Hierarchical medical image report adversarial generation with hybrid discriminator

BACKGROUND AND OBJECTIVES

Generating coherent reports from medical images is an important task for reducing doctors' workload. Unlike traditional image captioning tasks, the task of medical image report generation faces more challenges. Current models for generating reports from medical images often fail to characterize some abnormal findings, and some models generate reports with low quality. In this study, we propose a model to generate high-quality reports from medical images.

METHODS

In this paper, we propose a model called Hybrid Discriminator Generative Adversarial Network (HDGAN), which combines Generative Adversarial Network (GAN) with Reinforcement Learning (RL). The HDGAN model consists of a generator, a one-sentence discriminator, and a one-word discriminator. Specifically, the RL reward signals are judged on the one-sentence discriminator and one-word discriminator separately. The one-sentence discriminator can better learn sentence-level structural information, while the one-word discriminator can learn word diversity information effectively.

RESULTS

Our approach performs better on the IU-X-ray and COV-CTR datasets than the baseline models. For the ROUGE metric, our method outperforms the state-of-the-art model by 0.36 on the IU-X-ray, 0.06 on the MIMIC-CXR and 0.156 on the COV-CTR.

CONCLUSIONS

The compositional framework we proposed can generate more accurate medical image reports at different levels.

Chitosan-coated soybean protein isolate/lecithin nanoparticles for enhancing the stability and bioaccessibility of phytosterol

BACKGROUND

Phytosterols (PS) have various beneficial effects on human health, especially the property of reducing blood cholesterol. However, the low solubility and bioaccessibility of PS have greatly limited their application in functional food ingredients.

RESULTS

To improve the bioaccessibility and stability of PS, chitosan-coated PS nanoparticles (CS-PNP) were successfully prepared by self-assembly. The properties of CS-PNP, including size, zeta potential, encapsulation efficiency (EE) and loading amount (LA) were characterised. The optimisation of CS concentration (0.4 mg mL-1) and pH (3.5) resulted in the formation of CS-PNP with an EE of over 90% and a particle size of 187.7 nm. Due to the special properties of CS chitosan, the interaction between CS and soybean protein isolate (SPI)/lecithin (SL) led to the formation of a soluble complex. CS-PNP exhibited good stability to temperature variations but was more sensitive to salt ions. During in vitro digestion, CS efficiently maintained the stability of nanoparticles against the hydrolysis of SPI by pepsin under acidic conditions. However, these nanoparticles tended to aggregate in a neutral intestinal environment. After 3 h of in vitro digestion, the bioaccessibility of PS increased from 18.2% of free PS to 63.5% of CS-PNP.

CONCLUSION

Overall, these results highlight the potential of chitosan-coated nanoparticles as effective carriers for the oral administration of PS. This multilayer construction may serve as a promising for applications in food products as delivery vehicles for nutraceuticals. © 2024 Society of Chemical Industry.

Strain-Induced Self-Assembly at Interface of Two-Dimensional Heterostructures Boosts CO2 Reduction to Methanol by H2O

CO2 conversion with pure H2O into CH3OH and O2 driven by solar energy can supply fuels and life-essential substances for extraterrestrial exploration. However, the effective production of CH3OH is significantly challenging. Here we report an organozinc complex/MoS2 heterostructure linked by well-defined zinc-sulfur covalent bonds derived by the structural deformation and intensive coupling of dx2 - y2(Zn)-p(S) orbitals at the interface, resulting in distinctive charge transfer behaviors and excellent redox capabilities as revealed by experimental characterizations and first-principle calculations. The synthesis strategy is further generalized to more organometallic compounds, achieving various heterostructures for CO2 photoreduction. The optimal catalyst delivers a promising CH3OH yield of 2.57 mmol gcat-1 h-1 and selectivity of more than 99.5%. The reverse water gas shift mechanism is identified for methanol formation. Meanwhile, energy-unfavorable adsorption of methanol on MoS2, where the photogenerated holes accumulate, ensures the selective oxidation of water over methanol.

Subdural effusion associated with COVID-19 encephalopathy: A case report

BACKGROUND

The precise mechanism by which severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) impacts the central nervous system remains unclear, with manifestations spanning from mild symptoms (e.g., olfactory and gustatory deficits, hallucinations, and headache) to severe complications (e.g., stroke, seizures, encephalitis, and neurally demyelinating lesions). The occurrence of single-pass subdural effusion, as described below, is extremely rare.

CASE SUMMARY

A 56-year-old male patient presented with left-sided limb weakness and slurred speech as predominant clinical symptoms. Through comprehensive imaging and diagnostic assessments, he was diagnosed with cerebral infarction complicated by hemorrhagic transformation affecting the right frontal, temporal, and parietal regions. In addition, an intracranial infection with SARS-CoV-2 was identified during the rehabilitation process; consequently, an idiopathic subdural effusion developed. Remarkably, the subdural effusion underwent absorption within 6 d, with no recurrence observed during the 3-month follow-up.

CONCLUSION

Subdural effusion is a potentially rare intracranial complication associated with SARS-CoV-2 infection.

Silencing lncRNA-DARS-AS1 suppresses nonsmall cell lung cancer progression by stimulating miR-302a-3p to inhibit ACAT1 expression

Long noncoding RNAs (LncRNAs) have been gaining attention as potential therapeutic targets for lung cancer. In this study, we investigated the expression and biological behavior of lncRNA DARS-AS1, its predicted interacting partner miR-302a-3p, and ACAT1 in nonsmall cell lung cancer (NSCLC). The transcript level of DARS-AS1, miR-302a-3p, and ACAT1 was analyzed using qRT-PCR. Endogenous expression of ACAT1 and the expression of-and changes in-AKT/ERK pathway-related proteins were determined using western blotting. MTS, Transwell, and apoptosis experiments were used to investigate the behavior of cells. The subcellular localization of DARS-AS1 was verified using FISH, and its binding site was verified using dual-luciferase reporter experiments. The binding of DARS-AS1 to miR-302a-3p was verified using RNA co-immunoprecipitation. In vivo experiments were performed using a xenograft model to determine the effect of DARS-AS1 knockout on ACAT1 and NSCLC. lncRNA DARS-AS1 was upregulated in NSCLC cell lines and tissues and the expression of lncRNA DARS-AS1 was negatively correlated with survival of patients with NSCLC. Knockdown of DARS-AS1 inhibited the malignant behaviors of NSCLC via upregulating miR-302a-3p. miR-302a-3p induced suppression of malignancy through regulating oncogene ACAT1. This study demonstrates that the DARS-AS1-miR-302a-3p-ACAT1 pathway plays a key role in NSCLC.

Multi-energy CT material decomposition using graph model improved CNN

In spectral CT imaging, the coefficient image of the basis material obtained by the material decomposition technique can estimate the tissue composition, and its accuracy directly affects the disease diagnosis. Although the precision of material decomposition is increased by employing convolutional neural networks (CNN), extracting the non-local features from the CT image is restricted using the traditional CNN convolution operator. A graph model built by multi-scale non-local self-similar patterns is introduced into multi-material decomposition (MMD). We proposed a novel MMD method based on graph edge-conditioned convolution U-net (GECCU-net) to enhance material image quality. The GECCU-net focuses on developing a multi-scale encoder. At the network coding stage, three paths are applied to capture comprehensive image features. The local and non-local feature aggregation (LNFA) blocks are designed to integrate the local and non-local features from different paths. The graph edge-conditioned convolution based on non-Euclidean space excavates the non-local features. A hybrid loss function is defined to accommodate multi-scale input images and avoid over-smoothing of results. The proposed network is compared quantitatively with base CNN models on the simulated and real datasets. The material images generated by GECCU-net have less noise and artifacts while retaining more information on tissue. The Structural SIMilarity (SSIM) of the obtained abdomen and chest water maps reaches 0.9976 and 0.9990, respectively, and the RMSE reduces to 0.1218 and 0.4903 g/cm3. The proposed method can improve MMD performance and has potential applications.

CDKN2B-AS1 may act as miR-92a-3p sponge in coronary artery disease

BACKGROUND

LncRNAs, miRNAs, and the sponge effect between them exert diverse biological influences on the pathogenesis and progression of coronary artery disease (CAD), thus necessitating an exploration of the lncRNA-miRNA-gene regulatory network in CAD.

METHODS

Expression profile GSE98583 was obtained from NCBI, containing the data of 12 CAD patients and 6 controls. Limma package was utilized to determine the differentially expressed genes (DEGs). Functional enrichment analysis was performed by DAVID. The CAD-related miRNA-DEG associations were retrieved via HMDD and miRTarBase, and the CAD-related lncRNA-miRNA associations were retrieved via LncRNADisease and starBase. The CAD-related lncRNA-miRNA-DEG regulatory network was constructed by combining these associations. The dual luciferase test was carried out to validate the connections among lncRNA, miRNA, and gene.

RESULTS

Overall, 534 DEGs were identified between CAD samples and controls, including 243 up-regulated and 291 down-regulated, and were enriched in various gene ontology biological processes and KEGG pathways. The CAD-related miRNAs targeting DEGs included hsa-miR-206, has-miR-320b, has-miR-4513, has-miR-765, and has-miR-92a-3p, and hsa-miR-92a-3p regulated the most DEGs. In the lncRNA-miRNA associations, only CDKN2B-AS1 regulated the CAD-related miRNA, hsa-miR-92a-3p, which was validated using the dual luciferase test.

