Patient-specific 3D-printed Brace for Adolescent Idiopathic Scoliosis: A Prospective Cohort Study

OBJECTIVE

To evaluate the efficacy, safety of patient-tailored 3D printed brace in the treatment of adolescent idiopathic scoliosis (AIS), and to compare the health-related quality of life (HRQoL) of patients treated with two different types of brace.

MATERIALS AND METHODS

From September 2017 to August 2020, 103 AIS patients requiring non-operative management were prospectively recruited in this study. All patients were followed up every 6 months, clinical and radiological examination were assessed at each follow-up time. Full-length anteroposterior X-ray of the spine in the standing position was performed obtained. At the last follow-up, each patient completed a standardized HRQoL questionnaire. Compliance is defined as that the patient insists on wearing the brace for ≥ 23h every day (full-time wearing) and follow-up every 6 months until bone maturity.The rate of major curve Cobb progression was defined that maximum Cobb Angle of major curve greater than 6° compared with that at the initial diagnosis, or aggravated to more than 45° so that orthopedic surgery was recommended during treatment, which was defined as the rate of conversion to surgery. The effects of these two types of braces on the rate of major curve Cobb progression and HRQoL were analyzed by independent sample t-test ad Chi-square test.

RESULTS

The thickness was 4 mm for thoracolumbosacral orthosis (TLSO) and 3 mm for 3D-printed brace (3DPB). In addition, compared with the material used in TLSO, the weight (600-800 grams) of the 3DPB materials with the same area is reduced by about 25-30%. 55 patients (49.1%) and 48 patients (33.1%) were respectively included in the 3DPB cohort and the TLSO cohort.The maximum Cobb angle of major curve in the 3DPB cohort was significantly lower than those in the TLSO cohort at 6 months, 12 months and the last follow-up (p < 0.01). The thoracic kyphosis (TK) and lumbar lordosis (LL) of the two cohorts at the last follow-up were lower than those before brace treatment, in addition, there was a significant difference in TK (p = 0.001) and LL (p = 0.004) between the two cohorts at the follow-up. The scores of physical function, pain, self-image, mental health and treatment satisfaction in the Chinese version of SRS-22 in the 3DPB cohort were higher than those in the TLSO cohort (p < 0.01 and p < 0.05, respectively). The scores of the 3DPB cohort were significantly higher than those of the TLSO group in the four dimensions (p = 0.008, 0.013, 0.015, and 0.002, respectively) of the EuroQol-5D health description system except for mobility, and the overall health status of EuroQol-5D was higher for the 3DPB cohort (p < 0.001). At the last follow-up, One patient in the 3DPB cohort and ten patients in the TLSO cohort had major curve Cobb progression of greater than 6°, and the rate of major curve Cobb progression in 3DPB cohort was significantly lower than that in the TLSO cohort (OR 14.2, 95% CI 1.7∼115.8, p < 0.01). One patient in the 3DPB and seven patients in the TLSO cohorts received subsequent surgery or was recommended for surgery, and the rate of conversion to surgery was significantly lower than in the 3DPB cohort (OR 9.2, 95% CI 1.1∼77.9, p < 0.05).

CONCLUSIONS

Patient-tailored 3D-printed brace is lighter, thinner, and more comfortable than conventional braces in the treatment of AIS. It can substantially improve the HRQoL of patients and can significantly reduce the progression of major curve Cobb progression and rate of conversion of surgery.

Impacts of snow cover seasonality on spring land surface phenology of forests in Changbai mountains of Northeast China

Snow cover phenology (SCP) strongly affects forest spring phenology (the start of growing season, SOS), but the underlying mechanism of the relationship varies. In this study, we aimed to analyze the relationship between forest SOS and SCP, and investigate the mechanisms about how changes of SCP affect forest SOS. To do so, we extracted forest SOS and SCP from multiple remote sensing datasets and analyzed the spatio-temporal patterns of both in Changbai Mountains (2001-2020). We assessed the relationships between SCP and forest SOS using partial least squares regression analysis and investigated the potential mechanism of SCP changes affecting on forest SOS using path analysis. We found earlier forest SOS (-0.5 days/year), prolonged snow cover duration (SCD, 0.43 day/year), and earlier snow cover end day (SCED, -0.1 days/year) in the region. The results indicated that SCD showed negative influence while SCED showed positive influence on forest SOS in most of the region. Results revealed that the influence of SCP on forest SOS was mainly through altering spring temperature and the dominant path of SCP influencing forest SOS followed hydrothermal gradients. Our study reveals new insights into the influence of changing SCP on forest SOS, which provides the theoretical basis for including SCP in the phenological models.

Mild liver dysfunction in Klinefelter syndrome is associated with abdominal obesity and elevated lipids but not testosterone treatment

CONTEXT

Klinefelter syndrome (KS) is associated with hypergonadotropic hypogonadism, which contributes to characteristic phenotypical manifestations including metabolic alterations. Extensive research has demonstrated important associations between androgens and liver function.

OBJECTIVES

Investigation of the association between metabolic parameters, sex hormones and liver function in males with KS, both treated (T-KS) and untreated (U-KS) and healthy control males.

