Prognostic value of serial coronary computed tomography angiography-derived perivascular fat-attenuation index and plaque volume in patients with suspected coronary artery disease

AIMS

To investigate the prognostic value of serial coronary computed tomography angiography (CCTA) derived plaque information, fractional flow reserve (CT-FFR), and perivascular fat-attenuation index (FAI) on major adverse cardiac events (MACE) in patients with suspected coronary artery disease.

MATERIALS AND METHODS

A total of 252 patients who underwent serial CCTA between January 2018 and December 2021 and were followed until June 2022. MACE were recorded. The analysis indexes included percent diameter stenosis (%DS), lesion length, plaque volume, CT-FFR, and FAI, with an emphasis on their changes between the baseline and follow-up CCTAs. Multivariate regression analysis were employed to identify independent risk factors for MACE.

RESULTS

After a median follow-up of 48-month, MACE occurred in 32 patients (12.7%). Patients with MACE displayed more severe stenosis, longer lesions, and larger plaque volumes in both baseline and follow-up CCTAs compared with no-MACE patients (all P<0.05). Patients with MACE displayed more severe stenosis, longer lesion, and larger plaque volume in both baseline and follow-up CCTAs compared with no-MACE patients. In addition, MACE patients also showed lower CT-FFR and higher △CT-FFR. Although FAI was significantly higher in MACE patients at baseline CCTA, FAI was notably increased in MACE patients, and decreased in the no-MACE patients (all P<0.05). Logistic regression analysis showed that ΔFAI, %DS, and plaque volume were independent predictors of MACE, with ΔFAI being the most significant (OR: 16.725, P<0.000). A multivariable model showed a significantly improved C-index of 0.903 (95% confidence interval: 0.836-0.970) for MACE prediction, when compared with single index alone.

CONCLUSIONS

Serial CCTA-derived ΔFAI, %DS, and plaque volume are crucial independent predictors of MACE in patients with suspected coronary artery disease, highlighting the importance of CCTA in patient risk stratification and prognostic assessment.

Influence of Health Insurance Types on Clinical Cancer Care Accessibility and Quality Using All of Us Database

Background and Objectives: Cancer, as the second leading cause of death in the United States, poses a huge healthcare burden. Barriers to access to advanced therapies influence the outcome of cancer treatment. In this study, we examined whether insurance types affect the quality of cancer clinical care. Materials and Methods: Data for 13,340 cancer patients with Purchased or Medicaid insurance from the All of Us database were collected for this study. The chi-squared test of proportions was employed to determine the significance of patient cohort characteristics and the accessibility of healthcare services between the Purchased and Medicaid insurance groups. Results: Cancer patients who are African American, with lower socioeconomic status, or with lower educational attainment are more likely to be insured by Medicaid. An analysis of the survey questions demonstrated the relationship between income and education level and insurance type, as Medicaid cancer patients were less likely to receive primary care and specialist physician access and more likely to request lower-cost medications. Conclusions: The inequities of the US healthcare system are observed for cancer patient care; access to physicians and medications is highly varied and dependent on insurance types. Socioeconomic factors further influence insurance types, generating a significant impact on the overall clinical care quality for cancer patients that eventually determines treatment outcomes and the quality of life.

Identification of key factors affecting neonicotinoid residues in crops and risk of dietary exposure

Neonicotinoids, widely used on farmland, are ubiquitous in food; however, their distribution among various crops and associated exposure risks at the provincial level in China remain unclear. We collected 19 types of crop samples (fruits, vegetables, and tea) from farmland in nine prefectural cities in Zhejiang Province, China. We analyzed nine commonly used neonicotinoids in the edible portions of these crops. A notable detection rate (42.1 %-82.9 %) and high residual neonicotinoid concentrations (278 ± 357 ng/g) were observed. Tea exhibited the highest residue, followed by fruits, and vegetables showed the lowest (P < 0.05). Neonicotinoid ratios in crops to soil (R_C/S) and soil to water (R_S/W) were defined to discern insecticide distribution across different environments. Increased water solubility leads to increased migration of neonicotinoids (R_S/W) from agricultural soils to water through runoff, thereby increasing the relative contribution of nitenpyram and dinotefuran in water. In comparison with other studied compounds, all crops demonstrated the strongest soil uptake of thiamethoxam, denoted by the highest R_C/S value. Elevated R_C/S values in tea, pickled cabbage, and celery suggest increased susceptibility of these crops to neonicotinoid absorption from the soil (P < 0.05). Estimated dietary intake for teenagers, adults and elders was 8.9 ± 0.5, 8.9 ± 0.6, and 8.8 ± 0.3 μg/kg/d, respectively, below the reference dose (57 μg/kg/d). Teenagers, compared to adults and elders, exhibited significantly higher neonicotinoid exposure through fruit consumption, emphasizing the need for increased attention to neonicotinoid exposure among vulnerable populations.

Analysis of Anakinra Therapy for the Deficiency of Interleukin-1 Receptor Antagonist through Clinical Evidence

BACKGROUND

Deficiency of interleukin-1 receptor antagonist (DIRA) is a rare life-threatening autosomal recessive autoinflammatory disease with symptoms including but not limited to osteomyelitis, periostitis, and systemic inflammation. DIRA is developed from the loss-of-function biallelic mutations of the IL1RN gene that encodes IL-1 receptor antagonist (IL-1RA), leading to the unchecked pro-inflammatory signaling and subsequent systemic inflammation. Thus, anakinra as the recombinant IL-1RA has become the primary drug to treat DIRA. Although anakinra has been effective for the complete remission of DIRA, it has also shown various side effects. To confirm the efficacy and safety issues associated with DIRA treatment, we conducted a literature review and secondary data analysis to enhance our understanding on this important topic.

METHODS

Through comprehensive literature search, we have identified 15 papers with 25 patients studied. The demographic, clinical, and genetic data were extracted, followed by statistical analysis to support the physiological mechanisms of anakinra treatment.

RESULTS

Through the literature review and data analysis, it was found that 88% of patients had complete clinical remission of DIRA upon continual treatment with anakinra; patients had a mean improvement of Hemoglobin (+3.18 g/dL), Erythrocyte Sedimentation Rate (-53.4 mm/h), and C-reactive Protein (-135.45 mg/L) levels, suggesting that the improvement of hematopoietic function and inflammation is a mechanism for anakinra treatment. Various genetic variants were also identified from the patient data that cause the loss of function of IL-1RA, providing real patient genomic data to support the anakinra treatment.

CONCLUSIONS

Considering the inconsistency and certain variations from clinical research influenced by specific conditions, this review along with the data analysis confirms the efficacy and safety of anakinra treatment for DIRA.

Yield compensation among plant regions improves soybean adaptation to short-term high-temperature stress during the reproductive period

Extreme heat events prolong the reproductive period and threaten soybean yield, whereas the specific stage at which individual fruits growth is delayed, and yield/yield components at the node, region, and plant levels under short-term heat stress in the reproductive stage are elusive. In this study, heat treatments (40/30 °C) were applied at 0-6 days (HTF0-6), 6-12 days (HTF6-12), 12-18 days (HTF12-18), and 0-12 days (HTF0-12) after the plant's first flower opened, and a control treatment (32/22 °C) was performed. The influences of heat stress on fruit development and yield/yield components at the node, region, and plant levels were investigated. As a result, the growth of individual fruits at nodes was delayed by HTF0-6 and HTF0-12, which was primarily caused by the prolongation of flowering to pods with a length of 2 cm. Interestingly, there were no significant differences in yield between the control treatment and the various high-temperature stress treatments at the plant level. Further analysis of the regional yield of soybean showed that the yield in the bottom and top regions of plants played significant roles in compensating for yield loss in the middle region after HTF0-12. Moreover, the delayed growth of individual fruits in the middle region was negatively correlated with yield. Our results indicate that the prolongation of fruit development induced by HTF0-6 and HTF0-12 may adversely affect soybean yield. However, the spatial compensation of plants could help maintain soybean yield under various short-term high temperature stress treatments during the reproductive period, which should be considered when breeding for and selecting heat-tolerant varieties.

