Development of a new method framework to estimate the nonlinear and interaction relationship between environmental factors and soil heavy metals

The intricate and multifaceted nature of soil system profoundly influences the highly complex and often nonlinear changes that soil heavy metals (HM) undergo. Spatial heterogeneity, location and scale variability, and the interaction and superposition among environmental drivers challenged researchers to determine the sophisticated nature of soil HMs changes at the regional scale. This study aims to develop a new method framework and selects Ningbo as the case study to apportion the environmental factors responsible for soil HMs pollution that include Cd, Cr, Pb, Hg, As, Cu, Zn and Ni, focusing on nonlinearity and interaction. We harnessed the Random Forest model to apportion the environmental drivers of soil HM change. The directionality and shape of the nonlinear relationship between HMs and their individual contributors were derived by Partial Dependence Plots. The interactions of multiple drivers were quantitatively assessed by the Conditional Inference Tree. Our results demonstrated that soil HMs in the study area varied spatially. Soil HMs pollution was mitigated by natural factors and anthropogenic factors. The main influencing factors were pH, soil parent material type, enterprise activities, and agricultural application. The effects of some factors on soil HMs showed a monotonic linear trend, but some have apparent threshold effects. The direction of influence on soil HMs will shift when pH and phosphate fertilizer reach a specific value. The addition of enterprises in the area would rarely have an impact on the HMs pollution once it reached around 2 per km2 because of the industrial agglomeration. Soil HM concentrations were mainly from multi-pollutants and were governed by a combination of environmental factors. Our study provided managers and policymakers with site-specific and definite guidelines for preventing and controlling soil HM pollution.

Machine learning combined with Geodetector quantifies the synergistic effect of environmental factors on soil heavy metal pollution

The critical prerequisite for the prevention and control of soil heavy metal (HM) pollution is the identification of factors that influence soil HM accumulation. The dominant factors have been individually identified and apportioned in existing studies. However, the accumulation of soil HMs results from a combination of multiple factors, and the influence of a single factor is less than the interaction of multiple parameters on soil HM pollution. In this study, we employed Geodetector to delve into the interaction effect of the influencing factors on the variations of soil HMs. We performed partial dependence plot to depict how these factors interact with each other to affect the HM content. We found that both individually and interactively, pH and agricultural activities significantly impact soil HM content. Except for Hg and Cu, the pairs with the most significant interaction effects all involve pH. For Pb, As and Zn, interaction with pH has the most significant driving force compared to the other factors. For Cu, Hg, and Ni, all environmental factor interactions increased their explanatory power, while for Cr, the single most significant driver decreased its driving power when interacting with other factors. Additionally, the study area exhibited a widespread prevalence of changes in HM concentration being governed by the synergistic effect of two factors. For the response of HMs to the interaction of pH and fertilizer, soil HM concentration was sensitive to pH, while fertilizer had less effect. These results provide a dependable method of investigating the interaction of environmental factors on soil HM content and put forth efficacious and potent tactical measures for soil HM pollution prevention and control based on the interaction type.

Impacts of land use transitions on ecosystem services: A research framework coupled with structure, function, and dynamics

Rapid urbanization in China has resulted in drastic land use transitions (LUT) and has had a severe impact on the supply of regional ecosystem services (ESs). To improve ecosystem security and promote sustainable development regionally, it is essential to clarify spatial correlations between the multi-dimensional characteristics of LUT and ESs. We developed a theoretical framework to examine how LUT influenced regional ESs in three dimensions: land use structure, function, and dynamics. Using the Taihu Lake Rim urban agglomeration (TLRUA) as an example, we explored the process by which LUT affected the change in regional ESs. The results indicated that the TLRUA experienced accelerated urbanization between 2000 and 2018, with LUT and ESs exhibiting distinct characteristics in urban, suburban, and rural areas in different regions. The impact of LUT on ESs, as we analyzed them from different dimensions, embraced interactive effects and significant spatial spillover effects. The land use structural transitions were globally positively correlated with habitat maintenance, carbon sequestration, and recreation potential, whereas land use intensity and dynamics transitions exhibited negative correlations. Given their interactions at the local scale, we propose corresponding land management strategies, which can offer practical guidance for coordinating regional land resource development and ecosystem conservation.