METHODS

A total of 65 KS males were recruited, of which 32 received testosterone replacement therapy (TRT). Also, 69 healthy controls were recruited. We used alanine aminotransferase (ALAT), alkaline phosphatase and PP (prothrombin-proconvertin time ratio) as the main liver markers. Multivariable regression was performed within the three groups. All statistics were calculated using STATA. Principal component analysis was utilized to demonstrate the interconnected patterns among all measured biomarkers, and to elucidate how the different groups were linked to these patterns.

RESULTS

Higher levels of main liver markers were observed in U-KS compared to controls, with no significant differences between U-KS and T-KS. T-KS had lower abdominal fat, total cholesterol, and LDL cholesterol than U-KS. Using multivariable models, variation in ALAT in U-KS was explained by HOMA2%S; in T-KS by BMI and SHBG; and in controls by hip circumference and estradiol. We found no multivariable models explaining variation in PP in U-KS; in T-KS, PP was explained by BMI and LDL cholesterol, and in controls by total cholesterol. Using principal component analysis U-KS was positively associated to D1 (an obese profile, which also included ALAT) and controls negatively associated with D1 (non-obese profile).

CONCLUSION

KS males have mild liver dysfunction reflected by a significant increase in the main liver markers and decrease in albumin. The presented data underscore a primary role of metabolic conditions including obesity, insulin resistance and unfavourable lipid profile, in the elevated liver function markers seen in males with KS. Whether TRT can improve liver function in KS warrants further studies. Our findings, highlight that an evaluation of the liver function should be part of the clinical care in males with KS.

Construction of TiO2/WO3/TiO2 double heterojunction films for excellent electrochromic performance

Electrochromic devices are applied extensively to camouflages, smart windows, heat insulation layers, and automobile rearview mirrors, etc. The amorphous WO3 is a very attractive electrochromic material, whereas it suffers from degradation of optical modulation and reversibility on ion exchange owing to those deep trapped ions with irreversible reaction behavior. Herein, we designed and, by using magnetron sputtering, prepared a composite film with TiO2/WO3/TiO2 double heterojunctions, which is capable of eliminating the deep trapped ions by itself under ultraviolet light (UV) assistance. The electrochromic device based on this composite film, after being recovery by short-time UV irradiation, can maintain a high transmission modulation of 94.72% after 7000 cycles of the voltammetry measurement. This feature allows the device to maintain its initial electrochromic performance after prolonged use. Moreover, the double heterojunction structure can reduce colouring time and enormously improve the colouration efficiency (CE) of electrochromic devices. Experimental research shows that when the thickness of the bottom and upper TiO2 layer of the WO3 film was 145.5 nm and 97.0 nm, respectively, the CE of electrochromic devices reached a perfectly high value (479.3 cm2/C), being much higher than that of WO3 devices (69.5 cm2/C). Functions of the TiO2/WO3/TiO2 double heterojunction in electrochromic device were investigated by combining theoretical analysis and experiment validation, and these results provide a general framework for developing and designing superior electrochromic materials and devices.

The mental health of Australians bereaved during the first two years of the COVID-19 pandemic: a latent class analysis

BACKGROUND

The COVID-19 pandemic disrupted many areas of life, including culturally accepted practices at end-of-life care, funeral rites, and access to social, community, and professional support. This survey investigated the mental health outcomes of Australians bereaved during this time to determine how these factors might have impacted bereavement outcomes.

METHODS

An online survey indexing pandemic and bereavement experiences, levels of grief, depression, anxiety, and health, work, and social impairment. Latent class analysis (LCA) was used to identify groups of individuals who shared similar symptom patterns. Multinomial regressions identified pandemic-related, loss-related, and sociodemographic correlates of class membership.

RESULTS

1911 Australian adults completed the survey. The LCA identified four classes: low symptoms (46.8%), grief (17.3%), depression/anxiety (17.7%), and grief/depression/anxiety (18.2%). The latter group reported the highest levels of health, work, and social impairment. The death of a child or partner and an inability to care for the deceased due to COVID-19 public health measures were correlated with grief symptoms (with or without depression and anxiety). Preparedness for the person's death and levels of pandemic-related loneliness and social isolation differentiated all four classes. Unemployment was associated with depression/anxiety (with or without grief).

CONCLUSIONS

COVID-19 had profound impacts for the way we lived and died, with effects that are likely to ricochet through society into the foreseeable future. These lessons learned must inform policymakers and healthcare professionals to improve bereavement care and ensure preparedness during and following future predicted pandemics to prevent negative impacts.

Role of lens in early refractive development: evidence from a large cohort of Chinese children

AIMS

To document longitudinal changes in spherical equivalent refraction (SER) and related biometric factors during early refractive development.

METHODS

This was a prospective cohort study of Chinese children, starting in 2018 with annual follow-ups. At each visit, children received cycloplegic autorefraction and ocular biometry measurements. Lens power (LP) was calculated using Bennett's formula. Children were divided into eight groups based on baseline age: the 3-year-old (n=426, 49.77% girls), 4-year-old (n=834, 47.36% girls), 6-year-old (n=292, 46.58% girls), 7-year-old (n=964, 43.46% girls), 9-year-old (n=981, 46.18% girls), 10-year-old (n=1181, 46.32% girls), 12-year-old (n=504, 49.01%) and 13-year-old (n=644, 42.70%) age groups.

