Discovery and Optimization of Novel Nonbile Acid FXR Agonists as Preclinical Candidates for the Treatment of Inflammatory Bowel Disease

Inflammatory bowel disease (IBD) is a multifactorial chronic inflammation of the intestine and has become a global public health concern. A farnesoid X receptor (FXR) was recently reported to play a key role in hepatic-intestinal circulation, intestinal metabolism, immunity, and microbial regulation, and thus, it becomes a promising therapeutic target for IBD. In this study, we identified a series of nonbile acid FXR agonists, in which 33 novel compounds were designed and synthesized by the structure-based drug design strategy from our previously identified hit compound. Compound 33 exhibited a potent FXR agonistic activity, high intestinal distribution, good anti-inflammatory activity, and the ability to repair the colon epithelium in a DSS-induced acute enteritis model. Based on the results of RNA-seq analysis, we further investigated the therapeutic potential of the combination of compound 33 with 5-ASA. Overall, the results indicated that compound 33 is a promising drug candidate for IBD treatment.

Elucidating the links between N2O dynamics and changes in microbial communities following saltwater intrusions

Saltwater intrusion in estuarine ecosystems alters microbial communities as well as biogeochemical cycling processes and has become a worldwide problem. However, the impact of salinity intrusion on the dynamics of nitrous oxide (N2O) and associated microbial community are understudied. Here, we conducted field microcosms in a tidal estuary during different months (December, April and August) using dialysis bags, and microbes inside the bags encountered a change in salinity in natural setting. We then compared N2O dynamics in the microcosms with that in natural water. Regardless of incubation environment, saltwater intrusion altered the dissolved N2O depending on the initial saturation rates of N2O. While the impact of saltwater intrusion on N2O dynamics was consistent across months, the dissolved N2O was higher in summer than in winter. The N-related microbial communities following saltwater intrusion were dominated by denitrifers, with fewer nitrifiers and bacterial taxa involved in dissimilatory nitrate reduction to ammonium. While denitrification was a significant driver of N2O dynamics in the studied estuary, nitrifier-involved denitrification contributed to the additional production of N2O, evidenced by the strong associations with amoA genes and the abundance of Nitrospira. Higher N2O concentrations in the field microcosms than in natural water limited N2O consumption in the former, given the lack of an association with nosZ gene abundance. The differences in the N2O dynamics observed between the microcosms and natural water could be that the latter comprised not only indigenous microbes but also those accompanied with saltwater intrusion, and that immigrants might be functionally rich individuals and able to perform N transformation in multiple pathways. Our work provides the first quantitative assessment of in situ N2O concentrations in an estuary subjected to a saltwater intrusion. The results highlight the importance of ecosystem size and microbial connectivity in the source-sink dynamics of N2O in changing environments.

[Application of super-resolution and ultrafast ultrasound to reveal the characteristics of vascular blood flow changes after rat spinal cord injury at different segments]

Objective: To investigate the changes of spinal vascular blood flow in SD rats after cervical, thoracic and lumbar spinal cord injury (SCI) using super-resolution ultrafast ultrasound technology. Methods: A total of 9 SD rats were used to construct SCI models at different segments using a 50 g aneurysm clip. Super-resolution ultrafast ultrasound technology was used to perform vascular blood flow imaging on the spinal cord of rats before and after injury at 6 hours, obtaining quantitative information such as spinal cord vascular density and blood flow velocity. Results: Ultrasound imaging showed that after SCI, the vascular density in the thoracic segment decreased (18.16%±1.04%) more than in the cervical segment (11.42%±1.39%) and lumbar segment (13.88%±1.43%, both P<0.05). The length of the spinal cord with decreased vascular density in the thoracic segment [(4.80±0.34)mm] was longer than that in the cervical segment [(2.80±0.57)mm] and lumbar segment [(3.10±0.36)mm, both P<0.05]. After injury, the decrease of blood flow in the thoracic segment [(8.87±0.85)ml/min] was higher than that in the cervical segment [(4.88±0.56)ml/min] and lumbar segment [(6.19±0.71)ml/min, both P<0.05]. HE staining and Nissl staining showed that the proportion of cavity area after thoracic SCI (11.53%±0.93%) was higher than that in the cervical segment (4.90%±1.72%) and lumbar segment (7.64%±0.84%, both P<0.05). The number of Nissl bodies in the thoracic segment (18.0±5.3) was also lower than that in the cervical segment (32.3±5.1) and lumbar segment (37.0±5.6) (both P<0.05). Conclusions: There are different changes in vascular blood flow after SCI in different segments of rats. The same injury causes the most severe damage to blood vessels in the thoracic spinal cord, followed by the lumbar spinal cord, and the cervical spinal cord has the least damage.

Puerarin inhibits inflammation and oxidative stress in female BALB/c mouse models of Graves' disease

Background

Graves' disease (GD) is an autoimmune thyroid disorder. Our previous study has demonstrated a significant decrease in flavone levels among children with GD compared to the control group. Puerarin, a well-known flavonoid with anti-inflammatory and antioxidant properties. We wanted to investigate its potential impact on GD pathogenesis, aiming to determine whether increasing puerarin intake could prevent or delay the onset of GD.

Methods

Adenovirus with TSHR-289 subunit was used to establish a GD mice model, and mice were intragastrically administered with puerarin or sterilized water daily. Thyroid function and inflammatory cytokine levels were quantified using ELISA, lymphocyte subsets were analyzed via flow cytometry, oxidative stress (OS) markers were measured with a microplate reader, and the expression of pertinent signaling pathway proteins were assessed by Western blot.

Results

The results demonstrated that puerarin treatment significantly decreased thyroxin levels and alleviated thyroid pathological changes in GD mice. Furthermore, the immune imbalance of GD mice was improved, as evidenced by reduced inflammatory indexes, elevated antioxidant levels, and decreased malondialdehyde (MDA) levels compared to untreated GD mice. Puerarin-treated GD mice exhibited significantly lower expressions of heat shock protein (HSP): HSP70, HSP90, phosphorylated extracellular regulated kinases (p-ERK) and phosphorylated protein kinase B (p-AKT) than untreated GD mice. Moreover, low dosage puerarin (400 mg/kg) was associated with a better protective effect than high dosage (1,200 mg/kg).

Conclusions

Puerarin may have the potential to mitigate GD by inhibiting inflammatory and OS, through downregulating the expression of HSP70 and HSP90 and suppressing the activation of the PI3K/AKT/ERK signaling pathway. Furthermore, a lower dose exhibited superior protective effects compared to a higher dose.

Efficacy and Safety of First-line Therapies for Advanced Unresectable Oesophageal Squamous Cell Cancer: a Systematic Review and Network Meta-analysis

AIM

To compare the clinical efficacy and safety of first-line treatments for advanced unresectable oesophageal squamous cell cancer.

MATERIALS AND METHODS

A systematic review and network meta-analysis was carried out by retrieving and retaining relevant literature from databases. The studies were randomised controlled trials comparing first-line treatments for advanced unresectable oesophageal squamous cell cancer. A Bayesian network meta-analysis was used to assess clinical outcomes.

RESULTS

Nine studies including 4499 patients receiving first-line treatments were analysed. For all populations, toripalimab plus chemotherapy tended to provide the best overall survival (hazard ratio 0.58, 95% confidence intervals 0.43-0.78) and sintilimab plus chemotherapy provided the best progression-free survival (0.56, 0.46-0.68). Nivolumab plus chemotherapy presented the best objective response rate (odds ratio 2.45, 1.78-3.42) and camrelizumab plus chemotherapy (0.47, 0.29-0.74) appeared to be the safest. Sintilimab plus chemotherapy (0.55, 0.40-0.75) and nivolumab (0.54, 0.37-0.80) plus chemotherapy had the best overall survival in programmed death ligand 1 (PD-L1) tumour proportion score <1% and ≥1% subgroups. Toripalimab plus chemotherapy (0.61, 0.40-0.93) and pembrolizumab (0.57, 0.43-0.75) were the best in overall survival in combined positive score <10 and ≥10 subgroups, respectively. Toripalimab plus chemotherapy showed the best overall survival in the Asian group; pembrolizumab presented better overall survival in the Asian population than the non-Asian group.

CONCLUSION

Most immunotherapy combined with chemotherapy showed superior clinical benefits and sintilimab plus chemotherapy, toripalimab plus chemotherapy and tislelizumab plus chemotherapy had better comprehensive clinical efficacy. PD-L1 expression detection and ethnicity differences are still of great significance and most suitable regimens varied from each subgroup.

