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Zheng L, Gu X, Zhao P, Yang T, Zhang Q, Jiang S, Cao Y, Lee SK, Zhou W, Wang J. Characteristics of red blood cell transfusion among very preterm infants in China. Vox Sang 2024. [PMID: 38622920 DOI: 10.1111/vox.13622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 03/03/2024] [Accepted: 03/10/2024] [Indexed: 04/17/2024]
Abstract
BACKGROUND AND OBJECTIVES National-level data on the incidence of red blood cell (RBC) transfusions and outcomes among very preterm infants (VPIs) are lacking in China. This study aims to describe the use and variation of RBC transfusion among VPIs in China. MATERIALS AND METHODS This cohort study was conducted among 70 tertiary hospitals participating in the Chinese Neonatal Network (CHNN) from 2019 to 2020 across China. All VPIs admitted to the CHNN neonatal intensive care units (NICUs) were included. RESULTS A total of 13,447 VPIs were enrolled, of whom 7026 (52.2%) received ≥1 RBC transfusions. The mean number of transfusions per infant was 2 (interquartile range [IQR] 1-4 times) and the median age at first transfusion was 15 days (IQR 3-27 days). The transfusion rate was higher in critically ill infants compared with non-critically ill infants (70.5% vs. 39.3%). The transfusion rate varied widely (13.5%-95.0%) between different NICUs. The prevalence of death, severe intra-ventricular haemorrhage, necrotizing enterocolitis (NEC) or spontaneous intestinal perforation (SIP), sepsis, bronchopulmonary dysplasia (BPD), severe retinopathy of prematurity (ROP) and cystic periventricular leukomalacia (cPVL) was significantly higher in the transfused group. Among non-critically ill infants, RBC transfusion was independently associated with BPD, severe ROP and cPVL. CONCLUSION Our study, providing the first baseline data on RBC transfusions among VPIs in China, shows an alarmingly high RBC transfusion rate with significant site variations. There is an urgent need for national guidelines on RBC transfusions for VPIs in China.
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Affiliation(s)
- Lu Zheng
- Department of Neonatology, Children's Hospital of Fudan University, Shanghai, China
| | - Xinyue Gu
- NHC Key Laboratory of Neonatal Diseases, Fudan University, Children's Hospital of Fudan University, Shanghai, China
| | - Pu Zhao
- Department of Neonatology, Shaanxi Provincial People's Hospital, Xi'an, China
| | - Tongling Yang
- Department of Neonatology, Children's Hospital of Fudan University, Shanghai, China
| | - Qin Zhang
- Department of Neonatology, Shaanxi Provincial People's Hospital, Xi'an, China
| | - Siyuan Jiang
- Department of Neonatology, Children's Hospital of Fudan University, Shanghai, China
- NHC Key Laboratory of Neonatal Diseases, Fudan University, Children's Hospital of Fudan University, Shanghai, China
| | - Yun Cao
- Department of Neonatology, Children's Hospital of Fudan University, Shanghai, China
- NHC Key Laboratory of Neonatal Diseases, Fudan University, Children's Hospital of Fudan University, Shanghai, China
| | - Shoo K Lee
- Department of Pediatrics, Mount Sinai Hospital and University of Toronto, Toronto, Ontario, Canada
| | - Wenhao Zhou
- Department of Neonatology, Children's Hospital of Fudan University, Shanghai, China
- NHC Key Laboratory of Neonatal Diseases, Fudan University, Children's Hospital of Fudan University, Shanghai, China
| | - Jin Wang
- Department of Neonatology, Children's Hospital of Fudan University, Shanghai, China
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Chen X, Yuan L, Jiang S, Gu X, Lei X, Hu L, Xiao T, Zhu Y, Dang D, Li W, Cao Y, Du L, Lee SK, Chen C, Zhou W, Zhou J. Synergistic effects of achieving perinatal interventions on bronchopulmonary dysplasia in preterm infants. Eur J Pediatr 2024; 183:1711-1721. [PMID: 38231237 DOI: 10.1007/s00431-023-05355-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 11/24/2023] [Accepted: 11/28/2023] [Indexed: 01/18/2024]
Abstract
To investigate the effect of perinatal interventions on the risk of severe BPD (sBPD) and death in extremely preterm infants (EPIs) and their synergistic effects. This was a secondary analysis of the prospective cohort Chinese Neonatal Network (CHNN). Infants with a birth weight of 500 to 1250 g or 24-28 weeks completed gestational age were recruited. The impacts and the synergistic effects of six evidence-based perinatal interventions on the primary outcomes of sBPD and death were assessed by univariate and multivariable logistic regression modeling. Totally, 6568 EPIs were finally enrolled. Antenatal corticosteroid (adjusted OR, aOR, 0.74; 95%CI, 0.65-083), birth in centers with tertiary NICU (aOR, 0.64; 95%CI, 0.57-0.72), preventing intubation in the delivery room (aOR, 0.65; 95%CI, 0.58-0.73), early caffeine therapy (aOR, 0.59; 95%CI, 0.52-0.66), and early extubating (aOR, 0.42; 95%CI 0.37-0.47), were strongly associated with a lower risk of sBPD and death while early surfactant administration was associated with a lower risk of death (aOR, 0.84; 95%CI, 0.72, 0.98). Compared with achieving 0/1 perinatal interventions, achieving more than one intervention was associated with decreased rates (46.6% in 0/1 groups while 38.5%, 29.6%, 22.2%, 16.2%, and 11.7% in 2/3/4/5/6-intervention groups respectively) and reduced risks of sBPD/death with aORs of 0.76(0.60, 0.96), 0.55(0.43, 0.69), 0.38(0.30, 0.48), 0.28(0.22, 0.36), and 0.20(0.15, 0.27) in 2, 3, 4, 5, and 6 intervention groups respectively. Subgroup analyses showed consistent results. CONCLUSION Six perinatal interventions can effectively reduce the risk of sBPD and death in a synergistic form. WHAT IS KNOWN • Bronchopulmonary dysplasia (BPD) is a multifactorial chronic lung disease associated with prematurity. The effective management of BPD requires a comprehensive set of interventions. However, the extent to which these interventions can mitigate the risk of severe outcomes, such as severe BPD or mortality, or if they possess synergistic effects remains unknown. WHAT IS NEW • The implementation of various perinatal interventions, such as prenatal steroids, birth in centers with tertiary NICU, early non-Invasive respiratory support, surfactant administration within 2 hours after birth, early caffeine initiation within 3 days, and early extubation within 7 days after birth has shown promising results in the prevention of severe bronchopulmonary dysplasia (BPD) or mortality in extremely preterm infants. Moreover, these interventions have demonstrated synergistic effects when implemented in combination.
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Affiliation(s)
- Xiang Chen
- Department of Neonatology, Children's Hospital of Fudan University, Shanghai, China
- NHC Key Laboratory of Neonatal Diseases, Fudan University, Children's Hospital of Fudan University, Shanghai, China
| | - Lin Yuan
- Department of Neonatology, Children's Hospital of Fudan University, Shanghai, China
- NHC Key Laboratory of Neonatal Diseases, Fudan University, Children's Hospital of Fudan University, Shanghai, China
| | - Siyuan Jiang
- Department of Neonatology, Children's Hospital of Fudan University, Shanghai, China
- NHC Key Laboratory of Neonatal Diseases, Fudan University, Children's Hospital of Fudan University, Shanghai, China
| | - Xinyue Gu
- NHC Key Laboratory of Neonatal Diseases, Fudan University, Children's Hospital of Fudan University, Shanghai, China
| | - Xiaoping Lei
- Division of Neonatology, Department of Pediatrics, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Liyuan Hu
- Department of Neonatology, Children's Hospital of Fudan University, Shanghai, China
- NHC Key Laboratory of Neonatal Diseases, Fudan University, Children's Hospital of Fudan University, Shanghai, China
| | - Tiantian Xiao
- Department of Neonatology, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Yanping Zhu
- Department of Neonatology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Dan Dang
- Department of Neonatology, The First Hospital of Jilin University, Changchun, China
| | - Wenli Li
- Department of Neonatology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yun Cao
- Department of Neonatology, Children's Hospital of Fudan University, Shanghai, China
- NHC Key Laboratory of Neonatal Diseases, Fudan University, Children's Hospital of Fudan University, Shanghai, China
| | - Lizhong Du
- Neonatal Intensive Care Unit, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China
- National Clinical Research Center for Child Health, National Children's Regional Medical Center, Hangzhou, China
| | - Shoo K Lee
- Maternal-Infant Care Research Centre and Department of Pediatrics, Mount Sinai Hospital, Toronto, ON, Canada
| | - Chao Chen
- Department of Neonatology, Children's Hospital of Fudan University, Shanghai, China
- NHC Key Laboratory of Neonatal Diseases, Fudan University, Children's Hospital of Fudan University, Shanghai, China
| | - Wenhao Zhou
- Department of Neonatology, Children's Hospital of Fudan University, Shanghai, China.
- NHC Key Laboratory of Neonatal Diseases, Fudan University, Children's Hospital of Fudan University, Shanghai, China.
| | - Jianguo Zhou
- Department of Neonatology, Children's Hospital of Fudan University, Shanghai, China.
- NHC Key Laboratory of Neonatal Diseases, Fudan University, Children's Hospital of Fudan University, Shanghai, China.
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Arinanto LS, Hoffmann AA, Ross PA, Gu X. Hormetic effect induced by Beauveria bassiana in Myzus persicae. Pest Manag Sci 2024. [PMID: 38469952 DOI: 10.1002/ps.8075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 02/11/2024] [Accepted: 03/09/2024] [Indexed: 03/13/2024]
Abstract
BACKGROUND Myzus persicae, a serious sap-sucking pest of a large variety of host plants in agriculture, is traditionally controlled using chemical insecticides but there is interest in using biopesticides as restrictions are increasingly placed on the use of broad-spectrum pesticides. RESULTS Here, we show that in Petri dish experiments, high concentrations of the fungal entomopathogen Beauveria bassiana led to rapid mortality of M. persicae, although at a low concentration (1 × 104 conidia mL-1) there is a hormetic effect in which survival and fecundity are enhanced. Hormetic effects persisted across a generation with reduced development time and increased fecundity in the offspring of M. persicae exposed to B. bassiana. The whole-plant experiment points to a hormetic effect being detected in two out of three tested lines. The impact of these effects might also depend on whether M. persicae was transinfected with the endosymbiont Rickettsiella viridis, which decreases fecundity and survival compared with aphids lacking this endosymbiont. This fecundity cost was ameliorated in the generation following exposure to the entomopathogen. CONCLUSION Although B. bassiana is effective in controlling M. persicae especially at higher spore concentrations, utilization of this entomopathogen requires careful consideration of hormetic effects at lower spore concentrations, and further research to optimize its application for sustainable agriculture is recommended. © 2024 The Authors. Pest Management Science published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.
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Affiliation(s)
- Leonhard Satrio Arinanto
- School of BioSciences, Bio21 Molecular Science and Biotechnology Institute, The University of Melbourne, Parkville, VIC, Australia
| | - Ary Anthony Hoffmann
- School of BioSciences, Bio21 Molecular Science and Biotechnology Institute, The University of Melbourne, Parkville, VIC, Australia
| | - Perran Albert Ross
- School of BioSciences, Bio21 Molecular Science and Biotechnology Institute, The University of Melbourne, Parkville, VIC, Australia
- Section for Bioscience and Engineering, Department of Chemistry and Bioscience, Aalborg University, Aalborg, Denmark
| | - Xinyue Gu
- School of BioSciences, Bio21 Molecular Science and Biotechnology Institute, The University of Melbourne, Parkville, VIC, Australia
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Zhang Y, Liu Y, Gu X, Wang N, Wan J, Zhang Y, Chen L. [Epidemiological and clinical features of newly reported advanced schistosomiasis cases in Sichuan Province from 2011 to 2022]. Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi 2024; 35:621-625. [PMID: 38413023 DOI: 10.16250/j.32.1374.2023148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
Abstract
OBJECTIVE To analyze the epidemiological characteristics of newly reported advanced schistosomiasis cases in Sichuan Province, so as to provide the evidence for analyzing the causes and formulating targeted control measures of newly reported advanced schistosomiasis cases. METHODS Individual case investigation forms for advanced schistosomiasis cases were collected from the Sichuan Provincial Epidemic Annual Report System from 2011 to 2022, and patients' demographics, previous medical history and liver parenchymal grading were retrieved. All advanced schistosomiasis cases' medical records were reviewed, and the subtypes of schistosomiasis-endemic villages where the cases' household registration were, floating population, survival and death and time of death were collected. RESULTS A total of 321 newly reported advanced schistosomiasis cases were found in Sichuan Province from 2011 to 2022, with a male to female ratio of 0.99 to 1. There were 274 cases at ages of over 50 years (85.4%), with the highest proportion seen at ages of 60 to 69 years (87 cases, 27.1%), and splenomegaly was the most common type (180 cases, 56.1%), with no dwarfism type detected. The highest number of cases was reported in 2011 (78 cases), followed by in 2022 (74 cases), and the highest number of cases were reported in Meishan City (199 cases, 62.0%), Dongpo District (131 cases, 40.8%), and hilly subtype areas (136 cases, 42.4%). As of the end of 2022, there were 111 deaths due to advanced schistosomiasis, with the highest number of deaths seen in 2018 (25 deaths), and the highest mortality was seen among patients with the ascites type (41.2%). There were 47 (37.3%), 40 (59.5%) and 4 (23.5%) cases with grade III liver parenchyma among patients with splenomegaly, ascites, and colonic proliferation types, respectively, and there was a significant difference in the grading of III liver parenchyma among three types of patients (H = 12.092, P < 0.05), with more severe liver parenchyma injuries seen among patients with the ascites type than among those with splenomegaly and colonic proliferation type (Z = 24.262 and 44.738, both Padjusted values < 0.05). CONCLUSIONS There have been newly reported advanced schistosomiasis cases in Sichuan Province during recent years, and patients with the ascites type should be given a high priority among advanced schistosomiasis cases in Sichuan Province. Intensified clue surveys are needed for early identification and treatment of advanced schistosomiasis cases, so as to increase the survival rate and improve the quality of life.
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Affiliation(s)
- Y Zhang
- Sichuan Center for Disease Control and Prevention, Chengdu, Sichuan 610000, China
| | - Y Liu
- Sichuan Center for Disease Control and Prevention, Chengdu, Sichuan 610000, China
| | - X Gu
- Zhongjiang County Station of Schistosomiasis Prevention and Control, Deyang City, Sichuan Province, China
| | - N Wang
- Sichuan Center for Disease Control and Prevention, Chengdu, Sichuan 610000, China
| | - J Wan
- Sichuan Center for Disease Control and Prevention, Chengdu, Sichuan 610000, China
| | - Y Zhang
- Sichuan Center for Disease Control and Prevention, Chengdu, Sichuan 610000, China
| | - L Chen
- Sichuan Center for Disease Control and Prevention, Chengdu, Sichuan 610000, China
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Qian A, Jiang S, Gu X, Li S, Lei X, Shi W, Zhou J, Hu L, Xiao T, Zhu Y, Cao Y, Du L, Zhou W, Lee SK, Cheng R, Yin R. Treatment of patent ductus arteriosus and short-term outcomes among extremely preterm infants: a multicentre cohort study. EClinicalMedicine 2024; 67:102356. [PMID: 38125962 PMCID: PMC10730999 DOI: 10.1016/j.eclinm.2023.102356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 11/20/2023] [Accepted: 11/21/2023] [Indexed: 12/23/2023] Open
Abstract
Background The optimal treatment strategy for patent ductus arteriosus (PDA) in extremely preterm infants is currently highly controversial. This study aimed to evaluate the association between PDA treatment and short-term outcomes among extremely preterm infants. Methods This cohort study included all extremely preterm infants (≤27 and 6/7 weeks) who were admitted to hospitals participating in the Chinese Neonatal Network from January 2019 to December 2021, and were diagnosed to have PDA by echocardiogram. PDA treatment was defined as medical treatment and/or surgical ligation of PDA during hospitalization. Short-term outcomes included death, bronchopulmonary dysplasia (BPD), death/BPD, retinopathy of prematurity, necrotizing enterocolitis, and severe brain injury. Multivariate logistic regression was used to evaluate the association between PDA treatment and outcomes. Subgroup analysis were performed among infants with different respiratory support on 3 and 7 days of life. Findings A total of 2494 extremely preterm infants with the diagnosis of PDA were enrolled, of which 1299 (52.1%) received PDA treatment. PDA treatment was significantly associated with lower risk of death (adjusted odds ratio, 0.48; 95% confidence interval, 0.38-0.60). The decreased risk of death was accompanied by increased risk of BPD and death/BPD. In subgroup analysis according to respiratory support, PDA treatment was associated with lower risk of death among infants who required invasive ventilation. However, the beneficial effect on death was not significant among infants who did not require invasive ventilation. Interpretation PDA treatment was associated with reduced mortality in extremely preterm infants, but this beneficial effect was mainly present among infants who required invasive ventilation. Funding This study was funded by the Shanghai Science and Technology Commission's Scientific and Technological Innovation Action Plan (21Y21900800) and the Canadian Institutes of Health Research (CTP87518).
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Affiliation(s)
- Aimin Qian
- Department of Neonatology, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Siyuan Jiang
- Department of Neonatology, Children's Hospital of Fudan University, Shanghai, China
- NHC Key Laboratory of Neonatal Diseases, Fudan University, Children's Hospital of Fudan University, Shanghai, China
| | - Xinyue Gu
- NHC Key Laboratory of Neonatal Diseases, Fudan University, Children's Hospital of Fudan University, Shanghai, China
| | - Shujuan Li
- Department of Neonatology, Children's Hospital of Fudan University, Shanghai, China
| | - Xiaoping Lei
- Division of Neonatology, Department of Pediatrics, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Wei Shi
- Neonatal Intensive Care Unit, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China
- National Clinical Research Center for Child Health, Hangzhou, China
| | - Jianguo Zhou
- Department of Neonatology, Children's Hospital of Fudan University, Shanghai, China
| | - Liyuan Hu
- Department of Neonatology, Children's Hospital of Fudan University, Shanghai, China
| | - Tiantian Xiao
- Department of Neonatology, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Yanping Zhu
- Department of Neonatology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Yun Cao
- Department of Neonatology, Children's Hospital of Fudan University, Shanghai, China
- NHC Key Laboratory of Neonatal Diseases, Fudan University, Children's Hospital of Fudan University, Shanghai, China
| | - Lizhong Du
- Neonatal Intensive Care Unit, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China
- National Clinical Research Center for Child Health, Hangzhou, China
| | - Wenhao Zhou
- Department of Neonatology, Children's Hospital of Fudan University, Shanghai, China
- NHC Key Laboratory of Neonatal Diseases, Fudan University, Children's Hospital of Fudan University, Shanghai, China
| | - Shoo K. Lee
- Maternal-Infant Care Research Center and Department of Pediatrics, Mount Sinai Hospital, Toronto, Ontario, Canada
| | - Rui Cheng
- Department of Neonatology, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Rong Yin
- Department of Neonatology, Children's Hospital of Fudan University, Shanghai, China
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Gu X, Wei F, Tong J, Liu Y, Chen S, Zheng L, Xing Y. MiR-9 promotes G-MDSC recruitment and tumor proliferation by targeting SOCS3 in breast cancer. FASEB J 2024; 38:e23388. [PMID: 38145323 DOI: 10.1096/fj.202301764rr] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 11/17/2023] [Accepted: 12/11/2023] [Indexed: 12/26/2023]
Abstract
Myeloid-derived suppressor cells (MDSCs) are a heterogeneous group of cells that differentiate from myeloid cells, proliferate in cancer and inflammatory reactions, and mainly exert immunosuppressive functions. Nonetheless, the precise mechanisms that dictate both the accumulation and function of MDSCs remain only partially elucidated. In the course of our investigation, we observed a positive correlation between the content of MDSCs especially G-MDSCs and miR-9 level in the tumor tissues derived from miR-9 knockout MMTV-PyMT mice and 4T1 tumor-bearing mice with miR-9 overexpression. Combined with RNA-seq analysis, we identified SOCS2 and SOCS3 as direct targets of miR-9. Additionally, our research unveiled the pivotal role of the CCL5/CCR5 axis in orchestrating the chemotactic recruitment of G-MDSCs within the tumor microenvironment, a process that is enhanced by miR-9. These findings provide fresh insights into the molecular mechanisms governing the accumulation of MDSCs within the framework of breast cancer development.