Spatialization and driving factors of carbon budget at county level in the Yangtze River Delta of China

The county is the basic administrative unit of China, and the spatialization of carbon budget at the county scale plays an irreplaceable role in deepening the understanding of the carbon emission mechanism and spatial pattern. Yueqing County, an economically developed county in the Yangtze River Delta of China, was selected as the study area, the spatial pattern of the carbon budget and the optimal resolution of the spatialization at the county level were dissected on the basis of accurate accounting, and driving factors of carbon emissions were further identified using the geographically weighted regression model. The results indicated that (1) the carbon emissions were mainly generated from fossil fuel combustion related to energy, accounting for 98.8% of the total carbon budget in the study area; (2) the optimal resolution of spatialization was 200 m and carbon emissions were concentrated in the southeast of the study area; (3) energy intensity, energy structure, per capita GDP, and urbanization rate were positively correlated with carbon emissions, while population played a bidirectional role in carbon emissions. This study not only strengthens the understanding of the patterns and drivers of the carbon budget but also establishes a theoretical framework and operational tools for policymakers to formulate solutions to mitigate the carbon crisis.

Gastric H+/K+-ATPase Expression in Normal Laryngeal Tissue and Laryngeal Carcinoma

Background

Several studies have suggested that laryngopharyngeal reflux disease (LPRD) or gastroesophageal reflux disease (GERD) is an independent risk factor for laryngeal carcinoma. However, it remains unclear whether either condition affects the level of H⁺/K⁺-ATPase expression in laryngeal carcinoma.

Materials and Methods

Immunohistochemistry, real-time RT-PCR, and Western blotting were used to explore the distributions of proton pump (H⁺/K⁺-ATPase) α- and β-subunits in normal laryngeal tissue and laryngeal carcinoma.

Results

Messenger RNAs encoding both the α- and β-subunits were found in the normal epiglottic, ventricular fold, vocal fold, and arytenoid mucosae, as well as epiglottic cartilage. The distributions and expression levels of H+/K+-ATPase α-subunits in various laryngeal subregions did not significantly differ in IHC, RT-PCR, or Western blotting. However, Western blotting revealed a significant difference between the expression level of the β-subunit protein in the epiglottic cartilage and the levels in other sites. The expression levels of both subunits were significantly higher in carcinomatous than in paracarcinomatous tissue and normal laryngeal tissue. The mean follow-up duration was 66.2 months (range, 17–162 months). In all, 4 patients died during follow-up, 4 were lost to follow-up, and 22 were alive and free of disease at the end of follow-up. Two patients developed lung metastases and six developed disease recurrences (at 2, 8, 14, 16, 36, and 41 months). The 3- and 5-year overall survival (OS) rates were 93.0% and 77.0%, respectively. Univariate analyses showed that the 5-year OSs were significantly associated with the T, N, and clinical stages but not with age, alcohol use, pathological differentiation, or the expression levels of the α- or β-subunits (as revealed by IHC, RT-PCR, or Western blotting). However, in multivariate regression analyses, the 5-year OSs were not significantly associated with any clinicopathological factor or the expression levels of either subunit.

Conclusion

H⁺/K⁺-ATPase is expressed in the normal larynx, including in the epiglottic cartilage and the mucosae of the epiglottis, ventricular fold, and arytenoid vocal fold. The expression levels of the H⁺/K⁺-ATPase α- and β-subunits in laryngeal carcinomas were higher than in normal laryngeal tissues.