Evaluation of a dye-decolorizing peroxidase from Comamonas serinivorans for lignin valorization potentials

Although dye-decolourising peroxidases (DyPs) are well-known for lignin degradation, a comprehensive understanding of their mechanism remains unclear. Therefore, studying the mechanism of lignin degradation by DyPs is necessary for industrial applications and enzyme engineering. In this study, a dye-decolourising peroxidase (CsDyP) gene from C. serinivorans was heterologously expressed and studied for its lignin degradation potential. Molecular docking analysis predicted the binding of 2, 2-azino-bis (3-ethylbenzothiazoline-6-sulfonic acid) (ABTS), veratryl alcohol (VA), 2, 6-dimethylphenol (2, 6- DMP), guaiacol (GUA), and lignin to the substrate-binding pocket of CsDyP. Evaluation of the enzymatic properties showed that CsDyP requires pH 4.0 and 30 °C for optimal activity and has a high affinity for ABTS. In addition, CsDyP is stable over a wide range of temperatures and pH and can tolerate 5.0 mM organic solvents. Low NaCl concentrations promoted CsDyP activity. Further, CsDyP significantly reduced the chemical oxygen demand decolourised alkali lignin (AL) and milled wood lignin (MWL). CsDyP targets the β-O-4, CO, and CC bonds linking lignin's G, S, and H units to depolymerize and produce aromatic compounds. Overall, this study delivers valuable insights into the lignin degradation mechanism of CsDyP, which can benefit its industrial applications and lignin valorization.

A novel interpretative tool for early prediction of low cardiac output syndrome after valve surgery: online machine learning models

OBJECTIVE

Low cardiac output syndrome (LCOS) is a severe complication after valve surgery, with no uniform standard for early identification. We developed interpretative machine learning (ML) models for predicting LCOS risk preoperatively and 0.5 h postoperatively for intervention in advance.

METHODS

A total of 2218 patients undergoing valve surgery from June 2019 to Dec 2021 were finally enrolled to construct preoperative and postoperative models. Logistic regression, support vector machine (SVM), random forest classifier, extreme gradient boosting, and deep neural network were executed for model construction, and the performance of models was evaluated by area under the curve (AUC) of the receiver operating characteristic and calibration curves. Our models were interpreted through SHapley Additive exPlanations, and presented as an online tool to improve clinical operability.

RESULTS

The SVM algorithm was chosen for modeling due to better AUC and calibration capability. The AUCs of the preoperative and postoperative models were 0.786 (95% CI 0.729-0.843) and 0.863 (95% CI 0.824-0.902), and the Brier scores were 0.123 and 0.107. Our models have higher timeliness and interpretability, and wider coverage than the vasoactive-inotropic score, and the AUC of the postoperative model was significantly higher. Our preoperative and postoperative models are available online at http://njfh-yxb.com.cn:2022/lcos.

CONCLUSIONS

The first interpretable ML tool with two prediction periods for online early prediction of LCOS risk after valve surgery was successfully built in this study, in which the SVM model has the best performance, reserving enough time for early precise intervention in critical care.

Effect of ocean warming on pigment and photosynthetic carbon fixation of plankton assemblage in Pingtan Island of Southeast China

Temperature plays an important role in affecting the physiological traits of marine plankton. In this study, we conducted an outdoor incubation experiment to investigate the effects of elevated temperature on Chl a, photosynthetic carbon fixation and the composition of plankton communities in the surface seawater around Pingtan Island, the northwest Taiwan Strait in Autumn 2022. After 3-4 days of incubation, elevated temperature (1-4 °C higher than ambient temperature) led to a decrease in Chl a concentration across all three stations, did not result in significant increases in the particulate organic carbon (POC) and nitrogen (PON) concentrations in seawater with high nitrate concentrations, whereas increased POC and PON concentrations in nitrate-limited seawater. These findings suggest that the effect of temperature on the POC and PON contents of plankton is affected by the availability of nitrate. Diatoms were the dominant phytoplankton group in all three stations. Our results indicate that ocean warming has a potential to increase the POC contents of marine plankton per volume of seawater, which may increase the ability of phytoplankton to absorb atmospheric CO2 and to alleviate global warming.

High-normal serum uric acid predicts macrovascular events in patients with type 2 diabetes mellitus without hyperuricemia based on a 10-year cohort

BACKGROUND AND AIMS

The upper limits of normal serum uric acid (SUA) or the lower limits of hyperuricemia were frequently set at 420 or 360 μmol/L (7.0 or 6.0 mg/dL). We aimed to explore the association between high-normal SUA (360 ≤ SUA≤420 μmol/L) and incidence of macrovascular and renal events based on a 10-year cohort with type 2 diabetes mellitus (T2DM) to explore which cut-off was more appropriate.

METHODS AND RESULTS

A total of 2988 patients with T2DM without hyperuricemia (SUA≤420 μmol/L) were included and followed up. Cox proportional hazards models and restricted cubic spline regression were used to evaluate the relationship between baseline SUA (as continuous and categorical variable) and macrovascular and renal events. Patients were grouped as low-normal (SUA<360 μmol/L) and high-normal groups based on baseline SUA, and the latter group had higher incidence of macrovascular events. Multivariate Cox regression analysis indicated that baseline levels of SUA were significantly associated with cardiovascular (HR = 1.385, 95%CI:1.190-1.613, P < 0.001) and peripheral vascular events (HR = 1.266, 95%CI:1.018-1.574, P = 0.034), and the linear association existed. Moreover, fully adjusted multivariable Cox analyses indicated high-normal SUA increased the risks of cardiovascular (HR = 1.835, 95%CI:1.319-2.554, P < 0.001) and peripheral vascular events (HR = 1.661, 95%CI:1.000-2.760, P = 0.050) compared to low-normal SUA.

CONCLUSIONS

Baseline SUA levels were positively associated with cardiovascular and peripheral vascular events, and high-normal SUA increased the risks of these events in patients with T2DM even without hyperuricemia. A threshold value for SUA of 360 μmol/L should be more appropriate in terms of predicting macrovascular events risks compared to the value of 420 μmol/L.

The Incidence and Prognosis Value of Perineural Invasion in Rectal Carcinoma: From Meta-Analyses and Real-World Clinical Pathological Features

AIMS

Perineural invasion (PNI) is a special type of metastasis of several cancers and has been reported as being a factor for poor prognosis in colorectal carcinoma. However, investigations of PNI in only rectal cancer and a comprehensive analysis combining meta-analyses with real-world case studies remain lacking.

MATERIALS AND METHODS

First, articles from 2000 to 2020 concerning the relationship between PNI and rectal cancer prognoses and clinical features were meta-analysed. Subsequently, we carried out a retrospective analysis of 312 rectal cancer cases that underwent radical surgery in the real world. The incidence of PNI and the relationship between PNI and prognosis, as well as clinicopathological factors, were investigated.

RESULTS

The incidence of PNI was 23.09% and 33.01% in the meta-analysis and clinical cases, respectively. PNI occurred as early as stage I (2.94%). Moreover, neoadjuvant therapy significantly reduced the PNI-positive rate (20.34% versus 26.54%). Both meta-analysis and real-world clinical case studies suggested that PNI-positive patients had poorer prognoses than PNI-negative patients. We established an effective risk model consisting of T stage, differentiation and lymphovascular invasion to predict PNI in rectal cancer.

CONCLUSION

PNI is a poor prognostic factor for rectal cancer and could occur even in stage I. Additionally, neoadjuvant therapy could sufficiently reduce the PNI-positive rate. T stage, lymphovascular invasion and differentiation grade were independent risk factors for PNI and the risk model that included these factors could predict the probability of PNI.

Decolorization of reactive azo dye using novel halotolerant yeast consortium HYC and proposed degradation pathway

The presence of high salinity levels in textile wastewater poses a significant obstacle to the process of decolorizing azo dyes. The present study involved the construction of a yeast consortium HYC, which is halotolerant and was recently isolated from wood-feeding termites. The consortium HYC was mainly comprised of Sterigmatomyces halophilus SSA-1575 and Meyerozyma guilliermondii SSA-1547. The developed consortium demonstrated a decolourization efficiency of 96.1% when exposed to a concentration of 50 mg/l of Reactive Black 5 (RB5). The HYC consortium significantly decolorized RB5 up to concentrations of 400 mg/l and in the presence of NaCl up to 50 g/l. The effects of physicochemical factors and the degradation pathway were systematically investigated. The optimal pH, salinity, temperature, and initial dye concentration were 7.0, 3%, 35 °C and 50 mg/l, respectively. The co-carbon source was found to be essential, and the addition of glucose resulted in a 93% decolorization of 50 mg/l RB5. The enzymatic activity of various oxido-reductases was assessed, revealing that NADH-DCIP reductase and azo reductase exhibited greater activity in comparison to other enzymes. UV-Visible (UV-vis) spectrophotometry, Fourier-transform infrared spectroscopy (FTIR), high-performance liquid chromatography (HPLC), and gas chromatography-mass spectrometry (GC-MS) were utilized to identify the metabolites generated during the degradation of RB5. Subsequently, a metabolic pathway was proposed. The confirmation of degradation was established through alterations in the functional groups and modifications in molecular weight. The findings indicate that this halotolerant yeast consortium exhibits promising potential of degrading dye compounds. The results of this study offer significant theoretical basis and crucial perspectives for the implementation of halotolerant yeast consortia in the bioremediation of textile and hypersaline wastewater. This approach is particularly noteworthy as it does not produce aromatic amines.

