Development of generic metabolic Raman calibration models using solution titration in aqueous phase and data augmentation for in-line cell culture analysis

This study presents a novel approach for developing generic metabolic Raman calibration models for in-line cell culture analysis using glucose and lactate stock solution titration in an aqueous phase and data augmentation techniques. First, a successful set-up of the titration method was achieved by adding glucose or lactate solution at several different constant rates into the aqueous phase of a bench-top bioreactor. Subsequently, the in-line glucose and lactate concentration were calculated and interpolated based on the rate of glucose and lactate addition, enabling data augmentation and enhancing the robustness of the metabolic calibration model. Nine different combinations of spectra pretreatment, wavenumber range selection, and number of latent variables were evaluated and optimized using aqueous titration data as training set and a historical cell culture data set as validation and prediction set. Finally, Raman spectroscopy data collected from 11 historical cell culture batches (spanning four culture modes and scales ranging from 3 to 200 L) were utilized to predict the corresponding glucose and lactate values. The results demonstrated a high prediction accuracy, with an average root mean square errors of prediction of 0.65 g/L for glucose, and 0.48 g/L for lactate. This innovative method establishes a generic metabolic calibration model, and its applicability can be extended to other metabolites, reducing the cost of deploying real-time cell culture monitoring using Raman spectroscopy in bioprocesses.

Advancing injection force modeling and viscosity-dependent injectability evaluation for prefilled syringes

The development of PFS requires a detailed understanding of the forces occurring during the drug administration process and patient's capability. This research describes an advanced mathematic injection force model that consisting hydrodynamic force and friction force. The hydrodynamic force follows the basic law of Hagen-Poiseuille but refines the modeling approach by delving into specific properties of drug viscosity (Newtonian and Shear-thinning) and syringe shape constant, while the friction force was accounted from empty barrel injection force. Additionally, we take actual temperature of injection into consideration, providing more accurate predication. The results show that the derivation of the needle dimension constant and the rheological behavior of the protein solutions are critical parameters. Also, the counter pressure generated by the tissue has been considered in actual administration to address the issue of the inaccuracies of current injection force evaluation preformed in air, especially when the viscosity of the injected drug solution is below 9.0 cP (injecting with 1 mL L PFS staked with 29G ½ inch needle). Human factor studies on patients' capability against medication viscosity filled the gap in design space of PFS drug product and available viscosity data in very early phase.

A Review of Recent FDA-Approved Biologic-Device Combination Products

With the remarkably strong growth of the biopharmaceutical market, an increasing demand for self-administration and rising competitions attract substantial interest to the biologic-device combination products. The ease-of-use of biologic-device combination products can minimize dosing error, improve patient compliance and add value to the life-cycle management of biological products. As listed in the purple book issued by the U.S. Food and Drug Administration (FDA), a total of 98 brand biologic-device combination products have been approved with Biologic License Application from January 2000 to August 2023, where this review mainly focused on 63 products containing neither insulin nor vaccine. Prefilled syringes (PFS) and autoinjectors are the most widely adopted devices, whereas innovative modifications like needle safety guard and dual-chamber design and novel devices like on-body injector also emerged as promising presentations. All 16 insulin products employ pen injectors, while all 19 vaccine products are delivered by a PFS. This review provides a systematic summary of FDA-approved biologic-device combination products regarding their device configurations, routes of administration, formulations, instructions for use, etc. In addition, challenges and opportunities associated with biologic-device compatibility, regulatory complexity, and smart connected devices are also discussed. It is believed that evolving technologies will definitely move the boundaries of biologic-device combination product development even further.

Strictureplasty may lead to increased preference in the surgical management of Crohn's disease: a case-matched study

BACKGROUND

Resection and strictureplasty are the two surgical modalities used in the management of Crohn's disease (CD). The objective of this study was to compare morbidity and clinical recurrence between patients who underwent strictureplasty and patients who underwent resection.

METHODS

Patients with CD who underwent strictureplasty between January 2012 and December 2022 were enrolled. The patients were well matched with patients who underwent resection without strictureplasty. Patient- and disease-specific characteristics, postoperative morbidity, and clinical recurrence were also analyzed.

RESULTS

A total of 118 patients who underwent a total of 192 strictureplasties were well matched to 118 patients who underwent resection. The strictureplasty group exhibited significantly less blood loss (30 ml versus 50 ml, p < 0.001) and stoma creation (2.5% versus 16.9%, p < 0.001). No significant difference was found regarding postoperative complications or length of postoperative stay. At the end of the follow-up, the overall rate of clinical recurrence was 39.4%, and no difference was observed between the two groups. Postoperative prophylactic use of biologics (odds ratio = 0.2, p < 0.001) was the only protective factor against recurrence.

CONCLUSION

Strictureplasty does not increase the risk of complications or recurrence compared with resection. It represents a viable alternative to resection in selected patients, and as such, it should have a broader scope of indications and greater acceptance among surgeons.

Intensified perfusion culture (IPC) reduced recombinant protein fragmentation

Mammalian cells remain the mainstay of biological production host. In industry, cultivating and harvest strategies are sorted in batch mode (e.g., batch, fed-batch, concentrated fed-batch and intensified fed-batch) and continuous mode (e.g., perfusion). To retrieve greater productivity and better product quality, especially for the sensitive products prone to fragmentation, culture modes with various modifications are innovated (e.g., intensified perfusion culture [IPC]). In our study, we demonstrated that the fragmentation of Fc-fusion product (Molecule A) is time-dependent in traditional fed-batch (TFB) culture. The fragmentation proportion increased from 3.8% to 12.4% for Clone A, 0.8% to 1.7% for Clone B and 0.9% to 2.0% for Clone C from Day 10 to Day 14. By applying a novel bioprocess, IPC, which allows continuous feeding of the fresh medium and constant removal of the spent medium without bleeding cells to maintain a defined constant viable cell density, the fragmentation was reduced to 0.3% while the productivity was increased from 2.96 g/L to 15.51 g/L for Clone A. To validate whether the fragmentation reduction is product-sensitive, plasmids carrying the DNA sequences of two other Fc-fusion molecules (Molecule B and Molecule C) were transfected into the host. The results showed consistent fragmentation reducing effect by using IPC. Furthermore, the cultivation scale was expanded to 50 L and 1000 L. A minimum fragmentation level below 0.1% was observed for Molecule C. Our study revealed the capability of IPC in reducing Fc-fusion protein fragmentation and the reproducibility when scaling up while maintaining high productivity.

Biomechanical and aesthetic outcomes following radial forearm free flap transfer: comparison of ipsilateral full-thickness skin graft and traditional split-thickness skin graft

The radial forearm free flap (RFFF) is associated with donor site morbidity. This study aimed to quantify the functional and aesthetic outcomes after closure of the RFFF donor site using triangular full-thickness skin grafts (FTSGs) harvested adjacent to the flap or traditional split-thickness skin grafts (STSGs). The study included patients who underwent oral cavity reconstruction with an RFFF between March 2017 and August 2021. The patients were divided into two groups based on the donor site closure method: FTSG or STSG. The primary outcomes were biomechanical grip strength, pinch strength, and range of wrist movements. Subjective donor site morbidity, aesthetic and functional results were also analysed. The study included 75 patients (FTSG n = 35; STSG n = 40). Postoperatively, there was a statistically significant difference in grip strength (P = 0.049) and wrist extension (P = 0.047) between the FTSG and STSG groups, in favour of the STSG. Differences between the groups in pinch strength and other wrist motions were not statistically significant. The harvesting time was significantly shorter for the FTSG (P = 0.041) and the appearance of the donor site was better (P = 0.026) when compared to the STSG. Cold intolerance was more frequent in the STSG group (32.5% STSG vs 6.7% FTSG; P = 0.017). Subjective function, numbness, pain, hypertrophic scar, itching, and social stigma did not differ significantly between the groups. Compared with the STSG, the FTSG showed better cosmesis and avoided additional donor sites, with clinically negligible differences in hand biomechanics.