CONCLUSIONS

CDKN2B-AS1 may act as an hsa-miR-92a-3p sponge to regulate the downstream DEGs in CAD. CDKN2B-AS1/ hsa-miR-92a-3p/GATA2 might be a novel mechanism for CAD.

Predicting microvascular invasion in small (≤ 5 cm) hepatocellular carcinomas using radiomics-based peritumoral analysis

OBJECTIVE

We assessed the predictive capacity of computed tomography (CT)-enhanced radiomics models in determining microvascular invasion (MVI) for isolated hepatocellular carcinoma (HCC) ≤ 5 cm within peritumoral margins of 5 and 10 mm.

METHODS

Radiomics software was used for feature extraction. We used the least absolute shrinkage and selection operator (LASSO) algorithm to establish an effective model to predict patients' preoperative MVI status.

RESULTS

The area under the curve (AUC) values in the validation sets for the 5- and 10-mm radiomics models concerning arterial tumors were 0.759 and 0.637, respectively. In the portal vein phase, they were 0.626 and 0.693, respectively. Additionally, the combined radiomics model for arterial tumors and the peritumoral 5-mm margin had an AUC value of 0.820. The decision curve showed that the combined tumor and peritumoral radiomics model exhibited a somewhat superior benefit compared to the traditional model, while the fusion model demonstrated an even greater advantage, indicating its significant potential in clinical application.

CONCLUSION

The 5-mm peritumoral arterial model had superior accuracy and sensitivity in predicting MVI. Moreover, the combined tumor and peritumoral radiomics model outperformed both the individual tumor and peritumoral radiomics models. The most effective combination was the arterial phase tumor and peritumor 5-mm margin combination. Using a fusion model that integrates tumor and peritumoral radiomics and clinical data can aid in the preoperative diagnosis of the MVI of isolated HCC ≤ 5 cm, indicating considerable practical value.

CRITICAL RELEVANCE STATEMENT

The radiomics model including a 5-mm peritumoral expansion is a promising noninvasive biomarker for preoperatively predicting microvascular invasion in patients diagnosed with a solitary HCC ≤ 5 cm.

KEY POINTS

• Radiomics features extracted at a 5-mm distance from the tumor could better predict hepatocellular carcinoma microvascular invasion. • Peritumoral radiomics can be used to capture tumor heterogeneity and predict microvascular invasion. • This radiomics model stands as a promising noninvasive biomarker for preoperatively predicting MVI in individuals.

Light-driven phase transition of diffractive optical elements based on liquid crystal elastomers

Diffractive optical element is advantageous for miniaturization, arraying and integration of optical systems. They have been widely used in beam shaping, diffractive imaging, generating beam arrays, spectral optimization and other aspects. Currently, the vast majority of diffractive optics are not tunable. This limits the applicability and functionality of these devices. Here we report a tunable diffractive optical element controlled by light in the visible band. The diffractive optical element consists of a square gold microarray deposited on a deformable substrate. The substrate is made of a liquid crystal elastomer. When pumped by a 532 nm laser, the substrate is deformed to change the crystal lattice. This changes the far-field diffraction pattern of the device. The proposed concept establishes a light-controlled soft platform with great potential for tunable/reconfigurable photonic devices, such as filters, couplers, holograms and structural color displays.

Mulberry leaf polysaccharide improves cyclophosphamide-induced growth inhibition and intestinal damage in chicks by modulating intestinal flora, enhancing immune regulation and antioxidant capacity

Polysaccharides are generally considered to have immune enhancing functions, and mulberry leaf polysaccharide is the main active substance in mulberry leaves, while there are few studies on whether mulberry leaf polysaccharide (MLP) has an effect on immunosuppression and intestinal damage caused by cyclophosphamide (CTX), we investigated whether MLP has an ameliorative effect on intestinal damage caused by CTX. A total of 210 1-day-old Mahuang cocks were selected for this experiment. Were equally divided into six groups and used to evaluate the immune effect of MLP. Our results showed that MLP significantly enhanced the growth performance of chicks and significantly elevated the secretion of cytokines (IL-1β, IL-10, IL-6, TNF-α, and IFN-γ), immunoglobulins and antioxidant enzymes in the serum of immunosuppressed chicks. It attenuated jejunal damage and elevated the expression of jejunal tight junction proteins Claudin1, Zo-1 and MUC2, which protected intestinal health. MLP activated TLR4-MyD88-NF-κB pathway and enhanced the expression of TLR4, MyD88 and NF-κB, which served to protect the intestine. 16S rDNA gene high-throughput sequencing showed that MLP increased species richness, restored CTX-induced gut microbiome imbalance, and enhanced the abundance of probiotic bacteria in the gut. MLP improves cyclophosphamide-induced growth inhibition and intestinal damage in chicks by modulating intestinal flora and enhancing immune regulation and antioxidant capacity. In conclusion, this study provides a scientific basis for MLP as an immune enhancer to regulate chick intestinal flora and protect chick intestinal mucosal damage.

A Novel Thermal Interface Material Composed of Vertically Aligned Boron Nitride and Graphite Films for Ultrahigh Through-Plane Thermal Conductivity

The relentless drive toward miniaturization in microelectronic devices has sparked an urgent need for materials that offer both high thermal conductivity (TC) and excellent electrical insulation. Thermal interface materials (TIMs) possessing these dual attributes are highly sought after for modern electronics, but achieving such a combination has proven to be a formidable challenge. In this study, a cutting-edge solution is presented by developing boron nitride (BN) and graphite films layered silicone rubber composites with exceptional TC and electrical insulation properties. Through a carefully devised stacking-cutting method, the high orientation degree of both BN and graphite films is successfully preserved, resulting in an unprecedented through-plane TC of 23.7 Wm-1 K-1 and a remarkably low compressive modulus of 4.85 MPa. Furthermore, the exceptional properties of composites, including low thermal resistance and high resilience rate, make them a reliable and durable option for various applications. Practical tests demonstrate their outstanding heat dissipation performance, significantly reducing CPU temperatures in a computer cooling system. This research work unveils the possible upper limit of TC in BN-based TIMs and paves the way for their large-scale practical implementation, particularly in the thermal management of next-generation electronic devices.

Effects of different nitrogen applications and straw return depth on straw microbial and carbon and nitrogen cycles in paddy fields in the cool zone

Straw is an important source of organic fertilizer for soil enrichment, however, the effects of different nitrogen(N) application rates and depths on straw decomposition microorganisms and carbon and nitrogen cycling under full straw return conditions in cool regions of Northeast China are not clear at this stage. In this paper, we applied macro-genome sequencing technology to investigate the effects of different N application rates (110 kg hm-2, 120 kg hm-2, 130 kg hm-2, 140 kg hm-2, 150 kg hm-2) and depths (0-15 cm, 15-30 cm) on straw decomposing microorganisms and N cycling in paddy fields in the cool zone of Northeast China. The results showed that (1) about 150 functional genes are involved in the carbon cycle process of degradation during the degradation of returned straw, of which the largest number of functional genes are involved in the methane production pathway, about 42, the highest abundance of functional genes involved in the citric acid cycle pathway. There are 22 kinds of functional genes involved in the nitrogen cycle degradation process, among which there are more kinds involved in nitrogen fixation, with 4 kinds. (2) High nitrogen application (150 kg hm-2) inhibited the carbon and nitrogen conversion processes, and the abundance of straw-degrading microorganisms and nitrogen-cycling functional genes was relatively high at a nitrogen application rate of 130 kg hm-2. (3) Depth-dependent heterogeneity of the microbial community was reduced throughout the vertical space. At 71 days of straw return, the nitrogen cycling function decreased and some carbon functional genes showed an increasing trend with the increase of straw return depth. The nitrogen cycle function decreased with the increase of straw returning depth. The microbial community structure was best and the abundance of functional genes involved in the nitrogen cycling process was higher under the conditions of 0-15 cm of returning depth and 130 kg hm-2 of nitrogen application.

Carboxymethylated Abrus cantoniensis polysaccharide prevents CTX-induced immunosuppression and intestinal damage by regulating intestinal flora and butyric acid content

As a Chinese folk health product, Abrus cantoniensis exhibits good immunomodulatory activity because of its polysaccharide components (ACP), and carboxymethylation of polysaccharides can often further improve the biological activity of polysaccharides. In this study, we explored the impact of prophylactic administration of carboxymethylated Abrus cantoniensis polysaccharide (CM-ACP) on immunosuppression and intestinal damage induced by cyclophosphamide (CTX) in mice. Our findings demonstrated that CM-ACP exhibited a more potent immunomodulatory activity compared to ACP. Additionally, CM-ACP effectively enhanced the abundance of short-chain fatty acid (SCFA)-producing bacteria in immunosuppressed mice and regulated the gene expression of STAT6 and STAT3 mediated pathway signals. In order to further explore the relationship among polysaccharides, intestinal immunity and intestinal flora, we performed a pseudo-sterile mouse validation experiment and fecal microbiota transplantation (FMT) experiment. The findings suggest that CM-FMT and butyrate attenuate CTX-induced immunosuppression and intestinal injury. CM-FMT and butyrate show superior immunomodulatory ability, and may effectively regulate intestinal cell metabolism and repair the damaged intestine by activating STAT6 and STAT3-mediated pathways. These findings offer new insights into the mechanisms by which CM-ACP functions as functional food or drug, facilitating immune response regulation and maintaining intestinal health.

