Soil health hazards of di(2-ethylhexyl) phthalate: New perspectives on earthworms from different ecological niches DNA damage, gut microbial disruption and soil enzyme changes

Di(2-ethylhexyl) phthalate (DEHP) is perceived an emerging threat to terrestrial ecosystem, however, clear and accurate studies to fully understander ecotoxicity and underlying mechanisms of DEHP on the soil fauna remain poorly understood. Therefore, this study conducted a microcosm experiment of two earthworm ecotypes to investigate the ecological hazards of DHEP from multiple perspectives. The results showed that DEHP significantly increased the 8-hydroxy-deoxyguanosine (8-OHdG) content both in Eisenia foetida (13.76-133.0%) and Metaphire guillelmi (11.01-49.12%), leading to intracellular DNA damage. Meanwhile, DEHP negatively affected the expression of functional genes (ATP-6, NADH1, COX), which may be detrimental to mitochondrial respiration and oxidative stress at the gene level. The two earthworm guts shared analogous dominant bacteria however, the incorporation of DEHP drastically suppressed the homogeneity and diversity of the gut microbes, which further disrupted the homeostasis of the gut microbial ecological network. The keystone species in the gut of E. foetida decreased under DEHP stress but increased in the gut of M. guillelmi. Moreover, DEHP presented detrimental effects on soil enzyme activity, which is mainly associated with pollutant levels and earthworm activity. Collectively, the findings expand the understanding of soil ecological health and reveal the underlying mechanisms of the potential exposure risk to DEHP.

Biotoxicity responses of zebrafish in environmentally relevant concentration of di (2-ethylhexyl) phthalate

As an emerging environmental contaminant, di (2-ethylhexyl) phthalate (DEHP) is widely present in the aquatic environment, however, the effects and underlying mechanisms of DEHP on the aquatic organisms are poorly understood. This study systematically investigated the ecotoxicity induced by chronic exposure to environmental relevant concentrations of DEHP (0.03 mg/L, 0.1 mg/L, and 0.3 mg/L) on zebrafish brain. Results indicated that DEHP exposure significantly increased the levels of ROS and disturbance of the antioxidant enzymes activities in the brain, which may further enhance lipid peroxidation and DNA damage. Furthermore, acetylcholinesterase activity was first stimulated and inhibited by exposure to DEHP, and the antioxidant and apoptosis related genes were mainly upregulated. Risk assessment indicated that the ecotoxicity of DEHP on the zebrafish showed an "enhancement-reduction" trend as the exposure time was prolonged. Overall, these results provided new insights and useful information to ecological risk assessment and environmental management of DEHP pollution.

An Ontario Health (Cancer Care Ontario) Clinical Practice Guideline: Surveillance Strategies in Patients with Stage I, II, III or Resectable IV Melanoma Who Were Treated with Curative Intent

AIMS

To make recommendations on managing the surveillance of patients with stage I, II, III or resectable IV melanoma who are clinically free of disease following treatment with curative intent.

MATERIALS AND METHODS

This guideline was developed by Ontario Health's (Cancer Care Ontario's) Program in Evidence-Based Care and the Melanoma Disease Site Group (including seven medical oncologists, four surgical oncologists, three dermatologists, one radiation oncologist and one patient representative). The MEDLINE, EMBASE, Cochrane Library, PROSPERO databases and the main relevant guideline websites were searched. Internal and external reviews were conducted, with final approval by the Program in Evidence-Based Care and the Melanoma Disease Site Group. The Grading of Recommendations, Assessment, Development and Evaluation approach was followed, and the Modified Delphi method was used.

RESULTS

Based on the current evidence (eight eligible original study papers and four relevant guidelines) and the clinical opinions of the authors of this guideline, the initial recommendations were made. To reach 75% agreement for each recommendation, the Melanoma Disease Site Group (16 members) voted twice and one recommendation was voted on three times. After a comprehensive internal and external review process (including national and international reviewers), 12 recommendations, three weak recommendations and six qualified statements were ultimately made.

CONCLUSIONS

After a systematic review, a comprehensive internal and external review process and a consensus process, the current guideline has been created. The guideline authors believe that this guideline will help clinicians, patients and policymakers make well-informed healthcare decisions that will guide them in clinical melanoma surveillance and ultimately assist in improving patient outcomes.

Expanding the insight of ecological risk on the novel chiral pesticide mefentrifluconazole: Mechanism of enantioselective toxicity to earthworms (Eisenia fetida)

Continued application of new chiral fungicide mefentrifluconazole (MFZ) increases its risk to soil ecosystem. However, the toxicity of MFZ enantiomers to soil fauna and whether stereoselectivity exists remains poorly elucidated. Based on multilevel toxicity endpoints and transcriptomics, we investigated the negative effects of racemic, R-(-)-, and S-(+)-MFZ on Eisenia fetida. After exposure to S-(+) configuration at 4 mg/kg for 28 day, its reactive oxygen species levels were elevated by 15.4% compared to R-(-) configuration, inducing enantiospecific oxidative stress and transcriptional aberrations. The S-(+) isomer induced more severe cell membrane damage and apoptosis than the R-(-) isomer, and notably, the selectivity of apoptosis is probably dominated by the mitochondrial pathway. Mechanistically, differential mitochondrial stress lies in: S-(+) isomer specifically up-regulated mitochondrial cellular component compared to R-(-) isomer and identified more serious mitochondrial fission. Furthermore, S-(+) conformation down-regulated biological processes associated with ATP synthesis and metabolism, with specific inhibition of mitochondrial respiratory electron transport chain complex I and IV activity resulting in more severe electron flow disturbances. These ultimately mediated enantioselective ontogenetic process disorders, which were supported at phenotypic (weight loss), genetic, and protein (reverse modulate TCTP and Sox2 expression) levels. Our findings offer an important reference for elucidating the enantioselective toxicological mechanism of MFZ in soil fauna.

Mechanism of the adverse outcome of Chlorella vulgaris exposure to diethyl phthalate: Water environmental health reflected by primary producer toxicity

As a ubiquitous contaminant in aquatic environments, diethyl phthalate (DEP) is a major threat to ecosystems because of its increasing utilization. However, the ecological responses to and toxicity mechanisms of DEP in aquatic organisms remain poorly understood. To address this environmental concern, we selected Chlorella vulgaris (C. vulgaris) as a model organism and investigated the toxicological effects of environmentally relevant DEP concentrations at the individual, physiological, biochemical, and molecular levels. Results showed that the incorporation of DEP significantly inhibited the growth of C. vulgaris, with inhibition rates ranging from 10.3 % to 83.47 %, and disrupted intracellular chloroplast structure at the individual level, while the decrease in photosynthetic pigments, with inhibition rates ranging from 8.95 % to 73.27 %, and the imbalance of redox homeostasis implied an adverse effect of DEP at the physio-biochemical level. Furthermore, DEP significantly reduced the metabolic activity of algal cells and negatively altered the cell membrane integrity and mitochondrial membrane potential. In addition, the apoptosis rate of algal cells presented a significant dose-effect relationship, which was mainly attributed to the fact that DEP pollutants regulated Ca2+ homeostasis and further increased the expression of Caspase-8, Caspase-9, and Caspase-3, which are associated with internal and external pathways. The gene transcriptional expression profile further revealed that DEP-mediated toxicity in C. vulgaris was mainly related to the destruction of the photosynthetic system, terpenoid backbone biosynthesis, and DNA replication. Overall, this study offers constructive understandings for a comprehensive assessment of the toxicity risks posed by DEP to C. vulgaris.

