The Likelihood That Remedial Continuing Medical Education (CME) Reduces Disciplinary Recidivism Among Physicians

PURPOSE

State medical boards are charged through their medical practice acts to regulate physician practice and, when necessary, discipline physicians for incompetent or inappropriate behavior. Boards often authorize remedial continuing medical education (CME) as part of a disciplinary action; however, it is unclear how effective remedial CME is in reducing the likelihood of physicians receiving additional discipline. This study examined the relationship between physicians who were required to complete remedial CME as part of their first discipline by state medical boards and the likelihood of additional discipline.

METHOD

The national-level sample included 4,061 MD-physicians whose first discipline included license restrictions, probation, or other conditions imposed by state medical boards between 2011 and 2015. A multivariate logistic regression model examined whether physicians required to complete remedial CME as part of their first discipline were less likely to receive additional discipline by boards within 5 years.

RESULTS

Of the 4,061 physicians, 36% (n = 1,449) were required to complete remedial CME as part of their first discipline, and 35% (n = 1,426) received additional discipline within 5 years. After accounting for other factors, physicians who were required to complete remedial CME as part of their first discipline by boards were less likely to receive additional discipline (odds ratio = 0.597; 95% confidence interval = 0.513, 0.696; P < .001) within 5 years compared to physicians who were not required to complete remedial CME.

CONCLUSIONS

Findings support remedial CME as a means to help reduce physician disciplinary recidivism in certain circumstances. Physicians required to complete remedial CME as part of their first discipline were less likely to receive additional discipline by state medical boards within 5 years.

Toroidal micelles formed in viscoelastic aqueous solutions of a double-tailed surfactant with two quaternary ammonium head groups

Innovation in surfactant structures is an effective way to prepare new soft materials with novel applications. In this study, we synthesized a double-tailed surfactant containing two quaternary ammonium head groups (Di-C12-N2). The Di-C12-N2 solution behavior was investigated by surface tension, fluorescence, rheology, and cryo-TEM methods. Although Di-C12-N2 contained a large double-tailed hydrophobic group, the solubility of Di-C12-N2 was ∼90 mmol L-1 at 25 °C with a Krafft temperature of ∼1 °C. The increase in Di-C12-N2 concentration in the solutions led to the formation of various aggregates, including spherical micelles, worm-like micelles, multi-layered vesicles, and a rare type of small toroidal micelles. The two quaternary ammonium head groups in Di-C12-N2 led to strong electrostatic interactions between molecules, which was critical for the formation of toroidal micelles. Moreover, with an added NaCl concentration of 40 mmol L-1, the viscosity of the 5 mmol L-1Di-C12-N2 solution increased by ∼1000 times compared to the pure 5 mmol L-1Di-C12-N2 solution, revealing the high sensitivity of the unique head groups to ionic strength. This study enriches the research on the self-assembly principles of surfactants and brings new potential applications for new soft materials.

Developing screening tools to estimate the risk of diabetic kidney disease in patients with type 2 diabetes mellitus

BACKGROUND

Diabetic kidney disease (DKD) is an important microvascular complication of diabetes mellitus (DM).

OBJECTIVE

This study aimed to develop predictive nomograms to estimate the risk of DKD in patients with type 2 diabetes mellitus (T2DM).

METHODS

The medical records of patients with T2DM in our hospital from March 2022 to March 2023 were retrospectively reviewed. The enrolled patients were randomly selected for training and validation sets in a 7:3 ratio. The models for predicting risk of DKD were virtualized by the nomograms using logistic regression analysis.

RESULTS

Among the enrolled 597 patients, 418 were assigned to the training set, while 179 were assigned to the validation set. Using the predictors included glycated hemoglobin A1c (HbA1c), high density lipoprotein cholesterol (HDL-C), presence of diabetic retinopathy (DR) and duration of diabetes (DD), we constructed a full model (model 1) for predicting DKD. And using the laboratory indexes of HbA1c, HDL-C, and cystatin C (Cys-C), we developed a laboratory-based model (model 2). The C-indexes were 0.897 for model 1 and 0.867 for model 2, respectively. The calibration curves demonstrated a good agreement between prediction and observation in the two models. The decision curve analysis (DCA) curves showed that the two models achieved a net benefit across all threshold probabilities.

CONCLUSION

We successfully constructed two prediction models to evaluate the risk of DKD in patients with T2DM. The two models exhibited good predictive performance and could be recommended for DKD screening and early detection.

