Foam and fluid properties of purified saponins and non-purified water extracts from Camellia oleifera cake (by-product)

The physicochemical and foam properties of non-purified water extracts (WE) and purified tea saponins (TS) from Camellia oleifera cake (byproduct) were compared. WE showed different fluid properties at equal saponin concentrations (1.0 wt%) compared to TS. Particularly, it exhibited limited micelle size (average 434.1 nm), effective viscosity (0.15 Pa·s), and surface tension (43.9 mN/m) independently of pH. Moreover, the foam properties of WE were comparable to TS and better than sodium caseinate, especially foam stability. WE foam was more stable than TS foam under pH (3-7) and heating (40-80 °C). In the presence of NaCl, sucrose, and ethanol (5-20 wt%), WE and TS were effective and had similar foam behavior. Low concentrations of sucrose (<10 wt%)/ethanol (<20 wt%) significantly increased the foam capacity, while ethanol over 30 wt% was unfavorable. WE/TS foam contributes significantly to the desired physicochemical and sensory attributes (taste, texture, and appearance) of foods.

Personalised follow-up and management schema for patients with screen-detected pulmonary nodules: A dynamic modelling study

BACKGROUND

Selecting the time target for follow-up testing in lung cancer screening is challenging. We aim to devise dynamic, personalized lung cancer screening schema for patients with pulmonary nodules detected through low-dose computed tomography.

METHODS

We developed and validated dynamic models using data of pulmonary nodule patients (aged 55-74 years) from the National Lung Screening Trial. We predicted patient-specific risk profiles at baseline (R0) and updated the risk evaluation results in repeated screening rounds (R1 and R2). We used risk cutoffs to optimize time-dependent sensitivity at an early decision point (3 months) and time-dependent specificity at a late decision point (1 year).

RESULTS

In validation, area under receiver operating characteristic curve for predicting 12-month lung cancer onset was 0.867 (95 % confidence interval: 0.827-0.894) and 0.807 (0.765-0.948) at R0 and R1-R2, respectively. The personalized schema, compared with National Comprehensive Cancer Network (NCCN) guideline and Lung-RADS, yielded lower rates of delayed diagnosis (1.7% vs. 1.7% vs. 6.9 %) and over-testing (4.9% vs. 5.6% vs. 5.6 %) at R0, and lower rates of delayed diagnosis (0.0% vs. 18.2% vs. 18.2 %) and over-testing (2.6% vs. 8.3% vs. 7.3 %) at R2. Earlier test recommendation among cancer patients was more frequent using the personalized schema (vs. NCCN: 29.8% vs. 20.9 %, p = 0.0065; vs. Lung-RADS: 33.2% vs. 22.8 %, p = 0.0025), especially for women, patients aged ≥65 years, and part-solid or non-solid nodules.

CONCLUSIONS

The personalized schema is easy-to-implement and more accurate compared with rule-based protocols. The results highlight value of personalized approaches in realizing efficient nodule management.

Degradable, anti-swelling, high-strength cellulosic hydrogels via salting-out and ionic coordination

Cellulosic hydrogels are widely used in various applications, as they are natural raw materials and have excellent degradability. However, their poor mechanical properties restrict their practical application. This study presents a facile approach for fabricating cellulosic hydrogels with high strength by synergistically utilizing salting-out and ionic coordination, thereby inducing the collapse and aggregation of cellulose chains to form a cross-linked network structure. Cellulosic hydrogels are prepared by soaking cellulose in an Al2(SO4)3 solution, which is both strong (compressive strength of up to 16.99 MPa) and tough (compressive toughness of up to 2.86 MJ/m3). The prepared cellulosic hydrogels exhibit resistance to swelling in different solutions and good biodegradability in soil. The cellulosic hydrogels are incorporated into strain sensors for human-motion monitoring by introducing AgNWs. Thus, the study offers a promising, simple, and scalable approach for preparing strong, degradable, and anti-swelling hydrogels using common biomass resources with considerable potential for various applications.

Electrospinning and electrospun polysaccharide-based nanofiber membranes: A review

The electrospinning technology has set off a tide and given rise to the attention of a widespread range of research territories, benefiting from the enhancement of nanofibers which made a spurt of progress. Nanofibers, continuously produced via electrospinning technology, have greater specific surface area and higher porosity and play a non-substitutable key role in many fields. Combined with the degradability and compatibility of the natural structure characteristics of polysaccharides, electrospun polysaccharide nanofiber membranes gradually infiltrate into the life field to help filter air contamination particles and water pollutants, treat wounds, keep food fresh, monitor electronic equipment, etc., thus improving the life quality. Compared with the evaluation of polysaccharide-based nanofiber membranes in a specific field, this paper comprehensively summarized the existing electrospinning technology and focused on the latest research progress about the application of polysaccharide-based nanofiber in different fields, represented by starch, chitosan, and cellulose. Finally, the benefits and defects of electrospun are discussed in brief, and the prospects for broadening the application of polysaccharide nanofiber membranes are presented for the glorious expectation dedicated to the progress of the eras.

Structural performance of detachable precast concrete column-column joint

A novel type of detachable precast concrete column-column joint (DPC) is proposed in this study to solve the problems in current column-column dry connections including complex load path, uncertainty of structural stiffness of beam-column joints and inconvenience for disassembly. The dry connection technology is applied by composing of steel plate and concrete. Finite element models of DPC were created to study its structural performance including hysteresis curve, skeleton curve, ductility, and energy dissipation capacity. The benchmark models are firstly established and validated against the test data and after that a small-scale parametric study is prepared. The effect of axial pressure ratio and eccentricity distance size on the seismic performance of DPC was studied. Results indict that the optimal value of axial pressure ratio ranges from 0.5 to 0.7. With increase of the axial pressure ratio, the ductility coefficient shows a decreasing trend in general. The eccentricity has little effect on the energy dissipation capacity of the joint.

Decoding the potential role of regulatory T cells in sepsis-induced immunosuppression

Sepsis, a multiorgan dysfunction with high incidence and mortality, is caused by an imbalanced host-to-infection immune response. Organ-support therapy improves the early survival rate of sepsis patients. In the long term, those who survive the "cytokine storm" and its secondary damage usually show higher susceptibility to secondary infections and sepsis-induced immunosuppression, in which regulatory T cells (Tregs) are evidenced to play an essential role. However, the potential role and mechanism of Tregs in sepsis-induced immunosuppression remains elusive. In this review, we elucidate the role of different functional subpopulations of Tregs during sepsis and then review the mechanism of sepsis-induced immunosuppression from the aspects of regulatory characteristics, epigenetic modification, and immunometabolism of Tregs. Thoroughly understanding how Tregs impact the immune system during sepsis may shed light on preclinical research and help improve the translational value of sepsis immunotherapy.

Study on structure and properties of galactomannan and enzyme changes during fenugreek seeds germination

Fenugreek (Trigonella foenum-graecum L) galactomannan play an important role in the food and pharmaceutical sectors due to its attractive physicochemical properties. In this study, the changes of structure, properties and biological activity of fenugreek galactomannan (FG) during germination are analyzed by the activity and mechanism of endogenous enzymes (α-D-galactosidase and β-D-mannanase). The enzymes generally increased during germination and synergistically altered the structure of GM by cutting down the main chains and removing partial side residues. The mannose to galactose ratio (M/G) increased from 1.11 to 1.59, which is accompanied by a drastic decrease in molecular weight from 3.606 × 106 to 0.832 × 106 g/mol, and the drop of viscosity from 0.27 to 0.06 Pa·sn. The degraded macromolecules are attributed to the increase in solubility (from 64.55 % to 88.62 %). In terms of antioxidation and antidiabetic ability, germinated fenugreek galactomannan has the ability to scavenge 67.17 % ABTS free radicals and inhibit 86.89 % α-glucosidase. This galactomannan with low molecular weight and excellent biological activity precisely satisfies the current demands of pharmaceutical reagents and food industry. Seeds germination holds promise as a means of industrial scale production of low molecular weight galactomannans.

Enhancing enzymatic digestibility of bamboo residues using a combined low severity steam explosion and green liquor-sulfite pretreatment

In this study, the effect of the green liquor (GL)-sulfite pretreatment on bamboo for enzymatic hydrolysis was investigated. The performance characterization of the pretreated bamboo substrates, including the chemical composition, and the structural characteristics was carried out. The results showed that 91.3% of lignin removal was achieved when the sample was treated with a GL loading of 12.0 mL per g-DS at 120 °C for 1 h. After 120 h hydrolysis with 18 FPU per g-cellulose for cellulase and 27 CBU per g-cellulose for glucosidase, the glucose yield increased from 54.6% to 89.6%. The SE-treated bamboo could bind more easily to cellulase than GL-sulfite treated bamboo could. The structural changes on the surface of the samples were characterized by SEM. The results indicated that the surface lignin could be effectively removed during pretreatment, thereby decreasing the enzyme-lignin binding activity.