Photocatalytic degradation of butyl benzyl phthalate by S-scheme Bi/Bi2O2CO3/Bi2S3 under simulated sunlight irradiation

As a kind of plasticizer, butyl benzyl phthalate (BBP) presents a serious hazard to the ecosystem. Therefore, there is a strong need for an effective technique to eliminate the risk of BBP. In this work, a new photocatalyst of Bi/Bi2O2CO3/Bi2S3 with an S-scheme heterojunction was synthesized using Bi(NO3)3 as the Bi source, Na2S as the S source, and DMF as the carbon source and reductant. Numerous techniques have been used to characterize Bi/Bi2O2CO3/Bi2S3, such as scanning electron microscopy, high-resolution transmission electron microscopy, X-ray diffraction, and X-ray photoelectron spectroscopy. The improved photoactivity of Bi/Bi2O2CO3/Bi2S3 was evaluated by photoelectrochemical response, electrochemical impedance spectroscopy, photoluminescence, UV-Vis diffuse reflectance spectroscopy, and electrochemical Mott Schottky spectroscopy. The enhanced photocatalytic activity of this composite for BBP degradation under simulated sunlight irradiation could be attributed to the surface plasmon resonance effect of Bi metal and the heterojunction structure of Bi2O2CO3 and Bi2S3. The degradation rate of Bi/Bi2O2CO3/Bi2S3 was 85%, which was 4.52 and 1.52 times that of Bi2O2CO3 and Bi2S3, respectively. The prepared photocatalyst possessed good stability and reproducibility in eliminating BBP. The improved photocatalytic activity of Bi/Bi2O2CO3/Bi2S3 was demonstrated with the formation of an S-scheme heterojunction, and the degradation mechanism was discussed with a liquid chromatograph mass spectrometer.

Effects of butyl benzyl phthalate on zebrafish (Danio rerio) brain and the underlying molecular mechanisms revealed by transcriptome analysis

Butyl benzyl phthalate (BBP), a widely used class of plasticizers, has caused considerable concerns due to its widespread detection in various environmental media. However, the potential impact of BBP on the brain and its underlying molecular mechanisms remain poorly understood. In this study, adult zebrafish (Danio rerio) were exposed to 0, 5, 50, and 500 μg/L BBP for 28 days. Elevated levels of both reactive oxygen species and 8-hydroxydeoxyguanosine were observed, indicating the occurrence of oxidative stress and DNA damage. Furthermore, exposure to BBP resulted in neurotoxicity, apoptosis, and histopathological damage within the zebrafish brain. Transcriptome analysis further revealed that Gene Ontology terms associated with muscle contraction were specifically expressed in the brain after BBP exposure. In addition, BBP altered the transcriptome profile of the brain, with 293 genes induced and 511 genes repressed. Kyoto Encyclopedia of Genes and Genomes analysis highlighted the adverse effects of BBP on the complement and coagulation cascades and two cardiomyopathy-related pathways. Taken together, our results revealed that BBP resulted in brain oxidative stress, histological damage, and transcriptome alterations. These findings have the potential to offer novel insights into the adverse outcome pathways of key events in the brain.

Occurrence and health risk assessment of phthalates in a typical estuarine soil: A case study of the various functional areas of the Yellow River Delta

In recent years, the extensive distribution of phthalates (PAEs) in soils has attracted increasing attention. In this study, the concentrations of six types of PAEs were measured in five dissimilar regions of the Yellow River Delta (YRD), and regional differences, pollution characteristics and health risks of PAEs pollution were investigated. The detection rate of PAEs was 100 %, and the concentration range of Σ6PAEs was 0.709-9.565 mg/kg, with an average of 3.258 ± 2.031 mg/kg. There were different spatial distribution differences of PAEs in soils of the YRD, with residential living, chemical industrial, and crop growing areas being the main areas of PAEs distribution. It was worth noting that di (2-ethylhexyl) phthalate (DEHP) and dibutyl phthalate (DBP) are prominent contributors to PAEs in soils of the YRD. Correlation analyses showed that soils physicochemical properties such as SOM, TN and CEC were closely correlated to the transport and transformation of PAEs. Use by petrochemical industries, accumulation of plasticizers, additives (derived from cosmetics, food, pharmaceutical), fertilizers, pesticides, plastics, and atmospheric deposition are the principal sources of PAEs in the YRD. A health risk assessment showed that the health risk caused by non-dietary intake of PAEs was low and considered acceptable. PAEs pollution in the YRD soil is particularly noteworthy, especially for the prevention and control of DEHP and DBP pollution. This study provides basic data for an effective control of soil PAEs pollution in the YRD, which is conducive to the sustainable development of the region.

[Study the involvement of Langerin in mediating epicutaneous sensitization of atopic dermatitis-like mouse model]

Objective: To explore the role of Langerin in mediating epicutaneous sensitization of atopic dermatitis (AD) in mouse model. Methods: Mice were topically treated with calcipotriol (MC903) plus ovalbumin (OVA) on the ears to establish AD mouse models, and mice were divided into wild-type control group, wild-type AD group, Langerin knockout control group, and Langerin knockout AD group. Changes of lesion were daily observed. Infiltration of inflammatory cells, mRNA expression of Tslp, Il4, Il13, Il17a, and Il22, levels of serum total IgE, OVA-specific IgE (sIgE), OVA sIgG1 and OVA sIgG2a, proportion of regulatory T (Treg) cells in cervical draining lymph nodes were evaluated at the end of model preparation. Results: Skin tumidness and thickness, dermal inflammatory cells infiltration, the mRNA expression levels of Tslp, Il4, Il13, Il17a and Il22 in wild-type AD groups were higher than those in wild-type control groups, with (1.80±0.66, 1.64±0.25, 1.71±0.54, 2.41±0.23, 2.49±0.32) and (0.53±0.45, 0.85±0.29, 0.73±0.50, 0.72±0.25, 0.56±0.29), respectively (all P<0.05). In addition, the levels of serum total IgE, OVA sIgE and OVA sIgG1 in wild-type AD groups were higher than those in wild-type control groups, with [(1 216.00±572.70) ng/ml, (597.00±538.30) ng/ml, 1.59±0.09] and [(24.22±35.04) ng/ml, (20.01±41.71) ng/ml, 1.16±0.03], respectively (all P<0.05). In Langerin knockout mice, compared to wild-type mice, skin erythema, skin tumidness, epidermal thickening, inflammatory cell infiltration were more obvious; the mRNA expression levels of Tslp, Il4, Il13, Il17a and Il22 were upregulated with (8.19±6.44, 2.53±0.69, 2.82±0.73, 3.94±1.32, 3.80±1.43) (all P<0.05); the levels of serum total IgE, OVA sIgE and OVA sIgG1 were significantly increased with (2 508.00±657.10) ng/ml, (1 808.00±470.70) ng/ml, (1.73±0.09) (all P<0.05); the number of CD4+CD25+CD127-Treg cells were decreased significantly with (13.25±0.96)% and (15.31±1.47)%, respectively (P<0.05). Conclusion: Langerin is involved in mediating epicutaneous sensitization of the AD mouse model and plays a negative immunoregulatory role.

Multi-level biological effects of diverse alkyl chains phthalate esters on cotton seedlings (Gossypium hirsutum L.): Insights into individual, physiological-biochemical and molecular perspectives

Phthalate esters (PAEs) are organic contaminants that pose environmental threat and safety risks to soil health and crop production. However, the ecological toxicity of different PAEs to cotton and the underlying mechanisms are not clear. This study investigated the ecotoxic effects and potential mechanisms of different alkyl-chain PAEs, including dioctyl phthalate (DOP), dibutyl phthalate (DBP), and diethyl phthalate (DEP) on cotton seedlings at multiple levels. The results showed that PAEs significantly hindered the growth and development of cotton. The chlorophyll content decreased by 1.87-31.66 %, accompanied by non-stomatal photosynthetic inhibition. The antioxidant system was activated by the three PAEs in cotton seedlings, while the osmotic potential was boosted intracellularly. Additionally, PAEs significantly interfered with functional gene expression and exhibited genotoxicity. Risk assessment results indicated that the ecotoxicity was DOP >DBP >DEP, with a "dose-response" relationship. The affinity between the three PAEs and catalase increased as the alkyl chain length increased, further supporting the toxicity sequence. Surprisingly, the bioconcentration factors of short-chain DEP were 8.07 ± 5.89 times and 1837.49 ± 826.83 times higher than those of long-chain DBP and DOP, respectively. These results support the ecological risk assessment of PAEs in cotton and provide new insights into determining the toxicity levels of different PAEs.

