miR-486-5p diagnosed atrial fibrillation, predicted the risk of left atrial fibrosis, and regulated angiotensin II-induced cardiac fibrosis via modulating PI3K/Akt signaling through targeting FOXO1

This study focused on miR-486-5p in atrial fibrillation (AF) evaluating its clinical significance and revealing its regulatory mechanism in cardiac fibroblasts, aiming to explore a novel biomarker for AF. The study enrolled 131 AF patients and 77 non-AF individuals. With the help of polymerase chain reaction (PCR), the expression of miR-486-5p was evaluated. The significance of miR-486-5p in the diagnosis of AF and the occurrence of left atrial fibrosis (LAF) was assessed by receiver operating curve (ROC) and logistic analyses. The regulatory effect and mechanism of miR-486-5p on cardiac fibrosis were investigated in human cardiac fibroblasts treated with angiotensin II. miR-486-5p was significantly upregulated in AF patients and discriminated AF patients from non-AF individuals. Increasing miR-486-5p showed a significant association with decreasing left ventricular ejection fraction (LVEF), increasing left atrial diameter (LAD) and left ventricular end-diastolic diameter (LVEDd), and the high incidence of LAF in AF patients. Moreover, miR-486-5p was identified as a risk factor for LAF and could distinguish AF patients with LAF and without LAF. In cardiac fibroblasts, angiotensin II induced the upregulation of miR-486-5p and promoted cell proliferation, migration, and collagen synthesis. miR-486-5p negatively regulated forkhead box O1 (FOXO1) and its knockdown could reverse the promoted effect of angiotensin II. FOXO1 alleviated the effect of miR-486-5p, and the miR-486-5p/FOXO1 could activate PI3K/Akt signaling. The activation of PI3K/Akt signaling alleviated the enhanced proliferation, migration, and collagen synthesis of cardiac fibroblasts induced by angiotensin II, and its inhibition showed opposite effects. Increased miR-486-5p served as a biomarker for the diagnosis and development prediction of AF. miR-486-5p regulated cardiac fibroblast viability and collagen synthesis via modulating the PI3K/Akt signaling through targeting FOXO1.

Distinguished denitrifying phosphorus removal in the high-rate anoxic/microaerobic system for sewage treatment

This study re-evaluated the role of anoxic and anaerobic zones during the enhanced biological phosphorus (P) removal process by investigating the potential effect of introducing an anoxic zone into a high-rate microaerobic activated sludge (MAS) system (1.60-1.70 kg chemical oxygen demand (COD) m-3 d-1), i.e., a high-rate anoxic/microaerobic (A/M) system for sewage treatment. In the absence of a pre-anaerobic zone, introducing an anoxic zone considerably reduced effluent NOx--N concentrations (7.2 vs. 1.5 mg L-1) and remarkably enhanced total nitrogen (75% vs. 89%) and total P (18% vs. 60%) removal and sludge P content (1.48% vs. 1.77% (dry weight)) due to further anoxic denitrifying P removal in the anoxic zone (besides simultaneous nitrification and denitrification in the microaerobic zone). High-throughput pyrosequencing demonstrated the niche differentiation of different polyphosphate accumulating organism (PAO) clades (including denitrifying PAO [DPAO] and non-DPAO) in both systems. Introducing an anoxic zone considerably reduced the total PAO abundance in sludge samples by 42% and modified the PAO community structure, including 17-19 detected genera. The change was solely confined to non-DPAOs, as no obvious change in total abundance or community structure of DPAOs including 7 detected genera was observed. Additionally, introducing an anoxic zone increased the abundance of ammonia-oxidizing bacteria by 39%. The high-rate A/M process provided less aeration, higher treatment capacity, a lower COD requirement, and a 75% decrease in the production of waste sludge than the conventional biological nutrient removal process.

LINC00869 Promotes Hepatocellular Carcinoma Metastasis via Protrusion Formation

Coordination of filament assembly and membrane remodeling is required for the directional migration of cancer cells. The Wiskott-Aldrich syndrome protein (WASP) recruits the actin-related protein (ARP) 2/3 complex to assemble branched actin networks. The goal of our study was to assess the potential regulatory role exerted by the novel long noncoding RNA (lncRNA) LINC00869 on hepatocellular carcinoma (HCC) cells. We used HCC cells to overexpress or knockdown LINC00869, analyzed patient data from publicly available databases and Cancer Hospital Affiliated with Zhengzhou University, and used a xenograft mouse model of HCC to study the molecular mechanism associated with LINC00869 expression. We found that high levels of LINC00869 expression were associated with poor prognosis in patients with HCC. Next, we detected an interaction between LINC00869 and both WASP and ARP2 in HCC cells, and observed a modulatory effect of LINC00869 on the phosphorylation of WASP at Y291 and the activity of cell division control protein 42 (CDC42). These modulatory roles were required for WASP/CDC42 activity on F-actin polymerization to enhance membrane protrusion formation and maintain persistent cell polarization. This, in turn, promoted the migration and invasion abilities of HCC cells. Finally, we confirmed the role of LINC00869in vivo, using the tumor xenograft mouse model; and identified a positive correlation between LINC00869 expression levels and the phosphorylation levels of WASP in HCC samples. Overall, our findings suggest a unique mechanism by which LINC00869 orchestrates membrane protrusion during migration and invasion of HCC cells.

IMPLICATIONS

LncRNA LINC00869 regulates the activity of CDC42-WASP pathway and positively affects protrusion formation in HCC cells, which expands the current understanding of lncRNA functions as well as gives a better understanding of carcinogenesis.

Photoinduced Cuproptosis with Tumor-Specific for Metastasis-Inhibited Cancer Therapy

Cuproptosis is a novel form of regulated cell death which guarantees to increase the efficacy of existing anticancer treatments that employ traditional apoptotic therapeutics. However, reducing the amount of undesirable Cu ions released in normal tissue and maximizing Cu-induced cuproptosis therapeutic effects at tumor sites are the major challenges. In this study, exploiting the chemical properties of copper ionophores and the tumor microenvironment, a novel method is developed for controlling the valence of copper ions that cause photoinduced cuproptosis in tumor cells. CJS-Cu nanoparticles (NPs) can selectively induce cuproptosis after cascade reactions through H2 O2 -triggered Cu2+ release, photoirradiation-induced superoxide radical (∙O2 - ) generation, and reduction of Cu2+ to Cu+ by ∙O2 - . The generated reactive oxygen species can result in glutathione depletion and iron-sulfur cluster protein damage and further augmented cuproptosis. CJS-Cu NPs effectively suppressed tumor growth and downregulated the expression of metastasis-related proteins, contributing to the complete inhibition of lung metastasis. Ultimately, this study suggests novel avenues for the manipulation of cellular cuproptosis through photochemical reactions.