Computational Screening of a Single-Atom Catalyst Supported by Monolayer Nb2S2C for Oxygen Reduction Reaction

The search for high-performance catalysts to improve the catalytic activity for an oxygen reduction reaction (ORR) is crucial for developing a proton exchange membrane fuel cell. Using the first-principles method, we have performed computational screening on a series of transition metal (TM) atoms embedded in monolayer Nb2S2C to enhance the ORR activity. Through the scaling relationship and volcano plot, our results reveal that the introduction of a single Ni or Rh atom through substitutional doping into monolayer Nb2S2C yields promising ORR catalysts with low overpotentials of 0.52 and 0.42 V, respectively. These doped atoms remain intact on the monolayer Nb2S2C even at elevated temperatures. Importantly, the catalytic activity of the Nb2S2C doped with a TM atom can be effectively correlated with an intrinsic descriptor, which can be computed based on the number of d orbital electrons and the electronegativity of TM and O atoms.

Fully Biobased Degradable Vitrimer Foams: Mechanical Robust, Catalyst-Free Self-Healing, and Shape Memory Properties

Thermosetting foams have limited capabilities for recycling, reprocessing, or reshaping. Moreover, most of the foaming agents currently employed in these foams are derived from organic compounds sourced from petrochemicals, thereby posing a significant environmental threat due to heightened pollution. To solve these problems, a fully biobased degradable vitrimer foam (EPC-X) was fabricated using an environmentally friendly all-in-one foaming strategy by cross-linking epoxidized malepimaric anhydride (EMPA), 1,5-diaminopentane (PDA), and 1,5-diaminopentane carbamate (PDAC) as a latent curing-blowing agent. To our delight, the vitrimer foams exhibit excellent mechanical properties (2.86 ± 0.11 MPa compressive strength) owing to their unique rigid rosin backbone and cross-linking networks. The presence of dynamic β-hydroxy ester bonds and the self-catalytic behavior of tertiary amine groups facilitate network rearrangement without requiring additional catalysts, thereby resulting in the development of EPC-X with rapid self-healing and shape memory properties. The self-healing foam could support a weight of 500 g (approximately 562 times its own mass). Moreover, these high-performance vitrimer foams can also be easily degraded in an ethanolamine (EA) or NaOH solution under mild conditions. Such a design strategy offers an alternative approach for developing superior degradable and thermal stimuli-responsive thermosetting foams.

Toripalimab plus axitinib versus sunitinib as first-line treatment for advanced renal cell carcinoma: RENOTORCH, a randomized, open-label, phase III study

BACKGROUND

Immune checkpoint inhibitors in combination with tyrosine kinase inhibitors are standard treatments for advanced clear cell renal cell carcinoma (RCC). This phase III RENOTORCH study compared the efficacy and safety of toripalimab plus axitinib versus sunitinib for the first-line treatment of patients with intermediate-/poor-risk advanced RCC.

PATIENTS AND METHODS

Patients with intermediate-/poor-risk unresectable or metastatic RCC were randomized in a ratio of 1 : 1 to receive toripalimab (240 mg intravenously once every 3 weeks) plus axitinib (5 mg orally twice daily) or sunitinib [50 mg orally once daily for 4 weeks (6-week cycle) or 2 weeks (3-week cycle)]. The primary endpoint was progression-free survival (PFS) assessed by an independent review committee (IRC). The secondary endpoints were investigator-assessed PFS, overall response rate (ORR), overall survival (OS), and safety.

RESULTS

A total of 421 patients were randomized to receive toripalimab plus axitinib (n = 210) or sunitinib (n = 211). With a median follow-up of 14.6 months, toripalimab plus axitinib significantly reduced the risk of disease progression or death by 35% compared with sunitinib as assessed by an IRC [hazard ratio (HR) 0.65, 95% confidence interval (CI) 0.49-0.86; P = 0.0028]. The median PFS was 18.0 months in the toripalimab-axitinib group, whereas it was 9.8 months in the sunitinib group. The IRC-assessed ORR was significantly higher in the toripalimab-axitinib group compared with the sunitinib group (56.7% versus 30.8%; P < 0.0001). An OS trend favoring toripalimab plus axitinib was also observed (HR 0.61, 95% CI 0.40-0.92). Treatment-related grade ≥3 adverse events occurred in 61.5% of patients in the toripalimab-axitinib group and 58.6% of patients in the sunitinib group.

CONCLUSION

In patients with previously untreated intermediate-/poor-risk advanced RCC, toripalimab plus axitinib provided significantly longer PFS and higher ORR than sunitinib and had a manageable safety profile TRIAL REGISTRATION: ClinicalTrials.gov NCT04394975.

Efficient production of xylooligosaccharides from Camellia oleifera shells pretreated by pyruvic acid at lower temperature

XOS production from lignocellulose using organic carboxylic acids and alkyd acids has been widely reported. However, it still faces harsh challenges such as high energy consumption, high cost, and low purity. Pyruvic acid (PYA), a carbonyl acid with carbonyl and carboxyl groups, was used to produce XOS due to its stronger catalytic activity. In this work, XOS was efficiently prepared from COS in an autoclave under the condition of 0.21 M PYA-121 °C-35 min. The total yield of XOS reached 68.72 % without producing any toxic by-products, including furfural (FF) and 5-hydroxymethylfurfural (5-HMF). The yield of xylobiose (X2), xylotriose (X3), xylotetraose (X4), and xylopentaose (X5) were 20.58 %, 12.47 %, 15.74 %, and 10.05 %, respectively. Meanwhile, 89.05 % of lignin was retained in the solid residue, which provides a crucial functional group for synthesizing layered carbon materials (SRG-a). It achieves excellent electromagnetic shielding (EMS) performance through graphitization, reaching -30 dB at a thickness of 2.0 mm. The use of a PYA catalyst in the production of XOS has proven to be an efficient method due to lower temperature, lower acid consumption, and straightforward operation.

Structural characterization of lignin from the green pretreatments for co-producing xylo-oligosaccharides and glucose: Toward full biomass utilization

Three green non-enzymatic catalysis pretreatments (NECPs) including autohydrolysis, subcritical CO2-assisted seawater autohydrolysis, and inorganic salt catalysis were utilized to simultaneously produce xylo-oligosaccharides (XOS), glucose, and cellulolytic enzyme lignin (CEL) from sugarcane bagasse (SCB). The yield of XOS in all three NECPs was over 50 % with a competitive glucose yield of enzymatic hydrolysis. And the effects of different pretreatments on the chemical structure and composition of CEL samples were also investigated. The pretreatments significantly increased the thermal stability, yield, and purity of the CEL samples. Moreover, the net yield of lignin was 58.3 % with lignin purity was 98.9 % in the autohydrolysis system. Furthermore, there was a decrease in the molecular weight of CEL samples as the pretreatment intensity increased. And the original lignin structural units sustained less damage during the NECPs, due to the cleavage of the β-O-4 bonds dominating lignin degradation. Meanwhile, these pretreatments increased the phenolic-OH in CEL samples, making the lignin more reactive, and enhancing its subsequent modification and utilization. Collectively, the described techniques have demonstrated practical significance for the coproduction of XOS and glucose, and lignin, providing a promising strategy for full utilization of biomass.

Fabrication of multi-functional biodegradable liquid mulch utilizing xyloglucan derived from tamarind waste for agricultural application

Biodegradable liquid mulch is considered a promising alternative to plastic mulch for sustainable agriculture. This work proposed a xyloglucan-based liquid mulch with multi-function using a combination of chemical modification and blending methods. The esterification product of tamarind xyloglucan (TXG) from forestry wastes was synthesized with benzoic anhydride (BA). The effect of esterification modification was investigated, and BA-TXG was utilized as a film-forming and sand-fixation agent. The rheological properties, thermal stability, and hydrophobicity were improved following esterification. Additionally, waterborne polyurethane and urea were incorporated into the mulch to enhance its mechanical strength (23.28 MPa, 80.71 %), and homogeneity, as well as improve its nutritive properties. The xyloglucan-based liquid mulch has excellent UV protection, a high haze value (approximately 90 %), and retains water at a rate of 80.45 %. SEM and immersion experiment showed the effect of xyloglucan-based liquid mulch on sustainable sand-fixation. Moreover, the liquid mulch treatment demonstrated an impressive germination rate of 83.8 % and degradation rate of 51.59 % (60 days). The modified polysaccharide film increases stability and slows down the degradation rate. Tamarind xyloglucan-based liquid mulch exhibits powerful and diverse optical properties as well as sand fixation functions, indicating their great potential in sustainable agriculture as an alternative to plastic mulch.

Determination of the phase ratio of a dehydroabietic-acid-bonded silica-gel chromatographic stationary phase and its effect on separation thermodynamics

Rosin-based chromatographic columns are widely used for separation purposes, but, to date, their phase ratios (Φ) have been imprecisely measured. This affects the understanding of their separation mechanism and the calculation of related thermodynamic parameters. In this study, a stationary phase was synthesized by bonding dehydroabietic acid (DA) to silica gel (Si-DO) and applied for reversed-phase liquid chromatography. The distribution coefficient (Kdm) of methyl dehydroabietate (MD), which has the same structure as the bonded phase of Si-DO, was used as a surrogate for the determination of the equilibrium coefficient (K) of Si-DO, and the Kdm values of MD in different mobile phases were measured and compared with the K values of Si-DO. It was found that the phase ratio of Si-DO varied with mobile phase composition and temperature, as shown by the Φ values: 0.039-0.122 for the methanol/water system and 0.051-0.116 for the acetonitrile/water system; in addition, the a indices were 0.552-0.757 and 0.564-0.674, respectively. The Kdm of MD was closer to the K of Si-DO than those of other surrogate models, including the octanol-water and octane-mobile phase partition coefficients. In addition, the thermodynamic parameters (ΔG°, ΔH°, and ΔS°) of n-alkylbenzenes on Si-DO were negative, indicating a spontaneous and enthalpy-driven separation process. Overall, the phase ratio of rosin-based columns is crucial for accurate thermodynamic analysis and interpretation of the separation mechanism. Finally, the MD surrogate model allows the estimation of phase ratio of Si-DO and other similar columns, providing a novel method for measuring the phase ratio of rosin-based columns and providing a validated concept and methodology for determining the phase ratios of HPLC columns.