Effectiveness of Bladder Filling Control during Online MR-Guided Adaptive Radiotherapy for Rectum Cancer

PURPOSE/OBJECTIVE(S)

MR-guided adaptive radiotherapy (MRgART) treatment sessions at MR-Linac are time-consuming and changes in bladder filling during the session can impact the treatment dosimetry. In this work, we present the procedure implemented in the clinical workflow to stabilize bladder filling during the MR based adaptive radiotherapy sessions and evaluate its effectiveness and the resulting dosimetric impact on the adaptive plan.

MATERIALS/METHODS

Twenty-five rectum cancer patients treated at 1.5T MR-Linac with a short course radiotherapy (25 Gy in 5 fractions of 5 Gy each) were included in this retrospective study. Patients were treated with the adapt-to-shape workflow consisting of a plan adaptation based on the MRI acquired in each session and optimized on the corresponding MR-based synthetic CT. Considering the significant interval time between the acquisition of the first daily MRI used for plan adaptation, and the beam delivery, a bladder catheter was used to stabilize the bladder filling; the procedure consists of emptying the bladder and refilling it with a well-known amount of physiological solution before each MRI acquisition. Two MRIs were acquired at each session: the first was used for plan adaptation and the second was acquired while approving the adapted plan, to be rigidly registered with the first to ensure the appropriateness of the isodoses on the ongoing delivery treatment. A total of 125 sessions and 250 MRI images and bladder contours were analyzed; for each fraction, the time interval between the first and second MRI and the corresponding bladder volumes were recorded; the consistency of bladder volumes and shapes along each online session was assessed with the dice similarity index (DSC) and Hausdorff distance (HD); the impact on plan dosimetry was evaluated by comparing target and bladder DVH cut off points of the plan on the two different MRI datasets.

RESULTS

The time interval between the first and second MRI, averaged over the 125 sessions is 39.0 min, range (18.6-75.8) min. The changes in bladder volumes, DSC index, HD, and the differences between the bladder and target DVH cut-off points are shown in the table below. The DSC and HD are comparable to inter-observer variability in manual contour segmentation, with an average DSC of 0.91 and average HD of 2.13 mm; the average differences in bladder and target dosimetry remain under 0.63% and 0.10%, respectively.

CONCLUSION

The use of a procedure in the clinical workflow of MRgART to stabilize the bladder filling throughout the online session may be helpful to guarantee the accuracy of the ongoing delivered treatment.

Study on the Clinical Use of a Respiratory Navigator Combined with Breath-Hold for MRI- Guided Liver SBRT

PURPOSE/OBJECTIVE(S)

Respiratory movement strongly affects the accuracy of stereotactic body radiation therapy (SBRT) of liver malignancies treated without the use of a respiratory gating system. This study investigates the feasibility and advantages of using a respiratory navigator-guided combined with patient breath-hold for liver SBRT in an adaptive magnetic-resonance guided workflow.

MATERIALS/METHODS

Clinical datasets of 10 liver cancer patients treated with 1.5T MR-Linac with respiratory navigator-guided SBRT combined with patient breath-hold were retrospectively analyzed. All patients underwent simulation CT with and without contrast, and 4D-CT and 3D-T2w MRI without contrast. Patients received a prescription dose ranging from 36 to 50 Gy in 5 to 8 fractions and followed the adapt to shape (ATS) workflow including contours adjustment and a subsequent MR-based synthetic CT (sCT) calculation on the online MRI acquired. The reference treatment plan was optimized on the expiratory phase of the 4D-CT, and during the online session the contours and the adapted plans were performed using the 3D-T2w navigator MRI of the patient's end-expiratory signal; 2D-T2w real-time monitoring MRI was also used as support for the contour's definition. The radiation therapist instructed the patients to hold their breath at the end of the breathing cycle for the time of the beam on. A total of 59 fractions were analyzed. For each fraction the dosimetric parameters of the target and normal liver of the adaptive and reference plans were compared; particularly the volume, the conformity index (CI) and gradient index (GI) for the target, and V5, V10 and Dmean for the normal liver. T-student statistical analysis was performed; a p-value less than 0.05 was considered statistically significant.

RESULTS

In the free breathing state, the 3D-T2w navigator MRI images enable a clear visualization of the tumor and its boundaries. The average target CI of the adaptive and reference plans is not significantly different (p = 0.448), while the GI is significantly higher (p = 0.043). Normal liver V10 and Dmean are lower and V5 is slightly increased, but without statistical differences. The mean values and standard deviation of the dosimetric parameters of the reference and adapted plans are shown in the Table below.

CONCLUSION

The use of a respiratory navigator combined with the breath-hold for MRI- guided liver SBRT allows clear visualization of the tumor, ensures the accuracy of the delivered dose and may be considered an alternative when the respiratory gating system is not available during MRgART sessions.

Study on Lattice Radiotherapy Treatments (LRT) for Head and Neck Bulky Tumors

PURPOSE/OBJECTIVE(S)

Lattice radiotherapy (LRT) exploits various effects of radiation, such as the bystander effect and the abscopal effect, and consists on the administration of high dose fraction in small areas with large tumor masses, helping to solve the problem of treating bulky disease, especially if it is located in a critical anatomical area. The optimization of LRT treatment plans is challenging due to the difficulty to generate spots of high dose within the tumor with consequent high gradient. This study compares the plan dosimetry and delivery time of two delivery techniques VMAT and CyberKnife for LRT treatments of bulky head and neck lesions.

MATERIALS/METHODS

Six patients with giant head and neck tumors who received LRT at our institution were included in this study. Target and OARs were contoured following international guidelines; to allow easy identification of the desired high gradient zones, an artificial geometrical lattice structure with spherical vertices was arranged inside the target volume (GTV), and the vertices of the lattice representing the high dose boost volumes (GTVboost) were delineated. The GTVboost and GTV were prescribed to receive 12 Gy and 3 Gy, respectively in a single fraction. Separate VMAT and CyberKnife LRT plans were optimized for each patient with lattice vertex of 0.5 diameter and center-to-center distances of 1.5 cm (LRT1.5) and 3 cm (LRT3). The dose heterogeneity was measured as the peak-to-valley dose ratio (PVDR), with the traditional definition being replaced by the D10/D90 ratio, where D10 and D90 represent the doses covering 10% and 90% of the GTV, respectively. For each plan generated, the treatment delivery time, the monitor units (MU), and the PVDR were assessed. Pre-treatment plan verifications were performed with ArcCheck array and Gafchromics film for VMAT and CyberKnife, respectively, using gamma analysis criteria of 3%-3mm.

RESULTS

The mean PVDR obtained for VMAT LRT plans were 2.0 and 2.6 for LRT1.5 and LRT3, respectively, and 3.2 and 4.7, respectively for CyberKnife LRT plans. For each pre-treatment plan dose verification, the gamma passing rate (GPR) was higher than 95.0 %; CyberKnife delivery time and MU were more than 10 times higher than that of VMAT, nevertheless, VMAT had a lower PVDR. The detailed results are shown in the table below.

CONCLUSION

CyberKnife LRT has a strong ability to place the peak dose within the target, generating a higher peak-to-valley dose ratio, however its use is partially invalidated by the long beam delivery times and the resulting high MU number; the use of the VMAT LRT technique allows clinically adequate dosimetry with acceptable delivery times.

Phytoremediation of Lead-Contaminated Soil in the Westside of Atlanta, GA

Phytoremediation has been explored as a cost-effective method to remediate soil Pb contamination. A greenhouse study was conducted to evaluate the efficacy of Vigna unguiculata, Brassica pekinensis, Gomphrena globose, and Helianthus annuus for removing and immobilizing Pb in soil collected from the Westside Lead Superfund site in Atlanta. Plants were cultivated in sampled soil with a Pb concentration of 515 ± 10 mg/kg for 60 days. Soils growing H. annuus were additionally treated with ethylenediaminetetraacetic acid (EDTA) (0.1 g/kg) or compost (20% soil blend) to assess their capabilities for enhancing phytoremediation. Mean post-phytoremediation Pb concentrations in the four plant species were 23.5, 25.7, 50.0, and 58.1 mg/kg dry weight (DW), respectively, and were substantially higher than 1.55 mg/kg DW in respective plant species grown in control soils with no Pb contamination. The highest Pb concentration, translocation factor, and biomass were found in V. unguiculate among four species without soil amendments. H. annuus treated with EDTA and compost resulted in a significant increase in the total Pb uptake and larger biomass compared to non-treated plants, respectively. Although this study found that V. unguiculata was the best candidate for Pb accumulation and immobilization among four species, soil remediation was limited to 54 mg/kg in a growing season. We find that it is critically important to perform phytostabilization in a secure manner, since Pb bioavailability of edible plant parts implies the potential risk associated with their unintentional consumption. Efficiently and effectively remediating Pb-contaminated soils in a low-cost manner needs to be further studied.

