Supplementation with α-ketoglutarate improved the efficacy of anti-PD1 melanoma treatment through epigenetic modulation of PD-L1

Patients with advanced melanoma have shown an improved outlook after anti-PD1 therapy, but the low response rate restricts clinical benefit; therefore, enhancing anti-PD1 therapeutic efficacy remains a major challenge. Here, our findings showed a significantly increased abundance of α-KG in healthy controls, anti-PD1-sensitive melanoma-bearing mice, and anti-PD1-sensitive melanoma patients; moreover, supplementation with α-KG enhanced the efficacy of anti-PD1 immunotherapy and increased PD-L1 expression in melanoma tumors via STAT1/3. We also found that supplementation with α-KG significantly increased the activity of the methylcytosine dioxygenases TET2/3, which led to an increased 5-hydroxymethylcytosine (5-hmC) level in the PD-L1 promoter. As a consequence, STAT1/3 binding to the PD-L1 promoter was stabilized to upregulate PD-L1 expression. Importantly, single-cell sequencing of preclinical samples and analysis of clinical data revealed that TET2/3-STAT1/3-CD274 signaling was associated with sensitivity to anti-PD1 treatment in melanoma. Taken together, our results provide novel insight into α-KG's function in anti-PD1 treatment of melanoma and suggest supplementation with α-KG as a novel promising strategy to improve the efficacy of anti-PD1 therapy.

Spinful Topological Phases in Acoustic Crystals with Projective PT Symmetry

For the classification of topological phases of matter, an important consideration is whether a system is spinless or spinful, as these two classes have distinct symmetry algebra that gives rise to fundamentally different topological phases. However, only recently has it been realized theoretically that in the presence of gauge symmetry, the algebraic structure of symmetries can be projectively represented, which possibly enables the switch between spinless and spinful topological phases. Here, we report the experimental demonstration of this idea by realizing spinful topological phases in "spinless" acoustic crystals with projective space-time inversion symmetry. In particular, we realize a one-dimensional topologically gapped phase characterized by a 2Z winding number, which features double-degenerate bands in the entire Brillouin zone and two pairs of degenerate topological boundary modes. Our Letter thus overcomes a fundamental constraint on topological phases by spin classes.

Multiband topological states in the Penrose-triangle photonic crystals

The topological edge state (TES) and topological corner state (TCS) in photonic crystals (PCs) provide effective ways to manipulate the propagation of light. To improve the performance and integration of topological photonic devices, the realization of multiband topological states by PCs combined with quasi-periodic structure needs to be urgently explored. In this Letter, a Penrose-triangle (P-T) PC, which arranges the basic structural unit of a 12-fold Penrose-type photonic quasi-crystal (PQC) in a triangular lattice, is proposed. The TES and TCS at low- and high-frequency bands can be generated in the same structure, accompanied by the realization of three groups of TCSs. This will provide a new structure for the generation of TESs and TCSs in PCs, and will provide a new way to improve the performance and integration of topological photonic devices.

A versatile and convenient tool for regulation of DNA strand displacement and post-modification on pre-fabricated DNA nanodevices

Toehold-mediated strand displacement and its regulatory tools are fundamental for DNA nanotechnology. However, current regulatory tools all need to change the original sequence of reactants, making the regulation inconvenient and cumbersome. More importantly, the booming development of DNA nanotechnology will soon promote the production of packaged and batched devices or circuits with specified functions. Regarding standardized, packaged DNA nanodevices, access to personalized post-modification will greatly help users, whereas none of the current regulatory tools can provide such access, which has greatly constrained DNA nanodevices from becoming more powerful and practical. Herein, we developed a novel regulation tool named Cap which has two basic functions of subtle regulation of the reaction rate and erasability. Based on these functions, we further developed three advanced functions. Through integration of all functions of Cap and its distinct advantage of working independently, we finally realized personalized tailor-made post-modification on pre-fabricated DNA circuits. A pre-fabricated dual-output DNA circuit was successfully transformed into an equal-output circuit, a signal-antagonist circuit and a covariant circuit according to our requirements. Taken together, Cap is easy to design and generalizable for all strand displacement-based DNA nanodevices. We believe the Cap tool will be widely used in regulating reaction networks and personalized tailor-made post-modification of DNA nanodevices.