Developing an ultra-intensified fed-batch cell culture process with greatly improved performance and productivity

Intensified fed-batch (IFB), a popular cell culture intensification strategy, has been widely used for productivity improvement through high density inoculation followed by fed-batch cultivation. However, such an intensification strategy may counterproductively induce rapidly progressing cell apoptosis and difficult-to-sustain productivity. To improve culture performance, we developed a novel cell culture process intermittent-perfusion fed-batch (IPFB) which incorporates one single or multiple cycles of intermittent perfusion during an IFB process for better sustained cellular and metabolic behaviors and notably improved productivity. Unlike continuous perfusion or other semi-continuous processes such as hybrid perfusion fed-batch with only early-stage perfusion, IPFB applies limited times of intermittent perfusion in the mid-to-late stage of production and still inherits bolus feedings on nonperfusion days as in a fed-batch culture. Compared to IFB, an average titer increase of ~45% was obtained in eight recombinant CHO cell lines studied. Beyond IPFB, ultra-intensified IPFB (UI-IPFB) was designed with a markedly elevated seeding density of 20-80 × 106 cell/mL, achieved through the conventional alternating tangential flow filtration (ATF) perfusion expansion followed with a cell culture concentration step using the same ATF system. With UI-IPFB, up to ~6 folds of traditional fed-batch and ~3 folds of IFB productivity were achieved. Furthermore, the application grounded in these two novel processes showed broad-based feasibility in multiple cell lines and products of interest, and was proven to be effective in cost of goods reduction and readily scalable to a larger scale in existing facilities.

In Situ Regulating Cobalt/Iron Oxide-Oxyhydroxide Exchange by Dynamic Iron Incorporation for Robust Oxygen Evolution at Large Current Density

The key dilemma for green hydrogen production via electrocatalytic water splitting is the high overpotential required for anodic oxygen evolution reaction (OER). Co/Fe-based materials show superior catalytic OER activity to noble metal-based catalysts, but still lag far behind the state-of-the-art Ni/Fe-based catalysts probably due to undesirable side segregation of FeOOH with poor conductivity and unsatisfied structural durability under large current density. Here, a robust and durable OER catalyst affording current densities of 500 and 1000 mA cm-2 at extremely low overpotentials of 290 and 304 mV in base is reported. This catalyst evolves from amorphous bimetallic FeOOH/Co(OH)2 heterostructure microsheet arrays fabricated by a facile mechanical stirring strategy. Especially, in situ X-ray photoelectron spectroscopy (XPS) and Raman analysis decipher the rapid reconstruction of FeOOH/Co(OH)2 into dynamically stable Co1-x Fex OOH active phase through in situ iron incorporation into CoOOH, which perform as the real active sites accelerating the rate-determining step supported by density functional theory calculations. By coupling with MoNi4 /MoO2 cathode, the self-assembled alkaline electrolyzer can deliver 500 mA cm-2 at a low cell voltage of 1.613 V, better than commercial IrO2 (+) ||Pt/C(-) and most of reported transition metal-based electrolyzers. This work provides a feasible strategy for the exploration and design of industrial water-splitting catalysts for large-scale green hydrogen production.

Fish diversity and selection of taxa for conservation in the Salween and Irrawaddy Rivers, Southeast Asia

Species diversity indices provide quantitative data for understanding the variations and trends in fish species diversity, as well as information on species richness and evenness. However, these diversity indices do not reflect differences in specific taxa, which can be of importance as key conservation targets, especially during the planning and construction of protected areas. In this study, simultaneously combining our improved traditional fish fauna analysis (TFFA) with the value of fish fauna presence (VFFP) methods, we studied fish diversity in the Salween and Irrawaddy basins. The results of the TFFA reflected the families (subfamilies) and genera that constitute the main body of fish diversity in the river basins. The results of the VFFP assessment showed which families (subfamilies) and genera were representative of certain characteristics in the basins. The VFFP scores of genera could be used as indicator indices and as priority taxa in the planning and construction of fish resource reserves. In this paper, we propose for the first time that the role and status of monotypic genera (genera comprising only a single species) in the conservation of fish diversity should not be ignored, and they should rather be a priority for protection.

Further accelerating biologics development from DNA to IND: the journey from COVID-19 to non-COVID-19 programs

The Coronavirus Disease (COVID-19) pandemic has spurred adoption of revolutionary initiatives by regulatory agencies and pharmaceutical industry worldwide to deliver therapeutic COVID-19 antibodies to patients at unprecedented speed. Among these, timeline of chemistry, manufacturing and control (CMC), which involves process development and manufacturing activities critical for the assurance of product quality and consistency before first-in-human clinical trials, was greatly reduced from typically 12-15 months (using clonal materials) to approximately 3 months (using non-clonal materials) in multiple cases. In this perspective, we briefly review the acceleration approaches published for therapeutic COVID-19 antibodies and subsequently discuss the applicability of these approaches to achieve investigational new drug (IND) timelines of ≤10 months in over 60 COVID-19 and non-COVID-19 programs performed at WuXi Biologics. We are of the view that, with demonstrated product quality and consistency, innovative approaches used for COVID-19 can be widely applied in all disease areas for greater speed to clinic.

Regional variations in retinopathy of prematurity incidence for preterm infants <32 weeks' gestation in China

OBJECTIVES

National-level data on the incidence of retinopathy of prematurity (ROP) in different regions of China is insufficient. This study aimed to compare ROP incidences and care practices in different regions of China and their relationship with regional gross domestic product (GDP) per capita.

STUDY DESIGN

Retrospective cohort study.

METHODS

All infants born at <32 weeks gestational age (GA) and admitted to 70 neonatal intensive care units (NICUs) from January 1, 2019, to December 31, 2020, were enrolled. Hospitals were categorised into three regional groups according to geographical locations and GDP per capita from high to low: Eastern, Central, and Western China. The incidence of death or ROP, and care practices were compared among the groups.

RESULTS

A total of 18,579 infants were enrolled. Median GA was 29.9 (interquartile range 28.4-31.0) weeks and birth weight was 1318.1 (317.2) g. The percentage of GA <28 weeks, complete administration of antenatal steroids, and weight gain velocity during NICU stay were highest in Eastern China and lowest in Western China (all P < 0.01). In Eastern, Central, and Western China, the rates of death or any stage of ROP were 33.3%, 38.5%, and 39.2%, respectively (P < 0.01).

CONCLUSIONS

There were considerable regional disparities in ROP incidence in preterm infants with GA <32 weeks in China. The incidence of death or ROP ranged from high to low in Western, Central, and Eastern China.

Nanoparticle technology for mRNA: Delivery strategy, clinical application and developmental landscape

The mRNA vaccine, a groundbreaking advancement in the field of immunology, has garnered international recognition by being awarded the prestigious Nobel Prize, which has emerged as a promising prophylactic and therapeutic modality for various diseases, especially in cancer, rare disease, and infectious disease such as COVID-19, wherein successful mRNA treatment can be achieved by improving the stability of mRNA and introducing a safe and effective delivery system. Nanotechnology-based delivery systems, such as lipid nanoparticles, lipoplexes, polyplexes, lipid-polymer hybrid nanoparticles and others, have attracted great interest and have been explored for mRNA delivery. Nanoscale platforms can protect mRNA from extracellular degradation while promoting endosome escape after endocytosis, hence improving the efficacy. This review provides an overview of diverse nanoplatforms utilized for mRNA delivery in preclinical and clinical stages, including formulation, preparation process, transfection efficiency, and administration route. Furthermore, the market situation and prospects of mRNA vaccines are discussed here.