Identification of point and nonpoint emission sources of neonicotinoid pollution in regional surface water

Neonicotinoid insecticides are widely applied in farmland, with high detection rates in soils and surface waters, posing potential risks to biodiversity and human health. As a nonpoint emission, surface runoff is widely regarded as the major source of neonicotinoid pollution in surface waters, but few studies have determined the point source contribution to rivers that may be primarily from wastewater treatment plants (WWTPs). Here, we collected the surface water from eight river basins in Zhejiang Province of China and quantified residual concentrations of eight widely commercialized neonicotinoids. Four of these were detected in all samples, with concentrations of dinotefuran and nitenpyram of 119 ± 166 and 87.6 ± 25.3 ng/L, respectively, representing more than 90 % of the total (282 ± 174 ng/L). Neonicotinoid residues were higher in tributaries due to nearby farmland and more dilution effects in the mainstream, and the residues were higher in lower reaches which can be explained by the water flow direction. Significant spatial differences in neonicotinoid distribution between surface water and agricultural soils result from environmental factors (e.g., water turbidity, precipitation, temperature) impacting migration and transport processes. Neonicotinoid residues in surface water showed a significant positive correlation with total WWTP emissions after adjusting for environmental factors. Conversely, no significant association was observed with cropland density (a nonpoint emission source), indicating that point emission source (contributing 20.6 %) predominantly influenced neonicotinoid residue spatial variation in river basin-scale surface water.

A molecularly imprinted sensor for single-molecule detection of pesticide metabolite at the amol/L level sensitized by water-soluble luminol derivative encapsulated liposome via click reaction

A novel luminol derivative, 4-[(1,4-dioxo-1,2,3,4-tetrahydrophthalazin-5-yl)amino]-4-oxobut-2-enoic acid (ALD) with electrochemiluminescence intensity and stability characteristics similar to luminol, but higher solubility in near neutral solution, was designed and synthesized in this study. Using this derivative, a molecular imprinted electrochemiluminescence sensor (MIECLS) was prepared for the sensitive and selective determination of 2-amino-5-mercapto-1,3,4-thiadiazole (AMT), a metabolite of bismerthiazol, thiediazole copper, thiazole zinc, and other pesticides. The ALD probes encapsulated in liposomes are immobilized on the molecularly imprinted film by light-triggered click reaction, and the concurrent release of multiple probes allows for highly sensitive detection. In the AMT concentration range of 1.00 × 10-18 - 5.00 × 10-13 mol/L, the relation between ECL response and log AMT concentration is linear. With a detection limit of 5.25 × 10-19 mol/L (about 4 - 6 molecules in 10 μL of the sample), the sensor allows for high sensitivity analysis of ultra-trace amounts of small organic compounds. In general, the ECL-based single-molecule detection technique proposed herein might be a promising alternative to fluorescence single-molecule detection.

Multiblock Poly-ε-Caprolactones: One-Step Synthesis toward Programmable Properties

Control of monomer sequence enables predictable structure-property relationships in versatile polymeric materials. The facile synthesis of multiblock copolymers (MBCPs) with controlled chain structure is highly challenging, particularly for those prepared via one-pot copolymerization of mixed monomers. Herein, poly-ε-caprolactone MBCPs, a series of thermoplastic elastomers with tailored thermal, mechanical, rheological, and degradable properties, are synthesized by Janus polymerization. Melting temperature, tensile strength, ductility, viscosity, and enzymatic degradability are governed by block length which is in turn dictated by the monomer-to-catalyst feed ratio. The relationships between the physicochemical properties and the architectures are investigated in detail.

Glycine N-Thiocarboxyanhydride: A Key to Glycine-Rich Protein Mimics

Glycine-rich proteins (GRPs) containing a high content of glycine residues (>30%) possess unique structural stability. However, the controllable synthesis of glycine-rich poly(amino acid)s (PAAs) to mimic GRPs has not been realized yet due to the poor solubility of polyglycine segments. We developed a novel method to synthesize glycine-rich PAAs via the controlled ring-opening copolymerization of glycine-N-thiocarboxyanhydrides (Gly-NTA) with sarcosine-N-carboxyanhydride and ε-Cbz-l-lysine-N-carboxyanhydride. The random copolymerization is evidenced by a kinetic study that shows that the propagation rate constant of Gly-NTA is close to those of comonomers. The copolymers exhibit predictable molecular weights between 4.5 and 24.6 kg/mol and tunable glycine incorporation, varying from 10.3 to 59.2%. Poly(Gly-r-Sar) samples with various glycine contents form nanoparticles or a hydrogel in water. Remarkably, the β-sheet folding of poly(Gly-r-Lys) remains intact in a neutral environment where the amine groups are protonated. Overall, the strategy paves the way to engineer glycine-rich PAAs and thereby expands their applications.

Effect of sitagliptin combined with Yiqi yangyin huoxue decoction on clinical efficacy and hemorheology in early diabetic nephropathy

BACKGROUND

Early diabetic nephropathy (DN) is a complication of diabetes mellitus. It mainly affects kidney microvessels and glomerular function, and its timely and effective treatment is critical for early DN. However, the effects of treatments comprising simple Western medicine are not optimal. With the promotion and implementation of integrated Chinese and western medicine treatments, remarkable results have been achieved for many diseases. To this end, we explored the clinical efficacy of integrated traditional Chinese and western medicines for the treatment of early DN.

AIM

To investigate the effect of sitagliptin tablets combined with Yiqi yangyin huoxue decoction on clinical efficacy and hemorheology in patients with early DN.

METHODS

Through a retrospective analysis, 123 patients with early DN were admitted to the endocrinology clinic of the Changzhou NO. 7 People's Hospital from January 2021 to October 2022 and were selected as study subjects. After rigorous screening, 100 patients with early DN were enrolled. The control group (CG, n = 50) and the observation group (OG, n = 50) were divided according to the treatment method. The CG were treated with sitagliptin, and the OG were treated with sitagliptin plus the Yiqi yangyin huoxue decoction. Both groups were treated for 3 mo. For both groups, the baseline data and clinical efficacy were compared, and changes in blood glucose levels, lipid levels, renal function, and hematological indicators before (T0) and after (T1) treatment were assessed.

RESULTS

The total effective rate for the OG was 94.00% and that of the CG was 80.00% (P < 0.05). After treatment (T1), the levels of fasting blood glucose, 2 h postprandial glucose, total cholesterol, triacylglycerol, and low-density lipoprotein cholesterol in OG patients were obviously lower than those in the CG (P < 0.05), and cystatin C, homocysteine, urinary microalbumin, and blood creatinine values in OG patients were also obviously lower than those in the CG (P < 0.05); erythrocyte deposition, plasma viscosity, whole blood high shear viscosity, and whole blood low shear viscosity were markedly lower in OG patients than in the CG (P < 0.05).

CONCLUSION

Sitagliptin combined with Yiqi yangyin huoxue decoction has a remarkable effect when used to treat patients with early DN. Further, it is helpful in improving hemorheological indices and controlling disease progression.

