Tools to measure the burden on informal caregivers of cancer patients: A literature review

OBJECTIVES

(1) To describe existing tools to assess the burden of informal caregivers of people with cancer, (2) to describe how these tools have been validated and (3) to describe the areas of interest of existing assessment tool entries.

BACKGROUND

The caregiver burden of informal caregivers of people with cancer greatly affects their lives. There is a wide variety of relevant assessment tools available, but there are no studies to help researchers to select tools.

METHODS

A search was conducted using the keywords 'cancer', 'caregiver', 'burden' and 'scale' in Medline (PubMed), CINAHL and EMBASE to include articles that developed or applied tools to assess the burden on informal caregivers of cancer patients. Once eligible tools were identified, we searched their 'primary reference' studies. If the original scale was assessed in a population other than informal caregivers of cancer patients, we again searched for psychometric measures in the population of caregivers of cancer patients.

RESULTS

This study retrieved 938 articles on developing or applying the informal caregiver burden instrument for cancer patients, including 42 scales. Internal consistency of the original scales ranged from 0.53 to 0.96. Nineteen scales initially developed to assess caregiver burden for patients with dementia, stroke and other disorders were later used for caregivers of cancer patients, eight of which have not yet been validated. Reclassifying all scale domains of concern revealed that scale assessments focused more on caregivers' physical health, emotional state and caregiving tasks.

CONCLUSION

This review identifies many scales for assessing informal caregiver burden in cancer patients and gives scales recommended. However, a portion still needs to be validated. The development of a new scale proposes to be based on a theoretical framework and to consider dimensions for assessing support resources.

IMPACT

What problem did the study address?: This paper collates assessment tools on the burden of informal carers of people with cancer. It also provides information on the applicable population, reliability and validity. What were the main findings?: 41 scales could be considered for use, eight of which have not been validated. The scales focus more on assessing caregivers' physical health, emotional state and caregiving tasks, and less on the dimension of support resources. Where and on whom will the research have an impact?: There are implications for informal carers of cancer patients in hospitals or in the community, as well as for relevant researchers.

REPORTING METHOD

Retrieved with reference to systematic evaluation.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

Sleeve gastrectomy links the attenuation of diabetic kidney disease to the inhibition of renal tubular ferroptosis through down-regulating TGF-β1/Smad3 signaling pathway

PURPOSE

To investigate how sleeve gastrectomy (SG), a typical operation of bariatric surgery, attenuated symptom, and progression of diabetic kidney disease (DKD).

METHODS

DKD model was induced by high-fat diet (HFD) combined with streptozocin in Wistar rats. SG was performed, and the group subjected to sham surgery served as control. The animals were euthanized 12 weeks after surgery, followed by sample collection for the subsequent experiment. The HK-2, a renal proximal tubular epithelial cell line derived from human, was utilized to investigate the potential mechanisms.

RESULTS

SG improved metabolic parameters and glucose homeostasis, and could alleviate DKD in terms of renal function indices as well as histological and morphological structures in DM rats, accompanied with a significant reduction in renal tubular injury. Compared with sham group, SG reduced the renal tubular ferroptosis. To further clarify the mechanism involved, in vitro experiments were performed. In the presence of high glucose, renal tubular TGF-β1 secretion was significantly increased in HK-2 cell line, which led to activation of ferroptosis through TGF-β1/Smad3 signaling pathway. Inhibition of TGF-β1 receptor and phosphorylation of Smad3 significantly ameliorated TGF-β1-mediated ferroptosis. In vivo experiments also found that SG improved the hyperglycemic environment, reduced renal TGF-β1 concentrations, and down-regulated the TGF-β1/Smad3 signaling pathway.

CONCLUSIONS

With the capacity to lower the glucose, SG could attenuate the ferroptosis by inhibiting TGF-β1/Smad3 signaling pathway in DKD rats, and eventually attenuated DKD.

AAV9-based PMM2 gene replacement augments PMM2 expression and improves glycosylation in primary fibroblasts of patients with phosphomannomutase 2 deficiency (PMM2-CDG)

Inherited deficiency of phosphomannomutase 2 (PMM2) (aka PMM2-CDG) is the most common congenital disorders of glycosylation (CDG) and has no cure. With debilitating morbidity and significant mortality, it is imperative to explore novel, safe, and effective therapies for the disease. Our Proof-of-Concept study showed that AAV9-PMM2 infection of patient fibroblasts augmented PMM2 expression and improved glycosylation. Thus, AAV9-PMM2 gene replacement is a promising therapeutic strategy for PMM2-CDG patients.

The effects of different hydrocolloids on lotus root starch gelatinization and gels properties

In this study, xanthan gum (XG), sodium alginate (SA), guar gum (GG), and gum Arabic (GA), were used to modify Lotus root starch (LRS). The incorporation XG, SA, and GG significantly (p < 0.05) influence the swelling power (SP) of LRS, among which the 1.5 % of XG exhibited the highest value of 25.84 g/g at 90 °C. Gelatinization analysis revealed that XG raised the final viscosity (FV) and lowered the breakdown (BD), while SA significantly increased peak viscosity (PV) and BD. Furthermore, GG and GA exhibited a substantial reduction in setback (SB). The incorporation of XG, SA, and GG enhanced the rheological and structural properties (e.g., gel strength and elasticity) of LRS. Particularly, XG demonstrated a more prominent effect, while GA exhibited an opposite trend. Moreover, the structural analyses revealed that hydrophilic colloids have no impact on the functional group and crystal structure of the LRS. However, complex system exhibited the more stable hydrogen bonding. The addition of 1.5 % XG exhibited the most stable hydrogen bonding and highest water binding affinity. Overall, the results demonstrated the effect of different hydrophilic colloids on LRS, offering a theoretical basis for LRS applications and novel insights for the use of starches and hydrocolloids.