Higher Cognitive Reserve Is Beneficial for Cognitive Performance Via Various Locus Coeruleus Functional Pathways in the Pre-Dementia Stage of Alzheimer's Disease

BACKGROUND

Cognitive reserve (CR) shows protective effects on cognitive function in older adult and in Alzheimer's disease (AD). However, the brain mechanisms underlying the CR effect on the non-dementia AD spectrum (subjective cognitive decline (SCD) and mild cognitive impairment (MCI)) are unknown. The aim of this study was to investigate the potential moderate effect of CR on brain functional networks associated with cognitive performance.

METHODS

We selected 200 participants, including 48 cognitively normal (CN) and 56 SCD, and 96 patients with MCI from the Alzheimer's Disease Neuroimaging Initiative (ADNI). Seed-based locus coeruleus functional connectivity (LC FC) was conducted to detect early brain functional changes in the non-dementia AD spectrum. CR was assessed via years of education and intelligence (IQ). The ANDI composite executive function scores (ADNI-EF) and ADNI composite memory scores (ANDI-MEM) at baseline and 24-month follow-up were used to assess cognitive performance.

RESULTS

Compared to the CN group, the SCD group showed abnormal LC FC with the executive control network (dorsolateral prefrontal cortex, DLPFC), salience network, sensorimotor network, reward network, and hippocampus, while these alterations were inverted at the MCI stage. The LC-hippocampus FC was correlated with ADNI-MEM at baseline and follow-up, and these relationships were moderated by education. The LC-DLPFC FC was correlated with ADNI-EF at baseline, and this association was moderated by IQ.

CONCLUSION

Our results manifested that higher levels of CR would confer protective effects on SCD and MCI. Furthermore, IQ and education could moderate the relationship between LC FC and cognition through different pathways.

Health inequalities of global protein-energy malnutrition from 1990 to 2019 and forecast prevalence for 2044: data from the Global Burden of Disease Study 2019

OBJECTIVES

Protein-energy malnutrition poses a serious medical problem worldwide. This study aims to describe the global burden, trends, and health inequalities of protein-energy malnutrition and forecasts for future prevalence.

STUDY DESIGN

This was a comprehensive analysis based on data provided by the Global Burden of Disease Study 2019.

METHODS

Data were obtained from the Global Health Data Exchange query tool, including prevalence, deaths, disability-adjusted life years (DALYs) and sociodemographic index (SDI). The estimated annual percentage changes were calculated to evaluate temporal trends. We quantified cross-country inequalities in protein-energy malnutrition burden and predicted the prevalence number and rate to 2044.

RESULTS

Globally, there were 147,672,757 (130,405,923 to 167,471,359) cases of protein-energy malnutrition in 2019, with 212,242 (185,403 to 246,217) deaths. Eastern Sub-Saharan Africa had the highest age-standardised death and DALY rates in 2019. From 1990 to 2019, the global age-standardised prevalence rate of protein-energy malnutrition showed an upward trend, while the age-standardised death rate showed a downward trend. A significant decline occurred in SDI-related health inequality, from 2126.1 DALYs per 100,000 persons between the poorest and richest countries in 1990 to 357.9 DALYs per 100,000 persons in 2019. There was a trend of decreasing age-standardised death and DALY rates along with increases in the SDI. Frontier analyses showed that there is much room for improving the current situation of protein-energy malnutrition in some countries. In the next 35 years, the prevalence of protein-energy malnutrition will continue to increase.

CONCLUSION

Although the disease burden of protein-energy malnutrition has greatly decreased since 1990 and health inequalities between countries are shrinking, the prevalence in Asian and African countries may continue to increase. Focussing on regional differences and strengthening the nutritional intake of people in underdeveloped areas are necessary to reduce future burdens.

Enhanced Bonding to Caries-Affected Dentin Using an Isocyanate-Based Primer

Dental caries is the most common oral disease and the most common cause of resin restorations. In minimally invasive dentistry, the principle behind cavity preparation is to remove external caries-infected dentin (CID) and preserve internal caries-affected dentin (CAD) and sound dentin (SD). The cavity floor is mainly composed of CAD, but the poor bonding performance of CAD has become a widespread concern. This study evaluated the performance of a new collagen-reactive monomer (ITCM) used as a primer to improve the bonding performance of CAD. The experimental specimens were grouped as follows: SD, CAD, and ITCM-pretreated CAD (CAD-ITCM). Dentin slices were obtained for attenuated total reflectance-Fourier transform infrared (ATR-FTIR) analysis. The bonded samples were subjected to microtensile bond strength analysis after 24 h of water storage or aging by thermocycling, and the bonding interface quality was evaluated by nanoleakage assessment, interfacial nanoindentation testing, and in situ zymography. Cytotoxicity experiments with ITCM were performed. ATR-FTIR showed that the isocyanate groups in ITCM can covalently bind and form hydrogen bonds with the collagen in CAD to mediate chemical bonding. ITCM pretreatment significantly improved the bond strength of CAD (P < 0.05), reduced interfacial nanoleakage, improved the sealing of the bonding interface, enhanced the homogeneity of the hybrid layer, and inhibited matrix metalloproteinase activity. In addition, ITCM presented acceptable biocompatibility for dental restorative application. Taken together, this study reported the application of ITCM to induce collagen-based chemical bonding in the CAD bonding system, which fills the gap in strategies to improve the bonding performance of CAD immediately and after aging and has important clinical application prospects.

American Heart Association's new 'Life's Essential 8' score in association with cardiovascular disease: a national cross-sectional analysis

OBJECTIVE

The American Heart Association (AHA) has recently updated and enhanced the quantification of cardiovascular health by using the Life's Essential 8 (LE8) score. We intended to examine the correlation between cardiovascular health status, as measured by the new LE8 score, and cardiovascular disease (CVD) in US adults.

STUDY DESIGN

National cross-sectional study.

METHODS

A total of 24,730 individuals without pregnancy and with complete data from 2007 to 2018 enrolled in the study. The overall LE8 score was divided into low, moderate, and high groups. Multivariate logistic regressions were used to assess the odds ratios (ORs) and 95% confidence intervals (CIs) for the associations between the LE8 score and the presence of CVD.

RESULTS

Overall, the high LE8 group had a younger age (20-59 years, 82.95%) and more females (60.09%) compared to the low LE8 group. Moderate and high LE8 correlated negatively with the presence of CVD (moderate, OR: 0.46, 95% CI: 0.39-0.54; high, OR: 0.26, 95% CI: 0.21-0.33). One standard deviation increment in the LE8 score correlated significantly with lower odds of CVD (OR: 0.64; 95% CI: 0.60-0.69). Further stratification analysis also detected a significant relationship between the new LE8 score and CVD, and the result was enhanced among the young and women (P-interaction<0.001).

CONCLUSIONS

Higher LE8 score correlated with lower odds of CVD, especially among the young and women.