Cyantraniliprole seed treatment effectively controls wireworms (Pleonomus canaliculatus Faldermann) and white grubs (Anomala corpulenta Motschulsky) in maize fields

Wireworms and white grubs are destructive underground pests in maize fields in China. Cyantraniliprole has good control effect on coleoptera pests. Here, we evaluated the toxicity of cyantraniliprole to the second instar larvae of Anomala corpulenta Motschulsky and third-instar of larvae of Pleonomus canaliculatus Faldermann and the effects of sublethal concentrations on the activity of antioxidant and detoxification enzymes. We also explored the efficacy of cyantraniliprole on underground pests under indoor and field conditions. The LC₅₀ of cyantraniliprole for the third instar larvae of P. canaliculatus was 23.3712 mg/L, and that for the second instar larvae of A. corpulenta was 5.9715 mg/L. Cyantraniliprole can activate the activity of superoxide dismutase (SOD), peroxidase (POD), and glutathione S-transferase (GST) to different degrees at a sublethal dose. According to the pot experiment and the control efficacy test in the field, the indoor control effect of cyantraniliprole seed treatment on P. canaliculatus and white grubs was approximately 80%, and the maximum increase in yield achieved through cyantraniliprole application was approximately 15% in the field efficacy test. Cyantraniliprole has a strong control effect on wireworms and white grubs, so it can be used to treat seeds to control underground pests in maize fields.

One-step synthesis of Bi2O2CO3/Bi2S3 S-scheme heterostructure with enhanced photoactivity towards dibutyl phthalate degradation under visible light

Bi₂O₂CO₃/Bi₂S₃ heterojunction was prepared by one-step hydrothermal method, where Bi(NO₃)₃ was employed as Bi source, Na₂S was used as a sulfur source, and CO(NH₂)₂ was adopted as C source. The load of Bi₂S₃ was adjusted by changing the content of Na₂S. The prepared Bi₂O₂CO₃/Bi₂S₃ illustrated strong photocatalytic activity towards dibutyl phthalate (DBP) degradation. The degradation rate was 73.6% under the irradiation of visible light for 3 h, which were 3.5 and 1.87 times for Bi₂O₂CO₃ and Bi₂S₃, respectively. In addition, the mechanism for the enhanced photoactivity was investigated. After combined with Bi₂S₃, the formed heterojunction structure inhibited the recombination of photogenerated electron-hole pair, improved the visible light adsorption, and accelerated the migration rate of the photogenerated electron. As a result, analysis of the radical formation and the energy band structure revealed that Bi₂O₂CO₃/Bi₂S₃ was consistent with the S-scheme heterojunction model. The S-scheme heterojunction allowed the Bi₂O₂CO₃/Bi₂S₃ to possess high photocatalytic activity. The prepared photocatalyst presented acceptable cycle application stability. This work not only develops a facile one-step synthesis technique for Bi₂O₂CO₃/Bi₂S₃, and also provides a good platform for the degradation of DBP.

Ecotoxicological and biochemical effects of di(2-ethylhexyl)phthalate on wheat (Jimai 22, Triticum aestivum L.)

Di(2-ethylhexyl)phthalate esters (DEHP) has attracted widespread attention due to its ecotoxicological effects on organisms. In this study, wheat seedlings were exposed to DEHP- contaminated soil with 4 concentration gradients (0, 1, 10, and 100 mg kg^-1, respectively) for 30 days. The growth index, physiological index, oxidative damage system, and gene expression of wheat seedlings were comprehensively measured and analyzed. The results revealed that DEHP could reduce the germination rate of wheat. Only the 100 mg kg^-1 treatment group significantly inhibited root length, but no effect on plant height. At the biochemical level, photosynthetic pigments of wheat seedlings were promoted first and then inhibited, while the soluble sugar content presented a trend of "inhibition - activation - inhibition". The antioxidant enzymes (SOD and POD) presented an approximate parabolic trend, while it was opposite for CAT. Whereas the corresponding antioxidant enzyme genes were up-regulated, and the Hsp70 heat-shock protein gene was down-regulated. Finally, integrated biological response index (IBR) analysis showed that the DEHP toxicity to wheat seedlings was dose dependent. Molecular docking indicated that DEHP could stably bind to GBSS and GST by intermolecular force. Overall, this study provided constructive insights for a comprehensive assessment of the toxicity risk of DEHP to wheat.

EVALUATION OF PRE-ABLATION NLR AND LMR AS PREDICTORS OF DISTANT METASTASES IN PATIENTS WITH DIFFERENTIATED THYROID CANCER

Objective

This research aim was to evaluates the role of the pre-ablation neutrophil-to-lymphocyte ratio (NLR) and lymphocyte-to-monocyte ratio (LMR) as predictors of distant metastases in patients with differentiated thyroid cancer (DTC).

Methods

A retrospective analysis was given to 140 patients with DTC who received 131I remnant ablation after surgery. The patients were divided into two groups based on the existence of distant metastasis.

Results

The two groups showed no significant difference in age, gender, WBCs, neutrophils, monocytes, eosinophils, basophils and whether the tumor was multifocal. In the univariate analysis, significant differences were found in tumor size (p=0.021), lymphocyte (p=0.012), NLR (p=0.027), and LMR (p=0.007). According to the ROC curves, NLR had an AUC of 0.612 ± 0.097 with a cut-off value of 1.845, sensitivity of 60.0%, and specificity of 66.2% (p=0.027). LMR had an AUC of 0.638 ± 0.095 with a cut-off value of 4.630, sensitivity of 84.6%, and specificity of 35.4% (p=0.007). In the multivariate analysis, larger tumor size (OR=5.246, 95% CI 1.269-10.907, p=0.009) and higher NLR (OR=2.087, 95% CI 0.977-4.459, p=0.034) were statistically significant for distant metastases.

Conclusion

This research reveals that pre-ablation NLR and tumor size are significantly statistically correlated with distant metastases in patients with DTC.

Extreme environmental doses of diisobutyl phthalate exposure induce oxidative stress and DNA damage in earthworms (Eisenia fetida): Evidence at the biochemical and molecular levels

Diisobutyl phthalate (DIBP), as a plasticizer, is widely used and has caused many extreme soil contamination scenarios, posing potential risks to soil fauna. However, the toxic effects and mechanisms of DIBP on soil fauna remain unclear. In this study, earthworms (Eisenia fetida) were used as model animals to explore the subchronic toxicity of extreme DIBP soil exposure (300, 600, and 1200 mg/kg) for 28 days. The results showed that the level of reactive oxygen species (ROS) and the contents of malondialdehyde (MDA) and 8-hydroxydeoxyguanosine (8-OHdG) in E. fetida were significantly increased during continuous DIBP exposure. In addition, the activities of superoxide dismutase (SOD), catalase (CAT) and peroxidase (POD) were significantly inhibited while glutathione S-transferase (GST) activity was activated during continuous exposure. Integrated biological response (IBR) analysis showed that DIBP had positive dose-dependent toxicity and negative time-dependent toxicity to E. fetida, and SOD/CAT were selected as sensitive biomarkers. The molecular docking study found that DIBP could stably bind to SOD/CAT through hydrogen bonding, which further proved its sensitivity. This study provides primary data for ecological and environmental risk assessment of extreme dose DIBP soil pollution.