Regulation of SARS-CoV-2 infection by diet-modulated gut microbiota

Coronavirus disease 2019 (COVID-19) caused by SARS-CoV-2 infection has claimed millions of lives since late 2019, yet there are still many unexplored areas in its pathogenesis and clinical outcomes. COVID-19 is a disease that can affects multiple systems, some of which are overlapped with those modulated by gut microbiota, especially the immune system, thus leading to our concentration on analyzing the roles of microbiota in COVID-19 pathogenesis through the gut-lung axis. Dysbiosis of the commensal intestinal microbes and their metabolites (e.g., SCFAs) as well as the expression and activity of ACE2 in the gut could influence the host's immune system in COVID-19 patients. Moreover, it has been known that the elderly and individuals diagnosed with comorbidities (e.g., hypertension, type 2 diabetes mellitus, cardiovascular disease, etc.) are more susceptible to gut flora alterations, SARS-CoV-2 infection, and death. Thus, in this review we will focus on analyzing how the gut microbiota regulates the immune system that leads to different responses to SARS-CoV-2 infection. Since diet is a major factor to modulate the status of gut microbiota, dietary influence on COVID-19 pathogenesis will be also discussed, aiming to shed light on how diet-modulated gut microbiota regulates the susceptibility, severity, and treatment of SARS-CoV-2 infection.

All-organic polymeric materials with high refractive index and excellent transparency

High refractive index polymers (HRIPs) have drawn attention for their optoelectronic applications and HRIPs with excellent transparency and facile preparation are highly demanded. Herein, sulfur-containing all organic HRIPs with refractive indices up to 1.8433 at 589 nm and excellent optical transparency even in one hundred micrometre scale in the visual and RI region as well as high weight-average molecular weights (up to 44500) are prepared by our developed organobase catalyzed polymerization of bromoalkynes and dithiophenols in yields up to 92%. Notably, the fabricated optical transmission waveguides using the resultant HRIP with the highest refractive index display a reduced propagation loss compared with that generated by the commercial material of SU-8. In addition, the tetraphenylethylene containing polymer not only exhibits a reduced propagation loss, but also is used to examine the uniformity and continuity of optical waveguides with naked eyes because of its aggregation-induced emission feature.

Lysine-Sarcosine PiPo Functionalized Surface with Excellent Hemocompatibility

Polysarcosine (PSar) is an electrically neutral and excellently hydrophilic polypeptoid showing limited interaction with proteins and cells, which possesses better biocompatibility compared with polyethylene glycol. However, the immobilization of PSar is difficult due to the high water solubility. Herein, lysine-sarcosine PiPo, which was the random copolymer of lysine and sarcosine (PLS), was synthesized via a phosgene-free and water-tolerable polymerization of N-phenyloxycarbonyl-amino acids for the first time. PLS was immobilized by tannic acid (TA) on the polysulfone (PSf) membrane for a short time to obtain a neutral surface. The modified membrane showed improved hydrophilicity, decreased protein adsorption, and low cytotoxicity. Moreover, barely any hemolysis, no platelet adhesion, prolonged clotting time, and low complement activation further suggested good hemocompatibility. In order to improve the antifouling ability of the membrane under pressure, the neutral surface was oxidized by sodium periodate, which accelerated the chemical reaction between amino groups in PLS and phenolic hydroxyl groups in TA. Meanwhile, carboxyl groups generated due to the decomposition of TA and a negatively charged surface were obtained. While maintaining the good properties of the unoxidized one, the hydrophilicity of the oxidized membrane was improved and the clotting time was further prolonged. Besides, the filtration recovery of the oxidized membrane was improved remarkably. This approach of rapid immobilization of PSar has great potential for applications in the biomedical area, especially for blood-contacting materials.

[Efficacy of decitabine combined with low dose chemotherapy on children with acute myeloid leukemia]

Objective: To evaluate the efficacy of decitabine combined with low dose chemotherapy (LDC) in the treatment of high-risk, refractory and relapsed pediatric acute myeloid leukemia (AML). Methods: Clinical data of 19 AML children treated with decitabine combined with LDC in the Department of Hematology, Children's Hospital of Soochow University from April 2017 to November 2019 were analyzed retrospectively. The therapeutic response, adverse effects and survival status were analyzed,and the outcomes of patients were followed up. Results: Among 19 AML cases, there were 10 males and 9 females. Five cases were high-risk AML, 7 cases were refractory AML, and 7 cases were relapsed AML. After one course of decitabine+LDC treatment, 15 cases achieved complete remission, 3 cases got partial remission, and only 1 case didn't get remission. All patients received allogeneic hematopoietic stem cell transplantation as consolidation therapy. The follow-up time of all cases was 46 (37, 58) months, 14 children had survived. The cumulative three-year overall survival rate was (79±9) %, events free survival rates was (68±11) %, and recurrence free survival rate was (81±10) %. The most common adverse effects related to the induction treatment were cytopenia (19 cases) and infection (16 cases).There were no treatment-related death during the therapy. Conclusion: Decitabine combined with LDC is a safe and effective option for high-risk, refractory and relapsed AML children, which provides an opportunity for HSCT.

Stealth-like polysarcosine-modified nanoparticles with low dye doses and long blood circulation for efficient breast cancer pulmonary metastasis imaging

Fluorescence imaging (FLI) in the near-infrared-II (NIR-II; 1000-1700 nm) window holds great potential for cancer metastasis imaging owing to its deep tissue penetration and a high signal-to-background ratio. However, currently reported organic NIR-II contrast agents generally present problems such as poor water solubility, low NIR-II fluorescence quantum yield (QY), short blood circulation half-life (t_1/2), high injection doses, and undesirable tumor accumulation. In this study, an NIR-II small-molecule-based polymer (TQF-PSar) modified with four dense/hydrophilic polysarcosine (PSar) arms was prepared for efficient breast cancer pulmonary metastasis imaging. The NIR-II intensity of TQF-PSar (whose QY was calculated to be 1%) was 26.4-fold higher than that of the PEGylated nanoparticles (TQF-PEG NPs) at the same low dye dose (core TQF concentration: 2.5 μg mL^-1). Moreover, owing to the ideal stealth character, TQF-PSar displayed a more prolonged blood circulation t_1/2 (36.9 h) and better tumor accumulation capability than TQF-PEG NPs even at this low dye concentration. Finally, the successful use of TQF-PSar in noninvasive NIR-II FLI for breast cancer pulmonary metastasis was demonstrated in living mice.

Survival benefit of postoperative radiotherapy for pediatric patients with primary intracranial atypical teratoid/rhabdoid tumors: Propensity score analysis and prediction model construction in a multi-registry based cohort

BACKGROUND

The role of postoperative radiotherapy (PORT) in children with primary intracranial atypical teratoid/rhabdoid tumor (AT/RT) remains controversial, and real-world data with large sample size are still lacking. This study aims to estimate the survival benefit of PORT in pediatric patients with resected AT/RT.

METHODS

Using Seer database, we collected 246 eligible intracranial AT/RT patients diagnosed between 2000 and 2016 for our analysis. Propensity score matching (PSM) analysis was employed to minimize selection bias for evaluation of the PORT efficacy. Multivariate Cox regression was conducted to determine the factors related to the outcome. Interaction tests were further performed between PORT and the prognostic variables. After identifying the significant prognostic factors, we further developed a novel prediction model to predict the life expectancy of these patients, as well as the potential benefit from PORT.

RESULTS

We found that PORT was significantly related to the improved survival after adjusting for other prognosticators in both the entire and PSM-matched cohort. Significant interactions of PORT with age at diagnosis and tumor extension were also observed. On basis of the prognostic indictors identified by L1-penalized lasso Cox regression analysis, a novel nomogram model was successfully established and externally validated.

CONCLUSION

Our study indicated that PORT was significantly associated with the improved survival in pediatric AT/RT patients, and the greater survival benefit from PORT could be achieved in patients <3 years old or with locoregional tumors. The novel prediction model was developed to provide help in clinical practice and in the design of related trials.