CO2-Responsive Rosin-Based Supramolecular Hydrogels: Diverse Chiral Nanostructures and Their Application in In Situ Synthesis of Chiral Gold Nanoparticles

Natural small molecules have demonstrated tremendous potential for the construction of supramolecular chiral nanostructures owing to their unique molecular structures and chirality. In this study, novel CO2-responsive supramolecular hydrogels were constructed using a series of rosin-based surfactants (CnMPAN, n = 10, 12, and 14). The macroscopic properties, rheological properties, nanostructures, and intermolecular interactions of the hydrogels were investigated using differential scanning calorimetry, rotational rheometry, cryogenic transmission electron microscopy, and Fourier transform infrared spectroscopy. Interestingly, diverse nanostructures containing helical nanofibers, interwoven nanofibers, and twisted nanoribbons were formed in the hydrogels, which were rarely observed in reported supramolecular hydrogels, and the strength of the hydrogels was significantly enhanced by increasing the CnMPAN concentration and the alkyl chain length. The obtained hydrogels exhibited excellent CO2-responsiveness, with no obvious variation in the nanostructures and rheological properties after response to CO2/N2 for five cycles. Taking advantage of the chiral nanostructures of hydrogels, gold nanoparticles (GNPs) were further prepared. The average particle sizes of the resulting GNPs were as low as 2.5 nm, and the GNPs also had a chiral structure. It is worth noting that no additional reductants and UV-light irradiation were used during the reduction process of GNPs. This study emphasizes that the unique molecular structure and chirality of rosin are critical for the preparation of hydrogels with chiral nanostructures. In addition, this study enriches the applications of forest resources.

Factors associated with nocturnal and diurnal glycemic variability in patients with type 2 diabetes: a cross-sectional study

PURPOSE

There is little information on factors that influence the glycemic variability (GV) during the nocturnal and diurnal periods. We aimed to examine the relationship between clinical factors and GV during these two periods.

METHODS

This cross-sectional study included 134 patients with type 2 diabetes. 24-h changes in blood glucose were recorded by a continuous glucose monitoring system. Nocturnal and diurnal GV were assessed by standard deviation of blood glucose (SDBG), coefficient of variation (CV), and mean amplitude of glycemic excursions (MAGE), respectively. Robust regression analyses were performed to identify the factors associated with GV. Restricted cubic splines were used to determine dose-response relationship.

RESULTS

During the nocturnal period, age and glycemic level at 12:00 A.M. were positively associated with GV, whereas alanine aminotransferase was negatively associated with GV. During the diurnal period, homeostatic model assessment 2-insulin sensitivity (HOMA2-S) was positively associated with GV, whereas insulin secretion-sensitivity index-2 (ISSI2) was negatively associated with GV. Additionally, we found a J-shape association between the glycemic level at 12:00 A.M. and MAGE, with 9.0 mmol/L blood glucose level as a cutoff point. Similar nonlinear associations were found between ISSI2 and SDBG, and between ISSI2 and MAGE, with ISSI2 value of 175 as a cutoff point.

CONCLUSION

Factors associated with GV were different between nocturnal and diurnal periods. The cutoff points we found in this study may provide the therapeutic targets for beta-cell function and pre-sleep glycemic level in clinical practice.

A novel strategy by combining foam fractionation with high-speed countercurrent chromatography for the rapid and efficient isolation of antioxidants and cytostatics from Camellia oleifera cake

Camellia oleifera cake is a by-product, which is rich in functional chemical components. However, it is typically used as animal feed with no commercial value. The purpose of this study was to isolate and identify compounds from Camellia oleifera cake using a combination of foam fractionation and high-speed countercurrent chromatography (HSCCC) and to investigate their biological activities. Foam fractionation with enhanced drainage through a hollow regular decahedron (HRD) was first established for simultaneously enriching flavonoid glycosides and saponins for further separation of target compounds. Under suitable operating conditions, the introduction of HRD resulted in a threefold increase in enrichment ratio with no negative effect on recovery. A novel elution-extrusion countercurrent chromatography (EECCC) coupled with the consecutive injection mode was established for the successful simultaneous isolation of flavonoid glycosides and saponins. As a result, 38.7 mg of kaemferol-3-O-[2-O-D-glucopyranosyl-6-O-α-L-rhamnopyranosyl]-β-D-glucopyranoside (purity of 98.17%, FI), 70.8 mg of kaemferol-3-O-[2-O-β-D-xylopyranosyl-6-O-α-L-rhamnopyranosyl]-β-D-glucopyranoside (purity of 97.52%, FII), and 560 mg of an oleanane-type saponin (purity of 92.32%, FIII) were separated from the sample (900 mg). The present study clearly showed that FI and II were natural antioxidants (IC50 < 35 μg/mL) without hemolytic effect. FIII displayed the effect of inhibiting Hela cell proliferation (IC50 < 30 μg/mL). Further erythrocyte experiments showed that this correlated with the extremely strong hemolytic effect of FIII. Overall, this study offers a potential strategy for efficient and green isolation of natural products, and is beneficial to further expanding the application of by-products (Camellia oleifera cake) in food, cosmetics, and pharmacy.

Personalized Computational Causal Modeling of the Alzheimer Disease Biomarker Cascade

BACKGROUND

Mathematical models of complex diseases, such as Alzheimer's disease, have the potential to play a significant role in personalized medicine. Specifically, models can be personalized by fitting parameters with individual data for the purpose of discovering primary underlying disease drivers, predicting natural history, and assessing the effects of theoretical interventions. Previous work in causal/mechanistic modeling of Alzheimer's Disease progression has modeled the disease at the cellular level and on a short time scale, such as minutes to hours. No previous studies have addressed mechanistic modeling on a personalized level using clinically validated biomarkers in individual subjects.

OBJECTIVES

This study aimed to investigate the feasibility of personalizing a causal model of Alzheimer's Disease progression using longitudinal biomarker data.

DESIGN/SETTING/PARTICIPANTS/MEASUREMENTS

We chose the Alzheimer Disease Biomarker Cascade model, a widely-referenced hypothetical model of Alzheimer's Disease based on the amyloid cascade hypothesis, which we had previously implemented mathematically as a mechanistic model. We used available longitudinal demographic and serial biomarker data in over 800 subjects across the cognitive spectrum from the Alzheimer's Disease Neuroimaging Initiative. The data included participants that were cognitively normal, had mild cognitive impairment, or were diagnosed with dementia (probable Alzheimer's Disease). The model consisted of a sparse system of differential equations involving four measurable biomarkers based on cerebrospinal fluid proteins, imaging, and cognitive testing data.

RESULTS

Personalization of the Alzheimer Disease Biomarker Cascade model with individual serial biomarker data yielded fourteen personalized parameters in each subject reflecting physiologically meaningful characteristics. These included growth rates, latency values, and carrying capacities of the various biomarkers, most of which demonstrated significant differences across clinical diagnostic groups. The model fits to training data across the entire cohort had a root mean squared error (RMSE) of 0.09 (SD 0.081) on a variable scale between zero and one, and were robust, with over 90% of subjects showing an RMSE of < 0.2. Similarly, in a subset of subjects with data on all four biomarkers in at least one test set, performance was high on the test sets, with a mean RMSE of 0.15 (SD 0.117), with 80% of subjects demonstrating an RMSE < 0.2 in the estimation of future biomarker points. Cluster analysis of parameters revealed two distinct endophenotypic groups, with distinct biomarker profiles and disease trajectories.

CONCLUSION

Results support the feasibility of personalizing mechanistic models based on individual biomarker trajectories and suggest that this approach may be useful for reclassifying subjects on the Alzheimer's clinical spectrum. This computational modeling approach is not limited to the Alzheimer Disease Biomarker Cascade hypothesis, and can be applied to any mechanistic hypothesis of disease progression in the Alzheimer's field that can be monitored with biomarkers. Thus, it offers a computational platform to compare and validate various disease hypotheses, personalize individual biomarker trajectories and predict individual response to theoretical prevention and therapeutic intervention strategies.