Magnetic properties of γ-Fe2O3 nanoparticles in a porous SiO2 shell for drug delivery

A method is presented for synthesizing core-shell nanoparticles with a magnetic core and a porous shell suitable for drug delivery and other medical applications. The core contains multiple γ-Fe2O3 nanoparticles (∼15 nm) enclosed in a SiO2 (∼100-200 nm) matrix using either methyl (denoted TMOS-γ-Fe2O3) or ethyl (TEOS-γ-Fe2O3) template groups. Low-temperature Mössbauer spectroscopy showed that the magnetic nanoparticles have the maghemite structure, γ-Fe2O3, with all the vacancies in the octahedral sites. Saturation magnetization measurements revealed that the density of γ-Fe2O3 was greater in the TMOS-γ-Fe2O3 nanoparticles than TEOS-γ-Fe2O3 nanoparticles, presumably because of the smaller methyl group. Magnetization measurements showed that the blocking temperature is around room temperature for the TMOS-γ-Fe2O3 and around 250 K for the TEOS-γ-Fe2O3. Three dimensional topography analysis shows clearly that the magnetic nanoparticles are not only at the surface but have penetrated deep in the silica to form the core-shell structure.

GLUT-1 siRNA Enhances Radiosensitization Of Laryngeal Cancer Stem Cells Via Enhanced DNA Damage, Cell Cycle Redistribution, And Promotion Of Apoptosis In Vitro And In Vivo

Background

Radiotherapy does not show good efficacy against laryngeal cancer due to radioresistance. Cancer stem cells (CSCs) are considered among the causes of radioresistance. Inhibition of glucose transporter-1 (GLUT-1) using GLUT-1 small interfering RNA (siRNA) may enhance the radiosensitivity of laryngeal cancer cells, but the underlying cellular mechanisms remain unclear.

Methods

The CD133⁺-Hep-2R cell line was established with repeated irradiation and magnetic-activated cell sorting. The effects of irradiation on CD133⁺-Hep-2R cells were examined by CCK-8 assay, Transwell assay, quantitative real-time polymerase chain reaction (RT-PCR), and Western blotting. The effects of GLUT-1 siRNA on the radiosensitivity of CD133⁺-Hep-2/2R cells were examined by RT-PCR, Western blotting, CCK-8 assay, colony formation assay, and Transwell assay in vitro and in a xenograft tumor model in nude mice. The cellular mechanism of enhanced radiosensitivity associated with GLUT-1 siRNA was investigated. The cell cycle and apoptosis rate were analyzed by flow cytometry, and the repair capability was examined by determining the levels of RAD51 and DNA-PKcs.

Results

CD133⁺-Hep-2/2R cells showed stronger proliferation, lower apoptosis rate, lower percentage of G0/G1 phase cells, higher percentages of S and G2/M phase cells, and higher expression levels of GLUT-1 than Hep-2/2R cells. Transfection with GLUT-1 siRNA inhibited the proliferation and invasive capability of CD133⁺-Hep-2R cells by inhibiting GLUT-1 expression, which also caused a redistribution of the cell cycle (higher proportion of cells in the G0/G1 phase and lower proportion in the S and G2/M phases), increased the apoptosis rate, and reduced DNA repair capability by suppressing RAD51 and DNA-PKcs expression.

Conclusion

The results of this study suggest that GLUT-1 siRNA can enhance the radiosensitivity of CD133⁺-Hep-2R cells by inducing a redistribution of cell cycle phases, inhibiting DNA repair capability, and increasing apoptosis. Inhibition of GLUT-1 may have therapeutic potential for interventions to increase the radiosensitivity of laryngeal CSCs.

A Machine Learning Method for Identifying Lung Cancer Based on Routine Blood Indices: Qualitative Feasibility Study

Background

Liquid biopsies based on blood samples have been widely accepted as a diagnostic and monitoring tool for cancers, but extremely high sensitivity is frequently needed due to the very low levels of the specially selected DNA, RNA, or protein biomarkers that are released into blood. However, routine blood indices tests are frequently ordered by physicians, as they are easy to perform and are cost effective. In addition, machine learning is broadly accepted for its ability to decipher complicated connections between multiple sets of test data and diseases.