Role of Cisplatin in Inducing Acute Kidney Injury and Pyroptosis in Mice via the Exosome miR-122/ELAVL1 Regulatory Axis

Although cisplatin is an effective chemotherapy drug for the treatment of various cancers, its clinical use is limited due to its side effects, especially nephrotoxicity. Unfortunately, acute kidney injury (AKI) caused by cisplatin remains one of the main challenges in effective cancer treatment. Evidence increasingly suggests that renal inflammation and pyroptotic inflammatory cell death of renal tubular epithelial cells (RTECs) mainly determine the progression and outcome of cisplatin-induced AKI. However, it is not clear how cisplatin regulates the pyroptosis of RTECs cells in AKI. The current study aimed to determine the regulation mechanism of AKI induced by cisplatin. We used cisplatin to induce AKI in vivo. We performed H&E staining of mouse kidney tissue sections and evaluated serological indicators of kidney injury (including blood urea nitrogen (BUN), serum creatinine, and tumor necrosis factor-alpha (TNF-alpha)). We used immunohistochemistry and western blot to detect the important substrate protein gasdermin D (GSDMD) and key target caspase-1 of pyroptosis, respectively. Cisplatin induced mouse AKI and RTECs pyroptosis. HK2 cell-derived exosomes treated with cisplatin influenced pyroptosis of the surrounding HK2 cells. Cisplatin-treated HK2 cells exosome-derived miR-122 regulated pyroptosis in the surrounding cells. Exosome-derived miR-122 affected cisplatin-induced AKI and HK2 cells pyroptosis by regulating the expression of embryonic lethal abnormal vision (ELAVL1). These results suggest that exosome miR-122 inhibited pyroptosis and AKI by targeting ELAVL1 under cisplatin treatment, and this offers a potential target for the treatment of AKI.

Longitudinal Association Between Perceived Availability of Home- and Community-Based Services and All-Cause Mortality Among Chinese Older Adults: A National Cohort Study

Home- and community-based services (HCBS) may contribute to lowering mortality and enhancing quality of life among older adults. Limited research, however, has examined this relationship in the Chinese context. This study explored the longitudinal association between perceived availability of HCBS and all-cause mortality among Chinese older adults. This cohort study included 8,102 individuals aged 65 years and older from the 2011, 2014, and 2018 waves of the Chinese Longitudinal Healthy Longevity Survey. HCBS included daily life assistance, medical care services, emotional support and social services, and reconciliation and legal aid services. The association between perceived availability of HCBS and all-cause mortality was investigated using Cox proportional hazards models. Emotional support and social services were negatively associated with all-cause mortality (HR = 0.86, 95% CI: 0.78 ~ 0.95, P = .004). Daily life assistance, medical care services, and reconciliation and legal aid services were not significantly associated with all-cause mortality. Providing community-level emotional support and social services may reduce the risk of death. Focusing on the mental health and social well-being of older adults is just as important as caring for their physical health.

Effective degradation of anthraquinones in Folium Sennae with Monascus fermentation for toxicity reduce and efficacy enhancement

Folium Sennae are widely used around the world, mainly in purging and removal of endogenous active substances, such as anthraquinone and its derivatives. However, the potential toxicity of anthraquinones to the liver, kidney, and intestinal limits the application of Folium Sennae. In this study, we aimed at safe regulation of Folium Sennae to degrade anthraquinones, boosting medicinal properties and reducing toxicity and potency with Monascus fermentation. Monascus strains H1102 for Folium Sennae fermentation were selected as the initial strain which was capable of producing high yields of functional pigment and low yields of hazardous citrinin. The anthraquinone degradation rate reached 41.2%, with 212.2 U mL-1 of the pigment and approximately 0.038 mg L-1 of the citrinin under optimal fermentation conditions followed by response surface streamlining, which met the requirements of reducing toxicity, increasing efficiency of Monascus fermented Folium Sennae. Furthermore, the Monascus/Folium Sennae culture had no observable toxic effect on HK-2 and L-02 cells in vitro and further inhibited cell apoptosis and necrosis. Overall, our results showed that Monascus fermentation could provide an alternative strategy for toxicity reduction of herbal medicines as well as efficacy enhancement.