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Affiliation(s)
- Xinyue Gu
- School of Life Science and Technology, China Pharmaceutical University, Nanjing, People's Republic of China
- Jiangsu Key Laboratory of Carcinogenesis and Intervention, China Pharmaceutical University, Nanjing, People's Republic of China
| | - Fang Wei
- School of Life Science and Technology, China Pharmaceutical University, Nanjing, People's Republic of China
- Jiangsu Key Laboratory of Carcinogenesis and Intervention, China Pharmaceutical University, Nanjing, People's Republic of China
| | - Jinzhe Tong
- School of Life Science and Technology, China Pharmaceutical University, Nanjing, People's Republic of China
- Jiangsu Key Laboratory of Carcinogenesis and Intervention, China Pharmaceutical University, Nanjing, People's Republic of China
| | - Yichen Liu
- School of Life Science and Technology, China Pharmaceutical University, Nanjing, People's Republic of China
- Jiangsu Key Laboratory of Carcinogenesis and Intervention, China Pharmaceutical University, Nanjing, People's Republic of China
| | - Simiao Chen
- School of Life Science and Technology, China Pharmaceutical University, Nanjing, People's Republic of China
- Jiangsu Key Laboratory of Carcinogenesis and Intervention, China Pharmaceutical University, Nanjing, People's Republic of China
| | - Lufeng Zheng
- School of Life Science and Technology, China Pharmaceutical University, Nanjing, People's Republic of China
- Jiangsu Key Laboratory of Carcinogenesis and Intervention, China Pharmaceutical University, Nanjing, People's Republic of China
| | - Yingying Xing
- School of Life Science and Technology, China Pharmaceutical University, Nanjing, People's Republic of China
- Jiangsu Key Laboratory of Carcinogenesis and Intervention, China Pharmaceutical University, Nanjing, People's Republic of China
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Zhu P, Wang W, Qian M, Shi G, Zhang Q, Xu T, Xu H, Zhang H, Gu X, Ding Y, Lee A, Hayter M. Severe Loneliness and Isolation in Nursing Students during COVID-19 Lockdown: A Phenomenological Study. Healthcare (Basel) 2023; 12:19. [PMID: 38200925 PMCID: PMC10778901 DOI: 10.3390/healthcare12010019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 12/08/2023] [Accepted: 12/19/2023] [Indexed: 01/12/2024] Open
Abstract
In 2022, COVID-19 continued to spread across the globe, and to stop the spread of the virus and protect people's health, universities across China continued to remain in a lockdown state. Loneliness is an important topic among college students, and the coronavirus pandemic has exacerbated loneliness. This prolonged school lockdown was unprecedented and it caused severe social isolation and emotional loneliness for students. Few people know how nursing students experience loneliness and find a way through their experience. This qualitative phenomenological study was conducted to reveal the lived experiences of nursing students who indicated COVID-19 lockdown-related loneliness in a previous quantitative survey. We performed 20 semi-structured interviews with nursing students aged 19-23 yrs during their lockdown (April 2022 to June 2022). Our research applied Colaizzi's seven-step data analysis processes to reveal shared patterns in terms of how nursing students experienced lockdown and found the following four themes: emotional challenges associated with loneliness; causes of loneliness; positive and negative motivation to learn; and accepting solitude and reconstructing real life.
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Affiliation(s)
- Pingting Zhu
- School of Nursing, School of Public Health, Yangzhou University, Yangzhou 225009, China; (W.W.); (M.Q.); (G.S.); (Q.Z.); (T.X.); (H.X.); (H.Z.); (X.G.); (Y.D.)
- Jiangsu Key Laboratory of Zoonosis, Yangzhou 225009, China
| | - Wen Wang
- School of Nursing, School of Public Health, Yangzhou University, Yangzhou 225009, China; (W.W.); (M.Q.); (G.S.); (Q.Z.); (T.X.); (H.X.); (H.Z.); (X.G.); (Y.D.)
| | - Meiyan Qian
- School of Nursing, School of Public Health, Yangzhou University, Yangzhou 225009, China; (W.W.); (M.Q.); (G.S.); (Q.Z.); (T.X.); (H.X.); (H.Z.); (X.G.); (Y.D.)
| | - Guanghui Shi
- School of Nursing, School of Public Health, Yangzhou University, Yangzhou 225009, China; (W.W.); (M.Q.); (G.S.); (Q.Z.); (T.X.); (H.X.); (H.Z.); (X.G.); (Y.D.)
| | - Qianqian Zhang
- School of Nursing, School of Public Health, Yangzhou University, Yangzhou 225009, China; (W.W.); (M.Q.); (G.S.); (Q.Z.); (T.X.); (H.X.); (H.Z.); (X.G.); (Y.D.)
| | - Ting Xu
- School of Nursing, School of Public Health, Yangzhou University, Yangzhou 225009, China; (W.W.); (M.Q.); (G.S.); (Q.Z.); (T.X.); (H.X.); (H.Z.); (X.G.); (Y.D.)
| | - Huiwen Xu
- School of Nursing, School of Public Health, Yangzhou University, Yangzhou 225009, China; (W.W.); (M.Q.); (G.S.); (Q.Z.); (T.X.); (H.X.); (H.Z.); (X.G.); (Y.D.)
| | - Hui Zhang
- School of Nursing, School of Public Health, Yangzhou University, Yangzhou 225009, China; (W.W.); (M.Q.); (G.S.); (Q.Z.); (T.X.); (H.X.); (H.Z.); (X.G.); (Y.D.)
| | - Xinyue Gu
- School of Nursing, School of Public Health, Yangzhou University, Yangzhou 225009, China; (W.W.); (M.Q.); (G.S.); (Q.Z.); (T.X.); (H.X.); (H.Z.); (X.G.); (Y.D.)
| | - Yinwen Ding
- School of Nursing, School of Public Health, Yangzhou University, Yangzhou 225009, China; (W.W.); (M.Q.); (G.S.); (Q.Z.); (T.X.); (H.X.); (H.Z.); (X.G.); (Y.D.)
| | - Amanda Lee
- Faculty of Health & Education, Manchester Metropolitan University, Manchester M15 6GX, UK; (A.L.); (M.H.)
| | - Mark Hayter
- Faculty of Health & Education, Manchester Metropolitan University, Manchester M15 6GX, UK; (A.L.); (M.H.)
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Chirgwin E, Yang Q, Umina PA, Thia JA, Gill A, Song W, Gu X, Ross PA, Wei SJ, Hoffmann AA. Barley Yellow Dwarf Virus Influences Its Vector's Endosymbionts but Not Its Thermotolerance. Microorganisms 2023; 12:10. [PMID: 38276179 PMCID: PMC10819152 DOI: 10.3390/microorganisms12010010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 12/11/2023] [Accepted: 12/14/2023] [Indexed: 01/27/2024] Open
Abstract
The barley yellow dwarf virus (BYDV) of cereals is thought to substantially increase the high-temperature tolerance of its aphid vector, Rhopalosiphum padi, which may enhance its transmission efficiency. This is based on experiments with North American strains of BYDV and R. padi. Here, we independently test these by measuring the temperature tolerance, via Critical Thermal Maximum (CTmax) and knockdown time, of Australian R. padi infected with a local BYDV isolate. We further consider the interaction between BYDV transmission, the primary endosymbiont of R. padi (Buchnera aphidicola), and a transinfected secondary endosymbiont (Rickettsiella viridis) which reduces the thermotolerance of other aphid species. We failed to find an increase in tolerance to high temperatures in BYDV-infected aphids or an impact of Rickettsiella on thermotolerance. However, BYDV interacted with R. padi endosymbionts in unexpected ways, suppressing the density of Buchnera and Rickettsiella. BYDV density was also fourfold higher in Rickettsiella-infected aphids. Our findings indicate that BYDV does not necessarily increase the temperature tolerance of the aphid transmission vector to increase its transmission potential, at least for the genotype combinations tested here. The interactions between BYDV and Rickettsiella suggest new ways in which aphid endosymbionts may influence how BYDV spreads, which needs further testing in a field context.
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Affiliation(s)
- Evatt Chirgwin
- Cesar Australia, 95 Albert Street, Brunswick, VIC 3056, Australia;
| | - Qiong Yang
- PEARG Group, School of BioSciences, Bio21 Institute, The University of Melbourne, Parkville, VIC 2052, Australia; (J.A.T.); (A.G.); (X.G.); (P.A.R.); (A.A.H.)
| | - Paul A. Umina
- Cesar Australia, 95 Albert Street, Brunswick, VIC 3056, Australia;
- PEARG Group, School of BioSciences, Bio21 Institute, The University of Melbourne, Parkville, VIC 2052, Australia; (J.A.T.); (A.G.); (X.G.); (P.A.R.); (A.A.H.)
| | - Joshua A. Thia
- PEARG Group, School of BioSciences, Bio21 Institute, The University of Melbourne, Parkville, VIC 2052, Australia; (J.A.T.); (A.G.); (X.G.); (P.A.R.); (A.A.H.)
| | - Alex Gill
- PEARG Group, School of BioSciences, Bio21 Institute, The University of Melbourne, Parkville, VIC 2052, Australia; (J.A.T.); (A.G.); (X.G.); (P.A.R.); (A.A.H.)
| | - Wei Song
- Institute of Plant Protection, Beijing Academy of Agriculture and Forestry Sciences, Beijing 100097, China; (W.S.); (S.-J.W.)
| | - Xinyue Gu
- PEARG Group, School of BioSciences, Bio21 Institute, The University of Melbourne, Parkville, VIC 2052, Australia; (J.A.T.); (A.G.); (X.G.); (P.A.R.); (A.A.H.)
| | - Perran A. Ross
- PEARG Group, School of BioSciences, Bio21 Institute, The University of Melbourne, Parkville, VIC 2052, Australia; (J.A.T.); (A.G.); (X.G.); (P.A.R.); (A.A.H.)
| | - Shu-Jun Wei
- Institute of Plant Protection, Beijing Academy of Agriculture and Forestry Sciences, Beijing 100097, China; (W.S.); (S.-J.W.)
| | - Ary A. Hoffmann
- PEARG Group, School of BioSciences, Bio21 Institute, The University of Melbourne, Parkville, VIC 2052, Australia; (J.A.T.); (A.G.); (X.G.); (P.A.R.); (A.A.H.)
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Zhu P, Zhang H, Gu X, Ding Y, Qian M, Wang W, Shi G, Lee A. Quality of Life in Chinese Youth Following Open Thyroid Surgery: A Qualitative Study. Cancer Nurs 2023:00002820-990000000-00202. [PMID: 38100753 DOI: 10.1097/ncc.0000000000001314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2023]
Abstract
BACKGROUND Because of the increased incidence of thyroid cancer and good survival rates and with research into scarless techniques, it is increasingly important to understand the quality of life of thyroid cancer patients and identify areas for improvement. Therefore, it is necessary to explore the importance of neck appearance after thyroidectomy for thyroid cancer survivors in China. OBJECTIVE The purpose of this study was to investigate the effect of scarring after open thyroid surgery on the quality of life of young patients. METHODS A descriptive qualitative design was used. Data were collected using face-to-face semistructured interviews and analyzed using directed content analysis. RESULTS Five men and 19 women participated in the study. The following 3 broad themes and 9 subthemes emerged, which were (1) emotional functioning, including low self-esteem due to high visibility of scars, concerns and helplessness about scarring lesions, and feelings of isolation due to lack of support; (2) social functioning, including restricted choice of employment, avoidance of socializing with others, and reduced participation in social activities; and (3) information seeking, acceptance, and living with the scar, including bargaining, seeking professional help, and use of social media. CONCLUSIONS After open surgery for thyroid cancer, patients experience a variety of scarring features that affect their quality of life. Therefore, preoperative communication and long-term postoperative care should be emphasized in clinical practice and research. IMPLICATIONS FOR PRACTICE Understanding the experience of carrying scars after thyroid cancer surgery helps provide adequate information, expectation management, and informed decision-making.
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Affiliation(s)
- Pingting Zhu
- Author Affiliations: Department of Nursing, Yangzhou University, Yangzhou, Jiangsu, People's Republic of China (Mss Zhang, Gu, Ding, Qian, Wang, and Shi; Dr Zhu) and Manchester Metropolitan University, Manchester, England (Dr Lee)
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Wang Z, Gu X, Zhang X, Wang X, Zhang J, Liu Y, Tan X, Zhao Y, Kang D, Guo W, Ngo HH. New easily recycled carrier based polyurethane foam by loading Al-MOF and biochar for selective removal of fluoride ion from aqueous solutions. Sci Total Environ 2023; 901:166312. [PMID: 37586503 DOI: 10.1016/j.scitotenv.2023.166312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 08/11/2023] [Accepted: 08/12/2023] [Indexed: 08/18/2023]
Abstract
The production of Integrated circuits (ICs) generates wastewater with a high concentration of residual fluoride ions, necessitating highly efficient fluorine removal methods. In this study, a novel composite carrier was developed using a hydrothermal synthesis method to load Al-MOF and biochar (BC) onto polyurethane foam (PUF), resulting in the composite foam of Al-MOF-PUF@BC. The results showed that the composite carrier exhibited a stable fluoride removal effect, with a maximum adsorption capacity of 16.52 mg/g at room temperature. The adsorption isotherm curves were consistent with the Langmuir isotherm model, and the adsorption kinetics were well-described by the pseudo-first-order model. The mechanism of fluorine adsorption on Al-MOF-PUF@BC was ligand exchange with hydroxyl groups and the formation of FAl bonds. Density functional theory (DFT) calculations revealed that the adsorption energy reached -246.7 eV, indicating stable adsorption for fluoride ions. The composite foam demonstrated excellent regenerative properties and was effective for fluoride removal in actual IC wastewater.
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Affiliation(s)
- Zhe Wang
- Joint Research Center for Protective Infrastructure Technology and Environmental Green Bioprocess, School of Environmental and Municipal Engineering, Tianjin Chengjian University, Tianjin 300384, China
| | - Xinyue Gu
- Joint Research Center for Protective Infrastructure Technology and Environmental Green Bioprocess, School of Environmental and Municipal Engineering, Tianjin Chengjian University, Tianjin 300384, China
| | - Xinbo Zhang
- Joint Research Center for Protective Infrastructure Technology and Environmental Green Bioprocess, School of Environmental and Municipal Engineering, Tianjin Chengjian University, Tianjin 300384, China.
| | - Xiao Wang
- TG Hilyte Environment Technology (Beijing) Co., LTD., Beijing 100000, China
| | - Jianqing Zhang
- TG Hilyte Environment Technology (Beijing) Co., LTD., Beijing 100000, China
| | - Ying Liu
- Joint Research Center for Protective Infrastructure Technology and Environmental Green Bioprocess, School of Environmental and Municipal Engineering, Tianjin Chengjian University, Tianjin 300384, China
| | - Xinai Tan
- Dayu Environmental Protection Co., Ltd, Tianjin 301739, China
| | - Ying Zhao
- State Key Laboratory of Environmental Criteria and Risk Assessment, Chinese Research Academy of Environmental Sciences, Beijing 100012, China
| | - Dejun Kang
- College of Civil Engineering of Fuzhou University, Fuzhou University, Fuzhou 350108, China
| | - Wenshan Guo
- Joint Research Center for Protective Infrastructure Technology and Environmental Green Bioprocess, School of Environmental and Municipal Engineering, Tianjin Chengjian University, Tianjin 300384, China; Centre for Technology in Water and Wastewater, School of Civil and Environmental Engineering, University of Technology Sydney, Sydney, NSW 2007, Australia
| | - Huu Hao Ngo
- Joint Research Center for Protective Infrastructure Technology and Environmental Green Bioprocess, School of Environmental and Municipal Engineering, Tianjin Chengjian University, Tianjin 300384, China; Centre for Technology in Water and Wastewater, School of Civil and Environmental Engineering, University of Technology Sydney, Sydney, NSW 2007, Australia.
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11
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Jing S, Dai Z, Wu Y, Liu X, Ren T, Liu X, Zhang L, Fu J, Chen X, Xiao W, Wang H, Huang Y, Qu Y, Wang W, Gu X, Ma L, Zhang S, Yu Y, Li L, Han Z, Su X, Qiao Y, Wang C. Prevalence and influencing factors of depressive and anxiety symptoms among hospital-based healthcare workers during the surge period of the COVID-19 pandemic in the Chinese mainland: a multicenter cross-sectional study. QJM 2023; 116:911-922. [PMID: 37561096 DOI: 10.1093/qjmed/hcad188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 07/06/2023] [Indexed: 08/11/2023] Open
Abstract
BACKGROUND From November 2022 to February 2023, the Chinese mainland experienced a surge in COVID-19 infection and hospitalization, and the hospital-based healthcare workers (HCWs) might suffer serious psychological crisis during this period. This study aims to assess the depressive and anxiety symptoms among HCWs during the surge of COVID-19 pandemic and to provide possible reference on protecting mental health of HCWs in future infectious disease outbreaks. METHODS A multicenter cross-sectional study was carried out among hospital-based HCWs in the Chinese mainland from 5 January to 9 February 2023. The PHQ-9 (nine-item Patient Health Questionnaire) and GAD-7 (seven-item Generalized Anxiety Disorder Questionnaire) were used to measure depressive and anxiety symptoms. Ordinal logistic regression analysis was performed to identify influencing factors. RESULTS A total of 6522 hospital-based HCWs in the Chinse mainland were included in this survey. The prevalence of depressive symptoms among the HCWs was 70.75%, and anxiety symptoms was 47.87%. The HCWs who perceived higher risk of COVID-19 infection and those who had higher work intensity were more likely to experience depressive and anxiety symptoms. Additionally, higher levels of mindfulness, resilience and perceived social support were negatively associated with depressive and anxiety symptoms. CONCLUSION This study revealed that a high proportion of HCWs in the Chinese mainland suffered from mental health disturbances during the surge of the COVID-19 pandemic. Resilience, mindfulness and perceived social support are important protective factors of HCWs' mental health. Tailored interventions, such as mindfulness practice, should be implemented to alleviate psychological symptoms of HCWs during the COVID-19 pandemic or other similar events in the future.
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Affiliation(s)
- S Jing
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Z Dai
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Y Wu
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - X Liu
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - T Ren
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - X Liu
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - L Zhang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - J Fu
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - X Chen
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - W Xiao
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - H Wang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Y Huang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Y Qu
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - W Wang
- School of Nursing, Jining Medical University, Jining, Shandong, China
| | - X Gu
- Affiliated Tumor Hospital, Xinjiang Medical University, Urumqi, China
| | - L Ma
- Public Health School, Dalian Medical University, Dalian, China
| | - S Zhang
- Henan Cancer Hospital, Affiliate Cancer Hospital of Zhengzhou University, Zhengzhou, China
| | - Y Yu
- The First Affiliated Hospital of Baotou Medical College, Baotou, Inner Mongolia Autonomous Region, China
| | - L Li
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangdong, China
| | - Z Han
- China Foreign Affairs University, Beijing, China
| | - X Su
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Y Qiao
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
- Department of Epidemiology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - C Wang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
- Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
- National Clinical Research Center for Respiratory Diseases, Beijing, China
- Chinese Academy of Engineering, Beijing, China
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Xiong Y, Gu F, Cui J, Liu Y, Sun M, Gu X, Zhong L, Zhang K, Liu L. Construction and validation of a novel prognostic nomogram for predicting overall survival in lung adenocarcinoma patients with different patterns of metastasis. J Cancer Res Clin Oncol 2023; 149:15039-15053. [PMID: 37612389 PMCID: PMC10602951 DOI: 10.1007/s00432-023-05288-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 08/14/2023] [Indexed: 08/25/2023]
Abstract
OBJECTIVE Metastasis of lung cancer is an important factor affecting survival. The present study proposed to establish and verify a nomogram for predicting overall survival (OS) in lung adenocarcinoma (LUAD) patients with different patterns of metastasis. METHODS A total of 9727 patients diagnosed with metastatic LUAD patients from 2010 to 2015 were enrolled based on surveillance, epidemiology and end results (SEER) Database and then randomly divided into training and validation cohorts, and 136 patients in our Cancer Center were enrolled as the external validation cohort. Univariate and multivariate analyses were performed to evaluate the prognostic impact on OS. A prognostic nomogram was constructed and evaluated by C-index, calibration curve, decision curve analysis (DCA), and risk stratification system. RESULTS Ultimately, 6809 and 2918 patients diagnosed with metastatic LUAD in the training and validation cohorts were enrolled in the study, respectively. A male sex, a later T and N stage, a larger tumor size, treatment including no surgery, no chemotherapy and no radiotherapy, metastasis sites were found to be independent risk factors in LUAD patients for worse OS, and then incorporated into the nomogram. The frequency of bone metastasis was the highest, and in single site metastasis, the prognosis of liver metastasis was the worst. Two-site metastasis is more common than three-site and four-site metastasis, and co-metastasis eventually leads to a worse survival outcome. The C-index value of nomogram for predicting OS were 0.798, 0.703 and 0.698 in the internal training, validation and external validation cohorts, separately. The calibration curves for the 6-months, 1-year and 2-year showed significant agreement between nomogram models and actual observations. The DCA curves indicated nomogram was more beneficial than the AJCC TNM stage. Patients were further divided into low-risk and high-risk groups according to nomogram predicted scores and developed a survival risk classification system. CONCLUSIONS Our prognostic nomogram is expected to be an accurate and individualized clinical predictive tool for predicting OS in LUAD patients with different patterns of metastasis.
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Affiliation(s)
- Ying Xiong
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, Hubei, China
| | - Feifei Gu
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, Hubei, China
| | - Jin Cui
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, Hubei, China
| | - Yuting Liu
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, Hubei, China
| | - Min Sun
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, Hubei, China
| | - Xinyue Gu
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, Hubei, China
| | - Luhui Zhong
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, Hubei, China
| | - Kai Zhang
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, Hubei, China.
| | - Li Liu
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, Hubei, China.