Objective

The aim of this study is to discover the potential association between lung cancer and routine blood indices and thereby help clinicians and patients to identify lung cancer based on these routine tests.

Methods

The machine learning method known as Random Forest was adopted to build an identification model between routine blood indices and lung cancer that would determine if they were potentially linked. Ten-fold cross-validation and further tests were utilized to evaluate the reliability of the identification model.

Results

In total, 277 patients with 49 types of routine blood indices were included in this study, including 183 patients with lung cancer and 94 patients without lung cancer. Throughout the course of the study, there was correlation found between the combination of 19 types of routine blood indices and lung cancer. Lung cancer patients could be identified from other patients, especially those with tuberculosis (which usually has similar clinical symptoms to lung cancer), with a sensitivity, specificity and total accuracy of 96.3%, 94.97% and 95.7% for the cross-validation results, respectively. This identification method is called the routine blood indices model for lung cancer, and it promises to be of help as a tool for both clinicians and patients for the identification of lung cancer based on routine blood indices.

Conclusions

Lung cancer can be identified based on the combination of 19 types of routine blood indices, which implies that artificial intelligence can find the connections between a disease and the fundamental indices of blood, which could reduce the necessity of costly, elaborate blood test techniques for this purpose. It may also be possible that the combination of multiple indices obtained from routine blood tests may be connected to other diseases as well.

Stereotactic image-guided neoadjuvant ablative single-dose radiation, then lumpectomy, for early breast cancer: the SIGNAL prospective single-arm trial of single-dose radiation therapy

Background and Purpose

Adjuvant whole-breast irradiation after breast-conserving surgery, typically delivered over several weeks, is the traditional standard of care for low-risk breast cancer. More recently, hypofractionated, partial-breast irradiation has increasingly become established. Neoadjuvant single-fraction radiotherapy (rt) is an uncommon approach wherein the unresected lesion is irradiated preoperatively in a single fraction. We developed the signal (Stereotactic Image-Guided Neoadjuvant Ablative Radiation Then Lumpectomy) trial, a prospective single-arm trial to test our hypothesis that, for low-risk carcinoma of the breast, the preoperative single-fraction approach would be feasible and safe.

Methods

Patients presenting with early-stage (T < 3 cm), estrogen-positive, clinically node-negative invasive carcinoma of the breast with tumours at least 2 cm away from skin and chest wall were enrolled. All patients received prone breast magnetic resonance imaging (mri) and prone computed tomography simulation. Treatable patients received a single 21 Gy fraction of external-beam rt (as volumetric-modulated arc therapy) to the primary lesion in the breast, followed by definitive surgery 1 week later. The primary endpoints at 3 weeks, 6 months, and 1 year were toxicity and cosmesis (that is, safety) and feasibility (defined as the proportion of mri-appropriate patients receiving rt).

Results

Of 52 patients accrued, 27 were successfully treated. The initial dosimetric constraints resulted in a feasibility failure, because only 57% of eligible patients were successfully treated. Revised dosimetric constraints were developed, after which 100% of patients meeting mri criteria were treated according to protocol. At 3 weeks, 6 months, and 1 year after the operation, toxicity, patient- and physician-rated cosmesis, and quality of life were not significantly different from baseline.

Conclusions

The signal trial presents a feasible method of implementing single-dose preoperative rt in early-stage breast cancer. This pilot study did not identify any significant toxicity and demonstrated excellent cosmetic and quality-of-life outcomes. Future randomized multi-arm studies are required to corroborate these findings.

Continuous Temperature-Monitoring Socks for Home Use in Patients With Diabetes: Observational Study

Background

Over 30 million people in the United States (over 9%) have been diagnosed with diabetes. About 25% of people with diabetes will experience a diabetic foot ulcer (DFU) in their lifetime. Unresolved DFUs may lead to sepsis and are the leading cause of lower-limb amputations. DFU rates can be reduced by screening patients with diabetes to enable risk-based interventions. Skin temperature assessment has been shown to reduce the risk of foot ulceration. While several tools have been developed to measure plantar temperatures, they only measure temperature once a day or are designed for clinic use only. In this report, wireless sensor-embedded socks designed for daily wear are introduced, which perform continuous temperature monitoring of the feet of persons with diabetes in the home environment. Combined with a mobile app, this wearable device informs the wearer about temperature increases in one foot relative to the other, to facilitate early detection of ulcers and timely intervention.

