Dentition status and risk of frailty in older Chinese people: a 16-year prospective cohort study

OBJECTIVE

To explore associations of dentition status with frailty and death.

METHODS

Based on the "Chinese Longitudinal Healthy Longevity Survey (CLHLS) in 2002-2018", a prospective cohort study was conducted that 21,159 participants not frail and aged ≥ 65 were included at baseline. The outcome was frailty and death. Frailty index (FI) was constructed based on 44 health items. The mediation role of high sensitivity C-reactive protein (hs-CRP) was examined using cross-sectional data in 2008, 2011 and 2014.

RESULTS

The incidence density of frailty was 50.1 (95%CI: 48.8∼51.4) per 1,000 person-years. Compared with ≥ 20 natural teeth, the odds of frailty hazards were 1.27 (95%CI: 1.16∼1.39) times higher for < 20 natural teeth with dental prostheses, and were 1.24 (95%CI: 1.14∼1.35) times higher for < 20 natural teeth without dental prostheses; the odds of death hazards for < 20 natural teeth without dental prostheses were 1.36 (95%CI: 1.26∼1.45) times higher. Among participants with <20 natural teeth and without dental prostheses at baseline, the odds of frailty hazards for using dental prostheses were 0.48 (95%CI: 0.41∼0.56) times as high as those remaining not to use, and the odds of death hazards were 0.44 (95%CI: 0.39∼0.48) times as high. The cross-sectional data showed higher levels of hs-CRP explained 5∼6% of associations between dentition status and frailty.

CONCLUSION

Natural teeth <20 was associated with higher odds of frailty and death. Mediation analysis based on cross-sectional data offered clues for chronic inflammation pathway, yet this finding is still needed to be further verified.

Anthropometrics and cancer prognosis: a multi-center cohort study

BACKGROUND

Anthropometric indicators have been shown to be associated with the prognosis of patients with cancer. However, any single anthropometric index has limitation in predicting the prognosis.

OBJECTIVE

This study aimed to observe the predictive role of seven anthropometric indicators based on body size on the prognosis of patients with cancer.

DESIGN

A principal component analysis (PCA) on seven anthropometric measurements: height, weight, body mass index (BMI), hand grip strength (HGS), triceps skinfold thickness (TSF), mid-upper arm circumference (MAC), and calf circumference (CAC) was conducted. Principal components (PCs) were derived from this analysis. Cox regression analysis was used to investigate the association between the prognosis of patients with cancer and the PCs. Subgroups and sensitivity analyses were also conducted.

RESULTS

Through PCA, four distinct PCs were identified, collectively explaining 88.3% of the variance. PC1, primarily characterized by general obesity, exhibited a significant inverse association with the risk of cancer death (adjusted HR=0.86, 95% CI (0.83, 0.88)). PC2 (short stature with high TSF) was not significantly associated with cancer prognosis. PC3 (high BMI coupled with low HGS) demonstrated a significant increase with the risk of cancer-related death (adjusted HR=1.08, 95% CI (1.05, 1.11)). PC4 (tall stature with high TSF) exhibited a significant association with increased cancer risk (adjusted HR=1.05, 95% CI (1.02, 1.07)). These associations varied across different cancer stages. The stability of the results was confirmed through sensitivity analyses.

CONCLUSION

Different body sizes are associated with distinct prognostic outcomes in patients with cancer. The impact of BMI on prognosis is influenced by both HGS and subcutaneous fat. This finding may influence the clinical care of cancer and improve the survival of cancer patients.

Phospholipid Type Regulates Protein Corona Composition and In Vivo Performance of Lipid Nanodiscs

Over the years, there has been significant interest in PEGylated lipid-based nanocarriers within the drug delivery field. The inevitable interplay between the nanocarriers and plasma protein plays a pivotal role in their in vivo biological fate. Understanding the factors influencing lipid-based nanocarrier and protein corona interactions is of paramount importance in the design and clinical translation of these nanocarriers. Herein, discoid-shaped lipid nanodiscs (sNDs) composed of different phospholipids with varied lipid tails and head groups were fabricated. We investigated the impact of phospholipid components on the interaction between sNDs and serum proteins, particle stability, and biodistribution. The results showed that all of these lipid nanodiscs remained stable over a 15 day storage period, while their stability in the blood serum demonstrated significant differences. The sND composed of POPG exhibited the least stability due to its potent complement activation capability, resulting in rapid blood clearance. Furthermore, a negative correlation between the complement activation capability and serum stability was identified. Pharmacokinetic and biodistribution experiments indicated that phospholipid composition did not influence the capability of sNDs to evade the accelerated blood clearance phenomenon. Complement deposition on the sND was inversely associated with the area under the curve. Additionally, all lipid nanodiscs exhibited dominant adsorption of apolipoprotein. Remarkably, the POPC-based lipid nanodisc displayed a significantly higher deposition of apolipoprotein E, contributing to an obvious brain distribution, which provides a promising tool for brain-targeted drug delivery.

Evaluation and validation of neutrophil to albumin ratio as a promising prognostic marker for all-cause mortality in patients with cancer: a multicenter cohort study

OBJECTIVES

The practicality and effectiveness of using the prognostic value of the neutrophil-to-albumin ratio (NAR) in evaluating patients with cancer remain unclear, and research is needed to fully understand its potential application in the cancer population.

METHODS

The Kaplan-Meier method was used for survival analysis, and the log-rank test was employed for comparison. Univariate and multivariate Cox proportional hazards models were used to determine the prognostic biomarkers, and Logistic regression analysis was conducted to investigate the relationship between NAR and 90-day outcomes and cachexia.

RESULTS

The study included 14 682 patients with cancer, divided into discovery (6592 patients), internal validation (2820 patients), and external validation groups (5270 patients). Patients with high NAR had higher all-cause mortality than those with low NAR in the discovery (50.15% versus 69.29%, P < 0.001), internal validation (54.18% versus 70.91%, P < 0.001), and external validation cohorts (40.60% versus 66.68%, P < 0.001). In the discovery cohort, high NAR was observed to be independently associated with all-cause mortality in patients (HR 1.16, 95% CI 1.12-1.19; P < 0.001). Moreover, we validated the promising prognostic value of NAR as a predictor of survival in patients with cancer through internal validation (HR 1.21, 95% CI 1.16-1.27, P < 0.001) and external validation cohorts (HR 1.27, 95% CI 1.21-1.34, P < 0.001). Additionally, in the subgroup analysis by tumor type, high NAR was identified as a risk factor for most cancers, except for breast cancer.

CONCLUSIONS

This study showed that NAR is a feasible and promising biomarker for predicting prognosis and cancer cachexia in cancer patients.

The quality of life impacting factors in malnourished patients with gastric cancer

Introduction

Malnutrition is prevalent among individuals with gastric cancer and notably decreases their quality of life (QOL). However, the factors impacting QOL are yet to be clearly defined. This study aimed to identify essential factors impacting QOL in malnourished patients suffering from gastric cancer.

Methods

By using the Patient-Generated Subjective Global Assessment (PG-SGA) to assess the nutritional status (≥4 defined malnutrition) of hospitalized cancer patients, 4,586 gastric cancer patients were ultimately defined as malnourished. Spearman method was used to calculate the relationship between clinical features and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30). Then, univariate and multivariate logistic regression were used to observe which factors affected QOL, and subgroup analysis was performed in young and old population respectively. In addition, we used univariate and multivariate logistic regression to explore whether and how self-reported frequent symptoms in the last 2 weeks of the PG-SGA score affected QOL.

Results

In multivariate logistic regression analysis of clinical features of patients with malnourished gastric cancer, women, stage II, stage IV, WL had an independent correlation with a low global QOL scores. However, BMI, secondary education, higher education, surgery, chemotherapy, HGS had an independent correlation with a high global QOL scores. In multivariate logistic regression analysis of symptoms in self-reported PG-SGA scores in patients with malnourished gastric cancer, having no problem eating had an independent correlation with a high global QOL scores. However, they have no appetite, nausea, vomiting, constipation and pain had an independent correlation with a lower global QOL scores. The p values of the above statistical results are both < 0.05.

Conclusion

This study demonstrates that QOL in malnourished patients with gastric cancer is determined by female sex, stage II, stage IV, BMI, secondary and higher education or above, surgery, chemotherapy, WL, and HGS. Patients' self-reported symptoms of nearly 2 weeks, obtained by using PG-SGA, are also further predictive of malnourished gastric cancer patients. Detecting preliminary indicators of low QOL could aid in identifying patients who might benefit from an early referral to palliative care and assisted nursing.

Remnant cholesterol is an effective biomarker for predicting survival in patients with breast cancer

BACKGROUND

Breast cancer is the most common malignancy in women worldwide. The relationship between remnant cholesterol (RC) and the prognosis of patients with breast cancer has not been clearly reported. This study investigated the prognostic value of RC in predicting mortality in patients with breast cancer.

METHODS

This study prospectively analysed 709 women patients with breast cancer from the Investigation on Nutrition Status and Clinical Outcome of Common Cancers (INSCOC) project. Restricted cubic splines were used to analyse the dose-response relationship between RC and breast cancer mortality. The Kaplan-Meier method was used to evaluate the overall survival of patients with breast cancer. A Cox regression analyses was performed to assess the independent association between RC and breast cancer mortality. Inverse probability of treatment weighting (IPTW) using the propensity score was used to reduce confounding. Sensitivity analysis was performed after excluding patients with underlying diseases and survival times shorter than one year.

RESULTS

A linear dose-response relationship was identified between RC and the risk of all-cause mortality in patients with breast cancer (p = 0.036). Kaplan-Meier survival analysis and log-rank test showed that patients with high RC levels had poorer survival than those with low RC levels (p = 0.007). Univariate and multivariate Cox regression analyses showed that RC was an independent risk factor for mortality in women patients with breast cancer. IPTW-adjusted analyses and sensitivity analyses showed that CR remained a prognostic factor.

CONCLUSIONS

RC is an independent risk factor for the prognosis of patients with breast cancer, and patients with higher RC levels have poorer survival.