Combined transcriptome and proteome analysis revealed the molecular regulation mechanisms of zinc homeostasis and antioxidant machinery in tobacco in response to different zinc supplies

Zinc (Zn) is an essential micronutrient for plants. Adequate regulation of Zn uptake, transport and distribution, and adaptation to Zn-deficiency stress or Zn-excess toxicity are crucial for plant growth and development. However, little has been done to understand the molecular responses of plants toward different Zn supply levels. In the present study, we investigated the growth and physiological responses of tobacco seedlings grown under Zn-completely deficient, Zn-limiting, Zn-normal, and Zn-4-fold sufficient conditions, respectively, and demonstrated that Zn deficiency/limitation caused oxidative stress and impaired growth of tobacco plants. Combined transcriptome and proteome analysis revealed up-regulation of genes/proteins associated with Zn uptake and distribution, including ZIPs, NAS3s, and HMA1s, and up-regulation of genes/proteins involved in regulation of oxidative stress, including SODs, APX1s, GPX6, and GSTs in tobacco seedlings in response to Zn deficiency/limitation, suggesting that tobacco possessed mechanisms to regulate Zn homeostasis primarily through up-regulation of the ZIPs-NAS3s module, and to alleviate Zn deficiency/limitation-induced oxidative stress through activation of the antioxidant machinery. Our results provide novel insights into the adaptive mechanisms of tobacco in response to different Zn supplies, and would lay a theoretical foundation for development of varieties of tobacco or its relatives with high tolerance to Zn-deficiency.

Elevated serum beta-2 microglobulin level predicts short-term poor prognosis of patients with de novo acute omicron variant COVID-19 infection

Background

The devastating coronavirus disease of 2019 (COVID-2019) epidemic has been declared a public health emergency, resulting in a worldwide pandemic. The omicron variety is the most common epidemic mutant strain in the globe. Serum beta-2 microglobulin (β2-MG) is associated with endothelial cell injury and has value in monitoring the progression of inflammation in infected individuals. Nonetheless, the potential functions of β2-MG in omicron remain elusive.

Methods

To investigate the prognostic value of serum β2-MG levels at diagnosis, we retrospectively analyzed a cohort of 240 people with omicron. Over the course of 65 days, all patients were monitored, and death was the primary outcome. Patients were allocated to two groups: those with high and low β2-MG levels. The Kaplan-Meier method was used to examine OS, and the log-rank test was used to compare them. Univariate and multivariate Cox hazard models were used to determine the prognostic significance.

Results

Our results revealed that β2-MG was significantly elevated in omicron. β2-MG levels in severe patients were higher than in mild-to-moderate patients, and the difference was statistically significant. Timely, interleukin-6 (IL-6) and interleukin-10 (IL-10) were observed to be significantly increased in individuals exhibiting elevated levels of β2-MG. In addition, patients exhibiting elevated levels of β2-MG demonstrated a statistically significant decrease in overall survival (OS, P < 0.0001). An elevated β2-MG level (≥4.72 mg/l) was found to be an independent, adverse prognostic factor for OS in omicron patients, according to multivariate Cox proportional hazards regression analysis (P = 0.001).

Conclusion

Serum β2-MG level at initial diagnosis was significantly correlated with omicron severity and prognosis. Thus, we propose that β2-MG may be an independent poor additional prognostic factor in patients with omicron.

One-step simultaneous biomass synthesis of iron nanoparticles using tea extracts for the removal of metal(loid)s in acid mine drainage

Acid Mine Drainage (AMD) contains various metal/metalloid ions such as Fe, Cu, and As, which all impact seriously on mine ecosystems. Currently, the commonly used chemical methods for treating AMD may cause secondary pollution to appear in the environment. In this study, one-step simultaneous biomass synthesis of iron nanoparticles (Fe NPs) using tea extracts for the removal of heavy metals/metalloids in AMD is proposed. Characterizations revealed that the Fe NPs presented severely agglomerated particles with an average particle size of 119.80 ± 4.94 nm, on which various AMD-derived metal(loid)s, including As, Cu, and Ni, were uniformly dispersed. The biomolecules participating in the reaction in the tea extract were identified as polyphenols, organic acids, and sugars, which acted as complexing agents, reducing agents, covering/stabilizing agents, and promoted electron transfer. Meanwhile, the best reaction conditions (reaction time = 3.0 h, volume ratio of AMD and tea extract = 1.0:1.5, concentration of extract = 60 g/L, and T = 303 K) were obtained. Finally, the simultaneous formation of Fe NPs and their removal of heavy metals/metalloids from AMD was proposed, mainly involving the formation of Fe NPs and adsorption, co-precipitation, and reduction processes of heavy metals/metalloids.

Enhanced OER Performance and Dynamic Transition of Surface Reconstruction in LaNiO3 Thin Films with Nanoparticles Decoration

In an electrocatalytic process, the cognition of the active phase in a catalyst has been regarded as one of the most vital issues, which not only boosts the fundamental understanding of the reaction procedure but also guides the engineering and design for further promising catalysts. Here, based on the oxygen evolution reaction (OER), the stepwise evolution of the dominant active phase is demonstrated in the LaNiO₃ (LNO) catalyst once the single-crystal thin film is decorated by LNO nanoparticles. It is found that the OER performance can be dramatically improved by this decoration, and the catalytic current density at 1.65 V can be enhanced by ≈1000% via ≈10⁹ cm^-2 nanoparticle adhesion after extracting the contribution of surface enlargement. Most importantly, a transition of the active phase from LNO to NiOOH via surface reconstruction with the density of LNO nanoparticles is demonstrated. Several mechanisms in terms of this active phase transition are discussed involving lattice orientation-induced change of the surface energy profile, the lattice oxygen participation, and the A/B-site ions leaching during OER cycles. This study suggests that the active phases in transition metal-based OER catalysts can transform with morphology, which should be corresponding to distinct engineering strategies.

Host-Specific Diversity of Culturable Bacteria in the Gut Systems of Fungus-Growing Termites and Their Potential Functions towards Lignocellulose Bioconversion

Fungus-growing termites are eusocial insects that represent one of the most efficient and unique systems for lignocellulose bioconversion, evolved from a sophisticated symbiosis with lignocellulolytic fungi and gut bacterial communities. Despite a plethora of information generated during the last century, some essential information on gut bacterial profiles and their unique contributions to wood digestion in some fungus-growing termites is still inadequate. Hence, using the culture-dependent approach, the present study aims to assess and compare the diversity of lignocellulose-degrading bacterial symbionts within the gut systems of three fungus-growing termites: Ancistrotermes pakistanicus, Odontotermes longignathus, and Macrotermes sp. A total of 32 bacterial species, belonging to 18 genera and 10 different families, were successfully isolated and identified from three fungus-growing termites using Avicel or xylan as the sole source of carbon. Enterobacteriaceae was the most dominant family represented by 68.1% of the total bacteria, followed by Yersiniaceae (10.6%) and Moraxellaceae (9%). Interestingly, five bacterial genera such as Enterobacter, Citrobacter, Acinetobacter, Trabulsiella, and Kluyvera were common among the tested termites, while the other bacteria demonstrated a termite-specific distribution. Further, the lignocellulolytic potential of selected bacterial strains was tested on agricultural waste to evaluate their capability for lignocellulose bioconversion. The highest substrate degradation was achieved with E. chengduensis MA11 which degraded 45.52% of rice straw. All of the potential strains showed endoglucanase, exoglucanase, and xylanase activities depicting a symbiotic role towards the lignocellulose digestion within the termite gut. The above results indicated that fungus-growing termites harbor a diverse array of bacterial symbionts that differ from species to species, which may play an inevitable role to enhance the degradation efficacy in lignocellulose decomposition. The present study further elaborates our knowledge about the termite-bacteria symbiosis for lignocellulose bioconversion which could be helpful to design a future biorefinery.