Ecofriendly Viscoelastic Solutions Formed from a Recyclable Rosin-Based Amine Oxide Surfactant

Innovations in molecular structures formed using bioresources are efficient means to prepare surfactant aggregates with unique properties. Here, a rosin-based amine oxide surfactant (R-11-3-AO) containing large hydrophobic groups was synthesized from rosin derivatives, namely, dehydroabietic acid and long-chain amino acids. Cryo-transmission electron microscopy showed that R-11-3-AO molecules formed extremely long wormlike micelles with a cross-sectional diameter of 4-5 nm at a concentration of approximately 7 mmol·L^-1. A gel-like system was obtained at approximately 30 mmol·L^-1 due to the dense entanglement of the wormlike micelles. The solutions also exhibited unique shear thickening behavior at a shear rate of approximately 10 s^-1 even at high concentrations. The large hydrophobic group contained in R-11-3-AO is the origin of the strong van der Waals interactions between the surfactant molecules, resulting in the rapid growth of wormlike micelles. This rosin-based surfactant is the first recoverable amine oxide surfactant from solutions through the salting-out effect with high recovery rates. This work demonstrates the unique capabilities of rosin-based surfactants for forming wormlike micelles and provides opportunities for the development of surfactant recovery technologies.

The Role of Contextual Factors in Shaping Urban Older Adults' Intention of Institutional Care in China: A Mixed-Methods Study

BACKGROUND

This mixed-methods study explores older people's intention of institutional care and its contributing contextual factors, and the meaning given to their intention by older adults in the transitioning Chinese society.

METHODS

Guided by the extended Anderson model and frameworks of the ecological theory of aging, survey data collected from 1937 Chinese older adults were used. Transcripts from six focus group interviews were analyzed to incorporate the voices of the participants.

RESULTS

Community environment and services, health services, financial services, and regional service organizations were related to the institutional care intention of older people. The qualitative analysis showed that the reported conflicting feelings about institutional care was driven by the lack of supporting resources and age-friendly environment. The findings of this study suggested that the reported intention of Chinese older adults for institutional care may not be an ideal choice but a compromise or, in some cases, a forced choice.

CONCLUSIONS

Rather than treating the stated institutional intention as a simple expression of older Chinese people's likes or desires, the intention of institutional care should be understood within a framework that fully considers the influence of psycho-social factors and contextual organizations.

Recyclable Nonionic-Anionic Bola Surfactant as a Stabilizer of Size-Controllable and pH-Responsive Pickering Emulsions

A novel nonionic-anionic Bola surfactant (abbreviated as CH₃O(EO)₇-R₁₁-COOH) was designed and synthesized by condensation of methyl polyoxyethylene (7) ether with 12-bromododecanoic acid. In neutral aqueous solution, the surfactant behaves as a nonionic one and can stabilize oil-in-water (O/W) conventional emulsions alone and costabilize O/W Pickering emulsions with positively charged alumina nanoparticles with n-decane as the oil. In alkaline solution, the carboxylic acid group is deprotonated, becoming anionic and the surfactant is converted to Bola form, which is an inferior emulsifier and does not adsorb on particle surfaces, resulting in demulsification of both kinds of emulsions. With strong hydrophilicity, both the Bola surfactant and the bare particles return to the aqueous phase after demulsification, which is therefore recyclable and reusable in accordance with sustainable chemistry and engineering. In acidic media between pH 3 and 6, the ethyleneoxy groups tend to desorb from particle surfaces, slightly reducing the hydrophobicity of the particles. However, Pickering emulsions are still stable but their droplet size increases on lowering the pH. The Pickering emulsions are therefore pH-responsive and size-controllable. This newly designed Bola surfactant is effective in preparing smart emulsions, which are extensively applied in heterogeneous catalysis, oil product transportation, emulsion polymerization, and new material preparation.

Impact of the COVID-19 pandemic and corresponding control measures on long-term care facilities: a systematic review and meta-analysis

BACKGROUND

Long-term care facilities (LTCFs) were high-risk settings for COVID-19 outbreaks.

OBJECTIVE

To assess the impacts of the COVID-19 pandemic on LTCFs, including rates of infection, hospitalisation, case fatality, and mortality, and to determine the association between control measures and SARS-CoV-2 infection rates in residents and staff.

METHOD

We conducted a systematic search of six databases for articles published between December 2019 and 5 November 2021, and performed meta-analyses and subgroup analyses to identify the impact of COVID-19 on LTCFs and the association between control measures and infection rate.