[Epidemiological characteristics of diarrheagenic Escherichia coli infection in infectious diarrhea outpatients aged 15 years and older in Shanghai, 2014-2021]

Objective: To understand the epidemiological characteristics of diarrheagenic Escherichia (E. ) coli infection in infectious diarrhea outpatients aged 15 years and older in Shanghai and provide evidence for the development of disease control strategies. Methods: Based on multistage systematic sampling, diarrhea surveillance was conducted in 22 sentinel hospitals in Shanghai, the information about cases' demographic, clinical, and epidemiological characteristics were collected. Stool samples were collected for the detection and typing of diarrheagenic E. coli by local centers for disease control and prevention. The positive rate of diarrheagenic E. coli in different populations and seasons from 2014 to 2021 were analyzed. Statistical analysis was conducted by using χ2 test. Results: In 15 185 diarrhea cases, 8.05% (1 222/15 185) were positive for diarrheagenic E. coli. The positive rate was higher in men (8.74%, 684/7 824) than in women (7.31%, 538/7 361). The positive rate was highest in age group 15-29 years (9.14%, 335/3 665) and the annual positive rate was highest in 2021 (10.21%, 83/813), the differences were all significant (P<0.05). In the 1 264 strains of diarrheagenic E. coli analyzed through PCR, enterotoxingenic E. coli was the most frequently identified pathogen (50.24%, 635/1 264), followed by enteroadhesive E. coli (27.93%, 353/1 264), and enteropathogenic E. coli (21.36%, 270/1 264). The positive rate of diarrheagenic E. coli showed obvious seasonality with peak in summer (13.92%, 774/5 562) (χ2=495.73, P<0.001). Conclusions: Diarrheagenic E. coli has become a prominent pathogen in infectious diarrhea cases in Shanghai, the disease can occur all the year round with incidence peak during summer and autumn. Predominant subtypes included enterotoxingenic E. coli, enteroadhesive E. coli and enteropathogenic E. coli. Targeted prevention and control strategies are needed for diarrheagenic E. coli-induced infectious diarrhea in different age groups, seasons and for different types of infections.

Temporal relationship between inflammation and metabolic disorders and their impact on cancer risk

Background

Inflammation and metabolic disorders are closely associated with cancer. Whether inflammation leads to metabolic disorders or vice versa during cancer initiation remains unclear. In this study, we explored this temporal relationship and the co-exposure effect on cancer risk.

Methods

This prospective study had two phases. Initially, we examined the temporal relationship between inflammation (high-sensitivity C-reactive protein (CRP)) and metabolic disorders (metabolic syndrome severity Z-score (MetS-Z)) using a 3.98-year survey and cross-lagged analysis. Subsequently, we assessed the connection of co-exposure to inflammation and metabolic disorders, and the risks of overall cancer, as well as specific obesity-related, non-obesity-related, digestive system, lung, and other cancers using an 11.04-year survey and Cox proportional hazard models.

Results

The cross-lagged analysis revealed that the path coefficient from baseline CRP to follow-up MetS-Z (β2 = 0.032; 95% confidence interval (CI) = 0.026, 0.046) was more significant than the path coefficient from baseline MetS-Z to follow-up CRP (β1 = 0.009; 95% CI = -0.001, 0.019). During the follow-up, 2304 cases of cancer occurred. Compared with the risk of cancer of patients with low average cumulative CRP and MetS-Z, patients with high value had a significantly increased risk (hazard ratio = 1.54, 95% CI = 1.30, 1.83). The mediation analysis showed that MetS-Z mediated the association between CRP levels and overall cancer (12.67%), digestive system cancer (10.16%), and obesity-related cancer risk (13.87%).

Conclusions

Inflammation had a greater impact on metabolic disorders than vice versa. Co-exposure to inflammation and metabolic disorders significantly increased the risk of cancer, particularly digestive system and obesity-related cancers.

Registration

Chinese Clinical Trial Registry: ChiCTR-TNRC-11001489.

Neuroprotection of low dose carbon monoxide in Parkinson's disease models commensurate with the reduced risk of Parkinson's among smokers

Paradoxically, cigarette smoking is associated with a reduced risk of Parkinson's disease (PD). This led us to hypothesize that carbon monoxide (CO) levels, which are constitutively but modestly elevated in smokers, might contribute to neuroprotection. Using rodent models of PD based on α-synuclein (αSyn) accumulation and oxidative stress, we show that low-dose CO mitigates neurodegeneration and reduces αSyn pathology. Oral CO administration activated signaling cascades mediated by heme oxygenase-1 (HO-1), which have been implicated in limiting oxidative stress, and in promoting αSyn degradation, thereby conferring neuroprotection. Consistent with a neuroprotective effect of smoking, HO-1 levels in cerebrospinal fluid were higher in human smokers compared to nonsmokers. Moreover, in PD brain samples, HO-1 levels were higher in neurons without αSyn pathology. Thus, CO in rodent PD models reduces pathology and increases oxidative stress responses, phenocopying possible protective effects of smoking evident in PD patients. These data highlight the potential for low-dose CO modulated pathways to slow symptom onset and limit pathology in PD patients.

Age Differences in the Association of Sleep Duration Trajectory With Cancer Risk and Cancer-Specific Mortality: Prospective Cohort Study

BACKGROUND

Baseline sleep duration is associated with cancer risk and cancer-specific mortality; however, the association between longitudinal patterns of sleep duration and these risks remains unknown.

OBJECTIVE

This study aimed to elucidate the association between sleep duration trajectory and cancer risk and cancer-specific mortality.

METHODS

The participants recruited in this study were from the Kailuan cohort, with all participants aged between 18 and 98 years and without cancer at baseline. The sleep duration of participants was continuously recorded in 2006, 2008, and 2010. Latent mixture modeling was used to identify shared sleep duration trajectories. Furthermore, the Cox proportional risk model was used to examine the association of sleep duration trajectory with cancer risk and cancer-specific mortality.

RESULTS

A total of 53,273 participants were included in the present study, of whom 40,909 (76.79%) were men and 12,364 (23.21%) were women. The average age of the participants was 49.03 (SD 11.76) years. During a median follow-up of 10.99 (IQR 10.27-11.15) years, 2705 participants developed cancers. Three sleep duration trajectories were identified: normal-stable (44,844/53,273, 84.18%), median-stable (5877/53,273, 11.03%), and decreasing low-stable (2552/53,273, 4.79%). Compared with the normal-stable group, the decreasing low-stable group had increased cancer risk (hazard ratio [HR] 1.39, 95% CI 1.16-1.65) and cancer-specific mortality (HR 1.54, 95% CI 1.18-2.06). Dividing the participants by an age cutoff of 45 years revealed an increase in cancer risk (HR 1.88, 95% CI 1.30-2.71) and cancer-specific mortality (HR 2.52, 95% CI 1.22-5.19) only in participants younger than 45 years, rather than middle-aged or older participants. Joint analysis revealed that compared with participants who had a stable sleep duration within the normal range and did not snore, those with a shortened sleep duration and snoring had the highest cancer risk (HR 2.62, 95% CI 1.46-4.70).

CONCLUSIONS

Sleep duration trajectories and quality are closely associated with cancer risk and cancer-specific mortality. However, these associations differ with age and are more pronounced in individuals aged <45 years.

TRIAL REGISTRATION

Chinese Clinical Trial Registry ChiCTR-TNRC-11001489; http://tinyurl.com/2u89hrhx.

Association between short-term daily temperature variability and blood pressure in the Chinese population: From the China hypertension survey

BACKGROUND

We aimed to evaluate the impacts of short-term daily temperature variability (DTV) on blood pressure (BP) among participants with normotension, prehypertension, and hypertension, respectively, and explore the effects in different climate zones and seasons.

METHODS

A representative population sample (n = 397,173) covering the subtropical, temperate continental, and temperate monsoon zones was obtained from the China Hypertension Survey. DTV was calculated as the standard deviation of daily minimum and maximum temperatures during the exposure days. The linear mixed effect regression model was used to estimate the associations between DTV exposure and BP among normotension, prehypertension, and hypertension, respectively, and further stratified analysis was performed by climate zones and seasons.

RESULTS

After adjustment for confounders, per interquartile range (IQR) increase in DTV (2.28 °C) at 0-6 days of exposure was associated with an increase of 0.41 mmHg (95 % confidence interval [CI]: 0.07, 0.75) in systolic BP (SBP) and 0.41 mmHg (95 % CI: 0.09, 0.72) in pulse pressure (PP) among hypertensive participants in the subtropical zone. Similarly, DTV exposure was associated with an increase of 0.31 mmHg (95 % CI: 0.06, 0.55) in SBP and 0.59 mmHg (95 % CI: 0.24, 0.94) in PP among prehypertensive participants in the temperate continental zone. Additionally, during the warm season, DTV was positively associated with SBP among populations with prehypertension and hypertension, and with PP among all three populations.

CONCLUSION

Short-term DTV exposure was associated with an increase in SBP and PP among hypertensive and prehypertensive participants in the subtropical zone and the temperate continental zone. In addition, positive associations of DTV with SBP and PP were observed among participants with prehypertension and hypertension in the warm season. Comprehensive health education and effective intervention strategies should be implemented to mitigate the effects of temperature variations on BP, particularly among prehypertensive and hypertensive populations.

Association of systemic inflammation with the obesity paradox in cancer: results from multi-cohort studies

AIMS

This study aimed to explore whether the obesity paradox exists in overall and specific cancers and to investigate the role of systemic inflammation in the obesity paradox.

METHODS

The Cox proportional hazard model was used to explore the relationship between body mass index (BMI) and all-cause mortality. The mediated effect was used to investigate the proportion of systemic inflammation mediating the relationship between BMI and cancer survival risk.