Green Synthesis and Morphological Evolution for Bi2Te3 Nanosystems via a PVP-Assisted Hydrothermal Method

Bi2Te3 has been extensively used because of its excellent thermoelectric properties at room temperature. Here, 230-420 nm of Bi2Te3 hexagonal nanosheets has been successfully synthesized via a "green" method by using ethylene glycol solution and applying polyvinyl pyrrolidone (PVP) as a surfactant. In addition, factors influencing morphological evolution are discussed in detail in this study. Among these parameters, the reaction temperature, molar mass of NaOH, different surfactants, and reaction duration are considered as the most essential. The results show that the existence of PVP is vital to the formation of a plate-like morphology. The reaction temperature and alkaline surroundings played essential roles in the formation of Bi2Te3 single crystals. By spark plasma sintering, the Bi2Te3 hexagonal nanosheets were hot pressed into solid-state samples. We also studied the transport properties of solid-state samples. The electrical conductivity σ was 18.5 × 103 Sm-1 to 28.69 × 103 Sm-1, and the Seebeck coefficient S was -90.4 to -113.3 µVK-1 over a temperature range of 300-550 K. In conclusion, the observation above could serve as a catalyst for future exploration into photocatalysis, solar cells, nonlinear optics, thermoelectric generators, and ultraviolet selective photodetectors of Bi2Te3 nanosheet-based photodetectors.

[Pelvic coronal inclination change in adolescent flexible flatfoot surgically treated with arthroereisis]

Objective: To evaluate adolescent pelvic coronal inclination angle change after flatfoot treated with arthroereisis. Method: A case-series study. From June 2018 to September 2020, 25 children with flexible flat foot and pelvic obliquity were included in this retrospective study in Peking University Shenzhen Hospital. There were 17 males and 8 females with a mean age of (11.2±2.2) years (9-15 years). There were 5 cases of unilateral flatfoot and 20 cases of bilateral flatfoot. All of the patients were surgically treated with arthroereisis. Regular follow-up was done in 3 months, 1 and 2 years postoperatively. Weightbearing fluoroscopy of entire lower limb and foot were investigated to measure Meary's angle, calcaneal pitch angle, height difference at ankle and pelvic plane, pelvic inclination and sacrum-iliac distance (F value) on coronal plane. Results: The mean Mearys' angle at 3 month postoperatively was improved when compared with that before the operation (3.1°±1.5° vs 25.9°±4.3°, P<0.001), and it remained at the same level 2 years after the operation (compared with that at 1 year after the operation, P=0.748). The calcaneal pitch angle improved significantly at 3-month follow-up when compared with that before the operation (16.6°±2.4° vs 9.9°±1.5°, P<0.001), and there was no significant change between 1 year and 2 years after operation (P=0.542). The height difference at mortise plane were also reduced at the 3-month follow-up(P<0.001), and it remained at the same level at 1 year and 2 years after the operation (P=0.159). Pelvic height difference decreased dramatically from (12.4±1.7) mm (before operation) to (7.1±1.2) mm(3 month after the operation) (P<0.001), it decreased to (3.6±1.8) mm 1 year after the operation (compared with that at 3 months after the operation, P<0.001), and no further reduction was observed 2 years after the surgery (P=0.483). The pelvic inclination angle and sacrum-iliac distance were also improved at 3-month follow-up when compared with those before the operation (both P<0.001), and they declined further 1 year after the operation(both P<0.05), but the decreasing trend disappeared at the 2-year follow-up (both P>0.05). Conclusion: For adolescent flexible flat foot patients with pelvic obliquity, the coronal inclination and pelvic height discrepancy would partially recovered with correction of flatfoot deformity, but it could not be completely corrected in the mean follow-up period of 2 years after the operation.

A Retrospective Analysis of Immediate Postoperative Electron Radiotherapy for Keloids

PURPOSE/OBJECTIVE(S)

The increasing incidence of keloid has seriously affected people's physical and mental health, and the postoperative recurrence rate is as high as 50-80%. Postoperative radiotherapy has been shown to significantly reduce the recurrence of keloid. Given the different treatment patterns in different institutions, we tried to analyze the data of patients in our center.

MATERIALS/METHODS

We retrospectively analyzed the clinical data of 455 patients with 498 keloids treated in our institution from 2010 to 2017. All patients received a four-fraction electron radiotherapy with single dose of 4 Gy within 24 hours of surgery. The recurrence and adverse reaction of immediate adjuvant radiotherapy in these patients was evaluated.

RESULTS

At the last follow-up date, 130 (26.5%) keloids had recurred after a middle follow-up of 68.1 months (42.6-129.9 months). The recurrence rates of 1 year, 3 years and 5 years were respectively14.5%, 18.7% and 21%. Recurrence rates vary depending on the keloid location. Among them, the recurrence rate of ear was low with 14% (43/298). Face, head neck and limbs was moderate with 38.8% (17/44) and 33.3% (8/24). Chest and Suprapubic region had a high recurrence rate of 50.8% (32/64) and 47.8% (33/69). Among the patients with recurrence, 16.9% (22/130) felt that their symptoms were better than before treatment, and 37.7% (49/130) were not worsen, which was acceptable. Multivariate analysis showed that age and duration of postoperative pruritus pain were correlated with recurrence (P = 0.036; P = 0.02). Radiotherapy combined with steroid and silicone reduced the recurrence rate compared with radiotherapy alone (P = 0.015). During treatment and follow-up, Infection occurred in 2 patients and cutaneous fibroblastoma in 1 patient.

CONCLUSION

Our radiotherapy regimen can effectively reduce the recurrence rate and improve the symptoms of patients with keloids, especially ear keloids. High recurrence sites need further improvement of radiotherapy dose and fraction. Combination of multiple treatments is better than single treatment.

Early Stereotactic Body Radiotherapy to the Primary Lung Lesion for Patients with Advanced NSCLC Treated with First-Line Systemic Therapy

PURPOSE/OBJECTIVE(S)

Although adding consolidative stereotactic body radiotherapy (SBRT) to systemic therapy improves survival in advanced non-small cell lung cancer (NSCLC), the optimal timing of SBRT remains unclear. This study aimed to explore the clinical outcome of early and delayed SBRT to primary lung lesions of advanced NSCLC patients treated with first-line systemic therapy.

MATERIALS/METHODS

We identified patients with advanced NSCLC who were suitable to receiveSBRT for the primary lung tumors after first-line systemic therapy. All eligible patients were treated with first-line systemic therapy and SBRT for their primary lung lesions. Early SBRT group was defined as patients who received SBRT for their primary lung tumor at the maximal response of systemic therapy. Delayed SBRT group was defined as patients who received SBRT after the occurrence of oligoprogression in primary lung tumor. The primary endpoints were progression-free survival 1 (PFS1, time from start of first-line systemic therapy to disease progression) and PFS2 (time from start of first-line systemic therapy to disease progression after SBRT). Overall survival (OS) and adverse effects (AEs) were secondary endpoints. A two-sided P value of 0.05 was considered statistically significant. All of the statistical analyses were performed with statistical software.

RESULTS

A total of184 patients with advanced NSCLC treated with SBRT for primary tumors were screened, and 49 patients were eligible for enrollment in this study. The median age of the entire cohort was 66 years (range, 37-80 years), and 34 (69.4%) patients were male. Thirty-four patients (69.4%) were treated by target therapy and 15 (30.6%) were treated by chemotherapy and immunotherapy. Of the 49 eligible patients, 28(57.1%) received early SBRT to lung primary tumor and 21(42.9%) received delayed SBRT to lung primary tumor. The early SBRT group showed a significantly prolonged PFS1 as compared with the delayed SBRT group (mPFS1: 30 months vs. 8 months, P<0.001). The median PFS2 of the early SBRT group was longer than that of the delayed SBRT group, but the difference between the two groups did not achieve a statistical significance (mPFS2: 42 months vs. 23 months, P = 0.303). Median OS of both groups has not reached. No severe toxicities (≥grade 3) were observed in early SBRT group and only one patient in the delayed SBRT group experienced grade 3 radiation pneumonitis.

CONCLUSION

Early SBRT to the primary lung lesion significantly improved PFS and is a new potentially effective and tolerable treatment option for patients with advanced NSCLC who had stable disease during first-line systemic therapy.