Rational design of 4-((6-phenoxypyrimidin-4-yl)amino)-N-(4-(piperazin-1-yl)phenyl)-1H-pyrazole-3-carboxamide (LT-540-717) as orally bioavailable FLT3 inhibitor

In recent years, fms-like tyrosine kinase 3 (FLT3) was confirmed as an exciting target for treatment of AML. However, resistance to FLT3 inhibitors caused by acquired point mutations in tyrosine kinase domain (TKD) have limited their sustained efficacious. Thus, there remains an unmet need to develop high-efficacy FLT3 inhibitors against both FLT3 internal tandem duplication (ITD) and FLT3 (TKD) mutations. Herein, we describe the discovery of compound LT-540-717 (32), a potent FLT3 inhibitor (IC₅₀: 0.62 nM), starting from FN-1501. Compound 32 exhibited highly inhibitory activity against several acquired FLT3 mutations including FLT3 (ITD, D835V), FLT3 (ITD, F691L), FLT3 (D835Y) and FLT3 (D835V). Additionally, 32 displayed potent antiproliferative activity against FLT3-mutation driven BaF3 and AML cells. Oral administration of 32 (25 mg/kg, QD) significantly prohibited tumor growth (tumor-inhibition rate is 94.18%), and no obvious side effect was observed even when increasing dose to 50 mg/kg (tumor-inhibition rate is 93.98%). Furthermore, 32 showed an acceptable bioavailability (F = 33.3% in rat and 72.7% in beagles), a suitable half-life time (T_1/2 = 3.5 h in rat and T_1/2 = 11.1 h in beagles), and a satisfactory metabolic stability. In summary, these results show the therapeutic potential of 32 to become a new anti-AML drug, especially for AML harboring dual FLT3 (ITD, TKD) mutations.

Ring-Opening Polymerization of Cyclic Acetals: Strategy for both Recyclable and Degradable Materials

To cope with the severe plastic waste crisis, massive efforts have been made to develop sustainable polymer materials whose degradation involves a disposing and decomposing to small molecule (DDM) and/or a chemical recycling to monomer (CRM) process. Polyacetals, a type of pH-responsive polymers, are degradable under acidic conditions, while highly stable under neutral and basic circumstances. As for their synthesis, the cationic ring-opening polymerization (CROP) of cyclic acetals is an elegant and promising approach, though suffering from fatal side reactions and polymerization-depolymerization equilibrium. Recent development in CRM restimulates our interests in the long-forgotten CROP method due to its inherent depolymerization characteristics. In terms of the end-of-life options, polyacetals are recyclable materials with both DDM and CRM potentials. They not only expand the scope of materials for closed-loop recycling, but also help to tune the degradation properties of traditional polyesters and polyolefins. This review aims to discuss the synthesis of various polyacetals by CROP and their degradation properties from the perspectives of (1) polymerization of cyclic acetals, dioxepins, and hemiacetal esters, (2) copolymerization of cyclic acetals with heterocyclic or vinyl monomers, and (3) degradation and recycling properties of the related polymers. This article is protected by copyright. All rights reserved.

Abstract 3063: A novel mechanism for therapeutic targeting of the glucocorticoid receptor in triple negative breast cancer

Triple negative breast cancer (TNBC) is frequently diagnosed in younger women and is prevalent in African American women. Most TNBCs are highly aggressive with early pattern of metastasis, and with limited treatment options and poor prognosis. Finding effective therapeutic targets for TNBC has proven difficult so far. Therefore, there is an urgent need to develop new and novel therapeutic management of these patients. Recent studies have shown that glucocorticoid receptor (GR) is a mediator of pro-survival genes in TNBC cells, and its expression is predictive of increased risk of metastasis in TNBC tumors and decreased rate of patient survival. Therefore, blocking the effects of GR should be beneficial for TNBC patients. However, GR antagonists such as RU486 (mifepristone) targeting AF2/coactivators have shown only partial success in TNBC cell lines as well as in animal models. Based on our previous data we hypothesize that since in TNBC cells, the GR is constitutively active; therefore, attempts to block/inhibit GR activity through classic antagonists such as mifepristone that bind to ligand binding pocket of the receptor will have a limited clinical efficacy and higher side effects. To circumvent this problem, in this study, we propose a novel and innovative therapeutic approach to target constitutively active AF1 domain of the GR, which exists in an intrinsically disordered (ID) conformation. In this study, we tested our hypothesis that inhibiting/blocking TATA-box binding protein (TBP)-mediated GR’s AF1 activity by our newly identified molecule, PepT will attenuate TNBC cell survival via altering associated endogenous gene expressions. Our binding kinetics of AF1 showed that PepT binds to AF1 with about 10-fold higher affinity when compared with TBP’s binding to AF1. AF1 pre-bound with PepT fails to bind to TBP suggesting that PepT competes and blocks AF1-TBP interaction. We also found that treatment of MDA-MB-231 cells with PepT results in significant attenuation of cell viability and proliferation. Together, these results support our hypothesis that PepT has potential to kill TNBC cells by blocking GR AF1:co-regulator interactions.

Citation Format: Shagufta H. Khan, Christian Carbe, Jun Ling, Raj Kumar. A novel mechanism for therapeutic targeting of the glucocorticoid receptor in triple negative breast cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 3063.

Discovery of YH677 as a cancer stemness inhibitor that suppresses triple-negative breast cancer growth and metastasis by regulating the TGFβ signaling pathway

Triple-negative breast cancer (TNBC) has a poor prognosis due to the lack of specific and highly effective therapeutic agents. Cancer stem cells (CSCs) are one of the main factors contributing to TNBC relapse and metastasis. Therefore, targeting CSCs selectively with small molecules is a novel strategy for drug development. In this study, the natural product harmine (HM) was identified as a hit compound from 2632 natural product monomers based on phenotypic screening of a 2D assay and patient-derived organoid (PDO) model that was established from a patient who had multiple drug resistance and various visceral and contralateral breast metastases. Next, harmine was further modified and optimized to obtain a lead compound (YH677) with a tetrahydro-β-carboline scaffold. YH677 showed potent antiproliferative and antimigratory activities against several TNBC cell lines in vitro. In addition, YH677 inhibited epithelial mesenchymal transition (EMT) and stem cell marker expression in a dose-dependent manner. More importantly, YH677 suppressed breast cancer growth and metastasis in orthotopic, metastatic xenograft and patient-derived xenograft (PDX) models in vivo. Mechanistic studies showed that YH677 inhibits the expansion of CSCs by regulating the TGFβ/Smad signaling pathway. These preclinical data provide a basis for the development of YH677 as a lead compound for TNBC treatment.

First evidence of neonicotinoid insecticides in human bile and associated hepatotoxicity risk

Neonicotinoids (NEOs) are widely applied in agricultural lands and are widespread in different environments, accelerating threats to ecosystems and human health. A number of in vitro/in vivo studies have reported adverse effects of NEOs on mammalian health, but the link between NEO exposure and toxic effects on human liver remains unclear. We randomly recruited 201 participants and quantified eight commercialized NEOs in bile. High frequency and concentration of detection indicate low degradation of human liver on NEOs. The main NEOs are nitenpyram and dinotefuran, which contribute to about 86% of the total residual levels of eight NEOs, due to the highest solubility in bile and are not degraded easily in liver. In contrast, imidacloprid and thiacloprid are major compounds in human blood, according to previous studies, suggesting that individual NEOs behave differently in blood and bile distribution. There was no statistical difference in NEO residues between cancer and non-cancer participants and among the different participant demographics (e.g., age, gender, and body mass index). The serum hematological parameters -bile acid, total bilirubin, cholesterol and alkaline phosphatase -were positively correlated with individual NEO concentrations, suggesting that NEO exposure affects liver metabolism and even enterohepatic circulation. The study first examined the NEO residues in human bile and provided new insights into their bioavailability and hepatoxicity risk.