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Qian M, Zhu P, Wu Q, Wang W, Shi G, Ding Y, Zhang H, Gu X, Xu T, Zhang Q. Experience of verbal violence among Chinese nursing students in clinical practice: a qualitative study. BMC Med Educ 2023; 23:768. [PMID: 37845649 PMCID: PMC10577944 DOI: 10.1186/s12909-023-04741-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 09/30/2023] [Indexed: 10/18/2023]
Abstract
BACKGROUND Workplace violence is prevalent in the nursing profession, and as a relatively junior link of the professional hierarchy, nursing students are not immune to it. Among these, verbal violence may have more serious consequences for the victims than physical violence, but the literature on verbal violence among nursing students in Chinese clinical settings is limited. AIMS To explore the verbal violence experience among Chinese nursing students in clinical practice, and the strategies used by nursing students to cope with violence. DESIGN A descriptive qualitative study. METHODS From January 2022 to June 2022, semi-structured interviews were conducted with 21 nursing students in clinical practice by purposive snowball sampling. Nvivo12 software and inductive content analysis were used for data analysis. This paper followed the COREQ (Consolidated criteria for Reporting Qualitative Research) guidance. RESULTS Through data analysis, three themes were defined:(1) Multiform verbal violence; (2) Hurting and impacting and (3) Struggling or Coping. The findings indicated that nursing students were subjected to multiple forms of verbal violence in clinical practice, not only from patients and caregivers, but also from peers such as clinical tutors and doctors, which not only harmed students' personal health and well-being, but may also contribute to the nursing industry's future loss of human resources. Seeking emotional support from others and forcing themselves to grow up were the most commonly used coping strategies. CONCLUSION Nursing educators and nursing managers need to pay attention to verbal violence in the clinical environment, and actively develop the ability of nursing students to deal with uncivilized behavior. Establishing relevant courses and training such as communication, resilience, and violence prevention, establishing a stricter clinical mentor appointment system, and teaching assessment system may be strategies to help nursing students better perform clinical practice.
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Affiliation(s)
- Meiyan Qian
- School of Nursing, School of Public Health, Yangzhou University, 136 Jiangyang Middle Road, Yangzhou, China
| | - Pingting Zhu
- School of Nursing, School of Public Health, Yangzhou University, 136 Jiangyang Middle Road, Yangzhou, China.
- Jiangsu Key Laboratory of Zoonosis, Yangzhou, China.
| | - Qiwei Wu
- School of Nursing, School of Public Health, Yangzhou University, 136 Jiangyang Middle Road, Yangzhou, China
| | - Wen Wang
- School of Nursing, School of Public Health, Yangzhou University, 136 Jiangyang Middle Road, Yangzhou, China
| | - Guanghui Shi
- School of Nursing, School of Public Health, Yangzhou University, 136 Jiangyang Middle Road, Yangzhou, China
| | - Yinwen Ding
- School of Nursing, School of Public Health, Yangzhou University, 136 Jiangyang Middle Road, Yangzhou, China
| | - Hui Zhang
- School of Nursing, School of Public Health, Yangzhou University, 136 Jiangyang Middle Road, Yangzhou, China
| | - Xinyue Gu
- School of Nursing, School of Public Health, Yangzhou University, 136 Jiangyang Middle Road, Yangzhou, China
| | - Ting Xu
- School of Nursing, School of Public Health, Yangzhou University, 136 Jiangyang Middle Road, Yangzhou, China
| | - QianQian Zhang
- School of Nursing, School of Public Health, Yangzhou University, 136 Jiangyang Middle Road, Yangzhou, China
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Gonçalves M, Khera T, Otu HH, Narayanan S, Dillon ST, Shanker A, Gu X, Jung Y, Ngo LH, Marcantonio ER, Libermann TA, Subramaniam B. Multivariable model of postoperative delirium in cardiac surgery patients: proteomic and demographic contributions. medRxiv 2023:2023.05.30.23289741. [PMID: 37333093 PMCID: PMC10274980 DOI: 10.1101/2023.05.30.23289741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/20/2023]
Abstract
Background Delirium following cardiac surgery is common, morbid, and costly, but may be prevented with risk stratification and targeted intervention. Preoperative protein signatures may identify patients at increased risk for worse postoperative outcomes, including delirium. In this study, we aimed to identify plasma protein biomarkers and develop a predictive model for postoperative delirium in older patients undergoing cardiac surgery, while also uncovering possible pathophysiological mechanisms. Methods SOMAscan analysis of 1,305 proteins in the plasma from 57 older adults undergoing cardiac surgery requiring cardiopulmonary bypass was conducted to define delirium-specific protein signatures at baseline (PREOP) and postoperative day 2 (POD2). Selected proteins were validated in 115 patients using the ELLA multiplex immunoassay platform. Proteins were combined with clinical and demographic variables to build multivariable models that estimate the risk of postoperative delirium and bring light to the underlying pathophysiology. Results A total of 115 and 85 proteins from SOMAscan analyses were found altered in delirious patients at PREOP and POD2, respectively (p<0.05). Using four criteria including associations with surgery, delirium, and biological plausibility, 12 biomarker candidates (Tukey's fold change (|tFC|)>1.4, Benjamini-Hochberg (BH)-p<0.01) were selected for ELLA multiplex validation. Eight proteins were significantly altered at PREOP, and seven proteins at POD2 (p<0.05), in patients who developed postoperative delirium compared to non-delirious patients. Statistical analyses of model fit resulted in the selection of a combination of age, sex, and three proteins (angiopoietin-2 (ANGPT2); C-C motif chemokine 5 (CCL5); and metalloproteinase inhibitor 1 (TIMP1); AUC=0.829) as the best performing predictive model for delirium at PREOP. The delirium-associated proteins identified as biomarker candidates are involved with inflammation, glial dysfunction, vascularization, and hemostasis, highlighting the multifactorial pathophysiology of delirium. Conclusion Our study proposes a model of postoperative delirium that includes a combination of older age, female sex, and altered levels of three proteins. Our results support the identification of patients at higher risk of developing postoperative delirium after cardiac surgery and provide insights on the underlying pathophysiology. ClinicalTrials.gov ( NCT02546765 ).
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Zhou Z, Wu H, Fu B, Wang Z, Hong R, Huang L, Gu X, Gu C, Jin X. Dissolved black carbon incorporating with ferric minerals promoted photo-Fenton-like degradation of triclosan in acidic conditions. J Hazard Mater 2023; 459:132253. [PMID: 37567135 DOI: 10.1016/j.jhazmat.2023.132253] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 07/12/2023] [Accepted: 08/07/2023] [Indexed: 08/13/2023]
Abstract
Dissolved black carbon (DBC) has been recognized as an important organic matter that influences the photochemical processes of organic pollutants. The excited triplet state (3DBC*) of DBC usually exhibits activity in neutral and basic aqueous conditions, rather than in acidic conditions. In this study, we found the crop (wheat, rice, maize) straw sourced DBC can substantially enhance the photodegradation of triclosan in relatively acidic conditions, and in the presence of ferric minerals (ferrihydrite and lepidocrocite), when exposed to simulated sunlight irradiation. This should be ascribed to the rapid non-reductive dissolution of ferric minerals by DBC, which leads to the generation of abundant hydrogen peroxides (H2O2) and hydroxyl radicals (•OH) through photo Fenton-like reactions. •OH is the dominant reactive species that leads to triclosan degradation in acidic conditions. Otherwise, triclosan itself is resistant to direct photolysis at pH < 5.0. The triplet state (3DBC*) plays a critical role in accelerating the Fe3+/Fe2+ cycling, which further promotes •OH generation. This study provides a new perspective on the role of DBC in surface water or mineral-water interfaces with acidic conditions and adds a more comprehensive understanding about the environmental implications of the DBC-ferric mineral system in sunlit surface water.
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Affiliation(s)
- Ziyan Zhou
- State Key Laboratory of Pollution Control and Resource Reuse, School of Environment, Nanjing University, Nanjing 210023, PR China
| | - Hao Wu
- State Key Laboratory of Pollution Control and Resource Reuse, School of Environment, Nanjing University, Nanjing 210023, PR China
| | - Boming Fu
- Key Laboratory of Environmental Remediation and Ecological Health, Ministry of Industry and Information Technology, Jiangsu Environmental Engineering Technology Co., Ltd, Jiangsu Environmental Protection Group Co., Ltd, Nanjing 210019, PR China
| | - Zhe Wang
- State Key Laboratory of Pollution Control and Resource Reuse, School of Environment, Nanjing University, Nanjing 210023, PR China
| | - Ran Hong
- School of Chemical and Environmental Engineering, Anhui Polytechnic University, Wuhu 241000, PR China
| | - Liuqing Huang
- State Key Laboratory of Pollution Control and Resource Reuse, School of Environment, Nanjing University, Nanjing 210023, PR China
| | - Xinyue Gu
- State Key Laboratory of Pollution Control and Resource Reuse, School of Environment, Nanjing University, Nanjing 210023, PR China
| | - Cheng Gu
- State Key Laboratory of Pollution Control and Resource Reuse, School of Environment, Nanjing University, Nanjing 210023, PR China
| | - Xin Jin
- State Key Laboratory of Pollution Control and Resource Reuse, School of Environment, Nanjing University, Nanjing 210023, PR China; School of Environment, Nanjing Normal University, Nanjing 210023, PR China.
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Yang Z, Zamarud A, Marianayagam N, Park D, Yener U, Soltys SG, Chang SD, Meola A, Lu W, Gu X. Overall Survival Prediction in Stereotactic Radiosurgery Patients with Glioblastoma Via a Deep-Learning Approach. Int J Radiat Oncol Biol Phys 2023; 117:e159. [PMID: 37784752 DOI: 10.1016/j.ijrobp.2023.06.988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Accurate and automated early survival prediction is critical for glioblastoma (GBM) patients as their poor prognosis requires timely treatment decision-making. We have developed a deep learning (DL)-based GBM overall survival (OS) prediction model based on a multi-institutional public dataset using only pre-operative basic structural multi-parametric magnetic resonance images (MRIs). The purpose of this study is to evaluate this DL-based OS prediction model with an institutional stereotactic radiosurgery (SRS) clinical trial dataset. MATERIALS/METHODS The task of this study is to classify GBM patients into 3 OS classes: long-survivors (>15 months), mid-survivors (between 10 and 15 months) and short-survivors (< 10 months). The proposed OS prediction model is an ensemble of a ResNet-based classifier and a K-NN classifier. The ResNet-based classifier is trained in a Siamese fashion to explore inter-class differences. During testing, training sample features are implemented with a K-NN classifier to ensemble with the ResNet-based classifier. A public dataset from Medical Image Computing and Computer Assisted Intervention (MICCAI) Brain Tumor Segmentation (BraTS) challenge 2020 (235 patients) were used for model establishing and initial validation. Then the validated model was evaluated on 19 GBM patients from an institutional SRS clinical trial. Each data entry consists of pre-operative basic structural multi-parametric MRIs and survival days, as well as patient ages for BraTS data and basic clinical characteristics for institutional data. GBM sub-regions, including contrast-enhancing tumor, peri-tumoral edema, and necrotic/non-enhancing tumor core, were segmented in the multi-parametric MRIs by an in-house DL model for both datasets. The OS prediction model was trained on 90% of the segmented BraTS data and validated on the rest 10%, then further evaluated on the institutional data. The model performance was assessed by prediction accuracy (ACC) and the area under the curve (AUC). RESULTS For this 3-class OS classification task, our DL-based prediction model achieved an ACC of 65.22% and an AUC of 0.81 on the BraTS dataset compared with the top-ranked result from the BraTS challenge 2020 (Rank 1st: ACC 61.7%), and an ACC of 52.63% and an AUC of 0.69 on the institutional dataset. Further analysis of the institutional dataset found that the predicted OS class had a statistically significant correlation with treatment volume (p = 0.012) and age (p = 0.006), which matches the analysis that the patients' ground truth OS class is statistical significantly correlated with treatment volume (p = 0.045). CONCLUSION Our DL-based OS prediction model for GBM using basic structural multi-parametric pre-operative MRIs has demonstrated promising performance in both public and institutional dataset with minimal manual processing requirements. This OS prediction model can be potentially applied to assist timely clinical decision-making.
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Affiliation(s)
- Z Yang
- Department of Radiation Oncology, The University of Texas Southwestern Medical Center, Dallas, TX
| | - A Zamarud
- Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA
| | - N Marianayagam
- Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA
| | - D Park
- Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA
| | - U Yener
- Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA
| | - S G Soltys
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - S D Chang
- Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA
| | - A Meola
- Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA
| | - W Lu
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX
| | - X Gu
- Department of Radiation Oncology, The University of Texas Southwestern Medical Center, Dallas, TX; Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
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Montalvo SK, Ravella R, Zhang-Velten ER, Li X, Desai NB, Dan T, Timmerman RD, Jiang SB, Gu X, Parsons DDM, Kumar KA. Cardiac Sparing with Volumetric Modulated Arc Therapy Enabled Total Body Irradiation (CS VMAT-TBI). Int J Radiat Oncol Biol Phys 2023; 117:e477-e478. [PMID: 37785513 DOI: 10.1016/j.ijrobp.2023.06.1693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Volumetric modulated arc therapy (VMAT) enabled total body irradiation (TBI) has replaced conventional TBI in our institution given the improved treatment accuracy, patient comfort, and dose modulation ability. The risk of cardiovascular disease is several folds higher among transplant patients who receive TBI, likely related to dose to the heart. We hypothesize that a cardiac-sparing (CS) VMAT-TBI technique is feasible and can meaningfully reduce dose to the heart while still adequately covering nearby lymphatic tissue. MATERIALS/METHODS VMAT-TBI is delivered via multi-isocentric external beams in a frame-based setup. Heart is contoured as per published guidelines. A lymph node contour, which includes tonsils, neck nodal stations, mediastinal, abdominal, retroperitoneal, and pelvic nodes is created. Coverage of the lymph node contour is prioritized over organ-sparing during inverse optimization; with a goal of V90% greater than 99.5% and mean dose less than 800 cGy for the lymph nodes and heart, respectively. An IRB-approved retrospective review was performed with mean heart dose collected for all patients treated with CS VMAT-TBI and compared to a representative cohort of five patients treated with VMAT-TBI without cardiac sparing. RESULTS Thirty-one patients were treated with CS VMAT-TBI between 2020-2022 with a median follow up time of 11.5 months. Mean heart dose was 796 ± 71 cGy in the CS VMAT-TBI compared to 1247 ± 29 cGy in the VMAT-TBI group without cardiac sparing (p < 0.001). Of those treated with CS VMAT-TBI, three patients relapsed; one relapse occurred in bone marrow only, one relapse occurred in bone marrow and cervical, thoracic, and intra-abdominal lymphoid tissues, and one patient was simulated but never received induction therapy due to overt progression. 100-day relapse-free survival and overall survival were 82.5% and 86.2%, respectively. Median survival time has not been met. CONCLUSION Cardiac sparing is feasible in VMAT-TBI and is associated with significant decrease in mean heart dose of ∼450 cGy. This is estimated to confer a 33.3% decreased absolute risk for lifetime major coronary events compared to patients treated with VMAT-TBI without cardiac sparing. Although limited by short follow-up time, there does not appear to be a significant risk for early relapse despite de-escalating cardiac tissue, likely due to prioritizing coverage of lymph nodes. Prospective clinical studies are needed to further validate cardiac and other organ at risk sparing VMAT-TBI techniques.
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Affiliation(s)
- S K Montalvo
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX
| | - R Ravella
- UT Southwestern Medical Center, Dallas, TX
| | - E R Zhang-Velten
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX
| | - X Li
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - N B Desai
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX
| | - T Dan
- University of Texas Southwestern Department of Radiation Oncology, Dallas, TX
| | - R D Timmerman
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX
| | - S B Jiang
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX
| | - X Gu
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - D D M Parsons
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX
| | - K A Kumar
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX
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Jiang H, Fu J, Melemenidis S, Viswanathan V, Dutt S, Lau B, Soto LA, Manjappa R, Skinner L, Yu SJ, Surucu M, Graves EE, Casey K, Rankin E, Lu W, Loo BW, Gu X. An Online AI-Powered Interactive Histological Image Annotation Platform for Analyzing Intestinal Regenerating Crypts in Post-Irradiated Mice. Int J Radiat Oncol Biol Phys 2023; 117:e676. [PMID: 37785993 DOI: 10.1016/j.ijrobp.2023.06.2130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) The goal of this project is to build an online AI-powered interactive annotation platform to accurately and efficiently annotate intestinal regenerating crypts in histological images of mice after abdominal irradiation. MATERIALS/METHODS The proposed platform is developed by the seamless integration of a front-end web client and a back-end server. Such client/server design allows the users to access the platform without software installation on local computers. Our front-end client is developed with SvelteJS + WebGL technology stack, allowing access from any common web browsers and enabling user interaction, such as image importing/visualization, interactive crypt annotating, and annotation saving/deleting. The back-end server is responsible for executing the tasks requested from the web client, for instance, image pre-processing, AI-based crypts automatic identification, and database management. The image preprocessing is designed to extract a single cross section image using morphological operations because multiple hematoxylin and eosin (H&E) stained jejunum cross sections from post-irradiated mice are scanned within one slide. The auto-crypt identification is powered by a trained and validated AI engine U-Net, classifying image grid tiles into two groups with and without regenerating crypts. The database is implemented with the self-contained SQLite to support recording and indexing the annotated grid tiles with regenerating crypts. The workflow for crypt analysis on this interactive platform has 5 steps: 1) manually import a whole H&E slide image; 2) auto-preprocess the slide by extracting single cross-section images; 3) auto-identify regenerating crypts with an AI engine; 4) interactively annotate (add, delete, modify) auto-identified crypt markers; 5) save and/or output the annotation to the database or the local drive. RESULTS The performance of the developed interactive crypt analysis platform was evaluated in aspects of accuracy and efficiency. The AI-powered crypt auto-identification accuracy was assessed by computing the mean absolute error (MAE) on crypt number per cross section between manual and auto annotation using a testing dataset containing 80 cross sections. It achieved an MAE of 3.5±4.8 crypts per cross section, and 81.25% of the cross sections have no more than 5 crypts difference. The efficiency was assessed under two conditions with the server on the cloud and a local computer. It took about 2-3 minutes to finish the entire workflow on the cloud, while 1-2 minutes on the local by saving ∼1 minute on image uploading. CONCLUSION The developed web client/server platform enables online automatic identification and interactive annotation of mice crypts in minutes. It is a convenient tool that allows accurate and efficient crypt analysis and can be extended for other histologic image analyses.
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Affiliation(s)
| | - J Fu
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - S Melemenidis
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - V Viswanathan
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - S Dutt
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - B Lau
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - L A Soto
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - R Manjappa
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - L Skinner
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - S J Yu
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - M Surucu
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - E E Graves
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - K Casey
- Department of Comparative Medicine, Stanford University School of Medicine, Stanford, CA
| | - E Rankin
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - W Lu
- University of Texas Southwestern Department of Radiation Oncology, Dallas, TX
| | - B W Loo
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - X Gu
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
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Cai S, Xie L, Li M, Gu X, Tian Y. Green Tea Derivative (-)-Epigallocatechin-3-Gallate (EGCG) for Prevention of Acute Radiation-Induced Intestinal Injury: A Prospective Phase II Clinical Study in Pelvic Cancer Patients. Int J Radiat Oncol Biol Phys 2023; 117:e505. [PMID: 37785584 DOI: 10.1016/j.ijrobp.2023.06.1755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Radiation-induced intestinal injury (RIII) remains the most common dose-limiting toxicity following radiotherapy (RT) for pelvic malignancies. However, few efficient and safe methods for the prevention of RIII are available in the clinical practice. Our previous study proved that the green tea polyphenol (-)-epigallocatechin-3-gallate (EGCG) efficiently attenuates radiation-induced intestinal injury (RIII) in animal level. Therefore, this prospective phase II clinical study (ChiCTR2100053703) evaluated the efficacy of EGCG in the prevention of RIII. MATERIALS/METHODS Cervical or endometrial cancer patients who received adjuvant or radical RT in our department were enrolled, 400mg EGCG was taken daily, and RIII was evaluated weekly according to the RTOG criteria. RESULTS Between February 2022 to January 2023, 37 patients were enrolled (30 were cervical cancer and the other 7 were endometrial cancer), and were followed-up regularly. Among them, the majority patients (75.7%, 28 patients) developed grade 0 or 1 RIII, for which no medical intervention was required. Meanwhile, the occurrence of grade 2 RIII was 24.3% (9 patients), which was significantly lower than that in the historical controls (usually 60% to 80%). Besides that, no patients developed grade 3 or worse RIII. CONCLUSION In this phase II clinical trial, compared to historical controls, the prophylactic use of EGCG significantly reduced the incidence and severity of RIII in patients receiving pelvic RT. Therefore, EGCG has the potential to become a novel medical countermeasure for the prevention of RIII for pelvic cancer patients.