RESULTS

We included 108 studies from 19 countries. These studies included 1,902,044 residents and 255,498 staff from 81,572 LTCFs, among whom 296,024 residents and 36,807 staff were confirmed SARS-CoV-2 positive. The pooled infection rate was 32.63% (95%CI: 30.29 ~ 34.96%) for residents, whereas it was 10.33% (95%CI: 9.46 ~ 11.21%) for staff. In LTCFs that cancelled visits, new patient admissions, communal dining and group activities, and vaccinations, infection rates in residents and staff were lower than the global rate. We reported the residents' hospitalisation rate to be 29.09% (95%CI: 25.73 ~ 32.46%), with a case-fatality rate of 22.71% (95%CI: 21.31 ~ 24.11%) and mortality rate of 15.81% (95%CI: 14.32 ~ 17.30%). Significant publication biases were observed in the residents' case-fatality rate and the staff infection rate, but not in the infection, hospitalisation, or mortality rate of residents.

CONCLUSION

SARS-CoV-2 infection rates would be very high among LTCF residents and staff without appropriate control measures. Cancelling visits, communal dining and group activities, restricting new admissions, and increasing vaccination would significantly reduce the infection rates.

Substituted benzoate-anchored decanuclear titanium-oxo clusters featuring unprecedented defective double-cubane geometry

Based on DMF solvent, four titanium-oxo clusters (TOCs) [Ti10(μ3-O)12(L)6 (OiPr)10 (DMF)2] (Ti-L) (L=4-methylbenzoate(MB), 3,5-Di-tert-butylbenzoate (DTBB), 4-Methoxybenzoate (MOB) and 4-Methyl-3,5-dinitrobenzoate(MDNB) with the same coordination environments have been solvothermally synthesized with high...

APOBEC mutagenesis, kataegis, chromothripsis in EGFR-mutant osimertinib-resistant lung adenocarcinomas

BACKGROUND

Studies of targeted therapy resistance in lung cancer have primarily focused on single-gene alterations. Based on prior work implicating apolipoprotein b mRNA-editing enzyme, catalytic polypeptide-like (APOBEC) mutagenesis in histological transformation of epidermal growth factor receptor (EGFR)-mutant lung cancers, we hypothesized that mutational signature analysis may help elucidate acquired resistance to targeted therapies.

PATIENTS AND METHODS

APOBEC mutational signatures derived from an Food and Drug Administration-cleared multigene panel [Memorial Sloan Kettering Cancer Center Integrated Mutation Profiling of Actionable Cancer Targets (MSK-IMPACT)] using the Signature Multivariate Analysis (SigMA) algorithm were validated against the gold standard of mutational signatures derived from whole-exome sequencing. Mutational signatures were decomposed in 3276 unique lung adenocarcinomas (LUADs), including 93 paired osimertinib-naïve and -resistant EGFR-mutant tumors. Associations between APOBEC and mechanisms of resistance to osimertinib were investigated. Whole-genome sequencing was carried out on available EGFR-mutant lung cancer samples (10 paired, 17 unpaired) to investigate large-scale genomic alterations potentially contributing to osimertinib resistance.

RESULTS

APOBEC mutational signatures were more frequent in receptor tyrosine kinase (RTK)-driven lung cancers (EGFR, ALK, RET, and ROS1; 25%) compared to LUADs at large (20%, P < 0.001); across all subtypes, APOBEC mutational signatures were enriched in subclonal mutations (P < 0.001). In EGFR-mutant lung cancers, osimertinib-resistant samples more frequently displayed an APOBEC-dominant mutational signature compared to osimertinib-naïve samples (28% versus 14%, P = 0.03). Specifically, mutations detected in osimertinib-resistant tumors but not in pre-treatment samples significantly more frequently displayed an APOBEC-dominant mutational signature (44% versus 23%, P < 0.001). EGFR-mutant samples with APOBEC-dominant signatures had enrichment of large-scale genomic rearrangements (P = 0.01) and kataegis (P = 0.03) in areas of APOBEC mutagenesis.

CONCLUSIONS

APOBEC mutational signatures are frequent in RTK-driven LUADs and increase under the selective pressure of osimertinib in EGFR-mutant lung cancer. APOBEC mutational signature enrichment in subclonal mutations, private mutations acquired after osimertinib treatment, and areas of large-scale genomic rearrangements highlights a potentially fundamental role for APOBEC mutagenesis in the development of resistance to targeted therapies, which may be potentially exploited to overcome such resistance.