A cost-utility study of elective haemorrhoidectomies in Canada

AIM

The aim was to estimate the 10-year cost-utility of haemorrhoidectomy surgery with preference-based measures of health using Canadian health utility measures and costs.

METHODS

Patients undergoing elective haemorrhoidectomies by general and colorectal surgeons in British Columbia, Vancouver, between September 2015 and November 2022, completed preoperatively and postoperatively the EuroQol five-dimension five-level health-related quality of life questionnaire (EQ-5D-5L). Quality-adjusted life years (QALYs) attributable to surgery were calculated by discounting preoperative and postoperative health utility values derived from the EQ-5D-5L. Costs were measured from a health system perspective which incorporated costs of hospital stay and specialists' fees. Results are presented in 2021 Canadian dollars.

RESULTS

Of 94 (47%) patients who completed both the preoperative and postoperative questionnaires, the mean gain in QALYs 10 years after surgery was 1.0609, assuming a 3.5% annual discounting rate. The average cost of the surgery was $3166. The average cost per QALY was $2985 when benefits of the surgery were assumed to accrue for 10 years. The cost per QALY was higher for women ($3821) compared with men ($2485). Participants over the age of 70 had the highest cost per QALY ($8079/QALY).

CONCLUSIONS

Haemorrhoidectomies have been associated with significant gains in health status and are inexpensive relative to the associated gains in quality of life based on patients' perspectives of their improvement in health and well-being.

Reevaluating the accuracy and specificity of EDTA-based polyphosphate quantification method

Feng et al. (2020) developed a simple, nondestructive, and cost-effective method to quantify polyphosphate (poly-P) in poly-P-accumulating organism (PAO)-enriched sludge samples through 30-h anaerobic exposure to 1 % (w/v) ethylenediaminetetraacetic acid (EDTA). This study optimized the N/P ratio (∼2) of the PAO culture medium in order to provide excess P for poly-P formation in PAO cells. Subsequently, the fluorescence microscopic observation of stained cells confirmed that Corynebacterium glutamicum was a PAO species capable of heterotrophic nitrification. Finally, this study reevaluated the accuracy and specificity of the EDTA-based quantification method, using two confirmed PAO biomass, three confirmed non-PAO biomass, and two sludge samples. The 1 % (w/v) EDTA treatment appears destructive to non-PAO cells, causes the release of other P forms, and is not effective for all PAO species. Under the conditions, the actual P release amount should be calculated by subtracting approximately 8 mg P g-1 total suspended solids from the determination. The amounts of P released from sludge samples was determined not only by the PAO fractions described by Feng et al. but also by PAO community structure and sludge P content.

Proteomics-Based Investigation of Different Live Prey Administered to Freshwater Dark Sleeper (Odontobutis potamophila): Examining the Effects on Glycolipids and Energy Metabolism

Live prey is characterized by balanced rich nutrients and high palatability and is widely used for the seedling cultivation of freshwater dark sleeper (Odontobutis potamophila) larvae. In this study, we evaluated the effects of four groups of paired feeding regimens (group C (Daphnia magna), group L (Limnodrilus hoffmeisteri), group H (Hypophthalmichthys molitrix fry), and group M (mixed groups C, L, and H)) on glycolipid and energy metabolism in O. potamophila larvae. We observed that fatty acid synthase (FAS) and sterol-regulatory-element-binding protein-1 (SREBP-1) mRNA levels were significantly lower in group H when compared to mRNA levels in the other three groups (p < 0.05) and that carnitine palmitoyltransferase 1α (CPT1-α) mRNA levels were significantly lower in group L when compared to group M (p < 0.05). Relative glucokinase (GK) expression levels were significantly lower in group M when compared to the other three groups (p < 0.05). Using proteomics, we analyzed and compared groups H and L and identified 457 differentially expressed proteins (DEPs), of which 151 were significantly up-regulated and 306 were significantly down-regulated. In the comparison of group M with groups C, L, and H, we found significant enrichment in glycolytic processes, the endoplasmic reticulum lumen, NAD binding, intermediate filaments, and nutrient reservoir activity. Our results provide a theoretical guidance for bait selection during larvae cultivation stages in carnivorous fish.

Identification and characterization of a highly virulent Citrobacter freundii isolate and its activation on immune responses in largemouth bass (Micropterus salmoides)

Citrobacter freundii, a common pathogen of freshwater fish, causes significant commercial losses to the global fish farming industry. In the present study, a highly pathogenic C. freundii strain was isolated and identified from largemouth bass (Micropterus salmoides). The pathogenicity and antibiotic sensitivity of the C. freundii strain were evaluated, and the histopathology and host immune response of largemouth bass infected with C. freundii were investigated. The results showed that C. freundii was the pathogen causing disease outbreaks in largemouth bass, and the infected fish showed typical signs of acute hemorrhages and visceral enlargement. Antimicrobial susceptibility testing showed that the C. freundii strain was resistant to Kanamycin, Medimycin, Clindamycin, Penicillin, Oxacillin, Ampicillin, Cephalexin, Cefazolin, Cefradine and Vancomycin. Histopathological analysis showed different pathological changes in major tissues of diseased fish. In addition, humoral immune factors such as superoxide dismutase (SOD), catalase (CAT) and lysozyme (LZM) were used as serum indicators to evaluate the immune response of largemouth bass after infection. Quantitative real-time PCR (qRT-PCR) was performed to investigate the expression pattern of immune-related genes (CXCR1, IL-8, IRF7, IgM, CD40, IFN-γ, IL-1β, Hep1, and Hep2) in liver, spleen, and head kidney tissues, which demonstrated a strong immune response induced by C. freundii infection in largemouth bass. The present study provides insights into the pathogenic mechanism of C. freundii and immune response in largemouth bass, promoting the prevention and treatment of diseases caused by C. freundii infection.

A retrospective real-world study: the efficacy of immune-related combination therapies in advanced non-small cell lung cancer after resistance to EGFR-TKIs

BACKGROUND

Whether patients with advanced non-small cell lung cancer (NSCLC) should choose an immune-combination therapy regimen after EGFR-tyrosine kinase inhibitors (EGFR-TKIs) resistance is currently unclear.

METHODS

We evaluated 118 NSCLC patients treated by immune checkpoint inhibitors (ICIs) + chemotherapy (I + C), ICIs + chemotherapy + antiangiogenic therapy (I + C + A), chemotherapy + antiangiogenic therapy (C + A) after inefficacy of EGFR-TKIs. We assessed the objective remission rate (ORR), disease control rate (DCR), and progression-free survival (PFS) of these treatments.

