotherapy was comprehensively assessed versus placebo for overactive bladder.

METHODS

A systematic literature search was conducted up to June, 2020 using PUBMED, EMBASE and Cochrane Library. Randomized controlled trials evaluating safety of mirabegron in overactive bladder were collected, and safety was assessed according to 15 adverse events. Adverse events were widely selected to be assessed if they could be calculated. Heterogeneity among studies was assessed by using the χ² test based on the Q and I² tests. Pooled effect sizes were calculated using fixed model if I²<50%, otherwise a random-effects model was chosen. The outcomes were nasopharyngitis, dry mouth, hypertension, constipation, headache, dyspepsia, urinary tract infection, dizziness, blurred vision, nausea, cardiovascular events, influenza, electrocardiogram QT prolonged, upper respiratory tract infection and high blood pressure.

RESULTS

In all, 10 peer-reviewed trials comprising 6135 patients were identified. Compared with placebo, mirabegron 50mg had an unfavorable safety profile resulting in nasopharyngitis (OR, 1.54[95% credible interval, 1.05-2.25]; P=0.03. No statistical difference was found between mirabegron 50mg and placebo groups in other 14 outcomes.

CONCLUSION

Mirabegron 50mg is further confirmed to be nearly as safe as placebo, expect for nasopharyngitis. Nasopharyngitis is associated with mirabegron 50mg monotherapy for patients with overactive bladder.