[Research progress on the epidemiology and risk factors of dry eye in children]

The prevalence of dry eye in children is increasing with changes in the environment and the widespread use of electronic products. However, due to poor ability to express themselves and hidden symptoms of children, lack of understanding of dry eye in children, children with dry eye are likely to be misdiagnosed. Dry eye can seriously affect the quality of children's learning, life, vision and visual development. Therefore, it is urgent to raise awareness of clinical workers about dry eye in children, prevent the occurrence of related complications of dry eye, and avoid permanent visual damage to children. This review discusses and summarizes the epidemiology and common risk factors of children with dry eye, with the aim of improving doctors' understanding of dry eye in children.

[Exploration of making removable partial denture by digital technology]

To explore the digital manufacturing process of distal extension removable partial denture. From November 2021 to December 2022, 12 patients (7 males and 5 females) with free-ending situation were selected from the Department of Prosthodontics, School of Stomatology, The Fourth Military Medical University. Three-dimensional model of the relationship between alveolar ridge and jaw position was obtained by intraoral scanning technique. After routine design, manufacturing and try-in of metal framework for removable partial denture, the metal framework was located in the mouth and scanned again to obtain the composite model of dentition, alveolar ridge and metal framework. The free-end modified model is obtained by merging the digital model of free-end alveolar ridge with the virtual model with the metal framework. The three-dimensional model of artificial dentition, and base plate was designed on the free-end modified model, and the resin model were made by digital milling technology. The removable partial denture was made by accurately positioning the artificial dentition and base plate, bonding metal framework with injection resin, grinding and polishing the artificial dentition and resin base. Compared with the design data after clinical trial, the results showed that there was an error of 0.4-1.0 mm and an error of 0.03-0.10 mm in the connection between the resin base of artificial dentition and the connecting rod of the in-place bolt and the connection between artificial dentition and resin base. After denturen delivery, only 2 patients needed grinding adjustment in follow-up visit due to tenderness, and the rest patients did not find any discomfort. The digital fabrication process of removable partial denture used in this study can basically solve the problems of digital fabrication of free-end modified model and assembly of artificial dentition with resin base and metal framework.

Isolation and Transcriptome Analysis of Plant Cell Types

In multicellular organisms, developmental programming and environmental responses can be highly divergent in different cell types or even within cells, which is known as cellular heterogeneity. In recent years, single-cell and cell-type isolation combined with next-generation sequencing (NGS) techniques have become important tools for studying biological processes at single-cell resolution. However, isolating plant cells is relatively more difficult due to the presence of plant cell walls, which limits the application of single-cell approaches in plants. This protocol describes a robust procedure for fluorescence-activated cell sorting (FACS)-based single-cell and cell-type isolation with plant cells, which is suitable for downstream multi-omics analysis and other studies. Using Arabidopsis root fluorescent marker lines, we demonstrate how particular cell types, such as xylem-pole pericycle cells, lateral root initial cells, lateral root cap cells, cortex cells, and endodermal cells, are isolated. Furthermore, an effective downstream transcriptome analysis method using Smart-seq2 is also provided. The cell isolation method and transcriptome analysis techniques can be adapted to other cell types and plant species and have broad application potential in plant science.

Changes of dissolved organic matter following salinity invasion in different seasons in a nitrogen rich tidal reach

Dissolved organic matter (DOM) is a heterogeneous mixture of dissolved material found ubiquitously in aquatic systems and dissolved organic nitrogen is one of its most important components. We hypothesised nitrogen species and salinity intrusions affect the DOM changes. Here, using the nitrogen rich Minjiang River as an easily accessible natural laboratory 3 field surveys with 9 sampling sites (S1-S9) were conducted in November 2018, April and August 2019. The excitation emission matrices (EEMs) of DOM were explored with parallel factor (PARAFAC) and cosine-histogram similarity analysis. Four indices including fluorescence index (FI), biological index (BIX), humification index (HIX) and the fluorescent DOM (FDOM) were calculated and the impact of physicochemical properties was assessed. The results suggested that the highest salinities of 6.15, 2.98 and 10.10, during each campaign corresponded to DTN concentrations of 119.29-240.71, 149.12-262.42 and 88.27-155.29 μmol·L^-1, respectively. PARAFAC analysis revealed the presence of tyrosine-like proteins (C1), tryptophan-like proteins or a combination of the peak N and tryptophan-like fluorophore (C2) and the humic-like material (C3). The EEMs in the upstream reach (i.e. S1-S3) were complex with larger spectra ranges, higher intensities and similar similarity. Subsequently, the fluorescence intensity of three components decreased significantly with low similarity of EEMs (i.e. S4-S7). At the downstream, the fluorescence levels dispersed significantly and no obvious peaks were seen except in August. In addition, FI and HIX increased, while BIX and FDOM decreased from upstream to downstream. The salinity positively correlated with FI and HIX, and negatively related to BIX and FDOM. Besides, the elevated DTN had a significant effect on the DOM fluorescence indices. Altogether, salinity intrusion and elevated nitrogen are relevant for the distribution of the DOM, which is helpful for the water management tracing the DOM source according to the on-line monitoring of salinity and nitrogen in estuaries.

Hydrazine-Halogen Exchange Strategy Toward N═N-Containing Compounds and Process Tracking for Mechanistic Insight

An anhydride-promoted traceless hydrazine-I/Br exchange strategy is reported, where hydrazine hydrate and cyclic/linear iodonium, including rarely explored cyclic bromonium, are converted to benzo[c]cinnolines/azobenzenes in one pot. The reaction proceeds through diacylation (first and second C─N formation), N,N'-diarylation (third and fourth C─N formation), and deacylation/oxidation (2 C─N cleavages and 1 N═N formation). The reaction mechanism is investigated by isolating multiple intermediates and kinetic studies. Furthermore, time-dependent electrospray ionization mass spectrometry (TD ESI-MS) was applied to track the process by detecting most intermediates. The complex [Cu^III(iodobiphenyl)(bipy)I]⁺ (Int-C) was detected for the first time, giving evidence for oxidative addition of cyclic iodonium to Cu catalyst. Another complex [Cu^I(PHA)(bipy)] (Int-B) via ligand-exchange between the hydrazide and Cu catalyst was also detected, indicating a two-path initial activation process.

Isotopic compositions (δD, δ18O) and end-member mixing for the control interface in a complex tidal region

Identifying the mixing processes of waters and currents in tidal reach is an important aspect of environmental management to protect freshwater resources and prevent water pollution. In this study, three field investigations conducted in a typical tidal reach in August, November and the following April focused on two isotopes (δD and δ¹⁸O) and salinity. A salinity-isotope conservative mixing model was established to differentiate water flows of the important control interface (CI) from freshwater, transition zone and saltwater end-members. Results suggested that the average δD and δ¹⁸O values during the ebb and flood tides depleted from August to November, then enriched significantly in the following April and were even higher than those in August. The δD and δ¹⁸O values in the saltwater zone enriched markedly compared with those in freshwater zone and transition zone due to the stronger evaporation occurring in the saltwater zone. Based on the revised model, the average contributions of freshwater end-member, transition zone end-member and saltwater end-member in three months were, respectively, 51.50 %, 36.93 % and 11.57 %. However, the contributions of freshwater and transition zones in April end-member were equivalent (47.45 % vs 44.31 %). Meanwhile the largest contribution of saltwater end-member was 20.56 % and occurred in August. The proportions of three end-members that contributed to CI changed with different evaporation scenarios and moisture sources of precipitation. Our research provides important information that furthers our understanding of the isotopes and their applications to environmental management in estuarine regions.

Risk factors for falls among community-dwelling older adults: A systematic review and meta-analysis

Background and objective

The prevalence of falls among older adults living in the community is ~30% each year. The impacts of falls are not only confined to the individual but also affect families and the community. Injury from a fall also imposes a heavy financial burden on patients and their families. Currently, there are different reports on the risk factors for falls among older adults in the community. A retrospective analysis was used in this study to identify risk factors for falls in community-dwelling older adults. This research aimed to collect published studies to find risk factors for falls in community-dwelling older adults.

Methods

We searched for literature from the founding of PubMed, EMBASE, the Cochrane Library, the Web of Science, the China National Knowledge Infrastructure (CNKI), the China Science and Technology Periodicals Database (VIP), and the Wanfang database until September 2022. The studies were selected using inclusion and exclusion criteria. We collected information from relevant studies to compare the impact of potential risk factors such as age, female gender, fear of falling, history of falls, unclear vision, depression, and balance disorder on falls among community-dwelling older adults.