RESULTS

The ORR was 26.1% vs 38.2% vs 16.3% in the three groups (P = 0.093). The divergence in DCR was also statistically significant (65.2% vs 85.3% vs 74.4%, P = 0.209). The median PFS was no statistically significant difference in PFS (3.09 vs 6.31 vs 5.91 months, P = 0.809), but the Kaplan-Meier survival curve of 12-month-PFS indicated an apparent survival advantage in the I + C + A group (P = 0.001). In addition, the I + C/I + C + A group showed higher median PFS than the C + A group in patients with brain metastases (median PFS, 6.44 vs 4.21 months, P = 0.022). The divergence in ORR of patients in the brain group was also statistically significant (P = 0.045). The I + C + A group showed superior efficacy in patients with liver metastases (median PFS, 0.95 vs 6.44 vs 3.48 months, P < 0.0001). The Cox proportional hazard modeling analysis suggested that the age, brain metastases, and liver metastases were all connected with the prognosis.

CONCLUSIONS

This study suggests that advanced NSCLC patients after resistance to EGFR-TKIs may achieve better outcomes from triple therapy. Patients with brain metastases favor ICIs-related combination therapies and patients with liver metastases prefer I + C + A therapy.

Metabolic inhibitor-free assessment of the heterotrophic ammonia-oxidizing activity in activated sludge

When the contributions of three ammonia-oxidizing pathways (heterotrophic or autotrophic aerobic ammonia oxidization, and anammox) to wastewater biological nitrogen removal systems was compared by determining their ammonia-oxidizing activities, the key question is how to accurately determine the potential heterotrophic aerobic ammonia-oxidizing (PHAe) activity when the potential autotrophic aerobic ammonia-oxidizing (PAAe) activity (by ammonia-oxidizing bacteria (AOB) or archaea, or complete ammonia oxidization bacteria) also contributes to ammonia oxidization in PHAe activity assay medium. Using a AOB species and three heterotrophic AOB species as inocula, we demonstrated the feasibility of PHAe activity evaluation in the absence of a metabolic inhibitor, i.e., by subtracting the PAAe activity determined in PAAe activity assay medium from a combination of PAAe and PHAe activity determined in PHAe activity assay medium. Binary organic carbon sources (i.e., glucose and acetate) were included in the PHAe activity assay medium to fulfill the carbon requirements of most heterotrophic AOB genera. Higher ammonia-oxidizing activity in AOB biomass than heterotrophic AOB biomass (35.6 vs. 2.6-10.0 mg NH4+-N g-1 MLSS h-1) provides the remarkable advantages of autotrophic aerobic ammonia oxidization in biological nitrogen removal systems. Ammonia removal in three full-scale biological nitrogen removal systems for sewage treatment was predominantly mediated by PAAe activity (1.9-3.3 vs. 0.0-0.3 mg NH4+-N g1 MLSS h-1).

Distinguished denitrifying phosphorus removal in the high-rate anoxic/microaerobic system for sewage treatment

This study re-evaluated the role of anoxic and anaerobic zones during the enhanced biological phosphorus (P) removal process by investigating the potential effect of introducing an anoxic zone into a high-rate microaerobic activated sludge (MAS) system (1.60-1.70 kg chemical oxygen demand (COD) m-3 d-1), i.e., a high-rate anoxic/microaerobic (A/M) system for sewage treatment. In the absence of a pre-anaerobic zone, introducing an anoxic zone considerably reduced effluent NOx--N concentrations (7.2 vs. 1.5 mg L-1) and remarkably enhanced total nitrogen (75% vs. 89%) and total P (18% vs. 60%) removal and sludge P content (1.48% vs. 1.77% (dry weight)) due to further anoxic denitrifying P removal denitrification in the anoxic zone (besides simultaneous nitrification and denitrification in the microaerobic zone). High-throughput pyrosequencing demonstrated the niche differentiation of different polyphosphate accumulating organism (PAO) clades (including denitrifying PAO [DPAO] and non-DPAO) in both systems. Introducing an anoxic zone considerably reduced the total PAO abundance in sludge samples by 42% and modified the PAO community structure, including 17-19 detected genera. The change was solely confined to non-DPAOs, as no significant change in total abundance or community structure of DPAOs including seven detected genera was observed. Additionally, introducing an anoxic zone increased the abundance of ammonia-oxidizing bacteria by 39%. The high-rate A/M process provided less aeration, higher treatment capacity, a lower COD requirement, and a 75% decrease in the production of waste sludge than the conventional biological nutrient removal process.

[Study on F9 gene expression downregulation and its clinical value in hepatocellular carcinoma]

Objective: To analyze the expression levels of the F9 gene and F9 protein in hepatocellular carcinoma by combining multiple gene chip data, real-time fluorescence quantitative PCR (RT qPCR), and immunohistochemistry. Additionally, explore their correlation with the occurrence and development of hepatocellular carcinoma, as well as with various clinical indicators and prognosis. Methods: The mRNA microarray dataset from the GEO database was analyzed to identify the F9 gene with significant expression differences associated with hepatocellular carcinoma. Liver cancer and adjacent tissues were collected from 18 cases of hepatocellular carcinoma. RT-qPCR method was used to detect the F9 gene expression level. Immunohistochemistry was used to detect the F9 protein level. Combined with the TCGA database information, the correlation between F9 gene expression level and prognostic and clinicopathological parameters was analyzed. The biological function of F9 co-expressed genes associated with hepatocellular carcinoma was analyzed by the Gene Ontology (GO) and the Kyoto Encyclopedia of Genes and Genomes (KEGG). Statistical analysis was performed using Graphpad Prism software. Results: Meta-analysis results showed that the expression of the F9 gene was lower in HCC tissues than in non-cancerous tissues. Immunohistochemistry results were basically consistent with those of RT-qPCR. The data obtained from TCGA showed that the F9 gene had lower expression values in stages III-IV, T3-T4, and patients with vascular invasion. A total of 127 genes were selected for bioinformatics analysis as co-expressed genes of F9, which were highly enriched in redox processes and metabolic pathways. Conclusion: This study validates that the F9 gene and F9 protein are lower in HCC. The down-regulation of the F9 gene predicts adverse outcomes, which may provide a new therapeutic target for HCC.