Structural variations of lignin and lignin-carbohydrate complexes from the fruit shells of Camellia oleifera during ripening

Camellia oleifera fruit shell (CFS), a waste lignocellulosic biomass resulting from Camellia oleifera oil production industry, is abundantly available in Southern China. Herein, to understand the structural variations of CFS lignins and lignin-carbohydrate complexes (LCC) during ripening, the native lignin and LCC fractions from CFS (harvested every seven days from October 1 to 30, 2022) were isolated and characterized systematically. The molecular weights of both MWL and DEL fractions steadily increased during ripening. CFS lignins contained abundance of β-O-4' linkages (maximum of 58.6 per 100Ar in DEL-2), and had low S/G ratios (S/G < 0.6). Moreover, the amounts of β-O-4' linkages in MWL, DEL, and LCC-AcOH fractions increased first and then decreased during ripening. The main lignin-carbohydrate linkages in the LCC-AcOH fractions were benzyl-ether (7.0-9.4 per 100Ar) and phenyl-glycoside (4.5-5.2 per 100Ar) bonds. Based on the quantitative results, the potential structural diagrams of lignins from different ripening stages of CFS were proposed. Additionally, the LCC-AcOH fractions exhibited pronounced antioxidant capacity and were promising as natural antioxidants. The properties and functions of lignin in plant cell walls, as well as its further appreciation, are crucial for the design and selection of feasible pretreatment strategies for the lignocellulosic materials.

Symptom Burden among Older COVID-19 Survivors Two Years after Hospital Discharge

To study the long-term symptom burden among older COVID-19 survivors 2 years after hospital discharge and identify associated risk factors. The current cohort study included COVID-19 survivors aged 60 years and above, who were discharged between February 12 and April 10, 2020, from two designated hospitals in Wuhan, China. All patients were contacted via telephone and completed a standardized questionnaire assessing self-reported symptoms, the Checklist Individual Strength (CIS)-fatigue subscale, and two subscales of the Hospital Anxiety and Depression Scale (HADS). Of the 1,212 patients surveyed, the median (IQR) age was 68.0 (64.0-72.0), and 586 (48.3%) were male. At the two-year follow-up, 259 patients (21.4%) still reported at least one symptom. The most frequently self-reported symptoms were fatigue, anxiety, and dyspnea. Fatigue or myalgia, which was the most common symptom cluster (11.8%; 143/1212), often co-occurred with anxiety and chest symptoms. A total of 89 patients (7.7%) had CIS-fatigue scores ≥ 27, with older age (odds ratio [OR], 1.08; 95% CI: 1.05-1.11, P < 0.001) and oxygen therapy (OR, 2.19; 95% CI: 1.06-4.50, P= 0.03) being risk factors. A total of 43 patients (3.8%) had HADS-Anxiety scores ≥ 8, and 130 patients (11.5%) had HADS-Depression scores ≥ 8. For the 59 patients (5.2%) who had HADS total scores ≥ 16, older age, serious illness during hospitalization and coexisting cerebrovascular diseases were risk factors. Cooccurring fatigue, anxiety, and chest symptoms, as well as depression, were mainly responsible for long-term symptom burden among older COVID-19 survivors 2 years after discharge.

Clinical service evaluation of the feasibility and reproducibility of novel artificial intelligence based-echocardiographic quantification of global longitudinal strain and left ventricular ejection fraction in trastuzumab-treated patients

Introduction

Cardiotoxicity is a potential prognostically important complication of certain chemotherapeutic agents that may result in preclinical or overt clinical heart failure. In some cases, chemotherapy must be withheld when left ventricular (LV) systolic function becomes significantly impaired, to protect cardiac function at the expense of a change in the oncological treatment plan, leading to associated changes in oncological prognosis. Accordingly, patients receiving potentially cardiotoxic chemotherapy undergo routine surveillance before, during and following completion of therapy, usually with transthoracic echocardiography (TTE). Recent advancements in AI-based cardiac imaging reveal areas of promise but key challenges remain. There are ongoing questions as to whether the ability of AI to detect subtle changes in individual patients is at a level equivalent to manual analysis. This raises the question as to whether AI-based left ventricular strain analysis could provide a potential solution to left ventricular systolic function analysis in a manner equivocal to or superior to conventional assessment, in a real-world clinical service. AI based automated analyses may represent a potential solution for addressing the pressure of increasing echocardiographic demands within limited service-capacity healthcare systems, in addition to facilitating more accurate diagnoses.

Methods

This clinical service evaluation aims to establish whether AI-automated analysis compared to conventional methods (1) is a feasible method for assessing LV-GLS and LVEF, (2) yields moderate to good correlation between the two approaches, and (3) would lead to different clinical recommendations with serial surveillance in a real-world clinical population.

Results and Discussion

We observed a moderate correlation (r = 0.541) in GLS between AI automated assessment compared to conventional methods. The LVEF quantification between methods demonstrated a strong correlation (r = 0.895). AI-generated GLS and LVEF values compared reasonably well with conventional methods, demonstrating a similar temporal pattern throughout echocardiographic surveillance. The apical-three chamber view demonstrated the lowest correlation (r = 0.423) and revealed to be least successful for acquisition of GLS and LVEF. Compared to conventional methodology, AI-automated analysis has a significantly lower feasibility rate, demonstrating a success rate of 14% (GLS) and 51% (LVEF).

Efficient co-production of xylo-oligosaccharides and fermentable sugars from sugarcane bagasse by glutamic acid pretreatment

In the production of xylo-oligosaccharides (XOS) by organic acid pretreatment, it is often difficult to isolate organic acids from XOS. Here, an acidic amino acid, glutamic acid (GA), was used to pretreat sugarcane bagasse (SCB) to prepare XOS and fermentable sugars. The effects of GA concentration, hydrolysis temperature, and pretreatment time on the yield and polymerization distribution of XOS were investigated. After hydrolysis by 0.2 M GA at 140 °C for 30 min, the maximum yield of X2-5 was 53.3%, and the concentrations of xylose and furfural were 1.8 g/L and 0.1 g/L, respectively. Meanwhile, GA increased the pore size and porosity of SCB as well as the number of functional groups of amino acid residues, which improved the enzymatic efficiency and the maximum yield of glucose was 95.3%. Thus, GA pretreatment provides a more economical, environmentally friendly and sustainable method for the co-production of XOS and glucose from SCB.

Traffic safety and public health in China - Past knowledge, current status, and future directions

Transportation-related harms have developed into a social disease, threatening public safety and health in China. We aimed to increase the global understanding of traffic safety and public health in China from past knowledge, current status, and future directions by collecting, collating, and analyzing the Chinese traffic incidents reported in the published literature. A systematic search of China National Knowledge Infrastructure, Weipu, and published articles referenced in PubMed, Web of Science and ProQuest between January 1, 1988 and April 30, 2023 was performed. China encountered the first recorded traffic accident as early as three thousand years ago in the Shang Dynasty. An increase in vehicle capacity and velocity increased the traffic risks during the transition from rickshaws and livestock to motor vehicles in varying traffic environments. Humans are not only the decisive factor of a large number of vehicles, traffic routes, and environmental variables, but also the victims at the end and starting point of traffic accidents. Injuries (mechanical force, burns) and diseases (traffic-related air pollution, noise) caused by traffic activities not only threaten public health, but also cause risks to safe driving. Analysis of traffic activities and biomarkers promotes the treatment of traffic injuries in ethology and medicine. China prepared for the construction of healthy transportation in the "decade of road safety" toward an estimation of worldwide road traffic injuries in 2030. Improvement of traffic safety concerning public health under the "Outline of the National Comprehensive Three-dimensional Transportation Network Planning" in China will propel the realization of worldwide traffic environmental advancement.

Erratum: Search for Cosmic-Ray Boosted Sub-GeV Dark Matter Using Recoil Protons at Super-Kamiokande [Phys. Rev. Lett. 130, 031802 (2023)]

This corrects the article DOI: 10.1103/PhysRevLett.130.031802.

Determining the Dosimetric Accuracy of Deep Learning-Based Fully Automated Registration-Segmentation Approach for Thoracic Cancer Organs-at-Risk Contouring

PURPOSE/OBJECTIVE(S)

For adaptive radiation therapy (ART), the contours on the planning CT (pCT) are frequently propagated to cone-beam CT (CBCT) via deformable image registration and manually edited, which is observer-dependent and time-consuming. To automate this process, we created a fully automated workflow by combining a deep learning (DL)-based pCT segmentation model with a CT-to-CBCT registration-segmentation DL model. The purpose of our research is to determine how using the proposed workflow's automatically generated contours affects thoracic organs-at-risk sparing (OAR).

MATERIALS/METHODS

Seven patients with locally advanced non-small cell lung cancer who underwent treatment with intensity modulated radiation therapy were included in this study. Each patient's pCT was segmented using a published DL model that has been used for generating thoracic OAR segmentation and radiotherapy planning in the clinic since July of 2020. Next, pCT was deformably registered using a published recurrent deep registration-segmentation method. Whereas the original method's segmentation sub-network was only trained to segment esophagus, the registration sub-network was used to propagate contours for heart, esophagus, and the proximal bronchial tree (PBT). Geometric segmentation accuracy using the Dice Similarity Coefficient (DSC) and the 95th percentile Hausdorff Distance (HD) and dose metrics including the mean esophageal dose (MED) and D90% of the heart (D90) were computed from the total accumulated dose for the first two weeks of treatment.

RESULTS

The esophagus had a high DSC and a low HD (0.93 and 2.85mm) and conversely, the heart had lower accuracy (DSC = 0.85, HD = 22.06mm). PBT showed relatively high performance as well, with DSC of 0.91 and HD of 2.28mm, owing to its proximity to the esophagus. The accumulated MED for manual contour was slightly lower than AI-contours (11.34 vs 11.83 Gy), suggesting reliability of the proposed workflow. The reverse is seen for the D90 of the heart (manual = 1.74 and AI-contour = 1.56 Gy), likely due to the heart not being included in the original DL framework.