Pickering Emulsions Synergistically Stabilized by Aliphatic Primary Amines and Silica Nanoparticles

Innovation in emulsion compositions is necessary to enrich emulsion formulations and applications. Herein, Pickering emulsions were prepared using silica nanoparticles and aliphatic primary amines with an oil-water ratio of 1:1 (v/v). Contact angle experiments revealed that the in situ hydrophobization of nanoparticles was caused by the surface adsorption of amine molecules. Notably, the interactions between amine compounds and the surface of silica nanoparticles were electrostatic attractions and mutual hydrogen bonding. The existence of hydrogen bonds was further confirmed by demulsification experiments using a chaotropic agent DMF and increasing temperatures. The hydrophobicity of silica nanoparticles can be effectively improved using most commercially available aliphatic primary amines such as n-hexylamine, n-octylamine, n-decylamine, dodecylamine, and tetradecylamine. The minimum concentrations of the aforementioned amines necessary for stabilizing the emulsions with 0.3 wt % silica nanoparticles are 3, 0.6, 0.3, 0.06, and 0.03 mM, respectively, decreasing significantly with increasing alkyl chain length. With the increase of the amine concentrations, the hydrophobicity of silica particles monotonically increased and finally resulted in the inversion of emulsions. The amine concentrations for emulsion phase inversion were 150, 40, 30, 20, and 20 mM, respectively, in the presence of 0.3 wt % silica nanoparticles. In this work, silica nanoparticles were hydrophobized using aliphatic primary amines. The composite stabilizers developed are useful for developing novel stimuli-responsive Pickering emulsions, while the synergistic effects introduced herein are also helpful in expanding the hydrophobization methods available for nanoparticles.

Rheological behavior of thread-like fiber solutions formed from a rosin-based surfactant with two head groups

Wormlike micelles are conventional aggregates that exist in viscoelastic solutions. However, to achieve a solution with prominent viscoelasticity, rather high concentrations of surfactants are usually required due to the flexibility of aggregates in solution. If thread-like aggregates with rigidity can be formed by surfactants, the solutions are expected to show strong viscoelasticity at very low surfactant concentrations. Herein, A novel rosin-based quaternary ammonium surfactant with two head groups (abbreviated as R-11-3-DA) was synthesized. Cryogenic transmission electron microscopy (Cryo-TEM) images showed that flexible nanofibers with diameters of about 7-8 nm and lengths of over 1 μm were formed in the 1 : 1.5 R-11-3-DA : SL solutions. The rigidity of the aggregates seems to be inherited from the rigidity of the surfactant molecules. The novel aggregates endow the solutions with remarkable viscoelasticity at very low concentrations, with a critical overlap concentration of 0.01 wt% and a critical gelling concentration of 0.58 wt%. The rheological behavior of the solutions also shows excellent shear resistance and weak sensitivity to temperature below the critical gelation temperature (T_gel). This work reveals the advantages of viscoelastic solutions containing flexible nanofibers. The design principles of new molecular structures and system compositions can be applied to the preparation of smart soft materials based on the self-assembly of molecules.

Perceived availability of home- and community-based services and self-reported depression among Chinese older adults: A cross-sectional study

Few studies have assessed the association between perceived availability of home- and community-based services (HCBSs) and self-reported depression among Chinese older adults, which the present study attempts to rectify. This cross-sectional study enrolled 11,941 participants aged 65 and older from the Chinese Longitudinal Healthy Longevity Survey 2018 wave. The 10-item Center for Epidemiologic Studies Depression Scale (CESD-10) was used to evaluate depression, and perceived availability was measured for four categories of HCBSs: daily life assistance, medical care services, emotional support and social services, and other. These four categories and the number of services in each were used to represent the perceived availability of service provision. Binary logistic models were used to explore the relationship between perceived availability of HCBSs and depression in older adults. Perceived daily life assistance was found to be negatively associated with depression symptoms among Chinese older adults in both urban and rural areas [rural: OR (95%CI) = 0.66 (0.55-0.78), p < 0.001; urban: OR (95% CI) = 0.69(0.60-0.79), p < 0.001], while perceived levels of medical care services, emotional support and social services, and other were not associated with depression symptoms in rural or urban areas. Our primary finding was that providing daily life assistance at the community level may help to meet more older adults' daily needs, thus potentially decreasing the risk of depression.