[The association of intra-aortic balloon pump with prognosis of cardiogenic shock based on Society for Cardiovascular Angiography and Interventions classification]

The study aimed to evaluate whether an intra-aortic balloon pump (IABP) could improve the prognosis of patients with cardiogenic shock (CS) of Stage C (Classic), Stage D (Deteriorating), and Stage E (Extremis) based on Society for Cardiovascular Angiography and Interventions (SCAI) classification. The hospital information database was searched, and the patients who met the diagnostic criteria of CS were included and treated following the same protocol. The association between IABP and the survival of patients at 1 month and 6 months were analyzed separately in SCAI stage C of CS, and stages D and E of CS. The multiple logistic regression models were used to separately evaluate whether IABP was independently associated with increased survival in stage C of CS, and stages D and E of CS. A total of 141 patients with stage C of CS and 267 patients with stages D and E of CS were included. In stage C of CS, IABP was significantly associated with improved survival of patients at 1 month [adjusted OR (95%CI)=0.372 (0.171-0.809), P=0.013] and survival at 6 months [adjusted OR (95%CI)=0.401 (0.190-0.850), P=0.017]. However, when percutaneous coronary intervention or coronary artery bypass grafting (PCI/CABG) was introduced as an adjusted factor, there was a significant association between survival rates and PCI/CABG rather than IABP. In stages D and E of CS, IABP was significantly associated with an improved survival at 1 month [adjusted OR (95%CI)=0.053 (0.012-0.236), P=0.001]. Therefore, IABP could assist patients with stage C of CS in the perioperative period of PCI/CABG and improve survival rates, and IABP might prolong short-term prognosis of patients with stages D and E of CS.

Development of TaqMan-based real-time PCR assay based on the E1 genefor the quantitative detection of the Getah virus

To develop a sensitive, specific, and rapid approach for the detection Getah virus (GETV), a set of primers targeting the conserved region of the E1 gene was created. The TaqMan-based real-time PCR method for GETV detection was developed by optimizing the reaction conditions. The method demonstrated excellent specificity, and amplification did not occur with the causative agents of all prevalent swine viral infections (CSFV, PRRSV, PRV, PEDV, PTV, and JEV), except GETV. Additionally, upon assessing the sensitivity of the method, the minimum detection limit for GETV was found to be 5.94 copies/μL, which is 10 times higher than that of the traditional PCR approach. Further, the intra- and inter-assay variation coefficients were less than 1%, demonstrating good repeatability. Moreover, GETV was found in 10 of the 20 field serum samples using real-time PCR but only in three of the samples using traditional PCR. Consequently, the first GETV TaqMan-based real-time PCR approach based on the E1 gene was developed for GETV pathogenic diagnoses, and this exhibited high specificity, sensitivity, and repeatability. This assay is practical for the pathogenic diagnosis and epidemiology of GETV.

Deep learning for predicting the risk of immune checkpoint inhibitor-related pneumonitis in lung cancer

AIM

To develop and validate a nomogram model that combines computed tomography (CT)-based radiological factors extracted from deep-learning and clinical factors for the early predictions of immune checkpoint inhibitor-related pneumonitis (ICI-P).

MATERIALS AND METHODS

Forty ICI-P patients and 101 patients without ICI-P were divided randomly into the training (n=113) and test (n=28) sets. The convolution neural network (CNN) algorithm was used to extract the CT-based radiological features of predictable ICI-P and calculated the CT score of each patient. A nomogram model to predict the risk of ICI-P was developed by logistic regression.

RESULTS

CT score was calculated from five radiological features extracted by the residual neural network-50-V2 with feature pyramid networks. Four predictors of ICI-P in the nomogram model included a clinical feature (pre-existing lung diseases), two serum markers (absolute lymphocyte count and lactate dehydrogenase), and a CT score. The area under curve of the nomogram model in the training (0.910 versus 0.871 versus 0.778) and test (0.900 versus 0.856 versus 0.869) sets was better than the radiological and clinical models. The nomogram model showed good consistency and better clinical practicability.

CONCLUSION

The nomogram model that combined CT-based radiological factors and clinical factors can be used as a new non-invasive tool for the early prediction of ICI-P in lung cancer patients after immunotherapy with low cost and low manual input.

[Rapid evaluation of the early pathogen of severe Chlamydophila psittaci pneumonia by diagnostic bronchoscopy]

OBJECTIVE

To explore the rapid evaluation of the early pathogen of severe Chlamydophila psittaci pneumonia by bedside diagnostic bronchoscopy, so as to start effective anti-infection treatment before the results of macrogenome next generation sequencing (mNGS) test.

METHODS

The clinical data of three patients with severe Chlamydophila psittaci pneumonia who were successfully treated in the First Affiliated Hospital of Xinjiang Medical University, the First People's Hospital of Aksu District, and the First Division Hospital of Xinjiang Production and Construction Corps from October 2020 to June 2021 were retrospectively analyzed, including the rapid assessment of early pathogens by bedside diagnostic bronchoscopy and the use of antibiotics to start anti-infection treatment. These patients were successfully treated.

RESULTS

The three patients were male, aged 63, 45 and 58 years old, respectively. Before the onset of the penumonia, they had a clear medical history of bird exposure. The clinical manifestations mainly included fever, dry cough, shortness of breath and dyspnea. One case had abdominal pain and lethargy. The results of laboratory examination indicated that the peripheral blood white blood cell count (WBC) of two patients were high [(10.2-11.9)×10⁹/L], the percentage of neutrophils increased (85.2%-94.6%) and the percentage of lymphocytes decreased (3.2%-7.7%) in all 3 patients after admission to hospital and entering into intensive care unit (ICU). The procalcitonin (PCT) of 3 patients increased after admission, and still increased when entering ICU (0.3-4.8 ng/L), so did C-reactive protein (CRP, 58.0-162.0 mg/L) and erythrocyte sedimentation rate (ESR, 36.0-90.0 mm/1 h). After admission, serum alanine transaminase (ALT) increased in 2 cases (136.7 U/L, 220.5 U/L), so did aspartate transaminase (AST) in 2 cases (249.6 U/L, 164.2 U/L). ALT (162.2-267.9 U/L) and AST (189.8-223.2 U/L) increased in 3 patients when they entered ICU. The level of serum creatinine (SCr) of 3 patients were normal after admission and entering ICU. The chest computed tomography (CT) findings of 3 patients were acute interstitial pneumonia, bronchopneumonia and lung consolidation, of which 2 cases were accompanied by a small amount of pleural effusion, and 1 case was accompanied by more regular small air sacs. Multiple lung lobes were involved, but mainly one lung lobe. The oxygenation index (PaO₂/FiO₂) of the 3 patients admitting to ICU were 100.0, 57.5 and 105.4 mmHg (1 mmHg ≈ 0.133 kPa), respectively, which met with the diagnostic criteria of moderate and severe acute respiratory distress syndrome (ARDS). All three patients received endotracheal intubation and mechanical ventilation. Under the bedside bronchoscope, the bronchial mucosa of 3 patients were obviously congested and edematous, without purulent secretion, and there was 1 case with mucosal hemorrhage. Three patients underwent bedside diagnostic bronchoscopy, and the evaluation result of the pathogen was that it might be atypical pathogen infection, so they were given moxifloxacin, cisromet and doxycycline intravenously, respectively, and combined with carbapenem antibiotics intravenously. After 3 days, the detection results of mNGS in bronchoalveolar lavage fluid (BALF) showed that only Chlamydia psittaci was infected. At this time, the condition was significantly improved, and PaO₂/FiO₂ was significantly increased. Therefore, the antibiotic treatment scheme remained unchanged, and mNGS only served to verify the initial diagnosis. Two patients were extubated on the 7th and 12th day of admission to the ICU, respectively, while one patient was extubated on the 16th day of admission to the ICU due to nosocomial infection. All 3 patients were transferred to the respiratory ward after the condition was stable.