Recent advancements in the utilization of ultrasonic technology for the curing of processed meat products: A comprehensive review

Curation meat products involves multiple stages, including pre-curing processing (thawing, cleaning, and cutting), curing itself, and post-curing processing (freezing, and packaging). Ultrasound are nonthermal processing technology widely used in food industry. This technology is preferred because it reduces the damages caused by traditional processing techniques on food, while simultaneously improving the nutritional properties and processing characteristics of food. The utilization of ultrasonic-assisted curing technology has attracted significant attention within the realm of meat product curing, encouraging extensive research efforts. In terms of curing meat products, ultrasonic-assisted curing technology has been widely studied due to its advantages of accelerating the curing speed, reducing nutrient loss, and improving the tenderness of cured meats. Therefore, this article aims to comprehensively review the application and mechanism of ultrasound technology in various stages of meat product curing. Furthermore, it also elaborates the effects of ultrasonic-assisted curing on the tenderness, water retention, and flavor substances of the meat products during the curing process. Besides, the implication of the ultrasound in the processing of meat curation plays a potent role together with other technologies or methods. The use of ultrasound technology in the process of meat curation was analyzed, which might be a theoretical insight for the industrialization prospects of the meat product.

A comprehensive review of ultrasonic assisted extraction (UAE) for bioactive components: Principles, advantages, equipment, and combined technologies

The increasing focus on health and well-being has sparked a rising interest in bioactive components in the food, pharmaceutical, and nutraceutical industries. These components are gaining popularity due to their potential benefits for overall health. The growing interest has resulted in a continuous rise in demand for bioactive components, leading to the exploration of both edible and non-edible sources to obtain these valuable substances. Traditional extraction methods like solvent extraction, distillation, and pressing have certain drawbacks, including lower extraction efficiency, reduced yield, and the use of significant amounts of solvents or resources. Furthermore, certain extraction methods necessitate high temperatures, which can adversely affect certain bioactive components. Consequently, researchers are exploring non-thermal technologies to develop environmentally friendly and efficient extraction methods. Ultrasonic-assisted extraction (UAE) is recognized as an environmentally friendly and highly efficient extraction technology. The UAE has the potential to minimize or eliminate the need for organic solvents, thereby reducing its impact on the environment. Additionally, UAE has been found to significantly enhance the production of target bioactive components, making it an attractive method in the industry. The emergence of ultrasonic assisted extraction equipment (UAEE) has presented novel opportunities for research in chemistry, biology, pharmaceuticals, food, and other related fields. However, there is still a need for further investigation into the main components and working modes of UAEE, as current understanding in this area remains limited. Therefore, additional research and exploration are necessary to enhance our knowledge and optimize the application of UAEE. The core aim of this review is to gain a comprehensive understanding of the principles, benefits and impact on bioactive components of UAE, explore the different types of equipment used in this technique, examine the various working modes and control parameters employed in UAE, and provide a detailed overview of the blending of UAE with other emerging extraction technologies. In conclusion, the future development of UAEE is envisioned to focus on achieving increased efficiency, reduced costs, enhanced safety, and improved reliability. These key areas of advancement aim to optimize the performance and practicality of UAEE, making it a more efficient, cost-effective, and reliable extraction technology.

Noninvasive Radiation Markers Based on Lung Cancer CT Images and Dosimetry Features to Predict the Immune Response to Radiotherapy in Tumor Microenvironment

PURPOSE/OBJECTIVE(S)

For lung cancer patients with complex conditions, doctors need to determine treatment plan in combination with changes of immune response during radiotherapy. It was urgent to find a strategy to predict immune response to intervene the treatment at an early stage.

MATERIALS/METHODS

The radiotherapy process and tumor microenvironment status of 105 lung cancer patients were tracked and recorded in our hospital from 2019 to 2022, public database TCGA-LUAD/LUSC queue of TCIA image data was downloaded as external verification set. Data was analyzed according to the following methods: First, the 3D slicer software was used to process the CT imageomics data, and the doseomics information was calculated by DVHmetrics package from R software. Then Python was brought in to develop a non-invasive radiation scoring system through machine learning methods (T-test, LASSO, random forest and Xgboost). Finally, combined with the clinical information related to the patient's immune response, a nomogram was made to study the correlation between the score markers and the ratio of CD4 cells/CD8 cells in the tumor microenvironment, the prognosis of lung cancer, as well as the incidence of radiation pneumonia.

RESULTS

The radiation markers score formula was obtained with CT imageomics and DVH dosimics features, which achieved an AUC of 0.67-0.75 in predicting CD4/CD8 condition in tumor microenvironment after radiotherapy. It was worth noticing that in predicting the prognosis of lung cancer, it was difficult to distinguish between the radiation score and the patient's survival status (P>0.05). However, we found that the radiation pneumonitis of lung cancer patients in the low score group (42.6%) was significantly higher than that in the high score group (13.4%).

CONCLUSION

Radiation markers score was a non-invasive method to evaluate the immune response of patients with lung cancer, which can be used to predict the incidence of radiation pneumonitis.