Universal DNA methylation age across mammalian tissues

Aging, often considered a result of random cellular damage, can be accurately estimated using DNA methylation profiles, the foundation of pan-tissue epigenetic clocks. Here, we demonstrate the development of universal pan-mammalian clocks, using 11,754 methylation arrays from our Mammalian Methylation Consortium, which encompass 59 tissue types across 185 mammalian species. These predictive models estimate mammalian tissue age with high accuracy (r > 0.96). Age deviations correlate with human mortality risk, mouse somatotropic axis mutations and caloric restriction. We identified specific cytosines with methylation levels that change with age across numerous species. These sites, highly enriched in polycomb repressive complex 2-binding locations, are near genes implicated in mammalian development, cancer, obesity and longevity. Our findings offer new evidence suggesting that aging is evolutionarily conserved and intertwined with developmental processes across all mammals.

Low-Voltage Solution-Processed Zinc-Doped CuI Thin Film Transistors with NOR Logic and Artificial Synaptic Function

Low-voltage Zn-doped CuI thin film transistors (TFTs) gated by chitosan dielectric were fabricated at a low temperature. The Zn-doped CuI TFT exhibited a more superior on/off current ratio than CuI TFT due to the substitution or supplementation of copper vacancies by Zn ions. The Zn-doped CuI films were characterized by scanning electron microscope, X-ray diffraction, and X-ray photoelectron spectroscopy. The Zn-doped CuI TFTs exhibited an on/off current ratio of 1.58 × 104, a subthreshold swing of 70 mV/decade, and a field effect mobility of 0.40 cm2V-1s-1, demonstrating good operational stability. Due to the electric-double-layer (EDL) effect and high specific capacitance (17.3 μF/cm2) of chitosan gate dielectric, Zn-doped CuI TFT operates at a voltage below -2 V. The threshold voltage is -0.2 V. In particular, we have prepared Zn-doped CuI TFTs with two in-plane gates and NOR logic operation is implemented on such TFTs. In addition, using the ion relaxation effect and EDL effect of chitosan film, a simple pain neuron simulation is realized on such a p-type TFTs for the first time through the bottom gate to regulate the carrier transport of the channel. This p-type device has promising applications in low-cost electronic devices, complementary electronic circuit, and biosensors.

Association of edentulism and all-cause mortality in Chinese older adults: do sex differences exist?

OBJECTIVES

Previous studies revealed that tooth loss or edentulism was related to mortality. However, research in developing countries with large numbers of elderly populations is rare, and whether sex differences exist in this relationship is unknown. This study aimed to investigate the association between edentulism and 7-year all-cause mortality among older adults in China and whether sex differences existed.

STUDY DESIGN

This was a prospective cohort study.

METHODS

Data were from 2011 to 2018 waves of the China Health and Retirement Longitudinal Study. A total of 6538 participants aged ≥60 years were included. Logistic models were adopted to estimate the risks of mortality according to edentulism.

RESULTS

The participants with edentulism at baseline were 20% more likely to die over 7 years after controlling for a set of covariates (odds ratio [OR] = 1.20, 95% confidence interval [CI]: 1.02-1.42). Moreover, edentulism was associated with a 35% higher odds of death among male participants (OR = 1.35, 95% CI: 1.08-1.70), whereas a significant association was not found in female participants.

CONCLUSIONS

The findings demonstrated that baseline edentulism predicted all-cause mortality in Chinese older adults, and sex differences existed in this association. This study implied the importance of developing oral health education programs, incorporating dietary recommendations into dental care for edentulous patients, and expanding the coverage of dental services in the health insurance system to prevent edentulism and alleviate its negative outcomes for older adults.

Modulating and optimizing Pluronic F-68 concentrations and feeding for intensified perfusion Chinese hamster ovary cell cultures

Perfusion culture is often performed with micro-sparger to fulfill the high oxygen demand from the densified cells. Protective additive Pluronic F-68 (PF-68) is widely used to mitigate the adverse effect in cell viability from micro-sparging. In this study, different PF-68 retention ratio in alternating tangential filtration (ATF) columns was found to be crucial for cell performance of different perfusion culture modes. The PF-68 in the perfusion medium was found retained inside the bioreactor when exchanged through ATF hollow fibers with a small pore size (50 kD). The accumulated PF-68 could provide sufficient protection for cells under micro-sparging. On the other hand, with large-pore-size (0.2 μm) hollow fibers, PF-68 could pass through the ATF filtration membranes with little retention, and consequently led to compromised cell growth. To overcome the defect, a PF-68 feeding strategy was designed and successfully verified on promoting cell growth with different Chinese hamster ovary (CHO) cell lines. With PF-68 feeding, enhancements were observed in both viable cell densities (20%-30%) and productivity (~30%). A threshold PF-68 concentration of 5 g/L for high-density cell culture (up to 100 × 106  cells/mL) was also proposed and verified. The additional PF-68 feeding was not observed to affect product qualities. By designing the PF-68 concentration of perfusion medium to or higher than the threshold level, a similar cell growth enhancement was also achieved. This study systematically investigated the protecting role of PF-68 in intensified CHO cell cultures, shedding a light on the optimization of perfusion cultures through the control of protective additives.

[The design method of the digital sequential tooth-sectioning guide for the extraction of mandibular impacted third molars]

Objective: To explore a method for digitally designing and fabricating a sequential tooth-sectioning guide that can assist in the extraction of mandibular horizontal impacted third molars, preliminarily evaluate its feasibility and provide a reference for clinical application. Methods: Twenty patients with mandibular low level impacted third molars who visited the Department of General Dentistry, Peking University School and Hospital of Stomatology from March 2021 to January 2022 were selected. Cone-beam CT showed direct contact between the roots and mandibular canal, and full range impressions of the patients' intraoral teeth were taken and optical scans of the dental model were performed. The patients' cone-beam CT data and optical scan data were reconstructed in three dimensions, anatomical structure extraction, registration fusion, and the design of the structure of the guide (including crown-sectioning guide and root-sectioning guide) by Mimics 24.0, Geomagic Wrap 2021, and Magics 21.0 software, and then the titanium guide was three dimension printed, and the guide was tried on the dental model. After confirmation, the guide was used to assist the dentist in the operation. We observed whether the guide was in place, the number of tooth splitting, the matching of tooth splitting with the preoperative design, the operation time, and whether there were any complications. Results: In this study, 20 sectioning guides were successfully printed, all of them were well fitted in the patients' mouth, the average number of section was 3.4 times, the tooth parts was better matched with the preoperative design, and the average operative time of the guides was (29.2±9.8) minutes without complications such as perforation of the bone cortex. Conclusions: The use of sequential sectioning guides to assist in the extraction of mandibular impacted third molars was initially validated to accurately replicate the preoperative sectioning design, and is expected to provide a digital solution to improve surgical precision and ensure safety. Further studies with larger sample sizes are needed to evaluate its accuracy and safety.

[Mechanisms mediating the inhibitory effects of quercetin against phthalates-induced testicular oxidative damage in rats]

OBJECTIVE

To explore the mechanism underlying the inhibitory effect of quercetin against testicular oxidative damage induced by a mixture of 3 commonly used phthalates (MPEs) in rats.

METHODS

Forty male Sprague-Dawley rats were randomly divided into control group, MPEs exposure group, and MPEs with low-, median- and high-dose quercetin treatment groups. For MPEs exposure, the rats were subjected to intragastric administration of MPEs at the daily dose of 900 mg/kg for 30 consecutive days; Quercetin treatments were administered in the same manner at the daily dose of 10, 30, and 90 mg/kg. After the treatments, serum levels of testosterone, luteinizing hormone (LH), follicle stimulating hormone (FSH), and testicular malondialdeyhde (MDA), catalase (CAT) and superoxide dismutase (SOD) were detected, and testicular pathologies of the rats were observed with HE staining. The expressions of nuclear factor-E2-related factor 2 (Nrf2), Kelch-like ECH2 associated protein 1 (Keap1) and heme oxygenase 1 (HO-1) in the testis were detected using immunofluorescence assay and Western blotting.

