[Prediction of pathological remission of head and neck squamous cell carcinoma patients after neoadjuvant immunochemotherapy and construction of clinical model based on clinical features and inflammatory markers]

Objective: To analyze the potential clinical biological factors influencing the major pathological response (MPR) to neoadjuvant immunochemotherapy in patients with resectable head and neck squamous cell carcinoma (HNSCC). Methods: This retrospective study enrolled patients with resectable HNSCC who underwent neoadjuvant immunochemotherapy at Sun Yat-sen University Cancer Center from June 1, 2019 to December 31, 2021. Binary logistic regression was used to analyze the correlation between clinical characteristics, inflammatory markers and MPR, and a nomogram model was constructed. The calibration curve and decision curve analysis were used to verify the predictive ability and accuracy of the nomogram model. Results: A total of 173 patients were included in the study, with 141 males and 32 females, aged from 22 to 83 years. After pathological assessment, the patients were divided into two groups: MPR group (108 cases) and non MPR group (65 cases). Logistics regression analysis indicated that the patients with HPV+oropharyngeal cancer, partial response or complete response by imaging assessment, low pre-treatment platelet/lymphocyte ratio, low pre-treatment C reactive protein/albumin ratio and lower pre-and post-treatment C reactive protein/albumin ratio difference were more likely to have MPR (all P<0.05). Nomogram model was constructed based on the above factors, with a C-index of 0.826 (95%CI: 0.760-0.892), and the calibration curve and decision curve analysis confirmed the prediction accuracy of the model. Conclusion: This study shows that many factors are related to MPR of patients with resectable HNSCC receiving neoadjuvant immunochemotherapy and the constructed nomogram model helps to develop personalized treatment strategies for the patients.

Dynamic variation in the aroma characteristics of Rhus chinensis honey at different stages after capping

The ripening characteristics after capping of honey are favourable for improving its quality. However, research on the variation and formation of aroma characteristics of honey in this process is lacking. Therefore, the present study was carried out with different stages of Rhus chinensis honeys (RCHs) after capping and identified 192 volatiles with varying levels of concentration. "Fruity" was the main aroma characteristic of RCHs at different stages after capping, mainly contributed by (E)-β-damascenone. Methyl salicylate might be a potential indicator for differentiating RCHs at different stages after capping. The metabolic pathway analyses revealed that the aroma compounds in RCHs undergo transformation at different stages after capping, which subsequently affects its aroma characteristics formation. This work is the first to study the dynamic changes in honey aroma characteristics after capping from multiple perspectives, and the results are of great significance for understanding the aroma characteristics after capping and quality control of honey.

Characterization of Evodia rutaecarpa (Juss) Benth honey: volatile profile, odor-active compounds and odor properties

BACKGROUND

Aroma is one of the most important quality criterion of different honeys and even defines their merchant value. The composition of volatile compounds, especially the characteristic odor-active compounds, contributes significantly to the aroma of honey. Evodia rutaecarpa (Juss) Benth honey (ERBH) is a special honey in China with unique flavor characteristics. However, no work in the literature has investigated the volatile compounds and characteristic odor-active compounds of ERBHs. Therefore, it is imperative to conduct systematic investigation into the volatile profile, odor-active compounds and odor properties of ERBHs.

RESULTS

The characteristic fingerprint of ERBHs was successfully constructed with 12 characteristic peaks and a similarity range of 0.785-0.975. In total, 297 volatile compounds were identified and relatively quantified by headspace solid-phase microextraction coupled with gas chromatography quadrupole time-of-flight mass spectrometry, of which 61 and 31 were identified as odor-active compounds by relative odor activity values and GC-olfactometry analysis, respectively, especially the common 22 odor-active compounds (E)-β-damascenone, phenethyl acetate, linalool, cis-linalool oxide (furanoid), octanal, hotrienol, trans-linalool oxide (furanoid), 4-oxoisophorone and eugenol, etc., contributed significantly to the aroma of ERBHs. The primary odor properties of ERBHs were floral, followed by fruity, herbaceous and woody aromas. The partial least-squares regression results showed that the odor-active compounds had good correlations with the odor properties.

CONCLUSION

Identifying the aroma differences of different honeys is of great importance. The present study provides a reliable theoretical basis for the quality and authenticity of ERBHs. © 2023 Society of Chemical Industry.

Feasibility and performance of the chronic obstructive pulmonary disease population screener and chronic obstructive pulmonary disease screening questionnaire in a Chinese physical examination center

Background

Chronic obstructive pulmonary disease (COPD) affects up to 13% of the Chinese population, though it is under diagnosed throughout China. Screening among asymptomatic individual as part of routine health checks in China can facilitate early diagnosis and intervention to prevent disease progress. The COPD Population Screener (COPD-PS) or COPD Screening Questionnaire (COPD-SQ) has yet to be applied in Chinese physical examination centers (PECs) for COPD screening, and their feasibility and effectiveness should be clarified before full-scale implementation. This study is the first to apply the COPD-PS and COPD-SQ in a public hospital PEC in China to assess their feasibility and effectiveness and to identify their optimal cutoff values.

Methods

People aged ≥40 years who attended the Second Affiliated Hospital of Shantou University PECs from September 2021 to December 2022 were asked to complete the COPD-PS and COPD-SQ and to undergo spirometry. The optimal cutoff values of the two questionnaires at the maximal Youden index were found, and the sensitivity and specificity were calculated.

Results

Data from 198 participants were analyzed; mean [standard deviation (SD)] age of patients was 63.52 (10.94) years. Twenty-five participants (12.63%) were diagnosed with COPD. The number of COPD patients classified as Global Initiative for Chronic Obstructive Lung Disease (GOLD) grades 1 to 4 were 8, 12, 4, and 1, respectively. The area under the curves (AUCs) of the COPD-PS and COPD-SQ were 0.730 and 0.738, respectively. The optimal COPD-PS cutoff value of 4 points corresponded to a sensitivity of 72.00% and a specificity of 60.10%. The COPD-SQ optimal cutoff value of 15 points corresponded to a sensitivity of 76.00% and a specificity of 63.60%.

Conclusions

Applying the COPD-PS and COPD-SQ in Chinese PECs is feasible, cost-effective and effective. COPD-PS and COPD-SQ can facilitate the early diagnosis of COPD, and whether they can improve the participants' quality of life would benefit a further study. It is recommended that the COPD-PS or COPD-SQ questionnaires be added to the screening of the physical examination program in PECs as part of health checks for people over 40 years old.

Genome-wide association study and Mendelian randomization analyses provide insights into the causes of early-onset colorectal cancer

BACKGROUND

The incidence of early-onset colorectal cancer (EOCRC; diagnosed <50 years of age) is rising globally; however, the causes underlying this trend are largely unknown. Colorectal cancer (CRC) has strong genetic and environmental determinants, yet common genetic variants and causal modifiable risk factors underlying EOCRC are unknown. We conducted the first EOCRC-specific genome-wide association study (GWAS) and Mendelian randomization analyses to explore germline genetic and causal modifiable risk factors associated with EOCRC.

PATIENTS AND METHODS

We conducted a genome-wide association study meta-analysis of 6,176 EOCRC cases and 65,829 controls from Genetics and Epidemiology of Colorectal Cancer Consortium (GECCO), Colorectal Transdisciplinary study (CORECT), Colon Cancer Family Registry (CCFR), and UK Biobank. We then used the EOCRC GWAS to investigate 28 modifiable risk factors using two-sample Mendelian randomization (MR).

RESULTS

We found two novel risk loci for EOCRC at 1p34.1 and 4p15.33, not previously associated with CRC risk. We identified a deleterious coding variant (rs36053993, G396D) at polyposis-associated DNA repair gene MUTYH (OR=1.80 [95%CI=1.47-2.22]) but show that most of the common genetic susceptibility was from non-coding signals enriched in epigenetic markers present in gastrointestinal tract cells. We identified new EOCRC susceptibility genes, and in addition to pathways such as TGFβ, SMAD, BMP, and PI3K signaling, our study highlights a role for insulin signaling and immune/infection-related pathways in EOCRC. In our MR analyses, we found novel evidence of probable causal associations for higher levels of body size and metabolic factors - such as body fat percentage, waist circumference, waist to hip ratio, basal metabolic rate, and fasting insulin - higher alcohol drinking and lower education attainment, with increased EOCRC risk.

CONCLUSION

Our novel findings indicate inherited susceptibility to EOCRC and suggest modifiable lifestyle and metabolic targets that could also be used to risk stratify individuals for personalized screening strategies or other interventions.

