Changes in brain susceptibility in Wilson's disease patients: a quantitative susceptibility mapping study

AIM

To assess changes in the susceptibility of the caudate nucleus (CN), putamen, and globus pallidus (GP) in patients with neurological and hepatic Wilson's disease (WD) by quantitative susceptibility mapping (QSM).

MATERIAL AND METHODS

The brain MRI images of 33 patients diagnosed with WD and 20 age-matched controls were analysed retrospectively. All participants underwent brain T1-weighted, T2-weighted, and QSM imaging using a 1.5 T magnetic resonance imaging (MRI) machine. QSM maps were evaluated with the STISuite toolbox. The quantitative susceptibility levels of the CN, putamen, and GP were analysed using region of interest analysis on QSM maps. Differences among neurological WD patients, hepatic patients, and controls were determined.

RESULTS

Susceptibility levels were significantly higher for all examined structures (CN, putamen and GP) in patients with neurological WD compared with controls (all p<0.05) and hepatic WD patients (all p<0.05). No statistically significant differences were found in susceptibility levels between patients with hepatic WD and controls (all p>0.05).

CONCLUSION

The QSM technique is a valuable tool for detecting changes in brain susceptibility in WD patients, indicating abnormal metal deposition. Notably, the current findings suggest that neurological WD patients exhibit more severe susceptibility changes compared with hepatic WD patients. Therefore, QSM can be utilised as a complementary method to detect brain injury in WD patients.

Anthrax lethal toxin and tumor necrosis factor-α synergize on intestinal epithelia to induce mouse death

Bacillus anthracis lethal toxin (LT) is a determinant of lethal anthrax. Its function in myeloid cells is required for bacterial dissemination, and LT itself can directly trigger dysfunction of the cardiovascular system. The interplay between LT and the host responses is important in the pathogenesis, but our knowledge on this interplay remains limited. Tumor necrosis factor-α (TNF-α) is a pleiotropic pro-inflammatory cytokine induced by bacterial infections. Since LT accumulates and cytokines, predominantly TNF, amass during B. anthracis infection, co-treatment of TNF + LT in mice was used to mimic in vivo conditions for LT to function in inflamed hosts. Bone marrow transplantation and genetically engineered mice showed unexpectedly that the death of intestinal epithelial cells (IECs) rather than that of hematopoietic cells led to LT + TNF-induced lethality. Inhibition of p38α mitogen-activated protein kinase (MAPK) signaling by LT in IECs promoted TNF-induced apoptosis and necroptosis of IECs, leading to intestinal damage and mouse death. Consistently, p38α inhibition by LT enhanced TNF-mediated cell death in human colon epithelial HT-29 cells. As intestinal damage is one of the leading causes of lethality in anthrax patients, the IEC damage caused by LT + TNF would most likely be a mechanism underneath this clinical manifestation and could be a target for interventions.

Land subsidence susceptibility mapping: a new approach to improve decision stump classification (DSC) performance and combine it with four machine learning algorithms

Land subsidence is a worldwide threat. In arid and semiarid lands, groundwater depletion is the main factor that induce the subsidence resulting in environmental damages and socio-economic issues. To foresee and prevent the impact of land subsidence, it is necessary to develop accurate maps of the magnitude and evolution of the subsidences. Land subsidence susceptibility maps (LSSMs) provide one of the effective tools to manage vulnerable areas and to reduce or prevent land subsidence. In this study, we used a new approach to improve decision stump classification (DSC) performance and combine it with machine learning algorithms (MLAs) of naïve Bayes tree (NBTree), J48 decision tree, alternating decision tree (ADTree), logistic model tree (LMT), and support vector machine (SVM) in land subsidence susceptibility mapping (LSSSM). We employ data from 94 subsidence locations, among which 70% were used to train learning hybrid models and the other 30% were used for validation. In addition, the models' performance was assessed by ROC-AUC, accuracy, sensitivity, specificity, odd ratio, root-mean-square error (RMSE), kappa, frequency ratio, and F-score techniques. A comparison of the results obtained from the different models reveals that the new DSC-ADTree hybrid algorithm has the highest accuracy (AUC = 0.983) in preparing LSSSMs as compared to other learning models such as DSC-J48 (AUC = 0.976), DSC-NBTree (AUC = 0.959), DSC-LMT (AUC = 0.948), DSC-SVM (AUC = 0.939), and DSC (AUC = 0.911). The LSSSMs generated through the novel scientific approach presented in our study provide reliable tools for managing and reducing the risk of land subsidence.

