Emotional Appeals and Norms: How Normative Perceptions Moderate the Persuasive Impacts of Discrete Emotional Appeals within Tobacco Pictorial Warnings in China

Tobacco pictorial warnings could employ a variety of emotional appeals to enhance effectiveness; however, little research exists to guide the selection of discrete emotional appeals. Further, it remains unclear how contextual pro-smoking norms might influence the persuasive impacts of discrete emotional appeals within pictorial warnings, especially in China, where the overall smoking rate and social acceptance remain high. To fill these gaps, this study leveraged the largest set of pictorial warnings (K = 510) tested to date. Using a randomized large-K multiple-message design, we evaluated the impacts of disgust, fear, self-anger, contempt, shame, and hope appeals among Chinese adult male smokers (N = 2,306) on perceived message effectiveness (PME). Results showed that fear, self-anger, shame, and hope appeals significantly increased PME, while disgust and contempt appeals appeared less effective. Importantly, the PME of nearly all emotional appeals - except hope appeals - was weakened for Chinese adult male smokers with higher pro-smoking normative perceptions, highlighting the importance of considering local contextual influences when implementing pictorial warnings.

Clinical efficacy and safety of adjuvant immunotherapy (Tislelizumab) plus chemotherapy vs. adjuvant chemotherapy alone in lymph node-positive patients with gastric cancer after D2 radical resection: a prospective, 2-arm, phase II study

OBJECTIVE

This study aims to investigate the effectiveness and safety of adjuvant Tislelizumab (BeiGene China Co., Ltd, Changping District, Beijing, China) in combination with chemotherapy for patients with localized lymph node-positive disease following D2 (extended lymphadenectomy) radical gastrectomy for gastric cancer.

PATIENTS AND METHODS

Patients with lymph node-positive gastric cancer who underwent D2 radical gastrectomy at Yixing People's Hospital between April 2021 and June 2022 were selected and enrolled in the study. They were divided into the study group, which received immunotherapy (Tislelizumab) in combination with chemotherapy (XELOX regimen: Xeloda plus Oxaliplatin), or the control group, which received chemotherapy alone (XELOX regimen). Adverse events, disease-free survival (DFS), and overall survival (OS) were observed. This study was registered on ClinicalTrials.gov (ClinicalTrials.gov Identifier: NCT05844371).

RESULTS

The one-year disease-free survival (DFS) rate was 81.82% in the study group compared to 71.43% in the control group. Although the DFS rate tended to be higher in the study group, the difference did not reach statistical significance (p=0.388, HR=0.573, 95% CI: 0.161-2.032). Patients in both groups tolerated the treatment well. Both groups exhibited similar rates of neutropenia, hemoglobin depletion, gastrointestinal reactions, abnormal liver function, and peripheral neuritis. The majority of adverse events in both groups were grade 1-2, with only hypothyroidism showing a significant difference (p=0.021). The only statistically significant difference in grade 3-4 adverse events was thrombocytopenia (p=0.048). All adverse reactions were effectively managed with symptomatic treatment.

CONCLUSIONS

The addition of adjuvant PD-1 inhibitor (Tislelizumab) to XELOX therapy showed a favorable impact on the one-year disease-free survival (DFS) rate when compared to adjuvant XELOX chemotherapy alone in patients with regional lymph node-positive disease after D2 radical gastrectomy. Moreover, patients were able to tolerate the accompanying adverse effects, which were deemed safe.