A prospective comparative study on bladder volume measurement with portable ultrasound scanner and CT simulator in pelvic tumor radiotherapy

OBJECTIVE

The consistency of bladder volume is very important in pelvic tumor radiotherapy, and portable bladder scanner is a promising device to measure bladder volume. The purpose of this study was to investigate whether the bladder volume of patients with pelvic tumor treated with radiotherapy can be accurately measured using the Meike Palm Bladder Scanner PBSV3.2 manufactured in China and the accuracy of its measurement under different influencing factors.

METHODS

A total of 165 patients with pelvic tumor undergoing radiotherapy were prospectively collected. The bladder volume was measured with PBSV3.2 before simulated localization. CT simulated localization was performed when the bladder volume was 200-400ml. The bladder volume was measured with PBSV3.2 immediately after localization and recorded. The bladder volume was then delineated on CT simulation images and recorded. To compare the consistency of CT simulation bladder volume and bladder volume measured by PBSV3.2. To investigate the accuracy of PBSV3.2 in different sex, age, treatment purpose, and bladder volume.

RESULTS

There was a significant positive correlation with bladder volume on CT and PBSV3.2 (r = 0.874; p < 0.001). The mean difference between CT measured values and PBSV3.2 was (-0.14 ± 50.17) ml. The results of the different variables showed that the overall mean of PBSV3.2 and CT measurements were statistically different in the age ≥ 65 years, bladder volumes > 400ml and ≤ 400ml groups (p = 0.028, 0.002, 0.001). There was no statistical significance between the remaining variables. The volume difference between PBSV3.2 measurement and CT was 12.87ml in male patients, which was larger than that in female patients 3.27ml. Pearson correlation analysis showed that the correlation coefficient was 0.473 for bladder volume greater than 400ml and 0.868 for bladder volume less than 400ml; the correlation coefficient of the other variables ranged from 0.802 to 0.893.

CONCLUSION

This is the first large-sample study to evaluate the accuracy of PBSV3.2 in a pelvic tumor radiotherapy population using the convenient bladder scanner PBSV3.2 made in China. PBSV3.2 provides an acceptable indicator for monitoring bladder volume in patients with pelvic radiotherapy. It is recommended to monitor bladder volume with PBSV3.2 when the planned bladder volume is 200-400ml. For male and patients ≥ 65 years old, at least two repeat measurements are required when using a bladder scanner and the volume should be corrected by using a modified feature to improve bladder volume consistency.

Deep Learning Radiomics Analysis of CT Imaging for Differentiating Between Crohn's Disease and Intestinal Tuberculosis

This study aimed to develop and evaluate a CT-based deep learning radiomics model for differentiating between Crohn's disease (CD) and intestinal tuberculosis (ITB). A total of 330 patients with pathologically confirmed as CD or ITB from the First Affiliated Hospital of Zhengzhou University were divided into the validation dataset one (CD: 167; ITB: 57) and validation dataset two (CD: 78; ITB: 28). Based on the validation dataset one, the synthetic minority oversampling technique (SMOTE) was adopted to create balanced dataset as training data for feature selection and model construction. The handcrafted and deep learning (DL) radiomics features were extracted from the arterial and venous phases images, respectively. The interobserver consistency analysis, Spearman's correlation, univariate analysis, and the least absolute shrinkage and selection operator (LASSO) regression were used to select features. Based on extracted multi-phase radiomics features, six logistic regression models were finally constructed. The diagnostic performances of different models were compared using ROC analysis and Delong test. The arterial-venous combined deep learning radiomics model for differentiating between CD and ITB showed a high prediction quality with AUCs of 0.885, 0.877, and 0.800 in SMOTE dataset, validation dataset one, and validation dataset two, respectively. Moreover, the deep learning radiomics model outperformed the handcrafted radiomics model in same phase images. In validation dataset one, the Delong test results indicated that there was a significant difference in the AUC of the arterial models (p = 0.037), while not in venous and arterial-venous combined models (p = 0.398 and p = 0.265) as comparing deep learning radiomics models and handcrafted radiomics models. In our study, the arterial-venous combined model based on deep learning radiomics analysis exhibited good performance in differentiating between CD and ITB.

An efficient asymmetric structured hole transport material for perovskite solar cells

Hole transport materials (HTMs) play a crucial role in achieving efficient perovskite solar cells (PSCs). In this work, an HTM MF-ACD with an asymmetric structure is designed by introducing two different peripheral end groups. The asymmetric feature increases the molecular dipole of MF-ACD, and endows MF-ACD with good stability and film formation properties, higher hole mobility and conductivity. Consequently, the MF-ACD-based PSC shows a high efficiency of 23.1%, which is much higher than that of the symmetric counterpart. The results show that the asymmetric configuration might be a potential choice to develop more efficient HTMs.

RORα is required for expansion and memory maintenance of ILC1s via a lymph node-liver axis

Type 1 innate lymphoid cells (ILC1s) possess adaptive immune features, which confer antigen-specific memory responses against haptens and viruses. However, the transcriptional regulation of memory ILC1 responses is currently not known. We show that retinoic acid receptor-related orphan receptor alpha (RORα) has high expression in memory ILC1s in murine contact hypersensitivity (CHS) models. RORα deficiency diminishes ILC1-mediated CHS responses significantly but has no effect on memory T cell-mediated CHS responses. During sensitization, RORα promotes sensitized-ILC1 expansion by suppressing expression of cell-cycle repressors in draining lymph nodes. RORα programs gene-expression patterns related to cell survival and is required for the long-term maintenance of memory ILC1s in the liver. Our findings reveal RORα to be a key transcriptional factor for sensitized-ILC1 expansion and long-term maintenance of memory ILC1s.

Role of the Benzothiadiazole Unit in Organic Polymers on Photocatalytic Hydrogen Production

Organic polymers based on the donor-acceptor structure are a promising class of efficient photocatalysts for solar fuel production. Among these polymers, poly(9,9-dioctylfluorene-alt-1,2,3-benzothiadiazole) (PFBT) consisting of fluorene donor and benzothiadiazole acceptor units has shown good photocatalytic activity when it is prepared into polymer dots (Pdots) in water. In this work, we investigate the effect of the chemical environment on the activity of photocatalysis from PFBT Pdots for hydrogen production. This is carried out by comparing the samples with various concentrations of palladium under different pH conditions and with different sacrificial electron donors (SDs). Moreover, a model compound 1,2,3-benzothiadiazole di-9,9-dioctylfluorene (BTDF) is synthesized to investigate the mechanism for protonation of benzothiadiazole and its kinetics in the presence of an organic acid-salicylic acid by cyclic voltammetry. We experimentally show that benzothiadiazole in BTDF can rapidly react with protons with a fitted value of 0.1-5 × 1010 M-1 s-1 which should play a crucial role in the photocatalytic reaction with a polymer photocatalyst containing benzothiadiazole such as PFBT Pdots for hydrogen production in acidic conditions. This work gives insights into why organic polymers with benzothiadiazole work efficiently for photocatalytic hydrogen production.

Efficient and Stable Tin-Lead Mixed Perovskite Solar Cells Using Post-Treatment Additive with Synergistic Effects

Inhibiting the oxidation of Sn2+ during the crystallization process of Sn-Pb mixed perovskite film is found to be as important as the oxidation resistance of precursor solution to achieve high efficiency, but less investigated. Considering the excellent reduction feature of hydroquinone and the hydrophobicity of tert-butyl group, an antioxidant 2,5-di-tert-butylhydroquinone (DBHQ) was introduced into Sn-Pb mixed perovskite films using an anti-solvent approach to solve this problem. Interestingly, we find that DBHQ can act as function alterable additive during its utilization. On the one hand, DBHQ can restrict the oxidation of Sn2+ during the crystallization process, facilitating the fabrication of high-quality perovskite film; on the other hand, the generated oxidation product 2,5-di-tert-butyl-1,4-benzoquinone (DBBQ) can functionalize as defect passivator to inhibit the charge recombination. As a result, this synergetic effect renders the Sn-Pb mixed PSC a power conversion efficiency (PCE) up to 23.0 %, which is significantly higher than the reference device (19.6 %). Furthermore, the unencapsulated DBQH-modified PSCs exhibited excellent long-term stability and thermal stability, with the devices maintaining 84.2 % and 78.9 % of the initial PCEs after aging at 25 °C and 60 °C for 800 h and 120 h under N2 atmosphere, respectively. Therefore, the functional alterable strategy provides a novel cornerstone for high-performance Sn-Pb mixed PSCs.

Tunable Multivalent Aptamer-Based DNA Nanostructures To Regulate Multiheteroreceptor-Mediated Tumor Recognition

Precise mapping and regulation of cell surface receptors hold immense significance in disease treatment, such as cancer, infection, and neurodisorders, but also face enormous challenges. In this study, we designed a series of adjustable multivalent aptamer-based DNA nanostructures to precisely control their interaction with receptors in tumor cells. By profiling surface receptors on 12 cell lines using 10 different aptamers, we generated a heatmap that accurately distinguished between various tumor types based on multiple markers. We then incorporated these aptamers onto DNA origami structures to regulate receptor recognition, with patch-like structures demonstrating a tendency to be trapped on the cell surface and with tube-like structures showing a preference for internalization. Through precise control of aptamer species, valence, and geometric patterns, we found that multiheteroreceptor-mediated recognition not only favored the specific binding of nanostructures to tumor cells but also greatly enhanced intracellular uptake by promoting clathrin-dependent endocytosis. Specifically, we achieved over 5-fold uptake in different tumor cells versus normal cells using tube-like structures modified with different diheteroaptamer pairs, facilitating targeted drug delivery. Moreover, patch-like structures with triheteroaptamers guided specific interactions between macrophages and tumor cells, leading to effective immune clearance. This programmable multivalent system allows for the precise regulation of cell recognition using multiple parameters, demonstrating great potential for personalized tumor treatment.