RESULTS

This study included right-eye data from 5826 children. The 3-year-old and 4-year-old age groups demonstrated an inflection point in longitudinal SER changes at a mild hyperopic baseline SER (+1 to +2 D), with children with more myopic SER showing hyperopic refractive shifts while those with more hyperopic SER showing myopic shifts. The hyperopic shift in SER was mainly attributed to rapid LP loss and was rarely seen in the older age groups. Axial elongation accelerated in the premyopia stage, accompanied by a partially counter-balancing acceleration of LP loss. For children aged 3-7 years, those with annual SER changes <0.25 D were all mildly hyperopic at baseline (mean: 1.23 D, 95% CI 1.20 to 1.27 D).

CONCLUSION

Our findings suggest that during early refractive development, refractions cluster around or above +1.00 D. There is a pushback process in which increases in the rate of LP occur in parallel with increases in axial elongation.

Unconscious face processing shows a different lateralisation pattern

Faces contain rich information and play a pivotal role in human daily social interactions. Previous studies have provided evidence for the left-visual-field-advantage in face perception. The current study investigated lateralisation when face stimuli were unconsciously presented using interocular suppression methods. The results showed that when an unconscious face stimulus was presented in one side of the visual field without other face stimuli, the unconscious face in the right visual field could break through interocular suppression faster than that in the left (Experiments 1 and 2). However, this right visual field processing advantage reversed to the left when a face stimulus either with (Experiment 2) or without (Experiment 3) visual awareness was presented concurrently with or prior to (Experiment 4) the unconscious face stimuli. These results showed that the unconscious face might have a different processing pattern compared with the conscious face. The relationship between this novel behavioural observation and known functional lateralisation of the fusiform face areas is discussed, suggesting a dynamic interaction between the two cortical hemispheres may underlie the formation of visual awareness for faces. The current study expands our understanding of face processing lateralisation and provided evidence on the asymmetric inter-hemisphere interaction patterns in forming visual awareness.

Pulse Accumulation Approach Based on Signal Phase Estimation for Doppler Wind Lidar

Coherent Doppler wind lidar (CDWL) uses transmitted laser pulses to measure wind velocity distribution. However, the echo signal of CDWL is easily affected by atmospheric turbulence, which can decrease the signal-to-noise ratio (SNR) of lidar. To improve the SNR, this paper proposes a pulse accumulation method based on the cross-correlation function to estimate the phase of the signal. Compared with incoherent pulse accumulation, the proposed method significantly enhances the correlation between signals from different periods to obtain high SNR gains that arise from pulse accumulation. Using simulation, the study evaluates the effectiveness of this phase estimation method and its robustness against noise in algorithms which analyze Doppler frequency shifts. Furthermore, a CDWL is developed for measuring the speed of an indoor motor turntable and the outdoor atmospheric wind field. The phase estimation method yielded SNR gains of 28.18 dB and 32.03 dB for accumulation numbers of 500 and 1500, respectively. The implementation of this method in motor turntable speed measurements demonstrated a significant reduction in speed error-averaging 9.18% lower than that of incoherent accumulation lidar systems. In experiments that measure atmospheric wind fields, the linear fit curve slope between the measured wind speed and the wind speed measured via a commercial wind-measuring lidar can be reduced from 1.146 to 1.093.

A nomogram for predicting left atrial thrombus or spontaneous echo contrast in non-valvular atrial fibrillation patients using hemodynamic parameters from transthoracic echocardiography

Background

Atrial fibrillation (AF) is the most common cardiac arrhythmia and is associated with a high risk of stroke. This study was designed to investigate the relationship between hemodynamic parameters and left atrial thrombus/spontaneous echo contrast (LAT/SEC) in non-valvular atrial fibrillation (NVAF) patients and establish a predictive nomogram that integrates hemodynamic parameters with clinical predictors to predict the risk of LAT/SEC.

Methods

From January 2019 to September 2022, a total of 354 consecutive patients with NVAF were enrolled in this cross-sectional study at the First Affiliated Hospital of Guangxi Medical University. To identify the optimal predictive features, we employed least absolute shrinkage and selection operator (LASSO) regression. A multivariate logistic regression model was subsequently constructed, and the results were visualized with a nomogram. We evaluated the model's performance using discrimination, calibration, and the concordance index (C-index).

Results

We observed a 38.7% incidence of SEC/TH in NVAF patients. Independent influencing factors of LAT/SEC were identified through LASSO and multivariate logistic regression. Finally, four indicators were included, namely, previous stroke/transient ischaemic attack (OR = 4.25, 95% CI = 1.57-12.23, P = 0.006), left atrial volume index (LAVI) (OR = 1.04, 95% CI = 1.01-1.06, P = 0.001), S/D ratio (OR = 0.27, 95% CI = 0.11-0.59, P = 0.002), and left atrial acceleration factor (OR = 4.95, 95% CI = 2.05-12.79, P = 0.001). The nomogram, which incorporated these four influencing factors, demonstrated excellent predictive ability. The training set had a C-index of 0.878, while the validation set had a C-index of 0.872. Additionally, the calibration curve demonstrated great consistency between the predicted probabilities and the observed outcomes, and the decision curve analysis confirmed the important clinical advantage of the model for patients with NVAF.