Impacts of landscape pattern evolution on typical ecosystem services in Ganjiang River Basin, China

Understanding the response mechanism of ecosystem services (ES) to landscape patterns is important in regional landscape planning and sustainable development. In this study, the landscape index and InVEST model were used to quantitatively analyze the spatio-temporal evolution of landscape patterns and ES in the Ganjiang River Basin of China from 1990 to 2020. Furthermore, the bivariate Moran's I method and spatial error model were used to test the spatial correlation between landscape index and ES. The results showed that (1) cropland decreased and construction land increased, and the overall landscape tended to be fragmented, the patch shape complicated, and landscape diversity increased from 1990 to 2020. Water conservation (WC) and soil conservation (SC) capacity increased by 10.56 mm and 16.24 t hm-2 a-1, respectively, whereas carbon storage (CS) decreased by 1.22 t hm-2 a-1. (2) The responses of different typical ES to landscape patterns were different in the landscape index and response degree. Typical ES negatively responded to Shannon's diversity index and patch density. WC was sensitive to the Splitting Index, whereas SC and CS were more responsive to the average patch area. (3) The overall purpose of territorial spatial planning within a basin should be to reduce the fragmentation and heterogeneity of the landscape. According to four local aggregation patterns of landscape index and ES, corresponding measures can be taken according to local conditions in different regions. These results can provide a quantitative basis for landscape management and ecological construction in the Ganjiang River Basin and scientific guidance for the Yangtze River conservation strategy.

Measurement of Ultra-High-Energy Diffuse Gamma-Ray Emission of the Galactic Plane from 10 TeV to 1 PeV with LHAASO-KM2A

The diffuse Galactic γ-ray emission, mainly produced via interactions between cosmic rays and the interstellar medium and/or radiation field, is a very important probe of the distribution, propagation, and interaction of cosmic rays in the Milky Way. In this Letter, we report the measurements of diffuse γ rays from the Galactic plane between 10 TeV and 1 PeV energies, with the square kilometer array of the Large High Altitude Air Shower Observatory (LHAASO). Diffuse emissions from the inner (15°10  TeV). The energy spectrum in the inner Galaxy regions can be described by a power-law function with an index of -2.99±0.04, which is different from the curved spectrum as expected from hadronic interactions between locally measured cosmic rays and the line-of-sight integrated gas content. Furthermore, the measured flux is higher by a factor of ∼3 than the prediction. A similar spectrum with an index of -2.99±0.07 is found in the outer Galaxy region, and the absolute flux for 10≲E≲60  TeV is again higher than the prediction for hadronic cosmic ray interactions. The latitude distributions of the diffuse emission are consistent with the gas distribution, while the longitude distributions show clear deviation from the gas distribution. The LHAASO measurements imply that either additional emission sources exist or cosmic ray intensities have spatial variations.

Eggshell Biowaste-Derived Flexible and Self-Cleaning Films for Efficient Subambient Daytime Radiative Cooling

The management of the abundant eggshell biowaste produced worldwide has become a problematic issue due to the generated odor and microorganisms after direct disposal of the eggshell biowaste in landfills. Herein, we propose a new method to convert the hazardous eggshell biowaste to valuable resources for energy management applications. Eggshell-based films are fabricated by embedding eggshell powders into a polymer matrix to achieve highly efficient subambient daytime radiative cooling. Benefiting from the Mie scattering of the eggshell particles/air pores in the solar spectrum and the strong emission of the eggshell in the mid-infrared (mid-IR) range, the eggshell-based films present a high reflection of 0.96 in the solar spectrum and a high emission of 0.95 in the mid-IR range, with notable average temperature reductions of 4.1 and 11 °C below the ambient temperature during daytime and nighttime, respectively. Moreover, the eggshell-based films exhibit excellent flexibility and self-cleaning properties, which are beneficial for practical long-term outdoor applications. Our proposed design provides a new means for environmentally friendly and sustainable management of eggshell biowaste.

Learning Intention-Aware Policies in Deep Reinforcement Learning

Deep reinforcement learning (DRL) provides an agent with an optimal policy so as to maximize the cumulative rewards. The policy defined in DRL mainly depends on the state, historical memory, and policy model parameters. However, we humans usually take actions according to our own intentions, such as moving fast or slow, besides the elements included in the traditional policy models. In order to make the action-choosing mechanism more similar to humans and make the agent to select actions that incorporate intentions, we propose an intention-aware policy learning method in this letter To formalize this process, we first define an intention-aware policy by incorporating the intention information into the policy model, which is learned by maximizing the cumulative rewards with the mutual information (MI) between the intention and the action. Then we derive an approximation of the MI objective that can be optimized efficiently. Finally, we demonstrate the effectiveness of the intention-aware policy in the classical MuJoCo control task and the multigoal continuous chain walking task.