Results

A total of 31 studies were included with 70,868 community seniors. A significant risk factor for falls in the community of older adults was dementia (2.01, 95% CI: 1.41-2.86), age (1.15, 95% CI: 1.09-1.22), female gender (1.52, 95% CI: 1.27-1.81), fear of falling (2.82, 95% CI: 1.68-4.74), history of falls (3.22, 95% CI: 1.98-5.23), vision unclear (1.56, 95% CI: 1.29-1.89), depression (1.23, 95% CI: 1.10-1.37), and balance disorder (3.00, 95% CI: 2.05-4.39).

Conclusion

This study provides preliminary evidence that falls among community-dwelling older adults are associated with factors such as age, female gender, fear of falling, history of falls, unclear vision, depression, and balance disorders. The results of this research may help improve clinician awareness, risk stratification, and fall prevention among community-dwelling older adults.

Systematic review registration

identifier INPLASY2022120080.

The ZmMYB84-ZmPKSB regulatory module controls male fertility through modulating anther cuticle-pollen exine trade-off in maize anthers

Anther cuticle and pollen exine are two crucial lipid layers that ensure normal pollen development and pollen-stigma interaction for successful fertilization and seed production in plants. Their formation processes share certain common pathways of lipid biosynthesis and transport across four anther wall layers. However, molecular mechanism underlying a trade-off of lipid-metabolic products to promote the proper formation of the two lipid layers remains elusive. Here, we identified and characterized a maize male-sterility mutant pksb, which displayed denser anther cuticle but thinner pollen exine as well as delayed tapetal degeneration compared with its wild type. Based on map-based cloning and CRISPR/Cas9 mutagenesis, we found that the causal gene (ZmPKSB) of pksb mutant encoded an endoplasmic reticulum (ER)-localized polyketide synthase (PKS) with catalytic activities to malonyl-CoA and midchain-fatty acyl-CoA to generate triketide and tetraketide α-pyrone. A conserved catalytic triad (C171, H320 and N353) was essential for its enzymatic activity. ZmPKSB was specifically expressed in maize anthers from stages S8b to S9-10 with its peak at S9 and was directly activated by a transcription factor ZmMYB84. Moreover, loss function of ZmMYB84 resulted in denser anther cuticle but thinner pollen exine similar to the pksb mutant. The ZmMYB84-ZmPKSB regulatory module controlled a trade-off between anther cuticle and pollen exine formation by altering expression of a series of genes related to biosynthesis and transport of sporopollenin, cutin and wax. These findings provide new insights into the fine-tuning regulation of lipid-metabolic balance to precisely promote anther cuticle and pollen exine formation in plants.

The Value of Preoperative Phase-Contrast MRI in Predicting the Clinical Outcome of Moyamoya Disease after Encephalo-Duro-Arterial Synangiosis Surgery

BACKGROUND AND PURPOSE

In patients with Moyamoya disease, the relationship between preoperative hemodynamic status and prognosis after encephalo-duro-arterial synangiosis (EDAS) surgery was unclear. We aimed to explore the value of the preoperative hemodynamic status acquired by cine phase-contrast MR imaging in predicting collateral formation and clinical outcomes after EDAS surgery in patients with Moyamoya disease.

MATERIALS AND METHODS

Participants with Moyamoya disease were prospectively recruited and underwent preoperative phase-contrast MR imaging. All participants were classified into good and poor groups according to the collateral formation after EDAS surgery. On the basis of the change in the mRS system, participants were classified into the improved mRS group and the poor response group. Hemodynamic status including mean velocity, peak velocity, and blood volume flow of the superficial temporal artery was compared between groups. Logistic regression was performed to relate the phase-contrast MR imaging parameters to collateral formation and clinical outcomes.

RESULTS

A total of 45 patients with Moyamoya disease with unilateral EDAS surgery were finally included. Mean velocity, peak velocity, and blood volume flow of the ipsilateral superficial temporal artery were significantly greater in patients with good collateral formation compared with those with poor collateral formation (P = .011, .004, and .013, respectively). The mean velocity, peak velocity, and blood volume flow were independently associated with postoperative collateral formation after adjusting for confounding factors. Furthermore, the peak velocity of the ipsilateral superficial temporal artery was also significantly associated with improvement of the mRS score.

CONCLUSIONS

Good hemodynamic status of the ipsilateral superficial temporal artery as a donor artery evaluated by phase-contrast MR imaging was significantly associated with better collateral formation and improved mRS after EDAS surgery in patients with Moyamoya disease.

Arabinan hydrolysis by GH43 enzymes of Hungateiclostridium clariflavum and the potential synergistic mechanisms

Glycoside hydrolase family 43 (GH43) represents a major source of arabinan- and arabinoxylan-active enzymes. Interestingly, some microbes remarkably enriched GH genes of this family, with the reason unknown. Hungateiclostridium clariflavum DSM 19,732 is an efficient lignocellulose degrader, which harbors up to 7 GH43 genes in its genome. We cloned three of the seven GH43 genes, and found that Abn43A is a unique endoarabinanase, which unprecedently showed approximately two times larger activity on sugar beet arabinan (116.8 U/mg) than that on linear arabinan, and it is efficient in arabinooligosaccharide production. Abn43B is an exoarabinanase which directly releases arabinose from linear arabinan. Abn43C is an α-L-arabinofuranosidase which is capable of splitting the arabinose side-chains from arabinooligosaccharides, arabinoxylooligosaccharides, and arabinoxylan. Most importantly, the three GH43 enzymes synergized in hydrolyzing arabinan. Compared to Abn43B alone, a supplement of Abn43A increased the arabinose production from linear arabinan by 150%, reaching 0.44 g/g arabinan. Moreover, an addition of Abn43C to Abn43A and Abn43B boosted the arabinose production from sugar beet arabinan by 15 times, reaching 0.262 g/g arabinan. Our work suggested the intensified functions of multiple GH43 enzymes toward arabinan degradation in H. clariflavum, and a potential synergetic mechanism among the three GH43 enzymes is suggested. KEY POINTS: • Endoarabinanase GH43A prefers branched substrate to linear one • Exoarabinanase GH43B can directly release arabinose from linear arabinan • The three GH43 enzymes synergized in arabinan hydrolysis.

Exploring the region-wise diversity and functions of symbiotic bacteria in the gut system of wood-feeding termite, Coptotermes formosanus, toward the degradation of cellulose, hemicellulose, and organic dyes

The wood-feeding termite Coptotermes formosanus represents a unique and impressive system for lignocellulose degradation. The highly efficient digestion of lignocellulose is achieved through symbiosis with gut symbionts like bacteria. Despite extensive research during the last three decades, diversity of bacterial symbionts residing in individual gut regions of the termite and their associated functions is still lacking. To this end, cellulose, xylan, and dye-decolorization bacteria residing in foregut, midgut, and hindgut regions of C. formosanus were enlisted by using enrichment and culture-dependent molecular methods. A total of 87 bacterial strains were successfully isolated from different gut regions of C. formosanus which belonged to 27 different species of 10 genera, majorly affiliated with Proteobacteria (80%) and Firmicutes (18.3%). Among the gut regions, 37.9% of the total bacterial isolates were observed in the hindgut that demonstrated predominance of cellulolytic bacteria (47.6%). The majority of the xylanolytic and dye-decolorization bacteria (50%) were obtained from the foregut and midgut, respectively. Actinobacteria represented by Dietza sp. was observed in the hindgut only. Based on species richness, the highest diversity was observed in midgut and hindgut regions each of which harbored seven unique bacterial species. The members of Enterobacter, Klebsiella, and Pseudomonas were common among the gut regions. The lignocellulolytic activities of the selected potential bacteria signpost their assistance to the host for lignocellulose digestion. The overall results indicate that C. formosanus harbors diverse communities of lignocellulolytic bacteria in different regions of the gut system. These observations will significantly advance our understanding of the termite-bacteria symbiosis and their microbial ecology uniquely existed in different gut regions of C. formosanus, which may further shed a light on its potential values at termite-modeled biotechnology.

[Association between postpartum depression and concentrations of transforming growth factor-β in human colostrum: a nested cohort study]

OBJECTIVE

To explore the association between postpartum depression (PPD) and transforming growth factor-β (TGF-β) concentrations in human colostrum.

METHODS

Participants were recruited from a maternal and infant cohort established in a tertiary general hospital in Guangdong Province between December, 2020 and September, 2021. In the afternoon of the second postpartum day, the women were evaluated with Edinburgh Postnatal Depression Scale (EPDS) for screening PPD (defined as a score of 10 or higher). The women with PPD were matched at a 1:1 ratio with women without PPD with maternal age difference within 5 years and the same mode of delivery. Colostrum samples were collected in morning on the third postpartum day for measurement of TGF-β concentrations using enzyme-linked immunosorbent assay (ELISA), and the association between EPDS scores and TGF-β concentrations was analyzed in the two groups.