CONCLUSION

This study reported preliminary results on the feasibility of using a fully automated and patient-specific workflow for CBCT auto-segmentation in ART, confirming its role as a geometrically and dosimetrically accurate solution for thoracic OARs. However, because it is currently limited to the esophagus, we believe that re-training the algorithm will increase confidence in other OARs such as the heart and lungs.

Coproduction of xylooligosaccharides, glucose, and less-condensed lignin from sugarcane bagasse using syringic acid pretreatment

Current strategies for the production of xylooligosaccharides (XOS) from biomass through non-enzymatic catalysis often led to a certain degree of lignin condensation, which severely restrains subsequent enzyme hydrolysis of cellulose. Herein, syringic acid (SA) pretreatment was investigated to coproduce XOS, glucose, and less-condensed lignin from sugarcane bagasse. SA acted as a catalyst and lignin condensation inhibitor during the pretreatment. The highest XOS yield of 58.7% (27.7% xylobiose and 24.7% xylotriose) was obtained at 180 °C - 20 min - 9% SA, and the corresponding xylose/XOS ratio was only 0.42. Compared with the pretreatment at 180 °C - 20 min - 0% SA, the addition of 9% SA increased the glucose yield from 85.7% to 92.4% and decreased the degree of lignin condensation from 0.55 to 0.42. Moreover, 26.7% of SA could be easily recovered. This work presents a pretreatment strategy in which the efficient production of XOS and the suppression of lignin condensation are achieved simultaneously.

Clinical Feasibility of Deep Learning-Based CT during Treatment CBCT Tumor Registration-Segmentation in Thoracic Radiotherapy (RT)

PURPOSE/OBJECTIVE(S)

Accurate tumor segmentation on weekly cone-beam computed tomography (CBCT) images is critical for image-guided and adaptive radiation therapy (ART). In thoracic RT, low image contrast, imaging artifact, and geometry and image modality differences from the planning CT (pCT) typically limits accurate tumor segmentation and registration. Here, we explored the clinical feasibility of using 3D recurrent registration-segmentation deep learning (DL) that combines patient-specific anatomic and shape context from higher contrast pCT and planning contours (PACs) for tumor segmentation on during treatment CBCTs.

MATERIALS/METHODS

We included the pCT and CBCTs from six patients with locally advanced non-small cell lung cancer (LA-NSCLC) who had underwent RT. Cases were selected with a primary GTV contoured and labeled separately from the nodal GTV. Using rigidly aligned pCT and CBCT as inputs, DL auto-segmented the GTV on week 1 and 6 CBCTs, and these auto-segmented contours were manually inspected by a radiation oncologist that edited the GTV according to clinical standard quality. The Dice similarity coefficient (DSC), Hausdorff distance (HD95), mean surface distance (MSD), surface DSC (sDSC) and added path length (APL) were used to quantitively compare the DL and the edited GTV.

RESULTS

The primary GTV was in the right lung in five cases, and left lung in one case. Manual adjustments were typically made at the interface of GTV and lung parenchyma with partial inclusion of adjacent vessels. Hypodensities within the GTV were sometimes not segmented in all axial slices resulting in discontinuous components. The quantitative comparison between the edited and DL-generated GTV is shown in Table 1. For week 1, the average DSC and HD95 were 0.87 and 6.94 mm, respectively. The performance for week 6 was slightly lower than week 1, with a DSC of 0.85 and HD95 of 7.22 mm.

CONCLUSION

The agreement with the generated DL GTV and the edited GTV was high in week 1 and decreased somewhat later during the treatment course possibly due to a higher impact of geometric changes in tumor and adjacent structures. The proposed DL algorithm showed reasonable performance throughout the treatment, supporting its potential for use into clinical routine for LA-NSCLC.

Augmenting Prediction of Intracranial Aneurysms' Risk Status Using Velocity-Informatics: Initial Experience

Our primary goal here is to demonstrate that innovative analytics of aneurismal velocities, named velocity-informatics, enhances intracranial aneurysm (IA) rupture status prediction. 3D computer models were generated using imaging data from 112 subjects harboring anterior IAs (4-25 mm; 44 ruptured and 68 unruptured). Computational fluid dynamics simulations and geometrical analyses were performed. Then, computed 3D velocity vector fields within the IA dome were processed for velocity-informatics. Four machine learning methods (support vector machine, random forest, generalized linear model, and GLM with Lasso or elastic net regularization) were employed to assess the merits of the proposed velocity-informatics. All 4 ML methods consistently showed that, with velocity-informatics metrics, the area under the curve and prediction accuracy both improved by approximately 0.03. Overall, with velocity-informatics, the support vector machine's prediction was most promising: an AUC of 0.86 and total accuracy of 77%, with 60% and 88% of ruptured and unruptured IAs being correctly identified, respectively.

Correlation between nocturnal intermittent hypoxemia and mild cognitive impairment in the older adult and the role of BDNF Val66Met polymorphism: a hospital-based cross-sectional study

PURPOSE

To explore the prevalence of nocturnal intermittent hypoxemia (NIH) in a tertiary hospital geriatric department and the relationship between NIH and mild cognitive impairment (MCI) in older adults, and to examine the role of brain-derived neurotrophic factor (BDNF) Val66Met polymorphism.

METHODS

Older adults aged ≥ 60 were enrolled. NIH and cognitive assessments were conducted. BDNF concentrations and BDNF Val66Met polymorphism were detected for a preliminary exploration of the possible mechanism of the process.

RESULTS

Of 325 older adults enrolled, 157 (48%) had NIH and were further divided into mild, moderate, and severe NIH groups according to their oxygen desaturation of ≥ 4% per hour of sleep (ODI4). MCI detection rate in the four groups gradually increased, and the differences were statistically significant (chi-square = 4.457, P = 0.035). ODI4 was negatively correlated with MoCA score in all participants (r =  - 0.115, P = 0.039) and patients with NIH (r =  - 0.199, P = 0.012). After adjusting for sex, age, and cardiovascular risk factors, NIH and MCI remained independently associated (OR = 3.13, 95% CI 1.03-9.53, P = 0.045). BDNF levels were positively correlated with MoCA score (r = 0.169, P = 0.028) and negatively correlated with nocturnal average oxygen saturation in patients with NIH (r =  - 0.288, P = 0.008). Older adults with different BDNF Val66Met genotypes did not show significant differences in MCI rate and BDNF levels (P > 0.05).

CONCLUSION

The older adults with NIH have a higher MCI detection rate. BDNF levels may be a potential biomarker for cognitive dysfunction in patients with NIH.

The Effect of MDSC-Derived Exosomes Played in Esophageal Squamous Carcinoma Cells after Ionizing Radiation

PURPOSE/OBJECTIVE(S)

Radiotherapy is the main treatment for esophageal cancer. Previous studies have shown that radiotherapy not only kills tumor cells directly, but also reshapes the immune microenvironment of the tumor. It has been reported an increase in the recruitment of myeloid-derived suppressor cells (MDSC) can occur in tumor tissue after ionizing radiation. Exosomes are mediators of intercellular information exchange and are also involved in the regulation of the tumor microenvironment. In this study, we wanted to understand whether MDSC in esophageal cancer tissue are involved in the regulation of tumor cell response to ionizing radiation via exosomes.

MATERIALS/METHODS

KYSE-150 was used to construct a subcutaneous transplantation tumor model in nude mice. And then mice irradiated with 5 Gy×5fx and 0 Gy×5fx respectively. After irradiation, the spleens of the mice were used to isolate MDSC, and collect the cell supernatants to extract the exosomes. Based on the exosomes, we divided the experiment into three groups (control, exosomes, exosomes+radiation). Exosomes were injected into a nude mouse model of esophageal cancer via the tail vein or co-cultured with KYSE-150 cells. Mice were irradiated with a 5 Gy×5fx after completion of injection, and KYSE-150 cells were irradiated with a single dose 4 Gy. After radiation, KYSE-150 cells were used to detect cell cloning, apoptosis and cell cycle by flow cytometry, cell proliferation by CCK 8. XRCC4,XRCC5,XRCC6,γH2AX,ATM expression in cells and tumor tissue were measured by Western blot and RT-PCR.

RESULTS

The tumor volume was significantly reduced after 5 Gy x 5fx radiation. When exosomes co-cultured with KYSE-150 cells, decrease in apoptosis and increase in cell cloning and cell proliferation were found in the exosomes+radiation group and exosomes group after radiation when compared with the control group, with this change being more pronounced in the exosome+radiation group. The results of the cell cycle assay showed that after ionizing radiation, the proportion of cells in the G0/G1 phase was significantly lower, and the proportion of cells in the S and G2/M phases were significantly higher in the exosomes+radiation group and exosomes group when compared to the Control group. The protein and mRNA expression of XRCC4,XRCC5,XRCC6,γH2AX,ATM in cells were increased in exosomes+radiation group and exosomes group after radiation when compared with the control group, with this change being more obvious in the exosome+radiation group. After irradiation, tumor volumes were measured in nude mice and the results showed that exosomes+radiation group tumors were the largest in volume, while the control group regressed most significantly after irradiation.