Knockdown of Long Noncoding RNA CCAT2 Suppresses Malignant Phenotype in Human Laryngeal Squamous Cell Carcinoma

This study aimed to explore the biological role and mechanism underlying the effects of colon cancer-associated transcript 2 (CCAT2), a long noncoding RNA (lncRNA) in human laryngeal squamous cell carcinoma (LSCC). CCAT2 expression levels in clinical LSCC samples and TU-212 cell line were evaluated by quantitative real-time PCR. The correlation of CCAT2 expression level with clinical-pathological characteristics of patients and their prognosis was analyzed. The functional role of CCAT2 in human LSCC was assessed by Cell Counting Kit-8, Transwell assay, flow cytometric analysis, and LSCC xenograft experiment in vivo. The expression of potential targeted proteins was detected by Western blotting and immunohistochemistry. We found that expression of CCAT2 was significantly elevated in LSCC tissues and TU-212 cells (p<0.05). Survival analysis showed that LSCC patients with high expression of CCAT2 had a shorter 5-year overall survival rate than those with low expression (p<0.05). In addition, CCAT2 silencing with short hairpin RNA significantly decreased the proliferative and invasive potential of TU-212 cells (p<0.05) and promoted their apoptosis. In Nude mice, CCAT2 knockdown suppressed the growth of tumor and decreased its volume and weight in comparison with the controls (p<0.05). In TU-212 cells, CCAT2 silencing with short hairpin RNA significantly down-regulated the expression of β-catenin and CDK8 (p<0.05). Thus, knockdown of CCAT2 suppresses proliferation and invasion of the cells and inhibits Wnt/β-catenin signaling pathway in LSCC, which indicates novel therapeutic targets and prognostic indicators in patients with LSCC.

Design of a High-Performance Titanium Nitride Metastructure-Based Solar Absorber Using Quantum Computing-Assisted Optimization

Metastructures of titanium nitride (TiN), a plasmonic refractory material, can potentially achieve high solar absorptance while operating at elevated temperatures, but the design has been driven by expert intuition. Here, we design a high-performance solar absorber based on TiN metastructures using quantum computing-assisted optimization. The optimization scheme includes machine learning, quantum annealing, and optical simulation in an iterative cycle. It designs an optimal structure with solar absorptance > 95% within 40 h, much faster than an exhaustive search. Analysis of electric field distributions demonstrates that combined effects of Fabry-Perot interferences and surface plasmonic resonances contribute to the broadband high absorption efficiency of the optimally designed metastructure. The designed absorber may exhibit great potential for solar energy harvesting applications, and the optimization scheme can be applied to the design of other complex functional materials.

[Diagnosis and treatment procedures and health management for patients with hereditary angioedema]

As a recognized rare and highly fatal disease, hereditary angioedema (HAE) is difficult to diagnose and characterized by recurrent edema involving the head, limbs, genitals and larynx, etc. Diagnosis of HAE is not difficult. However, low incidence and lack of clinical characteristics lead to difficulty of doctors on timely diagnosis and correct intervention for HAE patients. Therefore, it is crucial to improve the awareness of this disease and prevent its recurrence. for HAE patients. In view of absent cognition of doctors and the general public on HAE, patients often suffer from sudden death or become disabled due to laryngeal edema which cannot be treated in time. Thus, based on the Internet mobile terminal platform, the team set up an all-day rapid emergency response system which is provided for HAE patients by setting up "one-click help". The aim is to offer optimization on overall management of HAE and designed the intelligent follow-up management to provide timely assistance and specialized suggestion for patients with acute attacks.