RESULTS

A total of 90 women were included in the final analysis. The mean concentrations of TGF-β1, TGF-β2 and TGF-β3 in the colostrum were 684.03 (321.22-859.25) pg/mL, 5116.50±1747.04 pg/mL and 147.84±48.68 pg/mL in women with PPD, respectively, as compared with 745.67 (596.00-964.22) pg/mL, 4912.40±1516.80 pg/mL, and 168.21±48.15 pg/mL in women without PPD, respectively. Compared with women without PPD, the women with PPD had significantly lower concentrations of TGF-β1 (P=0.026) and TGF-β3 (P=0.049) in the colostrum. Spearman correlation analysis revealed that the EPDS scores were negatively associated with the concentrations of TGF-β1 (r=-0.23, P=0.03) and TGF-β3 (r=-0.25, P=0.02) in the colostrum.

CONCLUSION

PPD is associated with decreased concentrations of TGF-β1 and TGF-β3 in human colostrum, suggesting the need of early PPD screening and interventions during pregnancy and the perinatal period to minimize the impact of PPD on human milk compositions.

Pan-cancer analysis of prognostic and immunological role of DTYMK in human tumors

Background: Deoxythymidylate kinase (DTYMK) has been reported to correlate with the progression of hepatocellular carcinoma. However, the role of DTYMK in human cancers is not studied. In this study, we studied the prognostic value, functional states, and correlations with immune infiltration of DTYMK in human cancers.

Methods: The Cancer Genome Atlas (TCGA), Genotype-Tissue Expression (GTEx), UALCAN, Clinical Proteomic Tumor Analysis Consortium (CPTAC), the search tool for the retrieval of interacting genes (STRING), GeneMANIA, cBioPortal, Cancer Single-cell State Atlas (CancerSEA), and Tumor IMmune Estimation Resource (TIMER) databases were utilized to analyze DTYMK in cancers.

Results: In general, DTYMK is abnormally expressed between most human cancer and normal tissues from a pan-cancer perspective. DTYMK can be used as a diagnostic biomarker to differentiate tumor tissues from normal tissues in most tumors. Upregulation of DTYMK predicted poor survival status in most cancer types in TCGA. Moreover, DTYMK expression was correlated with the T stage in ACC, BRCA, KIRC, LIHC, and LUAD, with the N stage in BLCA, HNSC, KICH, KIRC, LUAD, LUSC, and THCA, with the M stage in ACC, KIRC, KIRP, and LUAD, with TNM stage in ACC, KIRC, LIHC, LUAD, and LUSC. In addition, based on single-cell sequencing data, we concluded that the expression of DTYMK was correlated with the functional status of the cell cycle, DNA damage, DNA repair, invasion, EMT, and proliferation. Finally, DTYMK expression was correlated with six infiltrating immune cells, including B cells, CD4⁺ T cells, CD8⁺ T cells, neutrophils, macrophages, and dendritic cells by investigating TIMER.

Conclusion: Our findings suggested that abnormally expressed DTYMK was correlated with poor survival, malignant functional status, and immune infiltrates. DTYMK might be served as a potential biomarker for diagnosis and poor prognosis in various cancer types. DTYMK might act as a potential target for immune therapy.

JS08.6.A A connectivity signature for glioblastoma

Background

Tumor cell extensions called tumor microtubes (TMs) in glioma resemble neurites during neurodevelopment and connect glioma cells to a network that has considerable relevance for tumor progression and therapy resistance. The determination of interconnectivity in individual tumors has been challenging and the impact of tumor cell connectivity on patient survival remained unresolved so far.

Material and Methods

A connectivity signature was derived by single-cell RNA-sequencing (scRNA-Seq) of highly and lowly connected cells obtained from an SR101 dye transfer xenograft model of primary glioblastoma (GB). The signature was validated in different in vitro models of cell-to-cell connectivity and could be translated to GB clinical specimens.

Results

34 of 40 connectivity genes were related to neurogenesis, neural tube development or glioma progression, including the TM-network-relevant GAP43 gene. Astrocytic-like and mesenchymal-like GB cells had the highest connectivity signature scores in scRNA-Seq data of patient-derived xenografts and patient samples. In 230 human GBs, high connectivity correlated with the mesenchymal expression subtype, TP53 wildtype, and with dismal patient survival. CHI3L1 was identified and validated as a robust molecular marker of connectivity with a functional relevance.

Conclusion

The connectivity signature gives novel insights into brain tumor biology, provides a proof-of-principle that tumor cell connectivity is relevant for patients’ prognosis, and serves as a robust biomarker that can be used for future clinical trials

1,2-Diamines as the Amine Sources in Amidation and Rhodium-Catalyzed Asymmetric Reductive Amination Cascade Reactions

The sturdy chelation of 1,2-diamines and transition-metals would retard or even interrupt the routine catalytic cycles. In the amidation and asymmetric reductive amination (ARA) cascade reactions of diamines and ketoesters, we deployed sets of additives to ensure a smooth transformation catalyzed by the complexes of rhodium and versatile and highly modular phosphoramidite-phosphine ligands. The tunability of the ligands was fully exploited to accommodate various diamines and α-ketoesters for the efficient synthesis of chiral 3,4-dihydroquinoxalinones.

CircKIF5B Promotes Hepatocellular Carcinoma Progression by Regulating the miR-192 Family/XIAP Axis

Background

The long-term prognosis of HCC (hepatocellular carcinoma) with metastasis remains extremely poor. CircRNAs are promising as critical biological markers in identifying disease mechanisms and developing new effective treatments. However, the role of the aberrant expression of circRNAs in HCC progression remains largely unknown.

Methods

CircKIF5B location was investigated by RNA fluorescence in situ hybridization (RNA-FISH). For circRNA determination, RNase R treatment and Real-Time Quantitative RT-PCR (qRT-PCR) were performed. Transwell chamber assays examined the chemotactic migration and invasion of liver cancer cells.

Results

This study identified the circRNA circKIF5B originating from exons 1, 2, and 3 of the KIF5B gene. Importantly, we found that circKIF5B circRNA, rather than KIF5B linear mRNA, was notably upregulated in liver cancer cell lines and tissues. Moreover, we found that silencing circKIF5B markedly reduced the proliferation, invasion, and metastasis of liver cancer cells by sponging the miR-192 family, thus decreasing the expression of X-linked inhibitor of apoptosis (XIAP).

Conclusion

Our data demonstrate that circKIF5B can regulate XIAP expression by sponging miR-192 and miR-215 competing for the ceRNA mechanism, indicating that circKIF5B may act as an essential upstream regulator and providing mechanistic evidence to support the view that circKIF5B/miR-192s/XIAP is a promising therapeutic target for treating liver cancer.

POS1569-PARE TESTING A NEW APPROACH TO IDENTIFY AND ASSESS PATIENT-VALUED TREATMENT GOALS IN RHEUMATOID ARTHRITIS (RA): A PATIENT-ENGAGED HEALTHCARE VALUATION STRATEGY

Background

Common approaches to valuing health technologies often fail to capture outcomes that matter to patients and families. The treatment goals of people living with rheumatoid arthritis (RA) include common trial endpoints but also include other facets of disease impact. Identifying a feasible and rigorous approach to inclusion of the patient perspective is needed as trialists increasingly seek to incorporate patient-important outcomes in trial design and as varied patient-centered value assessment frameworks emerge. No standard approach is available to systemically identify and quantify patient-important outcomes, nor to include those outcomes in deliberative decision-making. We developed the Patient-Engaged Healthcare Valuation strategy, using principles of goal attainment scaling to frame survey-based goal collection directly from adults.

Objectives

To develop and test a goal-based method for collecting RA patient input for use in clinical trials and value assessment and evaluating the feasibility of this approach in people with RA.

Methods

Patient goals and domains were identified from (1) a literature review (2010-2020) of patient outcomes, goals, and preferences in RA, and (2) discussions with patients and clinicians during two meetings with a steering committee (SC) consisting of clinicians, outcomes researchers, patients/advocates, and health economists. These goals informed the development of a draft survey. Adults with RA were recruited from online patient networks to rate goal importance and suggest additional goals. SC members reviewed the survey findings and assessed feasibility of scaling up goal collection for HTA.

Results

Of 135 articles identified, 17 were retained. An inductive and iterative approach was used to identify and thematically group the final set of 36 goals into 4 domains. The draft survey was cognitively debriefed with 4 adults with RA. The first survey was administered to 20 participants; results informed item revisions and additions for the second round of data collection (n=27).