A Gender-, Age-, and Weight Status-Specific Analysis of the High Prevalence of Hyperuricemia Among Chinese Children and Adolescents with Obesity

Objective

To explore the gender-, age-, and weight status-specific prevalence of hyperuricemia (HUA) and its associated risk factors among Chinese children and adolescents with obesity.

Methods

A total of 1329 children aged 2-17 years, who were diagnosed with obesity and hospitalized in our center from January 2016 to December 2022 were recruited. They were divided into mild obesity, moderate obesity, and severe obesity groups. HUA was defined as fasting serum uric acid level >420 μmol/L for boys and >360 μmol/L for girls. Multivariate logistic regression analyses were performed to identify risk factors for HUA.

Results

The highest proportion of hospitalized obese children was aged 10-13 years comprising 677 (50.9%) followed by those aged 6-9 years comprising 348 (26.2%) whereas the least proportion was aged 2-5 years comprising 76 (5.7%). The above differences in age distribution were still present in subgroup analyses according to weight status. Most hospitalized obese children were boys (64.7%), especially in the severe obesity group (75.0%). The overall estimated prevalence of HUA in obese children was 54.8%. It presented a gradual increase trend over the last 7 years, with more rapidly in boys than in girls. Subgroup analysis by weight status showed that the prevalence of HUA was higher in children with moderate obesity (64.3%) and severe obesity (64.2%) when compared with mild obesity (48.2%) (P all<0.01). Boys reached a relatively high HUA incidence level (≥60%) at age 12, which occurred about 2 years later than in girls (age 10). With 12 years as the cut-off point, a high prevalence of HUA (≥60%) was observed in both genders. Multivariable logistic regression analyses showed that boy (OR=2.844, 95% CI 2.024-3.998), age (OR=1.253, 95% CI 1.155-1.360), BMI-Z score (OR=2.132, 95% CI 1.438-3.162), fasting blood glucose (OR=0.907, 95% CI 0.860-0.956), phosphorus (OR=4.123, 95% CI 2.349-7.239), alkaline phosphatase (OR=1.002, 95% CI 1.001-1.004), creatinine (OR=1.067, 95% CI 1.037-1.098), urea nitrogen (OR=1.193, 95% CI 1.032-1.378), aspartate aminotransferase (OR=1.016, 95% CI 1.002-1.030), triglycerides (OR=1.339, 95% CI 1.075-1.667), and high-density lipoprotein cholesterol (OR=0.381, 95% CI 0.160-0.910) were independently associated with odds of HUA (P all<0.05).

Conclusion

The prevalence of HUA in Chinese obese children and adolescents is unexpectedly high. Childhood HUA was significantly associated with obesity. Gender and age differences were observed in the association between childhood obesity and HUA. Obese children aged ≥12 years should be focused on screening the risk of HUA.

Diagnosis and treatment of high-risk bilateral lung ground-glass opacity nodules

In recent years, there has been a significant increase in the detection rate of Ground Glass Opacity (GGO) nodules through high-resolution computed tomography (HRCT). GGO is an imaging finding that encompasses various pathological types, some of which exhibit indolent growth, while others may represent early lung cancer or remain relatively stable, not significantly impacting the surgical treatment outcome. In clinical practice, patients often experience psychological anxiety when multiple pulmonary GGO nodules are present, and they may request simultaneous resection. However, there is currently no standardized criterion for determining when multiple GGO nodules should be resected. As personalized medicine continues to advance, the treatment approach for multiple pulmonary GGO nodules needs to prioritize accuracy. High-risk factors associated with multiple pulmonary GGO nodules may necessitate surgical intervention along with mediastinal lymph node dissection or sampling. This article provides a review of the characteristics, treatment methods, and clinical experiences related to multiple pulmonary GGO nodules, offering practical insights and guidance for healthcare professionals.

Incidence and risk of remnant gastric cancer after gastrectomy for gastric cancer: a population-based study from the SEER database

BACKGROUND

Gastric cancer (GC) constitutes a major global health problem, of which remnant gastric cancer (RGC) occurs less frequently. The rate of RGCs after gastrectomy for GC is increasing recently due to improved survival and screening, however, their incidence and risk have not been reported in the U.S.

POPULATION

The objective of this study was to evaluate the incidence and elevated risk of RGC after GC gastrectomy in this population, and to identify the risk factors.

METHODS

Patients underwent gastrectomy for first primary GC in 2000-2015 and those who developed RGC were identified from Surveillance, Epidemiology and End Results (SEER) database. Fine-Gray regression was used to estimate the cumulative incidence and to identify risk factors. Standardized incidence ratios (SIRs) were calculated by Poisson regression to compare the risk with the general population.

RESULTS

Among 21,566 patients included in the cohort, 227 developed RGC. The 20-year cumulative incidence of RGC was 1.88%. Multivariate analysis revealed that older age, invasion depth, male sex, marital status, and lower income are independent risk factors for RGC development. SIR was 7.70 overall and > 4.5 in each stratum.

CONCLUSIONS

Cumulative incidence and risk for RGCs increased continuously in patients underwent GC gastrectomy. Close and lifelong endoscopy surveillance should be recommended for patients who received GC gastrectomy, especially those with high-risk factors.

Analyzing robotic surgery impact on recovery quality & emotions

Background

The objective of this study is to investigate the postoperative recovery quality and emotional status of patients with non-small cell lung cancer (NSCLC) who underwent robot-assisted and video-assisted thoracoscopic surgery using the 15-item Quality of Recovery (QoR-15) scale and to analyze the correlation.

Methods

We collected clinical data from 320 patients with NSCLC who underwent lobectomy using either robot-assisted thoracoscopic surgery (RATS) or video-assisted thoracoscopic surgery (VATS) at our center from January 2021 to December 2022. We compared perioperative parameters and followed up after the operation using the QoR-15 scale to objectively assess the quality of postoperative recovery and physical and emotional status.

Results

Apart from a notable distinction in anesthesia time, no significant differences were observed in other general data. Notably, the overall recovery rate for patients in the RATS group surpassed that of the VATS group (P < 0.05). Specifically, the recovery rates in the RATS group were significantly superior to those in the VATS group across nociceptive factors, emotional factors, activities of daily living, physiological factors, and cognitive ability (P < 0.05). Spearman correlation analysis between surgical methods and various indicators of the QoR-15 scale showed significant correlations between surgical methods (P < 0.05).

Conclusion

The QoR-15 scale is a valuable tool for assessing the postoperative recovery quality in lung cancer patients. The RATS plays a significant role in promoting the swift postoperative recovery of patients and demonstrates excellent efficacy, safety, and reliability.

Exploration of potential shared gene signatures between periodontitis and multiple sclerosis

BACKGROUND

Although periodontitis has previously been reported to be linked with multiple sclerosis (MS), but the molecular mechanisms and pathological interactions between the two remain unclear. This study aims to explore potential crosstalk genes and pathways between periodontitis and MS.

METHODS

Periodontitis and MS data were obtained from the Gene Expression Omnibus (GEO) database. Shared genes were identified by differential expression analysis and weighted gene co-expression network analysis (WGCNA). Then, enrichment analysis for the shared genes was carried out by multiple methods. The least absolute shrinkage and selection operator (LASSO) regression was used to obtain potential shared diagnostic genes. Furthermore, the expression profile of 28 immune cells in periodontitis and MS was examined using single-sample GSEA (ssGSEA). Finally, real-time quantitative fluorescent PCR (qRT-PCR) and immune histochemical staining were employed to validate Hub gene expressions in periodontitis and MS samples.

RESULTS

FAM46C, SLC7A7, LY96, CFI, DDIT4L, CD14, C5AR1, and IGJ genes were the shared genes between periodontitis, and MS. GO analysis revealed that the shared genes exhibited the greatest enrichment in response to molecules of bacterial origin. LASSO analysis indicated that CFI, DDIT4L, and FAM46C were the most effective shared diagnostic biomarkers for periodontitis and MS, which were further validated by qPCR and immunohistochemical staining. ssGSEA analysis revealed that T and B cells significantly influence the development of MS and periodontitis.

CONCLUSIONS

FAM46C, SLC7A7, LY96, CFI, DDIT4L, CD14, C5AR1, and IGJ were the most important crosstalk genes between periodontitis, and MS. Further studies found that CFI, DDIT4L, and FAM46C were potential biomarkers in periodontitis and MS.