Targeting UBR5 inhibits postsurgical breast cancer lung metastases by inducing CDC73 and p53 mediated apoptosis

UBR5 is a HECT domain E3 ubiquitin ligase that is frequently amplified in breast, ovarian and prostate cancers. Heightened UBR5 expression plays a profound role in tumor growth through immune-dependent mechanisms; however, its mode of action in driving tumor metastasis has not been definitively delineated. Herein, we used a tetracycline (Tet)-inducible RNAi-mediated expression silencing cell system to investigate how UBR5 enables postsurgical mammary tumor metastatic growth in mouse lungs without the continuous influence of the primary lesion. In vitro, Ubr5 knockdown induces morphological and molecular changes characteristic of epithelial-mesenchymal transition (EMT). In vivo, UBR5 promotes lung metastasis in an E3 ubiquitin ligase-dependent manner. Moreover, doxycycline-induced UBR5 expression knockdown in metastatic cells in the lungs, following removing the primary tumors, resulted in increased apoptosis, decreased proliferation and prolonged survival, whereas silencing the expression of cell division cycle 73 (CDC73), a tumor suppressor and E3 ligase substrate of UBR5, reversed these effects. Transcriptome analyses revealed a prominent role of the p53 pathway in dovitinib-induced apoptosis of tumor cells differentially regulated by UBR5 and CDC73. In human triple-negative breast cancer (TNBC) patient specimens, a strong inverse correlation was observed between UBR5 and CDC73 protein levels, with reduced CDC73 expression at metastatic sites compared to primary lesions. Furthermore, a xenograft model of human TNBC recapitulated the metastatic properties and characteristics of the unique UBR5-CDC73 functional antagonism. This study reveals the novel and critical roles and intricate relationships of UBR5, CDC73 and p53 in postsurgical breast cancer metastasis and indicates the potential of targeting this pathway in cancer therapy.

The Effect of Characteristics of Patient Communication on Physician Feedback in Online Health Communities: An Observational Cross-Sectional Study

With the rapid development of e-health and telemedicine, previous studies have explored the relationship between physician-patient communication and patient satisfaction; however, there is a paucity of research on the influence of the characteristics of patient communication on the characteristics of physician feedback. Based on the communication accommodation theory, as well as the computer-mediated communication theory and media richness theory, this study aimed to explore how characteristics of patient communication influence characteristics of physician feedback in online health communities. We employed a crawler software to download the communication data between 1652 physicians and 105,325 patients from the Good Doctor platform, the biggest online health community in China. We built an empirical model using this data and employed a multilevel model to test our hypotheses using Stata and Python software. The results indicate that the amount of patients' rendered information positively influences the physicians' text (α = 0.123, t = 33.147, P < .001) and voice feedback (β = 0.201, t = 40.011, P < .001). Patients' hope for help signals and the provision of their electronic health records weaken the effect of the amount of patients' rendered information on physicians' text feedback (α = -0.040, t = -24.857, P < .001; α = -0.048, t = -15.784, P < .001), whereas, it strengthened the effect of the amount of patients' rendered information on physicians' voice feedback (β = 0.033, t = 14.789, P < .001; β = 0.017, t = 4.208, P < .001). Moreover, the occurrence of high-privacy diseases strengthened the effect of the amount of patients' presented information on physicians' text and voice feedback (α = 0.023, t = 4.870, P < .001; β = 0.028, t = 4.282, P < .001). This research contributes to the development of computer-mediated communication theories and sheds light on service delivery in the online health community.

Aromatic profiles and enantiomeric distributions of volatile compounds during the ripening of Dendropanax dentiger honey

Dendropanax dentiger honey (DDH) is a specialty herbal honey from China. Previous research on DDH has mostly focused on its composition and potential chemical markers, no studies have been conducted on the changes in aroma characteristics and chiral odorants during its maturation. Therefore, the present study aims to address the missing parts. The proportions and total concentrations of 185 volatile compounds identified in different classes varied with DDHs ripening. Fourteen common odor-active compounds were identified by odor activity values (OAVs) and GC-olfactometry (GC-O) analysis. The aroma profiles of DDHs were observed to vary at different ripening stages, although the dominant aroma characteristic was "fruity" aroma, which became more pronounced with increasing maturity. The enantiomeric contents and distributions of 7 volatile enantiomers were related to specific physicochemical indicators and the maturity of DDHs, among which the enantiomers of linalool oxide A may be a potential indicator to identify its maturity. Furthermore, precise quantification and OAVs calculation showed that the enantiomer (2S, 5S)-linalool oxide A presented the highest concentration (8.83-27.39 ng/mL) and only the enantiomer R-linalool (OAVs: 5.56-6.14) was an important contributor to the aroma profiles of DDHs at different stages of maturity. These results provided a new research idea for quality control and identification of DDHs at different maturity stages.

Scanning near-field optical microscopy measurements and simulations of regularly arranged silver nanoparticles

Silver nanoparticles on a glass substrate are experimentally investigated by aperture scanning near-field optical microscopy (a-SNOM). To understand the experimental results, finite-element-method simulations are performed building a theoretical model of the a-SNOM geometry. We systematically vary parameters like aperture size, aluminum-coating thickness, tip cone angle, and tip-surface distance and discuss their influence on the near-field enhancement. All these investigations are performed comparatively for constant-height and constant-gap scanning modes. In the end, we establish a reliable and stable optical model for simulating a-SNOM measurements, which is capable of reproducing trends observed in experimental data.

Novel insights into anticancer mechanisms of elesclomol: More than a prooxidant drug

As an essential micronutrient for humans, the metabolism of copper is fine-tuned by evolutionarily conserved homeostatic mechanisms. Copper toxicity occurs when its concentration exceeds a certain threshold, which has been exploited in the development of copper ionophores, such as elesclomol, for anticancer treatment. Elesclomol has garnered recognition as a potent anticancer drug and has been evaluated in numerous clinical trials. However, the mechanisms underlying elesclomol-induced cell death remain obscure. The discovery of cuproptosis, a novel form of cell death triggered by the targeted accumulation of copper in mitochondria, redefines the significance of elesclomol in cancer therapy. Here, we provide an overview of copper homeostasis and its associated pathological disorders, especially copper metabolism in carcinogenesis. We summarize our current knowledge of the tumor suppressive mechanisms of elesclomol, with emphasis on cuproptosis. Finally, we discuss the strategies that may contribute to better application of elesclomol in cancer therapy.

Association between peripheral orexin A/B levels and depression with childhood trauma

BACKGROUND

Orexin dysfunction has previously been demonstrated to be associated with depression. However, no studies reported the different effects of orexin A/B on depression with and without childhood trauma (CT). In this study，we assessed the correlation between expression of orexin A/B and depression severity in major depressive disorder (MDD) patients and healthy controls.

METHODS

A total of 97 MDD patients and 51 healthy controls were recruited in this study. According to the total scores of childhood trauma questionnaire (CTQ), the MDD patients were further divided into two subgroups, MDD with CT and MDD without CT. The 17-item Hamilton Depression Scale (HAMD-17), and plasma orexin A and orexin B concentrations were measured in all participants using enzyme-linked immunosorbent assay.

RESULTS

Orexin B plasma levels were significantly higher in MDD patients with CT and without CT than that in the healthy control group (P < 0.05), whereas there was no statistical difference between the two depression groups. After adjusting age and BMI for covariates, the LASSO regression revealed significant association between the plasma orexin B levels and the total scores of HAMD (β = 3.348), CTQ (β = 2.005). There was no difference in plasma orexin A levels among three groups (P > 0.05).

CONCLUSIONS

Although peripheral orexin B levels are associated with the depression, rather than orexin A, CT appear to play a role in the association between orexin B levels and depression. China Clinical Trial Registration Center (Registration No.: ChiCTR2000039692).

Outcomes and Failure Patterns after Chemoradiotherapy for Locally Advanced Rectal Cancer with Positive Lateral Pelvic Lymph Nodes: A Propensity Score-Matched Analysis

PURPOSE/OBJECTIVE(S)

Locally advanced rectal cancer (LARC) combined with positive lateral pelvic lymph nodes (LPLN) tends to present worse prognosis. However, for those patients it remains unclear whether other combination high-risk factors affect the prognosis. This study aimed to use propensity score matching (PSM) to examine long-term outcomes and failure patterns in patients with positive vs. negative LPLN.

MATERIALS/METHODS

Patients with LARC were retrospectively divided into LPLN-positive and LPLN-negative groups. LPLN-positivity was defined as lymph node short diameter greater than or equal to 7 mm with specific morphological features. Clinical characteristics were compared between the groups using the chi-square test. PSM was applied to balance these differences. Progression-free survival (PFS) and overall survival (OS), and local-regional recurrence (LRR) and distant metastasis (DM) rates were compared between the groups using the Kaplan-Meier method and log-rank tests.