The 47 respondents were mostly White (87%), college-educated (72%) women (93%) living with RA for an average of 15 years; 75% rated their RA as moderate to severe. Free-text goals added in round 1 include: 1) finding specialists who listen to patient input on symptoms; 2) addressing loneliness or isolation; and 3) finding support from or helping others with RA. All Symptom and Life Impact goals were rated as Important or Very Important by ≥85% of participants; endorsement for Management and Treatment goals was somewhat more variable, with ≥85% endorsing these as Somewhat to Very Important. Results suggested that domains match key goals. Steering committee ratings supported the feasibility of this method.

Conclusion

Goals relevant for RA treatment evaluation can be efficiently identified and rated for importance by patients. Patient-important goals can be incorporated into deliberative healthcare valuation using this method to permit “crowd-sourced” input from people living with RA and to capture heterogeneous patient perspectives in healthcare valuation.

Table 1.

Top Goals based on rating as “Very Important” by >70% of subjects, from set of 36. “My goals for living with RA are to…”

GoalsNot ImportantSomewhat ImportantImportantVery ImportantSymptom Managementimprove the quality of my life with RA0% (0)0% (0)23% (11)77% (36)manage my RA pain0% (0)2% (1)11% (5)87% (41)reduce how my RA pain interferes with my life0% (0)9% (4)17% (8)74% (35)Life Impactreduce the ways in which RA interferes with my life0% (0)2% (1)21% (10)77% (36)be independent in my daily functioning0% (0)4% (1)15% (4)81% (22)Managing my RAfeel like I can manage my RA0% (0)2% (1)26% (12)72% (34)Treatment Featuresunderstand my RA treatment options0% (0)4% (2)21% (10)74% (35)have the information I need to make treatment decisions0% (0)0% (0)19% (9)81% (38)know what to expect with my RA treatment0% (0)2% (1)23% (11)74% (35)find treatments that are effective0% (0)0% (0)6% (3)94% (44)

Acknowledgements

I have no acknowledgements to declare.

Disclosure of Interests

None declared

Decarbonylative/decarboxylative [4 + 2] annulation of phthalic anhydrides and cyclic iodoniums towards triphenylenes

A palladium-catalyzed decarbonylative/decarboxylative [4 + 2] annulation of phthalic anhydrides with cyclic diaryliodonium salts to synthesize triphenylenes has been developed. The reaction shows broad substrate scope with a high yield of up to 99%, and it provides an efficient and fast way to access functionalized triphenylenes in only one hour.

Recovery of phosphate and ammonium nitrogen as struvite from aqueous solutions using a magnesium-air cell system

The addition of alkaline and magnesium sources during the recovery of NH₄⁺ and PO₄^3- in the form of struvite using the traditional struvite precipitation method increases the production cost. To solve this problem, a magnesium-air cell (MAC) system was used herein to recover NH₄⁺ and PO₄^3- as struvite from wastewater using a magnesium strip (Mg²⁺) and the oxygen adsorbed on the surface of a titanium plate (OH^-) as the anode and cathode, respectively. Experimental parameters (i.e. initial solution pH, temperature, NH₄⁺/PO₄^3- molar ratio, NH₄⁺ and PO₄^3- initial concentrations and stirring intensity) were found to affect the removal rate of NH₄⁺ and PO₄^3-. The presence of Ca²⁺ decreased the struvite purity. At Ca²⁺/PO₄^3- ratios of 0:1 and 0.5:1, the purity of the obtained struvite after 6 h was 93.8% and 58.9%, respectively. Struvite with a purity of 95.7%, electricity with an average output power of 2.53 mW, and an energy density of 1.05 W/m² were obtained when the proposed system was used to recover NH₄⁺ and PO₄^3- from an actual supernatant of domestic sludge anaerobic digestion. Scanning electron microscopy-energy-dispersive X-ray spectroscopy, X-ray diffraction, Fourier transform infrared spectroscopy, Raman spectroscopy and thermogravimetric analyses showed that the obtained struvite exhibited almost the same physicochemical properties as commercial struvite. Thus, the MAC system can be regarded as an effective method for recovering NH₄⁺ and PO₄^3- in the form of struvite from wastewater.

Discovery of 4-cyclopropyl-3-(2-((1-cyclopropyl-1H-pyrazol-4-yl) amino) quinazolin-6-yl)-N-(3-(trifluoromethyl) phenyl) benzamides as potent discoidin domain receptor inhibitors for the treatment of idiopathic pulmonary fibrosis

Idiopathic pulmonary fibrosis (IPF) is a chronic fatal lung disease with a median survival time of 3–5 years. Inaccurate diagnosis, limited clinical therapy and high mortality together indicate that the development of effective therapeutics for IPF is an urgent need. In recent years, it was reported that DDRs are potential targets in anti-fibrosis treatment. Based on previous work we carried out further structure modifications and led to a more selective inhibitor 47 by averting some fibrosis-unrelated kinases, such as RET, AXL and ALK. Extensive profiling of compound 47 has demonstrated that it has potent DDR1/2 inhibitory activities, low toxicity, good pharmacokinetic properties and reliable in vivo anti-fibrosis efficacy. Therefore, we confirmed that discoidin domain receptors are promising drug targets for IPF, and compound 47 would be a promising candidate for further drug development.

Whole-exome sequencing in diagnosing 2 cases of Gitelman syndrome

Two patients with Gitelman syndrome were admitted to the Department of Endocrinology, Third Xiangya Hospital of Central South University. The genomic DNA from the patients' peripheral blood was extracted and the whole-exome sequencing was performed to detect the possible mutations. The function of the mutation sites was analyzed by bioinformatics software. Through whole-exome sequencing and Sanger sequencing, we have found that 2 patients with Gitelman syndrome carried compound heterozygous mutations of SLC12A3 gene, which were c.486_490delTACGGinsA, p.R943W, p.D486N, and p.R928C. Among them, c.486_490delTACGGinsA insertion deletion mutation causes frame shift and protein truncation. The p.R943W, p.D486N, and p.R928C of SLC12A3 gene were predicted to be pathogenic mutations by SIFT, PolyPhen2, and Mutation Taster. These 4 mutations were all reported, but p.R943W was first reported in Chinese population. Gitelman syndrome is rare in clinic and the rate of missed diagnosis is high. Early genetic analysis in patients with Gitelman syndrome is helpful to determine the etiology and guide the treatment.

The Pan-Cancer Crosstalk Between the EFNA Family and Tumor Microenvironment for Prognosis and Immunotherapy of Gastric Cancer

Background: EFNA1-5 have important physiological functions in regulating tumorigenesis and metastasis. However, correlating EFNA genes in the tumor immune microenvironment (TIME), and the prognosis of patients with gastric cancer remains to be determined. Methods: Using public databases, the expression of EFNA1-5 in pan-cancer and gastric cancer was comprehensively analyzed using UCSC Xena, the Oncomine dataset and UALCAN. We further completed survival analysis by Kaplan-Meier plotter to evaluate the prognosis of the high and low expression groups of the EFNAs gene in patients with gastric cancer. The TIMER tool was used to reveal the correlation between immune cell infiltration and genes of interest. Spearman correlation was used to find an association between the EFNA genes and tumor stem cells, TIME, microsatellite instability (MSI) or tumor mutational burden (TMB). We also used cBioportal, GeneMANIA and STRINGS to explore the types of changes in these genes and the protein interactions. Finally, we described the TIME based on QUANTISEQ algorithm, predicted the relationship between the EFNA genes and half-maximal inhibitory concentration (IC₅₀), and analyzed the relationship between the EFNA family genes and immune checkpoints. Results: The expression of EFNA1, EFNA3, EFNA4, and EFNA5 was elevated in pan-cancer. Compared with normal adjacent tissues, EFNA1, EFNA3, and EFNA4 were up-regulated in gastric cancer. In terms of the influence on the survival of patients, the expression of EFNA3 and EFNA4 were related to overall survival (OS) and disease-free survival (DFS) for patients with gastric cancer. High expression of EFNA5 often predicted poor OS and DFS. In gastric cancer, the expression of EFNA3 and EFNA4 showed a significant negative correlation with B cells. The higher the expression of EFNA5, the higher the abundance of B cells, CD4+T cells and macrophages. CD8+T cells, dendritic cells infiltration and EFNA1-4 expression were negatively correlated. The infiltration of CD4+T cells, macrophages and neutrophils was negatively correlated with the expression of EFNA1, EFNA3, and EFNA4. TMB and MSI were positively correlated with EFNA3/EFNA4 expression. In the tumor microenvironment and drug sensitivity, EFNA3/4/5 also showed a significant correlation. In addition, we explored the relationship between the EFNA family genes and the immune microenvironment (B cells, M2 macrophages, monocytes, CD8⁺ T cells, regulatory T cells, myeloid dendritic cells, natural killer cells, non-regulatory CD4⁺ T cells), immune checkpoint (PDCD1, PDCD1LG2, CD274, CTLA4), and IC₅₀ of common chemotherapeutic drugs for gastric cancer (5-fluorouracil, cisplatin, docetaxel and gemcitabine). Conclusions: Our study provides new ideas for tumor treatment and prognosis from the perspective of TIME, and nominates EFNA1-5 to become potential therapeutic targets for gastric cancer.