Objective

A pilot study was conducted to assess the accuracy of sensors used in daily wear socks, obtain user feedback on how comfortable sensor-embedded socks were for home use, and examine whether observed temperatures correlated with clinical observations.

Methods

Temperature accuracy of sensors was assessed both prior to incorporation in the socks, as well as in the completed design. The measured temperatures were compared to the reference standard, a high-precision thermostatic water bath in the range 20°C-40°C. A total of 35 patients, 18 years of age and older, with diabetic peripheral neuropathy were enrolled in a single-site study conducted under an Institutional Review Board–approved protocol. This study evaluated the usability of the sensor-embedded socks and correlated the observed temperatures with clinical findings.

Results

The temperatures measured by the stand-alone sensors were within 0.2°C of the reference standard. In the sensor-embedded socks, across multiple measurements for each of the six sensors, a high agreement (R²=1) between temperatures measured and the reference standard was observed. Patients reported that the socks were easy to use and comfortable, ranking them at a median score of 9 or 10 for comfort and ease of use on a 10-point scale. Case studies are presented showing that the temperature differences observed between the feet were consistent with clinical observations.

Conclusions

We report the first use of wireless continuous temperature monitoring for daily wear and home use in patients with diabetes and neuropathy. The wearers found the socks to be no different from standard socks. The temperature studies conducted show that the sensors used in the socks are reliable and accurate at detecting temperature and the findings matched clinical observations. Continuous temperature monitoring is a promising approach as an early warning system for foot ulcers, Charcot foot, and reulceration.

Radiologic-Pathologic Correlation of Tumor Thickness and Its Prognostic Importance in Squamous Cell Carcinoma of the Oral Cavity: Implications for the Eighth Edition Tumor, Node, Metastasis Classification

BACKGROUND AND PURPOSE

Addressing the performance of an imaging-based parameter compared to a "gold standard" pathologic measurement is essential to achieve accurate clinical T-classification. Our aim was to determine the radiologic-pathologic tumor thickness correlation and its prognostic value in oral squamous cell carcinoma.

MATERIALS AND METHODS

All pathologic T1-T3 (seventh edition of the Cancer Staging Manual of the American Joint Committee on Cancer) oral squamous cell carcinomas diagnosed between 2010 and 2015 were reviewed. Radiologic tumor thickness was measured on preoperative CT or MR imaging blinded to pathology. The radiologic-pathologic tumor thickness correlation was calculated. The impact of the imaging-to-surgery time interval and imaging technique on the correlation was explored. Intra-/interrater reliability on radiologic tumor thickness was calculated. The correlation of radiologic-versus-pathologic tumor thickness and its performance as the seventh edition T-category modifier was evaluated. Multivariable analysis assessed the prognostic value of the radiologic tumor thickness for overall survival adjusted for age, seventh edition T-category, and performance status.

RESULTS

For 354 consecutive patients, the radiologic-pathologic tumor thickness correlation was similar for the image-to-surgery interval of ≤4.0 weeks (ρ = 0.76) versus 4-8 weeks (ρ = 0.80) but lower in those with more than an 8-week interval (ρ = 0.62). CT and MR imaging had similar correlations (0.76 and 0.80). Intrarater and interrater reliability was excellent (0.88 and 0.84). Excluding 19 cases with an imaging-to-surgery interval of >8 weeks, 335 patients were eligible for further analysis. The radiologic-pathologic tumor thickness correlation was 0.78. The accuracy for upstaging the T-classification based on radiologic tumor thickness was 83% for pathologic T1 and 74% for pathologic T2 tumors. Multivariable analysis confirmed the prognostic value of radiologic tumor thickness (hazard ratio = 1.5, P = .02) for overall survival.