Protective Effect of Artocarpus heterophyllus Lam. (Jackfruit) Polysaccharides on Liver Injury Induced by Cyclophosphamide in Mice

In recent years, Artocarpus heterophyllus Lam. (jackfruit) polysaccharides (namely JFP-Ps) have attracted much attention due to their multiple biological activities. This study aimed to explore the protective effects and the underlying mechanisms of JFP-Ps on cyclophosphamide (Cp)-induced liver damage. The protective effect of JFP-Ps was evaluated using HE staining, antioxidant testing, enzyme-linked immunosorbent assay (ELISA), real-time quantitative polymerase chain reaction (RT-qPCR), Western blot and ultra-performance liquid chromatography equipped with quadrupole time-of-flight mass spectrometry (UPLC-Q-TOF-MS/MS) metabolomics analysis. The results showed that Cp caused pathological liver damage, activated oxidative stress and downregulated cytokine expression, while JFP-Ps treatment was found to exert antioxidant effects and play immune regulatory roles through mitogen-activated protein kinase/nuclear factor-κB (MAPK/NF-κB) related inflammation and cell apoptosis pathways to protect the Cp-induced liver injury. Metabolomic results showed that the liver-protective effects of JFP-Ps were mainly related to aminoacyl transfer ribonucleic acid (tRNA) biosynthesis, sphingolipid metabolism, purine metabolism and the citrate cycle. These results indicate that JFP-Ps have great potential application in alleviating liver injury.

A statistical study of postmortem heart weight in Chinese adults

INTRODUCTION

Objective assessment of cardiac hypertrophy in forensic pathology practice is of great significance for forensic pathologists, for whom reference values for normal heart weights are needed. Developed regions such as Europe, the United States, and Japan recalculate the weight of human organs at regular intervals, but in China, there has been no systematic calculation of the weights of human organs since 2006.

AIMS

To statistically analyse the heart weight of Chinese adults postmortem and obtain a reference range.

MATERIALS AND METHODS

4170 adult autopsy reports were collected from 12 forensic departments in 10 provinces in China. The causes of death were classified by sex, and heart weight and the heart weight/body height ratio reference values were further calculated according to different body mass index and body heights. Finally, the cutoff value of cardiac hypertrophy in Chinese adults was calculated.

RESULTS

In the group of non-cardiovascular disease causes of death, the cardiac weight of the electric death group was higher, while the heart weight of the prolonged bed-rest group was significantly reduced. After the electric death and prolonged bed-rest groups were excluded, heart weight, the heart weight/body height ratio, and cutoff values for cardiac hypertrophy were further classified and analysed according to body mass index. The mean reference values for heart weight in men and women with normal weight status were 325.82 ± 41.60 g and 286.39 ± 44.84 g, and the heart weight/body height ratios were 1.95 ± 0.23 in men and 1.82 ± 0.27, respectively. The cutoff values for cardiac hypertrophy were 387.35 g for men and 346.80 g for women.

CONCLUSION

The heart weight reference values of both sexes in this study were significantly higher than those in 2006, which is considered related to the development of China's economy and the improvement of people's living standards. This study also suggests the need for a new round of statistical surveys and updated data on the weight of other organs.

Switchable liquid crystal lenticular microlens arrays based on photopolymerization-induced phase separation for 2D/3D autostereoscopic displays

Conventionally, the fabrication of liquid crystal lenticular microlens arrays (LCLMLAs) is complicated and costly. Here, we demonstrate a one-step fabrication technique for LCLMLAs, which is prepared through the photopolymerization-induced phase separation in the LC/polymer composite. The LCLMLAs possess both polarization-dependent and electrically tunable focusing properties. Furthermore, we construct a 14-view 2D/3D switchable autostereoscopic display prototype based on a 2D LCD panel and the prepared LCLMLA, which has a viewing angle of 14° and a crosstalk of 46.2% at the optimal viewing zone. The proposed LCLMLAs have the merits of simple fabrication, large-scale production, and low cost.

The Role of Mesenchymal Stem Cells in Hair Regeneration and Hair Cycle

The health of hair is directly related to people's health and appearance. Hair has key physiological functions, including skin protection and temperature regulation. Hair follicle (HF) is a vital mini-organ that directly impacts hair growth. Besides, various signaling pathways and molecules regulate the growth cycle transition of HFs. Hair and its regeneration studies have attracted much interest in recent years with the increasing rate of alopecia. Mesenchymal stem cells (MSCs), as pluripotent stem cells, can differentiate into fat, bone, and cartilage and stimulate regeneration and immunological regulation. MSCs have been widely employed to treat various clinical diseases, such as bone and cartilage injury, nerve injury, and lung injury. Besides, MSCs can be used for treatment of hair diseases due to their regenerative and immunomodulatory abilities. This review aimed to assess MSCs' treatment for alopecia, pertinent signaling pathways, and new material for hair regeneration in the last 5 years.

Changes in Phenolic Compounds and Antioxidant Capacity of Artocarpus heterophyllus Lam. (Jackfruit) Pulp during In Vitro Gastrointestinal Digestion

An in vitro gastrointestinal digestion model was applied to investigate the effect of digestion on the phenolic compounds and antioxidant capacity of Artocarpus heterophyllus Lam. (jackfruit) pulp. The total phenol content (TPC) was determined using Folin-Ciocalteu method, and the antioxidant activities were evaluated by DPPH and ABTS assays. Phenolic compounds were analyzed using ultra-performance liquid chromatography coupled with electrospray ionization, followed by quadrupole time-of-flight mass spectrometry (UPLC-ESI-Q-TOF-MS/MS). The results showed that TPC was significantly higher after gastric digestion. Thirty phenolic compounds (hydroxybenzoic acids and derivatives, hydroxycinnamic acids and derivatives, and flavonoids) were identified. The antioxidant activities of the digested samples varied with the TPC, and there was a correlation between antioxidant activity and TPC. The present study implies that gastrointestinal digestion may improve TPC and increase the amount of free phenolic compounds, mainly related to changes in pH value and digestive enzymes.

Discovery of novel dual Bruton's tyrosine kinase (BTK) and Janus kinase 3 (JAK3) inhibitors as a promising strategy for rheumatoid arthritis

Rheumatoid arthritis (RA) is a chronically systemic autoimmune disorder, which is related with various cellular signal pathways. Both BTK (Bruton's Tyrosine Kinase) and JAK3 (Janus Kinase 3) play important roles in the pathogenesis of rheumatoid arthritis. Herein, we reported the discovery of dual BTK/JAK3 inhibitors through bioisosterism and computer-aided drug design based on the structure of BTK inhibitor ibrutinib. We reported the discovery of dual BTK/JAK3 inhibitors which are based on the structure of BTK inhibitor ibrutinib via the method of bioisosterism and computer-aided drug design) Most of the target compounds exhibited moderate to strong inhibitory activities against BTK and JAK3. Among them, compound XL-12 stood out as the most promising candidate targeting BTK and JAK3 with potent inhibitory activities (IC50 = 2.0 nM and IC50 = 14.0 nM respectively). In the in vivo studies, compound XL-12 (40 mg/kg) exhibited more potent antiarthritic activity than ibrutinib (10 mg/kg) in adjuvant arthritis (AA) rat model. Furthermore, compound XL-12 (LD50 > 1600 mg/kg) exerted improved safety compared with ibrutinib (LD50 = 750 mg/kg). These results indicated that compound XL-12, the dual BTK/JAK3 inhibitor, might be a potent drug candidate for the treatment of RA.

Origin of the Anomalous Electrical Transports in Quasi-One-Dimensional Ta2NiSe7

Exploration of exotic transport behavior is of great interest and importance for revealing the properties of the CDW phase of quasi-one-dimensional Ta2NiSe7. We report the anisotropic electrical transport properties of Ta2NiSe7 single crystals in the CDW phase. The anisotropic constant (γ = ρb/ρc) increased rapidly at TCDW = 60 K upon cooling. The results of the Hall resistivity show that both the concentrations and mobilities of carriers change abruptly at TCDW. The out-of-plane AMR exhibits C2 and C4 symmetry components while the in-plane AMR exhibits C2, C4, and C6 at the CDW state. The planar Hall effect is observed in Ta2NiSe7 at low temperature, which is suggested to originate from the anisotropic orbital magnetoresistance. The calculated results show that the Fermi surface of Ta2NiSe7 was slightly reconstructed due to the CDW transition. This work highlights the enhancement of Fermi surface anisotropy during CDW formation and provides a novel approach to study the CDW materials.

Precursor Reagent Hydrophobicity Affects Membrane Protein Footprinting

Membrane proteins (MPs) play a crucial role in cell signaling, molecular transport, and catalysis and thus are at the heart of designing pharmacological targets. Although structural characterization of MPs at the molecular level is essential to elucidate their biological function, it poses a significant challenge for structural biology. Although mass spectrometry-based protein footprinting may be developed into a powerful approach for studying MPs, the hydrophobic character of membrane regions makes structural characterization difficult using water-soluble footprinting reagents. Herein, we evaluated a small series of MS-based photoactivated iodine reagents with different hydrophobicities. We used tip sonication to facilitate diffusion into micelles, thus enhancing reagent access to the hydrophobic core of MPs. Quantification of the modification extent in hydrophilic extracellular and hydrophobic transmembrane domains provides structurally sensitive information at the residue-level as measured by proteolysis and LC-MS/MS for a model MP, vitamin K epoxide reductase (VKOR). It also reveals a relationship between the reagent hydrophobicity and its preferential labeling sites in the local environment. The outcome should guide the future development of chemical probes for MPs and promote a direction for relatively high-throughput information-rich characterization of MPs in biochemistry and drug discovery.