RESULTS

Prior to PSM, a total of 651 LARC patients were included. The LPLN-positive group had higher rates of lower location (53.1% vs. 43.0%, P = 0.025), mesorectal fascia (MRF)-positive (53.9% vs. 35.4%, P<0.001) and extramural venous invasion (EMVI)-positive (51.2% vs. 27.2%, P<0.001) disease than the LPLN-negative group. After PSM, there were 114 patients for each group along with the balanced clinical factors, and both groups had comparable surgery, pathologic complete response (pCR), and ypN stage rates. The median follow-up time was 45.9 months, 3-year OS (88.3% vs. 92.1%, P = 0.276) and LRR (5.7% vs. 2.8%, P = 0.172) rates were comparable between LPLN-positive and LPLN-negative groups. Meanwhile, despite no statistical difference, 3-year PFS (78.8% vs. 85.9%, P = 0.065) and DM (20.4% vs. 13.3%, P = 0.061) rates slightly differed between the groups. Among 10 patients with LRR, seven (70.0%) had lateral pelvic recurrence, among them, five patients were LPLN-positive, and four (80.0%) of these patients did not receive simultaneous integrated boost intensity-modulated radiotherapy (SIB- IMRT).45 patients were diagnosed with DM, 11 (40.7%) LPLN-positive and 3 (17.6%) LPLN-negative patients were diagnosed with oligometastases (P = 0.109).

CONCLUSION

Our study shows there is a tendency of worse PFS and DM in LPLN-positive than LPLN-negative patients, for LPLN-positive patients, oligometastases account for a large proportion of all distant metastases.

4D-MRI Guided Stereotactic Body Radiation Therapy for Unresectable Colorectal Liver Metastases

PURPOSE/OBJECTIVE(S)

This study evaluated the feasibilities and outcomes following four-dimensional magnetic resonance imaging (4D-MRI) guided stereotactic body radiation therapy (SBRT) for unresectable colorectal liver metastases (CRLM).

MATERIALS/METHODS

From March 2018 to January 2022, we identified 76 unresectable CRLM patients with 123 lesions who received 4D-MRI guided SBRT in our institution. 4D-MRI simulation with or without abdominal compression was conducted for all patients. The prescription dose was 50-65 Gy in 5-12 fractions. The image quality of computed tomography (CT) and MRI were compared using the Clarity Score. Clinical outcomes and toxicity profiles were evaluated.

RESULTS

The 4D-MRI significantly improved the image quality compared with CT images (mean Clarity Score: 1.67 vs 2.88, P < 0.001). The abdominal compression significantly reduced motions in cranial-caudal direction (P = 0.03) with 2 phase T2 weighted images assessing tumor motion. The median follow-up time was 12.5 months. For 98 lesions assessed for best response, the complete response, partial response and stable disease rate were 57.1 %, 30.6 % and 12.2 %, respectively. The local control (LC) rate at 2 year was 97.3%. 46.1% of patients experienced grade 1-2 toxicities and only 2.6% patients experienced grade 3 hematologic toxicities.

CONCLUSION

The 4D-MRI technique allowed precise target delineation and motion tracking in unresectable CRLM patients. High LC rate and mild toxicities were achieved. This study provided evidence for using 4D-MRI guided SBRT as an alternative treatment in unresectable CRLM.

Human umbilical cord mesenchymal stem cells ameliorate colon inflammation via modulation of gut microbiota-SCFAs-immune axis

BACKGROUND

Inflammatory bowel disease (IBD) is a global health problem in which gut microbiota dysbiosis plays a pivotal pathogenic role. Mesenchymal stem cells (MSCs) therapy has emerged as a prospective novel tool for managing IBD, and which can also regulate the composition of gut microbiota. However, the functional significance of MSCs-induced changes in gut microbiome is poorly understood.

METHODS

Here, we investigated for the first time the role of gut microbiota in mediating the protective effect of human umbilical cord MSCs (HUMSCs) on DSS-induced colitis. Gut microbiota alteration and short-chain fatty acids (SCFAs) production were analyzed through 16S rRNA sequencing and targeted metabolomics. Spectrum antibiotic cocktail (ABX), fecal microbiota transplantation (FMT) and sterile fecal filtrate (SFF) were employed to evaluate the protective effect of intestinal flora and its metabolites. Cytokine microarray, Enzyme-linked immunosorbent assay (ELISA), and flow cytometry were conducted to assess the effect on CD4+T homeostasis.

RESULTS

Here, we investigated for the first time the role of gut microbiota in mediating the protective effect of MSCs on DSS-induced colitis. By performing gut microbiota depletion and fecal microbiota transplantation (FMT) experiments, we revealed that MSCs derived from human umbilical cord ameliorated colon inflammation and reshaped T-cells immune homeostasis via remodeling the composition and diversity of gut flora, especially up-regulated SCFAs-producing bacterial abundance, such as Akkermansia, Faecalibaculum, and Clostridia_UCG_014. Consistently, targeted metabolomics manifested the increased SCFAs production with MSCs administration, and there was also a significant positive correlation between differential bacteria and SCFAs. Meanwhile, combined with sterile fecal filtrate (SFF) gavage experiments, the underlying protective mechanism was further associated with the improved Treg/Th2/Th17 balance in intestinal mucosa mediated via the increased microbiota-derived SCFAs production.

CONCLUSION

The present study advances understanding of MSCs in the protective effects on colitis, providing evidence for the new role of the microbiome-metabolite-immune axis in the recovery of colitis by MSCs.

[The mediating role of resilience between social capital at work and anxiety of medical staff]

Objective: To explore the influence of social capital at work on anxiety of medical staff, and the mediating role of resilience. Methods: From March to May 2022, a total of 201 medical staff in the Affiliated Hospital of Jining Medical University were investigated with the General Information Questionnaire, Workplace Social Capital Scale, Connor-Davidson Resilience Scale (CD-RISC-10) and Generalized Anxiety Disorder-7 (GAD-7) . K-S method was used for normdity test of econometic voriobles, and normal distribution data were represented by Mean±SD, Pearson correlation analysis and linear regression analysis were used to test correlation between variables and mediating effect, and Bootstrap method was carried out by SPSS macro program PROCESS v3.5 to verify the mediating effect. Results: The detection rate of anxiety was 59.20% (119/201) in medical staff. The scores of social capital at work (28.90±5.83) and resilience (31.55±4.98) were negatively correlated with the score of anxiety (7.20±2.06) (r=-0.338, -0.510, P<0.001) , while the score of social capital at work was positively correlated with resilience (r=0.392, P<0.001) . Workplace social capital positively predicted resilience (β=0.392, P<0.001) , and both workplace social capital (β=-0.222, P=0.001) and resilience at work (β=-0.423, P<0.001) negatively predicted anxiety score. The direct effect of social capital in the workplace of medical staff on anxiety was -0.222 (95%CI: -0.349~-0.095, P=0.001) , and the indirect effect of resilience on anxiety was -0.166 (95%CI: -0.265~-0.080) . The resilience of medical staff had a partial mediating effect between workplace social capital and anxiety, which accounted for 42.78% of the total effect. Conclusion: The resilience of medical staff has a partial mediating effect between workplace social capital and anxiety. Workplace social capital can not only directly affect the anxiety of medical staff, but also indirectly affect it through resilience.

Emerging insights into mechanisms of trastuzumab resistance in HER2-positive cancers

HER2 is an established therapeutic target in breast, gastric, and gastroesophageal junction carcinomas with HER2 overexpression or genomic alterations. The humanized monoclonal antibody trastuzumab targeting HER2 has substantially improved the clinical outcomes of HER2-positive patients, yet the inevitable intrinsic or acquired resistance to trastuzumab limits its clinical benefit, necessitating the elucidation of resistance mechanisms to develop alternate therapeutic strategies. This review presents an overview of trastuzumab resistance mechanisms involving signaling pathways, cellular metabolism, cell plasticity, and tumor microenvironment, particularly discussing the prospects of developing rational combinations to improve patient outcomes.

Spatiotemporal evolution and driving factors of carbon emission efficiency of resource-based cities in the Yellow River Basin of China

As an important part of regional coordinated development, the high-quality development of the Yellow River Basin has become a national strategy. It is imminent for resource-based cities to perform a high-quality transformation. The analysis of carbon emission efficiency in the Yellow River Basin includes the examination of spatiotemporal evolution characteristics and the main driving factors. This is done by utilizing the super-efficiency SBM-DEA and panel Tobit regression models, with the assistance of night light data. Our findings are as follows: (1) Carbon emissions continue to grow. The "Jiziwan" basin is an area where plenty of high-emitting cities agglomerate. The carbon emission of resource-based cities presents a W-shaped pattern in time. (2) In time, the carbon emission efficiency follows a U-shaped curve. Spatially, the carbon emission efficiency in the middle reaches is comparatively low, whereas it is relatively high in both the upper and lower reaches. And that in high carbon-emitting resource-based cities are in the low to medium range. (3) Carbon emission efficiency has a significant negative relationship with energy intensity, urbanization rate, and population density and a significant positive relationship with industrial proportion. Energy intensity is the most direct driving force. That is to say, we can increase carbon emission efficiency effectively by reducing energy intensity.