CONCLUSIONS

This study demonstrates a good radiologic-pathologic tumor thickness correlation. Intrarater and interrater reliability for radiologic tumor thickness was excellent. Radiologically thicker tumor was predictive of inferior survival.

Phase I study of concurrent and consolidation cisplatin and docetaxel chemotherapy with thoracic radiotherapy in non-small cell lung cancer

Background

We designed a phase i study of concurrent chemoradiotherapy (ccrt) with docetaxel (D) and cisplatin (C), followed by consolidation dc, for unresectable stage iii non-small cell lung cancer (nsclc).

Methods

Patients with histologically proven and unresectable stage iii nsclc were eligible. During ccrt, C was given every 3 weeks (75 mg/m²) and D given weekly. The starting dose of D was 20 mg/m², escalated in cohorts of 3 to define the maximum tolerated dose (mtd). Radiotherapy was prescribed to a dose of 60 Gy in 30 fractions. This was followed by 2 cycles of consolidation dc, which were dose escalated if ccrt was tolerated.

Results

Twenty-six patients were enrolled, with 1 excluded following evidence of metastatic disease. Nineteen patients completed both phases of treatment. There were 7 grade 3 events during ccrt (5 esophagitis, 2 nausea), and 8 grade 3 events during consolidation (2 neutropenia, 2 leukopenia, 1 esophagitis, 2 nausea, and 1 pneumonitis). Three patients had grade 4 neutropenia. No patients died due to toxicities. The mtd of concurrent weekly D was 20 mg/m². Consolidation D and C were each dose escalated to 75 mg/m² in 8 patients. The median overall survival (os) and progression-free survival (pfs) of all patients were 33.6 months and 17.2 months, respectively, with median follow-up of 26.6 months (range 0.43-110.8).

Conclusions

The use of docetaxel 20 mg/m² weekly and cisplatin 75 mg/m² every 3 weeks concurrent with thoracic radiotherapy, followed by consolidation docetaxel and cisplatin, both given at 75 mg/m² every 3 weeks, appears to be safe in this phase i trial.

Phase I Study of Concurrent and Consolidation Cisplatin and Docetaxel Chemotherapy with Thoracic Radiotherapy in Non-Small Cell Lung Cancer

Background: We designed a phase I study of concurrent chemoradiotherapy (CCRT) with docetaxel (D) and cisplatin (C), followed by consolidation DC, for unresectable stage III non-small cell lung cancer (NSCLC). Methods: Patients with histologically proven and unresectable stage III NSCLC were eligible. During CCRT, C was given every 3 weeks (75 mg/m2) and D given weekly. The starting dose of D was 20 mg/m2, escalated in cohorts of 3 to define the maximum tolerated dose (MTD). Radiotherapy was prescribed to a dose of 60 Gy in 30 fractions. This was followed by 2 cycles of consolidation DC, which were dose escalated if CCRT was tolerated. Results: Twenty-six patients were enrolled, with 1 excluded following evidence of metastatic disease. Nineteen patients completed both phases of treatment. There were 7 grade 3 events during CCRT (5 esophagitis, 2 nausea), and 8 grade 3 events during consolidation (2 neutropenia, 2 leukopenia, 1 esophagitis, 2 nausea, and 1 pneumonitis). Three patients had grade 4 neutropenia. No patients died due to toxicities. The MTD of concurrent weekly D was 20 mg/m2. Consolidation D and C were each dose escalated to 75 mg/m2 in 8 patients. The median overall survival (OS) and progression-free survival (pfs) of all patients were 33.6 months and 17.2 months, respectively, with median follow-up of 26.6 months (range 0.43–110.8). Conclusions: The use of docetaxel 20 mg/m2 weekly and cisplatin 75 mg/m2 every 3 weeks concurrent with thoracic radiotherapy, followed by consolidation docetaxel and cisplatin, both given at 75 mg/m2 every 3 weeks, appears to be safe in this phase I trial.