Fluorapatite nanorod arrays with enamel-like bundle structure regulated by iron ions

Pigmented rodent tooth enamel is mainly composed of parallel hydroxyapatite nanorods and a small amount of organic matrix. These hydroxyapatite nanorods tend to be carbonated and contain traces of iron, fluorine, and magnesium. The pigmented rodent tooth enamel which contains trace iron is stronger and more resistant to acid corrosion than unpigmented rodent enamel, which could provide inspiration for the preparation and synthesis of high performance and corrosion resistant artificial materials. However, the regulatory role and mechanical enhancement of iron ions in enamel growth are unclear. Here, we synthesized enamel-like fluorapatite nanorod arrays in vitro using a mineralization technique at room-temperature. To investigate the regulatory effect of iron ions on the fluorapatite nanorod arrays (FAP-Fe), the phosphate solution is slowly transfused dropwise in the calcium ion solution, and different concentrations of iron ions are added to the calcium ion solution in advance. We demonstrated that fluorapatite nanorod arrays (FAP) can be epitaxially grown from amorphous calcium phosphate nanoparticles and iron ions can improve the microstructure of FAP nanorod arrays and obtain the same enamel bundle structure as the natural enamel. Moreover, high concentration of iron ions can inhibit the crystallization of fluorapatite. The FAP-Fe nanorod arrays controlled by 0.02 mM Fe3+ have good mechanical properties. Their hardness is 1.34 ± 0.02 GPa and Young's modulus is 65.3 ± 0.4 GPa, respectively. This work is helpful to understand the role of trace elements in natural enamel in the regulation of enamel formation and to provide a theoretical foundation for the preparation of high strength artificial composites, which can play a greater role in the fields of biological alternative materials, anti-oil coating, oil/water separation, anti-bioadhesion and so on.

First Dark Matter Search with Nuclear Recoils from the XENONnT Experiment

We report on the first search for nuclear recoils from dark matter in the form of weakly interacting massive particles (WIMPs) with the XENONnT experiment, which is based on a two-phase time projection chamber with a sensitive liquid xenon mass of 5.9 ton. During the (1.09±0.03)  ton yr exposure used for this search, the intrinsic ^{85}Kr and ^{222}Rn concentrations in the liquid target are reduced to unprecedentedly low levels, giving an electronic recoil background rate of (15.8±1.3)  events/ton yr keV in the region of interest. A blind analysis of nuclear recoil events with energies between 3.3 and 60.5 keV finds no significant excess. This leads to a minimum upper limit on the spin-independent WIMP-nucleon cross section of 2.58×10^{-47}  cm^{2} for a WIMP mass of 28  GeV/c^{2} at 90% confidence level. Limits for spin-dependent interactions are also provided. Both the limit and the sensitivity for the full range of WIMP masses analyzed here improve on previous results obtained with the XENON1T experiment for the same exposure.

"Double-edged sword" effect of reactive oxygen species (ROS) in tumor development and carcinogenesis

Reactive oxygen species (ROS) are small reactive molecules produced by cellular metabolism and regulate various physiological and pathological functions. Many studies have shown that ROS plays an essential role in the proliferation and inhibition of tumor cells. Different concentrations of ROS can have a "double-edged sword" effect on the occurrence and development of tumors. A certain concentration of ROS can activate growth-promoting signals, enhance the proliferation and invasion of tumor cells, and cause damage to biomacromolecules such as proteins and nucleic acids. However, ROS can enhance the body's antitumor signal at higher levels by initiating oxidative stress-induced apoptosis and autophagy in tumor cells. This review analyzes ROS's unique bidirectional regulation mechanism on tumor cells, focusing on the key signaling pathways and regulatory factors that ROS affect the occurrence and development of tumors and providing ideas for an in-depth understanding of the mechanism of ROS action and its clinical application.

Searching for Heavy Dark Matter near the Planck Mass with XENON1T

Multiple viable theoretical models predict heavy dark matter particles with a mass close to the Planck mass, a range relatively unexplored by current experimental measurements. We use 219.4 days of data collected with the XENON1T experiment to conduct a blind search for signals from multiply interacting massive particles (MIMPs). Their unique track signature allows a targeted analysis with only 0.05 expected background events from muons. Following unblinding, we observe no signal candidate events. This Letter places strong constraints on spin-independent interactions of dark matter particles with a mass between 1×10^{12} and 2×10^{17}  GeV/c^{2}. In addition, we present the first exclusion limits on spin-dependent MIMP-neutron and MIMP-proton cross sections for dark matter particles with masses close to the Planck scale.

Ethanol as a switch to induce soybean lipophilic protein self-assembly and resveratrol delivery

Protein-based nanoparticles or nanocarriers of emulsion systems have piqued the interest of nutrition and health care goods. As a result, this work examines the characterisation of ethanol-induced soybean lipophilic protein (LP) self-assembly for resveratrol (Res) encapsulation, particularly the influence on emulsification. By varying the ethanol content ([E]) in the range of 0-70% (v/v), the structure, size, and morphology of LP nanoparticles may be adjusted. Similarly, the self-assembled LPs have a strong [E] dependency on the encapsulation efficiency of Res. For [E] = 40% (v/v), Res had the highest encapsulation efficiency (EE) and load capacity (LC) of 97.1% and 141.0 μg/mg nanoparticles, respectively. Most of the Res was encapsulated by the hydrophobic core of LP. Moreover, for [E] = 40% (v/v), LP-Res showed significantly improved emulsifying properties, independent of low-oil or high-oil emulsion systems. Furthermore, the ethanol-induced production of appropriate aggregates increased emulsion system stability, hence increasing Res retention during storage.