Suppressing Dendrite Growth and Side Reactions via Mechanically Robust Laponite-Based Electrolyte Membranes for Ultrastable Aqueous Zinc-Ion Batteries

The development of aqueous zinc-ion batteries (AZIBs) faces significant challenges because of water-induced side reactions arising from the high water activity in aqueous electrolytes. Herein, a quasi-solid-state electrolyte membrane with low water activity is designed based on a laponite (LP) nanoclay for separator-free AZIBs. The mechanically robust LP-based membrane can perform simultaneously as a separator and a quasi-solid-state electrolyte to inhibit dendrite growth and water-induced side reactions at the Zn/electrolyte interface. A combination of density functional theory calculations, theoretical analyses, and experiments ascertains that the water activities associated with self-dissociation, byproduct formation, and electrochemical decomposition could be substantially suppressed when the water molecules are absorbed by LP. This could be attributed to the high water adsorption and hydration capabilities of LP nanocrystals, resulting from the strong Coulombic and hydrogen-binding interactions between water and LP. Most importantly, the separator-free AZIBs exhibit high capacity retention rates of 94.10% after 2,000 cycles at 1 A/g and 86.32% after 10,000 cycles at 3 A/g, along with enhanced durability and record-low voltage decay rates over a 60-day storage period. This work provides a fundamental understanding of water activity and demonstrates that LP nanoclay is promising for ultrastable separator-free AZIBs for practical energy storage applications.

Genomic characterisation of de novo EGFR copy number gain and its impact on the efficacy of first-line EGFR-tyrosine kinase inhibitors for EGFR mutated non-small cell lung cancer

BACKGROUND

Non-small cell lung cancer (NSCLC) patients with epidermal growth factor receptor (EGFR) mutation generally respond well to epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs). However, genomic characterisation of de novo EGFR copy number gain (CNG) and its impact on the efficacy of first-line EGFR-TKIs remains unclear.

METHODS

This multicenter, retrospective and real-world study included two cohorts that enroled EGFR mutant NSCLC patients. EGFR CNG was tested by next-generation sequencing of untreated tissue specimens. Cohort 1 detected the impact of EGFR CNG on first-line EGFR-TKIs treatment, and cohort 2 explored the genomic characterisation.

RESULTS

Cohort 1 enroled 355 patients from four cancer centres between January 2013 and March 2022. The patients were divided into three groups, included the EGFR non-CNG, EGFR CNG, and EGFR uncertain-CNG. No significant difference in progression-free survival (PFS) was found between the three groups (10.0 months vs. 10.8 months vs. 9.9 months, respectively, p = 0.384). Furthermore, the overall response rate was not statistically significant in the EGFR CNG group compared to the EGFR non-CNG or uncertain arm (70.3% vs. 63.2% vs. 54.5%, respectively, p = 0.154). Cohort 2 included 7876 NSCLC patients with 16.4% showing EGFR CNG. Gene mutations such as TP53, IKZF1, RAC1, MYC, MET, CDKN2A/B and alterations of the metabolic-related and ERK signalling pathway were significantly associated with patients with EGFR CNG compared to those without.

CONCLUSIONS

De novo EGFR CNG had no effect on the efficacy of first-line EGFR-TKI treatment in EGFR mutant NSCLC patients, and tumours with EGFR CNG had more complex genomic profiles than those without.

CLDN6 Suppresses Migration and Invasion of MCF-7 and SKBR-3 Breast Cancer Cells by Blocking the SMAD/Snail/MMP-2/9 Axis