Evaluation of soil ecological health after exposure to environmentally relevant doses of Di (2-ethylhexyl) phthalate: Insights from toxicological studies of earthworms at different ecological niches

As one of the most critical soil faunas in agroecosystems, earthworms are significant in preserving soil ecological health. Di (2-ethylhexyl) phthalate (DEHP) is a major plasticizer and widely used in plastic products like agricultural films. However, it has become ubiquitous contaminant in agricultural soil and poses a potential threat to soil health. Although the awareness of the impacts of DEHP on soil ecology is increasing, its adverse effects on soil invertebrates, especially earthworms, are still not well developed. In this study, the ecotoxicological effects and underlying mechanisms of environmentally relevant doses DEHP on earthworms of different ecological niches were investigated at the individual, cytological, and biochemical levels, respectively. Results showed that the acute toxicity of DEHP to M. guillelmi was higher than E. foetida. DEHP induced reactive oxygen species (ROS) levels and further caused oxidative damage (including cellular DNA and lipid peroxidation damage) in both species, speculating that they may exhibit similar oxidative stress mechanisms. Furthermore, two earthworms presented the alleviated toxicity when re-cultured in uncontaminated circumstances, yet, the accumulated ROS in bodies could not be completely scavenged. Risk assessment indicated that the detrimental impacts of DEHP were more significant in the M. guillelmi than in E. foetida in whole experiments prides, and the biomarkers additionally showed a species-specific trend. Besides, molecular docking revealed that DEHP could bind to the active center of superoxide dismutase/catalase (SOD/CAT) by hydrogen bonding or hydrophobic interactions. Overall, this study will provide a novel insight for accurate contaminant risk assessment, and also highlight that the comprehensive biological effects of different species should be emphasized in soil ecological health diagnostics and environmental toxicology assays, as otherwise it may lead to underestimation or misestimation of the soil health risk of contaminants.

[Analysis of success rate of organoid construction of nasopharyngeal carcinoma by first-day suspension method]

Objective: To investigate the efficacy of the first-day suspension method for improving the success rate of construction of nasopharyngeal carcinoma-patient derived organoids (NPC-PDO). Methods: The tumor samples of 14 nasopharyngeal carcinoma(NPC) patients, i.e.,13 males and 1 female, with a mean age of 43.0±12.0 years old, were collected from the Affiliated Tumor Hospital of Guangxi Medical University and the First Affiliated Hospital of Guangxi Medical University from January 2022 to July 2022. The tumor samples of 3 patients were digested into single cell suspension and divided into 2 groups, for comparing the efficacy of NPC-PDO construction by the direct inoculation method and the first-day suspension method. The remaining 11 patients were randomized to receive either the direct inoculation method or the first-day suspension method for NPC-PDO construction. The diameter and the number of spheres of NPC-PDO constructed by the two methods were compared by optical microscope; the 3D cell viability detection kit was used to compare the cell viability; the survival rates were compared by trypan blue staining; the success rates of the two construction methods were compared; the number of cases which could be successfully passaged for more than 5 generations and were consistent with the original tissue by pathological examination was counted; and the dynamic changes of cells in suspension overnight were observed by live cell workstation. The independent sample t-test was applied to compare the measurement data of the two groups, and the chi-square test was used to compare the classification data. Results: Compared with the direct inoculation, the diameter and the number of spheres of NPC-PDO constructed by the first-day suspension method were increased, with a higher cell activity, and the success rate of construction was obviously improved (80.0% vs 16.7%, χ²=4.41, P<0.05). In the suspension state, some of the cells aggregated and increased their ability to proliferate. Conclusion: The first-day suspension method can improve the success rate of NPC-PDO construction, especially for those whose original tumor sample size is small.

Physiological and biochemical regulation of tobacco by oxathiapiprolin under Phytophthora nicotianae infection

As a fungicide, oxathiapiprolin has excellent effects on diseases caused by oomycetes. Fungicides generally protect crops by inhibiting pathogens, but little research has addressed the effects of fungicides on crops. This study combined transcriptomic and metabolomic analyses to systematically analyze the physiological regulatory mechanisms of oxathiapiprolin on tobacco under Phytophthora nicotianae infection. The results showed that under P. nicotianae infection, tobacco's photosynthetic rate and antioxidant enzyme activity increased after the application of oxathiapiprolin. Omics results showed that the genes related to carbon metabolism, disease-resistant proteins, and amino acid synthesis were highly expressed, and the amino acid content increased in tobacco leaves. This study is the first comprehensive investigation of the physiological regulatory effects of oxathiapiprolin on tobacco in response to P. nicotianae infection. These findings provide a basis for the balance between regulating tobacco growth and development and enhancing disease resistance under the stimulation of oxathiapiprolin and provide new research and development opportunities for identifying new disease-resistance genes and the development of high-yielding disease-resistant crop varieties.

Occurrence, source, ecological risk, and mitigation of phthalates (PAEs) in agricultural soils and the environment: A review

The widespread distribution of phthalates (PAEs) in agricultural soils is increasing drastically; however, the environmental occurrence and potential risk of PAEs in agricultural systems remain largely unreviewed. In this study, the occurrence, sources, ecotoxicity, exposure risks, and control measures of PAEs contaminants in agricultural soils are summarized, and it is concluded that PAEs have been widely detected and persist in the soil at concentrations ranging from a few μg/kg to tens of mg/kg, with spatial and vertical variations in China. Agrochemicals and atmospheric deposition have largely contributed to the elevated contamination status of PAEs in soils. In addition, PAEs cause multi-level hazards to soil organisms (survival, oxidative damage, genetic and molecular levels, etc.) and further disrupt the normal ecological functions of soil. The health hazards of PAEs to humans are mainly generated through dietary and non-dietary pathways, and children may be at a higher risk of exposure than adults. Improving the soil microenvironment and promoting biochemical reactions and metabolic processes of PAEs are the main mechanisms for mitigating contamination. Based on these reviews, this study provides a valuable framework for determining future study objectives to reveal environmental risks and reduce the resistance control of PAEs in agricultural soils.

Environmentally relevant concentrations of butyl benzyl phthalate triggered oxidative stress and apoptosis in adult zebrafish (Danio rerio) liver: Combined analysis at physiological and molecular levels

Butyl benzyl phthalate (BBP), a typical phthalate plasticizer, is frequently detected in aquatic environments, but its possible effects on fish liver are unknown. In this study, adult zebrafish were exposed to 5-500 μg/L BBP and cultured for 28 days. The toxicity mechanism of environmentally relevant concentrations of BBP in the liver was explored using integrated biomarker response (IBR), molecular docking, and histopathological analysis, based on the tests of oxidative stress, apoptosis, and tissue damage, respectively. The results revealed that exposure to 500 μg/L BBP caused lipid peroxidation and DNA damage and induced inflammatory responses in the liver and intestinal tissues. The accumulation of reactive oxygen species (ROS) is the primary manifestation of BBP toxicity and is accompanied by changes in the activities of antioxidant and detoxification enzymes. Notably, the pro-apoptotic genes (p53 and caspase-3) were still significantly upregulated in the 50 μg/L and 500 μg/L treatment groups on day 28. Moreover, BBP interfered with apoptosis by forming a stable complex with apoptosis proteins (P53 and Caspase-3). Our findings are helpful for understanding the toxicity mechanisms of BBP, which could further promote the assessment of the potential environmental risks of BBP.