[Efficacy of video-assisted thoracoscopic surgical decortication for stage Ⅲ tuberculous empyema]

Objective: To investigate the clinical efficacy, safety and feasibility of "double-portal" video-assisted thoracoscopic surgical(VATS) decortication among patients with stage Ⅲ tuberculous empyema, and then to evaluate the recovery of chest deformity. Method: This study was a single center retrospective study. A total of 49 patients with stage Ⅲ tuberculous empyema who underwent VATS pleural decortication at the Department of Thoracic Surgery, Public Health Clinical Center of Chengdu between June 2017 and April 2021 were enrolled, including 38 males, and 11 females, aged 13-60 (27.5±10.4) years. The safety and feasibility of VATS were further evaluated. The inner circumference of the chest on sternal and xiphoid planes on chest CT scans before and 1, 3, 6, 12months after decortication were collected through the measuring software of the CT. The samples in-pair test was used to compare the changes in the chest to reflect the recovery of the chest deformity. Results: In the 49 patients, The surgical time was (186±61) min, and the volume of blood loss was (366±267) ml. There were 8 cases (16.33%) with postoperative complications during the perioperative period. Constant air leak and pneumonia were the main postoperative complications. No relapse of empyema or dissemination of tuberculosis occured during the period of follow-up. Before surgery, the inner thoracic circumference of the thorax at the level of the carina plane was (655±54) mm, and the inner thoracic circumference of the thorax at the level of the xiphoid plane was (720±69) mm. Patients were followed for 12-36 months. The inner thoracic circumference of the thoracic cavity at the level of carina was (666±51), (667±47) and (671±47) mm at the 3rd, 6th and 12th months after operation, which were significantly larger than that at the level of carina before operation (all P<0.05). The inner thoracic circumference diameter of the thoracic cavity measured at the xiphoid level at the 3rd, 6th and 12th months after the operation was (730±65), (733±63) and (735±63) mm respectively(all P<0.05).The inner thoracic circumference of the thoracic cavity increased significantly than that before surgery (P<0.05). At 6 months after operation, there was significant difference in the improvement of the inner thoracic circumference of the carina plane in patients with age less than 20 years and FEV₁% less than 80% (P=0.015, P=0.003). The improvement in the inner thoracic circumference of the carina plane in patients with pleural thickening≥8 mm compared with those with less than 8 mm was not statistically different(P=0.070). Conclusions: For some patients with stage Ⅲ tuberculous empyema, pleural decortication under thoracoscopy is safe and feasible, and can significantly restore the inner thoracic circumference of the patient's chest, improve the collapse of the patient's chest, and have significant clinical effect. The "double-portal VATS" surgical technology has the advantage of less trauma, wide operation field, large operation space and is easy to master, which is worth further exploring for clinical application.

Ultrasound-assisted alkali removal of proteins from wastewater generated during oil bodies extraction

In this study, an ultrasonic-assisted alkaline method was used to remove proteins from wastewater generated during oil-body extraction, and the effects of different ultrasonic power settings (0, 150, 300, and 450 W) on protein recovery were investigated. The recoveries of the ultrasonically treated samples were higher than those of the samples without ultrasonic treatment, and the protein recoveries increased with increasing power, with a protein recovery of 50.10 % ± 0.19 % when the ultrasonic power was 450 W. Amino acid analysis showed that the amino acids comprising the recovered samples were consistent, regardless of the ultrasonic power used, but significant differences in the contents of amino acids were observed. No significant changes were observed in the protein electrophoretic profile using dodecyl polyacrylamide gel, indicating that sonication did not change the primary structures of the recovered samples. Fourier transform infrared and fluorescence spectroscopy revealed that the molecular structures of the samples changed after sonication, and the fluorescence intensity increased gradually with increasing sonication power. The contents of α-helices and random coils obtained at an ultrasonic power of 450 W decreased to 13.44 % and 14.31 %, respectively, whereas the β-sheet content generally increased. The denaturation temperatures of the proteins were determined using differential scanning calorimetry, and ultrasound treatment reduced the denaturation temperatures of the samples, which was associated with the structural and conformational changes caused by their chemical bonding. The solubility of the recovered protein increased with increasing ultrasound power, and a high solubility was essential in good emulsification. The emulsification of the samples was improved well. In conclusion, ultrasound treatment changed the structure and thus improved the functional properties of the protein.

An interpretable machine learning model for real-time sepsis prediction based on basic physiological indicators

OBJECTIVE

In view of the important role of risk prediction models in the clinical diagnosis and treatment of sepsis, and the limitations of existing models in terms of timeliness and interpretability, we intend to develop a real-time prediction model of sepsis with high timeliness and clinical interpretability.

PATIENTS AND METHODS

We used eight real-time basic physiological monitoring indicators of patients, including heart rate, respiratory rate, oxygen saturation, mean arterial pressure, systolic blood pressure, diastolic blood pressure, temperature and blood glucose, extracted three-hour dynamic feature sequences, and calculated 3 linear parameters (mean, standard deviation, and endpoint value), a 24-dimensional feature vector was constructed, and finally a real-time sepsis prediction model was constructed based on the Local Interpretable Model-Agnostic Explanation (LIME) interpretability method.

RESULTS

The area under the receiver operating characteristic curve (AUROC), Accuracy and F1 scores of Extremely Randomized Trees we built were higher than those of other models, with AUROC above 0.76, showing the best performance. The Imbalance XGBoost has a high specificity (0.86) in predicting sepsis. The LIME local interpretable model we built can display a large amount of valid model prediction details for clinical workers' reference, including the prediction probability and the influence of each feature on the prediction result, thus effectively assisting the work of clinical workers and improving diagnostic efficiency.

CONCLUSIONS

This model can provide real-time dynamic early warning of sepsis for critically ill patients under supervision and provide a reference for clinical decision support. At the same time, interpretive analysis of sepsis prediction models can improve the credibility of the models.