The study examined the mechanisms of action of signal protein claudin 6 (CLDN6) on migration and invasion of breast cancer cell lines MCF-7 and SKBR-3. To this end, the signal proteins SMAD were blocked with their inhibitor SB431542, the genes CLDN6 and SNAIL were knocked down with short hairpin RNAs, and MMP2 and MMP9 were inhibited with TIMP-1. Expressions of MMP2 and MMP9 mRNAs were evaluated by reverse transcription PCR, Expressions of MMP-2, MMP-9, E-cadherin, N-cadherin, and vimentin were examined by Western blotting. Migration and invasion were analyzed by scratch test and Matrigel invasion assay. SB431542 inhibited expression of MMP2 and MMP9 in both cell lines. Single use of SB431542 inhibited expression of MMP-2/MMP-9 and corresponding mRNAs, but subsequent silencing of CLDN6 gene reversed this effect. TIMP-1 reversed down-regulation of E-cadherin, upregulation of N-cadherin and vimentin, facilitation of migration and invasion evoked by CLDN6 knocking down. Silencing of SNAIL gene inhibited migration and invasion, upregulated the expression of E-cadherin, and down-regulated expression of MMP2, MMP 9, N-cadherin, and vimentin. Thus, CLDN6 suppresses the epithelial-mesenchymal transition, migration, and invasion via blocking SMAD/Snail/MMP-2/9 signaling pathway in MCF-7 and SKBR-3 cancer cell lines.

Molecular Alignment-Mediated Stick-Slip Poiseuille Flow of Oil in Graphene Nanochannels

The flow behavior of oil in nanochannels has attracted extensive attention for oil transport applications. In most, if not all, of the prior theoretical simulations, oil molecules were observed to flow steadily in nanochannels under pressure gradients. In this study, non-equilibrium molecular dynamics simulations are conducted to simulate the Poiseuille flow of oil with three different hydrocarbon chain lengths in graphene nanochannels. Contrary to the conventional perception of steady flows of oil in nanochannels, we find that oil molecules with the longest hydrocarbon chain (i.e., n-dodecane) exhibit notable stick-slip flow behavior. An alternation between the high average velocity of n-dodecane in the slip motion and the low average velocity in the stick motion is observed, with a drastic, abrupt velocity jolt of up to 40 times occurring at the transition in a stick-slip motion. Further statistical analyses show that the stick-slip flow behavior of n-dodecane molecules originates from the molecular alignment change of oil near the graphene wall. The molecular alignment of n-dodecane shows different statistical distributions under stick and slip motion states, leading to significant changes of friction forces and thus notable velocity fluctuations. This work provides new insights into the Poiseuille flow behavior of oil in graphene nanochannels and may offer useful guidelines for other mass transport applications.

A tera-electron volt afterglow from a narrow jet in an extremely bright gamma-ray burst

Some gamma-ray bursts (GRBs) have a tera-electron volt (TeV) afterglow, but the early onset of this has not been observed. We report observations with the Large High Altitude Air Shower Observatory of the bright GRB 221009A, which serendipitously occurred within the instrument field of view. More than 64,000 photons >0.2 TeV were detected within the first 3000 seconds. The TeV flux began several minutes after the GRB trigger, then rose to a peak about 10 seconds later. This was followed by a decay phase, which became more rapid ~650 seconds after the peak. We interpret the emission using a model of a relativistic jet with half-opening angle ~0.8°. This is consistent with the core of a structured jet and could explain the high isotropic energy of this GRB.

Photosynthetic Fixation of CO2 in Alkenes by Heterogeneous Photoredox Catalysis with Visible Light

Light-driven fixation of CO2 in organics has emerged as an appealing alternative for the synthesis of value-added fine chemicals. Challenges remain in the transformation of CO2 as well as product selectivity due to its thermodynamic stability and kinetic inertness. Here we develop a boron carbonitride (BCN) with the abundant terminal B/N defects around the mesoporous walls, which essentially enhances surface active sites as well as charge transfer kinetics, boosting the overall rate of CO2 adsorption and activation. In this protocol, anti-Markovnikov hydrocarboxylation of alkenes with CO2 to an extended carbon chain is achieved with good functional group tolerance and specific regioselectivity under visible light irradiation. The mechanistic studies demonstrate the formation of CO2 radical anion intermediate on defective boron carbonitride, leading to the anti-Markovnikov carboxylation. Gram-scale reaction, late-stage carboxylation of natural products and synthesis of anti-diabetic GPR40 agonists reveal the utility of this method. This study sheds new insight on the design and application of metal-free semiconductors for the conversion of CO2 in an atom-economic and sustainable manner.