RESULTS

The survival probability showed a step-like increase with an increase in BMI regardless of pathological stage. Approximately 10.8%-24.0% of the overall association between BMI and all-cause mortality in cancer was mediated by inflammation. In the internal validation, we found evidence of the obesity paradox in all body composition obtained using BIA, with inflammation remaining an important mediating factor. Furthermore, we also validated the existence of the obesity paradox of cancer in NHANES. Systemic inflammation remains an important factor in mediating the association between BMI and prognosis in cancer patients.

CONCLUSIONS

The obesity paradox is prevalent in most cancers, except for hepatic biliary cancer and breast cancer. Inflammation may be one of the true features of the obesity paradox in cancer.

PharmGWAS: a GWAS-based knowledgebase for drug repurposing

Leveraging genetics insights to promote drug repurposing has become a promising and active strategy in pharmacology. Indeed, among the 50 drugs approved by FDA in 2021, two-thirds have genetically supported evidence. In this regard, the increasing amount of widely available genome-wide association studies (GWAS) datasets have provided substantial opportunities for drug repurposing based on genetics discoveries. Here, we developed PharmGWAS, a comprehensive knowledgebase designed to identify candidate drugs through the integration of GWAS data. PharmGWAS focuses on novel connections between diseases and small-molecule compounds derived using a reverse relationship between the genetically-regulated expression signature and the drug-induced signature. Specifically, we collected and processed 1929 GWAS datasets across a diverse spectrum of diseases and 724 485 perturbation signatures pertaining to a substantial 33609 molecular compounds. To obtain reliable and robust predictions for the reverse connections, we implemented six distinct connectivity methods. In the current version, PharmGWAS deposits a total of 740 227 genetically-informed disease-drug pairs derived from drug-perturbation signatures, presenting a valuable and comprehensive catalog. Further equipped with its user-friendly web design, PharmGWAS is expected to greatly aid the discovery of novel drugs, the exploration of drug combination therapies and the identification of drug resistance or side effects. PharmGWAS is available at https://ngdc.cncb.ac.cn/pharmgwas.

TargetGene: a comprehensive database of cell-type-specific target genes for genetic variants

Annotating genetic variants to their target genes is of great importance in unraveling the causal variants and genetic mechanisms that underlie complex diseases. However, disease-associated genetic variants are often located in non-coding regions and manifest context-specific effects, making it challenging to accurately identify the target genes and regulatory mechanisms. Here, we present TargetGene (https://ngdc.cncb.ac.cn/targetgene/), a comprehensive database reporting target genes for human genetic variants from various aspects. Specifically, we collected a comprehensive catalog of multi-omics data at the single-cell and bulk levels and from various human tissues, cell types and developmental stages. To facilitate the identification of Single Nucleotide Polymorphism (SNP)-to-gene connections, we have implemented multiple analytical tools based on chromatin co-accessibility, 3D interaction, enhancer activities and quantitative trait loci, among others. We applied the pipeline to evaluate variants from nearly 1300 Genome-wide association studies (GWAS) and assembled a comprehensive atlas of multiscale regulation of genetic variants. TargetGene is equipped with user-friendly web interfaces that enable intuitive searching, navigation and browsing through the results. Overall, TargetGene provides a unique resource to empower researchers to study the regulatory mechanisms of genetic variants in complex human traits.

Database Resources of the National Genomics Data Center, China National Center for Bioinformation in 2024

The National Genomics Data Center (NGDC), which is a part of the China National Center for Bioinformation (CNCB), provides a family of database resources to support the global academic and industrial communities. With the rapid accumulation of multi-omics data at an unprecedented pace, CNCB-NGDC continuously expands and updates core database resources through big data archiving, integrative analysis and value-added curation. Importantly, NGDC collaborates closely with major international databases and initiatives to ensure seamless data exchange and interoperability. Over the past year, significant efforts have been dedicated to integrating diverse omics data, synthesizing expanding knowledge, developing new resources, and upgrading major existing resources. Particularly, several database resources are newly developed for the biodiversity of protists (P10K), bacteria (NTM-DB, MPA) as well as plant (PPGR, SoyOmics, PlantPan) and disease/trait association (CROST, HervD Atlas, HALL, MACdb, BioKA, BioKA, RePoS, PGG.SV, NAFLDkb). All the resources and services are publicly accessible at https://ngdc.cncb.ac.cn.

COLOCdb: a comprehensive resource for multi-model colocalization of complex traits

Large-scale genome-wide association studies (GWAS) have provided profound insights into complex traits and diseases. Yet, deciphering the fine-scale molecular mechanisms of how genetic variants manifest to cause the phenotypes remains a daunting task. Here, we present COLOCdb (https://ngdc.cncb.ac.cn/colocdb), a comprehensive genetic colocalization database by integrating more than 3000 GWAS summary statistics and 13 types of xQTL to date. By employing two representative approaches for the colocalization analysis, COLOCdb deposits results from three key components: (i) GWAS-xQTL, pair-wise colocalization between GWAS loci and different types of xQTL, (ii) GWAS-GWAS, pair-wise colocalization between the trait-associated genetic loci from GWASs and (iii) xQTL-xQTL, pair-wise colocalization between the genetic loci associated with molecular phenotypes in xQTLs. These results together represent the most comprehensive colocalization analysis, which also greatly expands the list of shared variants with genetic pleiotropy. We expect that COLOCdb can serve as a unique and useful resource in advancing the discovery of new biological mechanisms and benefit future functional studies.

Ang1/Tie2/VE-Cadherin Signaling Regulates DPSCs in Vascular Maturation

Adding dental pulp stem cells (DPSCs) to vascular endothelial cell-formed vessel-like structures can increase the longevity of these vessel networks. DPSCs display pericyte-like cell functions and closely assemble endothelial cells (ECs). However, the mechanisms of DPSC-derived pericyte-like cells in stabilizing the vessel networks are not fully understood. In this study, we investigated the functions of E-DPSCs, which were DPSCs isolated from the direct coculture of human umbilical vein endothelial cells (HUVECs) and DPSCs, and T-DPSCs, which were DPSCs treated by transforming growth factor beta 1 (TGF-β1), in stabilizing blood vessels in vitro and in vivo. A 3-dimensional coculture spheroid sprouting assay was conducted to compare the functions of E-DPSCs and T-DPSCs in vitro. Dental pulp angiogenesis in the severe combined immunodeficiency (SCID) mouse model was used to explore the roles of E-DPSCs and T-DPSCs in vascularization in vivo. The results demonstrated that both E-DPSCs and T-DPSCs possess smooth muscle cell-like cell properties, exhibiting higher expression of the mural cell-specific markers and the suppression of HUVEC sprouting. E-DPSCs and T-DPSCs inhibited HUVEC sprouting by activating TEK tyrosine kinase (Tie2) signaling, upregulating vascular endothelial (VE)-cadherin, and downregulating vascular endothelial growth factor receptor 2 (VEGFR2). In vivo study revealed more perfused and total blood vessels in the HUVEC + E-DPSC group, HUVEC + T-DPSC group, angiopoietin 1 (Ang1) pretreated group, and vascular endothelial protein tyrosine phosphatase (VE-PTP) inhibitor pretreated group, compared to HUVEC + DPSC group. In conclusion, these data indicated that E-DPSCs and T-DPSCs could stabilize the newly formed blood vessels and accelerate their perfusion. The critical regulating pathways are Ang1/Tie2/VE-cadherin and VEGF/VEGFR2 signaling.

Achieving High-Energy-Density Graphene/Single-Walled Carbon Nanotube Lithium-Ion Capacitors from Organic-Based Electrolytes

Developing electrode materials with high voltage and high specific capacity has always been an important strategy for increasing the energy density of lithium-ion capacitors (LICs). However, organic-based electrolytes with lithium salts limit their potential for application in LICs to voltages below 3.8 V in terms of polarization reactions. In this work, we introduce Li[N(C2F5SO2)2] (lithium Bis (pentafluoroethanesulfonyl)imide or LiBETI), an electrolyte with high conductivity and superior electrochemical and mechanical stability, to construct a three-electrode LIC system. After graphite anode pre-lithiation, the anode potential was stabilized in the three-electrode LIC system, and a stable solid electrolyte interface (SEI) film formed on the anode surface as expected. Meanwhile, the LIC device using LiBETI as the electrolyte, and a self-synthesized graphene/single-walled carbon nanotube (SWCNT) composite as the cathode, showed a high voltage window, allowing the LIC to achieve an operating voltage of 4.5 V. As a result, the LIC device has a high energy density of up to 182 Wh kg-1 and a 2678 W kg-1 power density at 4.5 V. At a current density of 2 A g-1, the capacity retention rate is 72.7% after 10,000 cycles.

Cholesterol-modified prognostic nutritional index (CPNI) as an effective tool for assessing the nutrition status and predicting survival in patients with breast cancer

BACKGROUND

Malnutrition is associated with poor overall survival (OS) in breast cancer patients; however, the most predictive nutritional indicators for the prognosis of patients with breast cancer are not well-established. This study aimed to compare the predictive effects of common nutritional indicators on OS and to refine existing nutritional indicators, thereby identifying a more effective nutritional evaluation indicator for predicting the prognosis in breast cancer patients.

METHODS

This prospective study analyzed data from 776 breast cancer patients enrolled in the "Investigation on Nutritional Status and its Clinical Outcome of Common Cancers" (INSCOC) project, which was conducted in 40 hospitals in China. We used the time-dependent receiver operating characteristic curve (ROC), Kaplan-Meier survival curve, and Cox regression analysis to evaluate the predictive effects of several nutritional assessments. These assessments included the patient-generated subjective nutrition assessment (PGSGA), the global leadership initiative on malnutrition (GLIM), the controlling nutritional status (CONUT), the nutritional risk index (NRI), and the prognostic nutritional index (PNI). Utilizing machine learning, these nutritional indicators were screened through single-factor analysis, and relatively important variables were selected to modify the PNI. The modified PNI, termed the cholesterol-modified prognostic nutritional index (CPNI), was evaluated for its predictive effect on the prognosis of patients.