How to Open the Ring of a Di-ene-Substituted-δ-Valerolactone: From Carbon Dioxide and 1,3-Butadiene to Functional Polyesters

As a substituted-δ-valerolactone, α-ethylidene-δ-vinyl-δ-valerolactone (EVL) provides a method of utilizing carbon dioxide with 1,3-butadiene to produce functional polymers. Its di-ene-substituted lactone ring was considered inactive in polymerization in the past two decades, while successful polymerization attempts of EVL have been reported very recently. Novel synthetic strategies and functional polymers from EVL have been developed. The ring-opening reactions of EVL and the corresponding polymers as well as the ring-opening (co)polymerizations of EVL and its derivatives are highlighted in this review. The obtained functional polymers with or without facile post-polymerization modification possess unique properties, such as amphipathy, elasticity, peel resistance, etc., allowing for application potential in various fields.

Integrated manganese (III)-doped nanosystem for optimizing photothermal ablation: Amplifying hyperthermia-induced STING pathway and enhancing antitumor immunity

Despite the great promise initially demonstrated by photothermal ablation (PTA) therapy, its inability to completely ablate large tumors is problematic, because this has been found to result in residual tumors at ablation margins and bring a relative high rate of subsequent recurrences and metastases. To address this issue, we herein report a smart photothermal nanosystem (PBM) based on FDA-approved Prussian blue (PB) nanoparticles, doped with Mn (III) to suppress the tumor debris left by incomplete ablation. Notably, our study demonstrated that PTA-induced hyperthermia plays a crucial role in initiating the cGAS-STING pathway by generating damaged cytosolic DNA. This PBM nanosystem, which consumes glutathione and continuously releases Mn(II), further amplifies the PTA-induced cGAS-STING pathway in CT26 colon and 4T1 breast tumor models. Moreover, treatment with PBM following PTA boosted the robust immune response in situ and extended to the whole body with a remarkable suppression effect on both local residual and distant tumors. This work, which improves the antitumor efficacy of nonablated areas utilizing hyperthermia-enhanced immune therapy, may therefore provide a promising adjuvant antitumor strategy for the issue of incomplete ablation. STATEMENT OF SIGNIFICANCE: This work discovered, for the first time, that photothermal ablation-induced hyperthermia plays a crucial role in initiating the cGAS-STING pathway. Taking advantage of this finding, we developed a smart photothermal material (PBM) tailored for incomplete tumor ablation. This integrated Mn(III)-doped nanosystem (PBM) demonstrated superior therapeutic benefits due to the thermal ablation process and immune enhancement. As the photothermal ablation-induced cGAS-STING pathway was triggered, the released Mn(III) consumes GSH while continuously transferred to Mn(II), which further amplified STING activation and facilitated a more robust antitumor immunity, thereby remarkably inhibiting both local residual and distant tumors in virtue of the biological changes under thermal ablation.

Sex Specific Global Burden of Osteoporosis in 204 Countries and Territories, from 1990 to 2030: An Age-Period-Cohort Modeling Study

BACKGROUND

Osteoporosis is a highly prevalent disease with distinct sex pattern. We aimed to estimate the sex specific incidence, prevalence, and disability-adjusted life (DALYs) years of osteoporosis between 1990 and 2019, with additional predictions from 2020 to 2034.

METHODS

We collected osteoporosis disease burden data from the Global Burden of Disease study covering the years 1990 through 2019 in 204 countries and territories. The data included information on the number of incident cases of osteoporosis, DALYs, age-standardized incidence rates (ASIR), age-standardized prevalence rates (ASPR) and age-standardized DALYs rates. Additionally, we performed an age-period-cohort analysis to forecast the burden of osteoporosis.

RESULTS

The global number of incidence cases of osteoporosis, in 2019, reached 41.5 million cases. From 1990 to 2019, the low-middle socio-demographic index (SDI) region had the highest estimated annual percentage change in the world. Compared to males, female's ASIR and ASPR were all about 1.5 times higher than males for the same years in the same SDI regions. The projected global total number of incidence cases for osteoporosis between 2030 and 2034 is estimated to reach 263.2 million (154.4 million for females and 108.8 for males). Additionally, the burden in terms of DALYs is predicted to be 128.7 million (with 78.4 million for females and 50.3 million for males).

CONCLUSION

The global burden of osteoporosis is still increasing, mainly observed in high SDI countries. Females bear a burden 1.5 times higher than males in terms of incidence and DALYs. Steps should be taken to reduce the osteoporosis burden, especially in high SDI countries.

Fe3+@PDOPA‑b‑PSar Nanoparticles for Magnetic Resonance Imaging and Cancer Chemotherapy

Purpose

Chemotherapy treatments for cancer are always accompanied by a low concentration of drug delivered in the tumor area and severe side effects including systemic toxicity. Improving the concentration, biocompatibility, and biodegradability of regional chemotherapy drugs is a pressing challenge in the field of materials.

Methods

N-Phenyloxycarbonyl-amino acids (NPCs) which exhibit significant tolerance to nucleophiles, such as water and hydroxyl-containing compounds, are promising monomers for the synthesis of polypeptides and polypeptoids. Cell line and mouse models were used to comprehensively explore how to enhance the tumor MRI signal and evaluate the therapeutic effect of Fe@POS-DOX nanoparticles.

Results

In this study, poly(3,4-dihydroxy-_L-phenylalanine)-b-polysarcosine (PDOPA-b-PSar, simplified as POS) was synthesized by the block copolymerization of DOPA-NPC with Sar-NPC. Fe@POS-DOX nanoparticles were prepared in order to utilize the strong chelation of catechol ligands to iron (III) cations and the hydrophobic interaction between DOX and DOPA block to deliver chemotherapeutics to tumor tissue. The Fe@POS-DOX nanoparticles exhibit high longitudinal relaxivity (r ₁ = 7.06 mM^-1·s^-1) and act as T ₁-weighted magnetic resonance (MR) imaging contrast agents. Further, the main focus was improving tumor site-specific bioavailability and achieving therapeutic effects through the biocompatibility and biodegradability of Fe@POS-DOX NPs. The Fe@POS-DOX treatment exhibited excellent antitumor effects.

Conclusion

Upon intravenous injection, Fe@POS-DOX delivers DOX specifically to the tumor tissues, as revealed by MR, and leads to the inhibition of tumor growth without overt toxicity to normal tissues, thus displaying considerable potential for use in clinical applications.

Exploration of a community pharmacy delivered mobile health intervention to support medication taking for patients with multiple long-term conditions

Introduction

Up to half of people with long-term conditions (LTCs) do not take their medicines as prescribed. Mobile health interventions, such as text messaging, have been shown to have positive impact on medication adherence.1 However, interventions for patients with multiple LTCs are lacking, and there are limited examples of their delivery from community pharmacy settings. We have developed a new intervention which combines a pharmacist consultation and automated two-way text messaging to support medicines taking. This has been developed using peer-reviewed literature and focus groups with patients and healthcare professionals (GPs, pharmacists, nurses). The intervention is tailored to the individual using a questionnaire and delivers content for up to eight LTCs.

Aim

To explore the acceptability of our new intervention with patients.

Methods

The new intervention was delivered to patients in a simulated environment, including a consultation with a pharmacist and two weeks of text messaging. Diary-interviews were used to gather feedback from eight patients, recruited through a public, patient and carer involvement group based at a university. Patients kept a diary during the period of text messaging and follow-up semi-structured interviews were conducted. Interviews were audio recorded and transcribed verbatim for analysis. Transcripts were coded for aspects of the intervention that the patients liked and ideas on how the intervention could be changed, including the impact of delivering the intervention from community pharmacies. Ethical approval for this study was granted by the University of Sunderland Research Ethics Committee.

Results

The intervention had good acceptability with patients. Patients were happy to interact with the text messaging content, including providing information about symptoms of their long-term condition and result of home monitoring. Patients liked that the intervention was linked to a pharmacist consultation, where there were opportunities to identify medication issues which text messaging could not solve. Delivering the intervention from a community pharmacy setting was felt to promote stronger engagement with the text messaging component, including the opportunity to build rapport with the pharmacist who would be overseeing the intervention. The mechanism to monitor medication adherence using two-way text messaging was suggested to be made more streamlined, and patients also wanted more examples of text message responses included in the patient information leaflet for the intervention.