PAM-independent ultra-specific activation of CRISPR-Cas12a via sticky-end dsDNA

Although CRISPR-Cas12a [clustered regularly interspaced short palindromic repeats (CRISPR)-CRISPR-associated protein 12a] combining pre-amplification technology has the advantage of high sensitivity in biosensing, its generality and specificity are insufficient, which greatly restrains its application range. Here, we discovered a new targeting substrate for LbaCas12a (Lachnospiraceae bacterium Cas12a), namely double-stranded DNA (dsDNA) with a sticky-end region (PAM-SE+ dsDNA). We discovered that CRISPR-Cas12a had special enzymatic properties for this substrate DNA, including the ability to recognize and cleave it without needing a protospacer adjacent motif (PAM) sequence and a high sensitivity to single-base mismatches in that substrate. Further mechanism studies revealed that guide RNA (gRNA) formed a triple-stranded flap structure with the substrate dsDNA. We also discovered the property of low-temperature activation of CRISPR-Cas12a and, by coupling with the unique DNA hybridization kinetics at low temperature, we constructed a complete workflow for low-abundance point mutation detection in real samples, which was fast, convenient and free of single-stranded DNA (ssDNA) transformation. The detection limits were 0.005-0.01% for synthesized strands and 0.01-0.05% for plasmid genomic DNA, and the mutation abundances provided by our system for 28 clinical samples were in accordance with next-generation sequencing results. We believe that our work not only reveals novel information about the target recognition mechanism of the CRISPR-Cas12a system, but also greatly broadens its application scenarios.

Characterization of diazotrophic root endophytes in Chinese silvergrass (Miscanthus sinensis)

BACKGROUND

Phytoremediation is a potentially cost-effective way to remediate highly contaminated mine tailing sites. However, nutrient limitations, especially the deficiency of nitrogen (N), can hinder the growth of plants and impair the phytoremediation of mine tailings. Nevertheless, pioneer plants can successfully colonize mine tailings and exhibit potential for tailing phytoremediation. Diazotrophs, especially diazotrophic endophytes, can promote the growth of their host plants. This was tested in a mine-tailing habitat by a combination of field sampling, DNA-stable isotope probing (SIP) analysis, and pot experiments.

RESULTS

Bacteria belonging to the genera Herbaspirillum, Rhizobium, Devosia, Pseudomonas, Microbacterium, and Delftia are crucial endophytes for Chinese silvergrass (Miscanthus sinensis) grown in the tailing, the model pioneer plant selected in this study. Further, DNA-SIP using ¹⁵N₂ identified Pseudomonas, Rhizobium, and Exiguobacterium as putative diazotrophic endophytes of M. sinensis. Metagenomic-binning suggested that these bacteria contained essential genes for nitrogen fixation and plant growth promotion. Finally, two diazotrophic endophytes Rhizobium sp. G-14 and Pseudomonas sp. Y-5 were isolated from M. sinensis. Inoculation of another pioneer plant in mine tailings, Bidens pilosa, with diazotrophic endophytes resulted in successful plant colonization, significantly increased nitrogen fixation activity, and promotion of plant growth.

CONCLUSIONS

This study indicated that diazotrophic endophytes have the potential to promote the growth of pioneer plant B. pilosa in mine tailings. Video Abstract.

Vanadate reducing bacteria and archaea may use different mechanisms to reduce vanadate in vanadium contaminated riverine ecosystems as revealed by the combination of DNA-SIP and metagenomic-binning