RESULTS

Among the nutritional assessments (including PGSGA, GLIM, CONUT, NRI, and PNI), PNI showed the highest predictive ability for patient prognosis (time-dependent ROC = 0.58). CPNI, which evolved from PNI, emerged as the superior nutritional index for OS in breast cancer patients, with the time-dependent ROC of 0.65. It also acted as an independent risk factor for mortality (p < 0.05). Moreover, the risk of malnutrition and mortality was observed to increase gradually among both premenopausal and postmenopausal age women, as well as among women categorized as non-overweight, overweight, and obese.

CONCLUSIONS

The CPNI proves to be an effective nutritional assessment tool for predicting the prognosis of patients with breast cancer.

[Analysis and prediction of burden of viral hepatitis C-associated diseases in China from 1990 to 2044]

OBJECTIVE

To measure the burden of hepatitis C-associated diseases in China from 1990 to 2019, and to predict its changes from 2020 to 2044, so as to provide insights into formulation of the targeted hepatitis C control strategy.

METHODS

The total burden due to hepatitis C-associated diseases in China from 1990 to 2019 were extracted from the Global Burden of Disease 2019 (GBD 2019) data resources, and the trends in age-standardized prevalence, incidence, mortality and disability-adjusted life years (DALYs) rate of hepatitis C-associated acute hepatitis C (AHC), chronic liver diseases (CLD) and liver cancer in China from 1990 to 2019 were evaluated in China from 1990 to 2019 using estimated annual percentage change (EAPC). In addition, the changes in the burden of hepatitis C-associated diseases were predicted in China from 2020 to 2044 using a Bayesian model.

RESULTS

The prevalence, incidence, mortality and DALY rate of hepatitis C-associated diseases all appeared an overall tendency towards a decline in China from 1990 to 2019 (EAPC = -2.64%, -2.24%, -3.81% and -3.90%, respectively); however, there was a minor rise in the incidence and prevalence of hepatitis C-associated diseases from 2015 to 2019. The overall prevalence of hepatitis C-associated diseases reduced from 2 152.7/105 in 1990 to 1 254.1/105 in 2019 in China, with a reduction of 41.7%. The overall incidence reduced from 87.9/105 in 1990 to 55.0/105 in 2019 in China, with a reduction of 37.4%, and the highest incidence was seen for AHC, followed by CLD and liver cancer. The overall mortality and DALY rate of hepatitis C-associated diseases was 4.0/105 and 100.8/105 in China from 1990 to 2019, with CLD showing the largest contributions to the gross mortality and DALY. The mortality and DALY rate of hepatitis C-associated diseases were 5.5/105 and 142.4/105 among men in China in 2019, which were both much higher than among women (2.8/105 and 60.3/105, respectively), and the overall prevalence (1 604.9/105), mortality (30.2/105) and DALYs (437.1/105) of hepatitis C-associated diseases were all highest among patients at ages of 70 years and older, and the highest incidence was seen among patients at ages of 0 to 9 years (167.3/105). The incidence of hepatitis C-associated diseases was predicted to rise in China from 2020 to 2044; however, the DALY rate was projected to appear a tendency towards a decline.

CONCLUSIONS

Although the burden of hepatitis C-associated diseases showed a tendency towards a decline in China from 1990 to 2019, the burden remained high, and was predicted to slightly rise from 2020 to 2044. High attention should be paid to screening of hepatitis C among infants and treatment among adults.

Individualized threshold of the involuntary weight loss in prognostic assessment of cancer

BACKGROUND

Involuntary weight loss (WL) is a common symptom in cancer patients and is associated with poor outcomes. However, there is no standardized definition of WL, and it is unclear what magnitude of weight loss should be considered significant for prognostic purposes. This study aimed to determine an individualized threshold for WL that can be used for prognostic assessment in cancer patients.

METHODS

Univariate and multivariate analyses of overall survival (OS) were performed using Cox proportional hazard models. The Kaplan-Meier method was performed to estimate the survival distribution of different WL levels. Logistic regression analysis was used to determine the relationship between WL and 90-day outcomes. Restricted cubic splines with three knots were used to examine the effects of WL on survival under different body mass index (BMI) conditions.

RESULTS

Among the 8806 enrolled patients with cancer, median survival time declined as WL increased, from 25.1 to 20.1, 17.8 and 16.4 months at <2%, 2-5%, 5-10% and ≥10% WL, respectively (P < 0.001). Multivariate adjusted Cox regression analysis showed that the risk of adverse prognosis increased by 18.1% based on the SD of WL (5.45 U) (HR: 1.181, 95% CI: 1.144-1.219, P < 0.001). Similarly, categorical WL was independently associated with OS in patients with cancer. With the worsening of WL, the risk of a poor prognosis in patients increases stepwise. Compared with <2% WL, all-cause mortalities were 15.1%, 37% and 64.2% higher in 2-5%, 5-10%, and ≥10% WL, respectively. WL can effectively stratify the prognosis of both overall and site-specific cancers. The clinical prognostic thresholds for WL based on different BMI levels were 4.21% (underweight), 5.03% (normal), 6.33% (overweight), and 7.60% (obese). Multivariate logistic regression analysis showed that WL was independently associated with 90-day outcomes in patients with cancer. Compared with patients with <2% WL, those with ≥10% WL had more than twice the risk of 90-day outcomes (OR: 3.277, 95% CI: 2.287-4.694, P < 0.001). Systemic inflammation was a cause of WL deterioration. WL mediates 6.3-10.3% of the overall association between systemic inflammation and poor prognoses in patients with cancer.

CONCLUSIONS

An individualized threshold for WL based on baseline BMI can be used for prognostic assessment in cancer patients. WL and BMI should be evaluated simultaneously in treatment decision-making, nutritional intervention, and prognosis discussions of patients with cancer.

Superiority of CRP-albumin-lymphocyte index as a prognostic biomarker for patients with gastric cancer

OBJECTIVES

The new C-reactive protein (CRP)-albumin-lymphocyte (CALLY) index is an immune nutrition scoring system based on serum CRP) serum albumin, and lymphocyte counts. The aim of this study was to verify the prognostic value of the CALLY index in patients with gastric cancer and to evaluate the superiority of this new system.

METHODS

We retrospectively analyzed the data of patients with gastric cancer who were followed up from the INSCOC database between May 2013 and December 2018. Through simple random sampling, patients with gastric cancer were placed into one of two groups: the training group (n = 684) or the verification group (n = 290) in a ratio of 7:3. Correlation analysis, Kaplan-Meier method, and cubic spline function were used to analyze the relationship between the CALLY index and overall survival (OS) in these patients. Based on the results of Cox regression analysis of the training cohort, a nomogram model for predicting 1 -, 2 -, 3-, and 5-y OS was established and verified internally. The prediction accuracy and benefit of the nomogram in gastric cancer were evaluated by calibration and clinical decision curve and compared with the traditional TNM gastric cancer staging system.

RESULTS

The CALLY index was negatively correlated with the age of patients with gastric cancer (men, r = -0.1; women, r = -0.1), but positively correlated with body mass index (BMI; men, r = 0.063; women, r = 0.058), and the cutoff value of the CALLY index was determined as 1.12. The OS of patients with gastric cancer and a CALLY index >1.12 was significantly higher than that of patients with gastric cancer and a CALLY index ≤1.12 (P < 0.0001). There was an L-shaped dose-response relationship between the CALLY index and OS in patients with gastric cancer, and age, TNM stage, surgical treatment, chemotherapy, BMI, and the CALLY index were significantly correlated with the prognosis of patients with gastric cancer. Tumor TNM stage, BMI, and the CALLY index were independent risk factors affecting the prognosis of patients with gastric cancer. The CALLY index was a protective factor in the following patient factors: diagnosis of gastric cancer; <65 y of age; male; TNM 3 stage; BMI 18.5 to 23.9 kg/m2; smoker; consumer of alcohol; no radio- or chemotherapy; surgery; presence of diabetes, hypertension, or both; no family history of cancer; experienced a significant interaction with chemotherapy and surgery. A nomogram based on TNM staging, BMI, and the CALLY index has good predictive ability and clinical application value. Compared with traditional TNM staging systems, the nomogram has better resolution and accuracy in predicting 1 -, 2 -, 3-, and 5-year OS.

CONCLUSION

The CALLY index can be used as an independent prognostic factor for patients with gastric cancer, and constructs a nomogram prediction model combining TNM staging, BMI, and CALLY index, which yields better predictions than traditional TNM staging.

Predicted lean body mass trajectories, and cancer risk and cancer-specific and all-cause mortality: A prospective cohort study

BACKGROUND

Although many studies have investigated the association between body composition, cancer risk and mortality, predicting these risks through a single body composition measurement undoubtedly increases the limitations of the study. Few studies have explored the association between the trajectory of changes in body composition and the risk of cancer and death. We aimed to explore the association of predicted lean mass trajectories with cancer risk, cancer-specific mortality and all-cause mortality.

METHODS

The participants in this study were all from the Kailuan cohort, a prospective, periodic, resurvey cohort study initiated in 2006. Latent mixture modelling was used to identify predicted lean mass trajectories for 2006-2010. The hazard ratios (HRs) and 95% confidence intervals (95% CIs) of the Cox proportional hazard models were used to describe the association between predicted lean mass trajectories and cancer risk and cancer-specific and all-cause mortality during follow-up (2010-2021).

RESULTS

A total of 44 374 participants (average age, 53.01 ± 11.41 years, 78.99% men and 21.01% women) were enrolled in this study. Five distinct trajectories were identified: low-stable (n = 12 060), low-increasing (n = 8027), moderately stable-decreasing (n = 4725), moderately stable-increasing (n = 8053) and high-stable (n = 11 509). During the 11-year follow-up period, 2183 cancer events were recorded. After adjusting for age, predicted fat mass in 2010, sex, BMI, sedentary, physical activity, smoke, alcohol use, salt consumption, high-fat diet, high-sensitivity C-reactive protein, serum creatinine, family history of tumour, hypertension, diabetes mellitus, compared with the low-stable group, participants in the low-increasing group (HR = 0.851, 95% CI, 0.748-0.969), moderately stable-increasing group (HR = 0.803, 95% CI, 0.697-0.925) and high-stable group (HR = 0.770, 95% CI, 0.659-0.901) had a lower cancer risk, but not in the moderately stable-decreasing group (HR = 0.864, 95% CI, 0.735-1.015). Compared with the low-stable group, the risk of cancer-specific mortality was reduced by 25.4% (8.8-38.9%), 36.5% (20.3-49.4%) and 35.4% (17.9-49.2%), and the risk of all-cause mortality was reduced by 24.2% (16.9-30.8%), 37.0% (30.0-43.2%) and 47.4% (41.0-53.1%) in the low-increasing, moderately stable-increasing group and high-stable groups, respectively.