CONCLUSION

MDSC-derived exosomes have a tumor growth-promoting effect in esophageal squamous carcinoma, which is enhanced by ionizing radiation, and this may be related to the accelerated repair of damage in tumor tissue after radiation.

A Combined Phase 0/2 "Trigger" Trial Evaluating Pamiparib or Olaparib with Concurrent Radiotherapy in Patients with Newly-Diagnosed or Recurrent Glioblastoma

PURPOSE/OBJECTIVE(S)

This study evaluates the pharmacokinetic (PK) and pharmacodynamic (PD) profiles and clinical efficacy of PARP1/2 selective inhibitors, pamiparib and olaparib, in newly-diagnosed or recurrent glioblastoma (GBM) patients in combination with radiotherapy (RT).

MATERIALS/METHODS

In this combined phase 0/2 trial presumed newly-diagnosed (Arm A) or recurrent (Arm B) GBM patients received 4 days of pamiparib (60 mg BID) prior to resection either 2-4 or 8-12 hours following the final dose. Arm C enrolled patients with recurrent GBM to 4 days of olaparib (200 mg BID) prior to resection. Enhancing and nonenhancing tumor tissue, cerebrospinal fluid (CSF) and plasma were collected. Total and unbound drug concentrations were measured using validated LC-MS/MS methods. A PK 'trigger', defined as unbound drug and gt; 5-fold biochemical IC 50 in nonenhancing tumor, determined eligibility for the therapeutic expansion phase 2. PARP inhibition was assessed via ex vivo radiation and quantification of PAR levels compared to non-radiated control. Newly-diagnosed MGMT unmethylated GBMs and recurrent GBMs exceeding the PK threshold were eligible for an expansion phase of pamiparib (Arms A and B) or olaparib (Arm C) with concurrent RT followed by maintenance pamiparib or olaparib. RT was 60 Gy in 30 fractions in newly-diagnosed patients and 40 Gy in 15 fractions in recurrent patients, delivered using volumetric-modulated arc therapy (VMAT).

RESULTS

A total of 38 patients (Arm A, n = 16; Arm B, n = 16; Arm C, n = 6) were enrolled in the initial phase 0 study. The mean unbound concentrations of pamiparib in nonenhancing tumor region for Arm A and Arm B were 167.3 nM and 109.4 nM respectively, and in Arm C the mean unbound concentration of olaparib was 5.2 nM. All patients in the pamiparib arms (n = 32/32) but only 1 of 6 patients in the olaparib Arm C exceeded the PK threshold. Radiation-induced PAR expression was 2.44-fold in untreated control vs 1.16 in Arm A (p<0.05), 0.85 in Arm B (p<0.01) and 1.11 in Arm C patients, respectively. In Arm A, 11 patients had unmethylated tumors, and of those, 7 patients enrolled in phase 2. In Arm B, 9 of the 16 clinically eligible patients with positive PK results were enrolled in phase 2. At a median follow-up of 8.4 months [range: 1.3-15.7 months], the median progression-free survival (PFS) was 5.4, 6.0, and 3.8 months for Arms A (n = 7), B (n = 9), and C (n = 1), respectively. Grade 3+ toxicities related to pamiparib occurred in 4 patients, with 2 adverse events resulting in treatment discontinuation. No grade 3+ toxicities were documented in the olaparib arm.

CONCLUSION

Pamiparib achieved pharmacologically-relevant concentrations in nonenhancing GBM tissue and suppressed induction of PAR levels ex vivo post-radiation. The majority of patients with MGMT-unmethylated GBM advanced to the phase 2 portion of the trial, and pamiparib was generally well-tolerated in these patients.

AI Serial Image Prediction of Progression-Free Survival (PFS) for Locally Advanced Non-Small Cell Lung Cancer (LA-NSCLC) Patients Treated with Chemoradiation (CRT) and Durvalumab Consolidation

PURPOSE/OBJECTIVE(S)

Patient outcomes with definitive CRT for LA-NSCLC remain poor, with no imaging biomarkers to predict benefit. Hence, we developed a serial image AI model using paired planning CT (pCT) and first week cone-beam CT (CBCT) to predict PFS and measured AI model fairness defined as the bias in the classification with respect to gender as a protected attribute.

MATERIALS/METHODS

Sixty-four consecutive patients with LA-NSCLC treated with concurrent CRT to 60 Gy in 30 fractions and durvalumab consolidation were analyzed. Three prediction models were created. A previously developed AI image foundation model [1] was pre-trained with unlabeled 6,402 3D CT scans sourced from institutional and the Cancer Imaging Archive and modified to predict PFS as a binarized outcome (high PFS > 6 months and low PFS < 6 months) using pCT scans. Serial image AI model was created by adding the first week CBCT scan. The third model measured tumor growth rate (TGR) as relative change in tumor and nodal volume from pCT to CBCT derived using a different published AI model [2]. Association with PFS using univariable and multivariable Cox regression after adjusting for age, gender, planning tumor volume, and smoking status were measured using TGR and the two AI model predictions using a cutoff of > 50% probability for low PFS. AI model fairness metrics area under receiver operating curve (AUROC), precision, sensitivity, and specificity were computed.

RESULTS

TGR was not associated with PFS on univariate (Hazard ratio [HR] of 1.515, 95% confidence interval [CI] of 0.32 to 7.26, p = 0.60) or multivariate analysis (HR: 1.58, 95% CI: 0.32 to 7.80, p = 0.58) and resulted in a Harrell's C-index of 54.7%. The serial image AI model prediction was associated with PFS in both univariable (HR: 2.12, 95% CI: 1.02 to 4.40, p = 0.045) and multivariable analysis (HR 2.39, 95% CI of 1.09 to 5.25, p = 0.029), and a C-index of 62.5%. The pCT AI model was associated with PFS in univariate (HR 2.06, 95% CI of 1.06 to 4.01, p = 0.034) but not in multivariable analysis (HR 1.89, 95% CI of 0.93 to 3.87, p = 0.08), and a C-index of 59.9%. The serial image AI model reduced the parity in classification compared to pCT AI model indicating higher fairness (Table I).

CONCLUSION

The multi-image AI model predicted PFS with slightly higher accuracy and resulted in higher fairness than the pCT AI model. These results underscore the potential for incorporating multi-imaging biomarkers to predict treatment response.

CTGF promotes the repair and regeneration of alveoli after acute lung injury by promoting the proliferation of subpopulation of AEC2s

BACKGROUND

Functional alveolar regeneration is essential for the restoration of normal lung homeostasis after acute lung injury (ALI) and acute respiratory distress syndrome (ARDS). Lung is a relatively quiescent organ and a variety of stem cells are recruited to participate in lung repair and regeneration after lung tissue injury. However, there is still no effective method for promoting the proliferation of endogenous lung stem cells to promote repair and regeneration.

METHODS

Using protein mass spectrometry analysis, we analyzed the microenvironment after acute lung injury. RNA sequencing and image cytometry were used in the alveolar epithelial type 2 cells (AEC2s) subgroup identification. Then we used Sftpc+AEC2 lineage tracking mice and purified AEC2s to further elucidate the molecular mechanism by which CTGF regulates AEC2s proliferation both in vitro and in vivo. Bronchoalveolar lavage fluid (BALF) from thirty ARDS patients who underwent bronchoalveolar lavage was collected for the analysis of the correlation between the expressing of Krt5 in BALF and patients' prognosis.

RESULTS

Here, we elucidate that AEC2s are the main facultative stem cells of the distal lung after ALI and ARDS. The increase of connective tissue growth factor (CTGF) in the microenvironment after ALI promoted the proliferation of AEC2s subpopulations. Proliferated AEC2s rapidly expanded and differentiated into alveolar epithelial type 1 cells (AEC1s) in the regeneration after ALI. CTGF initiates the phosphorylation of LRP6 by promoting the interaction between Krt5 and LRP6 of AEC2s, thus activating the Wnt signaling pathway, which is the molecular mechanism of CTGF promoting the proliferation of AEC2s subpopulation.

CONCLUSIONS

Our study verifies that CTGF promotes the repair and regeneration of alveoli after acute lung injury by promoting the proliferation of AEC2s subpopulation.

Fluorescence probe technique for determining the hydrophobic interactions and critical aggregation concentrations of Gleditsia microphylla gum, circular Gleditsia sinensis gum, and tara gum

Circular Gleditsia sinensis gum, Gleditsia microphylla gum, and tara gum are galactomannans (GMs) with similar mannose/galactose (M/G) molar ratios, which complicates the characterization of physicochemical properties using conventional methods. Herein, the hydrophobic interactions and critical aggregation concentrations (CACs) of the GMs were compared using a fluorescence probe technique, in which the I1/I3 ratio of pyrene indicated polarity changes. With increasing GM concentration, the I1/I3 ratio decreased slightly in dilute solutions below the CAC but decreased sharply in semidilute solutions above the CAC, indicating that the GMs formed hydrophobic domains. However, increases in temperature destroyed the hydrophobic microdomains and increased the CACs. Higher concentrations of salts (SO42-, Cl-, SCN-, and Al3+) promoted hydrophobic microdomain formation, and the CACs in Na2SO4 and NaSCN solutions were lower than those in pure water. Hydrophobic microdomain formation also occurred upon Cu2+ complexation. Although urea addition promoted hydrophobic microdomain formation in dilute solutions, the microdomains were destroyed in semidilute solutions and the CACs increased. The formation or destruction of hydrophobic microdomains depended on the molecular weight, M/G ratio and galactose distribution of GMs. Therefore, the fluorescent probe technique enables the characterization of hydrophobic interactions in GM solutions, which can provide valuable insight into molecular chain conformations.