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Affiliation(s)
- S Cai
- Department of Radiotherapy and Oncology, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - L Xie
- Department of Radiotherapy and Oncology, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - M Li
- Soochow University, Suzhou, China
| | - X Gu
- The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Y Tian
- Department of Radiotherapy and Oncology, The Second Affiliated Hospital of Soochow University, Suzhou, China
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Rahimi AS, Kim N, Leitch M, Gu X, Parsons DDM, Nwachukwu CR, Alluri PG, Lu W, Nichols EM, Becker SJ, Ahn C, Zhang Y, Spangler A, Farr D, Wooldridge R, Bahrami S, Stojadinovic S, Lieberman M, Neufeld S, Timmerman RD. Multi-Institutional Phase II Trial Using Dose Escalated Five Fraction Stereotactic Partial Breast Irradiation (S-PBI) with GammaPod TM for Early-Stage Breast Cancer. Int J Radiat Oncol Biol Phys 2023; 117:e203. [PMID: 37784857 DOI: 10.1016/j.ijrobp.2023.06.1082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) We report on our early experience of a multi-institutional phase II study of dose escalated five fraction stereotactic partial breast irradiation (S-PBI) for early-stage breast cancer after partial mastectomy using the GammaPodTM stereotactic radiation system. MATERIALS/METHODS Patient eligibility included DCIS or invasive epithelial histologies, AJCC clinical stage 0, I, or II with tumor size < 3 cm, and negative margins. Prior safety of Phase I dose escalation has been reported. Dose was 40 Gy delivered in 5 fractions to the CTV, and minimum dose 30 Gy in 5 fractions to the PTV. CTV margin was 1 cm and PTV margin 3 mm. For PTV cavities larger than 100cc, dose was reduced to 35Gy in 5 fractions to the CTV and 30 Gy in 5 fractions to the PTV. Primary endpoint of the study is to determine the 3-year patient global cosmesis score (4-point scale excellent, good, fair, or poor) and adverse cosmesis using a dose escalated approach with smaller PTV margins than conventional methods. Both patients and physicians completed baseline and subsequent cosmesis outcome questionnaires. Treatment related toxicity was graded using the NCI version 4.0 and RTOG/EORTC late radiation scale. RESULTS From 3/2019-10/2021, 74 patients were treated respectively. Of these, 38 were treated to 40Gy and 36 were treated to 35 Gy. Median follow up (f/u) was 24 months (mo), range (r) 3-39mo. Median age was 63 years (r 43-77). Histology included 28 DCIS, and 46 invasive carcinomas. 45/46 invasive tumors were ER+. 60/74 (81%) patients received endocrine therapy, and 7/74 patient received chemotherapy. There were 221 acute grade 1 toxicities, and 28 Grade 2 toxicities. No grade 3 or higher acute toxicities were reported (< 90 days). The most common Grade 2 toxicities were radiation dermatitis (10), breast pain (8), blister (4), skin infection (2), nipple discharge (2), and fatigue (2). In the late period, there were 54 Grade 1 late toxicities, 4 Grade 2 late toxicities, and no Grade 3 or higher late toxicities. Grade 2 toxicities included fibrosis (2), and pain (2). Two patients developed grade 1 asymptomatic nonpalpable fat necrosis both diagnosed at 12 months after radiation treatments. The most common grade 1 late toxicities were breast pain (14), hyperpigmentation (8), fibrosis (10), and fatigue (5). Physicians scored cosmesis excellent or good 70/73 (95.8%), 58/60 (96.7%), 36/36 (100%),17/17(100%) respectively at baseline, 12 months, 24 months, and 36months post SBRT, while patients scored the same periods 62/71 (83.7%), 53/59 (89.8%), 33/36 (91.6%), 17/18 (94.4%). There have been no reports of disease recurrences. CONCLUSION Results at 24-month median follow-up, of our dose escalated stereotactic partial breast 5 fraction regimen, has low acute and late toxicity, while maintaining high proportion of excellent/good cosmetic outcomes. Continued analysis of all cohorts is in progress. CLINICAL TRIALS gov identifier is NCT03581136.
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Affiliation(s)
- A S Rahimi
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX
| | - N Kim
- Vanderbilt University Department of Radiation Oncology, Nashville, TN
| | - M Leitch
- Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX
| | - X Gu
- Stanford University Department of Radiation Oncology, Palo Alto, CA
| | - D D M Parsons
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX
| | - C R Nwachukwu
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX
| | - P G Alluri
- University of Texas Southwestern Department of Radiation Oncology, Dallas, TX
| | - W Lu
- University of Texas Southwestern Department of Radiation Oncology, Dallas, TX
| | - E M Nichols
- University of Maryland School of Medicine, Baltimore, MD
| | - S J Becker
- University of Maryland School of Medicine, Baltimore, MD
| | - C Ahn
- Department of Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas, TX
| | - Y Zhang
- University of Texas Southwestern Department of Radiation Oncology, Dallas, TX
| | - A Spangler
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX
| | - D Farr
- Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX
| | - R Wooldridge
- Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX
| | - S Bahrami
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX
| | - S Stojadinovic
- University of Texas Southwestern Medical Center, Dallas, TX
| | - M Lieberman
- University of Texas Southwestern Medical Center, Dallas, TX
| | - S Neufeld
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX
| | - R D Timmerman
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX
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Fu J, Jiang H, Melemenidis S, Viswanathan V, Dutt S, Lau B, Soto LA, Manjappa R, Skinner L, Yu SJ, Surucu M, Graves EE, Casey K, Rankin E, Lu W, Loo BW, Gu X. Deep Learning-Based Pipeline for Automatic Identification of Intestinal Regenerating Crypts in Mouse Histological Images. Int J Radiat Oncol Biol Phys 2023; 117:S117-S118. [PMID: 37784305 DOI: 10.1016/j.ijrobp.2023.06.451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) A classical approach for evaluating normal tissue radiation response is to count the number of intestinal regenerating crypts in mouse histological images acquired after abdominal radiation. However, manual counting is time-consuming and subject to inter-observer variations. The goal of this study is to build a deep learning-based pipeline for automatically identifying intestinal regenerating crypts to facilitate high-throughput studies. MATERIALS/METHODS Sixty-six healthy C57BL/6 female mice underwent 16 MeV whole abdominal electron irradiation. The small bowel was collected from each mouse 4 days post-irradiation, and 9 jejunal cross-sections from each were processed together in a single slide. The slides were stained with hematoxylin and eosin (H&E) and subsequently scanned (x20), providing one electronic histological image per mouse. Regenerating crypts, consisting of more than 10 basophilic crypt epithelial cells, were manually identified using point annotations in histological images. The pipeline was built to take the input of the image containing 9 cross sections and automatically identify the regenerating crypts on each cross section. It mainly consists of two components, cross section segmentation using intensity thresholding and morphological operations and crypt identification using a UNet. The dataset was randomly split into 46, 10, and 10 slide images for UNet training, validation, and testing. Each slide image was split into grid tiles with a voxel size of 200 × 200, and 40 × 40 square masks were placed with centers at manual point annotations on tiles with regenerating crypts. 5203/5198 tiles (w/wo crypt mask) were extracted to train UNet by minimizing dice loss. The mask probability map generated by the UNet was post-processed to identify the crypt position. Postprocessing hyperparameters were tuned using the validation dataset. The model accuracy was evaluated using the testing dataset by computing the mean absolute error (MAE) of the crypt number averaged across all cross sections. RESULTS The number of regenerating crypts on testing cross sections ranges from 1 to 63. The testing cross-section-wise MAE achieved by the platform is 3.5±4.8 crypts. 81.25% of testing cross sections have absolute number differences less than or equal to 5 crypts. CONCLUSION Our established deep learning-based pipeline can accurately count the number of regenerating crypts in mouse intestinal histological images. We have integrated it into an online platform that enables automatic crypt identification and allows users to interactively modify auto-identified crypt annotations. The acquired annotations from the platform will be used to finetune the deep learning model to achieve better identification performance.
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Affiliation(s)
- J Fu
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | | | - S Melemenidis
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - V Viswanathan
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - S Dutt
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - B Lau
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - L A Soto
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - R Manjappa
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - L Skinner
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - S J Yu
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - M Surucu
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - E E Graves
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - K Casey
- Department of Comparative Medicine, Stanford University School of Medicine, Stanford, CA
| | - E Rankin
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - W Lu
- University of Texas Southwestern Department of Radiation Oncology, Dallas, TX
| | - B W Loo
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - X Gu
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
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22
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Yang Z, Fu J, Melemenidis S, Viswanathan V, Dutt S, Lau B, Soto LA, Manjappa R, Skinner L, Yu SJ, Surucu M, Casey K, Rankin E, Lu W, Jr BWL, Gu X. Equivalent Dose Estimation in FLASH Irradiation with a Deep Learning Approach. Int J Radiat Oncol Biol Phys 2023; 117:e272. [PMID: 37785029 DOI: 10.1016/j.ijrobp.2023.06.1241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Ultra-high dose rate (FLASH) irradiation has been reported to provide decreased normal tissue toxicity without compromising tumor control compared with conventional (CONV) irradiation. However, a comprehensive understanding of the FLASH biological effect requires precise quantification of radiobiology. The study is to explore whether deep learning (DL) can tackle the task. As a proof of concept, we investigate a DL model for estimating FLASH dose to its equivalent CONV dose. MATERIALS/METHODS Healthy C57Bl/6 female mice underwent FLASH (200Gy/s; n = 43) or CONV (0.12Gy/s; n = 41) whole abdominal irradiation using ∼16 MeV electron beams with a dose escalation scheme of 5 groups (n = 8 or 9) at 1Gy increments: 12-16Gy FLASH, 11-15Gy CONV. 4 days post-irradiation, 9 jejunum cross-sections per mouse were H&E stained for histological analysis. Each cross-section image was processed to remove lumen background and oversampled into multiple large-scale and small-scale patches along jejunal circumference. In CONV dataset, we randomly selected the data of 32 mice (80%) for model training and the rest (20%) for model validation. A ResNet101-based DL model, pre-trained with an unsupervised contrastive learning scheme, was retrained with only CONV training set to estimate corresponding CONV dose. For comparison, a crypt counting (CC) approach was implemented by manually counting the number of regenerating crypts on each cross-section image. An exponential function of dose vs crypt number was fitted with the CONV training set and used for dose estimation on the testing set. Mean squared error (MSE) was used to assess the accuracy of DL and CC approaches in estimating dose levels in CONV irradiation. The validated DL model was applied to the FLASH set to project FLASH dose into corresponding CONV dose that results in equivalent biological response. RESULTS The CONV dose estimated by DL and CC approaches and DL-estimated FLASH equivalent dose were summarized in Table 1. The DL model achieved an MSE of 0.21 Gy2 on CONV testing set compared with 0.32 Gy2 of the CC approach. FLASH equivalent dose estimated by DL model for 12, 13, 14, 15 and 16Gy were 12.16±0.40, 12.53±0.32, 12.72±0.24, 12.85±0.20 and 13.04±0.27 Sv, respectively. CONCLUSION Our proposed DL model can accurately estimate the CONV dose based on histological images. The DL predictions of FLASH dataset demonstrate that FLASH may reduce normal tissue toxicity with a lower equivalent dose, especially at high irradiated dose levels. Our study indicates that deep learning can be potentially used to assess the equivalent dose of FLASH irradiation to normal tissue.
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Affiliation(s)
- Z Yang
- Department of Radiation Oncology, The University of Texas Southwestern Medical Center, Dallas, TX
| | - J Fu
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - S Melemenidis
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - V Viswanathan
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - S Dutt
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - B Lau
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - L A Soto
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - R Manjappa
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - L Skinner
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - S J Yu
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - M Surucu
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - K Casey
- Department of Comparative Medicine, Stanford University School of Medicine, Stanford, CA
| | - E Rankin
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - W Lu
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX
| | - B W Loo Jr
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - X Gu
- Department of Radiation Oncology, The University of Texas Southwestern Medical Center, Dallas, TX; Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
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Kwon YS, Parsons DDM, Kim N, Lu W, Gu X, Stojadinovic S, Alluri PG, Arbab M, Lin MH, Chen L, Gonzalez Y, Chiu TD, Zhang Y, Timmerman RD, Rahimi AS. Assessment of Cardiac Radiation Dose in the Co-60 Prone Based Stereotactic Partial Breast Irradiation (CP-sPBI) Using the Distance from the Heart to the Planning Treatment Volume as a Surrogate Marker. Int J Radiat Oncol Biol Phys 2023; 117:e682. [PMID: 37786008 DOI: 10.1016/j.ijrobp.2023.06.2144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Irradiation of the breast has shown to provide sharp dose gradients using Co-60 prone based stereotactic partial breast irradiation (CP-sPBI), a contemporary device for stereotactic radiotherapy for breast cancer (BC) for accelerated partial breast irradiation (APBI). In addition, the precise setup of CP-sPBI permits a small planning treatment volume (PTV) margin of 3 mm creating a greater distance from PTV to organs at risk. However, to date the factors that influence dose gradients and subsequent cardiac doses of ionizing radiation using CP-sPBI have not been well-studied. Here we evaluate distance of the heart to the lumpectomy PTV cavity and how this effects cardiac dose. MATERIALS/METHODS A retrospective database of 113 consecutive patients treated by CP-sPBI for APBI from March 2019 to February 2023 who were treated with 30 Gy in 5 fractions were queried for analysis. The minimum distance from the heart to the PTV (hP) was measured in either the axial or sagittal view. A group of 28 patient cases were randomly selected to achieve an even distribution of 28 cases with hP < 2.75 cm and hP ≥ 2.75 cm to compare cardiac toxicities based on hP. Descriptive analyses were performed to evaluate various cardiac dosimetric parameters based on laterality of BC and hP, using the student's t test. RESULTS The mean (range) hP was 4.58 cm (0.80-12.23) for all cases. The subgroup analyses of 28 patient cases with cardiac parameters showed the heart mean (range) dose of 1.20 Gy (0.01-2.11). The mean and max heart dose to the left-sided BC were similar to those to the right-sided BC (mean dose: 1.20 vs. 1.19 Gy; P = 0.97 and max dose: 10.47 vs. 5.66 Gy; P = 0.06). An inverse correlation between hP and mean heart dose was shown with the correlation coefficient of -0.81. Using a cutoff of 2.75 cm hP, the differences between hP < 2.75 and hP ≥ 2.75 cm for all cardiac dosimetric evaluations were all statistically significant, including mean (1.67 vs. 0.79 Gy; p<0.01) and maximal heart dose (14.48 vs. 4.11 Gy; p<0.01) CONCLUSION: CP-sPBI treatment delivery system was able to achieve acceptable clinically relevant heart dosimetric parameters when delivering 5 fraction APBI with a mean heart dose of 1.20 Gy for all locations of PTV cavity volume in the breast. Due to CP-sPBIs excellent dose fall-off characteristics, APBI using CP-SPBI showed clinically acceptable cardiac dosimetric parameters, particularly for PTVs located > 2.75 cm from the heart.
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Affiliation(s)
- Y S Kwon
- University of Texas Southwestern Department of Radiation Oncology, Dallas, TX
| | - D D M Parsons
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX
| | - N Kim
- Vanderbilt University Department of Radiation Oncology, Nashville, TN
| | - W Lu
- University of Texas Southwestern Department of Radiation Oncology, Dallas, TX
| | - X Gu
- Stanford University Department of Radiation Oncology, Palo Alto, CA
| | - S Stojadinovic
- University of Texas Southwestern Department of Radiation Oncology, Dallas, TX
| | - P G Alluri
- University of Texas Southwestern Department of Radiation Oncology, Dallas, TX
| | - M Arbab
- University of Texas Southwestern Department of Radiation Oncology, Dallas, TX
| | - M H Lin
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX
| | - L Chen
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX
| | - Y Gonzalez
- University of Texas Southwestern Department of Radiation Oncology, Dallas, TX
| | - T D Chiu
- University of Texas Southwestern Department of Radiation Oncology, Dallas, TX
| | - Y Zhang
- University of Texas Southwestern Department of Radiation Oncology, Dallas, TX
| | - R D Timmerman
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX
| | - A S Rahimi
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX
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24
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Simmons A, Sher DJ, Kim N, Leitch M, Haas JA, Gu X, Ahn C, Gao A, Spangler A, Morgan HE, Farr D, Wooldridge R, Seiler S, Goudreau S, Bahrami S, Neufeld S, Mendez C, Lieberman M, Timmerman RD, Rahimi AS. Financial Toxicity and Patient Experience Outcomes on a Multi-Institutional Phase I Single Fraction Stereotactic Partial Breast Irradiation Protocol for Early-Stage Breast Cancer. Int J Radiat Oncol Biol Phys 2023; 117:e259-e260. [PMID: 37784994 DOI: 10.1016/j.ijrobp.2023.06.1212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Given the demonstrated financial toxicity (FT) of radiation treatment on breast cancer patients shown in both conventional and our recent 5 fraction stereotactic APBI (S-PBI) study, we assessed the FT, as well as patient-reported utility, quality-of-life and patient experience measures, on patients treated in our phase I single fraction S-PBI trial. MATERIALS/METHODS A phase I single fraction dose escalation trial of S-PBI for early-stage breast cancer was conducted. Women with in-situ or stage I-II (AJCC 6) invasive breast cancer following breast conserving surgery were treated with S-PBI in 1 fraction to a total dose of 22.5, 26.5 or 30 Gy (Clinical trials.gov ID NCT02685332). At one month follow-up, patients were asked to complete our novel "Patient Perspective Cost and Convenience of Care Questionnaire". Patients also completed the EQ-5D-5L, including the visual analogue scale of overall health (VAS), at enrollment, 6, 12-, 24-, 36-, and 48-month follow-up. RESULTS Of 29 patients enrolled and treated, questionnaire data was available for all patients. Our trial encompassed a wide range of annual household incomes, education, and employment status. Overall, 44.8% (n = 13/29) of patients reported that radiation treatment presented a financial burden. Interestingly, no demographic information, such as patient race, marital status, education, household income, or employment during treatment predicted perceived FT. Patients reporting FT trended towards younger age (median 64 vs 70.5) and having a cancer related co-pay similar to our 5 fraction S-PBI FT trial; however, due to the small size of this study, this did not reach significance (p = 0.24 and 0.10, respectively). VAS and utility scores were calculated per the EQ-5D-5L and remained unchanged from baseline through 4-year follow-up. Likewise, there was no difference in the utility or VAS between patients who reported FT and those who did not. Interestingly, while patient reported cosmesis was similar for all patients at enrollment, patients who reported FT noted significantly worse cosmesis scores (fair/poor vs good/excellent) at 6 month and 2-year follow-ups (p = 0.01 and 0.04, respectively). Finally, patients were surveyed on treatment related disruption to their daily activities and enjoyment of life. The median values were 0 (scale 0-10, with 0 being no disruption) regardless of perceived FT. Patients were also uniformly satisfied with treatment time with a median score of 10 (scale 0-10, 10 being most satisfied). CONCLUSION Here, we show that despite using SPBI in a single fraction, nearly half of the patients treated still reported FT of treatment. Importantly, single fraction S-PBI has no negative impact on patient VAS or utility scores, and all patients were uniformly satisfied with treatment time without significant disruption to their life.
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Affiliation(s)
- A Simmons
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX
| | - D J Sher
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX
| | - N Kim
- Vanderbilt University Department of Radiation Oncology, Nashville, TN
| | - M Leitch
- Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX
| | - J A Haas
- Department of Radiation Oncology, Perlmutter Cancer Center at New York University Langone Hospital - Long Island, Mineola, NY
| | - X Gu
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - C Ahn
- Department of Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas, TX
| | - A Gao
- Department of Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas, TX
| | - A Spangler
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX
| | | | - D Farr
- Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX
| | - R Wooldridge
- Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX
| | - S Seiler
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX
| | - S Goudreau
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX
| | - S Bahrami
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX
| | - S Neufeld
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX
| | - C Mendez
- Department of Radiation Oncology, Perlmutter Cancer Center at New York University Langone Hospital - Long Island, Mineola, NY
| | - M Lieberman
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX
| | - R D Timmerman
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX
| | - A S Rahimi
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX
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Yang Z, Chen M, Kazemimoghadam M, Wardak Z, Chukwuma C, Stojadinovic S, Timmerman RD, Dan T, Lu W, Gu X. Predicting Neurocognitive Decline in Multiple Brain Metastases Patients Undergoing Distributed Stereotactic Radiosurgery. Int J Radiat Oncol Biol Phys 2023; 117:e159. [PMID: 37784751 DOI: 10.1016/j.ijrobp.2023.06.987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Stereotactic radiosurgery (SRS) is the standard of care for treating a limited number (<3) of brain metastasis (BMs), which offers reduced neurotoxicity compared to whole brain radiotherapy (WBRT). Contemporary advancements in SRS made it possible to also commonly treat multiple (>4) BMs (mBMs). Emphasizing the value of preserving quality of life (QoL) after SRS, there is an urgent need for a systematic study of potential neurocognitive decline in patients receiving SRS treatment for mBMs. The purpose of this study is to use routine MRIs to predict neurocognitive decline for patients treated with distributed SRS, allowing for timely and effective treatment strategy design. MATERIALS/METHODS This study uses data from an institutional phase I/II clinical trial to determine the neurocognitive decline in patients with (>6) mBMs treated with distributed SRS. In the first 12 months post-SRS, participants are followed and evaluated with routine MRIs and the Hopkins Verbal Learning Test-Revised (HVLT-R) at 2 to 3-month intervals. Changes in HVLT-Delayed Recall scores between two visits are used to define neurocognitive decline. For each visit, an in-house deep learning model segments 66 cortical and 55 subcortical brain regions of interest (ROIs) from the T1 structural MRI and extracts 253 ROI features, including the surface area and thickness of cortical ROIs, and the volume of all ROIS. The difference in ROI features between two visits, together with other clinical factors (e.g., prescription, number of BMs, etc.), is considered as one sample. The study included 22 subjects with 91 visits, resulting in 171 samples with neurocognitive decline labels. The entire sample set is split into 10 folds on patient level for cross validation. In each fold, feature engineering is conducted to remove redundancy and to select the most-important features. The top 20% most frequently selected features are applied with Support Vector Machine to predict the neurocognitive decline label of each sample. RESULTS As a preliminary result, the proposed method achieves an accuracy of 76%, with an area under the curve (AUC) of 0.75, sensitivity of 0.65 and specificity of 0.83 for predicting neurocognitive decline in mBMs SRS patients using only routine T1 MRIs. The volume of lateral occipital complex, the thickness of inferior parietal lobe and postcentral gyrus, and the surface area of lateral orbitofrontal cortex and pars triangularis are identified as the 5 most important features for this task. CONCLUSION Our method shows promising findings for post-SRS neurocognitive decline prediction solely based on routine baseline and follow-up MRIs. In addition, it can identify critical brain ROIs associated with the post-SRS cognitive function. This method has the potential to assist treatment planning strategy to help preserve patients' QoL.