Conclusion

Our findings indicate that an enlarged left atrium and abnormal hemodynamic parameters in the left atrial and pulmonary veins are linked to a greater risk of LAT/SEC. Previous stroke/transient ischaemic attack, LAVI, the S/D ratio, and left atrial acceleration factor were independently associated with LAT/SEC in NVAF patients. With the incorporation of these four variables, the developed nomogram effectively predicts the risk of LAT/SEC and outperforms the CHA2DS2-VASc score.

Different roles of FeS and FeS2 on magnetic FeSx for the selective adsorption of Hg2+ from waste acids in smelters: Reaction mechanism, kinetics, and structure-activity relationship

Magnetic FeSx was developed as a high-performance sorbent for selectively adsorbing Hg2+ from waste acids in smelters. However, further improvement of its ability for Hg2+ adsorption was extremely restricted due to the lack of reaction mechanisms and structure-activity relationships. In this study, the roles of FeS and FeS2 on magnetic FeSx for Hg2+ adsorption were investigated with alternate adsorption of Hg2+ without/with Cl-. The structure-activity relationship of magnetic FeSx for Hg2+ adsorption and the negative effect of acid erosion were elucidated using kinetic analysis. FeS can react with Hg2+ with 1:1 stoichiometric ratio to form HgS, while FeS2 can react with Hg2+ in the presence of Cl- with novel 1:3 stoichiometric ratio to form Hg3S2Cl2. The rate of magnetic FeSx for Hg2+ adsorption was related to the instantaneous amounts of FeS and threefold FeS2 on magnetic FeSx and the amount of Hg2+ adsorbed. Meanwhile, its capacity for Hg2+ adsorption was related to the initial sum of FeS amount and threefold FeS2 amount on the surface and their ratios by acid erosion. Then, magnetic FeSx-400 was devised with adsorption rate of 2.12 mg g-1 min-1 and capacity of 1092 mg g-1 to recover Hg2+ from waste acids for centralized control.

Visual and auditory attention defects in children with intermittent exotropia

BACKGROUND

Previous studies have shown that children with intermittent exotropia (IXT) have a higher rate of psychiatric abnormalities as they grow up, such as attention deficit. This study explored visual and hearing attention among children with IXT, and evaluated its association with clinical characteristics and cognitive development.

METHODS

Forty-nine children with a diagnosis of IXT and 29 children with traditional development were recruited. The Integrated Visual and Auditory Continuous Performance Test (IVA-CPT) was used to measure the subjects' full-scale response control quotient (FSRCQ), full-scale attention quotient (FSAQ), auditory response control quotient (ARCQ), auditory attention quotient (AAQ), visual response control quotient (VRCQ), and visual attention quotient (VAQ). The Wechsler Intelligence Scale for Children-Fourth Edition (WISC-IV) was used to assess their cognitive function. The differences between the scores of children with IXT and normal controls were analyzed.

RESULTS

The results showed that the FSRCQ, FSAQ, ARCQ, AAQ, VRCQ, and VAQ of children with IXT were all lower than those of normal controls with the same age (P < 0.05). The level of attention was significantly correlated with the age of strabismus onset (P < 0.05), but not with the degree of strabismus, stereopsis, or fusion control score. In addition, audiovisual attention was correlated significantly with their cognitive development level. The random forest classifier prediction model showed that age of strabismus onset was an important predictor of attention.

CONCLUSION

Children with IXT have lower visual and auditory attention and control than their peers, and the age of onset of strabismus may be a major factor.

lncRNA Profiling of Exosomes and Its Communication Role in Regulating Silica-Stimulated Macrophage Apoptosis and Fibroblast Activation

Long-term silica particle exposure leads to interstitial pulmonary inflammation and fibrosis, called silicosis. Silica-activated macrophages secrete a wide range of cytokines resulting in persistent inflammation. In addition, silica-stimulated activation of fibroblast is another checkpoint in the progression of silicosis. The pathogenesis after silica exposure is complex, involving intercellular communication and intracellular signaling pathway transduction, which was ignored previously. Exosomes are noteworthy because of their crucial role in intercellular communication by delivering bioactive substances, such as lncRNA. However, the expression profile of exosomal lncRNA in silicosis has not been reported yet. In this study, exosomes were isolated from the peripheral serum of silicosis patients or healthy donors. The exosomal lncRNAs were profiled using high-throughput sequencing technology. Target genes were predicted, and functional annotation was performed using differentially expressed lncRNAs. Eight aberrant expressed exosomal lncRNAs were considered to play a key role in the process of silicosis according to the OPLS-DA. Furthermore, the increased expression of lncRNA MSTRG.43085.16 was testified in vitro. Its target gene PARP1 was critical in regulating apoptosis based on bioinformatics analysis. In addition, the effects of exosomes on macrophage apoptosis and fibroblast activation were checked based on a co-cultured system. Our findings suggested that upregulation of lncRNA MSTRG.43085.16 could regulate silica-induced macrophage apoptosis through elevating PARP1 expression, and promote fibroblast activation, implying that the exosomal lncRNA MSTRG.43085.16 might have potential as a biomarker for the early diagnosis of silicosis.