CONCLUSIONS

Predicted lean mass trajectories may be closely associated with cancer risk and cancer-specific and all-cause mortality. Regular monitoring of body composition is necessary.

[Burden of hepatitis B-associated diseases in China from 1990 to 2030]

OBJECTIVE

To measure the burden of hepatitis B-associated diseases in China from 1990 to 2019, and to predict its changes from 2020 to 2030.

METHODS

The age-standardized prevalence, incidence, mortality and disability-adjusted life years (DALY) rate of hepatitis B-associated diseases in China from 1990 to 2019 were extracted from the Global Burden of Disease 2019 (GBD 2019) data resources, and the trends in burdens of hepatitis B-associated diseases were evaluated from 1990 to 2019 using estimated annual percentage change (EAPC) and annual percent change (APC). In addition, the changes in the burden of hepatitis B-associated diseases were predicted in China from 2020 to 2023 using the Bayesian model.

RESULTS

The overall incidence of hepatitis B-associated diseases reduced from 2 725.98/105 in 1990 to 1 397.31/105 in 2019 in China [estimated annual percentage change (EAPC) = -2.35%, 95% confidential interval (CI): (-2.58%, -2.13%)], with a reduction in the prevalence from 12 239.53/105 in 1990 to 6 566.12/105 in 2019 [EAPC = -2.34%, 95% CI: (-2.54%, -2.14%)], a reduction in the mortality from 24.67/105 in 1990 to 8.07/105 in 2019 [EAPC = -4.92%, 95% CI: (-5.37%, -4.47%)], and a reduction in the DALY rate from 793.38/105 in 1990 to 247.71/105 in 2019 [(EAPC = -5.15%, 95% CI: (-5.64%, -4.66%)]. The DALY rate of hepatitis B-associated diseases were mainly attributed to liver cancer, and the DALY rate of hepatitis B-associated diseases appeared a tendency towards a rise in China from 2012 to 2019 [APC = 1.30%, 95% CI: (0.16%, 2.45%)]. The overall burden of hepatitis Bassociated diseases was higher in males than in females, and the DALY rate of hepatitis B-associated diseases increased with age, with the greatest DALY rate seen among patients at ages of 50 to 69 years. The overall incidence of hepatitis B-associated diseases was projected to be 866.79/105 in China in 2030, with the greatest incidence seen in acute hepatitis B (854.87/105), and the burden of hepatitis B-associated diseases was predicted to decline in China from 2020 to 2030; however, the burden of liver disease was projected to appear a tendency towards a rise.

CONCLUSIONS

The burden of hepatitis B-associated diseases appears an overall tendency towards a decline in China from 1990 to 2030; however, the burden of liver cancer appears a tendency towards aggravation. Early diagnosis and treatment of liver cancer should be given a high priority.

[Advances in the applications of dissolving polymer microneedles for delivering drugs in ocular diseases]

Due to the unique anatomical structure and physiological barriers of the eye, drug delivery for ocular diseases presents a formidable challenge. Conventional methods of ocular drug administration often suffer from limitations such as low drug bioavailability and a lack of tissue targeting, necessitating multiple administrations to achieve the desired therapeutic drug concentrations. In recent years, microneedles, known for their attributes of safety, minimally invasive application, and high efficiency, have found widespread application in ocular drug delivery research. Among the various types of microneedles, dissolving polymer microneedles have emerged as a prominent focus in the field of ocular drug delivery due to their distinct advantages over other microneedle types. This article provides a comprehensive summary and outlook on the progress in the application of dissolving polymer microneedles for drug delivery in ocular diseases.

Effects of dietary methionine supplementation from different sources on growth performance and meat quality of barrows and gilts

Methionine is indispensable for growth and meat formation in pigs. However, it is still unclear that increasing dietary sulphur-containing amino acid (SAA) levels using different methionine sources affects the growth performance and meat quality of barrows and gilts. To investigate this, 144 pigs (half barrows and half gilts) were fed the control (100% SAA, CON), DL-Methionine (125% SAA, DL-Met)-supplemented, or OH-Methionine (125% SAA, OH-Met)-supplemented diets during the 11-110 kg period. The results showed that plasma methionine levels varied among treatments during the experimental phase, with increased plasma methionine levels observed following increased SAA consumption during the 25-45 kg period. In contrast, pigs fed the DL-Met diet had lower plasma methionine levels than those fed the CON diet (95-110 kg). Additionally, gilts fed the DL-Met or OH-Met diets showed decreased drip loss in longissimus lumborum muscle (LM) compared to CON-fed gilts. OH-Met-fed gilts had higher pH45min values than those fed the CON or DL-Met diets, whereas OH-Met-fed barrows had higher L45min values than those fed the CON or DL-Met diets. Moreover, increased consumption of SAA, regardless of the methionine source, tended to decrease the shear force of the LM in pigs. In conclusion, this study indicates that increasing dietary levels of SAA (+25%) appeared to improve the meat quality of gilts by decreasing drip loss and increasing meat tenderness.

Single-stage computer-assisted approach for tumour resection and functional restoration of Brown class III maxillary defects-titanium mesh and zygomatic implants combined with vascularized anterolateral thigh flap

The functional restoration of Brown class III maxillary defects is a challenging endeavour in oral and maxillofacial surgery. Conventional reconstruction techniques with osseous free flaps have certain limitations, such as the need for multiple operations and greater patient morbidity. This study introduces a single-stage computer-assisted approach for tumour resection and functional restoration of these defects using titanium mesh, zygomatic implants, and a vascularized anterolateral thigh flap (ALTF). Virtual surgical planning was used to simulate tumour resection, titanium mesh placement, and zygomatic implant insertion. Surgery was performed under the guidance of mixed reality and surgical navigation. The tumour was resected by total hemimaxillectomy, and the reconstruction was performed using a pre-bent patient-specific titanium mesh for the orbital floor and two zygomatic implants placed and exposed through tunnels in an ALTF. The ALTF survived without any perioperative complications. A fixed prosthesis with built-in titanium frame was delivered 4 months postoperatively. At the 1-year follow-up, there was no tumour recurrence, the implants were osseointegrated, and aesthetics and masticatory function were satisfactory. An occlusal force of 155 N was attained on the reconstructed side, compared to 127 N on the non-surgical side.

Development and applicability of modified weight loss grading system in cancer: a real-world cohort study

BACKGROUND

The original weight loss grading system (WLGS) was developed in western population, which did not perform effectively in cancer patients from China. This study aimed to develop and validate the modified WLGS (mWLGS) in the prognostic assessment of cancer patients in China.

METHODS

A prospective multicentre real-world cohort study involving 16 842 patients diagnosed with cancer was conducted. Cox regression was used to calculate the hazard ratios for overall survival. Logistic linear regression was used to assess the odds ratio for 90-day outcomes.

RESULTS

We calculated survival risks for the 25 mWLGS groups and clustered the approximate survival risks. Finally, we revised the prognostic grading system for mWLGS to include five grades of 0-4. Compared with the original WLGS, the mWLGS had a better prognostic differentiation effect in predicting the prognosis of patients with cancer. The survival rate gradually deteriorated with increasing grade of mWLGS, with the survival rate of grade 0 decreasing from 76.4% to 48.2% for grade 4 (76.4 vs. 72.8 vs. 66.1 vs. 57.0 vs. 48.2%, respectively). The mWLGS provides effective prognostic stratification for most site-specific cancers, especially lung and gastrointestinal cancers. High-grade mWLGS is independently associated with an increased risk of poor quality of life and adverse 90-day outcomes. Multivariate Cox regression analysis showed that the mWLGS was an independent prognostic factor for cancer patients in the validation cohorts.

CONCLUSIONS

Compared with the original WLGS, the mWLGS can better stratify the prognosis of cancer patients. mWLGS is a useful tool for predicting survival, 90-day outcomes, and quality of life in patients with cancer. These analyses may provide new insights into the application of WLGS in cancer patients in China.

Improving the assessment of malnutrition in cancer: Using systemic inflammation markers as a supplement to the inflammation items of the GLIM criteria

BACKGROUND & AIMS

Systemic inflammation is a key pathogenic criterion for diagnosing malnutrition using the Global Leadership Initiative on Malnutrition (GLIM) criteria. Although cancer is commonly considered as a chronic inflammation-related disease, the inflammatory burden may vary depending on the type and stage of cancer. Therefore, a more precise definition of inflammation criteria could facilitate the identification of malnutrition in cancer.

METHODS

This prospective multicenter study included 1683 cancer patients screened via NRS2002 for malnutrition risk. The inflammatory burden index (IBI), C-reactive protein (CRP) level, neutrophil-to-lymphocyte ratio (NLR), and albumin (ALB) level were used to assess the inflammatory burden. Kaplan-Meier and Cox regression analyses were used to determine the relationship between the GLIM criteria and overall survival. Harrell's concordance index (C-index) was used to compare the discriminative performance of the original, IBI-based, CRP-based, NLR-based, and ALB-based GLIM criteria for survival. Logistic regression models were used to assess the association between GLIM criteria and short-term outcomes, length of hospital stay, and hospitalization costs.