[Uterine POLE mutant endometrioid carcinoma combined with human papilloma virus-associated cervical adenocarcinoma: A case report and literature review]

Independent primary uterine and cervical adenocarcinoma are rare and difficult to identify their origins, which makes treatment decision difficult. A 46-year-old female with endometrioid carcinoma and adenocarcinoma, human papilloma virus (HPV)-associated of the uterine cervix was reported. The patient presented with increased menstrual flow, contact bleeding and watery leucorrhea for more than one year, and the imaging findings showed abnormal uterine morphology, irregular margins, and multiple abnormal signals in uterine cavity and myometrium, which suggested multiple leiomyomas of the uterus. The signal intensity in the right muscle layer was markedly enhanced, suggesting a smooth muscle tumor of uncertain malignant potential. A large number of cystic hypointensity was seen in the cervix, and multiple cysts were considered. The initial preoperative diagnosis was multiple leiomyoma of the uterus, and a hysterectomy operation was planned. During the operation, the uterus was sent for frozen sections. There was a mass in the endometrium of the fundus, with a soft grayish-red cut surface and a clear border with the myometrium, and there was a grayish-white nodule in the cervix with a hard grayish-white cut surface. The two masses were well demarcated from each other, and the distance between them was 30 mm. The result of the frozen sections indicated the malignant tumor of the endometrium, and the extended hysterectomy+pelvic lymphadenectomy+partial resection of the greater omentum was performed. After the operation, the paraffin sections were sent to the Department of Pathology of the Peking University Third Hospital for histochemistry, POLE gene sequencing and HPV RNAscope tests, and the final diagnosis was a synchronous endometrioid carcinoma (POLE-mutant according to the WHO classification) and an adenocarcinoma, HPV-associated of the uterine cervix. Now the patient had been treated with 2 cycles of chemotherapy and her condition was fine. Through the analysis of the histological, immunohistochemical and molecular detection results of this case, the importance of applying HPV RNAscope and TCGA molecular typing in the diagnosis of cervical adenocarcinomas and endometrial carcinomas was emphasized. At the same time, gynecologists should not blindly rely on intraoperative frozen sections, and should pay attention to preoperative pathological examination, and make appropriate operation methods according to the results in order to prevent passivity in the surgery.

The risk assessment tool for intensive care unit readmission: A systematic review and meta-analysis

OBJECTIVE

To review and evaluate existing risk assessment tools for intensive care unitreadmission.

METHODS

Nine electronic databases (Medline, CINAHL, Web of Science, Cochrane Library, Embase, Sino Med, CNKI, VIP, and Wan fang) were systematically searched from their inception to September 2022. Two authors independently extracted data from the literature included. Meta-analysis was performed under the bivariate modeling and summary receiver operating characteristic curve method.

RESULTS

A total of 29 studies were included in this review, among which 11 were quantitatively Meta-analyzed. The results showed Stability and Workload Index for Transfer: Sensitivity = 0.55, Specificity = 0.65, Area under curve = 0.63. And Early warning score: Sensitivity = 0.78, Specificity = 0.83, Area under curve = 0.88. The remaining tools included scores, nomograms, machine learning models, and deep learning models. These studies, with varying reports on thresholds, case selection, data preprocessing, and model performance, have a high risk of bias.

CONCLUSION

We cannot identify a tool that can be used directly in intensive care unit readmission risk assessment. Scores based on early warning score are moderately accurate in predicting readmission, but there is heterogeneity and publication bias that requires model adjustment for local factors such as resources, demographics, and case mix. Machine learning models present a promising modeling technique but have a high methodological bias and require further validation.

IMPLICATIONS FOR CLINICAL PRACTICE

Using reliable risk assessment tools is essential for the early identification of unplanned intensive care unit readmission risk in critically ill patients.  A reliable risk assessment tool must be developed, which is the focus of further research.

Dithiothreitol-induced reassembly of soybean lipophilic protein as a carrier for resveratrol: Preparation, structural characterization, and functional properties

We employed dithiothreitol (DTT) to reassemble soy lipophilic protein (LP) and increased its solubility for encapsulating resveratrol (Res); we subsequently added hydroxypropyl methylcellulose (HPMC) to further stabilize Res. Physicochemical characterization, sodium dodecyl sulfate-polyacrylamide gel electrophoresis, and spectral analysis revealed that DTT triggered the breakage and reassembly of the disulfide bond. Consequently, the solubility of LP increased from 38.64 % to 71.49 %, and the number of free sulfhydryl groups increased to 7.84 mol·g-1. Furthermore, the encapsulation efficiency and structure of reassembled LP nanoparticles loaded with Res were found to be closely related to the DTT concentration used for induction. When HPMC was added, the LP-Res complex demonstrated spontaneous self-assembly, and the pH and temperature stability of the Res in the nanoparticles improved. An in vitro digestion simulation revealed that the reassembled LP was an efficient carrier for Res delivery. Particularly, HPMC improved the bioavailability and sustained release of Res.

Search for New Physics in Electronic Recoil Data from XENONnT

We report on a blinded analysis of low-energy electronic recoil data from the first science run of the XENONnT dark matter experiment. Novel subsystems and the increased 5.9 ton liquid xenon target reduced the background in the (1, 30) keV search region to (15.8±1.3)  events/(ton×year×keV), the lowest ever achieved in a dark matter detector and ∼5 times lower than in XENON1T. With an exposure of 1.16 ton-years, we observe no excess above background and set stringent new limits on solar axions, an enhanced neutrino magnetic moment, and bosonic dark matter.

Stability and digestibility of encapsulated lycopene in different emulsion systems stabilized by acid-modified soybean lipophilic protein

BACKGROUND

Owing to the harsh acidic environment of the stomach, acid-resistant emulsion products have wide-ranging applications in the food industry. Herein, natural soybean lipophilic protein (LP) was used to establish coarse emulsions, nanoemulsions, emulsion gels, and high internal phase Pickering emulsions (HIPPE) under acidic conditions. Furthermore, the carrying characteristics of the acid-resistant emulsion system with lycopene were explored.