[Enhanced endoplasmic reticulum RyR1 receptor phosphorylation leads to diaphragmatic dysfunction in septic rats]

OBJECTIVE

To explore the role of endoplasmic reticulum ryanodine receptor 1 (RyR1) expression and phosphorylation in sepsis- induced diaphragm dysfunction.

METHODS

Thirty SPF male SD rats were randomized equally into 5 groups, including a sham-operated group, 3 sepsis model groups observed at 6, 12, or 24 h following cecal ligation and perforation (CLP; CLP-6h, CLP-12h, and CLP-24h groups, respectively), and a CLP-24h group with a single intraperitoneal injection of KN- 93 immediately after the operation (CLP-24h+KN-93 group). At the indicated time points, diaphragm samples were collected for measurement of compound muscle action potential (CMAP), fatigue index of the isolated diaphragm and fitted frequencycontraction curves. The protein expression levels of CaMK Ⅱ, RyR1 and P-RyR1 in the diaphragm were detected using Western blotting.

RESULTS

In the rat models of sepsis, the amplitude of diaphragm CMAP decreased and its duration increased with time following CLP, and the changes were the most obvious at 24 h and significantly attenuated by KN-93 treatment (P < 0.05). The diaphragm fatigue index increased progressively following CLP (P < 0.05) irrespective of KN- 93 treatment (P>0.05). The frequency-contraction curve of the diaphragm muscle decreased progressively following CLP, and was significantly lower in CLP-24 h group than in CLP-24 h+KN-93 group (P < 0.05). Compared with that in the sham-operated group, RyR1 expression level in the diaphragm was significantly lowered at 24 h (P < 0.05) but not at 6 or 12 following CLP, irrespective of KN-93 treatment; The expression level of P-RyR1 increased gradually with time after CLP, and was significantly lowered by KN-93 treatment at 24 h following CLP (P < 0.05). The expression level of CaMKⅡ increased significantly at 24 h following CLP, and was obviously lowered by KN-93 treatment (P < 0.05).

CONCLUSION

Sepsis causes diaphragmatic dysfunction by enhancing CaMK Ⅱ expression and RyR1 receptor phosphorylation in the endoplasmic reticulum of the diaphragm.

[Genomic epidemiology of Vibrio parahaemolyticus from acute diarrheal patients in Shenzhen City from 2013 to 2021]

Objective: To characterize the prevalence and genomic epidemiology of Vibrio parahaemolyticus from acute diarrheal patients in Shenzhen City from 2013 to 2021. Methods: Based on the Shenzhen Infectious Diarrhea Surveillance System, acute diarrheal patients were actively monitored in sentinel hospitals from 2013 to 2021. Whole-genome sequencing (WGS) of Vibrio parahaemolyticus isolates was performed, and the genomic population structure, serotypes, virulence genes and multilocus sequence typing were analyzed. Outbreak clusters from 2019 to 2021 were explored based on single-nucleotide polymorphism analysis. Results: A total of 48 623 acute diarrhea cases were monitored in 15 sentinel hospitals from 2013 to 2021, and 1 135 Vibrio parahaemolyticus strains were isolated, with a positive isolation rate of 2.3%. Qualified whole-genome sequencing data of 852 isolates were obtained. Eighty-nine serotypes, 21 known ST types and 5 new ST types were identified by sequence analysis, and 93.2% of strains were detected with toxin profile of tdh+trh-. 8 clonal groups (CGs) were captured, with CG3 as the absolute predominance, followed by CG189. The CG3 group was dominated by O3:K6 serotype and ST3 sequence type, while CG189 group was mainly O4:KUT, O4:K8 serotypes and ST189a and ST189 type. A total of 13 clusters were identified, containing 154 cases. About 30 outbreak clusters with 29 outbreak clusters caused by CG3 strains from 2019 to 2021. Conclusion: Vibrio parahaemolyticus is a major pathogen of acute infectious diarrhea in Shenzhen City, with diverse population structures. CG3 and CG189 have been prevalent and predominant in Shenzhen City for a long time. Scattered outbreaks and persistent sources of contamination ignored by traditional methods could be captured by WGS analysis. Tracing the source of epidemic clone groups and taking precise prevention and control measures are expected to significantly reduce the burden of diarrhea diseases caused by Vibrio parahaemolyticus infection in Shenzhen City.