Biased Complementary-Label Learning Without True Labels

In complementary-label learning (CLL), the complementary transition matrix, denoting the probabilities that true labels flip into complementary labels (CLs) which specify classes observations do not belong to, is crucial to building statistically consistent classifiers. Most existing works implicitly assume that the transition probabilities are identical, which is not true in practice and may lead to undesirable bias in solutions. Few recent works have extended the problem to a biased setting but limit their explorations to modeling the transition matrix by exploiting the complementary class posteriors of anchor points (i.e., instances that almost certainly belong to a specific class). However, due to the severe corruption and unevenness of biased CLs, both anchor points and complementary class posteriors are difficult to predict accurately in the absence of true labels. In this article, rather than directly predicting these two error-prone items, we instead propose a divided-T estimator as an alternative to effectively learn transition matrices from only biased CLs. Specifically, we exploit semantic clustering to mitigate the adverse effects arising from CLs. By introducing the learned semantic clusters as an intermediate class, we factorize the original transition matrix into the product of two easy-to-estimate matrices that are not reliant on the two error-prone items. Both theoretical analyses and empirical results justify the effectiveness of the divided- T estimator for estimating transition matrices under a mild assumption. Experimental results on benchmark datasets further demonstrate that the divided- T estimator outperforms state-of-the-art (SOTA) methods by a substantial margin.

Diagnosis of obstetric brachial plexus injury in a 2-year-old girl using high‑frequency ultrasonography

We describe an unusual case of infant obstetric brachial plexus injury located in the cervical (C)5-C6 brachial plexus nerve, which was preoperatively diagnosed using high-frequency ultrasonography (US) at 2 years of age. The girl was diagnosed with a right clavicular fracture because of shoulder dystocia. She had been showing movement limitations of her entire right upper limb after fracture healing and was then referred to our hospital at 2 years of age. High-frequency US showed that the roots of the right brachial plexus ran continuously, but the diameter of C6 was thinner on the affected side than on the contralateral side (right 0.12 cm vs. left 0.20 cm). A traumatic neuroma had formed at the upper trunk, which was thicker (diameter: right 0.35 cm vs. left 0.23 cm; cross-sectional area: right 0.65 cm2 vs. left 0.31 cm2) at the level of the supraclavicular fossa. Intraoperative findings were consistent with ultrasound findings. Postoperative pathology confirmed brachial plexus traumatic neuroma.

Systematic investigation of cerebellar functional alterations and their association with surgical outcomes in patients with degenerative cervical myelopathy: a resting-state fMRI study

OBJECTIVE

The aim of this study was to systematically investigate the changes in cerebellar neural activity and cerebellar-cortical functional connectivity (FC) in patients with degenerative cervical myelopathy (DCM) using resting-state functional magnetic resonance imaging (fMRI).

METHODS

In this study, we collected clinical data and resting-state fMRI data from 54 DCM patients and 50 healthy controls (HCs). We analyzed voxel-wise regional fMRI metrics, including amplitude of low frequency fluctuation (ALFF), fractional ALFF, regional homogeneity, functional connectivity density, and voxel-mirrored homotopic connectivity. In analysis 1, we examined the differences in regional fMRI metrics within the cerebellum between the DCM patient group and the healthy control group, as well as their correlation with preoperative neurological status and prognosis. In analysis 2, we investigated cerebellar-cortical functional connectivity differences between the two groups and their correlation with preoperative neurological status and prognosis. Lastly, in analysis 3, we explored the internetwork connectivity between the 'cerebellar-SMN' (sensorimotor network) system, examined the between-group differences, and investigated its correlation with preoperative neurological status and prognosis.