CONCLUSIONS

The bedside diagnostic bronchoscopy based on clinical characteristics is conducive to not only the rapid assessment of the early pathogens of severe Chlamydia psittaci pneumonia, but also effective anti-infection treatment before the returning of mNGS test results, which can make up for the lag and uncertainty of the mNGS test results.

Association between Dried Fruit Intake and DNA Methylation: A Multivariable Mendelian Randomization Analysis

OBJECTIVES

Observational studies have reported associations between dried fruit intake and DNA methylation(DNAm). However, inherent flaws in observational study designs make them susceptible to confounding and reverse causality bias. Consequently, it is unclear whether a causal association exists. In the present study, we aimed to investigate the causal associations between dried fruit intake and DNAm.

METHODS

We performed two-sample Mendelian randomization (MR) using the IEU Open GWAS database aggregated data. Forty-three single nucleotide polymorphisms (SNPs) associated with dried fruit intake as instrumental variables (IVs) were selected as exposure. DNAm outcomes include Gran (estimated granulocyte proportions); AgeAccelGrim(GrimAge acceleration); Hannum (Hannum age acceleration); IEAA(Intrinsic epigenetic age acceleration), AgeAccelPheno( PhenoAge acceleration), and DNAmPAIadjAge (DNAm-estimated plasminogen activator inhibitor-1 levels). We used the MR pleiotropy residual sum and outlier test (MRPRESSO) and Radial-MR test to identify any level of multi-effect outliers and assessed the causal effect estimates(after removing outliers). The primary causal effects were estimated using inverse-variance weighted (IVW) method and undertook sensitivity analyses using MR methods robust to horizontal pleiotropy.The direct effects of dried fruit intake on DNAm were estimated using multivariable mendelian randomization (MVMR).

RESULTS

Leveraging two-sample MR analysis, we observed statistically significant associations between dried fruit intake with a lower AgeAccelGrim(β=-1.365, 95% confidence intervals [CI] -2.266 to -0.464, PIVW=2.985×10-3) and AgeAccelPheno (β= -1.933, 95% CI -3.068 to -0.798, PIVW=8.371×10-4). By contrast, the effects level on Gran (β=0.008, PIVW=0.430), Hannum(β=-0.430, PIVW=0.357), IEAA(β=-0.184, PIVW=0.700), and DNAmPAIadjAge (β=-1.861, PIVW=0.093) were not statistically significant. MVMR results adjusting for the potential effects of confounders showed that the causal relationship between dried fruit intake and AgeAccelGrim(β= -1.315, 95% CI -2.373 to -0.258, PIVW=1.480×10-2) and AgeAccelPheno(β= -1.595, 95% CI -2.987 to -0.202, PIVW=2.483×10-2) persisted. No significant horizontal polymorphism was found in the sensitivity analysis.

CONCLUSION

Our MR study suggested that increased dried fruit intake is associated with slower AgeAccelGrim and AgeAccelPheno. It can providing a promising avenue for exploring the beneficial effects of dried fruit intake on lifespan extension.

lncRNA Sequencing of Antler Mesenchymal Tissue Revealed that the Regulatory Network of Antler Cell Proliferation and Differentiation

Antlers have been widely studied due to their unique physiological characteristics, such as rapid growth, periodic shedding and regeneration. However, little is known about how antler growth is regulated by long non-coding RNA (lncRNA). The aim of the present study was to identify the lncRNAs expression profile and explore the function of lncRNAs during the antler growth. Herein, RNA-sequencing technology (RNA-seq) was performed on the three growth periods (early developmental period: EP, middle developmental period: MP, later developmental period: LP) of male sika deer (Cervus nippon) antler, 16 differentially expressed lncRNAs (DE lncRNAs) and 11 DE lncRNAs were identified in EP vs MP and MP vs LP related to cell proliferation and cell differentiation, respectively. Finally, lncRNAs-mRNAs co-expression networks were constructed based on the identified DE lncRNAs and their potential trans-target genes. The result reveals that lncRNAs may play diverse roles in different periods of antler growth. It provides a novel perspective for revealing the molecular mechanism of antler growth.

Challenges and Opportunities of Chemiresistors Based on Microelectromechanical Systems for Chemical Olfaction

Microelectromechanical-system (MEMS)-based semiconductor gas sensors are considered one of the fastest-growing, interdisciplinary high technologies during the post-Moore era. Modern advancements within this arena include wearable electronics, Internet of Things, and artificial brain-inspired intelligence, among other modalities, thus bringing opportunities to drive MEMS-based gas sensors with higher performance, lower costs, and wider applicability. However, the high demand for miniature and micropower sensors with unified processes on a single chip imposes great challenges. This review focuses on recent developments and pitfalls in MEMS-based micro- and nanoscale gas sensors and details future trends. We also cover the background of the topic, seminal efforts, current applications and challenges, and opportunities for next-generation systems.

Characterization of the pathogenesis and immune response to a highly virulent Edwardsiella tarda strain responsible for mass mortality in the hybrid snakehead (Channa maculate ♀ × Channa argus ♂)

Edwardsiella tarda is reported as the causative agent of the systemic disease Edwardsiellosis in fish, which lead to huge economic losses in aquaculture. The pathogenicity and immune response to a highly virulent E. tarda isolate responsible for mass mortality in hybrid snakehead were performed. After species identification, morphology and virulence gene detection of Edwardsiella isolated from hybrid snakehead, the pathogenicity of the strain and histopathological changes in infected fish were analyzed. The infected fish exhibited typical acute hemorrhagic symptoms and enlarged internal organs. Histopathology revealed that the liver, spleen, kidney and intestinal tissues of diseased fish exhibited marked inflammatory with vacuolar degeneration and cell necrosis. Subsequently, humoral immune factors such as superoxide dismutase, lysozyme and acid phosphatase activities were detected as serum indicators, and real-time quantitative PCR was used to investigate immune-related genes (STAT1, HSP70, IgM, IL-6, IL-8, TRAF2, CD40, HLA-DMA and LCK) expression patterns in liver, spleen and head kidney. The results showed that these enzyme activity indicators and immune-related gene expression were significantly activated compared with healthy fish. These data provide insight into the pathogenic mechanisms and host immune responses of E. tarda, which could be useful for the future prevention and treatment of Edwardsiellosis in fish.