Discussion/Conclusion

We found that our intervention to support medication taking from community pharmacies has initial acceptability with patients. Whilst others have trialled similar technologies from community pharmacies2 our intervention focussed solely on medication taking, and this seemed to result in positive attitudes towards its delivery from community pharmacies. The consultation was found to be an important component alongside the text messaging, how combining digital and non-digital components work together to support medication adherence was a gap highlighted in our previous review of similar interventions.3 Our intervention now requires changes based on the feedback gathered in this study and further testing in a larger and more diverse group.

References

1. Thakkar J, Kurup R, Laba T-L, Santo K, Thiagalingam A, Rodgers A, et al. Mobile Telephone Text Messaging for Medication Adherence in Chronic Disease: A Meta-analysis. JAMA Intern Med. 2016;176:340–9.

2. Cork T, Sanzeri D, Chambers R, Chamber C. Can pharmacists promote self-care using digital technology? Prescriber. 2018;29:21–4.

3. Donovan G, Hall N, Ling J, Smith F, Wilkes S. Influencing medication taking behaviors using automated two-way digital communication: A narrative synthesis systematic review informed by the Behavior Change Wheel. Br J Health Psychol. n/a n/a. https://doi.org/10.1111/bjhp.12580.

Nonsingular recursive-structure sliding mode control for high-order nonlinear systems and an application in a wheeled mobile robot

This work investigates the problem of fast tracking control for a class of high-order nonlinear systems subject to the matched disturbances. More particularly, a novel practical fixed-time disturbance observer is first presented by using a smooth hyperbolic tangent function. Then, a new nonsingular recursive-structure sliding mode surface is proposed based on the terminal sliding mode surface. With the reconstructed information deriving from the designed disturbance observer, a nonsingular recursive-structure sliding mode based finite-time tracking control approach incorporating with a new adaptive law is proposed to ensure the tracking errors converge to a small region of the origin in finite time. The finite-time stability of the closed-loop tracking control system driven by the proposed control scheme is analyzed and proved utilizing Lyapunov theory. And also, the proposed generalized control approach is applied to a mobile robotic experimental platform to achieve accurate trajectory tracking on the uneven ground. Finally, the numerical simulation and comparative experiment results demonstrate the effectiveness and superiority of the proposed approach.

Neonicotinoid pollution in marine sediments of the East China Sea

Neonicotinoid insecticides are widely and exceedingly applied in farmlands worldwide and are ubiquitous in various environments, including surface water, soil, river sediments, etc. However, few studies reported neonicotinoid residues in the marine environment. Considering the large application of neonicotinoids in China, here, we collected marine sediments in offshore and far sea areas of the East China Sea, including the Hangzhou Bay and the area along the Zhejiang Province coast, and measured the concentrations of nine commercialized neonicotinoids. The total concentration of neonicotinoids was 11.9 ± 6.22 ng/g (dry weight) (range: 4.77-29.9 ng/g), which was higher than other regions reported in previous studies. Neonicotinoid residues found in far sea areas were statistically lower than those in offshore areas. Nitenpyram and dinotefuran were the dominant compounds, contributing to >75 % of the total residue. It is thought that the flux of the Yangtze River is the main source of the neonicotinoid pollution in the East China Sea and the sediment is the sink of neonicotinoid residue from mainland China. Neonicotinoid residues were found to be negatively correlated with sediment pH, and positively correlated with microbial diversity and nitrate content. Based on structural equation modeling, we also illustrated the associations between neonicotinoid residues and different factors, suggesting that the change in sediment pH and microbial diversity were related to the degradation of neonicotinoid residues. Actinobacteriota, Chloroflexi, and Nitrospirota were found to be the key bacterial community at the phylum level on the degradation of neonicotinoids. Our findings provide new insights into the understanding of spatial distribution, source, and migration of neonicotinoids and their impacts on marine microorganisms.

Mathematical study of neural feedback roles in small target motion detection

Building an efficient and reliable small target motion detection visual system is challenging for artificial intelligence robotics because a small target only occupies few pixels and hardly displays visual features in images. Biological visual systems that have evolved over millions of years could be ideal templates for designing artificial visual systems. Insects benefit from a class of specialized neurons, called small target motion detectors (STMDs), which endow them with an excellent ability to detect small moving targets against a cluttered dynamic environment. Some bio-inspired models featured in feed-forward information processing architectures have been proposed to imitate the functions of the STMD neurons. However, feedback, a crucial mechanism for visual system regulation, has not been investigated deeply in the STMD-based neural circuits and its roles in small target motion detection remain unclear. In this paper, we propose a time-delay feedback STMD model for small target motion detection in complex backgrounds. The main contributions of this study are as follows. First, a feedback pathway is designed by transmitting information from output-layer neurons to lower-layer interneurons in the STMD pathway and the role of the feedback is analyzed from the view of mathematical analysis. Second, to estimate the feedback constant, the existence and uniqueness of solutions for nonlinear dynamical systems formed by feedback loop are analyzed via Schauder's fixed point theorem and contraction mapping theorem. Finally, an iterative algorithm is designed to solve the nonlinear problem and the performance of the proposed model is tested by experiments. Experimental results demonstrate that the feedback is able to weaken background false positives while maintaining a minor effect on small targets. It outperforms existing STMD-based models regarding the accuracy of fast-moving small target detection in visual clutter. The proposed feedback approach could inspire the relevant modeling of robust motion perception robotics visual systems.

A honeybee stinger-inspired self-interlocking microneedle patch and its application in myocardial infarction treatment

Weak tissue adhesion remains a major challenge in clinical translation of microneedle patches. Mimicking the structural features of honeybee stingers, stiff polymeric microneedles with unidirectionally backward-facing barbs were fabricated and embedded into various elastomer films to produce self-interlocking microneedle patches. The spirality of the barbing pattern was adjusted to increase interlocking efficiency. In addition, the micro-bleeding caused by microneedle puncturing adhered the porous surface of the patch substrate to the target tissue via coagulation. In the demonstrative application of myocardial infarction treatment, the bioinspired microneedle patches firmly fixed on challenging beating hearts, significantly reduced cardiac wall stress and strain in the infarct, and maintained left ventricular function and morphology. In addition, the microneedle patch was minimally invasively implanted onto beating porcine heart in 10 minutes, free of sutures and adhesives. Therefore, the honeybee stinger-inspired microneedles could provide an adaptive and convenient means to implant patches for various medical applications. STATEMENT OF SIGNIFICANCE: Adhesion between tissue and microneedle patches with smooth microneedles is usually weak. We introduce a novel barbing method of fabricating unidirectionally backward facing barbs with controllable spirality on the microneedles on microneedle patches. The microneedle patches self-interlock on mechanically dynamic beating hearts, similar to honeybee stingers. The micro-bleeding and coagulation on the porous surface provide additional adhesion force. The microneedle patches attenuate left ventricular remodeling via mechanical support and are compatible with minimally invasive implantation.

Two-year outcomes of Roux-en-Y gastric bypass vs medical treatment in type 2 diabetes with a body mass index lower than 32.5 kg/m2: a multicenter propensity score-matched analysis

BACKGROUND

Roux-en-Y gastric bypass (RYGB) has been widely reported to be safe and feasible, and has a powerful effect on improving metabolism and weight loss in patients with a high body mass index (BMI). A few studies have focused on the comparison of RYGB with medical treatment in type 2 diabetes (T2D) patients with a lower BMI.

OBJECTIVES

To compare the metabolic effects and safety of RYGB versus medical treatment during a 2 years follow-up in T2D patients with a BMI of 25 to 32.5 kg/m².