RESULTS

Comparisons of particle sizes, potentials, microstructures, and rheology of the four carrier systems revealed that HIPPE has a single particle-size distribution, the largest zeta potential, and an elastic gel-like network structure. Comparison of encapsulation rates indicated that HIPPE had the best effect on encapsulating lycopene, reaching approximately 90%. The pH stability, storage stability, and simulated in vitro digestion experiments showed that the four emulsions that were stable under acidic conditions had good acid resistance. Among them, the acid-induced LP-stabilized HIPPE had the best storage stability and superior compatibility with the harsh acidic environment of the stomach, which not only achieved the purpose of delaying the release of lipids but also conferred better protection to lycopene in the gastric tract; moreover, it achieved the best bioavailability.

CONCLUSION

LP-stabilized HIPPE has the best stability and can yield better absorption and utilization of lycopene by the body. The results of this study are helpful for the development of acid-resistant functional emulsion foods that are conducive to the absorption of lycopene. © 2022 Society of Chemical Industry.

[Bedside monitoring of lung perfusion by electrical impedance tomography]

As a non-invasive and radiation-free bedside imaging method, electrical impedance tomography (EIT) can perform real-time regional pulmonary ventilation evaluation and pulmonary blood flow monitoring for patients, thus realizing bedside ventilation/perfusion matching visualization, effectively guiding the pathophysiological mechanism of hypoxemia, and providing a new method for the study of pulmonary blood flow. EIT has also played a unique and irreplaceable role in COVID-19 research and treatment. At the same time, as functional imaging, the operation details and image reconstruction algorithm of this technology still need to be further optimized by more researches to provide a more robust evaluation in clinical application. In this paper, EIT pulmonary blood flow monitoring methods, operation and implementation of monitoring indicators, application and related research progress will be described.

Material radiopurity control in the XENONnT experiment

The selection of low-radioactive construction materials is of the utmost importance for rare-event searches and thus critical to the XENONnT experiment. Results of an extensive radioassay program are reported, in which material samples have been screened with gamma-ray spectroscopy, mass spectrometry, and \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$^{222}$$\end{document}222Rn emanation measurements. Furthermore, the cleanliness procedures applied to remove or mitigate surface contamination of detector materials are described. Screening results, used as inputs for a XENONnT Monte Carlo simulation, predict a reduction of materials background (\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\sim $$\end{document}∼17%) with respect to its predecessor XENON1T. Through radon emanation measurements, the expected \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$^{222}$$\end{document}222Rn activity concentration in XENONnT is determined to be 4.2 (\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$^{+0.5}_{-0.7}$$\end{document}-0.7+0.5) \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\upmu $$\end{document}μBq/kg, a factor three lower with respect to XENON1T. This radon concentration will be further suppressed by means of the novel radon distillation system.

Soy and whey protein isolate mixture/calcium chloride thermally induced emulsion gels: Rheological properties and digestive characteristics

We present the preparation and physicochemical properties of thermally induced emulsion gels of a soy protein isolate-whey protein isolate (SPI-WPI)/calcium chloride composite, and the analysis of their nutrient release behaviors using fat-soluble vitamin E as a model system by simulating its digestion in vitro. In general, the SPI-WPI composite emulsion gel was found to have better water-holding capacity and texture than the emulsion gels formed by the single protein. The microstructure and rheological properties of the gel suggested that the CaCl₂ concentration significantly influences the fundamental structure and mechanical properties of the SPI-WPI gel. The in vitro digestion experiments revealed that the mixed protein emulsion gel improves the bioavailability of vitamin E. This study is of great significance in the utilization of these natural emulsifiers, as they can be used in the development of emulsion delivery systems for lipophilic nutrients and other health products.

Soy lipophilic protein self-assembled by pH-shift combined with heat treatment: Structure, hydrophobic resveratrol encapsulation, emulsification, and digestion

This study evaluates the effect of pH (pH 3 and 11) and heat treatment (60 °C) in modifying the soybean lipophilic protein (LP) for the development of an encapsulation system to co-deliver resveratrol (Res) and vitamin D3. The structural and functional properties of LP after the modification will change to varying degrees. Meanwhile, Res was loaded into the hydrophobic core of LP, and the resulting Res-loaded structures have a uniform particle size distribution and a high encapsulation efficiency (78%). When the amount of Res encapsulation increases, the emulsification and oxidation resistance of the Pickering emulsion increased; the interfacial tension and interfacial protein adsorption increased to 11.21 mN/m and 97.34%, respectively. During simulated gastrointestinal digestion, the Pickering emulsion prepared with LP-Res nanoparticles at pH 11, 60 °C (pH 11, 60 °C-LP-Res) effectively protected Res and vitamin D3 from degradation or precipitation, indicating a significant increase in bioavailability.

Effects of ultrasound-assisted salt (NaCl) extraction method on the structural and functional properties of Oleosin

²We propose a new ultrasound-assisted salt (NaCl) Oleosin extraction method, where the addition of NaCl induces the dissociation of Oleosin subunits and promotes the unfolding of the protein spatial structure. The yield of Oleosin post extraction and purification and solubility of Oleosin obtained using the proposed method were higher than those of Oleosin extracted using traditional methods, by 17.6% and 122.9%, respectively; reduction in particle size (to 52 nm) was also noted. Hydrogen bond dissociation, increase in surface hydrophobicity, and disulfide bond formation occurred simultaneously. However, the overall structure of Oleosin was not negatively affected. The physical properties of Oleosin, such as water and oil absorption, emulsification, and antioxidant activity, were improved, and the rate of Oleosin digestion decreased during the in vitro simulated digestion process. The proposed method provides a theoretical basis for producing proteins. This method can be utilized for effective extraction of Oleosin to achieve sustained release of the produced proteins.