[Femtosecond laser-assisted open astigmatic keratotomy versus non-open astigmatic keratotomy for astigmatism correction in cataract surgery]

Objective: To compare the effects of femtosecond laser-assisted astigmatic keratotomy (FSAK) with and without a manual opening for correction of low to moderate corneal astigmatism at the time of cataract surgery. Methods: It was a prospective cohort study. Patients undergoing cataract surgery from June 2021 to June 2022 at the Army Specialty Medical Center were consecutively enrolled. To correct low to moderate astigmatism, they had combined FSAK with the corneal epithelium manually opened or not according to their own decisions. Pentacam HR corneal topography was performed at 3 months after surgery. The main indicators were target induced astigmatism, surgically induced astigmatism, difference vector, correction index and angle of error. The independent samples t-test was used for continuous variables conforming to a normal distribution, the Mann-Whitney U-test for those not conforming to a normal distribution, and the Chi-square test for categorical variables. Results: There were 51 patients (61 eyes), including 27 patients (31 eyes) receiving combined open FSAK and 24 patients (30 eyes) with non-open keratotomy. No statistical difference was found between the two groups of patients in terms of age, gender and mean follow-up time (P>0.05). The target induced astigmatism was 1.10(0.80, 1.50) D in patients with open keratotomy and 1.30(0.98, 1.73) D in patients with non-open keratotomy (Z=1.729, P=0.084). The surgically induced astigmatism was 0.70 (0.59, 1.25) D and 0.42 (0.20, 0.66) D (Z=-3.571, P<0.001), the difference vector was (0.51±0.31) D and (1.21±0.44) D (t=-7.238, P<0.001), the correction index was 0.78±0.32 and 0.38±0.25 (t=5.386, P<0.001), and the angle of error was -1.08°±10.76° and 5.93°±46.98° (t=0.809, P=0.422) in the two groups, respectively. Conclusion: Open FSAK can achieve better astigmatism correction and less postoperative residual astigmatism than non-open FSAK in cataract surgery.

Modes and Mechanisms of Pacific Decadal-Scale Variability

The modes of Pacific decadal-scale variability (PDV), traditionally defined as statistical patterns of variance, reflect to first order the ocean's integration (i.e., reddening) of atmospheric forcing that arises from both a shift and a change in strength of the climatological (time-mean) atmospheric circulation. While these patterns concisely describe PDV, they do not distinguish among the key dynamical processes driving the evolution of PDV anomalies, including atmospheric and ocean teleconnections and coupled feedbacks with similar spatial structures that operate on different timescales. In this review, we synthesize past analysis using an empirical dynamical model constructed from monthly ocean surface anomalies drawn from several reanalysis products, showing that the PDV modes of variance result from two fundamental low-frequency dynamical eigenmodes: the North Pacific-central Pacific (NP-CP) and Kuroshio-Oyashio Extension (KOE) modes. Both eigenmodes highlight how two-way tropical-extratropical teleconnection dynamics are the primary mechanisms energizing and synchronizing the basin-scale footprint of PDV. While the NP-CP mode captures interannual- to decadal-scale variability, the KOE mode is linked to the basin-scale expression of PDV on decadal to multidecadal timescales, including contributions from the South Pacific.