METHODS

This retrospective and multicenter cohort study participants were extracted from the T2D patients with a lower BMI (25-32.5 kg/m²) from three bariatric centers between 2009 and 2018. Propensity score matching (PSM) was used to minimize bias, and each patient in the surgical group was matched 1:2 to the patients in the medical group with the closest propensity score. Finally, 71 patients who received RYGB and 142 patients who underwent medical treatment with a 2 years follow-up were enrolled to compare the effects of RYGB and medical treatment. The primary endpoint was achievement of the triple endpoint (the simultaneous achievement of hemoglobin A1c (HbA1c) < 7.0%, fasting low-density lipoprotein cholesterol (LDL-C) < 100 mg/dL (2.6 mmol/L), and systolic blood pressure (SBP) < 130 mmHg at the year-1 visit). Changes in weight, BMI, medication usage, complications, and adverse events were assessed.

RESULTS

In total, 213 patients (mean age of 47.4 ± 9.5 years, 70.4% male, mean BMI of 28.6 ± 2.2 kg/m²) were included in this study. At the end of the first year, 17 patients (23.9%) in the surgical group and 10 (7.0%) in the medical group had achieved the composite triple endpoint (OR 4.64; 95% CI 1.82-11.81; p = 0.001). Additionally, 43 patients (60.6%) in the surgical group and 11 patients (19.7%) in the medical group experienced remission of T2D. However, more complications were observed in the surgical group (36 vs. 22, p < 0.01).

CONCLUSIONS

Among T2D patients with a BMI between 25.0 and 32.5 kg/m², RYGB was more effective than medical treatment in resolving metabolic disorders and also resulted in more complications. The risk for complications should be considered in the clinical decision-making process for T2D patients with a low BMI.

The glucosinolate profiles of Brassicaceae vegetables responded differently to quick-freezing and drying methods

Glucosinolates (GLS) are bioactive compounds found in Brassicaceae vegetables. Industrial food processing treatments, such as blanching, quick-freezing (QF), vacuum freeze-drying (VFD), vacuum-drying (VD) and oven-drying (OD), significantly affect the degradation and ingestion of GLS. Here, the effects of these treatments, followed by boiling, on the GLS content and mimicking ingestion level of isothiocyanate from Brassicaceae vegetables (broccoli, cauliflower, white and red cabbages, Chinese and baby cabbages, white and red radish roots) were investigated. The results showed that blanching-QF maintained or increased the GLS content as well as preserved the ingestion level of isothiocyanate, an optimum treatment for GLS preservation. Blanching-VFD was recommended for these vegetables, while blanching-VD and blanching-OD caused relatively high GLS losses and low isothiocyanate production. Additionally, stabilities of individual GLS during processing rely on their chemical structures and species. Generally, aliphatic GLS from Brassicaceae showed lower loss than indole GLS, indicating differences in their stabilities during processing.

Scintillation light detection in the 6-m drift-length ProtoDUNE Dual Phase liquid argon TPC

DUNE is a dual-site experiment for long-baseline neutrino oscillation studies, neutrino astrophysics and nucleon decay searches. ProtoDUNE Dual Phase (DP) is a 6  ×  6  ×  6 m 3 liquid argon time-projection-chamber (LArTPC) that recorded cosmic-muon data at the CERN Neutrino Platform in 2019-2020 as a prototype of the DUNE Far Detector. Charged particles propagating through the LArTPC produce ionization and scintillation light. The scintillation light signal in these detectors can provide the trigger for non-beam events. In addition, it adds precise timing capabilities and improves the calorimetry measurements. In ProtoDUNE-DP, scintillation and electroluminescence light produced by cosmic muons in the LArTPC is collected by photomultiplier tubes placed up to 7 m away from the ionizing track. In this paper, the ProtoDUNE-DP photon detection system performance is evaluated with a particular focus on the different wavelength shifters, such as PEN and TPB, and the use of Xe-doped LAr, considering its future use in giant LArTPCs. The scintillation light production and propagation processes are analyzed and a comparison of simulation to data is performed, improving understanding of the liquid argon properties.

High spatial resolved cropland coverage and cultivation category determine neonicotinoid distribution in agricultural soil at the provincial scale

Croplands are experiencing increasing neonicotinoid pollution and ecological health problems, which are especially widely applied in China. However, the large regional scale distribution of neonicotinoids and the key factors have seldom been determined. We show that the total residual concentration of neonicotinoids ranged from 13.4 to 157 ng/g with an average level of 75.8 ng/g and imidacloprid which was the dominant compound ranged from 10.4 to 81.3 ng/g during 2017-2021 in the Yangtze River Delta, China. In comparison, the neonicotinoid residues detected here were mostly higher than those in other regions. We further show that the 1-km spatial resolution cropland coverage (78.0%) and crop type (18.1%) predominantly contributed to the large spatial variation of neonicotinoids after adjusting for the factors including temperature, soil pH, soil moisture, and precipitation via automatic linear regression modeling at the provincial scale. Additional analyses revealed that tea croplands had significantly lowest concentration and fruit fields had the highest level due to the different application methods. Our findings provide new insight into key factors quantifying the high spatial resolved distribution of neonicotinoids and urgently call for reasonable application methods against rapidly growing ecology threats from neonicotinoid pollution in China.

Comparative study of conventional diffusion-weighted imaging and introvoxel incoherent motion in assessment of pathological grade of clear cell renal cell carcinoma

OBJECTIVE

To quantitatively compare the diagnostic values of conventional diffusion-weighted imaging (DWI) and introvoxel incoherent motion (IVIM) analysis of microstructural differences for clear cell renal cell carcinoma (ccRCC).

METHODS

Multiple b value DWIs and IVIMs were performed in patients with 146 ccRCCs, 42 with Grade Ⅰ, 46 with Grade Ⅱ, 28 with Grade Ⅲ and 30 with Grade Ⅳ. These tumours were divided into low (Ⅰ+Ⅱ, n = 88) and high grades (Ⅲ+Ⅳ, n = 58). The diagnostic efficacy of various diffusion parameters for predicting ccRCC grades was compared.

RESULTS

The mean signal-to-noise ratios (SNRs) of IVIM images at b = 0, 800 and 1500 s/mm2 were 31.9, 12.3 and 8.4, respectively. The apparent diffusion coefficient (ADC), D and D* values correlated negatively with ccRCC grading (r = -0.786,-0.913, -0879, p < 0.05). f values correlated positively with ccRCC grading (r = 0.811, p < 0.05). The ADC, D and D* values were higher for Grade Ⅱ ccRCC than that of Grade Ⅲ ccRCC (p < 005), however, f values were higher for Grade Ⅲ ccRCC than that of Grade Ⅱ ccRCC (p < 005). Receiver operating characteristic curve analyses showed that D values had the highest diagnostic efficacy in differentiating low/high and Ⅱ/Ⅲ ccRCC grading. The area under the curve, sensitivity, specificity and accuracy of the D values were 0.963, 0.960; 90.9%, 89.1%; 81.0%,78.6 and 89.0%, 87.8%, respectively. For pairwise comparisons of receiver operating characteristic curves and diagnostic efficacy, ADC was worse than IVIM (all p < 0.05).

CONCLUSION

IVIM parameters have better performance than ADC in differentiating ccRCC grading, given an adequate SNR of IVIM images.

ADVANCES IN KNOWLEDGE

1. D values had the highest diagnostic efficacy in differentiating low/high and Ⅱ/Ⅲ ccRCC grading. 2. IVIM parameters have better performance than ADC in differentiating ccRCC grading, given an adequate SNR of IVIM images. 3. The ADC, D and D* values correlated negatively with ccRCC grading, however, f values correlated positively with ccRCC grading.