RESULTS

Compared to the original GLIM criteria, the IBI/CRP/NLR/ALB-based GLIM criteria better predicted the long-term outcomes of patients with cancer (chi-square: 1.316 vs. 78.321 vs. 74.740 vs. 88.719 vs. 100.921). The C-index revealed that the inflammation marker-based GLIM criteria showed significantly better prognostic accuracy than the original GLIM criteria. The ALB-based GLIM criteria exhibited the best prognostic accuracy. The inflammation marker-based GLIM criteria were independent predictive factors for the long-term prognosis of cancer. Patients with malnutrition had a 45% higher risk of adverse long-term prognoses than those without malnutrition. The inflammation marker-based GLIM criteria had good prognostic ability to predict outcomes at 3, 6, and 12 months. The stepwise effect of the grading of severity via the IBI-based GLIM criteria and CRP-based GLIM criteria was notable. The inflammation marker-based GLIM criteria are useful for predicting short-term outcomes, length of hospitalization, and hospitalization costs.

CONCLUSION

The inflammation marker-based GLIM criteria have a stronger predictive value than the original GLIM criteria in evaluating both the short- and long-term prognoses of cancer patients. It is recommended to use the inflammation marker-based GLIM criteria for nutritional evaluation of cancer patients.

Selectively Irradiation of the Supraclavicular Area in Nasopharyngeal Carcinoma Treated with Intensity Modulated Radiotherapy

PURPOSE/OBJECTIVE(S)

The application of intensity-modulated radiotherapy (IMRT) has significantly improved the locoregional control and overall survival of patients with nasopharyngeal carcinoma (NPC), but how to deescalate the intensity of treatment to further reduce the side effects while ensuring the efficacy is the main concern of clinicians. Decreasing radiation volume is one of the hot research topics. Whole-neck irradiation is recommended for patients with cervical lymph node involvement, which includes levels IVb and Vc. Since the implementation of IMRT in our clinic, patients with only upper cervical lymph node invasion have not been irradiated in the levels IVb and Vc, and the regional control rate is comparable to that of other centers. This study intends to retrospectively analyze the feasibility of omitting levels IVb and Vc in patients with only upper cervical lymph node invasion, and provide a basis for the revision of international guideline for the delineation of the clinical target volume (CTV).

MATERIALS/METHODS

Patients with histologically confirmed NPC who completed IMRT successfully at our attending group between January 2014 to March 2018 were candidates for this study. Other eligibility criteria for analysis were as follows: (1) The first patient without distant metastasis; (2) Only patients with upper cervical lymph node invasion (only N1, N2, because the maximum diameter of the upper neck 6cm diagnosed as N3 patients were not included) (AJCC staging system, 8th edition); (3) Having complete baseline imaging data; (4) Over 3 months of follow-up; (5) Patients without previous history of malignant tumor and secondary cancer. According to the delineation of CTV in our protocol for patients with stage N1 and N2, levels IVb and Vc are not irradiated (i.e., retaining the original supraclavicular area). The main endpoints of the study were regional recurrence-free survival (RRFS) and recurrence rates in levels IVb and Vc.

RESULTS

In all, 363 patients with NPC and median follow-up of 61.9 months (range, 3.67-93.3) met the study inclusion criteria and comprise the dataset for the analysis. The overall survival, survival without local recurrence, survival without regional recurrence, and survival without distant metastasis at 3 and 5 years were 94.6% and 91.1%, 97.7% and 96.5%, 98.6% and 98.0%, 93.5% and 91.1%. At the final follow-up, 11 cases showed regional recurrence, and only one case (0.28%) showed recurrence in regions IVb and Vc, which were field recurrences, while the rest were intra-field recurrences.

CONCLUSION

Omitting levels Ⅳb and Ⅴc IMRT should be safe and feasible for patients who only had involvement of upper neck LNs. Further well-designed multicenter prospective trials should be conducted to confirm our results and further optimize the recommendation of the International Guideline.

New-Onset Age of Nonalcoholic Fatty Liver Disease and Cancer Risk

Importance

The onset age of nonalcoholic fatty liver disease (NAFLD) is decreasing, and whether earlier ages of NAFLD onset are associated with increased cancer risk is currently unclear.

Objective

To explore the association between NAFLD new-onset age and cancer risk.

Design, Setting, and Participants

This cohort study was conducted among 179 328 participants included in the Kailuan Cohort Study between 2006 and 2021. In total, 46 100 incident NAFLD cases were identified. For each case, a participant matched by age (older or younger by 1 year) and sex was randomly selected to create a new matched study cohort. Data were analyzed from December 2022 through April 2023.

Exposure

Onset of NAFLD.

Main Outcomes and Measures

The association between the onset age of NAFLD and the risk of different cancer types was evaluated using weighted Cox regression models. Population-attributable fractions (PAFs) were used to quantify the association of NAFLD with cancer risk at different ages.

Results

Among 63 696 participants (mean [SD] age, 51.37 [12.43] years; ‭10 932 females [17.2%] and ‭52 764 males [82.8%]), 31 848 individuals had NAFLD and 31 848 individuals were in the control group. During a median (IQR) follow-up of 10.16 (7.89-11.67) years, 2415 patients were diagnosed with cancer. Compared with the matched group, patients aged less than 45 years at NAFLD onset exhibited a higher risk of cancer (average hazard ratio [AHR], 1.52; 95% CI, 1.09-2.12), and as the onset age of NAFLD increased, the cancer risk decreased (ages 45-54 years: AHR, 1.50; 95% CI, 1.15-1.97; ages 55-64 years: AHR, 1.13; 95% CI, 0.97-1.33; ages >65 years: AHR, 0.75; 95% CI, 0.45-1.27; P for interaction < .001). Among patients aged less than 45 years at NAFLD onset, cancers were mainly digestive system and lung cancers, with AHR values of 2.00 (95% CI, 1.08-3.47) and 2.14 (95% CI, 1.05-4.36), respectively. PAFs also showed that in patients aged less than 45 years at NAFLD onset, 17.83% (95% CI, 4.92%-29.86%) of cancer risk was attributable to NAFLD.‬‬‬‬.

Conclusions and Relevance

This study found that NAFLD was associated with increased cancer risk and there was an interaction with onset age, such that the younger the onset age of NAFLD, the greater the cancer risk.

The combined toxicity of silver nanoparticles and typical personal care products in diatom Navicula sp

Toxicity of silver nanoparticles (AgNPs) at environmentally relevant concentrations has been received an increasing attention, and their influence on the bioavailability of personal care products has been seldom studied. Here, the toxicity of AgNPs in typical diatom Navicula sp. was explored, and their influence on the bioavailability of typical personal care products such as triclosan (TCS) and galaxolide (HHCB) was also investigated. The underlying toxicity mechanisms were explored using liquid chromatography-mass spectrometry (LC-MS)-based metabolomics. Low concentrations of AgNPs (10 and 50 μg L-1) induced no observable responses of Navicula sp., in terms of growth rate, chlorophyll contents, and malondialdehyde accumulation. Furthermore, low doses of AgNPs could attenuate TCS or HHCB toxicity to Navicula sp., which was mainly attributed to the reduced oxidative stress. Metabolomics revealed that the disruption of DNA or RNA synthesis and instability of cytokinin-like substances may be also the reasons for the toxicity of AgNPs and TCS to Navicula sp. The damaged algal photosynthesis exposed to HHCB may be recovered by AgNPs, and the presence of signal chemicals (dehydrophytosphingosine and cardamonin) also showed a recovered algal growth. These results emphasize the potential of metabolomics to reveal toxicity mechanism, providing a new perspective on the aquatic risk assessment of nanoparticles and emerging organic pollutants.

Maternal pesticide exposure and risk of preterm birth: A systematic review and meta-analysis

BACKGROUND

Maternal pesticide exposure might be associated with adverse pregnancy outcomes through triggering inflammation and oxidative stress and disrupting endocrine functions. Yet the association between prenatal pesticide exposure and risk of preterm birth remains inconclusive.

OBJECTIVES

To conduct a systematic review and meta-analysis of human observational studies using the Office of Health Assessment and Translation (OHAT) framework to explore the association of per ten-fold increase of pesticide concentrations in maternal biological samples during pregnancy with risk of preterm birth and length of gestational age at birth.

DATA SOURCE

Five English (PubMed, Embase, Cochrane Library, Web of Science and Scopus) and 3 Chinese databases (China national knowledge infrastructure (CNKI), Wanfang Data, and Chinese Biomedical Literature Database (CBM)) were searched till Jan 18th, 2023.

STUDY ELIGIBILITY CRITERIA, PARTICIPANTS, AND INTERVENTIONS

To be included, pesticide exposure should be measured in maternal biological samples during pregnancy and in log-transformed forms. The primary outcome was preterm birth and the secondary outcome was gestational age at birth.

STUDY APPRAISAL, SYNTHESIS METHODS AND CONFIDENCE ASSESSMENT

Quality of studies was evaluated using OHAT Risk of Bias Tool. Evidence was quantitatively synthesized with Correlated and Hierarchical Effects (CHE) model. The confidence rating in the body of evidence was done using OHAT.

RESULTS

A total of 21 studies reported by 18 papers were included, with 7 studies for preterm birth and 19 for gestational age at birth. The meta-analysis found a ten-fold increase of pesticide concentrations was potentially associated with risk of preterm birth (pooled OR = 1.28; 95%CI: 0.93, 1.78) and shortened gestational age at birth (β = -0.10; 95%CI: -0.21, 0.01). Sampling biospecimens in different trimesters was identified as a potential modifier in the association between pesticide exposure and length of gestational age (F = 2.77, P < 0.05). For studies that collected samples at any time during pregnancy, pesticide exposure was found to be associated with shortened length of gestational age (β = -0.43; 95%CI: -0.81, -0.06). The confidence rating in the body of evidence was "moderate" and "very low" for preterm birth and gestational age at birth, respectively.

CONCLUSION

Our result suggested moderate evidence of an association between pesticide exposure and higher risk of preterm birth. Yet more studies are still needed with larger sample size and careful considerations of confounders and accuracy of outcome measurements. Attention is also required on other pesticide compounds in addition to organochlorine and organophosphorus pesticides, and on windows of susceptibility.