Effect of night shift work on metabolic syndrome in adults who suffered from earthquake stress in early life

Objective

To examine the role of night shift work on the risk of metabolic syndrome (MetS) in adults suffered from earthquakes prenatally or as infants and to analyse the effect of stress on factors that influence MetS in this population.

Methods

We included 870 subjects from 2014 to 2015. All subjects work as miners for the Kailuan Mining Group and were born were living in Tangshan. Participants were classified into two groups on basis of their work schedules: day shift and night shift. They were further classified into the prenatal exposure group, the infancy exposure group, and the control group based on their age during the Tangshan earthquake. This study was conducted 38 years after the earthquake. Participants' general demographic data, smoking and drinking habits, as well as work schedules were collected. All participants' sleep status was assessed with the Pittsburgh Sleep Quality Index. The measurement of all subjects' waist circumference and blood pressure was made, and triglycerides, fasting blood glucose, high-density lipoproteins, and low-density lipoproteins were measured by collecting blood samples. The definition of MetS was made after the guidelines for preventing and controlling type 2 diabetes in China (2017 Edition).

Results

A total of 187 (21.5%) workers were determined to have MetS. The incidence of MetS was greatly higher in night shift workers who were exposed to an earthquake during infancy than in day shift workers (χ2 = 8.053, p = 0.005). A multivariate logistic regression analysis displayed male participants had a higher risk develop MetS than female participants (p = 0.042, OR = 0.368, 95% CI = 0.140, 0.965). Current smokers (p = 0.030, OR = 1.520, 95%CI = 1.042, 2.218) and participants who sleep fewer than 7 h per night (p = 0.015, OR = 1.638, 95%CI = 1.101, 2.437) had a higher risk of MetS. Prenatal earthquake stress was also a risk element for MetS (p = 0.012, OR = 1.644, 95%CI = 1.115, 2.423).

Conclusion

The risk of MetS is significantly higher in night shift workers exposed to earthquake stress during infancy than day shift workers. Earthquake exposure during pregnancy is an independent risk factor for MetS. Smoking and sleeping less than 7 h have a higher risk of MetS than the control group.

Spatiotemporal evolution and influence mechanism of the carbon footprint of energy consumption at county level in the Yellow River Basin

Implementing emission reduction policies at county level is important to realize high-quality development in the Yellow River Basin and achieve national "carbon peaking" and "carbon neutrality" goals. Based on remote-sensing data of night light, net primary productivity, and land use, the present study utilized the light‑carbon conversion and carbon footprint measurement models to quantify the carbon footprint of energy consumption. An exploratory spatiotemporal data analysis method was implemented to analyze the spatiotemporal evolution path. Panel quantile regression and spatiotemporal transition-nested models were used to reveal the influence mechanism of the spatiotemporal evolution of the carbon footprint. The following results were obtained. (1) The carbon footprint of counties increased from 2001 to 2020. Counties with high‑carbon footprint diffused around the "one center and two axes". Carbon-deficit counties exhibited a diffused trend towards the west. In 2020, 506 counties exhibited carbon deficits, and the carbon balance of the ecosystem was severely unbalanced. (2) The carbon footprint showed evident path dependence and Matthew effect. The high‑carbon footprint lock-in area comprising 177 counties is a challenging zone for governance. The 86 counties that exhibit carbon footprint changes are the key zones to drive the carbon footprint changes in the Basin. The change direction of the county's carbon footprint type, with evident spatial correlation characteristics, is in accordance with adjacent counties. (3) The carbon footprint spatiotemporal transition types and influence mechanisms in counties exhibited significant differences, with the coexistence of low-carbon footprint driving, low-carbon footprint restriction, high-carbon footprint driving and high-carbon footprint restriction modes. As the influence mechanisms of different modes and the paths to achieve "dual carbon" goals are different, the governance of different modes should focus on optimizing and strengthening restriction factors or controlling and improving of driving factors.

Ecological correlation between short term exposure to particulate matter and hospitalization for mental disorders in Shijiazhuang, China

The associations between particulate matter (PM) and overall and specific mental disorders (MDs) are investigated using data from two general hospitals in Shijiazhuang, China, from January 2014 to December 2019. A longitudinal time series study, as one type of ecological study, is conducted using a generalized additive model to examine the relationship between short-term exposure to PM2.5, PM10, and daily hospital admissions for MDs, and further stratification by subtypes, age, and gender. A total of 10,709 cases of hospital admissions for MDs have been identified. The significant short-time effects of PM2.5 on overall MDs at lag01 and PM10 at lag05 are observed, respectively. For specific mental disorders, there are substantial associations of PM pollution with mood disorders and organic mental disorders. PM2.5 has the greatest cumulative effect on daily admissions of mood disorders and organic mental disorders in lag01, and PM 10 has the greatest cumulative effect in lag05. Moreover, the effect modification by sex or age is statistically significant, with males and the elderly (≥ 45 years) having a stronger effect. Short-term exposure to PM2.5 and PM10can be associated with an increased risk of daily hospital admissions for MDs.

Participant experiences with a multipurpose vaginal ring for HIV and pregnancy prevention during a phase 1 clinical trial: learning from users to improve acceptability

Introduction

With high concurrent global rates of HIV incidence and unintended pregnancy, there is a need to provide options beyond condoms to enable users to simultaneously prevent HIV acquisition and pregnancy. Multiple vaginal rings are in development as "MPTs" (multipurpose prevention technologies) as they are shown to provide several co-occurring benefits such as discretion, convenience, reversibility and user control.

Methods

In this Phase 1 trial of a 3-month MPT ring in the U.S., 25 participants (low-risk for HIV and pregnancy) were randomized to use the study ring for 90 days continuously or in 28-day cycles with 2-day removal periods in between. All participants completed in-depth interviews at the end of their study participation.

Results

Overall, the ring was well tolerated. Participants resoundingly endorsed the concept of an extended-use, dual-purpose vaginal ring, but reported too many functional challenges and side effects to endorse this particular ring. Participants assigned to the continuous regimen reported more positive experiences with ring use than those in the cyclic group. A minority of participants who experienced minimal side effects and did not experience challenges with vaginal retention of the ring found it appealing. However, the majority of participants experienced challenges (ring slippage, expulsions, side effects, vaginal bleeding changes) with product use that outweighed the potential benefits and led them to report that - in the future - they would not be interested in using this specific version of the ring in its current form. A subset expressed interest in using the current MPT ring under certain conditions (e.g., if fewer expulsions, less bleeding, higher risk for HIV/pregnancy).

Discussion

User feedback regarding participant experiences and challenges with the study ring was continuously shared with the product developer, underscoring the value of early-stage end-user feedback in product development.

Breast cancer diagnosis and prognosis using a high b-value non-Gaussian continuous-time random-walk model

AIM

To compare the diagnostic performance of mono-exponential model-derived apparent diffusion coefficient (ADC), continuous-time random-walk (CTRW) model-derived D_m, α, β and their combinations in discriminating malignancy of breast lesions, and investigate the association between model-derived parameters and prognosis-related immunohistochemical indices.

MATERIALS AND METHODS

A total of 85 patients with breast lesions (51 malignant, 34 benign) were analysed in this retrospective study. Clinical characteristics include oestrogen receptor (ER), progesterone receptor (PR), human epidermal receptor 2 (HER2), and Ki-67. The ADC was fitted using a mono-exponential model (b-values = 0, 800 s/mm²), while D_m, α, and β were fitted using a CTRW model. Independent Student's t-test and the Mann-Whitney U-test were used for the comparison of parameters. Discrimination performance was accomplished by receiver operating characteristic (ROC) analysis, and Spearman's correlation analysis was used to explore the association between immunohistochemical indices and diffusion parameters, the statistical significance level was p<0.05.

RESULTS

D_m and ADC demonstrated similar performance in differentiating malignant and benign lesions (AUC = 0.928 versus 0.930), while the combination of D_m, α, and β could improve the AUC to 0.969. The combined parameter generated by ADC, D_m, α, and β was effective in identifying the ER+/ER- and PR+/PR- patients. Temporal heterogeneity parameter α correlated significantly with the expression of PR.

CONCLUSION

Diffusion parameters derived from the CTRW model could effectively discriminate the malignancy of breast lesions. Meanwhile, the hormone receptor expression could be distinguished by combined diffusion parameters, and have the potential to reflect the prognosis.

Estimated prevalence and sociodemographic correlates of mental disorders in medical students of Hebei Province, China: A cross-sectional study

BACKGROUND

In China, the identification rate and treatment rate of mental disorders are low, and there are few surveys on the prevalence of mental disorders among college students using diagnostic tools such as Mini-International Neuropsychiatric Interview (MINI), so the prevalence and treatment of mental disorders among college students are unclear.