Vanadium (V) is a transitional metal that poses health risks to exposed humans. Microorganisms play an important role in remediating V contamination by reducing more toxic and mobile vanadate (V(V)) to less toxic and mobile V(IV). In this study, DNA-stable isotope probing (SIP) coupled with metagenomic-binning was used to identify microorganisms responsible for V(V) reduction and determine potential metabolic mechanisms in cultures inoculated with a V-contaminated river sediment. Anaeromyxobacter and Geobacter spp. were identified as putative V(V)-reducing bacteria, while Methanosarcina spp. were identified as putative V(V)-reducing archaea. The bacteria may use the two nitrate reductases NarG and NapA for respiratory V(V) reduction, as has been demonstrated previously for other species. It is proposed that Methanosarcina spp. may reduce V(V) via anaerobic methane oxidation pathways (AOM-V) rather than via respiratory V(V) reduction performed by their bacterial counterparts, as indicated by the presence of genes associated with anaerobic methane oxidation coupled with metal reduction in the metagenome assembled genome (MAG) of Methanosarcina. Briefly, methane may be oxidized through the "reverse methanogenesis" pathway to produce electrons, which may be further captured by V(V) to promote V(V) reduction. More specially, V(V) reduction by members of Methanosarcina may be driven by electron transport (CoMS-SCoB heterodisulfide reductase (HdrDE), F₄₂₀H₂ dehydrogenases (Fpo), and multi-heme c-type cytochrome (MHC)). The identification of putative V(V)-reducing bacteria and archaea and the prediction of their different pathways for V(V) reduction expand current knowledge regarding the potential fate of V(V) in contaminated sites.

Impact of sodium-glucose co-transporter 2 inhibitors on cardiovascular outcomes in patients with chronic kidney disease: Hong Kong-wide, observational, propensity score matched analysis

Purpose

The impact of SGLT2i on patients with advanced chronic kidney disease (CKD) is limited. We aimed to compare hospitalization for heart failure (HHF) and cardiovascular (CV) death between new users of SGLT2i versus non-users across the spectrum of CKD stages.

Methods

We retrospectively analyzed 22,657 patients with CKD who were prescribed SGLT2i between August 2015 and August 2020 in 16 public hospitals in Hong Kong. Propensity-matched cohorts of SGLT2i users and non-users (n=3,704 per group) were generated on the basis of age, gender, baseline eGFR, co-morbidities and medications. Time to HHF and CV death was analyzed using COX proportional hazards model. Subgroup analysis was performed to detect heterogeneity of effect across stages of CKD.

Results

Of the whole cohort (N=22,657), the percentage of SGLT2i users in CKD stage G1 to G5 were 82.1%, 49.0%, 19.8%, 10.3%, 4.3%, and 1.6%, respectively. SGLT2i users and non-users groups were well balanced at baseline (mean age 64.7±12.7, female 37.1%), with a median follow-up of 2.8 (IQR: 1.1–5.1) years (22876.5 person-years). Overall, SGLT2i was associated with reduced risk of HHF (Hazards Ratio (HR) 0.12 (95% CI (0.10–0.16) and CV death (HR 0.17 (95% CI (0.12–0.25), compared with non-users. Subgroup analysis demonstrated benefit of SGLT2i on CV death in G3 to G5 groups but not in patients in earlier CKD stages (P for interaction <0.001) (Table). Reduction in risk of HHF was comparable across all CKD stages (P for interaction = 0.1).

Conclusion

Utilization of SGLT2i was associated with significant reduction in HHF and CV death in patients with moderate to severe CKD in a real-world setting. Our results suggest significant heterogeneity in CV death reduction with the largest benefit in patients with stage G3a and more advanced CKD.

Funding Acknowledgement

Type of funding sources: None.

Timing of initiation of sodium-glucose co-transporter 2 inhibitor in patients with diabetes and chronic cardiac failure

Purpose

Sodium-glucose cotransporter 2 (SGLT2) inhibitors reduce the risk of first hospitalization for heart failure (HHF) in patients with type 2 diabetes. We aimed to evaluate the impact of early initiation of SGLT2 inhibitors on recurrent HHF in diabetic patients with chronic cardiac failure.

Methods

We retrospectively analyzed 1,363 consecutive diabetic patients with chronic cardiac failure with index HHF between August 2015 and August 2020 in 16 public hospitals in Hong Kong who were prescribed SGLT2i (empagliflozin=1,009, 74% and dapagliflozin =354, 26%).Patients who initiated SGLT2i at discharge of index HHF were compared to those who were not. Risk of recurrent HHF was compared, using adjusted sub-distribution hazard ratios (aSHR) derived from Fine and Gray regression models, accounting for death as competing risk, adjusting for age, gender, concurrent medications. Comparisons were also conducted between initiation of SGLT2i ≤30 vs >30 days; and ≤90 vs. >90 days after discharge.