The usefulness of contrast echocardiography in the evaluation of cardiac masses: a multicenter study

BACKGROUND

Cardiac masses can encompass a variety of conditions, such as tumors, thrombi, vegetations, calcific lesions, and other rare diseases. Treatment and management of these types of cardiac masses differ considerably. Thus, accurately distinguishing among thrombi, benign tumors, and malignant tumors in the heart is of great importance. Contrast echocardiography (CE) has emerged as a promising technology. Although published guidelines suggest that CE can enhance image quality and assist in differentiating between benign and malignant lesions, most studies on CE diagnosis of cardiac masses are limited to case reports or retrospective/small-sample-sized prospective cohorts. This study aims to evaluate the diagnostic accuracy of CE in patients with suspected cardiac masses and address the insufficient evidence for differential diagnosis using CE.

METHODS

Between April 2018 and July 2022, a prospective multicenter study was conducted, which included 145 consecutive patients suspected to have cardiac masses based on transthoracic echocardiography. All patients underwent CE examinations. The echocardiographic diagnosis relied on qualitative factors such as echogenicity, boundary, morphology of the base, mass perfusion, pericardial effusion, and motility as well as quantitative factors such as the area of the masses and the peak intensity ratio of the masses to adjacent myocardium (A1/A2).

RESULTS

The final confirmed diagnoses were as follows: 2 patients had no cardiac mass, 4 patients had pseudomass, 43 patients had thrombus, 66 patients had benign tumors, and 30 patients had malignant tumors. The receiver operating characteristic (ROC) analysis indicated that an optimal A1/A2 cutoff value of 0.499 distinguished a cardiac tumor from a thrombus, with AUC, sensitivity, specificity, PPV, and NPV of 0.977, 97.9%, 90.7%, 95.9%, and 95.1%, respectively. The optimal A1/A2 cutoff value of 1.583 distinguished a cardiac tumor from a thrombus, with AUC, sensitivity, specificity, PPV, and NPV of 0.950, 93.3%, 93.9%, 87.5%, and 96.9%, respectively.

CONCLUSIONS

Combined with qualitative and quantitative analyses, CE has the potential to accurately differentiate among different types of cardiac masses.

Emerging sensing platforms based on Cucurbit[n]uril functionalized gold nanoparticles and electrodes

Cucurbit[n]urils (CB[n]s, n = 5-8, 10, and 14), synthetic macrocycles with unique host-guest properties, have triggered increasing research interest in recent years. Gold nanoparticles (Au NPs) and electrodes stand out as exceptional substrates for sensing due to their remarkable physicochemical characteristics. Coupling the CB[n]s with Au NPs and electrodes has enabled the development of emerging sensing platforms for various promising applications. However, monitoring the behavior of analytes at the single-molecule level is currently one of the most challenging topics in the field of CB[n]-based sensing. Constructing supramolecular junctions in a sensing platform provides an ideal structure for single-molecule analysis, which can provide insights for a fundamental understanding of supramolecular interactions and chemical reactions and guide the design of sensing applications. This feature article outlines the progress in the preparation of the CB[n] functionalized Au NPs and Au electrodes, as well as the construction and application of supramolecular junctions in sensing platforms, based on the methods of recognition tunneling (RT), surface-enhanced Raman spectroscopy (SERS), single-molecule force spectroscopy (SMFS), and electrochemical sensing (ECS). A brief perspective on the future development of and challenges in CB[n] mediated sensing platforms is also covered.

[Automated cephalometric landmark identification and location based on convolutional neural network]

Objective: To develop an automated landmark location system applicable to the case of landmark missing. Methods: Four and eighty-one lateral cephalograms, which contained 240 males and 241 females, with an average age of (24.5±5.6) years, taken from January 2015 to January 2021 in the Department of Orthodontics, Capital Medical University School of Stomatology, and met the inclusion criteria were collected. Five postgraduate orthodontic students were the annotators to manually locate 61 possible landmarks in 481 lateral cephalograms. Two assistant professors in the department as reviewers performed calibration. Two professors as arbitrators, made final decision. Data sets were established (341 were used as training set, 40 as validation set, and 100 as test set). In this paper, an automatic landmarks identification and location model based on convolutional neural networks (CNN), CephaNET, was developed. The model was trained by feeding the original image into the feature extraction module and convolutional pose machine (CPM) module to locate landmarks with high accuracy using deep supervision. Training set was enhanced to 1 684 images by histogram equalization, cropping, and adjustment of brightness. The model was trained to compare the Gaussian heat maps output from the network with the set threshold to identify landmark missing cases. Test set of 100 lateral cephalograms was used to test the accuracy of the model. The evaluation criteria used were success detection rate of missing landmark, mean radial error (MRE) and success detection rate (SDR) in the range of 2.0, 2.5, 3.0, 3.5 and 4.0 mm. Results: The model identified and located 61 commonly used landmarks in 0.13 seconds on average. It had an average accuracy of 93.5% in identifying missing landmarks. The MRE of our testing set was (1.19±0.91) mm. SDR of 2.0, 2.5, 3.0, 3.5 and 4.0 mm were 85.4%, 90.2%, 93.5%, 95.4%, 97.0% respectively. Conclusions: The model proposed in this paper could adapt to the absence of landmark in lateral cephalograms and locate 61 commonly used landmarks with high accuracy to meet the requirements of different cephalometric analysis methods.