AIM

To estimate prevalence of mental disorders among medical students in Hebei Province, and provide guidance for improving their mental health.

METHODS

This was a cross-sectional study based on an Internet-based survey. Three levels of medical students in Hebei Province were randomly selected (by cluster sampling) for screening. Using the information network assessment system, the subjects scanned the 2D code with their mobile phones, clicked to sign the informed consent, and answered a scale. A self-designed general status questionnaire was used to collect information about age, gender, ethnicity, grade, and origin of students. The MINI 5.0. was used to investigate mental disorders. Data analysis was performed with SPSS software. Statistically significant findings were determined using a two-tailed P value of 0.05.

RESULTS

A total of 7117 subjects completed the survey between October 11 and November 7, 2021. The estimated prevalence of any mental disorders within 12 mo was 7.4%. Mood disorders were the most common category (4.3%), followed by anxiety disorders (3.9%); 15.0% had been to psychological counseling, while only 5.7% had been to a psychiatric consultation, and only 10% had received drug therapy in the past 12 mo.

CONCLUSION

Although the estimated prevalence of mental disorders in medical students is lower than in the general population, the rate of adequate treatment is low. We determined that improving the mental health of medical students is an urgent matter.

Protective effects of low temperature on the risk of hospitalization for mental and behavioral disorders: a time series study

BACKGROUND

The high incidence of mental illness worldwide is a substantial economic burden on society. Temperature and the occurrence of mental and behavioral disorders (MDs) seem to have a relationship, but this has not been widely researched. Therefore, this study aimed to investigate the effect of temperature on the hospitalization rate of patients with MDs in a temperate monsoon climate region of northern China.

METHODS

Patients with MDs hospitalized in the Mental Health Center of Hebei Medical University, China, from January 2014 to December 2019 were included in the study. The delayed exposure-response relationship between temperature and the number of hospitalized MDs patients was analyzed using a quasi-Poisson generalized additive model combined with a distributed lag nonlinear model.

RESULTS

With the reference of 15.3℃ (temperature with the minimum hospitalizations), the single lag effect of low temperature (-2°C, 10th percentile) increased the hospitalization of patients with MDs, while the cumulative effect decreased the risk of hospitalization for some MD subtypes; it was an acute protective effect. The single and cumulative lag effect of high temperature statistically increased the hospitalization rates of patients with MDs. The optimum temperature for each subtype was different, and the males and the younger age group were more susceptible to high temperatures.

CONCLUSIONS

Low temperature has an acute protective effect on the hospitalization of patients with MDs. In comparison, high temperature increases hospitalization rates. Men and younger people are more affected by temperature, which provides early warning and health intervention measures for patients with corresponding temperature changes.

A new xAI framework with feature explainability for tumors decision-making in Ultrasound data: comparing with Grad-CAM

BACKGROUND AND OBJECTIVE

The value of implementing artificial intelligence (AI) on ultrasound screening for thyroid cancer has been acknowledged, with numerous early studies confirming AI might help physicians acquire more accurate diagnoses. However, the black box nature of AI's decision-making process makes it difficult for users to grasp the foundation of AI's predictions. Furthermore, explainability is not only related to AI performance, but also responsibility and risk in medical diagnosis. In this paper, we offer Explainer, an intrinsically explainable framework that can categorize images and create heatmaps highlighting the regions on which its prediction is based.

METHODS

A dataset of 19341 thyroid ultrasound images with pathological results and physician-annotated TI-RADS features is used to train and test the robustness of the proposed framework. Then we conducted a benign-malignant classification study to determine whether physicians perform better with the assistance of an explainer than they do alone or with Gradient-weighted Class Activation Mapping (Grad-CAM).

RESULTS

Reader studies show that the Explainer can achieve a more accurate diagnosis while explaining heatmaps, and that physicians' performances are improved when assisted by the Explainer. Case study results confirm that the Explainer is capable of locating more reasonable and feature-related regions than the Grad-CAM.

CONCLUSIONS

The Explainer offers physicians a tool to understand the basis of AI predictions and evaluate their reliability, which has the potential to unbox the "black box" of medical imaging AI.

Long Noncoding RNA LINC01614 is a Diagnostic and Prognostic Marker for Breast Cancer

BACKGROUND

The long intergenic non-coding RNA 01614 (LINC01614) is aberrantly expressed in various malignancies, suggesting its role in oncogenesis. However, it has not been well studied in breast cancer.

METHODS

The cancer genome atlas databases (TCGA) and public database of breast cancer gene-expression miner (bc-GenExMiner) were utilized to analyze the prognostic role of LINC01614 in breast cancer. Kaplan-Meier, and Cox regression analyses were conducted for survival analysis. Nomograms were built to predict survival. We used deconvolution-based methods, such as TIMER (Tumor Immune Estimation Resource) and CIBERSORT (cell-type identification by estimating relative subsets of RNA transcripts), to explore the relationship between LINC01614 and immune cell characteristics.

RESULTS

The very abnormal expression of LINC01614 was found in 14 types of malignancy, including breast cancer. The LINC01614 was significantly overexpressed in human epidermal growth factor receptor 2 (HER2)+, estrogen receptor (ER)+, progesterone receptor (PR)+, and non-triple negative breast cancer (non-TNBC). According to survival analysis, the higher expression of LINC01614 was related with poor survival. The co-expressed genes analysis exhibited that LINC01614 was closely associated with the collagen-associated process and phosphoinositide 3-kinases-protein kinase B (PI3K-Akt) signaling pathway. Moreover, this study has explored the association among LINC01614 expression, tumor-infiltrating immune cells, and the efficacy of chemotherapeutics.

CONCLUSIONS

Our data reveal the expression pattern of LINC01614 in breast carcinoma with different molecular subtypes. The results also indicated that the LINC01614 could be a novel diagnostic and prognostic marker for breast carcinoma.

Developing a culturally acceptable peanut nutrition bar with smallholder women farmers in Kaffrine, Senegal using response surface methodology

To increase farm income and food security, a collaboration was made with smallholder women farmers in Kaffrine, Senegal to develop a culturally acceptable peanut nutrition bar using healthy indigenous and local ingredients and feasible manufacturing methods. This study aimed to use response surface methodology to optimize the bar's formulation and characterize the texture, nutrient profile, sensory qualities, and water activity. The bars were made by varying the ratio of cowpea flour to corn flour (w/w, d.b., 0/100, 25/75, 50/50, 75/25, and 100/0) and the percentage of baobab pulp powder in the cowpea-corn flour blend (w/w, d.b., 15%, 20%, 25%, and 30%) with a fixed amount of 13 g of peanut paste added to all formulations. The use of acacia gum as a binder increased the bars' cohesiveness. Increasing the ratio of cowpea flour to corn flour decreased the cohesiveness and increased protein, fiber, calcium, iron, and folate levels of the bars. Increasing the percentage of baobab pulp powder increased the hardness, fiber, and vitamin C levels, and decreased cohesiveness and water activity of the bars. The bar formulation optimized for sensory acceptance had a cowpea to corn ratio of 85.3:14.7, a baobab level of 9.95%, and 13 g of peanut paste. According to the research, the optimum formulation gave 38%, 32%, 36%, 50%, 11%, and 83% of the recommended dietary allowance of protein, fiber, calcium, iron, vitamin C, and folate, respectively, per serving for school-age children and featured culturally acceptable texture and desirable water activity for commercialization. This study provided critical foundations for the subsequent feasibility assessment of a commercial launch, projected to significantly increase the revenue and nutrient intake of the partnering communities. PRACTICAL APPLICATION: The commercialization of the peanut nutrition bar will serve as a source of new income for Senegalese smallholder women farmers, provide essential nutrients for school-age children and potentially reduce post-harvest loss. Response surface methodology used in this study can also be applied to food product development with indigenous communities to develop an accepted and community-feasible product formulation.