Toxicity of dibutyl phthalate to pakchoi (Brassica campestris L.): Evaluation through different levels of biological organization

Dibutyl phthalate (DBP) is a typical persistent organic pollutant with a high load in the agricultural soils of vegetable crops. Currently, studies on the toxicity of DBP in vegetable crops are limited. Therefore, in this study, pakchoi (Brassica campestris L.), a typical vegetable crop, was used to evaluate the toxic effects of DBP. Pakchoi was exposed to DBP for 24 d at three doses (2, 20, and 200 mg/kg), and the phenotypic, biochemical, and molecular indicators were determined. The results revealed that DBP could reduce the emergence of pakchoi and inhibit plant height, root length, fresh weight, and leaf area. At the biochemical level, DBP exposure could reduce the content of three typical photosynthetic pigments (chlorophyll a and b and carotenoids). The effects of DBP exposure on the quality of pakchoi were primarily through reduced soluble sugar and increased proline contents. In addition, O₂·^- and H₂O₂ levels increased after DBP stress, and the corresponding antioxidant enzymes (SOD, POD, and CAT) were activated to resist oxidative damage. The dose- and time-dependent toxicities of DBP to pakchoi were demonstrated using an integrated biological response index. Finally, the molecular-level results on Day 24 showed that the three antioxidant enzyme genes (sod, pod, and cat) were significantly downregulated, and the antioxidant enzyme genes were more sensitive biomarkers than the enzyme activities. However, the expression level of enzyme genes was opposite to that of enzyme activity (SOD and POD); thus, DBP might directly interact with these enzymes. Molecular docking showed that DBP could stably bind near the SOD/POD active center through intermolecular interaction forces. This study provides essential information on the risk of DBP toxicity to vegetable crops.

Direct toxicity of the herbicide florasulam against Chlorella vulgaris: An integrated physiological and metabolomic analysis

Herbicides are the agents of choice for use in weed control; however, they can enter the aquatic environment, with potentially serious consequences for non-target organisms. Despite the possible deleterious effects, little information is available regarding the ecotoxicity of the herbicide florasulam toward aquatic organisms. Accordingly, in this study, we investigated the toxic effect of florasulam on the freshwater microalga Chlorella vulgaris and sought to identify the underlying mechanisms. For this, we employed a growth inhibition toxicity test, and then assessed the changes in physiological and metabolomic parameters, including photosynthetic pigment content, antioxidant system, intracellular structure and complexity, and metabolite levels. The results showed that treatment with florasulam for 96 h at the concentration of 2 mg/L, 2.84 mg/L, and 6 mg/L in medium significantly inhibited algal growth and photosynthetic pigment content. Moreover, the levels of reactive oxygen species were also increased, resulting in oxidative damage and the upregulation of the activities of several antioxidant enzymes. Transmission electron microscopic and flow cytometric analysis further demonstrated that exposure to florasulam (6 mg/L) for 96 h disrupted the cell structure of C. vulgaris, characterized by the loss of cell membrane integrity and alterations in cell morphology. Changes in amino acid metabolism, carbohydrate metabolism, and the antioxidant system were also observed and contributed to the suppressive effect of florasulam on the growth of this microalga. Our findings regarding the potential risks of florasulam in aquatic ecosystems provide a reference for the safe application of this herbicide in the environment.

Toxic effects of fludioxonil on the growth, photosynthetic activity, oxidative stress, cell morphology, apoptosis, and metabolism of Chlorella vulgaris

Fludioxonil is widely used in the control of crop diseases because of its broad spectrum and high activity, but its presence is now common in waterways proximate to treated areas. This study examined the toxic effects and mechanisms of fludioxonil on the microalgal taxa Chlorella vulgaris. The results showed that fludioxonil limited the growth of C. vulgaris and the median inhibitory concentration at 96 h was 1.87 mg/L. Concentrations of 0.75 and 3 mg/L fludioxonil reduced the content of photosynthetic pigments in algal cells to different degrees. Fludioxonil induced oxidative damage by altering C. vulgaris antioxidant enzyme activities and increasing reactive oxygen species levels. Fludioxonil at 0.75 mg/L significantly increased the activity of antioxidant enzymes. The highest level of activity was 1.60 times that of the control group. Both fludioxonil treatment groups significantly increased ROS levels, with the highest increase being 1.90 times that of the control group. Transmission electron microscope showed that treatment with 3 mg/L fludioxonil for 96 h disrupted cell integrity and changed cell morphology, and flow cytometer analysis showed that fludioxonil induced apoptosis. Changes in endogenous substances indicated that fludioxonil negatively affects C. vulgaris via altered energy metabolism, biosynthesis of amino acids, and unsaturated fatty acids. This study elucidates the effects of fludioxonil on microalgae and the biological mechanisms of its toxicity, providing insights into the importance of the proper management of this fungicide.

[The importance of intranasal trigeminal event-related potentials test for patients with olfactory dysfunction]

Objective: To analyze the characteristics of trigeminal event-related potentials (tERPs) in different kinds of olfactory disorders (OD), and to evaluate the importance of tERPs for the patients with olfactory dysfunction. Methods: Clinical data of 314 patients with olfactory dysfunction from the Smell and Taste Clinics in Beijing Anzhen Hospital from 2015 to 2021 were retrospectively reviewed, including 158 males and 156 females, aging from 6 to 78 years. The control group consisted of healthy people from medical examination center, who were gender and age matched. The clinical characteristics of OD were analyzed using Sniffin' Sticks test, olfactory event-related potentials (oERPs), tERPs and acoustic rhinometry test. SPSS 17.0 software was used to compare the difference of tERPs between the two groups, and to analyze the related factors affecting trigeminal function. Results: The ratio of tERPs presence was different in OD caused by different reasons: head traumatic OD (54.9%), post-virus infection OD (63.6%), sinonasal inflammatory OD (68.4%) and OD due to other causes (56.9%). Compared with controls, tERPs signals in OD patients showed a significant lower amplitude in the N₁ wave (all P<0.001), and lower amplitude in the P₂ wave in most OD patients (head trauma t=-4.11, P<0.001; sinonasal inflammation t=-2.04, P=0.046; others t=-2.40, P=0.020) except in OD by post-virus infection (t=-1.98, P=0.052). tERPs signals in OD patients by sinonasal inflammation showed longer latency in the N₁ wave (t=2.15, P=0.036), but this difference was not observed in other OD patients (all P>0.05). tERPs signals were significantly correlated with the Sniffin' Sticks score, deficiency of oERPs and nasal minimum cross-sectional area (all P<0.05). Conclusions: OD patients show neurophysiologic deficits in trigeminal function. The absence of tERPs or lower amplitude in N₁ waves are the important characteristics of patients with OD.

Effects of thifluzamide on soil fungal microbial ecology

Thifluzamide, a succinate dehydrogenase inhibitor fungicide, has been used extensively for many diseases control and has the risk of accumulation in soil ecology. In order to study the ecotoxicity of thifluzamide to soil fungal communities, typical corn field soils in north (Tai'an) and south (Guoyang) China were treated with thifluzamide (0, 0.1, 1.0 and 10.0 mg/kg) and incubated for 60 days. Thifluzamide exposure promoted soil basal respiration, and significantly reduced the number of soil culturable fungi and the abundance of soil fungi (RT-qPCR) in middle and late treatment period (15, 30, 60 days). Illumina Mi-Seq sequencing revealed that thifluzamide could reduce fungal alpha diversity (Sobs, Shannon, Simpson indexes) and change fungal community structure. FUN Guild analysis showed that the relative abundance of Undefined Saprotroph increased after the thifluzamide treatment, whereas that of Plant Pathogen decreased, and we concluded that exposure to thifluzamide could change the function of soil fungi. This study evaluated the soil ecological risk caused by thifluzamide's release into soil, providing a basis for its rational application.

131I SUCCESSFULLY TREATED A CASE OF HYPERTHYROIDISM AFTER ALLOGENEIC HEMATOPOIETIC STEM CELL TRANSPLANTATION

Hematopoietic stem cell transplantation (HSCT) is an effective treatment for various types of hereditary hematologic disease, hematological malignancy, primary immunodeficiency and metabolic disease. Thyroid dysfunction is a common complication of HSCT, which situation is mainly manifested as hypothyroidism and rarely as hyperthyroidism. This report presents a 28-year-old man who developed hyperthyroidism 9 years after sibling allogeneic HSCT, which was most likely caused by chronic GVHD. In the meantime, the patient also suffered from liver dysfunction and pancytopenia, for which he was inappropriate to take antithyroid drugs (ATD) for treatment of hyperthyroidism. The patient was orally administered 259 MBq ¹³¹I, an individualized dose. The symptoms of hyperthyroidism were mitigated by ¹³¹I treatment.