Sodium Dodecyl Sulfate-Dependent Disassembly and Reassembly of Soybean Lipophilic Protein Nanoparticles: An Environmentally Friendly Nanocarrier for Resveratrol

The development of protein-based nanocarriers to improve the water solubility, stability, and bioavailability of hydrophobic or poorly soluble bioactive molecules has attracted increasing interest in the food and pharmaceutical industries. In this study, a network-like nanostructure of soybean lipophilic protein (LP) was obtained through sodium dodecyl sulfate (SDS)-dependent decomposition and recombination. This nanostructure served as an excellent nanocarrier for resveratrol (Res), a poorly soluble biologically active molecule. The structure of LP gradually decomposed into its independent subunits at SDS concentrations ≤5% (w/v). After the removal of SDS, the dissociated subunits partially reassembled into a fibrous network-like nanostructure in which the Res molecules were encapsulated, and they preferentially interacted with the hydrophobic subunits (α and α' subunits and the 24 kDa subunit) of the protein. This system exhibited a high encapsulation efficiency (95.93%), high water solubility (85.29%), extraordinary oxidation resistance (DPPH radical scavenging activity of 67.1%), and improved Res digestibility (78.7%).

Context Matters: Social Psychological Factors That Underlie Academic Performance across Seven Institutions

To enhance equity and diversity in undergraduate biology, recent research in biology education focuses on best practices that reduce learning barriers for all students and improve academic performance. However, the majority of current research into student experiences in introductory biology takes place at large, predominantly White institutions. To foster contextual knowledge in biology education research, we harnessed data from a large research coordination network to examine the extent of academic performance gaps based on demographic status across institutional contexts and how two psychological factors, test anxiety and ethnicity stigma consciousness, may mediate performance in introductory biology. We used data from seven institutions across three institution types: 2-year community colleges, 4-year inclusive institutions (based on admissions selectivity; hereafter, inclusive), and 4-year selective institutions (hereafter, selective). In our sample, we did not observe binary gender gaps across institutional contexts, but found that performance gaps based on underrepresented minority status were evident at inclusive and selective 4-year institutions, but not at community colleges. Differences in social psychological factors and their impacts on academic performance varied substantially across institutional contexts. Our findings demonstrate that institutional context can play an important role in the mechanisms underlying performance gaps.

Dynamic gastric stability and in vitro lipid digestion of soybean protein isolate and three storage protein-stabilized emulsions: Effects of ultrasonic treatment

The emulsification of vegetable protein is closely related to solubility. The purpose of this study was to evaluate the effect of ultrasound on protein emulsification and to provide a prospective method for assessing the digestive properties of emulsions. In this article, we investigate the emulsion stability of ultrasonic pretreated soy protein isolate (SPI), and its three storage proteins, namely β-conglycinin (7S), lipophilic protein (LP), and glycinin (11S), under dynamic gastric conditions. The effects of these emulsions on lipolysis during digestion in the small intestine are also assessed using an in vitro dynamic human stomach simulator and a small intestine model. Particle size and ζ-potential measurements, as well as confocal laser scanning microscopy, revealed that during dynamic gastric digestion, the flocculation degree and floc size of 7S and soybean LP emulsions are larger than that of 11S and SPI emulsions. Meanwhile, ultrasound pretreatment of the proteins was found to prevent the agglomeration of the emulsion in a dynamic gastric environment. Moreover, enhanced flocculation delayed oil droplet delivery to the small intestine and subsequently retarded the release of lipophilic nutrients. The droplet size, molecular weight, and protein secondary structures of the ultrasonicated proteins were conducive to relatively higher rates and degrees of lipolysis in intestinal digestion than those of unsonicated proteins. Additionally, the slow-release effect of LP was superior to that of 11S and SPI, whereas 7S was comparatively more difficult to digest. The present study elucidated the fate of soy protein in the digestive tract and may facilitate microstructural food design to regulate physiological responses during digestion.

Linc00703 suppresses non-small cell lung cancer progression by modulating CyclinD1/CDK4 expression

OBJECTIVE

The aim of this study was to detect the expression of linc00703 in non-small cell lung cancer (NSCLC), and to explore the biological function and potential molecular mechanism of linc00703 in NSCLC using in vitro experiments.

PATIENTS AND METHODS

The carcinoma tissues and para-carcinoma tissues were collected from 32 patients diagnosed with NSCLC, from which the RNA was extracted. The relative expression of linc00703 in NSCLC tissues was detected via quantitative reverse transcription-polymerase chain reaction (qRT-PCR). The NSCLC cells and normal human bronchial epithelial cells were selected, in which the relative expression of linc00703 was determined via qRT-PCR. Next, the linc00703 overexpression plasmids were designed and synthesized, and then transiently transfected into NSCLC cells. After 48 h, the overexpression efficiency was detected. Finally, the changes in cell proliferation, apoptosis, cycle distribution and expressions of downstream molecular markers were determined using cell counting kit-8 (CCK8) assay, colony formation assay, flow cytometry and Western blotting, respectively, after overexpression of linc00703 in NSCLC cells.