TMT-based comprehensive proteomic profiling identifies serum prognostic signatures of acute myeloid leukemia

Acute myeloid leukemia (AML) is classified into favorable-risk, intermediate-risk, and poor-risk subtypes. This study aimed to compare the serum proteomic signatures of the three AML subtypes and identify prognostic biomarkers for AML. Serum samples from patients with favorable-risk (n = 14), intermediate-risk (n = 19), and poor-risk AMLs (n = 18) were used for the analysis of tandem mass tag (TMT) labeling-based quantitative proteomics. Comparative analysis was performed to identify differentially expressed proteins (DEPs) between groups. Prognostic proteins were screened using binary logistics regression analysis. TMT-MS/MS proteomics analysis identified 138 DEPs. Fumarate hydratase (FH), isocitrate dehydrogenase 2 (IDH2), and enolase 1 (ENO1) were significantly upregulated in poor-risk patients compared with favorable-risk patients. ELISA assay confirmed that patients with poor-risk AMLs had higher levels of IDH2, ENO1, and FH compared with intermediate-risk AML patients. Logistics analysis identified that proteins 3-hydroxyacyl-CoA dehydrogenase type-2 (HADH, odds ratio (OR) = 1.035, p = 0.010), glutamine synthetase (GLUL, OR = 1.022, p = 0.039), and lactotransferrin (LTF, OR = 1.1224, p = 0.016) were associated with poor prognosis, and proteins ENO1 (OR = 1.154, p = 0.053), FH (OR = 1.043, p = 0.059), and IDH2 (OR = 3.350, p = 0.055) were associated with AML prognosis. This study showed that AML patients had elevated levels of FH, IDH2, ENO1, LTF, and GLUL proteins and might be at high risk of poor prognosis.

Investigating Partially Discordant Results in Phase 3 Studies of Aducanumab

OBJECTIVES

Efficacy and safety results from the EMERGE (NCT02484547) and ENGAGE (NCT02477800) phase 3 studies of aducanumab in early Alzheimer's disease (AD) have been published. In EMERGE, but not in ENGAGE, high-dose aducanumab demonstrated significant treatment effects across primary and secondary endpoints. Low-dose aducanumab results were consistent across studies with non-significant differences versus placebo that were intermediate to the high-dose arm in EMERGE. The present investigation examined data from EMERGE and ENGAGE through post-hoc analyses to determine factors that contributed to discordant results between the high-dose arms of the two studies.

DESIGN

EMERGE and ENGAGE were 2 phase 3, randomized, double-blind, placebo-controlled, parallel-group studies.

SETTING

EMERGE and ENGAGE were 2 global multicenter studies involving 348 sites in 20 countries.

PARTICIPANTS

Participants in EMERGE and ENGAGE were aged 50 to 85 years and had mild cognitive impairment or mild AD dementia with confirmed amyloid pathology. The randomized and dosed population (all randomized patients who received at least one dose of study treatment) included 1638 patients in EMERGE and 1647 in ENGAGE.

INTERVENTION

In EMERGE and ENGAGE, participants were randomized to receive low- or high-dose aducanumab or placebo (1:1:1) once every 4 weeks.

MEASUREMENTS

In this paper, 4 areas were investigated through post-hoc analyses to understand the discordance in the high-dose arms of the EMERGE and ENGAGE studies: baseline characteristics, amyloid-related imaging abnormalities, non-normality of the data, and dosing/exposure to aducanumab.

RESULTS

Post-hoc analyses showed that outcomes in the ENGAGE high-dose group were affected by an imbalance in a small number of patients with extremely rapid progression and by lower exposure to the target dose of 10 mg/kg. These factors were confounded and present in early enrolled patients but were not present in later-enrolled patients who were randomized to the target dosing regimen of 10 mg/kg after titration. Neither baseline characteristics nor amyloid-related imaging abnormalities contributed to the difference in results between the high-dose arms.

CONCLUSIONS

Results were consistent across studies in later enrolled patients in which the incidence of rapidly progressing patients was balanced across treatment arms.