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Affiliation(s)
- Z Yang
- Department of Radiation Oncology, The University of Texas Southwestern Medical Center, Dallas, TX
| | - M Chen
- Department of Radiation Oncology, The University of Texas Southwestern Medical Center, Dallas, TX
| | - M Kazemimoghadam
- Department of Radiation Oncology, The University of Texas Southwestern Medical Center, Dallas, TX
| | - Z Wardak
- Department of Radiation Oncology, The University of Texas Southwestern Medical Center, Dallas, TX
| | - C Chukwuma
- Department of Radiation Oncology, The University of Texas Southwestern Medical Center, Dallas, TX
| | - S Stojadinovic
- Department of Radiation Oncology, The University of Texas Southwestern Medical Center, Dallas, TX
| | - R D Timmerman
- Department of Radiation Oncology, The University of Texas Southwestern Medical Center, Dallas, TX
| | - T Dan
- Department of Radiation Oncology, The University of Texas Southwestern Medical Center, Dallas, TX
| | - W Lu
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX
| | - X Gu
- Department of Radiation Oncology, The University of Texas Southwestern Medical Center, Dallas, TX; Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
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Kazemimoghadam M, Yang Z, Chen M, Rahimi AS, Kim DN, Alluri PG, Nwachukwu CR, Lu W, Gu X. A Comprehensive Deep Learning Framework for Automatic Target Volumes Segmentation in Post-Operative Stereotactic Partial Breast Irradiation (S-PBI). Int J Radiat Oncol Biol Phys 2023; 117:e183. [PMID: 37784808 DOI: 10.1016/j.ijrobp.2023.06.1038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) In S-PBI, accurate delineation of post-surgical tumor bed volume (TBV) and clinical target volume (CTV) are crucial tasks to achieve effective radiotherapy outcomes. However, manual contouring is labor intensive, time consuming, and largely relies on the experience of clinicians. We aimed to propose a deep learning (DL) approach which mimics physicians' contouring practice to accurately segment target volumes in post-operative breast CT images. MATERIALS/METHODS Our approach incorporated domain knowledge into a 3D U-Net based DL model for breast target volumes (TBV and CTV) delineation. Our TBV segmentation approach was inspired by the marker-guidance procedure in manual delineation, where the visual clues provided by the markers assist physicians in defining TBV. For this purpose, a distance-transformation coupled with a Gaussian filter was adopted to convert markers' locations on the CT images to saliency maps. Subsequently, the CT images and the corresponding saliency maps formed a two-channel input for the segmentation model. For CTV segmentation, TBV was incorporated as an input in addition to the CT images, guiding the model to encode the location-related image features. The architecture allowed the network to emulate the oncologist's manual delineation where CTV is derived from TBV via a margin expansion, followed by correcting the extensions for anatomical barriers of tumor invasion (e.g., skin, chest wall). We retrospectively collected 175 prone CT images from 35 post-operative breast cancer patients who received 5-fraction partial breast irradiation (PBI) regimen on a Co-60 prone based S-PBI unit. The 35 patients were randomly split into 25, 5, and 5 for model training, validation, and testing respectively. RESULTS We evaluated the performance of the developed DL model on the testing dataset by comparing the predicted volumes with the manually delineated contours (ground truth) using Dice similarity coefficient (DSC), 95th percentile Hausdorff distance (HD95), and average symmetric surface distance (ASD). For TBV segmentation, our model achieved mean (standard deviation) of 0.76 (±2.7), 6.76 (±1.83) mm, and 1.9 (±0.66) mm for DSC, HD95, and ASD respectively. For CTV segmentation, our model achieved 0.94 (±0.02), 2.46 (±0.5) mm, and 0.53 (±0.14) mm for DSC, HD95, and ASD respectively. The proposed auto-segmentation approach generated TBV and CTV masks in ∼11 seconds per CT volume, implying significantly improved efficiency compared to manual contouring. CONCLUSION We developed a comprehensive DL framework mimicking clinical contouring practice for auto-segmentation of target volumes in S-PBI. The results demonstrated high levels of agreement between the predicted contours and physicians' manual contours. The approach is promising for improving the efficiency and accuracy of the on-line treatment planning workflow, such as adaptive based S-PBI.
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Affiliation(s)
- M Kazemimoghadam
- Department of Radiation Oncology, The University of Texas Southwestern Medical Center, Dallas, TX
| | - Z Yang
- Department of Radiation Oncology, The University of Texas Southwestern Medical Center, Dallas, TX
| | - M Chen
- Department of Radiation Oncology, The University of Texas Southwestern Medical Center, Dallas, TX
| | - A S Rahimi
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX
| | - D N Kim
- Department of Radiation Oncology, The University of Texas Southwestern Medical Center, Dallas, TX
| | - P G Alluri
- University of Texas Southwestern Department of Radiation Oncology, Dallas, TX
| | - C R Nwachukwu
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX
| | - W Lu
- University of Texas Southwestern Department of Radiation Oncology, Dallas, TX
| | - X Gu
- Stanford University Department of Radiation Oncology, Palo Alto, CA
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Wang JY, Chen Y, Pham D, Lewis J, Beadle BM, Gensheimer MF, Le QT, Gu X, Xing L. Prospective Clinical Adoption of Artificial Intelligence for Organ Contouring in Head and Neck Radiation Treatment Planning. Int J Radiat Oncol Biol Phys 2023; 117:e490-e491. [PMID: 37785549 DOI: 10.1016/j.ijrobp.2023.06.1721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Patients that undergo head and neck (H&N) radiation therapy (RT) require laborious delineation of organs-at-risk (OARs) on computed tomography (CT) scans in a treatment planning system (TPS) to minimize radiation to normal tissue. This task can be completed rapidly and accurately with recently developed artificial intelligence-based semantic segmentation models. The current study aims to deploy and evaluate a strategy for improving clinical practice with this technology. MATERIALS/METHODS Deep learning models were trained and tested with CT scans and OAR contours from previous H&N RT cases at our clinic. Two medical physicists vetted the models and selected a 2.5D U-Net for further implementation. The model was embedded in a dedicated server at the hospital, programmed to read H&N CT scans staged for import into the TPS, generate auto-contours, and write them into a TPS-compatible format made available alongside the scan. In the pilot implementation, the auto-contouring service was utilized for more than 60 cases, prospectively. The auto-contours were quantitatively evaluated against the treatment-approved contours to determine how much modification was performed by the clinical team. RESULTS The 2.5D U-Net selected for clinical integration segments 21 OARs in less than 3 minutes per scan. Across all the prospective cases, the mean Dice score and mean 95th percentile Hausdorff distance (mm) between the auto-contour and treatment-approved contour for each of the 21 OARs were as follows, respectively: brainstem (0.93, 1.94), optic chiasm (0.70, 2.96), left cochlea (0.69, 2.37), right cochlea (0.68, 2.44), esophagus (0.88, 2.46), left globe (0.93, 1.50), right globe (0.93, 1.63), glottis (0.91, 2.13), larynx (0.93, 2.76), mandible (0.90, 4.86), left optic nerve (0.78, 1.64), right optic nerve (0.82, 1.65), oral cavity (0.86, 8.46), left parotid gland (0.91, 2.78), right parotid gland (0.91, 2.39), pharynx (0.85, 2.39), spinal cord (0.87, 2.27), left submandibular gland (0.85, 3.46), right submandibular gland (0.83, 3.69), left temporal lobe (0.94, 2.20), and right temporal lobe (0.95, 2.09). The auto-contours for the optic chiasm, optic nerves, cochleas, and submandibular glands differed substantially from the final contours, a finding corroborated by the clinical team; the rest were clinically acceptable with minor or no edits necessary. CONCLUSION The proposed strategy provides a sophisticated starting point for treatment planning that has garnered overall favorable feedback from the participating radiation oncologists and dosimetrists. Consequently, the technique is being extended to other treatment sites.
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Affiliation(s)
- J Y Wang
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - Y Chen
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - D Pham
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - J Lewis
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - B M Beadle
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - M F Gensheimer
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - Q T Le
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - X Gu
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - L Xing
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
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Zhu P, Qian M, Lee A, Hayter M, Wang W, Shi G, Wu Q, Ji Q, Gu X, Zhang H, Ding Y. Trajectory analysis of the work and life experience of healthcare workers during the COVID-19 pandemic: a longitudinal qualitative study. BMC Nurs 2023; 22:333. [PMID: 37759182 PMCID: PMC10523727 DOI: 10.1186/s12912-023-01520-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Accepted: 09/19/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has posed a global health threat and has had a profoundly negative impact on the work and lives of healthcare workers. However, few people know how their experiences have evolved over time. AIMS To describe healthcare workers' experiences during clinical responses to COVID-19 and how they changed over time. DESIGN A longitudinal qualitative study. METHODS We undertook a series of four semi-structured qualitative interviews of 14 healthcare workers called as 1st responders to the COVID-19 pandemic. Participants were recruited through purposive snowball sampling. Interviews were undertaken between May 2020 and May 2022 and trajectory approach was used to reveal individual experiences over time. This paper follows the COREQ (Consolidated criteria for Reporting Qualitative Research) guidance. RESULTS Data analysis yielded the following four themes: (1) Changes in emotions; (2) Changes in organization and management of care; (3) Changes in knowledge and capabilities; and (4) Changes in outlook on life and career. CONCLUSION Healthcare workers have become stronger in the pandemic and have demonstrated a high degree of professional loyalty and responsibility. However, there is a need to focus on the issue of jealousy and create a harmonious and safe work environment to reduce harm to healthcare workers. Additionally, human resource management strategies must support well-being of healthcare workers and maximize the efficiency of human resource utilization to enable them to respond to current and future needs and emergencies.
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Affiliation(s)
- Pingting Zhu
- School of Nursing, School of Public Health, Yangzhou University, Yangzhou, China.
- Jiangsu Key Laboratory of Zoonosis, Yangzhou, China.
| | - Meiyan Qian
- School of Nursing, School of Public Health, Yangzhou University, Yangzhou, China
| | - Amanda Lee
- Manchester Metropolitan University, Manchester, England
| | - Mark Hayter
- Manchester Metropolitan University, Manchester, England.
| | - Wen Wang
- School of Nursing, School of Public Health, Yangzhou University, Yangzhou, China
| | - Guanghui Shi
- School of Nursing, School of Public Health, Yangzhou University, Yangzhou, China
| | - Qiwei Wu
- School of Nursing, School of Public Health, Yangzhou University, Yangzhou, China
| | - Qiaoying Ji
- School of Nursing, School of Public Health, Yangzhou University, Yangzhou, China
| | - Xinyue Gu
- School of Nursing, School of Public Health, Yangzhou University, Yangzhou, China
| | - Hui Zhang
- School of Nursing, School of Public Health, Yangzhou University, Yangzhou, China
| | - Yinwen Ding
- School of Nursing, School of Public Health, Yangzhou University, Yangzhou, China
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29
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Liu L, Cheng M, Yang L, Gu X, Jin J, Fu M. Regulation of straw decomposition and its effect on soil function by the amount of returned straw in a cool zone rice crop system. Sci Rep 2023; 13:15673. [PMID: 37735486 PMCID: PMC10514278 DOI: 10.1038/s41598-023-42650-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 09/13/2023] [Indexed: 09/23/2023] Open
Abstract
The degradation process of returned straw in rice fields can improve soil organic matter and promote sustainable agriculture. The degradation process of returned straw is a humification process as well as a mineralization process involving microorganisms and enzymes. However, the degradation process of returned straw, the effect on straw decomposing microorganisms and the regulatory mechanism on potential functionality under cool climate flooding conditions are currently unknown.For this purpose, we investigated the biodegradation of straw from a biodegradation point of view at 20, 40, 71, 104, and 137 d after return under conventional (130 kg hm-2), 1/3 straw return (2933 kg hm-2), 2/3 straw return (5866 kg hm-2), and full straw return (8800 kg hm-2) applications in cool climate rice fields.. The test found Paludibacteraceae and Archaeaceae were the dominant bacteria for straw degradation, and their relative abundance was highest when 2/3 of straw was returned to the field. The straw degradation extracellular enzyme activity was higher in the late return period (104 d). At this time, the potential functionality of the soil differed significantly among the different return amounts, with the best extracellular enzyme activity and potential functionality at the 2/3 straw return amount. Therefore, the optimal amount of rice straw returned to the field is 5866 kg hm-2 at the current conventional N application rate (130 kg hm-2) in the cold zone.
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Affiliation(s)
- Lin Liu
- School of Agriculture, Yanbian University, Yanji, 133002, China
- College of Resources and Environment, China Agricultural University, Beijing, 100193, China
| | - Ming Cheng
- School of Agriculture, Yanbian University, Yanji, 133002, China
| | - Lei Yang
- School of Agriculture, Yanbian University, Yanji, 133002, China
| | - Xinyue Gu
- School of Agriculture, Yanbian University, Yanji, 133002, China
| | - Jingyi Jin
- Research Center of Chemical Biology, Yanbian University, Yanji, 133002, China
| | - Minjie Fu
- School of Agriculture, Yanbian University, Yanji, 133002, China.
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Zhu P, Zhang H, Wang W, Gu X, Ding Y, Qian M, Shi G. The challenges of returning to work for differentiated thyroid cancer survivors in china: a qualitative study. Support Care Cancer 2023; 31:582. [PMID: 37728637 DOI: 10.1007/s00520-023-08049-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 09/11/2023] [Indexed: 09/21/2023]
Abstract
PURPOSE Although thyroid cancer survivors have a good prognosis and the survival rate of differentiated thyroid cancer is close to 100%, treatment and its side effects seriously affect the quality of life of patients, especially rehabilitation at work. The purpose of this study was to explore the challenges faced by differentiated thyroid cancer survivors in returning to work and maintaining employment. METHODS A purposive sample of differentiated thyroid cancer patients who had undergone surgical treatment and were followed up at the outpatient departments of thyroid surgery wards of two tertiary care hospitals in Jiangsu Province, China, between January and March 2023, were subjected to semi-structured interviews. An inductive content analysis was conducted to identify themes. RESULTS A total of 27 participants, aged 23-56 years, were interviewed. Three themes and eight subthemes were identified: pressure perception including social pressure in the workplace, regular appointments conflict with work schedules, and dilemma of career development; the challenges of self-adjustment including physical disorder, unable to adapt to the pace of work, and unstable mood affects working condition; and lack of social support including lack of access to information or support groups, lack of sympathy and understanding from employers, and lack of professional support. CONCLUSIONS Our study identified that our participants with differentiated thyroid cancer patients face challenges in trying to return to work or maintain employment within the confines of their disease. Multilevel interventions, ranging from employer and co-worker understanding to information, psychological and other support from health care professionals, can facilitate the process of returning to work and help patients reconcile illness and work.
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Affiliation(s)
- Pingting Zhu
- School of Nursing, Yangzhou University, Hanjiang County,136 Jiangyang Middle Road, Yangzhou, 225009, Jiangsu Province, China.
| | - Hui Zhang
- School of Nursing, Yangzhou University, Hanjiang County,136 Jiangyang Middle Road, Yangzhou, 225009, Jiangsu Province, China
| | - Wen Wang
- School of Nursing, Yangzhou University, Hanjiang County,136 Jiangyang Middle Road, Yangzhou, 225009, Jiangsu Province, China
| | - Xinyue Gu
- School of Nursing, Yangzhou University, Hanjiang County,136 Jiangyang Middle Road, Yangzhou, 225009, Jiangsu Province, China
| | - Yinwen Ding
- School of Nursing, Yangzhou University, Hanjiang County,136 Jiangyang Middle Road, Yangzhou, 225009, Jiangsu Province, China
| | - Meiyan Qian
- School of Nursing, Yangzhou University, Hanjiang County,136 Jiangyang Middle Road, Yangzhou, 225009, Jiangsu Province, China
| | - Guanghui Shi
- School of Nursing, Yangzhou University, Hanjiang County,136 Jiangyang Middle Road, Yangzhou, 225009, Jiangsu Province, China
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Shen L, Xing BL, Gu X, Zhang YY, Zhang X. [Primary salivary gland-type duct carcinoma of lung: report of a case]. Zhonghua Bing Li Xue Za Zhi 2023; 52:958-960. [PMID: 37670632 DOI: 10.3760/cma.j.cn112151-20230106-00009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 09/07/2023]
Affiliation(s)
- L Shen
- Department of Pathology, Shanghai Zhoupu Hospital Affiliated Health Medical College, Shanghai 201318, China
| | - B L Xing
- Department of Pathology, Shanghai Zhoupu Hospital Affiliated Health Medical College, Shanghai 201318, China
| | - X Gu
- Department of Pathology, Shanghai Zhoupu Hospital Affiliated Health Medical College, Shanghai 201318, China
| | - Y Y Zhang
- Department of Pathology, Shanghai Zhoupu Hospital Affiliated Health Medical College, Shanghai 201318, China
| | - X Zhang
- Department of Pathology, Shanghai Zhoupu Hospital Affiliated Health Medical College, Shanghai 201318, China
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Yuan J, Gu X, Yang J, Lin X, Hu J, Jiang S, Du L, Zhou W, Cao Y, Lee SK, Shan R, Zhang L. Impact of Maternal Diabetes Mellitus on Neonatal Outcomes among Infants <32 Weeks of Gestation in China: A Multicenter Cohort Study. Am J Perinatol 2023. [PMID: 37579765 DOI: 10.1055/s-0043-1771501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/16/2023]
Abstract
OBJECTIVE Our study aimed to determine the relationship between maternal diabetes mellitus (MDM) and mortality and major morbidities for very preterm infants, as well as the effects of insulin-treated MDM, in the Chinese population. STUDY DESIGN This retrospective cohort study included all preterm infants born at 240/7 to 316/7 weeks of gestation and admitted to 57 tertiary neonatal intensive care units participating in the Chinese Neonatal Network in 2019. All infants were followed up until discharging from the hospitals. RESULTS A total of 9,244 very preterm infants were enrolled, with 1,584 (17.1%) born to mothers with MDM. The rates of mortality or any major morbidity in the MDM and non-MDM groups were 45.9% (727/1,584) and 48.1% (3,682/7,660), respectively. After adjustment, the risk of mortality or any morbidity was not significantly increased in the MDM group (adjusted odds ratio [aOR], 1.07; 95% confidence interval [CI], 0.94-1.22) compared with the non-MDM group. Among MDM mothers with treatment data, 18.0% (256/1,420) were treated with insulin. Insulin-treated MDM was not independently associated with the risk of mortality or any morbidity (aOR, 1.01; 95% CI, 0.76-1.34) among very preterm infants, but it was associated with an elevated risk of severe retinopathy of prematurity (aOR, 2.39; 95% CI, 1.13-5.04). CONCLUSION While the MDM diagnostic rate for mothers of very preterm infants was high in China, MDM was not associated with mortality or major morbidities for very preterm infants. KEY POINTS · A total of 17% of very preterm infants in Chinese neonatal intensive care units were born to mothers with MDM.. · MDM was not related to mortality or major morbidities in very preterm infants.. · MDM treated by insulin was associated with severe retinopathy of prematurity..
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Affiliation(s)
- Jing Yuan
- Department of Neonatology, Qingdao Women and Children's Hospital, Qingdao, Shandong Province, China
| | - Xinyue Gu
- NHC Key Laboratory of Neonatal Diseases (Fudan University), Children's Hospital of Fudan University, Shanghai, China
| | - Jie Yang
- Department of Neonatology, Guangdong Women and Children's Hospital, Guangzhou, Guangdong Province, China
| | - Xinzhu Lin
- Department of Neonatology, Women and Children's Hospital, School of Medicine, Xiamen University, Xiamen, Fujian Province, China
| | - Jingfei Hu
- Department of Neonatology, Children's Hospital of Fudan University, Shanghai, China
| | - Siyuan Jiang
- NHC Key Laboratory of Neonatal Diseases (Fudan University), Children's Hospital of Fudan University, Shanghai, China
- Department of Neonatology, Children's Hospital of Fudan University, Shanghai, China
| | - Lizhong Du
- Department of Neonatology, Children's Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China
| | - Wenhao Zhou
- NHC Key Laboratory of Neonatal Diseases (Fudan University), Children's Hospital of Fudan University, Shanghai, China
- Department of Neonatology, Children's Hospital of Fudan University, Shanghai, China
| | - Yun Cao
- NHC Key Laboratory of Neonatal Diseases (Fudan University), Children's Hospital of Fudan University, Shanghai, China
- Department of Neonatology, Children's Hospital of Fudan University, Shanghai, China
| | - Shoo K Lee
- Department of Pediatrics, Mount Sinai Hospital, Toronto, Canada
- Department of Pediatrics, University of Toronto, Toronto, Canada
| | - Ruobing Shan
- Department of Neonatology, Qingdao Women and Children's Hospital, Qingdao, Shandong Province, China
| | - Lan Zhang
- NHC Key Laboratory of Neonatal Diseases (Fudan University), Children's Hospital of Fudan University, Shanghai, China
- Department of Neonatology, Children's Hospital of Fudan University, Shanghai, China
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Geng ZY, Chen NX, You W, Liu K, Gu X, Wei J, Ma L, Zhang XX. [Efficacy of non-surgical comprehensive treatment for locally advanced hypopharyngeal carcinoma with cervical esophagus invasion]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2023; 58:773-780. [PMID: 37599238 DOI: 10.3760/cma.j.cn115330-20221108-00670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 08/22/2023]
Abstract
Objective: To analyze the treatment effects and side effects of non-surgical comprehensive treatment for locally advanced hypopharyngeal carcinoma invading cervical esophagus. Methods: A retrospective analysis was performed on sixty-six patients with locally advanced hypopharyngeal carcinoma invade the esophagus. These patients were treated in the Department of Otolaryngology, Head and Neck Surgery of Chinese People's Liberation Army General Hospital between January 2011 and May 2022, including sixty-five males and one female, aged 43-71 years. Treatment regimen consisted of induction chemotherapy and concurrent chemoradiothrapy and epidermal growth factor receptor (EGFR)-targeted therapy, three of these cases were treated with programmed cell death 1 (PD-1) immunotherapy. The Kaplan-Meier method was used for survival analysis. Side effects were evaluated with the established CTCAE (Common Terminology Criteria for Adverse Events) 5.0 criteria. The factors affecting prognosis were analyzed by Cox multivariate regression analysis. Results: Sixty-four (97.0%, 64/66) patients completed the radiotherapy and chemotherapy plan. The most common grade three side effects were radioactive oropharyngeal mucositis (89.1%, 57/64) and leukopenia (23.4%, 15/64). Five (7.8%, 5/64) patients showed grade three hoarseness; two patients (3.1%, 2/64) suffered from grade three swallowing dysfunction and required feeding tube and intravenous nutrition; the remaining patients(89.1%) retained good vocal and swallowing functions. The overall survival (OS) of all patients was 81.5% after one year, 54.0% after three years, and 39.9% after five years; the progression-free survival (PFS) was 78.3% after one year, 54.9% after three years, and 42.6% after five years; local control rate (LCR) was 80.9% after one year, 62.5% after three years, and 52.0% after five years. T4a patients showed better OS, PFS and LCR than T4b patients, with statistically significant differences (χ2=8.10, 8.27, and 6.64, respectively, all P<0.05). Cox multivariate regression analysis showed that lymph node metastasis was an independent factor affecting prognosis (χ2=10.21, P<0.05). Conclusion: Non-surgical comprehensive treatment can provide with another option of radical treatment for locally advanced hypopharyngeal carcinoma with cervical esophagus invasion, offering the patients higher rate of larynx and esophageal preservation with tolerable side effects.