[Patient experience in the implementation of enhanced recovery after surgery strategy after radical gastric cancer surgery]

Objective: To investigate the experience of patients in the implementation of enhanced recovery after surgery (ERAS) strategy after radical gastrectomy and the factors affecting the treatment experience. Methods: A prospective cohort study was carried out. Patients who were diagnosed with gastric cancer by pathology and underwent radical gastrectomy at the Xijing Digestive Disease Hospital from December 2019 to December 2020 were consecutively enrolled. Those who received emergency surgery, residual gastric cancer surgery, preoperative neoadjuvant chemotherapy, non-curative tumor resection, intraperitoneal metastasis, or other malignant tumors were excluded. Patients' expectation and experience during implementation were investigated by questionnaires. The questionnaire included three main parts: patients' expectation for ERAS, patients' experience during the ERAS implementation, and patients' outcomes within 30 days after discharge. The items on the expectation and experience were ranked from 0 to 10 by patients, which indicated to be unsatisfied/unimportant and satisfied/important respectively. According to their attitudes towards the ERAS strategy, patients were divided into the support group and the reject group. Patients' expectation and experience of hospital stay, and the clinical outcomes within 30 days after discharge were compared between the two groups. Categorical data were reported as number with percentage and the quantitative data were reported as mean with standard deviation, or where appropriate, as the median with interquartile range (Q₁, Q₃). Categorical data were compared using the Chi-squared test or Fisher's exact test, where appropriate. For continuous data, Student's t test or Mann-Whitney U test were used. Complication was classified according to Clavien-Dindo classification. Results: Of the included 112 patients (88 males and 24 females), aged (57.8±10.0) years, 35 patients (31.3%) were in the support group and 77 (68.7%) in the reject group. Anxiety was detected in 56.2% (63/112) of the patients with score >8. The admission education during the ERAS implementation improved the patients' cognitions of the ERAS strategy [M(Q₁, Q₃) score: 8 (4, 10) vs. 2 (0, 5), Z=-7.130, P<0.001]. The expected hospital stay of patients was longer than the actual stay [7 (7, 10) days vs. 6 (6, 7) days, Z=-4.800, P<0.001]. During the ERAS implementation, patients had low score in early mobilization [3 (1, 6)] and early oral intake [5 (2.25, 8)]. Fifty-eight (51.8%) patients planned the ERAS implementation at home after discharge, while 32.1% (36/112) preferred to stay in hospital until they felt totally recovered. Compared with the reject group, the support group had shorter expected hospital stay [7 (6, 10) days vs. 10 (7, 15) days, Z=-2.607, P=0.009], and higher expected recovery-efficiency score [9 (8, 10) vs. 7(5, 9), Z=-3.078, P=0.002], lower expected less-pain score [8 (6, 10) vs. 6 (5, 9) days, Z=-1.996, P=0.046], expected faster recovery of physical strength score [8 (6, 10) vs. 6 (4, 9), Z=-2.200, P=0.028] and expected less drainage tube score [8 (8, 10) vs. 8 (5, 10), Z=-2.075, P=0.038]. Worrying about complications (49.1%) and self-recognition of not recovery (46.4%) were the major concerns when assessing the experience toward ERAS. During the follow-up, 105 patients received follow-up calls. There were 57.1% (60/105) of patients who experienced a variety of discomforts after discharge, including pain (28.6%), bloating (20.0%), nausea (12.4%), fatigue (7.6%), and fever (2.9%). Within 30 days after discharge, 6.7% (7/105) of patients developed Clavien-Dindo level I and II operation-associated complications, including poor wound healing, intestinal obstruction, intraperitoneal bleeding, and wound infection, all of which were cured by conservative treatment. There were no complications of level III or above in the whole group after surgery. Compared with the support group, more patients in the reject group reported that they had not yet achieved self-expected recovery when discharged [57.1% (44/77) vs. 22.9% (8/35), χ²=11.372, P<0.001], and expected to return to their daily lives [39.0% (30/77) vs. 8.6% (3/35), χ²=10.693, P<0.001], with statistically significant differences (all P<0.05). Only 52.4% (55/105) of patients returned home to continue rehabilitation, and the remaining patients chose to go to other hospitals to continue their hospitalization after discharge, with a median length of stay of 7 (7, 9) days. Compared with the reject group, the support group had a higher proportion of home rehabilitation [59.7% (12/33) vs. 36.4% (43/72), χ²=4.950, P=0.026], and shorter time of self-perceived postoperative full recovery [14 (10, 20) days vs. 15 (14, 20) days, Z=2.100, P=0.036], with statistically significant differences (all P<0.05). Conclusions: Although ERAS has promoted postoperative rehabilitation while ensuring surgical safety, it has not been unanimously recognized by patients. Adequate rehabilitation education, good analgesia, good physical recovery, and early removal of drainage tubes may improve the patient's experience of ERAS.

Effect of High Molecular Mass Tail in the Mol Mass Distribution of Polypropylene on Injection Molding

The effect of high molecular mass (MM) tail in the molecular mass distribution (MMD) of polypropylene (PP) on injection molding has been studied using injection molded tensile bars from a commercial PP resin and two samples of the above resin deprived of the high MM tail in different degrees by controlled degradation during extruder reaction with an added processing aid named Promax. The central portions of the tensile bars were studied by polarizing microscopy of microtomed sections parallel and perpendicular to the melt flow direction, and by density and birefringence profiles across the thickness of the bar. Mechanical properties and acoustic emission behavior in stretching of these injection molded tensile bars are also discussed. The experimental results show that by stripping off the high MM tail in the MMD the injection molded tensile bar has smaller degree of crystallization, less frozen orientation, improved uniformity across the thickness and the thickness of the skin part is greatly reduced. Better quality of the fabricated articles is to be expected by using Promax with PP for injection molding.

Causal roles of daytime sleepiness in cardiometabolic diseases and osteoporosis

OBJECTIVE

Daytime sleepiness has some association with cardiometabolic diseases and osteoporosis, but it is unknown whether their relationship is causal. This two-sample Mendelian randomization (MR) study aims to explore their causal relationship.

MATERIALS AND METHODS

We included the largest genome-wide association studies (GWASs) associated with daytime sleepiness, cardiometabolic diseases and osteoporosis. 34 single nucleotide polymorphisms (SNPs) were used as the instrumental variables of daytime sleepiness.

RESULTS

Genetic predisposition to excessive daytime sleepiness was strongly associated with increased risk of coronary artery disease (beta-estimate: 0.610, 95% confidence interval [CI]: 0.128 to 1.093, standard error [SE]: 0.246, p-value=0.013) and may increase the incidence of type 2 diabetes (beta-estimate: 0.614, 95% CI: 0.009 to 1.219, SE: 0.309, p-value=0.047). We found no causal influence of daytime sleepiness on heart failure, atrial fibrillation, cerebral ischemia, intracerebral hemorrhage, forearm bone mineral density (FA-BMD), femoral neck BMD (FN-BMD), and lumbar spine BMD (LS-BMD).