Results

Of 1,363 patients (mean age 63.9±11.6, female 34.6%), 85% had no history of previous HHF at enrollment, 11.9% had up to 2 and 3.1% and 3.1% ≥3 HHF in the past 5 years. SGLT2i was initiated in 37.4% of patients at discharge of index HHF and the median time from index HHF to SGLT2i initiation for the other patients was 4.2 (IQR: 0–20.4) months. During a median follow-up of 1.3 (IQR: 0.2–2.7) years, initiation of SGLT2i at discharge was associated with lower risk of recurrent HHF (aSHR = 0.79, 95% CI: 0.68–0.92). Similar effect was observed between SGLT2i initiation ≤30 vs. >30 days (aSHR = 0.82, 95% CI: 0.70–0.95) but not between ≤90 vs. >90 days (P=0.19).

Conclusion

Among patients with diabetes and chronic cardiac failure, the risk of recurrent HHF was reduced when SGLT2 was initiated early after index HHF.

Funding Acknowledgement

Type of funding sources: None.

Low-density lipoprotein cholesterol target attainment among statin-naive Chinese atherosclerotic vascular disease patients

Background

Low-density lipoprotein cholesterol (LDL-C) of patients with atherosclerotic vascular disease (ASCVD) is expected to be lowered by ≥50% and <1.4 mmol/L. Despite the use of lipid-lowering therapies, most of Chinese patients failed to meet the treatment target.

Purpose

We aimed to evaluate the potential of different statin intensities on LDL-C target attainment among statin-naïve Chinese ASCVD patients.

Methods

We retrospectively analyzed statin-naïve ASCVD patients who were initiated with statin therapy between January and July 2020 from 43 public hospitals or clinics in Hong Kong. Patients were divided into high-intensity (HI-S, atorvastatin 40–80 mg, rosuvastatin 20–40 mg), moderate-intensity (MI-S, atorvastatin 10–20 mg, rosuvastatin 5–10 mg, simvastatin 20–40 mg) and low-intensity (LI-S, simvastatin 10 mg) statin groups. With baseline and follow-up LDL-C, percentage reduction was calculated and the distance to LDL-C target was investigated within groups.

Results

Of 7,241 patients (mean age 61.8±12.4 years and 64.2% male), 4,451 (61.5%) had coronary artery disease, 109 (1.5%) peripheral artery disease, and 2,879 (39.8%) cerebrovascular disease. HI-S, MI-S and LI-S were prescribed in 20% (n=1,450), 61.1% (n=4,421) and 18.9% (n=1,370) patients, respectively. Mean baseline LDL-C was 2.9±1.0 mmol/L and mean follow-up value was 1.9±0.8 mmol/L with median LDL-C reduction of 46.1%, 40.4%, and 32.0% by HI-S, MI-S, and LI-S, respectively. 42.1%, 31.8%, and 14.7% of patients on HI-S, MI-S, and LI-S achieved ≥50% LDL-C reduction and only 23.5%, 18.2%, and 8.8% reached both ≥50% LDL-C reduction and <1.4 mmol/L. One in ten patients require further ≥50% LDL-C reduction to reach <1.4 mmol/L.

Conclusion

In statin-naïve Chinese ASCVD patients, most patients did not reach guidelines recommended LDL-C target even with high-intensity statin. Early statin up-titration or addition of non-statin lipid-lowering therapy may be required in majority of patients.

Funding Acknowledgement

Type of funding sources: None.