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Affiliation(s)
- Z Y Geng
- College of Otolaryngology Head and Neck Surgery, Chinese People's Liberation Army General Hospital, National Clinical Research Center for Otolaryngologic Diseases, Beijing 100853, China
| | - N X Chen
- College of Otolaryngology Head and Neck Surgery, Chinese People's Liberation Army General Hospital, National Clinical Research Center for Otolaryngologic Diseases, Beijing 100853, China
| | - W You
- College of Otolaryngology Head and Neck Surgery, Chinese People's Liberation Army General Hospital, National Clinical Research Center for Otolaryngologic Diseases, Beijing 100853, China
| | - K Liu
- College of Otolaryngology Head and Neck Surgery, Chinese People's Liberation Army General Hospital, National Clinical Research Center for Otolaryngologic Diseases, Beijing 100853, China
| | - X Gu
- College of Otolaryngology Head and Neck Surgery, Chinese People's Liberation Army General Hospital, National Clinical Research Center for Otolaryngologic Diseases, Beijing 100853, China
| | - J Wei
- College of Otolaryngology Head and Neck Surgery, Chinese People's Liberation Army General Hospital, National Clinical Research Center for Otolaryngologic Diseases, Beijing 100853, China
| | - L Ma
- Department of Radiology, the First Medical Center, Chinese People's Liberation Army General Hospital, Beijing 100853, China
| | - X X Zhang
- College of Otolaryngology Head and Neck Surgery, Chinese People's Liberation Army General Hospital, National Clinical Research Center for Otolaryngologic Diseases, Beijing 100853, China
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Wu Q, Zhu P, Ji Q, Shi G, Qian M, Xu H, Gu X, Wang W, Zhang Q. The effect of death education course utilizing constructivist learning theory on first grade undergraduate nursing student attitudes and coping abilities towards death: A mixed study design. Nurse Educ Today 2023; 126:105809. [PMID: 37058871 DOI: 10.1016/j.nedt.2023.105809] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 02/26/2023] [Accepted: 03/28/2023] [Indexed: 05/25/2023]
Abstract
Inadequate clinical preparation for palliative care is often reflected in inadequate education about death. Nursing students as nurses of the future, it is necessary to make them aware of death and overcome fear of it so that they can cope with their future careers and provide qualified and warmly care service. OBJECTIVES To determine the effect of death education course using constructivist learning theory on first grade undergraduate nursing student attitudes and coping abilities towards death. DESIGN This study was designed using a mixed-methods design. SETTING Two campuses of a university school of nursing in China. PARTICIPANTS First grade Bachelor of Nursing Science students (n = 191). METHODS Data collection includes questionnaires and reflective writing as after class task. Quantitative data were analyzed using descriptive statistics, the Wilcoxon Signed Rank test, and the Mann-Whitney U test. As for reflective writing, content analysis was hired to analysis. RESULTS The intervention group's attitude towards death tended to be neutral acceptance. The intervention group's ability to deal with death (Z = -5.354, p < 0.001) and expression of thoughts about death (Z = -3.89 b, p < 0.001) greater than that of the control group. Four themes (Awareness of death before class, Knowledge, The meaning of palliative care, New cognition) were identified from reflecting writing. CONCLUSION Compared with the conventional teaching, death education course utilizing constructivist learning theory was found to be a more effective method for developing students' death coping skills and reducing fear of death.
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Affiliation(s)
- Qiwei Wu
- School of Nursing, Yangzhou University, 136 Jiangyang Middle Road, Hanjing County, Yangzhou City 225009, Jiangsu Province, China
| | - Pingting Zhu
- School of Nursing, Yangzhou University, 136 Jiangyang Middle Road, Hanjing County, Yangzhou City 225009, Jiangsu Province, China; Jiangsu Key Laboratory of Zoonosis, 136 Jiangyang Middle Road, Hanjing County, Yangzhou City 225009, Jiangsu Province, China.
| | - Qiaoying Ji
- School of Nursing, Yangzhou University, 136 Jiangyang Middle Road, Hanjing County, Yangzhou City 225009, Jiangsu Province, China
| | - Guanghui Shi
- School of Nursing, Yangzhou University, 136 Jiangyang Middle Road, Hanjing County, Yangzhou City 225009, Jiangsu Province, China
| | - Meiyan Qian
- School of Nursing, Yangzhou University, 136 Jiangyang Middle Road, Hanjing County, Yangzhou City 225009, Jiangsu Province, China
| | - HuiWen Xu
- School of Nursing, Yangzhou University, 136 Jiangyang Middle Road, Hanjing County, Yangzhou City 225009, Jiangsu Province, China
| | - Xinyue Gu
- School of Nursing, Yangzhou University, 136 Jiangyang Middle Road, Hanjing County, Yangzhou City 225009, Jiangsu Province, China
| | - Wen Wang
- School of Nursing, Yangzhou University, 136 Jiangyang Middle Road, Hanjing County, Yangzhou City 225009, Jiangsu Province, China
| | - Qianqian Zhang
- School of Nursing, Yangzhou University, 136 Jiangyang Middle Road, Hanjing County, Yangzhou City 225009, Jiangsu Province, China
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Mo Y, Gu X, Li D, Dai W, Xu J, Lee SK, Zhou W, Cao Y, Wei Q, Jiang S. Use of narcotics and sedatives among very preterm infants in neonatal intensive care units in China: an observational cohort study. Transl Pediatr 2023; 12:1170-1180. [PMID: 37427065 PMCID: PMC10326749 DOI: 10.21037/tp-22-672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Accepted: 04/18/2023] [Indexed: 07/11/2023] Open
Abstract
Background Narcotics and sedatives are widely used in neonatal intensive care units for very preterm infants. This study aimed to describe the current use of narcotics and/or sedatives among very preterm infants in Chinese neonatal intensive care units, with an emphasis on infants on invasive mechanical ventilation, and to investigate the association of exposure to narcotics and/or sedatives with neonatal outcomes. Methods This was a retrospective observational cohort study that enrolled all infants born at 24+0-31+6 weeks and admitted to 57 tertiary neonatal intensive care units in the Chinese Neonatal Network in 2019. A multivariate logistic regression model was used to assess the association between narcotics and/or sedatives exposure and major neonatal outcomes. Results Among 9,442 very preterm infants enrolled, 1,566 (16.6%) received at least one dose of narcotics or sedatives, 111 (1.2%) received only narcotics, 1,301 (13.8%) received sedatives solely, and 154 (1.6%) received both narcotics and sedatives during their hospital stay. Of 4,172 very preterm infants who underwent invasive mechanical ventilation, 1,117 (26.8%) received at least one dose of narcotics or sedatives, with 883 (21.2%) only received sedatives. Significant site variation of narcotics/sedatives use existed among hospitals, with the application rate ranging from 0-72.5% in individual hospital. The narcotics and/or sedatives use by very preterm infants was independently associated with increased risks for periventricular leukomalacia, severe retinopathy of prematurity, and bronchopulmonary dysplasia. Conclusions Narcotic and/or sedative administration is relatively conservative for very preterm infants in Chinese neonatal intensive care units, with significant variation among hospitals. Since narcotic and sedative use might be related to adverse neonatal outcomes, a pressing and developing need for national quality improvement initiatives is seen with respect to pain/stress management for very preterm infants.
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Affiliation(s)
- Yan Mo
- Neonatal Medical Center, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
- Guangxi Clinical Research Center for Pediatric Diseases, Nanning, China
| | - Xinyue Gu
- NHC Key Laboratory of Neonatal Diseases (Fudan University), Children’s Hospital of Fudan University, Shanghai, China
| | - Dong Li
- Dalian Women and Children Medical Center, Dalian, China
| | - Wei Dai
- Neonatal Medical Center, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
- Guangxi Clinical Research Center for Pediatric Diseases, Nanning, China
| | - Jing Xu
- Dalian Women and Children Medical Center, Dalian, China
| | - Shoo K. Lee
- Maternal-Infants Care Research Centre and Department of Pediatrics, Mount Sinai Hospital, Toronto, Ontario, Canada
- Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
| | - Wenhao Zhou
- NHC Key Laboratory of Neonatal Diseases (Fudan University), Children’s Hospital of Fudan University, Shanghai, China
- Division of Neonatology, Children’s Hospital of Fudan University, Shanghai, China
| | - Yun Cao
- NHC Key Laboratory of Neonatal Diseases (Fudan University), Children’s Hospital of Fudan University, Shanghai, China
- Division of Neonatology, Children’s Hospital of Fudan University, Shanghai, China
| | - Qiufen Wei
- Neonatal Medical Center, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
- Guangxi Clinical Research Center for Pediatric Diseases, Nanning, China
| | - Siyuan Jiang
- NHC Key Laboratory of Neonatal Diseases (Fudan University), Children’s Hospital of Fudan University, Shanghai, China
- Division of Neonatology, Children’s Hospital of Fudan University, Shanghai, China
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Yang F, Yang B, Gu X, Li M, Qi K, Yan Y. Detection of enrofloxacin residues in dairy products based on their fluorescence quenching effect on AgInS 2 QDs. Spectrochim Acta A Mol Biomol Spectrosc 2023; 301:122985. [PMID: 37311364 DOI: 10.1016/j.saa.2023.122985] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 05/29/2023] [Accepted: 06/04/2023] [Indexed: 06/15/2023]
Abstract
Water-soluble AgInS2 (AIS) quantum dots (QDs) were successfully prepared through the one-pot water phase method with thioglycolic acid (TGA) as the stabilizing agent. Because enrofloxacin (ENR) effectively quenches the fluorescence of AIS QDs, a highly-sensitive fluorescence detection method is proposed to detect ENR residues in milk. Under optimal detection conditions, there was a good linear relationship between the relative fluorescence quenching amount (ΔF/F0) of AgInS2 with ENR and ENR concentration (C). The detection range was 0.3125-20.00 μg/mL, r = 0.9964, and the detection limit (LOD) was 0.024 μg/mL (n = 11). The average recovery of ENR in milk ranged from 95.43 to 114.28%. The method established in this study has advantages including a high sensitivity, a low detection limit, simple operation and a low cost. The fluorescence quenching mechanism of AIS QDs with ENR was discussed and the dynamic quenching mechanism of light-induced electron transfer was proposed.
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Affiliation(s)
- Fengjiao Yang
- College of Pharmacy, Dali University, Dali 671000, Yunnan, China
| | - Bingyu Yang
- College of Pharmacy, Dali University, Dali 671000, Yunnan, China
| | - Xinyue Gu
- College of Pharmacy, Dali University, Dali 671000, Yunnan, China
| | - Minghua Li
- College of Pharmacy, Dali University, Dali 671000, Yunnan, China
| | - Kezhen Qi
- College of Pharmacy, Dali University, Dali 671000, Yunnan, China.
| | - Ya Yan
- College of Pharmacy, Dali University, Dali 671000, Yunnan, China; Key Laboratory of Advanced Energy Materials Chemistry (Ministry of Education), Nankai University, Tianjin 300071, China.
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Zhou JS, Xu RZ, Yu XQ, Cheng FJ, Zhao WX, Du X, Wang SZ, Zhang QQ, Gu X, He SM, Li YD, Ren MQ, Ma XC, Xue QK, Chen YL, Song CL, Yang LX. Evidence for Band Renormalizations in Strong-Coupling Superconducting Alkali-Fulleride Films. Phys Rev Lett 2023; 130:216004. [PMID: 37295091 DOI: 10.1103/physrevlett.130.216004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 02/06/2023] [Accepted: 04/17/2023] [Indexed: 06/12/2023]
Abstract
There has been a long-standing debate about the mechanism of the unusual superconductivity in alkali-intercalated fullerides. In this Letter, using high-resolution angle-resolved photoemission spectroscopy, we systematically investigate the electronic structures of superconducting K_{3}C_{60} thin films. We observe a dispersive energy band crossing the Fermi level with the occupied bandwidth of about 130 meV. The measured band structure shows prominent quasiparticle kinks and a replica band involving the Jahn-Teller active phonon modes, which reflects strong electron-phonon coupling in the system. The electron-phonon coupling constant is estimated to be about 1.2, which dominates the quasiparticle mass renormalization. Moreover, we observe an isotropic nodeless superconducting gap beyond the mean-field estimation (2Δ/k_{B}T_{c}≈5). Both the large electron-phonon coupling constant and large reduced superconducting gap suggest a strong-coupling superconductivity in K_{3}C_{60}, while the electronic correlation effect is suggested by the observation of a waterfall-like band dispersion and the small bandwidth compared with the effective Coulomb interaction. Our results not only directly visualize the crucial band structure but also provide important insights into the mechanism of the unusual superconductivity of fulleride compounds.
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Affiliation(s)
- J S Zhou
- State Key Laboratory of Low Dimensional Quantum Physics, Department of Physics, Tsinghua University, Beijing 100084, China
- Frontier Science Center for Quantum Information, Beijing 100084, China
| | - R Z Xu
- State Key Laboratory of Low Dimensional Quantum Physics, Department of Physics, Tsinghua University, Beijing 100084, China
- Frontier Science Center for Quantum Information, Beijing 100084, China
| | - X Q Yu
- State Key Laboratory of Low Dimensional Quantum Physics, Department of Physics, Tsinghua University, Beijing 100084, China
- Frontier Science Center for Quantum Information, Beijing 100084, China
| | - F J Cheng
- State Key Laboratory of Low Dimensional Quantum Physics, Department of Physics, Tsinghua University, Beijing 100084, China
- Frontier Science Center for Quantum Information, Beijing 100084, China
| | - W X Zhao
- State Key Laboratory of Low Dimensional Quantum Physics, Department of Physics, Tsinghua University, Beijing 100084, China
- Frontier Science Center for Quantum Information, Beijing 100084, China
| | - X Du
- State Key Laboratory of Low Dimensional Quantum Physics, Department of Physics, Tsinghua University, Beijing 100084, China
- Frontier Science Center for Quantum Information, Beijing 100084, China
| | - S Z Wang
- State Key Laboratory of Low Dimensional Quantum Physics, Department of Physics, Tsinghua University, Beijing 100084, China
- Frontier Science Center for Quantum Information, Beijing 100084, China
| | - Q Q Zhang
- State Key Laboratory of Low Dimensional Quantum Physics, Department of Physics, Tsinghua University, Beijing 100084, China
- Frontier Science Center for Quantum Information, Beijing 100084, China
| | - X Gu
- State Key Laboratory of Low Dimensional Quantum Physics, Department of Physics, Tsinghua University, Beijing 100084, China
- Frontier Science Center for Quantum Information, Beijing 100084, China
| | - S M He
- Department of Physics, Clarendon Laboratory, University of Oxford, Parks Road, Oxford OX1 3PU, United Kingdom
| | - Y D Li
- State Key Laboratory of Low Dimensional Quantum Physics, Department of Physics, Tsinghua University, Beijing 100084, China
- Frontier Science Center for Quantum Information, Beijing 100084, China
| | - M Q Ren
- State Key Laboratory of Low Dimensional Quantum Physics, Department of Physics, Tsinghua University, Beijing 100084, China
- Frontier Science Center for Quantum Information, Beijing 100084, China
| | - X C Ma
- State Key Laboratory of Low Dimensional Quantum Physics, Department of Physics, Tsinghua University, Beijing 100084, China
- Frontier Science Center for Quantum Information, Beijing 100084, China
- Collaborative Innovation Center of Quantum Matter, Beijing 100084, China
| | - Q K Xue
- State Key Laboratory of Low Dimensional Quantum Physics, Department of Physics, Tsinghua University, Beijing 100084, China
- Frontier Science Center for Quantum Information, Beijing 100084, China
| | - Y L Chen
- Department of Physics, Clarendon Laboratory, University of Oxford, Parks Road, Oxford OX1 3PU, United Kingdom
- School of Physical Science and Technology, ShanghaiTech University and CAS-Shanghai Science Research Center, Shanghai 201210, China
- ShanghaiTech Laboratory for Topological Physics, Shanghai 200031, China
| | - C L Song
- State Key Laboratory of Low Dimensional Quantum Physics, Department of Physics, Tsinghua University, Beijing 100084, China
- Frontier Science Center for Quantum Information, Beijing 100084, China
- Collaborative Innovation Center of Quantum Matter, Beijing 100084, China
| | - L X Yang
- State Key Laboratory of Low Dimensional Quantum Physics, Department of Physics, Tsinghua University, Beijing 100084, China
- Frontier Science Center for Quantum Information, Beijing 100084, China
- Collaborative Innovation Center of Quantum Matter, Beijing 100084, China
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Gu X, Ross PA, Gill A, Yang Q, Ansermin E, Sharma S, Soleimannejad S, Sharma K, Callahan A, Brown C, Umina PA, Kristensen TN, Hoffmann AA. A rapidly spreading deleterious aphid endosymbiont that uses horizontal as well as vertical transmission. Proc Natl Acad Sci U S A 2023; 120:e2217278120. [PMID: 37094148 PMCID: PMC10161079 DOI: 10.1073/pnas.2217278120] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 03/23/2023] [Indexed: 04/26/2023] Open
Abstract
Endosymbiotic bacteria that live inside the cells of insects are typically only transmitted maternally and can spread by increasing host fitness and/or modifying reproduction in sexual hosts. Transinfections of Wolbachia endosymbionts are now being used to introduce useful phenotypes into sexual host populations, but there has been limited progress on applications using other endosymbionts and in asexual populations. Here, we develop a unique pathway to application in aphids by transferring the endosymbiont Rickettsiella viridis to the major crop pest Myzus persicae. Rickettsiella infection greatly reduced aphid fecundity, decreased heat tolerance, and modified aphid body color, from light to dark green. Despite inducing host fitness costs, Rickettsiella spread rapidly through caged aphid populations via plant-mediated horizontal transmission. The phenotypic effects of Rickettsiella were sensitive to temperature, with spread only occurring at 19 °C and not 25 °C. Body color modification was also lost at high temperatures despite Rickettsiella maintaining a high density. Rickettsiella shows the potential to spread through natural M. persicae populations by horizontal transmission and subsequent vertical transmission. Establishment of Rickettsiella in natural populations could reduce crop damage by modifying population age structure, reducing population growth and providing context-dependent effects on host fitness. Our results highlight the importance of plant-mediated horizontal transmission and interactions with temperature as drivers of endosymbiont spread in asexual insect populations.