Lutein-Based pH and Photo Dual-Responsive Novel Liposomes Coated with Ce6 and PTX for Tumor Therapy

Liposomes are considered the best nanocarrier for delivering cancer drugs such as chlorin e6 (Ce6) and paclitaxel (PTX). However, the poor stability and non-selectivity release of liposomes may severely limit their further applications. In this study, based on the characteristics of lutein (L) photo-response and orthoester (OE) acid-response, stable and dual-responsive liposomes (Dr-lips) have been prepared. The Dr-lips exhibited a spherical shape with a uniform size of approximately 58.27 nm. Moreover, they displayed a zeta potential ranging from -45.45 to -28.25 mV and showed excellent storage stability, indicating stable colloidal properties. Additionally, they achieved high drug encapsulation rates, with 92.27% for PTX and 90.34% for Ce6, respectively. Meanwhile, under near-infrared (NIR) light at 660 nm, Ce6 plays a key role in accelerating the photodegradation rate of lutein and PEG-OE-L while also enhancing tissue penetration ability. Additionally, Dr-lips loaded with Ce6 and PTX not only displayed excellent pH and photo dual-responsiveness for targeted delivering and releasing but also showed remarkable reactive oxygen species (ROS) generation capacity and impressive anti-tumor activity in vitro. Therefore, it provides a novel strategy for optimizing stability and enhancing their targeted drug delivery of liposome.

VSIG2 promotes malignant progression of pancreatic ductal adenocarcinoma by enhancing LAMTOR2-mediated mTOR activation

BACKGROUND

Pancreatic ductal adenocarcinoma (PDAC) is one of the most intractable malignancies to overcome clinically due to its insidious onset as well as rapid progression. It is urgent to seek new diagnostic markers and therapeutic targets in order to furthest ameliorate the prognosis of patients with PDAC. V-set and immunoglobulin domain containing 2 (VSIG2) belongs to immunoglobulin superfamily (IgSF), which function as coinhibitory molecule to mediate immune evasion of tumors. Nevertheless, the role of VSIG2 in PDAC and related mechanism still keep unclear.

METHODS

Different expression of VSIG2 in PDAC tissues and cells were detected by bioinformatic analysis, immunohistochemistry, real-time quantitative PCR as well as western blotting. CCK-8, colony formation, Transwell assay, and scratch experiment were utilized to assess proliferation, invasion and migration properties of PDAC cells. The relationship of VSIG2 with late endosomal/lysosomal adaptor, MAPK and MTOR activator 2 (LAMTOR2) and mechanistic target of rapamycin (mTOR) was identified using mass spectrometry, co-immunoprecipitation and immunofluorescence. GO and KEGG enrichment analysis were performed for further pathway verification using western blotting. Additionally, subcutaneous xenograft tumor model and clinical samples analysis were implemented to further elucidate the oncogenic effect of VSIG2 on PDAC in vivo and clinically.

RESULTS

VSIG2 was highly expressed in PDAC tissues and cells. Overexpression of VSIG2 facilitated the proliferation, invasion and migration abilities of PDAC cells, while VSIG2-inhibition exerted opposite effects. Mechanistically, VSIG2 could simultaneously bind to LAMTOR2 and mTOR, thereby enhancing interaction between two molecules, which resulted in elevated phosphorylation-modificatory activation of mTOR and downstream key molecules. Clinically, up-regulation of VSIG2 was positively associated with advanced stage, overall survival and disease-free survival of PDAC patients.

CONCLUSIONS

Our study disclosed that VSIG2 was overexpressed in PDAC, which promoted the proliferation, invasion and metastasis. Mechanically, VSIG2 acted as a scaffold to recruit LAMTOR2 and mTOR simultaneously, stabilize the interaction between them, thus enhancing LAMTOR2-mediated mTOR phosphorylated activation. Collectively, VSIG2 could be exploited as a biomarker for diagnosis and prognosis monitor of PDAC in the future, meanwhile, targeting VSIG2 in PDAC management is expected to be a novel strategy. Video Abstract. Video Abstract.

[Comparison of long-term clinical outcomes between transvaginal mesh and pelvic floor reconstruction with native tissue repair in the treatment of advanced pelvic organ prolapse]

Objective: To study the long-term clinical effect of transvaginal mesh (TVM) and pelvic floor reconstruction with native tissue repair (NTR) in the treatment of advanced pelvic organ prolapse (POP). Methods: Totally 207 patients with advanced POP who were treated in Hunan Provincial Maternal and Child Health Care Hospital from Jan. 2016 to Sep. 2019 were enrolled. The patient's pelvic organ prolapse quantification were all at degree Ⅲ or above, and they all complained for different degree of symptoms. They were divided into two groups according to the different surgical methods, TVM group and NTR group. In TVM group, the mesh was implanted through the vagina for pelvic floor reconstruction, while in NTR group, the traditional transvaginal hysterectomy combined with uterosacral ligament suspension and anterior and posterior wall repair, as well as perineal body repair were performed. The median follow-up time was 60 months, during the follow up time, 164 cases (79.2%, 164/207) had completed follow-up, including 76 cases in TVM group and 88 cases in NTR group. The perioperative data and complication rates of the two groups were compared, and the subjective and objective outcomes of the two groups at 1, 3 and 5 years were observed, respectively. The objective efficacy was evaluated by three composite criteria, namely: (1) the distance from the farthest end of the prolapse of the anterior and posterior wall of the vagina to the hymen is ≤0 cm, and the descending distance of the top is ≤1/2 of the total length of the vagina; (2) determine the disappearance of relevant POP symptoms according to "Do you often see or feel vaginal mass prolapse？"; (3) no further operation or pessary treatment was performed due to prolapse. If the above three criteria were met at the same time, the operation is successful; otherwise, it was recurrence. The subjective efficacy was evaluated by the pelvic floor distress inventory-short form 20 (PFDI-20) and pelvic floor impact questionnaire-short form 7 (PFIQ-7). Results: The median follow-up time of the two groups was 60 months (range: 41-82 months). Five years after the operation, the subjective and objective cure rates of TVM group were 89.5% (68/76) and 94.7% (72/76), respectively. The subjective and objective cure rates in NTR group were 80.7% (71/88) and 85.2% (75/88), respectively. There were significant differences in the subjective and objective cure rates between the two groups (χ2=9.869, P=0.002; χ2=3.969, P=0.046). The recurrence rate of TVM group was 5.3% (4/76), and that of NTR group was 14.8% (13/88). There was a significant difference between the two groups (P=0.046). The postoperative PFDI-20 and PFIQ-7 scores of the two groups were significantly lower than those before surgery, and there were significant differences of the two groups before and after surgery (all P<0.05). Postoperative mesh exposure in TVM group was 1.3% (1/76). Conclusions: The long-term outcomes between the two groups show that the subjective and objective outcomes of pelvic floor reconstruction in TVM group are significantly higher than those in NTR group, and the recurrence rate is significantly lower than that in NTR group. TVM has certain advantages in the treatment of advanced POP.

[A clustered epidemic investigation of non-marital non-commercial heterosexual contact of HIV in Zhejiang Province]

Objective: To identify the transmission relationship between HIV infection cases the non-marital non-commercial heterosexual contact in Zhejiang Province. Methods: When HIV positive was informed during January 2020 to January 2022, the staff conducted an epidemiological investigation to collect cases information on sociodemographic characteristics, mobility information, past HIV testing history, high-risk sexual behaviors, sexual partners, and etcetera. At the same time, 6-8 ml of blood from the new diagnosis of people infected with HIV before antiviral treatment was collected to separate the bleeding plasma. pol gene was amplified by nucleic acid extraction and PCR, sequenced by Sequencer 5.0 software, and Cytoscape 3.6.0 software was used to draw HIV molecular transmission network. Results: From January 2020 to January 2022, 88 HIV infected individuals were found in Pujiang County, of which 74 were transmitted through heterosexual transmission, of which 31 were infected through non-marital non-commercial heterosexual contact. Preliminary case studies have found that three female cases have engaged in unprotected non-marital non-commercial heterosexual contact with one male case. Among the 4 infected individuals, 2 of their spouses tested positive for HIV antibodies. Molecular transmission network monitoring was carried out on 65 newly diagnosed cases of heterosexual transmission with acquired sequences, forming 9 transmission clusters. The largest cluster contained 10 cases. A total of 11 HIV-infected individuals were involved in this HIV cluster epidemic. They were 3 males and 8 females, all over 50 years old and were farmers or rural housewives. They were traced to 7 sexual partners (6 negatives of HIV, 1 undetected). Among the 18 respondents' sexual social network relationships, there were 6 couples, 8 permanent partners, and 3 temporary partners. Among 11 HIV infected individuals, there were 9 cases of non-marital non-commercial heterosexual transmission and 2 cases of intramarital transmission. The epidemiological association between 7 non-married non-commercial heterosexual partners and case 2 (56-year-old male farmer), 3 cases confirmed by epidemiological investigation and molecular transmission cluster results, 3 cases confirmed by molecular transmission cluster and epidemiological investigation results, and 1 case confirmed by epidemiological investigation results. Conclusions: The transmission mode of this cluster epidemic was to spread HIV through heterosexual sex with a male case as the core, then cause the transmission within marriage and between fixed sexual partners. The combination of epidemiological investigation and molecular transmission network traceability survey supports the conclusion of this study.