Stabilization of Guest Molecules inside Cation-Lidded Cucurbiturils Reveals that Hydration of Receptor Sites Can Impede Binding

Docking of alkali metal ions to water-soluble macrocyclic receptors generally reduces the affinity of guest molecules due to competitive binding. The idea that solvation water molecules could display a larger steric hindrance towards guest binding than cations has not been considered to date. We show that the docking of large cations to cucurbit[5]uril (CB5) unexpectedly increases (by a factor of 5-8) the binding of hydrophobic guests, methane and ethane. This is due to the removal of water molecules from the carbonyl portals of CB5 during cation binding, which frees up space for hydrophobe encapsulation. In contrast, smaller cations like sodium protrude deeply into the cavity of CB5 and cause the expected decrease in binding, such that the rational selection of alkali cations allows for a variation of up to a factor of 20 in binding of methane and ethane. The statistical analysis of crystallographic data shows that the cavity volume of CB5 can be enlarged by placing large alkali ions (Rb+ and Cs+ ) centro-symmetrically at the portals. The results reveal a hitherto elusive steric hindrance of solvation water molecules near receptor binding sites, which is pertinent for the design of supramolecular catalysts and the understanding of biological receptors.

Inorganic salt recrystallization strategy for achieving ultralong room temperature phosphorescence through structural confinement and aluminized reconstruction

Achieving highly efficient and stable room temperature phosphorescence (RTP) with ultralong lifetime is critical for the multi-purpose applications of phosphorescent materials. In this work, we propose an inorganic salt heating recrystallization strategy to simultaneously improve the lifetime, quantum efficiency, and stability of phosphorescent scandium/leucine microspheres (Sc/Leu-MSs). Inorganic salt-treated Sc/Leu-MSs are obtained by simply heating and drying inorganic salt solution containing Sc/Leu-MSs, which can achieve a maximum lifetime increase of 4.42-times from 208.37 ms (Sc/Leu-MSs) to 920.08 ms (Al2(SO4)3-treated Sc/Leu-MSs), accompanied by a RTP intensity increase up to 24.08-times. The enhancement mechanism of RTP efficiency is attributed to the stabilization of triplet excitons caused by inorganic salt coating that suppresses molecular motion and isolates oxygen on the one hand, and the efficient intersystem crossing promoted by aluminized reconstruction-caused duplex heavy atom effects on the other hand. This study provides new design principle and a facile strategy to construct RTP materials with ultralong lifetime, high phosphorescent quantum efficiency, and high stability for promising applications such as anti-counterfeiting and light emitting diodes.

Schiff Base Reaction in a Living Cell: In Situ Synthesis of a Hollow Covalent Organic Polymer To Regulate Biological Functions

Artificially performing chemical reactions in living biosystems to attain various physiological aims remains an intriguing but very challenging task. In this study, the Schiff base reaction was conducted in cells using Sc(OTf)3 as a catalyst, enabling the in situ synthesis of a hollow covalent organic polymer (HCOP) without external stimuli. The reversible Schiff base reaction mediated intracellular Oswald ripening endows the HCOP with a spherical, hollow porous structure and a large specific surface area. The intracellularly generated HCOP reduced cellular motility by restraining actin polymerization, which consequently induced mitochondrial deactivation, apoptosis, and necroptosis. The presented intracellular synthesis system inspired by the Schiff base reaction has strong potential to regulate cell fate and biological functions, opening up a new strategic possibility for intervening in cellular behavior.

Spatiotemporal Controlled Formation of Synthetic Nanoreactors in Single Living Cells

Cellular compartments provide confined environments for spatiotemporal control of biological processes and enzymatic reactions. To mimic such compartmentalization of eukaryotic cells, we report an efficient and general platform to precisely control the formation of artificial nanoreactors in single living cells. We introduce an electroosmotic controlled strategy for the synthesis of ZIF-8 at the nanoscale liquid-liquid interface around the tip of a nanopipet, whereby the formed ZIF-8 nanoparticles are driven into a single living cell by the electroosmotic flow. The porous ZIF-8 nanoparticles, as synthetic nanoreactors, are not only able to harvest fluorescent molecules from peripheral cytoplasm but also perform the subsequent photocatalytic degradation, mimicking compartmentalized chemical reactions in eukaryotic cells. Our strategy provides a useful tool for spatiotemporal controlled synthesis of artificial nanoreactors with on-demand functions in single living cells with versatile applications in chemical biology.

Treatment Tolerance and Toxicity in Elderly Oropharyngeal Cancer Patients and Implication on Outcomes

PURPOSE/OBJECTIVE(S)

To investigate the tolerance level and toxicity for standard of care treatment for oropharyngeal cancer (OP) in elderly patients and their impact on outcomes.

MATERIALS/METHODS

Using our in-house head and neck cancer database, we looked for non-metastatic OP cases that received definitive treatment between 1/2009-6/2020. All patients received either definitive radiation therapy (RT) +/- concomitant systemic therapy (ST), or surgery followed by adjuvant RT or RT-ST. For the elderly (age at diagnosis ≥65 years) and young (<65 years) patients, we compared treatment package time (TPT) (time from surgery to RT conclusion) for adjuvant RT, total RT duration and unplanned RT interruptions. ST details and dose/protocol modifications were also compared. We evaluated worst grade of pain and mucositis, hospitalization for non-hydration causes and febrile neutropenia (FN) during RT. Feeding tube (FT) use and weight loss were compared. The independent effect of these indicators on locoregional (LRFS), distant (DRFS) recurrence free and overall (OS) survival was assessed using multivariate analyses (MVA).