Market potential and value-added opportunities of cold-hardy berries and small fruits in the Intermountain West, USA

Novel cold-hardy berries and small fruits represent an opportunity for growers in the Intermountain West, USA, as the harsh environment is not suited for other common berries and small fruits. This study analyzed the fresh market and value-added potential of haskap berries (Lonicera caerulea), saskatoon berries (Amelenchier alnifolia), and dwarf sour cherry (DSC) fruit (Prunus x kerrasis) by instrumental and consumer studies. Fresh and 2-week stored haskap (cv. Aurora), saskatoon (Lee 3), and DSC (Romeo) were measured for fruit weight, flesh firmness, bulk titratable acidity, pH, and soluble solid content. Participants (n = 115) in at-home sensory tests scored these fruits for overall liking (OL, 9-point hedonic scale), purchase intent (PI, 5-point scale), and willingness-to-pay (WTP, 5-point scale). Ten participants further shared insight on these fruits in focus groups. Instrumental testing found a significant decrease in flesh firmness for 2-week stored haskap, but the consumers' OL was still comparable to fresh haskap. The fresh and 2-week stored haskap received significantly higher OL, PI, and WTP scores (7.7 ± 1.0, 3.8 ± 1.0, and $3.7 ± 1.0; 7.7 ± 1.2, 3.8 ± 1.1, and $3.7 ± 1.0, respectively) compared to saskatoon (6.1 ± 1.8, 2.8 ± 1.1, and $3.0 ± 0.9, respectively) and DSC (5.6 ± 2.2, 2.5 ± 1.2, and $3.1 ± 1.0, respectively) (α = 0.05). The focus groups indicated that participants want to support local produce. The participants expressed interest in fresh unprocessed haskap berries, but preferred saskatoon and DSC in different value-added formats. Hence, this study concluded that there is an untapped fresh-market potential for haskap berries and there are value-added opportunities to extend the sale season and improve the palatability of saskatoon and DSC. PRACTICAL APPLICATION: This research has examined consumer perception of three species of novel small fruits by determining fresh-market potential and linking this to the opportunity for value-added product development. For haskap berries, the study not only indicated fresh market potential, but for the cultivar Aurora, consumer liking was not meaningfully altered by 2 weeks of cold storage. These results are meaningful because they will assist growers in the Intermountain West with market planning, including the possibility of formulating products that utilize these novel crops. This study provides growers the opportunity to diversify their income stream by utilizing local produce.

Long-term effects of early stress due to earthquake exposure on depression symptoms in adulthood: a cross-sectional study

OBJECTIVE

This study aimed to investigate the long-term effects of early stress by Tangshan earthquake on symptoms of depression in adulthood.

METHOD

A total of 1534 volunteers born and raised in Tangshan were investigated; finally, 1328 subjects were enrolled in the study. They were divided into three groups according to their birth dates: infant exposure, prenatal exposure, and non-exposure. The questionnaires and psychological evaluation of all subjects were completed using a one-on-one psychological test.

RESULTS

The rate of depressive symptoms in the prenatal exposure group was the highest, and the lowest in the non-exposure group, with statistical differences among the three groups (P = 0.002). Moreover, the incidences of depressed mood, suicide ideation and work and loss of interest in the prenatal exposure group were significantly higher than those in the infant exposure group and the non-exposure group (P = 0.008, P = 0.001, P = 0.038, respectively). Multiple logistic regression analysis showed that male could be a protective factor for symptoms of depression in adulthood, and earthquake exposure was an important predictor of the incidence of depression symptoms.

CONCLUSIONS

Fetal or infancy exposure to earthquake might correlate to depression symptoms in adulthood.

[Predictive value of SYNTAX-Ⅱ score on prognosis of patients with chronic total occlusion undergoing percutaneous coronary intervention]

Objective: To investigate the predictive value of SYNTAX-Ⅱ score on long term prognosis of patients diagnosed with chronic total occlusion (CTO) and received percutaneous coronary intervention (PCI). Methods: Patients undergoing CTO-PCI in Fuwai hospital from January 2010 to December 2013 were enrolled in this retrospective analysis. The SYNTAX-Ⅱ score of the patients was calculated. According to SYNTAX-Ⅱ score tertiles, patients were stratified as follows: SYNTAX-Ⅱ≤20, 20<SYNTAX-Ⅱ≤27, SYNTAX-Ⅱ>27. Primary endpoint was major adverse cardiac events (MACCE), including all-cause death, myocardial infarction, stroke and any revascularization. Secondary endpoints included stent thrombosis, heart failure and target lesion failure (TLF). Patients were followed up by outpatient visit or telephone call at 1 month, 6 months and 1 year after PCI, and annually up to 5 years. Multivariate Cox regression model was used to analyze the independent risk factors of all-cause death in patients undergoing CTO-PCI. The predictive value of SYNTAX score with SYNTAX-Ⅱ score for all-cause death was evaluated by the receiver operating characteristic (ROC) curve and the area under the curve (AUC). Results: A total of 2 391 patients with CTO and received PCI were enrolled in this study. The mean age was (57.0±10.5) years, 1 994 (83.40%) patients were male. There were 802 patients in lower tertile group (SYNTAX-Ⅱ≤20), 798 patients in intermediate group (20<SYNTAX-Ⅱ≤27) and 791 patients in upper tertile group (SYNTAX-Ⅱ>27). At the end of 5-year follow-up, the loss to follow-up rate of the three groups was 9.10%(73/802), 10.78%(86/798)and 8.85%(70/791), respectively. The rate of all-cause mortality (1.78% (13/729) vs. 3.65% (26/712) vs. 9.02% (65/721), P<0.001), cardiac death (1.37% (10/729) vs. 2.11% (15/712) vs. 4.85% (35/721), P<0.001), target vessel myocardial infarctions (4.25% (31/729) vs. 4.49% (32/712) vs. 7.07% (51/721), P=0.03), probable stent thrombosis (1.51% (11/729) vs. 2.81% (20/712) vs. 3.61% (26/721), P=0.04) and heart failure (1.78% (13/729) vs. 1.97% (14/712) vs. 5.41% (39/721), P<0.001) increased in proportion to increasing SYNTAX-Ⅱ score (all P<0.05). Multivariable Cox regression analysis indicated that female (HR=2.05, 95%CI 1.12-3.73, P=0.01), left ventricular ejection fraction (HR=0.97, 95%CI 0.95-1.00, P=0.05) and SYNTAX-Ⅱ score (HR=1.07, 95%CI 1.02-1.11,P=0.01) were independent predictors for all-cause mortality in patients undergoing CTO-PCI. The predicted value of the SYNTAX-Ⅱ score for all-cause death was significantly higher than the SYNTAX score (AUC 0.71 vs. 0.60, P=0.003). Conclusion: For CTO patients who underwent percutaneous coronary intervention, SYNTAX-Ⅱ score is an independent predictor for 5-year all-cause death, and SYNTAX-Ⅱ serves as an important predictor for all-cause death in these patients.

A case of an occult bronchial foreign body in the right upper lung of an adult.. [DOI: 10.21203/rs.3.rs-2276172/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0]

Background Bronchial foreign bodies (BFBs) are less common in adults. An occult bronchial foreign body (OBFB) is a BFB with nontypical history, symptoms, physical signs and imaging, and is prone to either a delayed diagnosis, a missed diagnosis, or a misdiagnosis. There are no reported cases of adult OBFBs present in the upper lobe of the right lung alone. Case Description A 57-year-old previously healthy woman with no history of foreign body aspiration presented with recurrent cough and sputum that was present from August 2021 to May 2022. Her chest computed tomography (CT) suggested pneumonia in the upper lobe of the right lung, and tuberculosis had to be ruled out. After the laboratory tests to exclude tuberculosis were performed, she was diagnosed with pneumonia of the upper lobe of the right lung. Her symptoms were still recurrent after anti-infection and expectorant treatment. Finally, a yellowish-white substance (curd-like or cottage cheese-like) was found in the upper lobe of the right lung under flexible bronchoscopy, and the patient's cough and sputum symptoms were significantly relieved after removal of the substance. Conclusions OBFBs in adults are clinically rare and are prone to either a delayed diagnosis, a missed diagnosis or a misdiagnosis. A patient can be suspected of having a BFB after meeting the 4 conditions of OBFB and having any one indicator—risk factors, indirect signs of lesions on CT, or recurrent respiratory symptoms after treatment. Flexible bronchoscopy is necessary, and rigid bronchoscopy and surgery can be alternate means.