Construction and validation of 3-genes hypoxia-related prognostic signature to predict the prognosis and therapeutic response of hepatocellular carcinoma patients

BACKGROUND

Previous studies have shown that the hypoxia microenvironment significantly impacted tumor progression. However, the clinical prognostic value of hypoxia-related risk signatures and their effects on the tumor microenvironment (TME) in hepatocellular carcinoma (HCC) remains hazy. This study aimed to conduct novel hypoxia-related prognostic signatures and improve HCC prognosis and treatment.

METHODS

Differentially expressed hypoxia-related genes (HGs) were identified with the gene set enrichment analysis (GSEA). Univariate Cox regression was utilized to generate the tumor hypoxia-related prognostic signature, which consists of 3 HGs, based on the least absolute shrinkage and selection operator (LASSO) algorithm. Then the risk score for each patient was performed. The prognostic signature's independent prognostic usefulness was confirmed, and systematic analyses were done on the relationships between the prognostic signature and immune cell infiltration, somatic cell mutation, medication sensitivity, and putative immunological checkpoints.

RESULTS

A prognostic risk model of four HGs (FDPS, SRM, and NDRG1) was constructed and validated in the training, testing, and validation datasets. To determine the model's performance in patients with HCC, Kaplan-Meier curves and time-dependent receiver operating characteristic (ROC) curves analysis was implemented. According to immune infiltration analysis, the high-risk group had a significant infiltration of CD4+ T cells, M0 macrophages, and dendritic cells (DCs) than those of the low-risk subtype. In addition, the presence of TP53 mutations in the high-risk group was higher, in which LY317615, PF-562271, Pyrimethamine, and Sunitinib were more sensitive. The CD86, LAIR1, and LGALS9 expression were upregulated in the high-risk subtype.

CONCLUSIONS

The hypoxia-related risk signature is a reliable predictive model for better clinical management of HCC patients and offers clinicians a holistic viewpoint when determining the diagnosis and course of HCC treatment.

USP33 promotes pancreatic cancer malignant phenotype through the regulation of TGFBR2/TGFβ signaling pathway

Pancreatic cancer (PC) ranked fourth among cancer-related death worldwide with a survival rate less than 5%. The abnormal proliferation and distant metastasis are major obstacles for the diagnosis and treatment of pancreatic cancer, therefore, it is urgent for researchers to uncover the molecular mechanisms underlying the PC proliferation and metastasis. In current study, we found that USP33, a member of deubiquitinating enzyme family, was upregulated among PC samples and cells, meanwhile, the high expression of USP33 correlated with poor prognosis of patients. Function experiments revealed that USP33 overexpression promoted the proliferation, migration and invasion of PC cells while the inhibition of USP33 expression in PC cells exhibited the opposite effect. The mass spectrum and luciferase complementation assay screened TGFBR2 as the potential binding protein of USP33. Mechanistically, USP33 triggered the deubiquitination of TGFBR2 and prevented its degradation by lysosome, therefore promoted TGFBR2 accumulation in cell membrane and eventually contributed to the sustained activation of TGF-β signaling. Moreover, our results revealed that the activation of TGF-β targeted gene ZEB1 promoted the transcription of USP33. In conclusion, our study found that USP33 contributed to the proliferation and metastasis of pancreatic cancer through a positive feedback loop with TGF-β signaling pathway. Moreover, this study suggested that USP33 may serve as a potential prognostic and therapeutic target in PC.

Screening and Evaluation of Novel α-Glucosidase Inhibitory Peptides from Ginkgo biloba Seed Cake Based on Molecular Docking Combined with Molecular Dynamics Simulation

Food-derived α-glucosidase inhibitory peptides have gained significant interest in treating type 2 diabetes mellitus (T2DM) owing to their favorable safety profiles. Molecular docking combined with molecular dynamics simulation was performed to screen α-glucosidase inhibitory peptides from Ginkgo biloba seed cake (GBSC), and two novel peptides (Met-Pro-Gly-Pro-Pro (MPGPP) and Phe-Ala-Pro-Ser-Trp (FAPSW)) were acquired. The results of molecular docking and molecular dynamics simulation suggested that FAPSW and MPGPP could generate stable complexes with 3wy1, and the electrostatic and van der Waals forces played contributory roles in FAPSW and MPGPP binding to 3wy1. The α-glucosidase inhibition assay corroborated that FAPSW and MPGPP had good α-glucosidase inhibition capacity, with IC₅₀ values of 445.34 ± 49.48 and 1025.68 ± 140.78 μM, respectively. In vitro simulated digestion results demonstrated that FAPSW and MPGPP strongly resisted digestion. These findings lay a theoretical foundation for FAPSW and MPGPP in treating T2DM.

[Development and validation of prognostic nomogram for malignant pleural mesothelioma]

Objective: To development the prognostic nomogram for malignant pleural mesothelioma (MPM). Methods: Two hundred and ten patients pathologically confirmed as MPM were enrolled in this retrospective study from 2007 to 2020 in the People's Hospital of Chuxiong Yi Autonomous Prefecture, the First and Third Affiliated Hospital of Kunming Medical University, and divided into training (n=112) and test (n=98) sets according to the admission time. The observation factors included demography, symptoms, history, clinical score and stage, blood cell and biochemistry, tumor markers, pathology and treatment. The Cox proportional risk model was used to analyze the prognostic factors of 112 patients in the training set. According to the results of multivariate Cox regression analysis, the prognostic prediction nomogram was established. C-Index and calibration curve were used to evaluate the model's discrimination and consistency in raining and test sets, respectively. Patients were stratified according to the median risk score of nomogram in the training set. Log rank test was performed to compare the survival differences between the high and low risk groups in the two sets. Results: The median overall survival (OS) of 210 MPM patients was 384 days (IQR=472 days), and the 6-month, 1-year, 2-year, and 3-year survival rates were 75.7%, 52.6%, 19.7%, and 13.0%, respectively. Cox multivariate regression analysis showed that residence (HR=2.127, 95% CI: 1.154-3.920), serum albumin (HR=1.583, 95% CI: 1.017-2.464), clinical stage (stage Ⅳ: HR=3.073, 95% CI: 1.366-6.910) and the chemotherapy (HR=0.476, 95% CI: 0.292-0.777) were independent prognostic factors for MPM patients. The C-index of the nomogram established based on the results of Cox multivariate regression analysis in the training and test sets were 0.662 and 0.613, respectively. Calibration curves for both the training and test sets showed moderate consistency between the predicted and actual survival probabilities of MPM patients at 6 months, 1 year, and 2 years. The low-risk group had better outcomes than the high-risk group in both training (P=0.001) and test (P=0.003) sets. Conclusion: The survival prediction nomogram established based on routine clinical indicators of MPM patients provides a reliable tool for prognostic prediction and risk stratification.

Circ_0002111/miR-134-5p/FSTL1 signal axis regulates tumor progression and glycolytic metabolism in papillary thyroid carcinoma cells

BACKGROUND

Circular RNAs (circRNAs) have essential roles in the malignant progression of papillary thyroid carcinoma (PTC). Circ_0002111 was reported to facilitate cell proliferation and invasion abilities in PTC. This study was performed to explore the regulatory mechanism of circ_0002111 in PTC progression.

METHODS

Reverse transcription-quantitative polymerase chain reaction (RT-qPCR) was used for the level detection of circ_0002111, microRNA-134-5p (miR-134-5p) and Follistatin Like 1 (FSTL1). Cell proliferation was assessed by 3-(4, 5-dimethylthiazol-2-y1)-2, 5-diphenyl tetrazolium bromide (MTT) assay, EdU assay and colony formation assay. Cell migration ability was determined by transwell assay. Glycolysis was analyzed by extracellular acidification rate (ECAR), oxygen consumption rate (OCR), glucose consumption and lactate production. The protein quantification was performed through western blot. Xenograft tumor assay was used for the functional analysis of circ_0002111 in vivo. The target interaction was confirmed by dual-luciferase reporter assay and RNA pull-down assay.

RESULTS

The significant upregulation of circ_0002111 was detected in PTC samples and cells. PTC cell proliferation, migration and glycolytic metabolism were suppressed after circ_0002111 downregulation. PTC tumorigenesis in vivo was also inhibited by circ_0002111 knockdown. In addition, circ_0002111 could target miR-134-5p and si-circ_0002111#1-induced inhibition of PTC progression was relieved by miR-134-5p expression downregulation. Furthermore, FSTL1 was a target gene for miR-134-5p and miR-134-5p served as a tumor repressor in PTC by targeting FSTL1. Moreover, circ_0002111 could increase the FSTL1 level via sponging miR-134-5p.

CONCLUSION

All results indicated that circ_0002111 promoted the malignant behaviors of PTC cells partly by regulating the miR-134-5p/FSTL1 molecular network.