Knowledge, attitudes, and practice with respect to antibiotic use among pharmacy students: a cross-sectional study

OBJECTIVE

Antibiotic resistance is a major health threat and efforts should be intensified to reduce its burden. Healthcare providers, especially pharmacists, can be actively involved in the reduction of antibiotic resistance. However, negative practices among pharmacists have been observed. This study evaluated knowledge, attitudes, and practices (KAP) among Jordanian pharmacy students.

PATIENTS AND METHODS

A cross-sectional study used an online questionnaire that was developed and distributed to Jordanian pharmacy students from five different universities. KAP scores were calculated, with students categorized into low and high levels based on each score mean.

RESULTS

A total of 890 pharmacy students completed the questionnaire. High positive response rate (PR%) for the majority of the knowledge items was observed, exceeding 60% in all knowledge items, and similar PR% was observed in attitude items. The variables significantly associated with attitude were age [OR=0.92 (95% CI 0.87: 0.98), p=0.01] and knowledge [OR=1.35 (95% CI 1.01:1.82), p=0.04], while knowledge was significantly associated with practice [OR=0.23 (95% CI 0.16:0.31), p<0.001].

CONCLUSIONS

Jordanian pharmacy students showed adequate KAP toward the use of antibiotics although several aspects of malpractice were identified. Hence, adequate knowledge about antibiotics among pharmacy students should be ensured as knowledge is associated with attitudes and practices.

Post-harvest Application of Methyl Jasmonate or Prohydrojasmon Affects Color Development and Anthocyanins Biosynthesis in Peach by Regulation of Sucrose Metabolism

The roles of methyl jasmonate (MeJA) and prohydrojasmon (PDJ) in postharvest color development and anthocyanins biosynthesis in the skin of peach fruit remain unclear. In this study, peach fruit were infiltrated with MeJA (200 μM) or PDJ (40 μM) and stored at 22°C for 7 days. The results showed that treatment with MeJA or PDJ had a positive effect on red color formation in peach fruits due to anthocyanins accumulation (∼120% increase). This was attributed to increased enzyme activities, and enhanced transcript abundance of the genes associated with anthocyanins biosynthesis, induced by MeJA or PDJ. Both MeJA and PDJ promoted sucrose biosynthesis, and the subsequently elevated levels of the sucrose during storage were positively correlated with anthocyanins accumulation (0.49) and the activities of key biosynthesis enzymes (0.42-0.79). Based on these findings, we proposed that MeJA or PDJ treatments promote anthocyanins biosynthesis by regulating sucrose metabolism during the postharvest storage of peach fruit.

Factors influencing hypertension and diabetes mellitus control among Syrian refugees in Zaatari refugee camp

OBJECTIVE

Syrian refugees in Zaatari Refugee Camp are in dire need of investigations of the control status of different chronic diseases. The current study aims to evaluate hypertension (HTN) and diabetes (DM) control among Syrian refugees in the Zaatari Refugee Camp.

PATIENTS AND METHODS

This is a retrospective cross-sectional study. Patients' files were collected from the Zaatari camp database. Participants who had an HbA1c of less than 7 were considered to have controlled DM and a cut-off point of 130/80 was used for HTN. A p-value of <0.05 was considered statistically significant.

RESULTS

A total of 418 patients (276 females) were included in the study. None of the patients-controlled blood pressure and only 25 controlled DM. Univariate analysis showed an association of smoking status with HbA1c and mean arterial pressure (MAP) (p-value=0.007 and <0.001 respectively), while taking insulin and Triglyceride (TyG) index had an association with HbA1c alone (p-value<0.001). Significant in the MANCOVA analysis were smoking status, taking insulin, and TyG index (p-value<0.001).

CONCLUSIONS

This study demonstrates that refugees in Zaatari Refugee Camp have uncontrollable DM and HTN. More focus should be highlighted on controlling these diseases in order to prevent future complications.

Factors associated with glycemic control among patients with type 2 diabetes: a cross-sectional study

OBJECTIVE

Achieving glycemic control significantly improves the progression of the disease among diabetes mellitus patients although this is not achieved by many diabetics. The aim of the study is to explore the factors associated with glycemic control among patients with type 2 diabetes.

PATIENTS AND METHODS

In addition to sociodemographic variables, beliefs about medications and medication adherence were evaluated using the validated Beliefs about Medications Questionnaire and the 4-item medication adherence scale. A cut-off point of HbA1c% <7 was used as an indicator of glycemic control. Stepwise binary logistic regression was conducted to explore the variables associated with poor glycemic control.

RESULTS

A total of 287 patients participated in the study. More than half (58%) were found to have poor glycemic control‎. Females had significantly higher odds of having controlled diabetes (OR=2.28, p-value <0.01). Increasing necessity for diabetes medications was significantly associated with improved glycemic control (OR=2.75, p-value <0.01). Participants in low or moderate adherence groups had significantly higher odds of having uncontrolled diabetes.

CONCLUSIONS

Future diabetes management programs should focus on emphasizing medication necessity and improving medication adherence, particularly for male patients, with the aim of improving glycemic control and health outcomes among patients with type 2 diabetes.

Biodegradable Polysarcosine with Inserted Alanine Residues: Synthesis and Enzymolysis

Polysarcosine (PSar), a water-soluble polypeptoid, is gifted with biodegradability via the random ring-opening copolymerization of sarcosine- and alanine-N-thiocarboxyanhydrides catalyzed by acetic acid in controlled manners. Kinetic investigation reveals the copolymerization behavior of the two monomers. The random copolymers, named PaS, with high molecular weights between 5.3 and 43.6 kg/mol and tunable Ala molar fractions varying from 6 to 43% can be degraded by porcine pancreatic elastase within 50 days under mild conditions (pH = 8.0 at 37 °C). Both the biodegradation rate and water solubility of PaS depend on the content of Ala residues. PaS with Ala fractions below 43% are soluble in water, while the one with 43% Ala self-assembles in water into nanoparticles. Moreover, PaS are noncytotoxic at the concentration of 5 mg/mL. The biodegradability and biocompatibility endow the Ala-containing PSar with the potential to replace poly(ethylene glycol) as a protective shield in drug-delivery.

NHS Health Check programme: a rapid review update

OBJECTIVE

To update a rapid review published in 2017, which evaluated the NHS Health Check programme.

METHODS

An enlarged body of evidence was used to readdress six research objectives from a rapid review published in 2017, relating to the uptake, patient experiences and effectiveness of the NHS Health Check programme. Data sources included MEDLINE, PubMed, Embase, Health Management Information Consortium (HMIC), Cumulative Index of Nursing and Allied Health Literature (CINAHL), Global Health, PsycINFO, the Cochrane Library, NHS Evidence, Google Scholar, Google, ClinicalTrials.gov and the ISRCTN registry, Web of Science, Science Citation Index, The Cochrane Library, NHS Evidence, OpenGrey and hand searching article reference lists. These searches identified records from between January 1996 and December 2019. Screening, data extraction and quality appraisal using the Critical Appraisals Skills Programme checklists were performed in duplicate. Grading of Recommendations Assessment, Development and Evaluations was implemented. Data were synthesised narratively.

RESULTS

697 studies were identified, and 29 new studies included in the review update. The number of published studies on the uptake, patient experiences and effectiveness of the NHS Health Check programme has increased by 43% since the rapid review published in 2017. However, findings from the original review remain largely unchanged. NHS Health Checks led to an overall increase in the detection of raised risk factors and morbidities including diabetes mellitus, hypertension, raised blood pressure, cholesterol and chronic kidney disease. Individuals most likely to attend the NHS Health Check programme included women, persons aged ≥60 years and those from more socioeconomically advantaged backgrounds. Opportunistic invitations increased uptake among men, younger persons and those with a higher deprivation level.

CONCLUSIONS

Although results are inconsistent between studies, the NHS Health Check programme is associated with increased detection of heightened cardiovascular disease risk factors and diagnoses. Uptake varied between population subgroups. Opportunistic invitations may increase uptake.