Perampanel attenuates oxidative stress and pyroptosis following subarachnoid hemorrhage via the SIRT3/FOXO3α pathway

Subarachnoid hemorrhage (SAH) occurs most commonly after rupture of an aneurysm, resulting in high disability and mortality due to the absence of effective therapy. Its subsequent stage, early brain injury (EBI), promotes the sustainable development of injury in the brain and ultimately leads to poor prognosis. As a new antiepileptic drug, the effect of perampanel on EBI after SAH is unknown. Pyroptosis, a process of inflammatory programmed cell death, has been confirmed in most studies to play a substantial role in aggravating SAH-post EBI. Similarly, oxidative stress is closely involved in neuronal pyroptosis and the pathophysiological mechanism of SAH-post EBI, leading to a devastating outcome for SAH patients. Nonetheless, no studies have been conducted to determine whether perampanel reduces pyroptosis and oxidative stress in the context of SAH-induced EBI. Rat SAH model via endovascular perforation was constructed in this study, to assess the neuroprotective effect of perampanel on SAH-post EBI, and to clarify the possible molecular mechanism. By means of the neurological score, brain edema detection, FJB staining, immunofluorescence, WB, ELISA, and ROS assay, we found that perampanel can improve neuroscores and reduce brain edema and neuronal degeneration at 24 h after SAH; we also found that perampanel reduced oxidative stress, neuronal pyroptosis, and inhibition of the SIRT3-FOXO3α pathway at 24 h after SAH. When 3-TYP, an inhibitor of SIRT3, was administered, the effects of perampanel on the SIRT3-FOXO3a pathway, antioxidant stress, and neuronal pyroptosis were reversed. Taken together, our data indicate that perampanel attenuates oxidative stress and pyroptosis following subarachnoid hemorrhage via the SIRT3/FOXO3α pathway. This study highlights the application value of perampanel in subarachnoid hemorrhage and lays a foundation for clinical research and later transformation of perampanel in SAH.

Efficient electrocatalyst for solar-driven electrolytic water splitting: Phosphorus (P) and niobium (Nb) co-doped NiFe2O4 nanosheet

In the context of hydrogen production through water electrolysis, the development of efficient and stable electrocatalysts is of paramount importance. However, the creation of cost-effective electrocatalysts poses a significant challenge. In this study, a P and Nb co-doped NiFe2O4 nanosheet is designed and grown on Fe foam (referred to as P, Nb-NiFe2O4/FF). The P, Nb-NiFe2O4/FF exhibits a distinctive crystalline/amorphous heterostructure, and the co-doping of P and Nb in the material leads to the exposure of additional catalytic active sites, optimization of the electronic structure, and enhancement of charge conductivity. Additionally, the P, Nb-NiFe2O4/FF possesses a superhydrophilic surface for the enhancement of charge/mass transfer at interface and a superaerophobic surface, facilitating the efficient release of gas. The P, Nb-NiFe2O4/FF demonstrates remarkable oxygen evolution reaction (OER) and hydrogen evolution reaction (HER) activities, achieving overpotential as low as 247 mV and 127 mV, respectively, to attain the current density response of 100 mA cm-2. Based on the high bifunctional activities, the P, Nb-NiFe2O4/FF requires only a working voltage of 1.56 V to obtain the current density of 10 mA cm-2 in overall water splitting. Furthermore, the overall water splitting device of P, Nb-NiFe2O4/FF is integrated with a commercial solar cell to simulate a solar-powered water splitting system, resulting in as superior solar-to-hydrogen conversion efficiency of 15.11%.

Deep learning radiomics analysis based on computed tomography for survival prediction in gastric neuroendocrine neoplasm: a multicenter study

Background

Survival prediction is crucial for patients with gastric neuroendocrine neoplasms (gNENs) to assess the treatment programs and may guide personalized medicine. This study aimed to develop and evaluate a deep learning (DL) radiomics model to predict the overall survival (OS) in patients with gNENs.

Methods

The retrospective analysis included 162 consecutive patients with gNENs from two hospitals, who were divided into a training cohort, internal validation cohort (The First Affiliated Hospital of Zhengzhou University; n=108), and an external validation cohort (The Henan Cancer Hospital; n=54). DL radiomics analysis was applied to computed tomography (CT) images of the arterial phase and venous phase, respectively. Based on pretreatment CT images, two DL radiomics signatures were developed to predict OS. The combined model incorporating the radiomics signatures and clinical factors was built through the multivariable Cox proportional hazards (CPH) method. The combined model was visualized into a radiomics nomogram for individualized OS estimation. Prediction performance was assessed with the concordance index (C-index) and the Kaplan-Meier (KM) estimator.

Results

The DL-based radiomics signatures based on two phases were significantly correlated with OS in the training (C-index: 0.79-0.92; P<0.01), internal validation (C-index: 0.61-0.86; P<0.01), and external validation (C-index: 0.56-0.75; P<0.01) cohorts. The combined model integrating radiomics signatures with clinical factors showed a significant improvement in predictive performance compared to the clinical model in the training (C-index: 0.86 vs. 0.80; P<0.01), internal validation (C-index: 0.77 vs. 0.71; P<0.01), and external validation (C-index: 0.71 vs. 0.66; P<0.01) cohorts. Moreover, the combined model classified patients into high-risk and low-risk groups, and the high-risk group had a shorter OS compared to the low-risk group in the training cohort [hazard ratio (HR) 3.12, 95% confidence interval (CI): 2.34-3.93; P<0.01], which was validated in the internal (HR 2.51, 95% CI: 1.57-3.99; P<0.01) and external validation cohort (HR 1.77, 95% CI: 1.21-2.59; P<0.01).

Conclusions

DL radiomics analysis could serve as a potential and noninvasive tool for prognostic prediction and risk stratification in patients with gNENs.

The Impact of Inadequate Energy Intake on Readmission Burden of Patients With Heart Failure

BACKGROUND

Adequate energy intake is essential for good clinical outcomes. The association between energy intake and readmission burden of patients with heart failure (HF) still needs to be clarified.

OBJECTIVE

In this study, our aim was to determine the association between energy intake and readmission in patients with HF.

METHODS

A total of 311 inpatients with HF were recruited. Demographic and clinical information were collected during hospitalization; the daily diets of the participants were collected in the second week after discharge using the 3-day diet record, and the energy intake was calculated using a standardized nutrition calculator. The inadequate energy intake was defined as <70% × 25 kcal/kg of ideal body weight. The participants were followed up for 12 weeks after discharge. The number, reasons, and length of stay of unplanned readmissions were collected. Regression analyses were used to evaluate the associations between inadequate energy intake, and readmission rate and readmission days.

RESULTS

The median of the energy intake of participants was 1032 (interquartile range, 809-1266) kcal/d. The prevalence of inadequate energy intake was 40%. Patients with inadequate energy intake had a higher risk of unplanned readmission (odds ratio, 5.616; 95% confidence interval, 3.015-10.462; P < .001) and more readmission days (incidence rate ratio, 5.226; 95% confidence interval, 3.829-7.134, P < .001) after adjusting for potential confounders.

CONCLUSIONS

Patients with HF had a high incidence of inadequate dietary energy intake, and it increases the burden of readmission.

Impacts of Lithology and Slope Position on Arbuscular Mycorrhizal Fungi Communities in a Karst Forest Soil

The influence of lithology and slope position on arbuscular mycorrhizal fungi (AMF) communities has been explored in various ecosystems, but there is a limited understanding of these mechanisms in karst regions. This study focused on typical karst hills with contrasting lithologies, specifically dolomite and limestone. Additionally, three slope positions (upper, middle, and lower) were investigated within each hill in karst forest ecosystems. Total phosphorus (TP) content in the soil was higher in dolomite compared to limestone. Conversely, exchangeable calcium (Ca) was lower in dolomite than in limestone. Notably, the lithology, rather than the slope position, exerted a significant impact on AMF diversity and abundance and the presence of specific AMF taxa. Dolomite exhibited greater AMF richness and a higher Shannon index in comparison to limestone when not accounting for slope position. The AMF community composition differed between dolomite and limestone. For instance, without considering slope position, the relative abundance of Acaulospora, Diversispora, and Paraglomus was higher in dolomite than in limestone, while the relative abundance of Claroideoglomus displayed an opposing trend. Furthermore, a more complex interaction among AMF taxa was observed in dolomite as compared to limestone, as evidenced by an increase in the number of nodes and edges in the co-occurrence networks within the dolomite. The genera Glomus, Claroideoglomus, and Diversispora exhibited a higher number of links with each other and with other AMF taxa. The study identified TP and Ca as the primary factors determining variations in AMF diversity between dolomite and limestone. Consequently, it is imperative to consider the underlying lithology and soil conditions when addressing the restoration of degraded karst hilly areas.

Asymmetric Small Molecule as Interface "Governor" for FAPbI3 Perovskite Solar Cells

Delicate interface modification is necessary for improving the photovoltaic performance of a perovskite solar cell (PSC). Herein, two asymmetric small molecules, termed BTD-DA and BTD-PA are designed and synthesized to govern the perovskite/Spiro-OMeTAD interface. The molecule BTD-PA featuring a donor-acceptor-acceptor (D-A-A') configuration shows a larger molecule dipole and a better effect on defect passivation and energy level regulation through the strong interaction between the pyridine group in BTD-PA and the surficial uncoordinated Pb2+. Consequently, the PSCs based on the BTD-PA treatment harvest a champion power conversion efficiency (PCE) of 24.46% for a 0.09 cm2 active area and 22.46% for the 1 cm2 device. Moreover, the long-term stability of FAPbI3 PSCs is also significantly improved because of the enhanced hydrophobicity and the inhibited phase transition of the FAPbI3 film with BTD-PA treatment. Our research provides a new strategy for interfacial engineering to boost the PCE and stability of the FAPbI3 PSCs.