RESULTS

The results of qRT-PCR revealed that the expression of linc00703 was down-regulated by 5.14 times on average in 29 out of 32 cases of NSCLC tissues, and it was also down-regulated in NSCLC cells. Besides, it was found through CCK-8 assay, colony formation assay and flow cytometry that after overexpression of linc00703 in NSCLC cells, the cell proliferation was inhibited, the apoptosis was enhanced, and the cell cycle was arrested in G1/G0 phase. Furthermore, the results of Western blotting showed that after overexpression of linc00703, the protein expressions of cyclinD1 and cyclin-dependent kinase 4 (CDK4) declined, while those of cyclinE1 and CDK2 did not change.

CONCLUSIONS

The expression of linc00703 is down-regulated in NSCLC, and it suppresses the occurrence and development of NSCLC via mediating the expression of cyclinD1/CDK4.

Medical ozone induces proliferation and migration inhibition through ROS accumulation and PI3K/AKT/NF-κB suppression in human liver cancer cells in vitro

BACKGROUND

Hepatocellular carcinoma is one of the most common malignancies and leading cancer-associated deaths worldwide. Ozone has been proposed as a promising therapeutic agent in the treatment of various disorders.

PURPOSE

The purpose of this paper is to assess the potential anticancer effects of the ozone on liver cancer cells.

METHOD

The liver cancer cell line of bel7402 and SMMC7721 was used in this study. Proliferation was evaluated using the CCK-8 and the colony formation assay. Wond healing assay and transwell assay without Matrigel were used to evaluate their migration ability. Flow cytometry was used for cell cycle analysis and reactive oxygen species (ROS) determination. Glutathione detection kit was used for measurement of glutathione level. Protein expression was estimated by western blot analysis.

RESULTS

Ozone treatment inhibited liver cancer cell proliferation, colony formation. Ozone induced G2/M phase cell cycle arrest, which could be elucidated by the change of protein levels of p53, p21, Cyclin D1, cyclin B1, cdc2, and CDK4. We also found that ozone treatment inhibited migration ability by inhibiting EMT-relating protein. Ozone also induced ROS accumulation and decreased glutathione level decreased, which contributed to the inactivation of the PI3K/AKT/NF-κB pathway. Finally, we found that pre-treatment of liver cancer cells with N-acetylcysteine resisted ozone-induced effects.

CONCLUSIONS

Ozone restrains the proliferation and migration potential and EMT process of liver cancer cells via ROS accumulation and PI3K/AKT/NF-κB suppression.

MicroRNA-597 inhibits NSCLC progression through negatively regulating CDK2 expression

OBJECTIVE

Previous studies have shown that microRNA-597 serves as a tumor suppressor gene. However, the role of microRNA-597 in non-small cell lung cancer (NSCLC) has not been fully elucidated. Therefore, the aim of this study was to investigate the expression of microRNA-597 in NSCLC, and to further explore the possible underlying mechanism.

PATIENTS AND METHODS

Real-time quantitative polymerase chain reaction (qPCR) was performed to examine microRNA-597 level in tumor tissues and para-cancerous normal tissues collected from 50 patients with NSCLC. The interplay between microRNA-597 expression and clinical indicators, as well as prognosis of NSCLC patients, was analyzed. Meanwhile, qPCR was used to verify microRNA-59 level in NSCLC cell lines. Subsequently, microRNA-597 overexpression and knockdown models were constructed using lentivirus in NSCLC cell lines (including H1299 and PC-9). The impacts of microRNA-597 on the biological functions of NSCLC cells were evaluated using cell counting kit-8 (CCK-8), colony formation, and 5-Ethynyl-2'-deoxyuridine (EdU) assay, respectively. Finally, luciferase reporter gene assay and recovery experiment were performed to investigate the underlying molecular mechanism.

RESULTS

QPCR results indicated that microRNA-597 level in NSCLC tissues was remarkably lower than that of adjacent normal tissues, and the difference was statistically significant (p<0.05). Compared with patients with high expression of microRNA-597, patients with low expression of microRNA-597 exhibited significantly higher incidence of pathological stage and lower overall survival rate (p<0.05). Similarly, compared with NC group, the proliferation ability of NSCLC cells was remarkably weakened in microRNA-597 overexpression group (p<0.05). However, the opposite results were observed in microRNA-597 inhibitor group (p<0.05). CDK2 expression was found remarkably elevated in NSCLC cell lines as well as in tissue samples CDK2 expression. Meanwhile, CDK2 expression was negatively correlated with microRNA-597 expression. Luciferase reporter gene assay demonstrated that overexpression of CDK2 could significantly attenuate the luciferase activity of wild-type microRNA-597 vector without attenuating that of mutant vector CDK2 expression. This further suggested that microRNA-597 could target bind to CDK2. Furthermore, cell recovery experiment revealed that CDK2 could reverse the impact of microRNA-597 on the malignant progression of NSCLC.

CONCLUSIONS

MicroRNA-597 expression was significantly down-regulated in NSCLC tissues, as well as cell lines. Meanwhile, microRNA-597 expression was associated with the pathological staging and poor prognosis of patients with NSCLC. In addition, microRNA-597 might suppress the malignant progression of NSCLC through the regulation of CDK2.

[Advances in researches on neoadjuvant therapy for resectable colorectal liver metastasis]

Surgery is recognized as the core treatment for colorectal liver metastasis (CRLM), while its recurrence rate remains relatively high, even for resectable CRLM. This hints that the efficacy of treatment involves not only technological factors of surgery, but also biological behavior of tumor. For resectable CRLM, neoadjuvant therapy is beneficial to eliminate the micro-metastasis, reduce postoperative recurrence rate, screen tumor biological behavior and improve prognosis. However, questions about which kind of CRLM patients fits for neoadjuvant therapy and what regimen should be used are still debatable. This paper reviews stratified management of resectable CRLM, choice of neoadjuvant regimen, especially the application value of targeted therapy, based on the latest guidelines and studies.