A novel senescence-related lncRNA signature that predicts prognosis and the tumor microenvironment in patients with lung adenocarcinoma

Background: Cellular senescence has recently been considered a new cancer hallmark. However, the factors regulating cellular senescence have not been well characterized. The aim of this study is to identify long non-coding RNAs (lncRNAs) associated with senescence and prognosis in patients with lung adenocarcinoma (LUAD). Methods: Using RNA sequence data from the Cancer Genome Atlas Lung Adenocarcinoma (TCGA-LUAD) and senescence genes from the CellAge database, a subset of senescence-related lncRNAs was first identified. Then, using univariate and multivariate Cox regression analyses, a senescence lncRNA signature (LUADSenLncSig) associated with LUAD prognosis was developed. Based on the median LUADSenLncSig risk score, LUAD patients were divided into high-risk and low-risk groups. Kaplan-Meier analysis was used to compare the overall survival (OS) in the high- and low-risk score subgroups. Differences in Gene Set Enrichment Analysis (GSEA), immune infiltration, tumor mutation burden (TMB), tumor immune dysfunction and exclusion (TIDE) module score, chemotherapy, and targeted therapy selection were also compared between the high-risk and low-risk groups. Results: A prognostic risk model was obtained consisting of the following nine senescence-related lncRNAs: LINC01116, AC005838.2, SH3PXD2A-AS1, VIMS-AS1, SH3BP5-AS1, AC092279.1, AC026355.1, AC027020.2, and LINC00996. The LUADSenLncSig high-risk group was associated with poor OS (hazard ratio = 1.17, 95% confidence interval = 1.102-1.242; p < 0.001). The accuracy of the model was further supported based on receiver operating characteristic (ROC), principal component analysis (PCA), and internal validation cohorts. In addition, a nomogram was developed consisting of LUADSenLncSig for LUAD prognosis, which is consistent with the actual probability of OS. Furthermore, immune infiltration analysis showed the low-risk group had a stronger anti-tumor immune response in the tumor microenvironment. Notably, the levels of immune checkpoint genes such as CTLA-4, PDCD-1, and CD274, and the TIDE scores were significantly higher in the low-risk subgroups than in high-risk subgroups (p < 0.001). This finding indicates the LUADSenLncSig can potentially predict immunotherapy efficacy. Conclusion: In this study, a lncRNA signature, LUADSenLncSig, that has dual functions of senescence phenotype identification and prognostic prediction as well as the potential to predict the LUAD response to immunotherapy was developed.

National audit of non-melanoma skin cancer excisions performed by plastic surgery in the UK

A national, multi-centre audit of non-melanoma skin cancer excisions by plastic surgery.

Genome-wide DNA methylation profiles of autism spectrum disorder

OBJECTIVES

We aimed to identify differentially methylated genes and related signaling pathways in autism spectrum disorder (ASD).

METHODS

First, the DNA methylation profile in the brain samples (GSE131706 and GSE80017) and peripheral blood samples (GSE109905) was downloaded from the Gene Expression Omnibus database (GEO) dataset, followed by identification of differentially methylated genes and functional analysis. Second, the GSE109905 data set was used to further validate the methylation state and test the ability to diagnose disease of identified differentially methylated genes. Third, expression measurement of selected differentially methylated genes was performed in whole blood from an independent sample. Finally, protein-protein interaction (PPI) network of core differentially methylated genes was constructed.

RESULTS

Totally, 74 differentially methylated genes were identified in ASD, including 38 hypermethylated genes and 36 hypomethylated genes. 15 differentially methylated genes were further identified after validation in the GSE109905 data set. Among these, major histocompatibility complex (HLA)-DQA1 was involved in the molecular function of myosin heavy chain class II receptor activity; HLA-DRB5 was involved in the signaling pathways of cell adhesion molecules, Epstein-Barr virus infection and antigen processing and presentation. In the PPI analysis, the interaction pairs of HLA-DQA1 and HLA-DRB5, FMN2 and ACTR3, and CALCOCO2 and BAZ2B were identified. Interestingly, FMN2, BAZ2B, HLA-DRB5, CALCOCO2 and DUSP22 had a potential diagnostic value for patients with ASD. The expression result of four differentially methylated genes (HLA-DRB5, NTM, IL16 and COL5A3) in the independent sample was consistent with the integrated analysis.

CONCLUSIONS

Identified differentially methylated genes and enriched signaling pathway could be associated with ASD.

Acceptability of PC-1005 Gel Administered Rectally to HIV-1 Seronegative Adults at Three Different Volume Levels (MTN-037)

Multipurpose prevention technologies (MPT) have been increasingly researched for their dual-purpose preventative properties against HIV and other STIs. The acceptability of PC-1005, a topical MPT candidate, was explored among men and women participating in the MTN-037 Phase I trial at two U.S. sites (Pittsburgh, PA, and Birmingham, AL). We triangulated quantitative and qualitative assessments of the acceptability of three volumes (4 mL, 16 mL, 32 mL) of PC-1005 administered rectally (N = 12; 6 males, 6 females). Participants rated overall gel acceptability on a scale of 1-10, with a median of 7.17 (SD = 2.04) and had positive feelings about all three dose volumes, citing them to be very comfortable or comfortable (dose 1 = 91.7%; dose 2 = 91.7%; dose 3 = 83.3%). High acceptability of and comfort with all three dose volumes shows promise for PC-1005 as an MPT to prevent HIV and STIs, warranting future clinical development.

[Association of glutamate receptor metabotropic 5 polymorphisms with schizophrenia susceptibility in a Chinese Han population]

Objectives: To investigate the association of single nucleotide polymorphisms (SNP) of glutamate receptor metabotropic 5 (GRM5) gene with schizophrenia susceptibility(SZ) in a Chinese Han population. Methods: Twenty-two SNPs located in GRM5 gene in 528 paranoid SZ patients and 528 control subjects recruited from northern Henanwere analyzed. The clinical features of 267 first-episode SZ patients were assessed with the Positive and Negative Syndrome Scale (PANSS). Results: The SZ group included 264 males and 264 females, aged (27±8) years; the healthy control group had 264 males and 264 females, aged (28±8) years.The differences in the genotypic and allelic frequencies of two SNPs (rs567990 and rs12421343) were statistically significant between the SZ patients and control groups (all P<0.05). The allele frequency of rs504183 was also statistically different between the two groups (P=0.030). When the subjects were stratified by sex, the genotypic and allelic frequencies of rs12421343 in female subjects were statistically different between the SZ patients and control groups. The allele frequencies of SNPs (rs12422021, rs567990, and rs7101540) were also statisticallydifferent between the two groups (all P<0.05). Meanwhile, rs567990 AG+GG carriers had a higher risk for SZ than AA carriers in female subjects(OR=1.946, 95%CI: 1.264-2.995). In addition, the patients with different genotypes (GG, AA+AG) of rs12422021 showed statistically significant differences in PANSS total score(84.8±24.4 vs 75.3±18.6), positive (16.2±4.3 vs 14.4±4.2), excitement (12.4±5.1 vs 10.2±4.1) and cognitive impairment factor scores (15.2±6.8 vs 13.3±3.9) (all P<0.05). The patients with AC and the other two genotypes (AA and CC) of rs504183 showed statistically significant differences in PANSS negative factor score(27.4±9.9 vs 24.7±8.4 and 23.4±8.1, both P<0.05). Conclusion: The current study provides further evidence that GRM5 is associated with SZ, and suggests a putative sex difference.

UBR5 promotes tumor immune evasion through enhancing IFN-γ-induced PDL1 transcription in triple negative breast cancer

Background: The up-regulation of PD-L1 is recognized as an adaption of cancer cells to evade immune surveillance and attack. However, the intrinsic mechanisms of the induction of PD-L1 by interferon-γ (IFN-γ) in tumor microenvironment remain incompletely characterized. Ubiquitin ligase E3 component N-recognition protein 5 (UBR5) has a critical role in tumorigenesis of triple negative breast cancer (TNBC) by triggering specific immune responses to the tumor. Dual targeting of UBR5 and PD-L1 exhibited superior therapeutic benefits in a preclinical TNBC model in short term. Methods: The regulation of UBR5 to PD-L1 upon IFN-γ stimulation was evaluated through in UBR5 deficiency, reconstitution or overexpression cell line models by quantitative PCR, immunohistochemistry and RNA-seq. The effects of PD-L1 regulation by UBR5 and double blockade of both genes were evaluated in mouse TNBC model. Luciferase reporter assay, chromatin immunoprecipitation-qPCR and bioinformatics analysis were performed to explore the transcription factors involved in the regulation of UBR5 to PD-L1. Results: E3 ubiquitin ligase UBR5 plays a key role in IFN-γ-induced PDL1 transcription in TNBC in an E3 ubiquitination activity-independent manner. RNA-seq-based transcriptomic analyses reveal that UBR5 globally affects the genes in the IFN-γ-induced signaling pathway. Through its poly adenylate binding (PABC) domain, UBR5 enhances the transactivation of PDL1 by upregulating protein kinase RNA-activated (PKR), and PKR's downstream factors including signal transducers and activators of transcription 1 (STAT1) and interferon regulatory factor 1 (IRF1). Restoration of PD-L1 expression in UBR5-deficient tumor cells recoups their malignancy in vivo, whereas CRISPR/Cas9-mediated simultaneous abrogation of UBR5 and PD-L1 expression yields synergistic therapeutic benefits than either blockade alone, with a strong impact on the tumor microenvironment. Conclusions: This study identifies a novel regulator of PDL1 transcription, elucidates the underlying molecular mechanisms and provides a strong rationale for combination cancer immunotherapies targeting UBR5 and PD-L1.