Single-cell transcriptional gene signature analysis identifies IL-17 signaling pathway as the key pathway in sepsis

Sepsis is a multiple dysregulated systemic inflammatory response with high mortality and leads to public concern. This study was designed to identify possible critical pathways associated with sepsis clinical severity and outcome, which offer potential biomarkers and therapeutic targets for sepsis diagnosis and treatment. Single-cell transcriptome profiles of human peripheral blood mononuclear (PBMC) in the healthy control population and sepsis patients were downloaded from the sepsis database GSE167363 and performed quality control before subsequent analysis. The bulk-RNA sequencing of blood samples in the sepsis-associated databases GSE100159 and GSE133822 was also used to confirm the association between critical pathways and sepsis pathology after processing raw data. We found there was a total of 18 distinct clusters in PBMC of sepsis, which was identified by the t-SNE and UMAP dimension reduction analysis. Meanwhile, the main cell types including B, NK, T, and monocyte cells were identified via the cell maker website and the "Single R" package cell-type annotation analysis. Subsequently, GO and KEGG enrichment analysis of differential expression genes in each cluster found that DEGs between healthy control and sepsis patients were significantly enriched in the IL-17 signaling pathway in monocyte, NK, and T cells. Finally, GSE100159 and GSE133822 confirmed IL-17 signaling pathway-associated genes including IL-17R, TRAF6, RELB, TRAF5, CEBPB, JUNB, CXCL1, CXCL3, CXCL8, CXCR1, and CXCR2 were significantly up-regulated in sepsis blood samples compared with the age-matched healthy control population. Taken together, we concluded that the IL-17 signaling pathway serves as a significant potential mechanism of sepsis and provides a promising therapeutic target for sepsis treatment. This research will further deepen our understanding of sepsis development.

Electron transfer bridge inducing polarization of nitrogen molecules for enhanced photocatalytic nitrogen fixation

Ammonia (NH3) plays a crucial role in the production of fertilizers, medicines, fibers, etc., which are closely relevant to the development of human society. However, the inert and nonpolar properties of NN seriously hinder artificial nitrogen fixation under mild conditions. Herein, we introduce a novel strategy to enhance the photocatalytic efficiency of N2 fixation through the directional polarization of N2 by rare earth metal atoms, which act as a local "electron transfer bridge." This bridge facilitates the transfer of delocalized electrons to the distal N atom and redirects the polarization of adsorbed N2 molecules. Taking cerium doped BiOCl (Ce-BiOCl) as an example, our results reveal that the electrons transfer to the distal N atom through the cerium atom, resulting in absorbed nitrogen molecular polarization. Consequently, the polarized nitrogen molecules exhibit an easier trend for NN cleavage and the subsequent hydrogenation process, and exhibit a greatly enhanced photocatalytic ammonia production rate of 46.7 μmol g-1 h-1 in cerium doped BiOCl, nearly 4 times higher than that of pure BiOCl. The original concept of directional polarization of N2 presented in this work not only deepens our understanding of the N2 molecular activation mechanism but also broadens our horizons for designing highly efficient catalysts for N2 fixation.

A blinded-endpoint, randomized controlled trial of Sanyrene with natural active ingredient for prophylaxis of radiation dermatitis in patients receiving radiotherapy

BACKGROUND

Randomized controlled study was conducted to evaluate the efficacy of Sanyrene® vs. control intervention (DaBao®, a complex of hyaluronic acid and Vitamin E) for acute radiation dermatitis in patients receiving radiotherapy.

METHODS

Patients with breast cancer or head and neck cancer undergoing radiotherapy (≥ 50 Gy) were eligible. Participants were randomly assigned to either Sanyrene arm or control intervention arm in a ratio of 1:1. The primary endpoint was incidence rate of ≥ grade 2 radiation induced dermatitis. (Trial Registration: ChiCTR2100050910, registration date: 9/7/2021) RESULTS: A total of 102 eligible patients were randomly assigned into the study. The rate of ≥ grade 2 radiation dermatitis was 22% in Sanyrene group, as compared with 67.3% in the control intervention group (P<0.001). The incidence of grade 3 radiation dermatitis was 20.4% and 8.0% in control intervention group and Sanyrene group, respectively (P = 0.076). Patients in Sanyrene group had a longer median time to reach ≥ grade 2 radiation dermatitis compared to these in control intervention group, with hazard ratio of 0.231 (95%CI:0.116-0.458, p < 0.001). Mean score of SD-16 were much higher in control intervention group than Sanyrene group at end of radiotherapy (25 vs.8.3), 2 weeks after radiotherapy (22.9 vs. 0.5) and 4 weeks after radiotherapy (4.2 vs.0), with significantly statistical difference between two groups.

CONCLUSIONS

This trial suggests that Sanyrene is effective on preventing serious radiation dermatitis and improving skin related quality of life in patients with breast cancer or head and neck cancer receiving radiotherapy.

Measurement of the Positive Muon Anomalous Magnetic Moment to 0.20 ppm

We present a new measurement of the positive muon magnetic anomaly, a_{μ}≡(g_{μ}-2)/2, from the Fermilab Muon g-2 Experiment using data collected in 2019 and 2020. We have analyzed more than 4 times the number of positrons from muon decay than in our previous result from 2018 data. The systematic error is reduced by more than a factor of 2 due to better running conditions, a more stable beam, and improved knowledge of the magnetic field weighted by the muon distribution, ω[over ˜]_{p}^{'}, and of the anomalous precession frequency corrected for beam dynamics effects, ω_{a}. From the ratio ω_{a}/ω[over ˜]_{p}^{'}, together with precisely determined external parameters, we determine a_{μ}=116 592 057(25)×10^{-11} (0.21 ppm). Combining this result with our previous result from the 2018 data, we obtain a_{μ}(FNAL)=116 592 055(24)×10^{-11} (0.20 ppm). The new experimental world average is a_{μ}(exp)=116 592 059(22)×10^{-11} (0.19 ppm), which represents a factor of 2 improvement in precision.

C-type natriuretic peptide improves maternally aged oocytes quality by inhibiting excessive PINK1/Parkin-mediated mitophagy

The overall oocyte quality declines with aging, and this effect is strongly associated with a higher reactive oxygen species (ROS) level and the resultant oxidative damage. C-type natriuretic peptide (CNP) is a well-characterized physiological meiotic inhibitor that has been successfully used to improve immature oocyte quality during in vitro maturation. However, the underlying roles of CNP in maternally aged oocytes have not been reported. Here, we found that the age-related reduction in the serum CNP concentration was highly correlated with decreased oocyte quality. Treatment with exogenous CNP promoted follicle growth and ovulation in aged mice and enhanced meiotic competency and fertilization ability. Interestingly, the cytoplasmic maturation of aged oocytes was thoroughly improved by CNP treatment, as assessed by spindle/chromosome morphology and redistribution of organelles (mitochondria, the endoplasmic reticulum, cortical granules, and the Golgi apparatus). CNP treatment also ameliorated DNA damage and apoptosis caused by ROS accumulation in aged oocytes. Importantly, oocyte RNA-seq revealed that the beneficial effect of CNP on aged oocytes was mediated by restoration of mitochondrial oxidative phosphorylation, eliminating excessive mitophagy. CNP reversed the defective phenotypes in aged oocytes by alleviating oxidative damage and suppressing excessive PINK1/Parkin-mediated mitophagy. Mechanistically, CNP functioned as a cAMP/PKA pathway modulator to decrease PINK1 stability and inhibit Parkin recruitment. In summary, our results demonstrated that CNP supplementation constitutes an alternative therapeutic approach for advanced maternal age-related oocyte deterioration and may improve the overall success rates of clinically assisted reproduction in older women.

Survival outcome of local versus radical resection for jejunoileal gastrointestinal stromal tumors: a propensity score-matched population-based analysis

PURPOSE

Survival after local resection (LR) versus radical resection (RR) has been revealed comparable for patients with rectal and duodenal gastrointestinal stromal tumors (GISTs), but is unknown for jejunoileal (JI) GISTs. This study aimed to compare the long-term survival between patients with JI GISTs who underwent LR and RR, and to find out the prognostic factors for JI GISTs.

METHODS

Patients diagnosed with JI GISTs in 1975-2019 were identified from Surveillance, Epidemiology, and End Results (SEER) database and grouped according to surgical modality. Propensity score matching (PSM) was performed to balance the LR and RR groups. Overall survival (OS) and disease-specific survival (DSS) were compared in the full and matched cohorts using Kaplan-Meier (KM) analysis. Subgroup sensitivity analyses were also performed. Risk factors associated with DSS were analyzed in multivariate Cox analysis following model selection.

RESULTS

1107 patients diagnosed with JI GISTs were included in the study cohort. After PSM, OS and DSS were comparable in LR and RR groups. Consistently, the two groups had similar DSS in all subgroup analyses. Moreover, multivariate Cox analysis identified lymphadenectomy, older age, larger tumor size, distant metastasis, high and unknown mitotic rate, but not LR, as independent prognostic risk factors for JI GISTs.