Water-in-Oil Emulsion Gels Stabilized by a Low-Molecular Weight Organogelator Derived from Dehydroabietic Acid

High concentrations of surfactants or gelators are usually necessary to prepare emulsions gels with unusual physicochemical properties. This situation may be improved by innovating the aggregate morphology in systems. Herein, a rosin-based molecule is designed and synthesized using dehydroabietic acid as the starting material (denoted as R-Lys-R). The molecule acts as an effective organogelator and can gelate several hydrocarbon compounds with a minimum gelation concentration of 0.2% (w/v). Analysis using atomic force microscopy (AFM) and circular dichroism (CD) reveals that in n-decane, R-Lys-R forms left-handed helical fibers with a cross-sectional diameter of approximately 15 nm. The directional hydrogen bonding of the amide group is helpful to the formation of aggregates. At concentrations of R-Lys-R above 2%, water-in-oil emulsions are transformed into emulsion gels owing to the aptitude of R-Lys-R in gelating the oil phase. The concentrations of the emulsifier can be adjusted to obtain emulsion gels with different formulations. This work reveals the potential of rosin derivatives for the formation of small molecular weight organogels and provides a novel method for the utilization of natural resources in soft materials and home care products.

Recyclable and re-usable smart surfactant for stabilization of various multi-responsive emulsions alone or with nanoparticles

A novel multi-responsive surfactant (abbreviated as N⁺-8P8-N) was synthesized, in which one octyl trimethylamine group (quaternary ammonium) and one octyl dimethylamine group are connected to a benzene ring through ether bonds. This novel surfactant can stabilize conventional oil-in-water (O/W) emulsions alone, and O/W Pickering emulsions and novel oil-in-dispersion emulsions together with oppositely and similarly charged nanoparticles, respectively. In all cases rapid demulsification can be achieved through either pH or CO₂/N₂ triggers, by which the surfactant is reversibly converted between a normal cationic surfactant form (N⁺-8P8-N) and a strongly hydrophilic and surface-inactive bola form (N⁺-8P8-NH⁺). Notably, the bola form N⁺-8P8-NH⁺ dissolves in the aqueous phase alone or together with nanoparticles after demulsification without contamination of the oil phase, and the aqueous phase can be recycled many times triggered by pH or CO₂/N₂ in accordance with the principle of green chemistry. This newly designed re-usable smart surfactant is significant for the development of various temporarily stable emulsions, which are extensively applied in emulsion polymerization, new material synthesis, heterogeneous catalysis and oil transportation.

Gestational bisphenol A exposure impairs hepatic lipid metabolism by altering mTOR/CRTC2/SREBP1 in male rat offspring

Lipid metabolism is an important biochemical process in the body. Recent studies have found that environmental endocrine disruptors play an important role in the regulation of lipid metabolism. Bisphenol A (BPA), a common environmental endocrine disruptor, has adverse effects on lipid metabolism, but the mechanism is still unclear. This study aimed to investigate the effects of gestational BPA exposure on hepatic lipid metabolism and its possible mechanism in male offspring. The pregnant Sprague-Dawley rats were exposed to BPA (0, 0.05, 0.5, 5 mg/kg/day) from day 5 to day 19 of gestation to investigate the levels of triglyceride (TG) and total cholesterol (TC), and the expression of liver lipid metabolism-related genes in male offspring rats. The results showed that compared with the control group, the TG and TC levels in serum and liver in BPA-exposed groups was increased. And the expressions of liver fatty acid oxidation related genes, such as peroxisome proliferators-activated receptor α (PPARα) and carnitine palmitoyl transferase 1α (CPT1α), were down-regulated. However, the expressions of fatty acid synthesis related genes, such as sterol regulatory element binding proteins 1 (SREBP-1), acetyl-CoA carboxylase 1 (ACC1), fatty acid synthase (FAS) and stearoyl-CoA desaturase 1 (SCD-1), were up-regulated. The increased protein levels of mTOR and p-CRTC2 suggested that CREB-regulated transcription coactivator 2 (CRTC2) might be an important mediator in the mTOR/SREBP-1 pathway. In conclusion, these results demonstrated that mTOR/CRTC2/SREBP-1 could be affected by gestational BPA exposure, which may involve in the lipid metabolic disorders in later life.