RESULTS

A cohort of 326 patients was included: 36% elderly (n = 118) and 64% young (n = 208), with no differences in AJCC stage distribution (8th), treatment received and HPV status (HPV+ve: 73% vs 74.6%; p = 0.86). In 23.6 % who received adjuvant RT, median TPT was 86 (range 72-128) and 81 (65-137) days for elderly vs young (p = 0.27); whereas in the definitive RT cases 76.4%, total RT duration was 49 days for both age groups. Overall, prescribed RT course was not completed in 4% and unplanned RT interruptions occurred in 22.8% and both were non-significant between age groups. Among the 261 patients that received ST, elderly utilized more cetuximab (26 vs 12%; p = 0.007). For those who received cisplatin, 20% of elderly had cumulative dose <200 mg/m2 compared to 6% among the younger age group (p = 0.006); and cisplatin was changed to carboplatin or cetuximab in 18% vs 8% (p = 0.019). Delayed/cancelled cycles and dose reductions were similar. There were more hospitalizations (47% vs 27%; p<0.001) and a trend for more FN (9% vs 3%; p = 0.09) with older age, while worst pain and mucositis was similar. FTs were used more in elderly patients (64% vs 50%; p = 0.02), for a median of 97 vs 64 days (p = 0.31); of which 19.5% vs 11% (p = 0.28) were inserted before RT start. However, % weight loss was non-significant. On MVA, longer RT duration, FT use and hospitalizations predicted worse LRFS and DRFS; and they were prognostic for OS in addition to TPT >90 days (p<0.05 for all). Nevertheless, elderly vs young had non-significant 3-year LRFS (91% vs 90% and 67% vs 69%), DRFS (86% vs 90% and 79% vs 81%) & OS (85% vs 81% and 39% vs 52%) for HPV+ve and HPV-ve respectively (p>0.05).

CONCLUSION

Elderly patients with OP need more multi-disciplinary supportive care when receiving RT and concurrent ST. However, survival outcomes are equivalent to younger patients. Ongoing studies should enroll more elderly candidates and stratify endpoints with age.

Sexual Orientation and Gender Identity (SOGI) Data Collection: Opportunities to Advance Best Clinical Practices for LGBTQ+ Patients in Radiation Oncology

PURPOSE/OBJECTIVE(S)

A long-standing barrier to progress against health disparities is the lack of data regarding cancer risks, prevalence, treatment, and outcomes for sexual and gender minority (SGM) patients. Sexual orientation and gender identity (SOGI) data are not routinely collected by individual oncologists, cancer centers, or most non-federal hospital systems. Alarmingly high proportions of SGM patients report discrimination in healthcare or avoid routine care due to perceived lack of acceptance in the healthcare system. For these and other reasons, healthcare institutions must adopt practices that promote an inclusive environment for all patients including those self-identified from SGM groups. One strategy to achieve this aim is through SOGI data collection. The purpose of this study was to pilot new procedures and training for SOGI data collection, the aims of this project were to standardize the collection of SOGI data for all new patients referred to the Division of Radiation Oncology; promote clinical staff awareness of SGM health disparities and strategies for fostering an inclusive hospital environment; and to provide SGM patients and caregivers educational resources and support systems tailored to their needs.

MATERIALS/METHODS

We designed a Quality Improvement program for collecting SOGI data, which was approved by our institution's QIAB. Patient access specialists (PAS) were trained to collect SOGI data from newly registered patients and enter the data into the electronic health record. Radiation Oncology staff completed surveys before and after SOGI training to estimate its impact on the provision of patient care. A Fisher's exact test was utilized to evaluate associations between training and provider-reported outcomes.

RESULTS

Within a 3-week period starting in January 2023, two 1-hour interactive training sessions were offered to twenty-five PAS. Three 1-hour training sessions were offered to twenty-seven Radiation Oncology clinical staff. (1) Confidence for incorporating SOGI classifiers around patients improved from before training (52%, 13/25) to after training (100%, 17/17) among medical providers surveyed (odds ratio (OR) 32, 95% confidence interval (CI) 0.70-1493, p = 0.005). Use of SOGI data in clinical decision making increased from before training (9/25, 36%) to after training (100%, 17/17) among medical providers (OR 60.79, 95% CI 3.271-1130, p<0.0001). (2) A clinical pathway for SGM patients was developed to facilitate referral to our institution's SGM patient support group and distribution of patient education materials focused on sexual health.

CONCLUSION

Establishing standardized SOGI data collection can facilitate the provision of tailored resources and care that meets the needs of patients and staff in a large comprehensive cancer center. Specialized training for staff developed through this initiative helps foster an inclusive and welcoming environment that promotes the integration, visibility, and advancement of SGM cancer care at our institution.