The effects of polyethersulfone and Nylon 6 micromembrane filters on the pyraclostrobin detection: adsorption performance and mechanism

Adsorption of test substances on micromembrane filters during sample pretreatment before qualitative and quantitative analysis has greatly affected the accuracy of the measurement. In the present study, it was found that the adsorption rate of pyraclostrobin reached 77.7-100% when water samples of pyraclostrobin (1 mL) were filtered with polyethersulfone (PES) and Nylon 6 filters. Therefore, the adsorption mechanisms were investigated from the kinetics, isotherms, and thermodynamics of the pyraclostrobin adsorption process, combined with attenuated total reflection-Fourier transform infrared (ATR-FTIR) spectroscopy and X-ray photoelectron spectroscopy (XPS) analysis. The results showed that PES accorded with second-order adsorption kinetics and Nylon 6 with first-order adsorption kinetics, and the correlation coefficient R² was 0.98. The adsorption behavior of the two micromembranes followed the linear isothermal model, indicating that the adsorption process was through monolayer adsorption. Thermodynamic study showed that the adsorption of pyracoethyl on PES membrane was spontaneous endothermic, while that on Nylon 6 was spontaneous exothermic. The π-π electron-donor-acceptor (EDA) between pyraclostrobin and PES may promote the adsorption of PES to pyraclostrobin, and hydrogen bonding between pyraclostrobin and Nylon 6 micromembrane may be involved in the adsorption. Our study also proved that the adding 60% methanol and iodine solution (2 mmol/L) was an effective strategy to reduce the adsorption effects and to increase the accuracy of the detection.

Observation of Dirac Hierarchy in Three-Dimensional Acoustic Topological Insulators

Dirac cones (DCs) play a pivotal role in various unique phenomena ranging from massless electrons in graphene to robust surface states in topological insulators (TIs). Recent studies have theoretically revealed a full Dirac hierarchy comprising an eightfold bulk DC, a fourfold surface DC, and a twofold hinge DC, associated with a hierarchy of topological phases including first-order to third-order three-dimensional (3D) topological insulators, using the same 3D base lattice. Here, we report the first experimental observation of the Dirac hierarchy in 3D acoustic TIs. Using acoustic measurements, we unambiguously reveal that lifting of multifold DCs in each hierarchy can induce two-dimensional topological surface states with a fourfold DC in a first-order 3D TI, one-dimensional topological hinge states with a twofold DC in a second-order 3D TI, and zero-dimensional topological corner states in a third-order 3D TI. Our Letter not only expands the fundamental research scope of Dirac physics, but also opens up a new route for multidimensional robust wave manipulation.

Personal network protects, social media harms: Evidence from two surveys during the COVID-19 pandemic

Background

The classic debate regarding the complex relationships between personal network, social media use, and mental well-being requires renewed examination in the novel context of pandemic-related social isolation.

Data and method

We present two surveys conducted at (i) the earlier months of the pandemic and (ii) the end of large scale social-lockdown measures in the U.S. to explore the social and behavioral antecedents of mental health states relating to social media use. Study 1 tracked the longitudinal changes of personal network, social media use, and anxiety level of a group of individuals (N = 147) over a three-month period during the pandemic. Study 2 replicated and extended the theoretical model to a race-representative U.S. adult sample (N = 258).

Results

Both studies consistently show that (1) more time on social media worsens anxiety. It also mediates the relationship between personal network size and anxiety. That is, a small personal network predicts more social media use, which is in turn related to increased anxiety. (2) Moreover, the effect of social media use on anxiety is mainly explained by news consumption on social media, rather than non-news related usage. (3) This link’s strength is moderated by one’s perception of COVID-19 impact, such that news consumption on social media increases anxiety more when the perceived impact is higher.

Conclusion

These results demonstrate communication technologies’ increasingly critical and multifaceted role in affecting mental health conditions.

Cost-effectiveness analysis of colorectal cancer screening in Shanghai, China: a modelling study

•

The current Shanghai CRC screening program is cost-effective.

•

Changing to a validated FIT would make the program more efficient.

•

The results were sensitive to an increase in the cost of the validated FIT.

•

The results were sensitive to more participation in screening and colonoscopy.

Background

The current community-based colorectal cancer (CRC) screening program in Shanghai, launched in 2013, invited individuals aged 50–74 years to triennial screening with a qualitative faecal immunochemical test (FIT) and questionnaire-based risk assessment (RA). We aimed to evaluate the effectiveness and cost-effectiveness of the existing Shanghai screening program and compare it to using a validated two-sample quantitative FIT.