[Differential expression profile of miRNAs in amniotic fluid exosomes from fetuses with Down syndrome]

OBJECTIVE

To investigate the role of miRNAs in amniotic fluid exosomes in growth and development of fetuses with Down syndrome (DS).

METHODS

Amniotic fluid were collected from 20 fetuses with DS and 20 normal fetuses (control) to extract amniotic exosome miRNA. MicroRNA sequencing technique was used to identify the differentially expressed miRNAs between the two groups, for which gene ontology (GO) and pathway analysis was performed. Three differentially expressed miRNAs with the strongest correlation with DS phenotype were selected for qPCR verification. Dual luciferase reporter assay was used to verify the activity of let-7d-5p for targeted regulation of BACH1.

RESULTS

We identified 15 differentially expressed miRNAs in DS as compared with the control group, among which 7 miRNAs were up-regulated and 8 were down-regulated. Target gene prediction results showed that the differentially expressed miRNAs targeted 17 DS-related genes. GO analysis revealed that the main functions of the target genes involved protein binding, protein transport, ATP binding, transferase activity and synapses. Pathway analysis revealed that the functional pathways were closely related with the development of the nervous system. qPCR results showed that the expression levels of miR-140-3p and let-7d-5p were significantly lower in DS group than in the control group (P < 0.05), as was consistent with miRNA sequencing results; the expression level of miR-4512 was significantly higher in DS group than in control group (P < 0.05), which was contrary to miRNA sequencing results. The results of double luciferase reporter gene assay confirmed that let-7d-5p was capable of targeted regulation of BACH1 expression.

CONCLUSION

Let-7d-5p in amniotic fluid exosomes may promote oxidative stress events in the brain of fetuses with DS by regulating BACH1 expression.

Polarization conversion in the caviton driven by linearly polarized lasers

In one-dimensional particle-in-cell simulations of a plasma irradiated by linearly polarized lasers from both sides of boundaries, it is found that there is an appreciable growth of the electromagnetic field in cavitons in the transverse direction perpendicular to the direction of polarization, which indicates the polarization conversion of the electromagnetic field in cavitons. This paper demonstrates the mechanism of this phenomenon based on parametric resonance induced by ponderomotive force with twice the frequency of the electromagnetic radiation in the caviton. We develop a theoretical model and verify it with simulation results. This phenomenon contributes to the heating and acceleration of particles and traps more EM energy in cavitons.

Effect of Hemoglobin A1c Trajectories on Future Outcomes in a 10-Year Cohort With Type 2 Diabetes Mellitus

BACKGROUND

Hemoglobin A1c (HbA1c) variability may be a predictor of diabetic complications, but the predictive values of HbA1c trajectories remain unclear. We aimed to classify long-term HbA1c trajectories and to explore their effects on future clinical outcomes in a 10-year cohort with type 2 diabetes mellitus (T2DM).

METHODS

A total of 2,161 participants with T2DM from the Beijing Community Diabetes Study were included. The 10-year follow-up was divided into two stages for the present data analysis. Stage I (from 2008 to 2014) was used to identify the HbA1c trajectories and to calculate the adjusted SD of HbA1c (HbA1c-adjSD), or the coefficient of variation of HbA1c (HbA1c-CV). Stage II (from 2014 to 2018) was used to collect the records of the new occurrence of diabetes-related clinical outcomes. Latent growth mixture models were used to identify HbA1c trajectories. Cox proportional hazards models were used to explore the relationship between HbA1c trajectories, HbA1c-adjSD, or HbA1c-CV and the future outcomes.

RESULTS

Three HbA1c trajectories were identified, including low stable (88.34%), gradual decreasing (5.83%), and pre-stable and post-increase (5.83%). Either the risk of death or the chronic complications were significantly higher in the latter two groups compared to the low stable group after adjustment for average HbA1c and other traditional risk factors, the adjusted hazard ratios (HRs) for renal events, composite endpoint, and all-cause death for the pre-stable and post-increase group were 2.83 [95%CI: 1.25-6.41, p = 0.013], 1.85 (95%CI: 1.10-3.10, p = 0.020), and 3.01 (95%CI: 1.13-8.07, p = 0.028), respectively, and the adjusted HR for renal events for the gradual decreasing group was 2.37 (95%CI: 1.08-5.21, p = 0.032). In addition, both univariate and multivariate Cox HR models indicated that participants in the fourth and third quartiles of HbA1c-CV or HbA1c-adjSD were at higher risk of renal events compared to participants in the first quartile.

CONCLUSIONS

HbA1c trajectories, HbA1c-CV, and HbA1c-adjSD could all predict diabetes-related clinical outcomes. HbA1c trajectories could reflect long-term blood glucose fluctuation more intuitively, and non-stable HbA1c trajectories may predict increased risk of renal events, all-cause death, and composite endpoint events, independent of average HbA1c.

A photo-responsive p-Si/TiO2/Ag heterostructure with charge transfer for recyclable surface-enhanced Raman scattering substrates

A Si/TiO2/Ag heterostructure is prepared as a recyclable SERS substrate with EF of 1.23 × 1012 and excellent repeatability, which can boost performance effectively by the synergistic contribution of the EM and CT enhancement effects.

Cu/Fe-mediated N(sp2)-arylation/alkenylation of pyridines with aryl-/alkenylboronic acids to yield versatile cationic materials

Cu/Fe-mediated N(sp2)-arylation/alkenylation of pyridines with aryl-/alkenylboronic acids to yield length-controllable and multi-responsive pyridinium salts is disclosed.

Disordered beta thinned ensemble with applications

It recently has been found that methods of the statistical theories of spectra can be a useful tool in the analysis of spectra far from levels of Hamiltonian systems. The purpose of the present study is to deepen this kind of approach by performing a more comprehensive spectral analysis that measures both the local- and long-range statistics. We have found that, as a common feature, spectra of this kind can exhibit a situation in which local statistics are relatively quenched while the long-range ones show large fluctuations. By combining three extensions of the standard random matrix theory (RMT) and considering long spectra, we demonstrate that this phenomenon occurs when disorder and level incompleteness are introduced in an RMT spectrum. Consequently, the long-range statistics follow Taylor's law, suggesting the presence of a fluctuation scaling (FS) mechanism in this kind of spectra. Applications of the combined ensemble are then presented for spectra originate from several very diverse areas, including complex networks, COVID-19 time series, and quantitative linguistics, which demonstrate that short- and long-range statistics reflect the rigid and elastic characteristics of a given spectrum, respectively. These observations may shed some light on spectral data classification.

Association between coronary artery vitamin D receptor expression and select systemic risks factors for coronary artery atherosclerosis

OBJECTIVE

The aim of this study is to analyze the association between coronary artery vitamin D receptor (VDR) expression and systemic coronary artery atherosclerosis (CAA) risk factors.

METHODS

Female cynomolgus monkeys (n = 39) consumed atherogenic diets containing the women's equivalent of 1000 IU/day of vitamin D₃. After 32 months consuming the diets, each monkey underwent surgical menopause. After 32 postmenopausal months, CAA and VDR expression were quantified in the left anterior descending coronary artery. Plasma 25OHD_3, lipid profiles and serum monocyte chemotactic protein-1 (MCP-1) were measured.

RESULTS

In postmenopausal monkeys receiving atherogenic diets, serum MCP-1 was significantly elevated compared with baseline (482.2 ± 174.2 pg/ml vs. 349.1 ± 163.2 pg/ml, respectively; p < 0.001; d = 0.79) and at the start of menopause (363.4 ± 117.2 pg/ml; p < 0.001; d = 0.80). Coronary VDR expression was inversely correlated with serum MCP-1 (p = 0.042). Additionally, the change of postmenopausal MCP-1 (from baseline to necropsy) was significantly reduced in the group with higher, compared to below the median, VDR expression (p = 0.038). The combination of plasma 25OHD₃ and total plasma cholesterol/high-density lipoprotein cholesterol was subsequently broken into low-risk, moderate-risk and high-risk groups; as the risk increased, the VDR quantity decreased (p = 0.04). CAA was not associated with various atherogenic diets.

CONCLUSION

Coronary artery VDR expression was inversely correlated with markers of CAA risk and inflammation, including MCP-1, suggesting that systemic and perhaps local inflammation in the artery may be associated with reduced arterial VDR expression.