CONCLUSIONS

We conducted the first population-based comparison between the effect of different surgical modes on survival for patients with JI GISTs. LR can be carried out safely without compromising oncological outcome, and should be considered as a treatment option in selected patients with JI GISTs.

Predicting compressive strength of RCFST columns under different loading scenarios using machine learning optimization

Accurate bearing capacity assessment under load conditions is essential for the design of concrete-filled steel tube (CFST) columns. This paper presents an optimization-based machine learning method to estimate the ultimate compressive strength of rectangular concrete-filled steel tube (RCFST) columns. A hybrid model, GS-SVR, was developed based on support vector machine regression (SVR) optimized by the grid search (GS) algorithm. The model was built based on a sample of 1003 axially loaded and 401 eccentrically loaded test data sets. The predictive performance of the proposed model is compared with two commonly used machine learning models and two design codes. The results obtained for the axial loading dataset with R2 of 0.983, MAE of 177.062, RMSE of 240.963, and MAPE of 12.209%, and for the eccentric loading dataset with R2 of 0.984, MAE of 93.234, RMSE of 124.924, and MAPE of 10.032% show that GS-SVR is the best model for predicting the compressive strength of RCFST columns under axial and eccentric loadings. It is an effective alternative method that can be used to assist and guide the design of RCFST columns to save time and cost of some laboratory experiments. Additionally, the impact of input parameters on the output was investigated.

The Efficacy of Silver Sulfadiazine (SSD) Dressing Combined with Recombinant Human Epidermal Growth Factor in the Treatment of Third-Grade Radiation Dermatitis: A Randomized Controlled Study

PURPOSE/OBJECTIVE(S)

Radiation dermatitis is the most common complication of radiation therapy for oncology. Studies have shown that approximately 47% patients develop a second-degree or higher radiation skin reaction after radiotherapy. Although skin products that form a surface barrier such as dressings are standard of care in wound care management, they have been poorly reported in the management of radiation dermatitis. Many systemic and topical treatments have been investigated for the prevention and management of radiation dermatitis, however, how to improve this process is still needed. We hypothesize that silver sulfadiazine (SSD) dressings combined with recombinant human epidermal growth factor (EGF) may accelerate wound healing and reduce painful dressing changes.

MATERIALS/METHODS

Sixty patients who received radiotherapy and developed tertiary radiation dermatitis in our department from January 2019 to December 2022 were selected for the study, and were randomly divided into a control group (n = 30) and an observation group (n = 30) in a 1:1 ratio according to the inclusion criteria, both groups were first aseptically cleared with 0.9% sodium chloride injection and uniformly sprayed with recombinant human epidermal growth factor solution. In the control group, a foam dressing was used, while in the observation group, a silver sulfadiazine dressing was used to cover the wound, and in both groups, a double layer of sterile gauze was fixed on the outer layer. Wound healing time and pain level, and secondary observation endpoints were patient quality of life scores (SF-36, including physical function, psychological function, social function, daily activities, all scored on a percentage scale), patient satisfaction, and skin temperature.

RESULTS

The results of the control group vs. the observation group showed: wound healing time (d) of (12±5.08) vs. (8.57±3.11), p = 0.03; NRS pain score of (2.98±1.65) vs. (2.08±1.66), p = 0.04; quality of life assessment showed: psychological aspects (88.25±8.12) vs. 96.34±6.18), p = 0.0413; physical aspects (85.78±5.71) vs. (94.48±4.09), p = 0.0227; environmental aspects (90.15±3.56) vs. (98.09±1.21), p = 0.0137; satisfaction rate 28 (93.33%) vs. 30 (100.00%) , dissatisfaction rate was 2 (6.67%) vs. 0 (0.00%), p = 0.0086; skin temperature (32.08±0.79) vs. (32.14±0.43), no statistically significant difference p>0.05.

CONCLUSION

This randomized preliminary study showed that silver sulfadiazine dressing combined with recombinant human epidermal growth factor was significantly more effective than foam dressing in the treatment of tertiary radiation dermatitis, accelerating wound healing time, reducing patient painful dressing changes, and improving patient satisfaction.

The Effect of Nursing Intervention Based on HFMEA Model on the Prevention of Radiation Dermatitis: A Randomized Controlled Study

PURPOSE/OBJECTIVE(S)

Radiationdermatitis is one of the most common complications in patients received radiotherapy. Previous studies shown that incidence of radiation induced dermatitis (RD) is 95%. HFMEA (Healthcare Failure Mode and Effect Analysis) is a new model of nursing management. Many studies reported that HFMEA could reduce incidence of complications and adverse events, and significantly improve patient satisfaction.

MATERIALS/METHODS

From March 2023 to October 2022, patients received radiotherapy in our center were recruited in this study. Participants were randomly divided into control group (N = 60) and observation group (N = 60) in a ratio of 1:1. Patients in the control group were given routine skin care, health education before radiotherapy and skin care manual during radiotherapy. Based on the standard care, a HFMEA-based nursing intervention was adopted in the observation group by the following methods: Set up HFMEA care team. HFMEA team is composed of head nurses, wound specialist nurses, psychotherapists, etc. The members of the group searched the literature, case analysis and brainstorming to find out the potential failure reasons in every process of nursing radiotherapy patients in the past. Implementation of targeted measures to improve the corresponding: all patients with radiation dermatitis baseline assessment, focus on high-risk patients to shift, regular guidance medication, responsible nurses check the management of patients' skin every day to strengthen the attention of medical staff and patients' family members to radiation dermatitis. The degree of skin injury, pain and psychological status were compared between the two groups at the end of radiotherapy.

RESULTS

A total of 120 patients were enrolled in this study. Grade 1 RD was the most common in the observation group at the end of radiotherapy, and Grade 2 and 3 skin RD were less in the observation group than in the control group. There was not significant difference in the scores of SAS and SDS between the two groups before and after nursing (P > 0.05). In the observation group, the SAS scores (44.10±11.25 vs. 32.29 ± 7.72, P = 0.016) and SDS scores (40.98 ± 9.12 vs. 30.11 ± 5.23, P = 0.013) were significantly higher than the control group after nursing(P<0.05). The scores of SAS and SDS in the Observation Group were significantly lower than those in the control group. The scores of SAS in the Observation Group VS the control group were 32.29 ± 7.72 VS 39.09 ± 9.37 after nursing, SDS scores of Observation Group VS control group (30.11 ± 5.23 VS 38.76 ± 7.52, P<0.05). The visual analogue scale (Vas) score in the observation group was significantly lower than that in the control group (2.37 ± 0.45 VS 4.02 ± 0.53, P & Lt; 0.001), and the satisfaction degree of patients in the observation group was significantly higher than that in the control group (96.67% VS 80%, p = 0.004).

CONCLUSION

HFMEA model could effectively reduce incidence of RD, eliminate negative emotion, relieve pain and improve nursing satisfaction.

A Novel Deep Learning Model for Medical Report Generation by Inter-Intra Information Calibration

Automatic generation of medical reports can provide diagnostic assistance to doctors and reduce their workload. To improve the quality of the generated medical reports, injecting auxiliary information through knowledge graphs or templates into the model is widely adopted in previous methods. However, they suffer from two problems: 1) The injected external information is limited in amount and difficult to adequately meet the information needs of medical report generation in content. 2) The injected external information increases the complexity of model and is hard to be reasonably integrated into the generation process of medical reports. Therefore, we propose an Information Calibrated Transformer (ICT) to address the above issues. First, we design a Precursor-information Enhancement Module (PEM), which can effectively extract numerous inter-intra report features from the datasets as the auxiliary information without external injection. And the auxiliary information can be dynamically updated with the training process. Secondly, a combination mode, which consists of PEM and our proposed Information Calibration Attention Module (ICA), is designed and embedded into ICT. In this method, the auxiliary information extracted from PEM is flexibly injected into ICT and the increment of model parameters is small. The comprehensive evaluations validate that the ICT is not only superior to previous methods in the X-Ray datasets, IU-X-Ray and MIMIC-CXR, but also successfully be extended to a CT COVID-19 dataset COV-CTR.

Stimuli-Responsive PROTACs for Controlled Protein Degradation

Proteolysis Targeting Chimeras (PROTACs) represent a promising therapeutic modality to address undruggable and resistant issues in drug discovery. However, potential on-target toxicity remains clinically challenging. We developed a generalized caging strategy to synthesize a series of stimuli-responsive PROTACs (sr-PROTACs) with diverse molecular blocks bearing robust and cleavable linkers, presenting "turn on" features in manipulating protein degradation. By leveraging pathological cues, such as elevated ROS, phosphatase, H2 S, or hypoxia, and external triggers, such as ultraviolet light, X-Ray, or bioorthogonal reagents, we achieved site-specific activation and traceless release of original PROTACs through de-caging and subsequent self-immolative cleavage, realizing selective uptake and controlled protein degradation in vitro. An in vivo study revealed that two sr-PROTACs with phosphate- and fluorine-containing cages exhibited high solubility and long plasma exposure, which were specifically activated by tumor overexpressing phosphatase or low dosage of X-Ray irradiation in situ, leading to efficient protein degradation and potent tumor remission. With more reactive biomarkers to be screened from clinical practice, our caging library could provide a general tool to design activatable PROTACs, prodrugs, antibody-drug conjugates, and smart biomaterials for personalized treatment, tissue engineering or regenerative medicine.