RESULTS

Compared with the control group, the rats with MPEs exposure showed significant reductions of the anogenital distance, weight of the testis and epididymis, and the coefficients of the testis and epididymis with lowered serum testosterone, LH and FSH levels (P < 0.05). Testicular histological examination revealed atrophy of the seminiferous tubules, spermatogenic arrest, and hyperplasia of the Leydig cells in MPEs-exposed rats. MPEs exposure also caused significant increments of testicular Nrf2, MDA, SOD, CAT and HO-1 expressions and lowered testicular Keap1 expression (P < 0.05). Treatment with quercetin at the median and high doses significantly ameliorated the pathological changes induced by MPEs exposure (P < 0.05).

CONCLUSION

Quercetin treatment inhibits MPEs-induced oxidative testicular damage in rats possibly by direct scavenging of free radicals to lower testicular oxidative stress and restore the regulation of the Nrf2 signaling pathway.

Correlation between the Protein Pharmaceutical Surface Activity and Interfacial Stability

The interaction of protein drugs with the air-liquid interface plays a crucial role in the overall stability in aqueous formulations, particularly when the adsorbed proteins are subjected to the surface flow. Nonionic surfactants are usually added into the formulation solutions to address this issue. A diversity of studies have been focused on the usage of surfactants, the stability mechanism of surfactants, or seeking new pharmaceutical surfactants. However, the real protagonist, the basic properties of protein drugs, was neglected, which may play a vital role in the stability of protein drugs. Herein, we aim to clarify the correlation between the surface behavior of proteins and the interfacial stability. A force tensiometer is used to track the surface tension reduction and the competition between surfactants and proteins at the surface. We find that the surface behaviors of proteins vary with storage temperature and protein types including monoclonal antibodies (mAb), bispecific monoclonal antibodies (BsAb), and antibody-drug conjugates (ADCs). Especially for the protein stored at 5 °C, the surface activity of proteins is better than that of surfactants. It indicates that the ability of proteins to adsorb at the interface should not be ignored compared to surfactants. The significant difference in the interfacial stability of protein pharmaceuticals formulated in the same buffer and excipients as well as the surfactants with the same concentration further confirms the interfacial adsorption capacity of proteins that should not be ignored. These findings provide a new angle and valuable insights into the correlation between the surface activity of the proteins and interfacial stability, which may pave the way for future preformulation studies on therapeutic proteins and broaden the thoughts of formulation development.

Acetate accumulation and regulation by process parameters control in Chinese hamster ovary cell culture

Chinese hamster ovary (CHO) cells represent a group of predominantly used mammalian hosts for producing recombinant therapeutic proteins. Known for their rapid proliferation rates, CHO cells undergo aerobic glycolysis that is characterized by fast glucose consumption, that ultimately gives rise to a group of small-molecule organic acids. However, only the function of lactate has been extensively studied in CHO cell culture. In this study, we observed the accumulation of acetate from the late exponential phase to harvest day, potentially contributing to the pH decline in late culture stage regardless of lactate consumption. In addition, we evaluated the acidification of the fresh media and the cell culture suspension, and the data revealed that acetate presented a lower acidification capacity compared to lactate and exhibited limited inhibitory effect on cells with less than 20 mM supplemented in the media. This study also explored the ways to control acetate accumulation in CHO cell culture by manipulating the process parameters such as temperature, glucose, and pH control. The positive correlation between the specific glucose consumption rate and acetate generation rate provides evidence of the endogenous acetate generation from overflow metabolism. Reducing these parameters (temperature, glucose consumption) and HCl-controlled low pH ultimately suppress acetate build-up. In addition, the specific acetate generation rate and relevant glucose consumption rate are found to be a metabolic trait associated with specific cell lines. Taken together, the results presented in these experiments provide a means to advance industrial CHO cell culture process control and development.

Interactive Effects of Dietary Inflammatory Index with BMI for the Risk of Stroke among Adults in the United States: Insight from NHANES 2011-2018

BACKGROUND AND AIM

Research on the correlation between Dietary Inflammation Index (DII) and stroke is limited. Patients with high body mass index (BMI), as a high-risk group for stroke, require attention. Therefore, we aimed to examine the interactive effects of dietary inflammation and BMI on the risk of stroke among adults in the United States.

METHODS AND RESULTS

Overall, 9,384 participants were included in this study. The exposure variable was the DII, which was calculated based on the overall inflammatory effect score, and the outcome was stroke. Overall, there was a positive relationship between DII (as a continuous variable) and stroke. Increased level of DII was significantly associated with increased risk of stroke (odds ratio [OR]: 1.21, 95% CI: 1.06-1.38), which was enhanced by higher BMI (OR: 1.35, 95% CI: 1.15-1.58) with significant additive interactions. There was a significant secondary interaction of copresence of BMI ≥25 kg/m2, systolic blood pressure (SBP) ≥140 mmHg, and high DII for increased stroke, with a further increase in OR to 1.41 (1.19-1.67).

CONCLUSIONS

This cross-sectional study shows that the relationship between higher DII levels and the significant increase in stroke prevalence was further amplified in patients with SBP ≥140 mmHg and higher BMI.

Global Prevalence and Factors Associated with Frailty among Community-Dwelling Older Adults with Hypertension: A Systematic Review and Meta-Analysis

BACKGROUND

Frailty may increase the risk of adverse outcomes and the presence of comorbidities in hypertension. Understanding the prevalence of frailty in older adults with hypertension is of great importance, whereas estimates of the prevalence of frailty in this population vary greatly.

OBJECTIVES

A systematic review and meta-analysis was conducted to estimate the pooled prevalence of frailty and prefrailty among community-dwelling older adults with hypertension, and to examine the risk factors associated with (pre)frailty in this population.

METHODS

PubMed, Web of Science, The Cochrane Library, EMBASE, and CINAHL were searched from the inception to May 10, 2023. Investigators assessed eligibility, extracted data, and evaluated methodological quality. The pooled prevalence of frailty and prefrailty was calculated using the random-effects model. Meta-regression analysis and subgroup analysis were conducted to explore sources of heterogeneity. Sensitivity analysis was undertaken by the leave-one-out method and by removing studies with moderate/high risk of bias. The Mantel-Haenszel or inverse variance method was used to estimate risk factors of frailty.

RESULTS

A total of 14 studies met the inclusion criteria, involving 185,249 participants. The pooled prevalence in older adults with hypertension was 23% (95% CI 0.09-0.36) for frailty and 46% (95% CI 0.38-0.54) for prefrailty. The pooled prevalence of frailty was greater in studies with a higher proportion of females (24%, 95% CI 0.05-0.50), using multidimensional tools to define frailty (30%, 95% CI 0.10-0.51) and conducted in Western Pacific (27%, 95% CI 0.17-0.39). Age, female sex, depression, and previous hospitalizations were risk factors of frailty among older adults with hypertension.

CONCLUSION

Frailty and prefrailty are prevalent in community-dwelling older adults with hypertension, and limited risk factors are identified. This implicates the importance of frailty assessment integrated into the routine primary care for older adults with hypertension in community settings as well as the understanding of potential factors.