Seed bulb size influences the effects of exogenous brassinolide on yield and quality of Pinellia ternata

In recent years, natural Pinellia ternata populations of have gradually been exhausted, while the cultivated yield has been limited due to lack of research and uncertain climate condition. Therefore, it is necessary to explore methods of improving yield and quality in P. ternata using brassinolide (BR) treatments and choice of a suitable seed bulb size. This article reports the effects of BR and two seed bulb sizes (diameter: 0.5-1.0 cm and 1.0-1.5 cm) on active and nutrient components and antioxidant activity in P. ternata. The experiment included six levels of BR (0, 0.05, 0.10, 0.50, 1.00 and 2.00 mg l^-1 ). The tuber yield of the two seed bulb sizes and bulbil yield of small seed bulbs increased 5.67%, 22.66% and 69.23% by day 105 after 0.50 mg l^-1 BR treatment, compared with the control. On day 105, only 0.05 mg l^-1 BR increased scores in principal components analysis (PCA) in tubers of small seed bulbs by 167.29%, and 0.05 and 0.50 mg l^-1 BR increased PCA score in bulbils of large seed bulbs by 145.66% and 252.97%, respectively, compared with the control. Significant BR × seed bulb size interactions were found on yield and quality of P. ternata. The results indicate that BR effects on yield and quality of tubers and bulbils of P. ternata are not only related to BR concentration but also to seed bulb size.

Effects of nitrogen supply rate on photosynthesis, nitrogen uptake and growth of seedlings in a Eucalyptus/Dalbergia odorifera intercropping system

The introduction of N₂ -fixing species into a Eucalyptus plantation resulted in a successful planting system. It is essential to understand the contribution of nitrogen (N) competition and photosynthetic efficiency to plant dry matter yield to shed more light on the growth mechanism of the Eucalyptus/legume system. We compared N competition, photosynthesis and dry matter yield of Eucalyptus urophylla × E. grandis and the N₂ -fixing tree species Dalbergia odorifera in intercropping and monoculture systems under different N levels. The photosynthesis of E. urophylla × E. grandis was improved, while that of D. odorifera was inhibited in the intercropping system. Intercropped E. urophylla × E. grandis increased the N utilization and the dry matter yield by 6.57-48.46% and 7.59-97.26%, and decreased those of D. odorifera by 10.21-30.33% and 0.48-13.19%, respectively. Furthermore, N application enhanced the competitive ability of E. urophylla × E. grandis relative to D. odorifera and changed the N contents and chlorophyll synthesis to optimize the photosynthetic structure of both species. Our results reveal Eucalyptus for photosynthesis, N absorption and increasing the growth benefit from the introduction of N₂ -fixing species, which hence can be considered to be an effective sustainable management option of Eucalyptus plantations.

Generalizability of the EAST-AFNET 4 trial: assessing outcomes of early rhythm-control therapy in patients with atrial fibrillation

Background

The Early Treatment of Atrial Fibrillation for Stroke Prevention Trial (EAST-AFNET 4) demonstrated clinical benefit of early rhythm-control therapy in patients with recently diagnosed atrial fibrillation (AF) and concomitant cardiovascular conditions (CHA2DS2-VASc-Score ≥2) compared to the current practice of limited rhythm-control therapy to improve AF-related symptoms.

Purpose

To evaluate the generalizability of the EAST-AFNET 4 trial in routine practice, we assessed the proportion of patients who would have met trial eligibility and examined the association between early rhythm-control and clinical outcomes.

Methods

Using a large US administrative database, we identified 109,739 patients with newly diagnosed AF from July 28th, 2011 to December 30th, 2016, the enrollment period of the EAST-AFNET 4 trial. Eligibility for trial inclusion was assessed based on inclusion criteria. Eligible patients were classified as either receiving early rhythm-control, i.e AF ablation and/or any antiarrhythmic drug therapy, within the first year after AF diagnosis (N=27,106) or patients not receiving early rhythm-control (N=82,633). The date 12 months after the first AF diagnosis was defined as the index date and the start of the follow up period. Propensity score overlap weighting was used to balance patients on 90 baseline characteristics. Cox proportional hazards regression was used to compare early rhythm-control with no early rhythm-control for the primary outcome of a composite end point of all-cause mortality, stroke, or hospitalization with the diagnoses heart failure or myocardial infarction.

Results

Eligible for the trial were 72.9% (82,633/109,739) of all patients with newly diagnosed AF. Early rhythm-control therapy was associated with a reduction in the composite end point in the overall cohort of patients (hazard ratio [HR] 0.85; 95% confidence interval [CI] 0.75–0.97; P=0.015) with largely consistent treatment effects between patients eligible or ineligible for the trial. The reduction of stroke risk associated with early rhythm-control therapy was found in the overall cohort (HR 0.66; 95% CI 0.47–0.93; P=0.017) and in the trial-eligible cohort (HR 0.67; 95% CI 0.45–0.98; P=0.041).

Conclusion

In a large health care data set, the majority of patients with newly diagnosed AF were eligible for the trial. Early rhythm-control therapy was associated with a 15% reduction in the composite end point of all-cause mortality, stroke, or hospitalization with the diagnoses heart failure or myocardial infarction, with the greatest benefit in the reduction of stroke risk. The treatment effect was consistent between patients eligible or ineligible for the trial. Patients in routine practice had higher rates of adverse outcomes than the trial, but the relative risk reduction with early rhythm-control therapy was similar. These data demonstrate the potential of early rhythm-control therapy to reduce outcomes in patients with AF.

Funding Acknowledgement

Type of funding sources: Foundation. Main funding source(s): German Heart Foundation (Mit Fördermitteln der Deutschen Herzstiftung e.V.)

Multiparametric Magnetic Resonance Imaging in the Diagnosis of Clinically Significant Prostate Cancer: an Updated Systematic Review

There has been growing utilisation of multiparametric magnetic resonance imaging (MPMRI) as a non-invasive tool to diagnose and localise clinically significant prostate cancer (CSPCa). This updated systematic review examines the use of MPMRI in patients with an elevated risk of CSPCa who have had a prior negative transrectal ultrasound systematic biopsy (TRUS-SB) and who were biopsy naïve. MEDLINE, EMBASE and the Cochrane Database of Systematic Reviews were searched for existing systematic reviews published up to September 2020. The literature search of the electronic databases combined disease-specific terms (prostate cancer, prostate carcinoma, etc.) and treatment-specific terms (magnetic resonance, etc.). Studies were included if they were randomised controlled trials (RCTs) comparing MPMRI to template transperineal mapping biopsy (TPMB) or to TRUS-SB. Thirty-six RCTs were eligible. For biopsy-naïve men, accuracy of diagnosis of CSPCa showed sensitivities from 87 to 96% and specificities ranging from 29 to 45%. Meta-analyses for CSPCa showed increased detection favouring MPMRI-targeted biopsy over TRUS-SB by 3% (95% confidence interval 0-7%, P = 0.03) and decreased detection of clinically insignificant prostate cancer (CISPCa) favouring MPMRI by 8% (95% confidence interval -11 to 5%, P < 0.00001). Accuracy of MPMRI for men with prior negative biopsy showed sensitivities of 78-100% and specificities of 30-100%. Meta-analyses comparing MPMRI to TRUS-SB showed increased detection of 5% (95% confidence interval 3-7%, P < 0.0001) with a reduction of CISPCa detection of 7% (95% confidence interval 4-9%, P < 0.00001). The growing acceptance of MPMRI utilisation internationally and the recent publication of several RCTs regarding MPMRI in reducing CISPCa detection rates, particularly in biopsy-naïve men, without loss of sensitivity for CSPCa necessitates the synthesis of updated evidence examining MPMRI in the diagnosis of CSPCa.

The efficacy and safety of dupilumab in Chinese patients with moderate-to-severe atopic dermatitis: a randomized, double-blind, placebo-controlled study

BACKGROUND

Dupilumab is an antibody against interleukin 4 receptor α, used in treating atopic dermatitis (AD).

OBJECTIVES

To evaluate the efficacy and safety of dupilumab in adult Chinese patients with moderate-to-severe AD.