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Affiliation(s)
- Xinyue Gu
- Pest and Environmental Adaptation Research Group, School of BioSciences, Bio21 Molecular Science and Biotechnology Institute, The University of Melbourne, Parkville, VIC 3052, Australia
| | - Perran A. Ross
- Pest and Environmental Adaptation Research Group, School of BioSciences, Bio21 Molecular Science and Biotechnology Institute, The University of Melbourne, Parkville, VIC 3052, Australia
- Section for Bioscience and Engineering, Department of Chemistry and Bioscience, Aalborg University, Aalborg9220, Denmark
| | - Alex Gill
- Pest and Environmental Adaptation Research Group, School of BioSciences, Bio21 Molecular Science and Biotechnology Institute, The University of Melbourne, Parkville, VIC 3052, Australia
| | - Qiong Yang
- Pest and Environmental Adaptation Research Group, School of BioSciences, Bio21 Molecular Science and Biotechnology Institute, The University of Melbourne, Parkville, VIC 3052, Australia
| | - Eloïse Ansermin
- Pest and Environmental Adaptation Research Group, School of BioSciences, Bio21 Molecular Science and Biotechnology Institute, The University of Melbourne, Parkville, VIC 3052, Australia
| | - Sonia Sharma
- Pest and Environmental Adaptation Research Group, School of BioSciences, Bio21 Molecular Science and Biotechnology Institute, The University of Melbourne, Parkville, VIC 3052, Australia
| | - Safieh Soleimannejad
- Pest and Environmental Adaptation Research Group, School of BioSciences, Bio21 Molecular Science and Biotechnology Institute, The University of Melbourne, Parkville, VIC 3052, Australia
| | - Kanav Sharma
- Pest and Environmental Adaptation Research Group, School of BioSciences, Bio21 Molecular Science and Biotechnology Institute, The University of Melbourne, Parkville, VIC 3052, Australia
| | - Ashley Callahan
- Pest and Environmental Adaptation Research Group, School of BioSciences, Bio21 Molecular Science and Biotechnology Institute, The University of Melbourne, Parkville, VIC 3052, Australia
| | - Courtney Brown
- Pest and Environmental Adaptation Research Group, School of BioSciences, Bio21 Molecular Science and Biotechnology Institute, The University of Melbourne, Parkville, VIC 3052, Australia
| | - Paul A. Umina
- Pest and Environmental Adaptation Research Group, School of BioSciences, Bio21 Molecular Science and Biotechnology Institute, The University of Melbourne, Parkville, VIC 3052, Australia
- Cesar Australia, Brunswick, VIC 3052, Australia
| | - Torsten N. Kristensen
- Section for Bioscience and Engineering, Department of Chemistry and Bioscience, Aalborg University, Aalborg9220, Denmark
| | - Ary A. Hoffmann
- Pest and Environmental Adaptation Research Group, School of BioSciences, Bio21 Molecular Science and Biotechnology Institute, The University of Melbourne, Parkville, VIC 3052, Australia
- Section for Bioscience and Engineering, Department of Chemistry and Bioscience, Aalborg University, Aalborg9220, Denmark
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Wang C, Gu X, Dong R, Chen Z, Jin X, Gao J, Ok YS, Gu C. Natural Solar Irradiation Produces Fluorescent and Biodegradable Nanoplastics. Environ Sci Technol 2023; 57:6626-6635. [PMID: 37042100 DOI: 10.1021/acs.est.2c07537] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Abstract
Nanoplastics (NPs) have raised global concern owing to their potential health effects. Herein, after simulated and natural solar irradiation, polyethylene, polypropylene, polystyrene, and poly(vinyl chloride) nanoplastics (PVC NPs) were observed to exhibit enhanced fluorescence, particularly PVC NPs. Furthermore, the role of photoaged NPs as a potential fluorescence indicator was evaluated by exposing a model aquatic organism Daphnia magna to these NPs. Our results revealed that photoaged NPs exhibited strong fluorescence owing to the generation of conjugated π bonds, which can achieve π-π* electron transition with low energy consumption. Photogenerated fluorescence also enabled the photoaged NPs to act as efficient fluorescent tracers, which can help track NP migration in various organisms. The results of two-photon laser confocal scanning microscopy revealed that the photoaged NPs could translocate across biological barriers and accumulate in extraintestinal tissues in addition to being ingested and excreted. Moreover, compared with pristine NPs, the photoaged NPs underwent biodegradation more easily, probably because of increased hydrophilicity due to photogenerated oxygen-containing moieties. Therefore, in addition to producing fluorescent NPs without the attachment of external fluorescent dyes, the natural photoaging process can promote the migration and degradation of photoaged NPs in food chains.
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Affiliation(s)
- Chao Wang
- State Key Laboratory of Pollution Control and Resource Reuse, School of Environment, Nanjing University, Nanjing 210023, P. R. China
| | - Xinyue Gu
- State Key Laboratory of Pollution Control and Resource Reuse, School of Environment, Nanjing University, Nanjing 210023, P. R. China
| | - Ruochen Dong
- State Key Laboratory of Pollution Control and Resource Reuse, School of Environment, Nanjing University, Nanjing 210023, P. R. China
| | - Zeyou Chen
- College of Environmental Science and Engineering, Ministry of Education Key Laboratory of Pollution Processes and Environmental Criteria, Nankai University, Tianjin 300071, P. R. China
| | - Xin Jin
- State Key Laboratory of Pollution Control and Resource Reuse, School of Environment, Nanjing University, Nanjing 210023, P. R. China
| | - Juan Gao
- Key Laboratory of Soil Environment and Pollution Remediation, Institute of Soil Science, Chinese Academy of Sciences, Nanjing, Jiangsu 210008, P. R. China
| | - Yong Sik Ok
- Korea Biochar Research Center, APRU Sustainable Waste Management Program and Division of Environmental Science and Ecological Engineering, Korea University, Seoul 02841, Republic of Korea
| | - Cheng Gu
- State Key Laboratory of Pollution Control and Resource Reuse, School of Environment, Nanjing University, Nanjing 210023, P. R. China
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Wang Q, Li Y, Gu X, Zhang N, Xie J, Niu B, Xing Y, He Y. Imaging diagnosis of intravenous leiomyomatosis: an institutional experience. Clin Radiol 2023:S0009-9260(23)00138-1. [PMID: 37365113 DOI: 10.1016/j.crad.2023.03.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 03/14/2023] [Accepted: 03/28/2023] [Indexed: 06/28/2023]
Abstract
AIM To review and summarise the clinical and imaging characteristics of intravenous leiomyomatosis (IVL), a rare smooth muscle tumour originating from the uterus. MATERIALS AND METHODS Twenty-seven patients with a histopathological diagnosis of IVL who underwent surgery were reviewed retrospectively. All patients underwent pelvic ultrasonography, inferior vena cava (IVC) ultrasonography, and echocardiography before surgery. Computed tomography (CT) with contrast enhancement was performed in patients with extrapelvic IVL. Some patients underwent pelvic magnetic resonance imaging (MRI). RESULTS Mean age was 44.81 years. Clinical symptoms were non-specific. IVL was intrapelvic in seven patients and extrapelvic in 20. Preoperative pelvic ultrasonography missed the diagnosis in 85.7% of patients with intrapelvic IVL. Pelvic MRI was useful to evaluate the parauterine vessels. Incidence of cardiac involvement was 59.26%. Echocardiography showed a highly mobile sessile mass in the right atrium with moderate-to-low echogenicity that originates from the IVC. Ninety per cent of extrapelvic lesions showed unilateral growth. The most common growth pattern was via the right uterine vein-internal iliac vein-IVC pathway. CONCLUSION The clinical symptoms of IVL are non-specific. For patients with intrapelvic IVL, early diagnosis is difficult. Pelvic ultrasound should focus on the parauterine vessels, the iliac and ovarian veins should be explored carefully. MRI has obvious advantages in evaluating parauterine vessel involvement, which is helpful for early diagnosis. For patients with extrapelvic IVL, CT should be performed before surgery as part of a comprehensive evaluation. IVC ultrasonography and echocardiography are recommended when IVL is highly suspected.
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Affiliation(s)
- Q Wang
- Echocardiography Medical Center, Beijing Anzhen Hospital, Capital Medical University, China
| | - Y Li
- Department of Radiology, The Seventh Affiliated Hospital of Sun Yat-sen University, China
| | - X Gu
- Echocardiography Medical Center, Beijing Anzhen Hospital, Capital Medical University, China
| | - N Zhang
- Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, China
| | - J Xie
- Department of Cardiology, Jiahui International Hospital, China
| | - B Niu
- Echocardiography Medical Center, Beijing Anzhen Hospital, Capital Medical University, China
| | - Y Xing
- Department of Comprehensive Ultrasound, Beijing Anzhen Hospital, Capital Medical University, China
| | - Y He
- Echocardiography Medical Center, Beijing Anzhen Hospital, Capital Medical University, China.
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Yu W, Zhang L, Li S, Yan W, Bai R, Yang Z, Shi J, Yuan J, Yang C, Cai W, Wang Y, Zhang Y, Gu X, Cao X, Huang Y, Hong L, Zhou Q, Yang Y, Lee SK, Jiang S, Cao Y. Early Antibiotic Use and Neonatal Outcomes Among Preterm Infants Without Infections. Pediatrics 2023; 151:191046. [PMID: 37042203 DOI: 10.1542/peds.2022-059427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/02/2023] [Indexed: 04/13/2023] Open
Abstract
OBJECTIVES To determine whether use, duration, and types of early antibiotics were associated with neonatal outcomes and late antibiotic use in preterm infants without infection-related diseases. METHODS This cohort study enrolled infants admitted to 25 tertiary NICUs in China within 24 hours of birth during 2015-2018. Death, discharge, or infection-related morbidities within 7 days of birth; major congenital anomalies; and error data on antibiotic use were excluded. The composite outcome was death or adverse morbidities. Late antibiotic use indicated antibiotics used after 7 days of age. Late antibiotic use rate was total antibiotic use days divided by the days of hospital stay after the first 7 days of life. RESULTS Among 21 540 infants, 18 302 (85.0%) received early antibiotics. Early antibiotics was related to increased bronchopulmonary dysplasia (BPD) (adjusted odds ratio [aOR], 1.28; 95% confidence interval [CI], 1.05-1.56), late antibiotic use (aOR, 4.64; 95% CI, 4.19-5.14), and late antibiotic use rate (adjusted mean difference, 130 days/1000 patient-days; 95% CI, 112-147). Each additional day of early antibiotics was associated with increased BPD (aOR, 1.07; 95% CI, 1.04-1.10) and late antibiotic use (aOR, 1.41; 95% CI, 1.39-1.43). Broad-spectrum antibiotics showed larger effect size on neonatal outcomes than narrow-spectrum antibiotics. The correlation between early antibiotics and outcomes was significant among noncritical infants but disappeared for critical infants. CONCLUSIONS Among infants without infection, early antibiotic use was associated with increased risk of BPD and late antibiotic use. Judicious early antibiotic use, especially avoiding prolonged duration and broad-spectrum antibiotics among noncritical infants, may improve neonatal outcomes and overall antibiotic use in NICUs.
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Affiliation(s)
- Weiyin Yu
- Division of Neonatology, Children's Hospital of Fudan University, Shanghai, China
| | - Lan Zhang
- Division of Neonatology, Children's Hospital of Fudan University, Shanghai, China
- NHC Key Laboratory of Neonatal Diseases, Fudan University, Children's Hospital of Fudan University, Shanghai, China
| | - Shujuan Li
- Division of Neonatology, Children's Hospital of Fudan University, Shanghai, China
| | - Weili Yan
- Department of Clinical Epidemiology, Children's Hospital of Fudan University, Shanghai, China
| | - Ruimiao Bai
- Northwest Women's and Children's Hospital, The Affiliated Northwest Women's and Children's Hospital of ξ'an Jiaotong University, Shaanxi, China
| | - Zuming Yang
- Suzhou Municipal Hospital, The Affiliated Suzhou Hospital of Nanjing Medical University, Jiangsu, China
| | - Jingyun Shi
- Gansu Provincial Maternal and Child-care Hospital/Gansu Provincial Central Hospital, Gansu, China
| | - Jing Yuan
- Qingdao Women and Children's Hospital, Qingdao University, Shandong, China
| | - Chuanzhong Yang
- Depatment of Neonatology, The Affiliated Shenzhen Maternity & Child Healthcare Hospital, Southern Medical University, Guangdong, China
| | - Wenhong Cai
- Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fujian, China
| | - Yang Wang
- Department of Pediatrics, The First Affiliated Hospital of Anhui Medical University, Anhui, China
| | - Yi Zhang
- Department of Clinical Epidemiology, Children's Hospital of Fudan University, Shanghai, China
| | - Xinyue Gu
- NHC Key Laboratory of Neonatal Diseases, Fudan University, Children's Hospital of Fudan University, Shanghai, China
| | - Xincheng Cao
- Division of Neonatology, Children's Hospital of Fudan University, Shanghai, China
| | - Yihuang Huang
- Division of Neonatology, Children's Hospital of Fudan University, Shanghai, China
- NHC Key Laboratory of Neonatal Diseases, Fudan University, Children's Hospital of Fudan University, Shanghai, China
| | - Luyang Hong
- Division of Neonatology, Children's Hospital of Fudan University, Shanghai, China
| | - Qi Zhou
- Division of Neonatology, Children's Hospital of Fudan University, Shanghai, China
| | - Yi Yang
- NHC Key Laboratory of Neonatal Diseases, Fudan University, Children's Hospital of Fudan University, Shanghai, China
| | - Shoo K Lee
- Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada; and
- Department of Obstetrics and Gynecology and Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Siyuan Jiang
- Division of Neonatology, Children's Hospital of Fudan University, Shanghai, China
- NHC Key Laboratory of Neonatal Diseases, Fudan University, Children's Hospital of Fudan University, Shanghai, China
| | - Yun Cao
- Division of Neonatology, Children's Hospital of Fudan University, Shanghai, China
- NHC Key Laboratory of Neonatal Diseases, Fudan University, Children's Hospital of Fudan University, Shanghai, China
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Wang C, Liang S, Bai L, Gu X, Jin X, Ok YS, Gu C. Photoaging of Typical Microplastics as Affected by Air Humidity: Mechanistic Insights into the Important Role of Water Molecules. Environ Sci Technol 2023; 57:5967-5977. [PMID: 36991324 DOI: 10.1021/acs.est.2c08571] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Abstract
Recent studies showed that land is the most important sink for microplastics (MPs); however, limited information is available on the photoaging processes of land surface MPs that are exposed to the air. Herein, this study developed two in situ spectroscopic methods to systematically explore the effect of air humidity on MP photoaging using a microscope of Fourier transform infrared spectroscopy and a laser Raman microscope, which were equipped with a humidity control system. Polyethylene microplastics, polystyrene microplastics, and poly(vinyl chloride) microplastics (PVC-MPs) were used as model MPs. Our results showed that relative humidity (RH) could significantly influence the MP surface oxygen-containing moieties generated from photo-oxidation, especially for PVC-MPs. As the RH level varied from 10 to 90%, a decrease in the photogenerated carbonyl group and an increase in the hydroxyl group were observed. This could be attributed to the involvement of water molecules in the production of hydroxyl groups, which subsequently inhibited carbonyl generation. Moreover, the adsorption of coexisting contaminants (i.e., tetracycline) on photoaged MPs exhibited strong RH dependence, which could be assigned to the varied hydrogen bonding between tetracycline carbonyls and aged MP surface hydroxyls. This study reveals a ubiquitous but previously overlooked MP aging route, which may account for the changed MP surface physiochemical properties under solar irradiation.
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Affiliation(s)
- Chao Wang
- State Key Laboratory of Pollution Control and Resource Reuse, School of Environment, Nanjing University, Nanjing 210023, P. R. China
| | - Sijia Liang
- State Key Laboratory of Pollution Control and Resource Reuse, School of Environment, Nanjing University, Nanjing 210023, P. R. China
| | - Lihua Bai
- State Key Laboratory of Pollution Control and Resource Reuse, School of Environment, Nanjing University, Nanjing 210023, P. R. China
| | - Xinyue Gu
- State Key Laboratory of Pollution Control and Resource Reuse, School of Environment, Nanjing University, Nanjing 210023, P. R. China
| | - Xin Jin
- State Key Laboratory of Pollution Control and Resource Reuse, School of Environment, Nanjing University, Nanjing 210023, P. R. China
| | - Yong Sik Ok
- Korea Biochar Research Center, APRU Sustainable Waste Management Program and Division of Environmental Science and Ecological Engineering, Korea University, Seoul 02841, Republic of Korea
| | - Cheng Gu
- State Key Laboratory of Pollution Control and Resource Reuse, School of Environment, Nanjing University, Nanjing 210023, P. R. China
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Zhao J, Feng Z, Dai Y, Zhang W, Jiang S, Wang Y, Gu X, Sun J, Cao Y, Lee SK, Tian X, Yang Z. Use of antenatal corticosteroids among infants with gestational age at 24 to 31 weeks in 57 neonatal intensive care units of China: a cross-sectional study. Chin Med J (Engl) 2023; 136:822-829. [PMID: 36848141 PMCID: PMC10150864 DOI: 10.1097/cm9.0000000000002266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Indexed: 03/01/2023] Open
Abstract
BACKGROUND Antenatal corticosteroids (ACS) can significantly improve the outcomes of preterm infants. This study aimed to describe the ACS use rates among preterm infants admitted to Chinese neonatal intensive care units (NICU) and to explore perinatal factors associated with ACS use, using the largest contemporary cohort of very preterm infants in China. METHODS This cross-sectional study enrolled all infants born at 24 +0 to 31 +6 weeks and admitted to 57 NICUs of the Chinese Neonatal Network from January 1st, 2019 to December 30th, 2019. The ACS administration was defined as at least one dose of dexamethasone and betamethasone given before delivery. Multiple logistic regressions were applied to determine the association between perinatal factors and ACS usage. RESULTS A total of 7828 infants were enrolled, among which 6103 (78.0%) infants received ACS. ACS use rates increased with increasing gestational age (GA), from 177/259 (68.3%) at 24 to 25 weeks' gestation to 3120/3960 (78.8%) at 30 to 31 weeks' gestation. Among infants exposed to ACS, 2999 of 6103 (49.1%) infants received a single complete course, and 33.4% (2039/6103) infants received a partial course. ACS use rates varied from 30.2% to 100% among different hospitals. Multivariate regression showed that increasing GA, born in hospital (inborn), increasing maternal age, maternal hypertension and premature rupture of membranes were associated with higher likelihood to receive ACS. CONCLUSIONS The use rate of ACS remained low for infants at 24 to 31 weeks' gestation admitted to Chinese NICUs, with fewer infants receiving a complete course. The use rates varied significantly among different hospitals. Efforts are urgently needed to propose improvement measures and thus improve the usage of ACS.
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Affiliation(s)
- Jing Zhao
- Division of Neonatology, Tianjin Central Hospital of Obstetrics and Gynecology, Tianjin 300052, China
- Tianjin Key Laboratory of Human Development and Reproductive Regulation, Tianjin 300052, China
- Nankai University Maternity Hospital, Tianjin 300052, China
| | - Zongtai Feng
- Division of Neonatology, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, Jiangsu 215002, China
| | - Yun Dai
- Division of Neonatology, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, Jiangsu 215002, China
| | - Wanxian Zhang
- Division of Neonatology, Tianjin Central Hospital of Obstetrics and Gynecology, Tianjin 300052, China
- Tianjin Key Laboratory of Human Development and Reproductive Regulation, Tianjin 300052, China
- Nankai University Maternity Hospital, Tianjin 300052, China
| | - Siyuan Jiang
- Division of Neonatology, Children's Hospital of Fudan University, Shanghai 201102, China
- NHC Key Laboratory of Neonatal Diseases, Fudan University, Children's Hospital of Fudan University, Shanghai 201102, China
| | - Yanchen Wang
- NHC Key Laboratory of Neonatal Diseases, Fudan University, Children's Hospital of Fudan University, Shanghai 201102, China
| | - Xinyue Gu
- NHC Key Laboratory of Neonatal Diseases, Fudan University, Children's Hospital of Fudan University, Shanghai 201102, China
| | - Jianhua Sun
- Department of Neonatology, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China
| | - Yun Cao
- Division of Neonatology, Children's Hospital of Fudan University, Shanghai 201102, China
- NHC Key Laboratory of Neonatal Diseases, Fudan University, Children's Hospital of Fudan University, Shanghai 201102, China
| | - Shoo K. Lee
- Maternal-Infants Care Research Centre, Mount Sinai Hospital, Toronto, ON M5G 1X5, Canada
- University of Toronto, Toronto, ON M5T 3M7, Canada
| | - Xiuying Tian
- Division of Neonatology, Tianjin Central Hospital of Obstetrics and Gynecology, Tianjin 300052, China
- Tianjin Key Laboratory of Human Development and Reproductive Regulation, Tianjin 300052, China
- Nankai University Maternity Hospital, Tianjin 300052, China
| | - Zuming Yang
- Division of Neonatology, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, Jiangsu 215002, China
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Hao Y, Si J, Wei J, Gu X, Wang W, Zhang Y, Guan Y, Huang H, Xu C, Song Z. 221P Comparison of efficacy and safety of carboplatin combined with nab-paclitaxel or paclitaxel as first-line therapy for advanced thymic epithelial tumors. J Thorac Oncol 2023. [DOI: 10.1016/s1556-0864(23)00474-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023]
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Li J, Dong C, Gan H, Gu X, Zhang J, Zhu Y, Xiong J, Song C, Wang L. Nondestructive separation/enrichment and rolling circle amplification-powered sensitive SERS enumeration of circulating tumor cells via aptamer recognition. Biosens Bioelectron 2023; 231:115273. [PMID: 37054599 DOI: 10.1016/j.bios.2023.115273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 03/17/2023] [Accepted: 03/27/2023] [Indexed: 03/30/2023]
Abstract
Nondestructive separation/enrichment and reliable detection of extremely rare circulating tumor cells (CTCs) in peripheral blood are of considerable importance in tumor precision diagnosis and treatment, yet this remains a big challenge. Herein, a novel strategy for nondestructive separation/enrichment and ultra-sensitive surface-enhanced Raman scattering (SERS)-based enumeration of CTCs is proposed via aptamer recognition and rolling circle amplification (RCA). In this work the magnetic beads modified with "Aptamer (Apt)-Primer" (AP) probes were utilized to specifically capture CTCs, and then after magnetic separation/enrichment, the RCA-powered SERS counting and benzonase nuclease cleavage-assisted nondestructive release of CTCs were realized, respectively. The AP was assembled by hybridizing the EpCAM-specific aptamer with a primer, and the optimal AP contains 4 mismatched bases. The RCA enhanced SERS signal nearly 4.5-fold, and the SERS strategy has good specificity, uniformity and reproducibility. The proposed SERS detection possesses a good linear relationship with the concentration of MCF-7 cells spiked in PBS with the limit of detection (LOD) of 2 cells/mL, which shows good potential practicality for detecting CTCs in blood with recoveries ranging from 100.56% to 116.78%. Besides, the released CTCs remained good cellular activity with the normal proliferation after re-culture for 48 h and normal growth for at least three generations. The proposed strategy of nondestructive separation/enrichment and SERS-based sensitive enumeration is promising for reliable analysis of EpCAM-positive CTCs in blood, which is expected to provide a powerful tool for analysis of extremely rare circulating tumor cells in complex peripheral blood for liquid biopsy.