Machine learning model for anti-cancer drug combinations: Analysis, prediction, and validation

Drug combination therapy is a highly effective approach for enhancing the therapeutic efficacy of anti-cancer drugs and overcoming drug resistance. However, the innumerable possible drug combinations make it impractical to screen all synergistic drug pairs. Moreover, biological insights into synergistic drug pairs are still lacking. To address this challenge, we systematically analyzed drug combination datasets curated from multiple databases to identify drug pairs more likely to show synergy. We classified drug pairs based on their MoA and discovered that 110 MoA pairs were significantly enriched in synergy in at least one type of cancer. To improve the accuracy of predicting synergistic effects of drug pairs, we developed a suite of machine learning models that achieve better predictive performance. Unlike most previous methods that were rarely validated by wet-lab experiments, our models were validated using two-dimensional cell lines and three-dimensional tumor slice culture (3D-TSC) models, implying their practical utility. Our prediction and validation results indicated that the combination of the RTK inhibitors Lapatinib and Pazopanib exhibited a strong therapeutic effect in breast cancer by blocking the downstream PI3K/AKT/mTOR signaling pathway. Furthermore, we incorporated molecular features to identify potential biomarkers for synergistic drug pairs, and almost all potential biomarkers found connections between drug targets and corresponding molecular features using protein-protein interaction network. Overall, this study provides valuable insights to complement and guide rational efforts to develop drug combination treatments.

Identification of SH2 domain-containing proteins and motifs prediction by a deep learning method

The Src Homology 2 (SH2) domain plays an important role in the signal transmission mechanism in organisms. It mediates the protein-protein interactions based on the combination between phosphotyrosine and motifs in SH2 domain. In this study, we designed a method to identify SH2 domain-containing proteins and non-SH2 domain-containing proteins through deep learning technology. Firstly, we collected SH2 and non-SH2 domain-containing protein sequences including multiple species. We built six deep learning models through DeepBIO after data preprocessing and compared their performance. Secondly, we selected the model with the strongest comprehensive ability to conduct training and test separately again, and analyze the results visually. It was found that 288-dimensional (288D) feature could effectively identify two types of proteins. Finally, motifs analysis discovered the specific motif YKIR and revealed its function in signal transduction. In summary, we successfully identified SH2 domain and non-SH2 domain proteins through deep learning method, and obtained 288D features that perform best. In addition, we found a new motif YKIR in SH2 domain, and analyzed its function which helps to further understand the signaling mechanisms within the organism.

Genome-wide epistasis study highlights genetic interactions influencing severity of COVID-19

Coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may lead to life-threatening respiratory symptoms. Understanding the genetic basis of the prognosis of COVID-19 is important for risk profiling of potentially severe symptoms. Here, we conducted a genome-wide epistasis study of COVID-19 severity in 2243 patients with severe symptoms and 12,612 patients with no or mild symptoms from the UK Biobank, followed by a replication study in an independent Spanish cohort (1416 cases, 4382 controls). Our study highlighted 3 interactions with genome-wide significance in the discovery phase, nominally significant in the replication phase, and enhanced significance in the meta-analysis. For example, the lead interaction was found between rs9792388 upstream of PDGFRL and rs3025892 downstream of SNAP25, where the composite genotype of rs3025892 CT and rs9792388 CA/AA showed higher risk of severe disease than any other genotypes (P = 2.77 × 10-12, proportion of severe cases = 0.24 ~ 0.29 vs. 0.09 ~ 0.18, genotypic OR = 1.96 ~ 2.70). This interaction was replicated in the Spanish cohort (P = 0.002, proportion of severe cases = 0.30 ~ 0.36 vs. 0.14 ~ 0.25, genotypic OR = 1.45 ~ 2.37) and showed enhanced significance in the meta-analysis (P = 4.97 × 10-14). Notably, these interactions indicated a possible molecular mechanism by which SARS-CoV-2 affects the nervous system. The first exhaustive genome-wide screening for epistasis improved our understanding of genetic basis underlying the severity of COVID-19.

[Clinical characteristics of 13 cases with entrapped temporal horn syndrome and efficacy of refined temporal-to-frontal horn shunt]

Thirteen consecutive patients with entrapped temporal horn syndrome in the Department of Neurosurgery of Beijing Tiantan Hospital from February 2018 to September 2022 were retrospectively analyzed, and there were 5 males and 8 females, with a mean age of (43±21) years. Increased intracranial pressure caused by hydrocephalus was the main clinical symptom. All the patients underwent refined temporal-to-frontal horn shunt, and all the symptoms were improved after surgery. Postoperative Karnofsky performance score (KPS) [90 (90, 100)] was higher than preoperative KPS [57 (40, 70)] (P=0.001). However, postoperative entrapped temporal horn volume [13.85 (8.90, 15.25) cm³] decreased, compared with preoperative volume [66.52 (38.65, 88.65) cm³] (P=0.001). Likewise, postoperative midline shift [0.77 (0, 1.50) mm] was longer than preoperative midline shift [6.69 (2.50, 10.00) mm] (P=0.002). No surgery-related complications were observed after the operation. Therefore, the refined temporal-to-frontal horn shunt is safe and effective treatment for entrapped temporal horn syndrome, with favorable outcomes.

Fatigue at sea during and after the COVID-19 pandemic: A comparative study of two matched samples of seafarers

This paper examines seafarers' experience of fatigue during and after the pandemic. A multi-phase mixed methods research design was used, including two quantitative surveys (N_{during-pandemic=501} and N_{after-pandemic=412}) and 36 in-depth interviews. Applying propensity score matching the two samples to approximate the conditions of a randomized controlled experiment, the study shows that surprisingly seafarers reported higher levels of fatigue after the pandemic. Qualitative interviews with seafarers and ship managers reveal the underlying reason - the intensified ship inspection regime together with policy and regulatory updates/revisions in the immediate aftermath of the pandemic increased seafarers' workload and made seafarers more fatigued. The results of the two surveys also show that while fatigue risk factors differed between the two periods, fatigue risk can be managed and mitigated in both periods by implementing fatigue risk management policies and practices. Policy and management implications for improving seafarers' occupational health and safety are discussed at the end of the paper.

Enhanced functional connectome of cerebellum in chronic insomnia patients

BACKGROUND

Functional abnormalities of the cerebellum have been found to be closely associated with chronic insomnia (CI). However, whether there are abnormalities in the topology of the functional connectome of the cerebellum in these patients is still unknown. This study aimed to investigate topological abnormalities of the cerebellar functional connectome in individuals with CI.

MATERIALS AND METHODS

We used resting-state functional magnetic resonance imaging (rs-fMRI) and graph-theoretic analysis to construct a functional connectivity matrix and extract topological property features of the cerebellar functional connectome in patients with CI. We examined global and nodal topological property changes in the cerebellar functional connectome in 102 patients with CI (CI group) and 101 healthy participants without insomnia symptoms (HC group) to determine the differences between groups. Correlations between the topological properties of the cerebellar functional connectome and clinical assessments were calculated to confirm the differences between groups.

RESULTS

The cerebellar functional connectome of both CI and HC patients exhibited small-world properties. The CI group showed higher standardized clustering coefficients at the global properties and higher betweenness centrality in the cerebellar Crus II vermis region at the nodal properties compared with participants in the HC group. However, the topological properties of cerebellar functional connectome abnormalities in the CI group were not significantly different from those in clinical assessments.

CONCLUSION

Our findings suggest that the abnormal global and nodal topological properties of the cerebellar functional connectome are associated with CI and could serve as an important biomarker for CI.

Improved Measurement of the Evolution of the Reactor Antineutrino Flux and Spectrum at Daya Bay

Reactor neutrino experiments play a crucial role in advancing our knowledge of neutrinos. In this Letter, the evolution of the flux and spectrum as a function of the reactor isotopic content is reported in terms of the inverse-beta-decay yield at Daya Bay with 1958 days of data and improved systematic uncertainties. These measurements are compared with two signature model predictions: the Huber-Mueller model based on the conversion method and the SM2018 model based on the summation method. The measured average flux and spectrum, as well as the flux evolution with the ^{239}Pu isotopic fraction, are inconsistent with the predictions of the Huber-Mueller model. In contrast, the SM2018 model is shown to agree with the average flux and its evolution but fails to describe the energy spectrum. Altering the predicted inverse-beta-decay spectrum from ^{239}Pu fission does not improve the agreement with the measurement for either model. The models can be brought into better agreement with the measurements if either the predicted spectrum due to ^{235}U fission is changed or the predicted ^{235}U, ^{238}U, ^{239}Pu, and ^{241}Pu spectra are changed in equal measure.