METHODS

In this randomized, double-blind, placebo-controlled, parallel-group, phase III study, conducted between December 2018 and February 2020, patients with AD received dupilumab (300mg) or placebo once every 2 weeks for 16 weeks, and were followed up for 12 weeks. The primary efficacy endpoint was the proportion of patients with both Investigator's Global Assessment (IGA) score of 0-1 and a reduction from baseline of ≥2 points at week 16.

RESULTS

Overall, 165 patients (mean age: 30.6 years; 71.5% male) were randomized: 82 to dupilumab and 83 to placebo. At week 16, 26.8% of patients in the dupilumab group and 4.8% of patients in the placebo group achieved the primary endpoint (difference, 22.0%; 95% confidence interval [CI], 11.37-32.65%; p<0.0001). Compared with placebo, higher proportions of patients in the dupilumab group achieved ≥75% reduction in the Eczema Area and Severity Index score (57.3% vs 14.5%; difference, 42.9%; 95% CI, 29.75-55.97%; p<0.0001) and had ≥3-point (52.4% vs 9.6%; difference, 42.8%; 95% CI, 30.26-55.34%; p<0.0001) and ≥4-point (39.0% vs 4.8%; difference, 34.2%; 95% CI, 22.69-45.72%; p<0.0001) reductions in weekly average daily peak daily pruritus numerical rating scale scores. The incidence of TEAEs during the treatment period was similar in the two groups. The incidence of conjunctivitis, allergic conjunctivitis, and injection site reaction was higher in the dupilumab group than in the placebo group.

CONCLUSIONS

In adult Chinese patients, dupilumab was effective in improving the signs and symptoms of AD and demonstrated a favorable safety profile.

Bacterial adhesion inhibitor prevents infection in a rodent surgical incision model

Surgical site infection risk continues to increase due to lack of efficacy in current standard of care drugs. New methods to treat or prevent antibiotic-resistant bacterial infections are needed. Multivalent Adhesion Molecules (MAM) are bacterial adhesins required for virulence. We developed a bacterial adhesion inhibitor using recombinant MAM fragment bound to polymer scaffold, mimicking MAM7 display on the bacterial surface. Here, we test MAM7 inhibitor efficacy to prevent Gram-positive and Gram-negative infections. Using a rodent model of surgical infection, incision sites were infected with antibiotic-resistant bioluminescent strains of Staphylococcus aureus or Pseudomonas aeruginosa. Infections were treated with MAM7 inhibitor or control suspension. Bacterial abundance was quantified for nine days post infection. Inflammatory responses and histology were characterized using fixed tissue sections. MAM7 inhibitor treatment decreased burden of S. aureus and P. aeruginosa below detection threshold. Bacterial load of groups treated with control were significantly higher than MAM7 inhibitor-treated groups. Treatment with inhibitor reduced colonization of clinically-relevant pathogens in an in vivo model of surgical infection. Use of MAM7 inhibitor to block initial adhesion of bacteria to tissue in surgical incisions may reduce infection rates, presenting a strategy to mitigate overuse of antibiotics to prevent surgical site infections.

Taraxasterol inhibits TGF-β1-induced epithelial-to-mesenchymal transition in papillary thyroid cancer cells through regulating the Wnt/β-catenin signaling

Taraxasterol (TAR) is a kind of active compound extracted from dandelion and its molecular structure resembles steroid hormones. Recently, TAR has been reported to show an anti-tumor activity. However, the specific role of TAR in papillary thyroid cancer (PTC) has not been clarified. In this study, we investigated the effect of TAR on PTC cell migration, invasion and epithelial-to-mesenchymal transition (EMT) induced by TGF-β1. PTC cells were exposed to TGF-β1 (5 ng/mL) and then treated with different concentrations of TAR. We found that TAR showed no obvious cytotoxicity below 10 μg/mL but notably reduced migration and invasion of TGF-β1-treated PTC cells. Moreover, TAR treatment decreased MMP-2 and MMP-9 levels, and obviously affected the expression of EMT markers. We also observed that Wnt3a and β-catenin levels were significantly increased in TGF-β1-treated PTC cells while TAR inhibited these effects in a concentration-dependent manner. Additionally, activation of the Wnt pathway by LiCl attenuated the suppressive effect of TAR on TGF-β1-induced migration, invasion and EMT in PTC cells. Taken together, we highlighted that TAR could significantly suppress TGF-β1-regulated migration and invasion by reversing the EMT process via the Wnt/β-catenin pathway, suggesting that TAR may be a potential anti-cancer agent for PTC treatment.

[Swertiamarin alleviates diabetic peripheral neuropathy in rats by suppressing NOXS/ ROS/NLRP3 signal pathway]

OBJECTIVE

To observe the therapeutic effect of swertiamarin on diabetic peripheral neuropathy (DPN) in rats and explore the molecular mechanism in light of the NOXS/ROS/NLRP3 signal pathway.

OBJECTIVE

Thirty-two SD rats were randomly divided into control group, DPN model group (treated with saline), swertiamarin (5 mg/kg) treatment group and NOXS inhibitor (10 mL/kg DPI) treatment group. Rat models of DPN were established in the latter 3 groups by intraperitoneal injections of STZ, and the treatments were administered on days 1, 7 and 14 after modeling. Tactile hypersensitivity of the rats was evaluated 30 min after the treatment. The expressions of NOXS, ROS, NLRP3 and inflammatory factors in the spinal cord tissue were detected using ELISA, and the protein expressions of NOXS, ROS, and NLRP3 were also detected with Western blotting.

OBJECTIVE

Compared with those in the control group, the rats in DPN group showed significant hyperalgesia (P < 0.001), increased expressions of TNF-α (P < 0.001) and IL-6 (P < 0.001), decreased expressions of TGF-β (P < 0.001), and increased expressions of NOXS/ROS/NLRP3 signal pathway (P < 0.001). Compared with those in DPN model group, the rats with swertiamarin treatment showed improved hyperalgesia (P < 0.001), decreased expressions of TNF-α (P=0.03) and IL-6 (P=0.002), increased expressions of TGF-β (P=0.04), and decreased expressions of NOXS (P < 0.001), ROS (P < 0.001) and NLRP3 (P=0.002). Treatment with swertiamarin and the NOXS inhibitor produced similar effects on the expressions of the inflammatory factors in the rat models (P>0.05).

OBJECTIVE

DPN effectively relieves hyperalgesia in rat models of DPN by restoring the balance in the expressions of the inflammatory factors by suppressing NOXs/ROS/NLRP3 signaling pathway.

Effects of a novel fungicide benzovindiflupyr in Eisenia fetida: Evaluation through different levels of biological organization

Although benzovindiflupyr (BZF), which is a novel succinate dehydrogenase inhibitor fungicide, has considerable application potential worldwide, its extensive use is toxic to non-targeted soil organisms. Therefore, this study aimed to evaluate the acute and subchronic toxicity of BZF to earthworms (Eisenia fetida). The acute toxicity of BZF to adult and larval earthworms was measured, as indicated by the following LC₅₀ values obtained after 14 days of exposure: 416 mg/kg for adult earthworms and 341 mg/kg for juveniles. Subchronic toxicity tests were conducted using only adult earthworms. The earthworms' weight gain was slower on days 14 and 28 after commencing the BZF T100 treatment (50 mg/kg of soil). Following 14 days of BZF exposure, enzymes and gene expressions associated with the mitochondrial respiratory chain and energy metabolism were activated to some extent, and the reactive oxygen species level and malondialdehyde content also increased. Antioxidant and detoxifying enzymes and metallothionein gene, Heat shock protein 70 gene associated with resistance to oxidative damage were also activated to varying degrees. Increased BZF concentrations corresponded to increased genotoxicity. Integrated biological response (IBR) values were calculated at the biochemical and molecular levels to show increased toxicity with increased BZF concentration. Although a series of biomarkers changes occurred after initiating BZF treatment, these changes were all likely to have been resisted by the earthworms' own antioxidant defense system and only showed phenotypic (weight-related) changes with treatments of 50 mg/kg. In conclusion, reasonable levels of BZF application may have little impact on earthworms. Our findings provide insights on the toxic effects of BZF on earthworms and may prove useful for risk assessments relating to BZF's impacts on soil ecosystems.