Smart Nanoplatform for Visualizing Hydrogen Sulfide and Amplifying Oxidative Stress to Tumor Apoptosis

Oxidative stress is involved in various signaling pathways and serves a key role in inducing cell apoptosis. Therefore, it is significant to monitor oxidative stress upon drug release for the assessment of therapeutic effects in cancer cells. Herein, a glutathione (GSH)-responsive surface-enhanced Raman scattering (SERS) nanoplatform is proposed for ultra-sensitively monitoring the substance related with oxidative stress (hydrogen sulfide, H2S), depleting reactive sulfur species and releasing anticancer drugs to amplify oxidative stress for tumor apoptosis. The Au@Raman reporter@Ag (Au@M@Ag) nanoparticles, where a 4-mercaptobenzonitrile molecule as a Raman reporter was embedded between layers of gold and silver to obtain sensitive SERS response, were coated with a covalent organic framework (COF) shell to form a core-shell structure (Au@M@Ag@COFs) as the SERS nanoplatform. The COF shell loading doxorubicin (DOX) of Au@M@Ag@COFs exhibited the GSH-responsive degradation capacity to release DOX, and its Ag layer as the sensing agent was oxidized to Ag2S by H2S to result in its prominent changes in SERS signals with a low detection limit of 0.33 nM. Moreover, the releasing DOX can inhibit the generation of H2S to promote the production of reactive oxygen species, and the depletion of reactive sulfur species (GSH and H2S) in cancer cells can further enhance the oxidative stress to induce tumor apoptosis. Overall, the SERS strategy could provide a powerful tool to monitor the dynamic changes of oxidative stress during therapeutic processes in a tumor microenvironment.

N-carbamylglutamate supplementation regulates hindgut microbiota composition and short-chain fatty acid contents in Charollais and Small Tail Han crossbred sheep

Introduction

The objective of this study was to investigate the effects of N-carbamylglutamate (NCG) supplementation on the growth performance, hindgut microbiota composition, and short-chain fatty acid (SCFA) contents in Charollais and Small Tail Han crossbred sheep.

Methods

A total of 16 female crossbred mutton sheep (Charollais × Small Tail Han), aged 4 months, with an initial body weight of 30.03 ± 0.08 kg, were utilized in a 60 days experiment. The sheep were divided into two groups based on their initial body weight. Each group consisted of 8 replicates, with each individual sheep considered as a replicate. The dietary treatments comprised a basal diet supplemented with either 0.00% or 0.12% NCG.

Results and discussion

Our findings indicate that NCG supplementation did not have a significant effect on the growth performance of mutton sheep. However, it did lead to changes in hindgut SCFA contents. Specifically, NCG supplementation increased the content of propanoic acid while decreasing acetic acid and hexanoic acid in the hindgut. Through microbiota analysis using the 16S rRNA technique, we identified Lachnospiraceae_NK3A20_group and Parasutterella as biomarkers for the hindgut microbiota in mutton sheep fed a diet containing NCG. Further analysis of the microbiota composition revealed that NCG supplementation significantly increased the abundance of Lachnospiraceae_NK3A20_group and Parasutterella, while decreasing unclassified_f_Lachnospiraceae and Lachnoclostridium. Correlation analysis between hindgut SCFA contents and microbiota composition revealed that the abundance of Lachnoclostridium was positively correlated with the contents of acetic acid and hexanoic acid, but negatively correlated with propanoic acid. Additionally, the abundance of Lachnospiraceae_NK3A20_group and Parasutterella was positively correlated with the content of propanoic acid, while being negatively correlated with acetic acid and hexanoic acid. Based on these findings, we conclude that dietary supplementation of 0.12% NCG can modulate hindgut SCFA contents in mutton sheep by regulating the composition of the hindgut microbiota.

[Source Analysis and Health Risk Assessment of Heavy Metals in the Groundwater of Shijiazhuang, a Typical City in North China Plain]

Increasing attention has been paid to the heavy metal pollution in groundwater. The source analysis and risk assessment of heavy metals will provide data and method support for the targeted control of heavy metal pollution in groundwater. In this study, 20 sampling sites were selected in Shijiazhuang City. The APCS-MLR model and health risk model were applied to analyze and evaluate the pollution sources and health risks of 10 types of heavy metals in the groundwater of Shijiazhuang. The results showed that ① the mean concentration of heavy metals in groundwater followed the order of Fe>Zn>Mn>Cu>Al>Pb>Cr>As>Cd>Hg, and the mean ρ(Fe) and ρ(Pb) were 260.3 μg·L-1 and 10.01 μg·L-1, respectively. According to the results of the single factor and Nemerow index, Pb, Fe, and Cd primarily contributed to the heavy metal pollution in the groundwater. ② The concentration of heavy metals ranged from 47.30 to 2560 μg·L-1. In terms of spatial distribution, the highest concentration appeared at S3 (2560 μg·L-1), whereas the lowest concentration was at S9 (47.30 μg·L-1). ③ Source analysis results showed that industrial and agricultural activities, transportation emission, and geological background were the major heavy metal sources, among which the contribution of industrial and agricultural activities was the highest (47.83%). ④ The industrial-agricultural activities posed a potential threat to adults (HI>1); however, the non-cancer and the cancer risks of other sources for both adults and children were at an acceptable level (HI<1) and potential threat level, respectively; industrial-agricultural activities were the major source of non-cancer (adults:52.46%, children:52.45%) and cancer risks (adults:65.22%, children:65.69%), among which Cd and As showed high cancer risk. Therefore, to ensure the safety of the groundwater environment, strictly controlling the pollution sources and further strengthening the risk control of heavy metal pollution in groundwater are necessary.