[The clinical value of oral robotic surgery in the treatment of oropharyngeal squamous cell carcinoma]

Objective: To explore the therapeutic effects of transoral robotic surgery (TORS) and traditional surgical modes in oropharyngeal squamous cell carcinoma (OPSCC). Methods: The clinicopathological data of patients with oropharyngeal squamous cell carcinoma treated at Sun Yat-sen University Cancer Center from 2010 to 2018 were retrospectively analyzed. 135 cases were treated with traditional surgery (non-TORS group), while 52 cases were treated with TORS (TORS group). The prognosis of the two groups of patients were analyzed by Kaplan-Meier method and Log rank test, the influencing factors were analyzed by Cox regression model. Results: The 2-year overall survival (OS, 94.2%) and 2-year progression-free survival (PFS, 93.8%) of patients in the TORS group were better than those in the non-TORS group (71.4% and 71.4%, respectively, P<0.05). The 2-year OS (93.3%) and 2-year PFS (92.8%) of TORS group patients in T1-2 stage were better than those of non-TORS group (73.1% and 72.8%, respectively, P<0.05). The 2-year OS (95.8%) and 2-year PFS (95.2%) of patients with stage Ⅰ to Ⅱ in the TORS group were not significantly different from those in the non-TORS group (84.1% and 83.9%, respectively, P>0.05). The 2-year OS (92.9%) and 2-year PFS rate (92.7%) of patients with stage Ⅲ to Ⅳ in the TORS group were better than those in the non-TORS group (64.7% and 63.9%, respectively, P<0.05). The 2-year OS (94.4%) of HPV-positive patients in the TORS group was not significantly different from that in the non-TORS group (83.3%, P=0.222). The 2-year OS of HPV-negative patients in the TORS group (94.1%) was significantly different from that in the non-TORS group (43.7%, P<0.001). HPV status was an independent prognostic factor (P=0.008). Conclusions: TORS has a better prognosis in the treatment of oropharyngeal squamous cell carcinoma compared with the traditional treatment methods. The patients with T1-T2 can achieve better survival benefits after TORS treatment. The HPV-positive OPSCC patients has a better prognosis than that of HPV-negative OPSCC patients, and regardless of HPV status, OPSCC patients in the TORS group could obtain a better survival prognosis.

Vitronectin-Derived Peptide Promotes Reparative Dentin Formation

Exposed dental pulp can maintain its vitality through a pulp-capping procedure with biocompatible materials, followed by reparative dentin formation. Our previous study demonstrated that a vitronectin-derived peptide (VnP-16) promotes osteoblast differentiation and concomitantly restrains osteoclast differentiation and resorptive function. In this study, we aimed to demonstrate that VnP-16 promotes odontoblast differentiation, mineralization, and reparative dentin formation in a pulp exposure model using a rat tooth. VnP-16 showed no cytotoxicity and promoted cellular behavior in human dental pulp cells, enhancing their differentiation into odontoblast-like cells and mineralization, effects that are comparable to those obtained with vitronectin. In a rat pulp exposure model, VnP-16 showed mild inflammatory responses at 2 and 4 wk or none. Mineral trioxide aggregate (MTA) demonstrated a tendency of early formation of reparative dentin at 2 wk when compared with recombinant human bone morphogenetic protein 2 (rhBMP-2) and VnP-16. However, VnP-16 induced reparative dentin formation similar to MTA and rhBMP-2 without inflammation at 4 wk. In addition, VnP-16 showed a thicker and homogeneous reparative dentin formation versus MTA and rhBMP-2. Collectively, these results suggest that VnP-16 can be a useful, direct pulp-capping agent for highly qualified reparative dentin formation by promoting cell behavior and odontoblastic differentiation of human dental pulp cells.

Numerical Optimization of a Nanophotonic Cavity by Machine Learning for Near-Unity Photon Indistinguishability at Room Temperature

Room-temperature (RT), on-chip deterministic generation of indistinguishable photons coupled to photonic integrated circuits is key for quantum photonic applications. Nevertheless, high indistinguishability (I) at RT is difficult to obtain due to the intrinsic dephasing of most deterministic single-photon sources (SPS). Here, we present a numerical demonstration of the design and optimization of a hybrid slot-Bragg nanophotonic cavity that achieves a theoretical near-unity I and a high coupling efficiency (β) at RT for a variety of single-photon emitters. Our numerical simulations predict modal volumes in the order of 10^-3(λ/2n)³, allowing for strong coupling of quantum photonic emitters that can be heterogeneously integrated. We show that high I and β should be possible by fine-tuning the quality factor (Q) depending on the intrinsic properties of the single-photon emitter. Furthermore, we perform a machine learning optimization based on the combination of a deep neural network and a genetic algorithm (GA) to further decrease the modal volume by almost 3 times while relaxing the tight dimensions of the slot width required for strong coupling. The optimized device has a slot width of 20 nm. The design requires fabrication resolution in the limit of the current state-of-the-art technology. Also, the condition for high I and β requires a positioning accuracy of the quantum emitter at the nanometer level. Although the proposal is not a scalable technology, it can be suitable for experimental demonstration of single-photon operation.

Long noncoding RNA TNFRSF10A-AS1 promotes colorectal cancer through upregulation of HuR

BACKGROUND

Recent studies have emphasized the emerging importance of long noncoding RNAs (lncRNAs) in colorectal cancer (CRC). However, the functions and regulatory mechanisms of numerous lncRNAs in CRC have not been fully elucidated.

AIM

To explore the functional role and underlying molecular mechanisms of lncRNA TNFRSF10A-AS1 in CRC.

METHODS

TNFRSF10A-AS1 expression was measured by quantitative real-time polymerase chain reaction in CRC, and the relationship between TNFRSF10A-AS1 levels and the clinicopathological features of CRC patients was analyzed. The effect of TNFRSF10A-AS1 expression on CRC proliferation and metastasis was examined in vitro and in vivo. Mechanistically, we investigated how TNFRSF10A-AS1 is involved in CRC as a competitive endogenous RNA.

RESULTS

TNFRSF10A-AS1 was expressed at a high level in CRC and the upregulation of TNFRSF10A-AS1 was associated with advanced T grade and tumor size in CRC patients. A functional investigation revealed that TNFRSF10A-AS1 enhanced the proliferation, migration ability and invasion ability of colon cancer cells in vitro and in vivo. A mechanistic analysis demonstrated that TNFRSF10A-AS1 acted as a miR-3121-3p molecular sponge to regulate HuR expression, ultimately promoting colorectal tumorigenesis and progression.

CONCLUSION

TNFRSF10A-AS1 exerts a tumor-promoting function through the miR-3121-3p/HuR axis in CRC, indicating that it may be a novel target for CRC therapy.

[Retropharyngeal lymph node dissection in head and neck cancers treated with transoral robotic surgery]

Objective: To evaluate the indications, safety, feasibility, and surgical technique for patients with head and neck cancers undergoing transoral robotic retropharyngeal lymph node (RPLN) dissection. Methods: The current study enrolled 12 consecutive head and neck cancer patients (seven males and four females) who underwent transoral robotic RPLN dissection with the da Vinci surgical robotic system at the Sun Yat-sen University Cancer Center from May 2019 to July 2020. Seven patients were diagnosed as nasopharyngeal carcinoma with RPLN metastasis after initial treatments, 4 patients were diagnosed as thyroid carcinoma with RPLN metastasis after initial treatments, and one patient was diagnosed as oropharyngeal carcinoma with RPLN metastasis before initial treatments. The operation procedure and duration time, intraoperative blood loss volume and complications, nasogastric feeding tube dependence, tracheostomy dependence, postoperative complications, and hospitalization time were recorded and analyzed. Results: All patients were successfully treated by transoral robotic dissection of the metastatic RPLNs, none of which was converted to open surgery. RPLNs were completely resected in 10 patients, and partly resected in 2 patients (both were nasopharyngeal carcinoma patients). The mean number of RPLN dissected was 1.7. The operation duration time and intraoperative blood loss volume were (191.3±101.1) min and (150.0±86.6) ml, respectively. There was no severe intraoperative complication such as massive haemorrhage or adjacent organ injury during surgery. Nasogastric tube use was required in all patients with (17.1±10.6) days of dependence, while tracheotomy was performed in 8 patients with (11.6±10.7) days of dependence. The postoperative hospitalization stay was (8.5±5.7) days. Postoperative complications occurred in 4 patients, including 2 of retropharyngeal incision and 2 of dysphagia. During a follow-up of (6.5±5.1) months, disease-free progression was observed in all patients, 10 patients were disease-free survival and other 2 patients were survival with tumor burden. Conclusions: The transoral robotic RPLN dissection is safety and feasible. Compared with the traditional open surgical approach, it is less traumatic and safer, has fewer complications and good clinical application potentiality. The indications for transoral robotic RPLN dissection include thyroid carcinoma, oropharyngeal carcinoma, and some selected nasopharyngeal carcinoma and other head and neck cancers. Metastatic RPLNs from some nasopharyngeal carcinoma with incomplete capsule, unclear border and adhesion to the surrounding vessels are not suitable for transoral robotic RPLN dissection.