Mono- and biallelic variant effects on disease at biobank scale

Identifying causal factors for Mendelian and common diseases is an ongoing challenge in medical genetics¹. Population bottleneck events, such as those that occurred in the history of the Finnish population, enrich some homozygous variants to higher frequencies, which facilitates the identification of variants that cause diseases with recessive inheritance^2,3. Here we examine the homozygous and heterozygous effects of 44,370 coding variants on 2,444 disease phenotypes using data from the nationwide electronic health records of 176,899 Finnish individuals. We find associations for homozygous genotypes across a broad spectrum of phenotypes, including known associations with retinal dystrophy and novel associations with adult-onset cataract and female infertility. Of the recessive disease associations that we identify, 13 out of 20 would have been missed by the additive model that is typically used in genome-wide association studies. We use these results to find many known Mendelian variants whose inheritance cannot be adequately described by a conventional definition of dominant or recessive. In particular, we find variants that are known to cause diseases with recessive inheritance with significant heterozygous phenotypic effects. Similarly, we find presumed benign variants with disease effects. Our results show how biobanks, particularly in founder populations, can broaden our understanding of complex dosage effects of Mendelian variants on disease.

Rapidly accelerated development of neutralizing COVID-19 antibodies by reducing cell line and CMC development timelines

Since the Coronavirus Disease 2019 (COVID-19) outbreak, unconventional cell line development (CLD) strategies have been taken to enable development of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-neutralizing antibodies at expedited speed. We previously reported a novel chemistry, manufacturing, and control (CMC) workflow and demonstrated a much-shortened timeline of 3-6 months from DNA to investigational new drug (IND) application. Hereafter, we have incorporated this CMC strategy for many SARS-CoV-2-neutralizing antibody programs at WuXi Biologics. In this paper, we summarize the accelerated development of a total of seven antibody programs, some of which have received emergency use authorization  approval in less than 2 years. Stable pools generated under good manufacturing practice (GMP) conditions consistently exhibited similar productivity and product quality at different scales and batches, enabling rapid initiation of phase I clinical trials. Clones with comparable product quality as parental pools were subsequently screened and selected for late-stage development and manufacturing. Moreover, a preliminary stability study plan was devised to greatly reduce the time required for final clone determination and next-generation sequencing-based viral testing was implemented to support rapid conditional release of the master cell bank for GMP production. The successful execution of these COVID-19 programs relies on our robust, fit for purpose, and continuously improving CLD platform. The speed achieved for pandemic-related biologics development may innovate typical biologics development timelines and become a new standard in the industry.

Competition of Photo-Excitation and Photo-Desorption Induced Positive and Negative Photoconductivity Switch in Te Nanowires

The photocurrent in tellurium nanowire (Te NW) exhibits a subtle influence by many extrinsic factors. Herein, we fabricate Te NW devices and explore their photoresponse properties in detail. It is observed that the current increases greatly at low environmental relative humidity (RH) under light illumination, demonstrating an evident positive photoconductivity (PPC). However, the photocurrent reduces at high RH, yielding a typical negative photoconductivity (NPC). In addition, when exposed to a proper relative humidity, Te NW devices show PPC immediately and then transfer to NPC gradually under illumination, exhibiting the RH sensitive PPC/NPC switch. It is proposed that the competition between photo-excitation and photo-desorption is responsible for this subtle switch of PPC/NPC. On the one hand, the adsorbed water molecules on the surface of Te nanowires, acting as electron acceptors, lead to an increase of conductance, exhibiting the PPC phenomenon. On the other hand, the photo-desorption of water molecules from the surface results in a decreased carrier concentration in the Te nanowires, yielding the NPC phenomenon. The in-depth understanding of such charge transfer processes between the absorbed water molecules and Te nanowires provides an effective route to modulate the carrier densities and control the PPC/NPC switch, which will accelerate the design and application of novel optoelectronic nanodevices.

Ferroelectric-gated MoSe2photodetectors with high photoresponsivity

Ferroelectric transistors with semiconductors as the channel material and ferroelectrics as the gate insulator have potential applications in nanoelectronics. We report in-situ modulation of optoelectronic properties of MoSe₂thin flakes on ferroelectric 0.7PbMg_1/3Nb_2/3O₃-0.3PbTiO₃(PMN-PT). Under the excitation of 638 nm laser, the photoresponsivity can be greatly boosted to 59.8 A W^-1and the detectivity to 3.2 × 10¹⁰Jones, with the improvement rates of about 1500% and 450%, respectively. These results suggest hybrid structure photodetector of two-dimensional layered material and ferroelectric has great application prospects in photoelectric detector.

Application of machine learning to identify top determinants of fibrofatty plaque burden by CCTA in humans with psoriasis

Introduction

Fibrofatty plaque burden (FFB) is a high-risk, vulnerable plaque feature comprised of an atheromatous core and fibrous cap with increased risk of coronary artery disease (CAD) [1]. Psoriasis (PSO) is a chronic inflammatory disease linked with atherosclerotic risk and premature cardiovascular disease, driven in part by vulnerable plaque rupture [2,3]. Machine learning (ML) previously showed the prognostic value of FFB in predicting 5-year risk of cardiac-related mortality in patients with CAD [4]. Whether ML can predict FFB in psoriasis is understudied.

Purpose

To use ML to identify top determinants of FFB by CCTA in PSO.

Methods

320 consecutive participants with psoriasis were recruited as part of an ongoing cohort study, of whom 307 had FFB analyzed with coronary computed tomography angiography (CCTA) and quantified by QAngio CT (Medis, The Netherlands). 140 out of 182 potential determinants were subjected to ML algorithms analyzed by random forest and validated by 5-fold cross validation to select the top determinants based on R-square criteria. Lipid concentration and size were measured by nuclear magnetic resonance (NMR) and sdLDL-C was calculated by Sampson's formula.

Results

The top 21 determinants of FFB at baseline were grouped into 3 categories: cardiometabolic risk factors (BMI, sex, DBP, mean arterial pressure, exercise, heart rate, glucose, anxiety, psoriasis disease duration), clinical measurements (basophils, platelets, hemoglobin, RBC, alkaline phosphatase, ALT, creatinine, neutrophil-to-lymphocyte ratio), and lipoproteins (LDL particle size, apolipoprotein A1, apolipoprotein B-to-A1 ratio, calculated sdLDL-C).

Conclusion

ML confirmed that FFB strongly correlates with cardiometabolic risk factors, clinical measurements, and lipoproteins. Further investigations into these top determinants of FFB over time may provide insight into potential therapeutic interventions that decrease cardiovascular risk in patients with chronic inflammatory diseases and should be validated in larger studies.

Funding Acknowledgement

Type of funding sources: Public Institution(s). Main funding source(s): This study was supported by the National Heart, Lung and Blood Institute (NHLBI) IntramuralResearch Program (ZIA-HL-06193). This research was made possible through the NIH MedicalResearch Scholars Program, a public-private partnership supported jointly by the NIH andcontributions to the Foundation for the NIH from the Doris Duke Charitable Foundation,Genentech, the American Association for Dental Research, the Colgate-Palmolive Company, andother private donors.

Effect of a home-based resistance exercise program in elderly participants with osteoporosis: a randomized controlled trial

The effectiveness of home-based resistance exercise in elder participants with osteoporosis remains unclear. This study demonstrates the beneficial effects of this mode of exercise on improving physical function, increasing confidence in exercise, and reducing fear of falling.

INTRODUCTION

This study aims to evaluate the effect of a home-based resistance exercise (HBRE) program versus control on physical function, exercise self-efficacy, falling efficacy, and health-related quality of life (HRQOL).

METHODS

This randomized controlled trial included 72 elderly participants with osteoporosis. Participants in the intervention group received a 12-week HBRE program, and the control group received usual care. The primary outcome was physical function, including muscle strength and balance ability; secondary outcomes were exercise self-efficacy, falling efficacy, and HRQOL. Within-group and between-group changes in outcome were evaluated by t-test and rank-sum test.