CONCLUSIONS

This study suggested that excessive daytime sleepiness was causally associated with increased risk of coronary artery disease, which may benefit to prevent this disease.

[The effect of Endocrine disrupting chemicals on myocardial fibrosis and related mechanism]

Endocrine-disrupting chemicals (EDCs) an exogenous agent that interferes with the synthesis, secretion, transport, binding, action, or can mimic the occurrence of natural hormones that damage for the balance of homeostasis. Exposure to EDCs results in damage to human health that may persist in the long term. In recent years, accumulative evidence has demonstrated that EDCs also play a pivotal role in the onset and development of myocardial fibrosis, including heart failure, hypertension and vascular stiffening. Studies indicate that EDCs plays the negative effects of the cardiovascular system, however, EDCs-induced toxicity on heart remains unclear. This review summarized EDCs-induced myocardial fibrosis, and discuss the possible mechanisms of myocardial fibrosis induced by EDCs. This paper could provide further understandings for prevention, diagnosis and treatment of myocardial fibrosis.

State-of-the-Art Advancements in Photocatalytic Hydrogenation: Reaction Mechanism and Recent Progress in Metal-Organic Framework (MOF)-Based Catalysts

Photocatalytic hydrogenation provides an effective alternative way for the synthesis of industrial chemicals to meet the economic and environment expectations. Especially, over the past few years, metal-organic frameworks (MOFs), featured with tunable structure, porosity, and crystallinity, have been significantly developed as many high-performance catalysts in the field of photocatalysis. In this review, the background and development of photocatalytic hydrogenation are systemically summarized. In particular, the comparison between photocatalysis and thermal catalysis, and the fundamental understanding of photohydrogenation, including reaction pathways, reducing species, regulation of selectivity, and critical parameters of light, are proposed. Moreover, this review highlights the advantages of MOFs-based photocatalysts in the area of photohydrogenation. Typical effective strategies for modifying MOFs-based composites to produce their advantages are concluded. The recent progress in the application of various types of MOFs-based photocatalysts for photohydrogenation of unsaturated organic chemicals and carbon dioxide (CO2 ) is summarized and discussed in detail. Finally, a brief conclusion and personal perspective on current challenges and future developments of photocatalytic hydrogenation processes and MOFs-based photocatalysts are also highlighted.

Schottky Contacts Regularized Linear Regression for Signal Inconsistency Circumvent in Resistive Gas Micro-Nanosensors

In the frontier resistive micro-nano gas sensors, the change rate reliability between the measured quantity and output signals has long been puzzled by the ineluctable device-to-device and run-to-run disparities. Here, a neotype sensing data interpretation method to circumvent these signal inconsistencies is reported. The method is based on discovery of a strong linear relation between the initial resistance in air (R_a ) and the absolute change in resistance after exposure to target gas (R_a -R_g ). Metal oxide gas sensors based on a micro-hot-plate are employed as the model system. The study finds that such correlation has a wide universality, even for devices incorporated with different sensing materials or under different gas atmosphere. Furthermore, this rule can also be extensible to graphene-based interdigital microelectrode. In situ probe scanning analyses illuminate that the linear dependence is closely related to work function matching level between metal electrode and sensitive layer. The Schottky barrier at metal-semiconductor junctions is the prominent parameter, whose height (ϕ_B ) can fundamentally impact material/electrode contact resistance, thereby further affecting the realistic nature expression of sensing materials. Using this correlation, a calibration procedure is proposed and embed in a fully integrated pocket-size sensor prototype, whose response outcomes demonstrated high credibility as compared to commercial apparatus.

[Predictive value of neutrophil-lymphocyte ratio on admission and before discharge for long-term all-cause death in hospitalized heart failure patients with reduced ejection fraction]

Objective: To evaluate the predictive value of neutrophil-lymphocyte ratio (NLR) on admission and before discharge for long-term all-cause death (ACD) in patients hospitalized with heart failure with reduced ejection fraction (HFrEF). Methods: Patients hospitalized and discharged from hospital alive with the clinical diagnosis of HFrEF in cardiac care unit (CCU) of TEDA International Cardiovascular Hospital from January 2013 to December 2017 were consecutively enrolled. NLR, which was defined as neutrophil counts divided by lymphocyte counts, was measured 1 day within admission and 3 days before discharge to evaluate the prognostic value of admission NLR in combination with discharge NLR for the ACD after discharge by using of multivariate Cox regression analysis. Patients were followed-up until December 2020 or ACD. Results: A total of 368 patients hospitalized with HFrEF were enrolled with an age of (54±14) years, including 79 females (21.5%). During the median (inter-quartile range, IQR) duration of follow-up after discharge of 30 (10, 60) months, 95 patients died, thus, the rate of ACD was 25.8%. Multivariate Cox regression analysis showed that the NLR level before discharge was an independent predictor of ACD after discharge [hazard ratio (HR)=1.143, 95% confidence interval (CI) 1.048-1.248, P=0.003] after adjusting for other parameters such as systolic blood pressure on admission and at discharge, left ventricular end-diastolic diameter on admission, and usage of aldosterone receptor blockers at discharge. Moreover, compared to those with NLR level at admission ≤2.25 and ≤2.00 before discharge, the long-term risk of ACD after discharge was nearly doubled for patients with NLR level at admission>2.25 and>2.00 before discharge (adjusted HR=1.968, 95%CI 1.198-3.234, P=0.008). Conclusions: The NLR level before discharge was an independent predictor of ACD after discharge for patients hospitalized with HFrEF. Combining NLR levels at admission and before discharge help to better predictive the risk of long-term ACD after discharge.

Supersolidity in Two-Dimensional Trapped Dipolar Droplet Arrays

We theoretically investigate the ground states and the spectrum of elementary excitations across the superfluid to droplet crystallization transition of an oblate dipolar Bose-Einstein condensate. We systematically identify regimes where spontaneous rotational symmetry breaking leads to the emergence of a supersolid phase with characteristic collective excitations, such as the Higgs amplitude mode. Furthermore, we study the dynamics across the transition and show how these supersolids can be realized with standard protocols in state-of-the-art experiments.

Development and validation of a three-immune-related gene signature prognostic risk model in papillary thyroid carcinoma

PURPOSE

Increasing evidence indicates that there is a correlation between papillary thyroid carcinoma (PTC) prognosis and the immune signature. Our goal was to construct a new prognostic tool based on immune genes to achieve more accurate prognosis predictions and earlier diagnoses of PTC.