Methods

We simulated four strategies (no screening, Shanghai FIT, Shanghai FIT + RA and validated FIT) for the Shanghai screening program and evaluated CRC incidence, CRC mortality, the number of life years gained (LYG), the number of FITs, and colonoscopies required for each. An incremental cost-effectiveness analysis was performed to assess the cost- effectiveness of each strategy.

Results

All screening modalities reduced CRC incidence and CRC mortality, gained extra number of LYG compared to no screening. Screening using the Shanghai FIT and validated FIT reduced CRC incidence from 45 cases to 43 per 1,000 simulated individuals (4.4%). Incidence was reduced to 42 cases (6.7%) using the Shanghai FIT + RA. All screening strategies reduced CRC mortality by 10.0% (from 10 to 9 deaths) and resulted in 6 to 7 LYG. The validated FIT was the most cost-effective among the evaluated strategies (ICER ¥26,461 per LYG).

Conclusions

Our findings show that the current Shanghai screening program is (cost-) effective compared to no screening, but changing to a validated FIT would make the program more efficient.

The Off-Target Effect of CRISPR-Cas12a System toward Insertions and Deletions between Target DNA and crRNA Sequences

The CRISPR-Cas12a system is a new type of genome editing tool with high efficiency and targeting. However, other sequences in the genome may also be cleaved nonspecifically, resulting in unavoidable off-target effects. Therefore, it is necessary to learn more about the mechanism of CRISPR-Cas12a to recognize target sequences to avoid its off-target effects. Here, we show that insertion (DNA bubble) or deletion (RNA bubble) of the target dsDNA sequence compared with the crRNA sequence, the CRISPR-Cas12a system can still recognize and cleave the target dsDNA sequence. We conclude that the tolerance of CRISPR-Cas12a to the bubbles is closely related to the location and size of the bubble and the GC base content of crRNA. In addition, we used the unique property of CRISPR-Cas12a to invent a new method to detect mutations and successfully detect the CD41-42(-CTTT) mutation. The detection limit of this method is 0.001%. Overall, our results strongly indicate that in addition to considering off-target effects caused by base mismatches, a comprehensive off-target analysis of the insertion and deletion of the target dsDNA sequence is required, and specific guidelines for effectively reducing potential off-target cleavage are proposed, to improve the safety manual of CRISPR-Cas12a biological application.

Higher-order topological states in two-dimensional Stampfli-Triangle photonic crystals

In this Letter, the higher-order topological state (HOTS) and its mechanism in two-dimensional Stampfli-Triangle (2D S-T) photonic crystals (PhCs) is explored. The topological corner states (TCSs) in 2D S-T PhCs are based on two physical mechanisms: one is caused by the photonic quantum spin Hall effect (PQSHE), and the other is caused by the topological interface state. While the former leads to the spin-direction locked effect which can change the distribution of the TCSs, the latter is conducive to the emergence of multiband TCSs in the same structure due to the characteristics of plentiful photonic bandgap (PBG) and broadband in 2D S-T PhCs. These findings allow new, to the best of our knowledge, insight into the HOTS, and are significant to the future design of photonic microcavities, high-quality factor lasers, and other related integrated multiband photonic devices.

Mechanism-Based Pharmacokinetic Model for the Deglycosylation Kinetics of 20(S)-Ginsenosides Rh2

Aim: The 20(S)-ginsenoside Rh2 (Rh2) is being developed as a new antitumor drug. However, to date, little is known about the kinetics of its deglycosylation metabolite (protopanoxadiol) (PPD) following Rh2 administration. The aim of this work was to 1) simultaneously characterise the pharmacokinetics of Rh2 and PPD following intravenous and oral Rh2 administration, 2) develop and validate a mechanism-based pharmacokinetic model to describe the deglycosylation kinetics and 3) predict the percentage of Rh2 entering the systemic circulation in PPD form.