[Analysis on missed diagnosis or misdiagnosis of anomalous origin of left coronary artery from pulmonary artery by echocardiography from one single medical center]

Objectives: To analyze the reasons of missed diagnosis or misdiagnosis on anomalous origin of left coronary artery from pulmonary artery (ALCAPA) by echocardiography. Methods: This is a retrospective study. Patients with ALCAPA who underwent surgical treatment in Union Hospital, Tongji Medical College, Huazhong University of Science and Technology from August 2008 to December 2021 were included. According to the results of preoperative echocardiography and surgical diagnosis, the patients were divided into confirmed group or missed diagnosis/misdiagnosis group. The results of preoperative echocardiography were collected, and the specific echocardiographic signs were analyzed. According to the experience of the doctors, the echocardiographic signs were divided into four types, namely clear displayed, vague/doubtful displayed, no display and no notice, and the display rate of each sign was calculated (display rate=number of clearly displayed cases/total number of cases×100%). By referring the surgical data, we analyzed and recorded the pathological anatomy and pathophysiological characteristics of the patients, and the rate of missed diagnosis/misdiagnosis of echocardiography in patients with different characteristics was compared. Results: A total of 21 patients were enrolled, including 11 males, aged 1.8 (0.8, 12.3) years (range 1 month to 47 years). Except for one patient with anomalous origin of left anterior descending artery, the others were all originated from the main left coronary artery (LCA). There were 13 cases of ALCAPA in infant and children, and 8 cases of adult ALCAPA. There were 15 cases in the confirmed group (diagnostic accuracy was 71.4% (15/21)), and 6 cases in the missed diagnosis/misdiagnosis group (three cases were misdiagnosed as primary endocardial fibroelastosis, two cases were misdiagnosed as coronary-pulmonary artery fistula; and one case was missed diagnosis). The working years of the physicians in the confirmed group were longer than those in the missed diagnosis/misdiagnosed group ((12.8±5.6) years vs. (8.3±4.7) years, P=0.045). In infants with ALCAPA, the detection rate of LCA-pulmonary shunt (8/10 vs. 0, P=0.035) and coronary collateral circulation (7/10 vs. 0, P=0.042) in confirmed group was higher than that in missed diagnosis/misdiagnosed group. In adult ALCAPA patients, the detection rate of LCA-pulmonary artery shunt was higher in confirmed group than that in missed diagnosis/misdiagnosed group (4/5 vs. 0, P=0.021). The missed diagnosis/misdiagnosis rate of adult type was higher than that of infant type (3/8 vs. 3/13, P=0.410). The rate of missed diagnosis/misdiagnosis was higher in patients with abnormal origin of branches than that of abnormal origin of main trunk (1/1 vs. 5/21, P=0.028). The rate of missed diagnosis/misdiagnosis in patients with LCA running between the main and pulmonary arteries was higher than that distant from the main pulmonary artery septum (4/7 vs. 2/14, P=0.064). The rate of missed diagnosis/misdiagnosis in patients with severe pulmonary hypertension was higher than that in patients without severe pulmonary hypertension (2/3 vs. 4/18, P=0.184). The reasons with an echocardiography missed diagnosis/misdiagnosis rate of≥50% included that (1) the proximal segment of LCA ran between the main and pulmonary arteries; (2) abnormal opening of LCA at the right posterior part of the pulmonary artery; (3) abnormal origin of LCA branches; (4) complicated with severe pulmonary hypertension. Conclusions: Echocardiography physicians' knowledge of ALCAPA and diagnostic vigilance are critical to the accuracy of diagnosis. Attention should be paid to the pediatric cases with no obvious precipitating factors of left ventricular enlargement, regardless of whether the left ventricular function is normal or not, the origin of coronary artery should be routinely explored.

Cross-country comparison of income-related inequality in physical functional disability among middle-aged and older adults: Evidence from 33 countries

Background

Physical functional disability is prevalent among middle-aged and older adults, with substantial health inequality. This study compared cross-country variation in the prevalence and inequality of physical functional disability and investigated the potential determinants of household income-related inequality.

Methods

This cross-sectional study used data from 33 countries between 2017 and 2020, containing 141 016 participants aged 55 years and older. Physical functions were grouped into three domains: activities of daily living (ADLs), instrumental activities of daily living (IADLs), and mobility function. Physical functional disability of each domain was indicated by having some difficulty with the activity. We first estimated the prevalence of physical functional disability in each country. Second, the concentration index was used to quantify household income-related health inequality. Finally, recentred influence function (RIF) decomposition method was used to decompose the inequality into individual and country-level determinants.

Results

Physical functional disability prevalence was higher in lower-middle-income countries than in high-income countries and more prevalent in the poor-income groups in all study countries. Besides, health inequality in different domains of disability was higher in high-income countries than in low-income countries. Regarding determinants of health inequality, we found that individual married, tertiary education, and country-level health infrastructure and resources were associated with reduced health inequality. In contrast, age, unhealthy lifestyles, and chronic diseases were associated with increased health inequality.

Conclusions

Inequality in physical functional disability among middle-aged and older adults varies substantially across countries, with individual and macro determinants being contributing factors. Policies to achieve healthy ageing and reduce the inequality of physical function disability can focus on improving individual healthy lifestyles and country health care facilities.

Generality-oriented optimization of enantioselective aminoxyl radical catalysis

Catalytic enantioselective methods that are generally applicable to a broad range of substrates are rare. We report a strategy for the oxidative desymmetrization of meso-diols predicated on a nontraditional catalyst optimization protocol by using a panel of screening substrates rather than a singular model substrate. Critical to this approach was rational modulation of a peptide sequence in the catalyst incorporating a distinct aminoxyl-based active residue. A general catalyst emerged, providing high selectivity in the delivery of enantioenriched lactones across a broad range of diols, while also achieving up to ~100,000 turnovers.

Individual and combined toxicity of silver nanoparticles and triclosan or galaxolide in the freshwater algae Euglena sp

With the widespread production and usage, silver nanoparticles (AgNPs) can be extensively found in the aquatic environment and co-exist with other pollutants for a prolonged time, leading to a more complex ecological risk in natural waters. In this work, the model freshwater algae Euglena sp. was selected to study the toxicity of AgNPs and explore their influences on the toxicity of two frequently detected personal care products, triclosan (TCS) and galaxolide (HHCB). The LC-MS targeted metabolomics was used to analyze the possible toxicity mechanism at the molecular level. Results showed that AgNPs was toxic to Euglena sp. upon 24 h exposure, but the toxicity decreased gradually as exposure times increased. AgNPs (<100 μg L^-1) attenuated TCS and HHCB toxicity to Euglena sp., which could be attributed primarily to the decreased oxidative stress. Metabolomic analysis revealed that AgNPs induced a stress on algal defense system upon TCS exposure, but promoted the algal defense system upon HHCB exposure. Furthermore, DNA or RNA biosynthesis was accelerated in algae exposed to TCS or HHCB after the addition of AgNPs, implying that AgNPs may mitigate the genetic toxicity of TCS or HHCB in Euglena sp. These results emphasize the potential of metabolomics to reveal toxicity mechanism and provide new perspectives on the aquatic risk assessment of personal care products in the presence of AgNPs.

Interplay between Liposomes and IgM: Principles, Challenges, and Opportunities

Liposomes have received tremendous attention as a class of versatile pharmaceutical vehicles of great potential over the past several decades. However, the application of liposomes encounters major challenges due to the knowledge gaps in their in vivo delivery process. Immunoglobulin M (IgM) displays both pervasiveness and complexity in regulating the biological functions as well as eliciting adverse effects of liposomes. Understanding, mitigating, and exploiting the duality of IgM are prerequisites for achieving various biomedical applications of liposomes. In this review, the intricate relationship between liposomes and their biological environments has been summarized, with an emphasis on the regulatory effects of IgM on in vivo performance of liposomes. Corresponding solutions have also been discussed to evade IgM-mediated opsonization for safe and efficient drug delivery.

Precision Measurement of Reactor Antineutrino Oscillation at Kilometer-Scale Baselines by Daya Bay

We present a new determination of the smallest neutrino mixing angle θ_{13} and the mass-squared difference Δm_{32}^{2} using a final sample of 5.55×10^{6} inverse beta-decay (IBD) candidates with the final-state neutron captured on gadolinium. This sample is selected from the complete dataset obtained by the Daya Bay reactor neutrino experiment in 3158 days of operation. Compared to the previous Daya Bay results, selection of IBD candidates has been optimized, energy calibration refined, and treatment of backgrounds further improved. The resulting oscillation parameters are sin^{2}2θ_{13}=0.0851±0.0024, Δm_{32}^{2}=(2.466±0.060)×10^{-3}  eV^{2} for the normal mass ordering or Δm_{32}^{2}=-(2.571±0.060)×10^{-3}  eV^{2} for the inverted mass ordering.

Non-invasive diagnosis of acute kidney injury using Mn-doped carbon dots-based magnetic resonance imaging

As Gd-based contrast agents suffer from the risk of causing nephrogenic systemic fibrosis, less toxic contrast agents are urgently needed in contrast-enhanced magnetic resonance imaging (CE-MRI) of kidney injury. Herein, we develop a non-invasive diagnosis method for acute kidney injury using CE-MRI based on manganese-doped carbon dots (Mn-CDs). The synthesized Mn-CDs possess an ultrasmall size of 5 nm, good biocompatibility, and a high T1 relaxation rate (10.8 mM^-1 s^-1), which can produce effective positive enhancement in the kidneys and clearly show the fine structures of the kidneys including the cortex, outer medulla, and inner medulla. In an acute kidney injury model, Mn-CDs-based CE-MRI can not only accurately and intuitively reveal the site of kidney injury consistent with the pathological analysis, but also reflect the functional changes in the injured kidney. Collectively, our study provides a new strategy for the non-invasive diagnosis of acute kidney injury using CE-MRI based on Mn-CDs.

Site-2 Protease Slr1821 Regulates Carbon/Nitrogen Homeostasis during Ammonium Stress Acclimation in Cyanobacterium Synechocystis sp. PCC 6803

Excess ammonium imposes toxicity and stress response in cyanobacteria. How cyanobacteria acclimate to NH4+ stress is so far poorly understood. Here, Synechocystis sp. PCC6803 S2P homolog Slr1821 was identified as the essential regulator through physiological characterization and transcriptomic analysis of its knockout mutant. The proper expression of 60% and 67% of the NH4+ activated and repressed genes, respectively, were actually Slr1821-dependent since they were abolished or reversed in ∆slr1821. Synechocystis 6803 suppressed nitrogen uptake and assimilation, ammonium integration and mobilization of other nitrogen sources upon NH4+ stress. Opposite regulation on genes for assimilation of nitrogen and carbon, such as repression of nitrogen regulatory protein PII, PII interactive protein PirC and activation of carbon acquisition regulator RcbR, demonstrated that Synechocystis 6803 coordinated regulation to maintain carbon/nitrogen homeostasis under increasing nitrogen, while functional Slr1821 was indispensable for most of this coordinated regulation. Additionally, slr1821 knockout disrupted the proper response of regulators and transporters in the ammonium-specific stimulon, and resulted in defective photosynthesis as well as compromised translational and transcriptional machinery. These results provide new insight into the coordinated regulation of nutritional fluctuation and the functional characterization of S2Ps. They also provide new targets for bioengineering cyanobacteria in bioremediation and improving ammonium tolerance in crop plants.