METHODS

The 493 PTCs samples and 58 tumor-adjacent normal tissues were obtained from The Cancer Genome Atlas database (TCGA). Immune genes were obtained from the ImmPort database. First, this cohort was randomly divided into training cohort and testing cohort. Second, the differentially expressed (DE) immune genes from the training set were used to construct the prognostic model. Then, the testing and entire data cohorts were used to validate the model, and the data were analyzed to determine the correlation of the clinical prognostic model with immune cell infiltration and expression profiles of human leukocyte antigen (HLA) genes. Finally, an analysis of the gene ontology (GO) annotation was performed.

RESULTS

A total of 189 upregulated and 128 downregulated DE immune genes were identified. We developed and validated a three-immune gene model for PTC that includes Hsp70, NOX5, and FGF23. This model was demonstrated to be an independent prognostic variable. In addition, the overall immune activity of the high-risk group was higher than that of the low-risk group.

CONCLUSIONS

We developed and validated a three-immune gene model for PTC that includes HSPA1A, NOX5, and FGF23. This model can be used as a validated tool to predict outcomes in PTC.

[PI3K/Akt/mTOR signal pathway in endocrine disrupting chemicals-induced apoptosis and autophagy of thyroid follicular cells]

Endocrine disrupting chemicals (EDCs) are a kind of exogenous chemicals widely existing in the environment, which cause serious harm to the environment and human health. At present, the impact of this type of substance on the thyroid has attracted much attention.This review summarized the effects of EDCs on thyroid hormones, and phosphatidylinositol 3-kinase (PI3K) /protein kinase B (Akt) /mammalian target of rapamycin (mTOR) (PI3K/Akt/mTOR) signaling pathway and its role in thyroid diseases, and explore the role of PI3K/Akt/mTOR signaling pathway in EDCs-induced apoptosis and autophagy of thyroid follicular epithelial cells.This paper could provide further understandings for thyroid diseases induced by the autophagy and apoptosis of thyroid follicular epithelial cells.

Fiber Length Distribution in Twin-Screw Extrusion of Fiber-Reinforced Polymer Composites: A Comparison between Shear and Extensional Mixing

New extensional mixing elements (EME) for twin-screw extrusion were applied to compound glass fibers (GF), carbon fibers (CF) or polyethylene terephthalate fibers (PETF) reinforced polymer composites with polymer matrix of polypropylene (PP) or polyethylene oxide (PEO) and the resulting fiber degradation upon processing was evaluated and compared with compounding via shear flow-dominated kneading blocks (KB). Composites structures were characterized in terms of fiber length and distribution, and cumulative length ratio, at five locations along the mixing zone. Although significant fiber breakage was achieved for both configurations, it was markedly lower in composites processed using the EME, because whereas the high shear stress kneading motion in the KB degrades fibers significantly, fiber breakup is significantly minimized by the alignment induced by the EME prior to flow in the high-stress regions.

Roton Excitations in an Oblate Dipolar Quantum Gas

We observe signatures of radial and angular roton excitations around a droplet crystallization transition in dipolar Bose-Einstein condensates. In situ measurements are used to characterize the density fluctuations near this transition. The static structure factor is extracted and used to identify the radial and angular roton excitations by their characteristic symmetries. These fluctuations peak as a function of the interaction strength indicating the crystallization transition of the system. We compare our observations to a theoretically calculated excitation spectrum allowing us to connect the crystallization mechanism with the softening of the angular roton modes.

The significance of Hashimoto's thyroiditis for postoperative complications of thyroid surgery: a systematic review and meta-analysis

INTRODUCTION

Hashimoto's thyroiditis (HT) is one of the most common immune-mediated diseases. It makes thyroid surgery more complicated and difficult because there may be adhesions between the thyroid gland and surrounding structures. However, it is still controversial whether HT patients carry a high risk for postoperative complications of thyroid surgery. The purpose of this study was to investigate the significance of HT for the postoperative complications of thyroid surgery.

METHODS

A search for studies assessing the postoperative complication risks of HT patients compared with that of patients with benign nodules (BNs) was performed in PubMed, EMBASE and Web of Science. Nine studies (20,118 cases, 1,582 cases of HT and 18,536 cases of BN) were identified, and the data from the relevant outcomes were extracted and analysed.

RESULTS

There were no significant differences between the HT group and BN group in recurrent laryngeal nerve palsy (RLNP) and permanent hypoparathyroidism (PHP). The rate of transient hypocalcaemia (THC) was significantly higher in the HT group (16.85%) than in the BN group (13.20%).

CONCLUSIONS

The meta-analysis showed that HT only increased the risk of the postoperative complication THC compared to BN. Understanding the significance of HT in postoperative hypoparathyroidism after thyroid surgery would help clinicians perform sufficient preoperative (and postoperative) assessments and to optimise surgical planning.

An Acylase from Shewanella Putrefaciens Presents a Vibrio Parahaemolyticus Acylhomoserine Lactone-Degrading Activity and Exhibits Temperature-, Ph- and Metal-Dependences

Shewanella putrefaciens supernatant was found to increase the virulence factors of Vibrio parahaemolyticus by efficiently degrading its acylhomoserine lactone (AHL). To further reveal the regulation mechanism and its key degrading enzyme, a potential AHL-degrading enzyme acylase (Aac) from S. putrefaciens was cloned, and the influences of temperature, pH, protein modifiers, and metals on Aac were tested. Aac was significantly influenced by temperature and pH, and exhibited the highest AHL-degrading activity at temperatures of 37 °C and pH of 8. Mg2+ and Fe2+ can further increase the AHL-degrading activity. 10 mM EDTA inhibited its activity possibly by chelating the co-factors (metals) required for Aac activity. Tryptophan and arginine were identified as key components for Aac activity that are critical to its AHL-degrading activity. This study provides useful information on Aac and for V. parahaemolyticus control.

User testing to examine patient understanding of pharmacy generated medication labels

OBJECTIVE

To examine patients' and carers' understanding of pharmacy generated medication labels.

METHODS

A user testing questionnaire was conducted individually for 80 participants at 2 hospitals through a face-to face semi-structured interview. Pharmacy generated medication labels from different locations were grouped based on components into 4 different variations. Participants were asked to read and demonstrate understanding of the dose and frequency from 1 of the 4 variations for 4 prescription medications. Twenty participants for each variation were recruited so that demographic characteristics matched between variations.

RESULTS

Overall, only 45% of participants were able to correctly understand the dose and frequency presented on all the pharmacy labels presented on medications. Medication labels with standardised timing performed better than other variations with 91% of participants able to determine the correct frequency. The use of numeric figures was understood by 80-90% of participants compared to the use of capitalised text (65-70%). Pharmacy generated medication labels that proposed one step were better understood than instructions that incorporated several steps.

CONCLUSION/PRACTICE IMPLICATIONS

The study supports the use of simple, clear and explicit written instructions along with the use of numeric figures in pharmacy generated medication labels to achieve higher understandability in patients.