Methods: Plasma samples were collected from rats after the I.V. or P.O. administration of Rh2. The plasma Rh2 and PPD concentrations were determined using HPLC-MS. The transformation from Rh2 to PPD, its absorption, and elimination were integrated into the mechanism based pharmacokinetic model to describe the pharmacokinetics of Rh2 and PPD simultaneously at 10 mg/kg. The concentration data collected following a 20 mg/kg dose of Rh2 was used for model validation.

Results: Following Rh2 administration, PPD exhibited high exposure and atypical double peaks. The model described the abnormal kinetics well and was further validated using external data. A total of 11% of the administered Rh2 was predicted to be transformed into PPD and enter the systemic circulation after I.V. administration, and a total of 20% of Rh2 was predicted to be absorbed into the systemic circulation in PPD form after P.O. administration of Rh2.

Conclusion: The developed model provides a useful tool to quantitatively study the deglycosylation kinetics of Rh2 and thus, provides a valuable resource for future pharmacokinetic studies of glycosides with similar deglycosylation metabolism.

Germination Characteristics Associated With Glutathione S-Transferases Endowed Quizalofop-p-Ethyl Resistance in Polypogon fugax

Quantification of germination characteristics between herbicide-resistant and -susceptible weeds might provide methods to control resistant weeds and permit better prediction of evolution and persistence of herbicide resistance. This study aimed to compare the germination characteristics of Asian minor bluegrass (Polypogon fugax) populations that are resistant or susceptible to quizalofop-p-ethyl under controlled conditions, which the resistance mechanism is involved in glutathione S-transferases (GSTs) metabolism-based resistance. No major differences in seed germination were found at diverse temperatures, pH ranges, and light conditions. However, a significant difference that seed response to a gradient of osmotic and salt stress between the resistant and susceptible P. fugax populations were found. Two stress response genes (P5CS-1 and CDPK-2) in P. fugax were likely involved in germination rate as well as germination speed in response to these stresses. Subsequently, population verification demonstrated that P5CS-1 and CDPK-2 genes may be linked to the resistance mechanism. Additionally, the two genes play an important role in response to salt stress and osmotic stress as shown by transcript abundance after stress treatments. Our findings suggest that the variation of the germination characteristics in P. fugax associates with the presence of GST-endowed resistance mechanism.

Optimising colorectal cancer screening in Shanghai, China: a modelling study

INTRODUCTION

To reduce the burden of colorectal cancer (CRC) in Shanghai, China, a CRC screening programme was commenced in 2013 inviting those aged 50-74 years to triennial screening with a faecal immunochemical test (FIT) and risk assessment. However, it is unknown whether this is the optimal screening strategy for this population. We aimed to determine the optimal CRC screening programme for Shanghai in terms of benefits, burden, harms and cost-effectiveness.

METHODS

Using Microsimulation Screening Analysis-Colon (MISCAN-Colon), we estimated the costs and effects of the current screening programme compared with a situation without screening. Subsequently, we estimated the benefits (life years gained (LYG)), burden (number of screening events, colonoscopies and false-positive tests), harms (number of colonoscopy complications) and costs (Renminb (¥)) of screening for 324 alternative screening strategies. We compared several different age ranges, screening modalities, intervals and FIT cut-off levels. An incremental cost-effectiveness analysis determined the optimal strategy assuming a willingness-to-pay of ¥193 931 per LYG.

RESULTS

Compared with no screening, the current screening programme reduced CRC incidence by 40% (19 cases per 1000 screened individuals) and CRC mortality by 67% (7 deaths). This strategy gained 32 additional life years, increased colonoscopy demand to 1434 per 1000 individuals and cost an additional ¥199 652. The optimal screening strategy was annual testing using a validated one-sample FIT, with a cut-off of 10 µg haemoglobin per gram from ages 45 to 80 years (incremental cost-effectiveness ratio, ¥62 107). This strategy increased LY by 0.18% and costs by 27%. Several alternative cost-effective strategies using a validated FIT offered comparable benefits to the current programme but lower burden and costs.

CONCLUSIONS

Although the current screening programme in Shanghai is effective at reducing CRC incidence and mortality, the programme could be optimised using a validated FIT. When implementing CRC screening, jurisdictions with limited health resources should use a validated test.