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Cai SY, Gu X, Liu PJ, Li RS, Jiang JJ, Zhao SP, Yao W, Jiang YN, Yin YH, Yu B, Yuan ZY, Wang JA. [Efficacy and safety of various doses of hybutimibe monotherapy or in combination with atorvastatin for primary hypercholesterolemia: a multicenter, randomized, double-blind, double-dummy, parallel-controlled phase Ⅲ clinical trial]. Zhonghua Xin Xue Guan Bing Za Zhi 2023; 51:180-187. [PMID: 36789598 DOI: 10.3760/cma.j.cn112148-20230105-00009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
Objective: To evaluate the efficacy and safety of hybutimibe monotherapy or in combination with atorvastatin in the treatment of primary hypercholesterolemia. Methods: This was a multicenter, randomized, double-blind, double-dummy, parallel-controlled phase Ⅲ clinical trial of patients with untreated primary hypercholesterolemia from 41 centers in China between August 2015 and April 2019. Patients were randomly assigned, at a ratio of 1∶1∶1∶1∶1∶1, to the atorvastatin 10 mg group (group A), hybutimibe 20 mg group (group B), hybutimibe 20 mg plus atorvastatin 10 mg group (group C), hybutimibe 10 mg group (group D), hybutimibe 10 mg plus atorvastatin 10 mg group (group E), and placebo group (group F). After a dietary run-in period for at least 4 weeks, all patients were administered orally once a day according to their groups. The treatment period was 12 weeks after the first dose of the study drug, and efficacy and safety were evaluated at weeks 2, 4, 8, and 12. After the treatment period, patients voluntarily entered the long-term safety evaluation period and continued the assigned treatment (those in group F were randomly assigned to group B or D), with 40 weeks' observation. The primary endpoint was the percent change in low density lipoprotein cholesterol (LDL-C) from baseline at week 12. Secondary endpoints included the percent changes in high density lipoprotein cholesterol (HDL-C), triglyceride (TG), apolipoprotein B (Apo B) at week 12 and changes of the four above-mentioned lipid indicators at weeks 18, 24, 38, and 52. Safety was evaluated during the whole treatment period. Results: Totally, 727 patients were included in the treatment period with a mean age of (55.0±9.3) years old, including 253 males. No statistical differences were observed among the groups in demographics, comorbidities, and baseline blood lipid levels. At week 12, the percent changes in LDL-C were significantly different among groups A to F (all P<0.01). Compared to atorvastatin alone, hybutimibe combined with atorvastatin could further improve LDL-C, TG, and Apo B (all P<0.05). Furthermore, there was no significant difference in percent changes in LDL-C at week 12 between group C and group E (P=0.991 7). During the long-term evaluation period, there were intergroup statistical differences in changes of LDL-C, TG and Apo B at 18, 24, 38, and 52 weeks from baseline among the statins group (group A), hybutimibe group (groups B, D, and F), and combination group (groups C and E) (all P<0.01), with the best effect observed in the combination group. The incidence of adverse events was 64.2% in the statins group, 61.7% in the hybutimibe group, and 71.0% in the combination group during the long-term evaluation period. No treatment-related serious adverse events or adverse events leading to death occurred during the 52-week study period. Conclusions: Hybutimibe combined with atorvastatin showed confirmatory efficacy in patients with untreated primary hypercholesterolemia, which could further enhance the efficacy on the basis of atorvastatin monotherapy, with a good overall safety profile.
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Affiliation(s)
- S Y Cai
- Department of Cardiology, The Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou 310009, China
| | - X Gu
- Department of Cardiology, Subei People's Hospital of Jiangsu Province, Yangzhou 225001, China
| | - P J Liu
- Department of Cardiology, Affiliated Hospital of Jiangsu University, Zhenjiang 212001, China
| | - R S Li
- Department of Cardiology, Liuzhou People's Hospital, Liuzhou 545026, China
| | - J J Jiang
- Department of Cardiology, Taizhou Hospital of Zhejiang Province, Taizhou 317000, China
| | - S P Zhao
- Department of Cardiology, the Second Xiangya Hospital of Central South University, Changsha 410011, China
| | - W Yao
- Department of Cardiology, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Y N Jiang
- Department of Cardiology, the First Affiliated Hospital of Dalian Medical University, Dalian 116011, China
| | - Y H Yin
- Department of Cardiology, the Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, China
| | - B Yu
- Department of Cardiology, the Second Affiliated Hospital of Harbin Medical University, Harbin 150001, China
| | - Z Y Yuan
- Department of Cardiology, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China
| | - J A Wang
- Department of Cardiology, The Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou 310009, China
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Ge J, Gu X, Jiang S, Yang L, Li X, Jiang S, Jia B, Chen C, Cao Y, Lee S, Zhao X, Ji Y, Zhou W. Impact of hypertensive disorders of pregnancy on neonatal outcomes among infants born at 24 +0-31 +6 weeks' gestation in China: A multicenter cohort study. Front Pediatr 2023; 11:1005383. [PMID: 36911015 PMCID: PMC9996092 DOI: 10.3389/fped.2023.1005383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 01/24/2023] [Indexed: 02/25/2023] Open
Abstract
Objective To describe the rate of hypertensive disorder of pregnancy (HDP) among mothers of very preterm infants (VPIs) admitted to Chinese neonatal intensive care units (NICUs), and to investigate the relationship between HDP and the outcomes of VPIs. Study design Cohort study of all VPIs born at a gestational age of 24+0-31+6 weeks and admitted to 57 tertiary NICUs of the Chinese Neonatal Network (CHNN) in 2019. Infants with severe congenital anomalies or missing maternal HDP information were excluded. Two multivariate logistic regression models were generated to assess the relationship between HDP and neonatal outcomes. Results Among 9,262 infants enrolled, 1,744 (18.8%) infants were born to mothers with HDP, with an increasing incidence with increasing gestational age. VPIs born to mothers with HDP had higher gestational age but lower birth weight and were more likely to be small for gestational age. Mothers with HDP were more likely to receive antenatal steroids, MgSO4 and cesarean section. Infants in the HDP group showed higher observed rates of mortality or any morbidity than infants in the non-HDP group (50.2% vs. 47.2%, crude odds ratio (OR) 1.13, 95% CI 1.02-1.26). However, the associations between HDP and adverse outcomes were not significant after adjustment. In the HDP group, mothers of 1,324/1,688 (78.4%) infants were diagnosed with preeclampsia/eclampsia. Infants born to mothers with preeclampsia/eclampsia had significantly lower odds of early death and severe retinopathy of prematurity. Conclusions Nearly one-fifth of VPIs were born to mothers with HDP in Chinese NICUs. No significant association was identified between HDP and adverse neonatal short-term outcomes of VPIs, while long-term follow-up of these infants is needed.
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Affiliation(s)
- Jianfang Ge
- Department of Neonatology, Shanxi Provincial Children's Hospital, Taiyuan, China
| | - Xinyue Gu
- NHC Key Laboratory of Neonatal Diseases, Children's Hospital, Fudan University, Shanghai, China
| | - Shanyu Jiang
- Department of Neonatology, Wuxi Maternity and Child Health Care Hospital, Wuxi, China
| | - Ling Yang
- Department of Neonatology, Hainan Women and Children's Medical Center, Haikou, China
| | - Xiaoyan Li
- Department of Neonatology, Shanxi Provincial Children's Hospital, Taiyuan, China
| | - Siyuan Jiang
- Department of Neonatology, Shanxi Provincial Children's Hospital, Taiyuan, China
| | - Beibei Jia
- Department of Neonatology, Wuxi Maternity and Child Health Care Hospital, Wuxi, China
| | - Caihua Chen
- Department of Neonatology, Hainan Women and Children's Medical Center, Haikou, China
| | - Yun Cao
- NHC Key Laboratory of Neonatal Diseases, Children's Hospital, Fudan University, Shanghai, China
| | - Shoo Lee
- Department of Paediatric, University of Toronto, Toronto, ON, Canada
| | - Xiaopeng Zhao
- Department of Neonatology, Guangzhou Women and Children's Hospital, Guangzhou, China
| | - Yong Ji
- Department of Neonatology, Shanxi Provincial Children's Hospital, Taiyuan, China
| | - Wenhao Zhou
- NHC Key Laboratory of Neonatal Diseases, Children's Hospital, Fudan University, Shanghai, China
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Xu RZ, Gu X, Zhao WX, Zhou JS, Zhang QQ, Du X, Li YD, Mao YH, Zhao D, Huang K, Zhang CF, Wang F, Liu ZK, Chen YL, Yang LX. Development of a laser-based angle-resolved-photoemission spectrometer with sub-micrometer spatial resolution and high-efficiency spin detection. Rev Sci Instrum 2023; 94:023903. [PMID: 36859063 DOI: 10.1063/5.0106351] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 01/20/2023] [Indexed: 06/18/2023]
Abstract
Angle-resolved photoemission spectroscopy with sub-micrometer spatial resolution (μ-ARPES), has become a powerful tool for studying quantum materials. To achieve sub-micrometer or even nanometer-scale spatial resolution, it is important to focus the incident light beam (usually from synchrotron radiation) using x-ray optics, such as the zone plate or ellipsoidal capillary mirrors. Recently, we developed a laser-based μ-ARPES with spin-resolution (LMS-ARPES). The 177 nm laser beam is achieved by frequency-doubling a 355 nm beam using a KBBF crystal and subsequently focused using an optical lens with a focal length of about 16 mm. By characterizing the focused spot size using different methods and performing spatial-scanning photoemission measurement, we confirm the sub-micron spatial resolution of the system. Compared with the μ-ARPES facilities based on the synchrotron radiation, our LMS-ARPES system is not only more economical and convenient, but also with higher photon flux (>5 × 1013 photons/s), thus enabling the high-resolution and high-statistics measurements. Moreover, the system is equipped with a two-dimensional spin detector based on exchange scattering at a surface-passivated iron film grown on a W(100) substrate. We investigate the spin structure of the prototype topological insulator Bi2Se3 and reveal a high spin-polarization rate, confirming its spin-momentum locking property. This lab-based LMS-ARPES will be a powerful research tool for studying the local fine electronic structures of different condensed matter systems, including topological quantum materials, mesoscopic materials and structures, and phase-separated materials.
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Affiliation(s)
- R Z Xu
- State Key Laboratory of Low Dimensional Quantum Physics, Department of Physics, Tsinghua University, Beijing 100084, China
| | - X Gu
- State Key Laboratory of Low Dimensional Quantum Physics, Department of Physics, Tsinghua University, Beijing 100084, China
| | - W X Zhao
- State Key Laboratory of Low Dimensional Quantum Physics, Department of Physics, Tsinghua University, Beijing 100084, China
| | - J S Zhou
- State Key Laboratory of Low Dimensional Quantum Physics, Department of Physics, Tsinghua University, Beijing 100084, China
| | - Q Q Zhang
- State Key Laboratory of Low Dimensional Quantum Physics, Department of Physics, Tsinghua University, Beijing 100084, China
| | - X Du
- State Key Laboratory of Low Dimensional Quantum Physics, Department of Physics, Tsinghua University, Beijing 100084, China
| | - Y D Li
- State Key Laboratory of Low Dimensional Quantum Physics, Department of Physics, Tsinghua University, Beijing 100084, China
| | - Y H Mao
- College of Advanced Interdisciplinary Studies, National University of Defense Technology, Changsha, Hunan 410073, China
| | - D Zhao
- Department of Optics and Optical Engineering, University of Science and Technology of China, Hefei, Anhui 230026, China
| | - K Huang
- Department of Optics and Optical Engineering, University of Science and Technology of China, Hefei, Anhui 230026, China
| | - C F Zhang
- College of Advanced Interdisciplinary Studies, National University of Defense Technology, Changsha, Hunan 410073, China
| | - F Wang
- ShanghaiTech Laboratory for Topological Physics, Shanghai 200031, China
| | - Z K Liu
- ShanghaiTech Laboratory for Topological Physics, Shanghai 200031, China
| | - Y L Chen
- ShanghaiTech Laboratory for Topological Physics, Shanghai 200031, China
| | - L X Yang
- State Key Laboratory of Low Dimensional Quantum Physics, Department of Physics, Tsinghua University, Beijing 100084, China
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Yang LJ, Zhou JZ, Zheng YF, Hu X, He ZY, Du LJ, Gu X, Huang XY, Li J, Li YQ, Pan LY, Zhang XX, Gu XJ. Association of non-alcoholic fatty liver disease with total testosterone in non-overweight/obese men with type 2 diabetes mellitus. J Endocrinol Invest 2023:10.1007/s40618-023-02006-6. [PMID: 36725809 DOI: 10.1007/s40618-023-02006-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 01/04/2023] [Indexed: 02/03/2023]
Abstract
PURPOSE Non-alcoholic fatty liver disease (NAFLD) is considered as both a vital risk factor and a consequence of type 2 diabetes mellitus (T2DM). Low total testosterone (TT) is common in men with T2DM, contributing to increased risks of metabolic diseases. This study aimed to investigate the association between TT levels and the prevalence of NAFLD in men with T2DM. METHODS In this cross-sectional study, 1005 men with T2DM were enrolled in National Metabolic Management Center (MMC) of First Affiliated Hospital of Wenzhou Medical University between January 2017 and August 2021. NAFLD was diagnosed using ultrasound as described by the Chinese Liver Disease Association. Overweight/obesity was defined as body mass index (BMI) ≥ 25 kg/m2 according to WHO BMI classifications. RESULTS Individuals without NAFLD had higher serum TT levels than those with NAFLD. After adjustments for potential confounding factors, the top tertile was significantly associated with lower prevalence of NAFLD compared with the bottom tertile of TT level [odds ratio (OR) 0.303, 95% confidence interval (CI) 0.281-0.713; P < 0.001]. The association between TT with NAFLD in individuals with normal weight (OR 0.175, 95% CI 0.098-0.315; P < 0.001) was stronger than in individuals with overweight/obesity (OR 0.509, 95% CI 0.267-0.971; P = 0.040). There was a significant interaction of TT with overweight/obesity (P for interaction = 0.018 for NAFLD). CONCLUSION Higher serum TT was significantly associated with a lower prevalence of NAFLD in men with T2DM. We found that the relationship of TT and NAFLD was stronger in individuals with non-overweight/obesity.
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Affiliation(s)
- L J Yang
- Department of Endocrine and Metabolic Diseases, The First Affiliated Hospital of Wenzhou Medical University, Ouhai District, Wenzhou, 325000, Zhejiang Province, China
| | - J Z Zhou
- Department of Endocrine and Metabolic Diseases, The First Affiliated Hospital of Wenzhou Medical University, Ouhai District, Wenzhou, 325000, Zhejiang Province, China
| | - Y F Zheng
- Department of Endocrine and Metabolic Diseases, The First Affiliated Hospital of Wenzhou Medical University, Ouhai District, Wenzhou, 325000, Zhejiang Province, China
| | - X Hu
- Department of Endocrine and Metabolic Diseases, The First Affiliated Hospital of Wenzhou Medical University, Ouhai District, Wenzhou, 325000, Zhejiang Province, China
| | - Z Y He
- Department of Endocrine and Metabolic Diseases, The First Affiliated Hospital of Wenzhou Medical University, Ouhai District, Wenzhou, 325000, Zhejiang Province, China
| | - L J Du
- Department of Endocrine and Metabolic Diseases, The First Affiliated Hospital of Wenzhou Medical University, Ouhai District, Wenzhou, 325000, Zhejiang Province, China
| | - X Gu
- Department of Endocrine and Metabolic Diseases, The First Affiliated Hospital of Wenzhou Medical University, Ouhai District, Wenzhou, 325000, Zhejiang Province, China
| | - X Y Huang
- Department of Endocrine and Metabolic Diseases, The First Affiliated Hospital of Wenzhou Medical University, Ouhai District, Wenzhou, 325000, Zhejiang Province, China
| | - J Li
- Department of Endocrine and Metabolic Diseases, The First Affiliated Hospital of Wenzhou Medical University, Ouhai District, Wenzhou, 325000, Zhejiang Province, China
| | - Y Q Li
- Department of Endocrine and Metabolic Diseases, The First Affiliated Hospital of Wenzhou Medical University, Ouhai District, Wenzhou, 325000, Zhejiang Province, China
| | - L Y Pan
- Department of Endocrine and Metabolic Diseases, The First Affiliated Hospital of Wenzhou Medical University, Ouhai District, Wenzhou, 325000, Zhejiang Province, China
| | - X X Zhang
- Department of Endocrine and Metabolic Diseases, The First Affiliated Hospital of Wenzhou Medical University, Ouhai District, Wenzhou, 325000, Zhejiang Province, China
| | - X J Gu
- Department of Endocrine and Metabolic Diseases, The First Affiliated Hospital of Wenzhou Medical University, Ouhai District, Wenzhou, 325000, Zhejiang Province, China.
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Shen M, Cai C, Song L, Qiu J, Ma C, Wang D, Gu X, Yang X, Wei W, Tao Y, Zhang J, Liu G, Zhu C. Elevated CO 2 and temperature under future climate change increase severity of rice sheath blight. Front Plant Sci 2023; 14:1115614. [PMID: 36778685 PMCID: PMC9909553 DOI: 10.3389/fpls.2023.1115614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Accepted: 01/12/2023] [Indexed: 06/18/2023]
Abstract
Sheath blight (ShB), caused by Rhizoctonia solani, is one of the major threats to rice (Oryza sativa L.) production. However, it is not clear how the risk of rice ShB will respond to elevated CO2 and temperature under future climate change. Here, we conducted, field experiments of inoculated R. solani under combinations of two CO2 levels (ambient and enriched up to 590 μmol mol-1) and two temperature levels (ambient and increased by 2.0°C) in temperature by free-air CO2 enrichment (T-FACE) system for two cultivars (a susceptible cultivar, Lemont and a resistant cultivar, YSBR1). Results indicate that for the inoculation of plants with R. solani, the vertical length of ShB lesions for cv. Lemont was significantly longer than that for cv. YSBR1 under four CO2 and temperature treatments. The vertical length of ShB lesions was significantly increased by elevated temperature, but not by elevated CO2, for both cultivars. The vertical length of ShB lesions under the combination of elevated CO2 and elevated temperature was increased by 21-38% for cv. Lemont and by -1-6% for cv. YSBR1. A significant increase in MDA level was related to a significant increase in the vertical length of ShB lesions under the combination of elevated CO2 and elevated temperature. Elevated CO2 could not compensate for the negative effect of elevated temperature on yield of both cultivars under future climate change. Rice yield and biomass were further decreased by 2.0-2.5% and 2.9-4.2% by an increase in the severity of ShB under the combination of elevated CO2 and elevated temperature. Thus, reasonable agronomic management practices are required to improve both resistance to ShB disease and grain yield for rice under future climate change.
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Affiliation(s)
- Min Shen
- State Key Laboratory of Soil and Sustainable Agriculture, Institute of Soil Science, Chinese Academy of Sciences, Nanjing, China
- University of Chinese Academy of Sciences, Beijing, China
| | - Chuang Cai
- State Key Laboratory of Soil and Sustainable Agriculture, Institute of Soil Science, Chinese Academy of Sciences, Nanjing, China
| | - Lian Song
- State Key Laboratory of Soil and Sustainable Agriculture, Institute of Soil Science, Chinese Academy of Sciences, Nanjing, China
| | - Jiangbo Qiu
- School of Environmental and Civil Engineering, Jiangnan University, Wuxi, China
| | - Chuanqi Ma
- State Key Laboratory of Soil and Sustainable Agriculture, Institute of Soil Science, Chinese Academy of Sciences, Nanjing, China
- University of Chinese Academy of Sciences, Beijing, China
| | - Dongming Wang
- State Key Laboratory of Soil and Sustainable Agriculture, Institute of Soil Science, Chinese Academy of Sciences, Nanjing, China
- University of Chinese Academy of Sciences, Beijing, China
| | - Xinyue Gu
- State Key Laboratory of Soil and Sustainable Agriculture, Institute of Soil Science, Chinese Academy of Sciences, Nanjing, China
- University of Chinese Academy of Sciences, Beijing, China
| | - Xiong Yang
- State Key Laboratory of Soil and Sustainable Agriculture, Institute of Soil Science, Chinese Academy of Sciences, Nanjing, China
- University of Chinese Academy of Sciences, Beijing, China
| | - Wei Wei
- State Key Laboratory of Soil and Sustainable Agriculture, Institute of Soil Science, Chinese Academy of Sciences, Nanjing, China
- University of Chinese Academy of Sciences, Beijing, China
| | - Ye Tao
- State Key Laboratory of Soil and Sustainable Agriculture, Institute of Soil Science, Chinese Academy of Sciences, Nanjing, China
- University of Chinese Academy of Sciences, Beijing, China
| | - Jishuang Zhang
- State Key Laboratory of Soil and Sustainable Agriculture, Institute of Soil Science, Chinese Academy of Sciences, Nanjing, China
- University of Chinese Academy of Sciences, Beijing, China
| | - Gang Liu
- State Key Laboratory of Soil and Sustainable Agriculture, Institute of Soil Science, Chinese Academy of Sciences, Nanjing, China
| | - Chunwu Zhu
- State Key Laboratory of Soil and Sustainable Agriculture, Institute of Soil Science, Chinese Academy of Sciences, Nanjing, China
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