RESULTS

A total of 68 subjects were included in the final analysis. Improvement in physical function was significantly greater in the HBRE group compared with controls. On a psychological level, exercise self-efficacy and falling efficacy improved significantly in the HBRE group; no significant change was observed in the control group. Most of the dimensions of HRQOL demonstrated improvements as well. The adherence was 85.29%, with no adverse events related to the exercise.

CONCLUSION

A 12-week HBRE program was safe non-pharmacological therapy for elderly participants with osteoporosis, improving physical function, exercise self-efficacy, reduced fear of falling, and improved HRQOL.

TRIAL REGISTRATION

Chinese Clinical Trial Register: ChiCTR2100051455. Registered 23.09.21. Retrospectively registered.

[Preconception reproductive health and birth outcome cohort in Chongqing: the cohort profile]

Birth cohort is an important platform to study the effect of early-life exposure on health outcome, but large cohorts to investigate the effect of preconception exposure, especially paternal exposure, on reproductive health and birth outcome are limited. The Preconception Reproductive Health and Birth Outcome Cohort (PREBIC) is a prospective birth cohort study which pays equal attention to the contribution of environmental, psychological, behavioral as well as other factors to reproductive health and adverse birth outcomes in both men and women in Chongqing, China. PREBIC started in 2019 and plans to recruit 20 800 reproductive-age couples with child-bearing willingness. Followed up was conducted to understand the conception status of the women within two years. Women in pregnancy would be visited at first, second, third trimesters and after delivery. The offspring would be monitored until 2 years old to understand the incidences of preterm birth, low birth weight, birth defects, neurodevelopmental disorders and other outcomes. Related information and biospecimen collections (including semen, peripheral blood, urine, placenta, umbilical cord, cord blood and oral swab) were scheduled in each period. By January 2022, PREBIC had recruited 8 698 participants from all 38 districts in Chongqing. The goal of PREBIC is to establish one of the largest prospective preconception birth cohorts covering both men and women, which might provide a unique insight to understand the effects of the full reproductive cycle on reproductive health and adverse outcomes, with especial emphasis on preconception exposures.

Approaching intrinsic dynamics of MXenes hybrid hydrogel for 3D printed multimodal intelligent devices with ultrahigh superelasticity and temperature sensitivity

Hydrogels are investigated broadly in flexible sensors which have been applied into wearable electronics. However, further application of hydrogels is restricted by the ambiguity of the sensing mechanisms, and the multi-functionalization of flexible sensing systems based on hydrogels in terms of cost, difficulty in integration, and device fabrication remains a challenge, obstructing the specific application scenarios. Herein, cost-effective, structure-specialized and scenario-applicable 3D printing of direct ink writing (DIW) technology fabricated two-dimensional (2D) transition metal carbides (MXenes) bonded hydrogel sensor with excellent strain and temperature sensing performance is developed. Gauge factor (GF) of 5.7 (0 − 191% strain) and high temperature sensitivity (−5.27% °C⁻¹) within wide working range (0 − 80 °C) can be achieved. In particular, the corresponding mechanisms are clarified based on finite element analysis and the first use of in situ temperature-dependent Raman technology for hydrogels, and the printed sensor can realize precise temperature indication of shape memory solar array hinge.

Cost effective device fabrication of powerful hydrogel sensors remains challenging. Here, the authors propose a cost-effective and structure-specialized direct ink writing technique for the fabrication of two-dimensional MXene bonded hydrogel sensors with excellent strain and temperature sensing performance.

[Cone-beam CT analysis of external root resorption of maxillary incisors before and after traction of impacted canines]

Objective: To analyze the external root resorption of incisors caused by maxillary canine impaction, and to explore the changes of incisor external root resorption after orthodontic treatment. Methods: Twenty-four patients with impacted maxillary canines leading to external root resorption of incisors treated in Department of Orthodontics, Affiliated Hospital of Stomatology, Nanjing Medical University from July 2011 to January 2019 were selected. The age ranged from 10 to 14 years [(12.3±1.6) years], including 11 males and 14 females. The maxillary incisors with external root resorption before treatment were included in the resorption group (21 central incisors and 22 lateral incisors), and the maxillary incisors without external root resorption were used as the control group (26 central incisors and 21 lateral incisors). Cone-beam CT was taken before treatment, immediately after treatment and one year after treatment. At the one year follow-up 15 patients were collected (10 central incisors and 12 lateral incisors in the resorption group, while 16 central incisors and 12 lateral incisors in the control group). The root length and tooth volume of maxillary incisors were measured and analyzed before canine traction, after canine traction finished and at the one year follow-up. Results: After the treatment of maxillary impacted canines, the root length and volume of the central and lateral incisors in both resorption group and control group were significantly less than that before treatment (P<0.05). At the one year follow-up, the root length and volume of the incisors (central incisors in the resorption group and the central and lateral incisors in control group) were significantly less than those immediately after impacted canine traction (P<0.05). During the canine traction, the difference of the volume change in lateral incisors between the resorption group [(17±6) mm³] and the control group [(12±5) mm³] was statistically significant (t=2.51, P<0.05). During the one year follow-up period, the difference between the changes of the root length in maxillary central incisors in the resorption group [(0.5±0.4) mm] and in the control group [(0.2±0.1) mm] was statistically significant (t=2.35, P<0.05). Conclusions: For maxillary incisors with external root resorption caused by impacted maxillary canines, the external root resorption could not stop immediately after the treatment of impacted canines. The root resorption in maxillary lateral incisors mainly occured during the traction process, while the root resorption in maxillary central incisors existed during the orthodontic treatment and in the follow-up period.

Cardiopulmonary transit time: A novel PET imaging biomarker of in vivo physiology for risk stratification of heart transplant recipients

BACKGROUND

Myocardial blood flow (MBF) can be quantified using dynamic PET studies. These studies also inherently contain tomographic images of early bolus displacement, which can provide cardiopulmonary transit times (CPTT) as measure of cardiopulmonary physiology. The aim of this study was to assess the incremental prognostic value of CPTT in heart transplant (OHT) recipients.

METHODS

94 patients (age 56 ± 16 years, 78% male) undergoing dynamic 13N-ammonia stress/rest studies were included, of which 68 underwent right-heart catherization. A recently validated cardiac allograft vasculopathy (CAV) score based on PET measures of regional perfusion, peak MBF and left-ventricular (LV) ejection fraction (LVEF) was used to identify patients with no, mild or moderate-severe CAV. Time-activity curves of the LV and right ventricular (RV) cavities were obtained and used to calculate the difference between the LV and RV bolus midpoint times, which represents the CPTT and is expressed in heartbeats. Patients were followed for a median of 2.5 years for the occurrence of major adverse cardiac events (MACE), including cardiovascular death, hospitalization for heart failure or acute coronary syndrome, or re-transplantation.

RESULTS

CPTT was significantly correlated with cardiac filling pressures (r = .434, P = .0002 and r = .439, P = .0002 for right atrial and pulmonary wedge pressure), cardiac output (r = - .315, P = .01) and LVEF (r = - .513, P < .0001). CPTT was prolonged in patients with MACE (19.4 ± 6.0 vs 14.5 ± 3.0 heartbeats, P < .001, N = 15) with CPTT ≥ 17.75 beats showing optimal discriminatory value in ROC analysis. CPTT ≥ 17.75 heartbeats was associated with a 10.1-fold increased risk (P < .001) of MACE and a 7.3-fold increased risk (P < .001) after adjusting for PET-CAV, age, sex and time since transplant.

CONCLUSION

Measurements of cardiopulmonary transit time provide incremental risk stratification in OHT recipients and enhance the value of multiparametric dynamic PET imaging, particularly in identifying high-risk patients.