RESULTS

(1) Relative to HCs, DCM patients exhibited functional alterations in wide-spread cerebellar regions; (2) DCM patients exhibited altered cerebellar-cortical FC which was associated with the preoperative neurological status and prognosis; (3) DCM patients exhibited altered internetwork connectivity between 'cerebellar-SMN' system which was associated with duration of symptom.

CONCLUSION

Wide-spread cerebellar functional alterations occur in DCM pathogenesis and the deficits in cerebellar-SMN functional connectivity may be beneficial in future studies for predicting surgical outcomes in patients with DCM.

Mapping microhabitats of lignocellulose decomposition by a microbial consortium

The leaf-cutter ant fungal garden ecosystem is a naturally evolved model system for efficient plant biomass degradation. Degradation processes mediated by the symbiotic fungus Leucoagaricus gongylophorus are difficult to characterize due to dynamic metabolisms and spatial complexity of the system. Herein, we performed microscale imaging across 12-µm-thick adjacent sections of Atta cephalotes fungal gardens and applied a metabolome-informed proteome imaging approach to map lignin degradation. This approach combines two spatial multiomics mass spectrometry modalities that enabled us to visualize colocalized metabolites and proteins across and through the fungal garden. Spatially profiled metabolites revealed an accumulation of lignin-related products, outlining morphologically unique lignin microhabitats. Metaproteomic analyses of these microhabitats revealed carbohydrate-degrading enzymes, indicating a prominent fungal role in lignocellulose decomposition. Integration of metabolome-informed proteome imaging data provides a comprehensive view of underlying biological pathways to inform our understanding of metabolic fungal pathways in plant matter degradation within the micrometer-scale environment.

Gekko Coil System for Intracranial Aneurysms Treatment in China (GREAT-China): A Prospective Randomized Controlled Open-Label Noninferiority Trial

OBJECTIVE

This study aimed to evaluate the safety and efficacy of the Gekko coil system in treating intracranial aneurysms (IAs) in clinical practice.

METHODS

A prospective multicenter randomized open-label parallel positive control noninferiority trial was conducted by 11 centers in China. Patients with a target IA were randomized 1:1 to coiling with either Gekko or Axium coils. The primary outcome was successful aneurysm occlusion at 6 months postoperative follow-up, whereas the secondary outcomes included the successful occlusion aneurysm rate in the immediate postoperative period, recanalization rate at the 6 months follow-up, and technical success and security.

RESULTS

Between May 2018 and September 2020, 256 patients were enrolled and randomized. Per-protocol analysis showed that the successful aneurysm occlusion rate at 6 months was 96.08% for the Gekko coil group compared with 96.12% in the Axium coil group, with a difference of -0.04% (P = 0.877). The successful immediate aneurysm occlusion rates were 86.00% and 77.45% in the Gekko coil group and the Axium coil group, respectively, showing no significant difference between the 2 groups (P = 0.116), whereas the recanalization rates during the 6 months follow-up were 2.02% and 1.96% in the Gekko and Axium coil groups, respectively, which was not statistically significant (P = 1.000).

CONCLUSIONS

This trial showed that the Gekko coil system was noninferior to the Axium coil system in terms of efficacy and safety for IA embolization. In clinical practice, the Gekko coil system can be considered safe and effective for treating patients with IA.

Comparison of clinical and economic evaluation between selected generic and original febuxostat tablets in Chinese gout patients with hyperuricemia: A real-world multicenter retrospective study

Generic febuxostat tablets were listed in China's third-round centralized drug procurement program. However, there are no sufficient data available on the use of febuxostat in a real-world setting. This study aimed to compare the efficacy, safety, and cost of selected generic febuxostat with original febuxostat in primary gout and hyperuricemia. Medical records at 3 tertiary hospitals from January 2014 to February 2022 were retrospectively analyzed. Propensity score matching was used to balance the distribution of baseline characteristics. The proportion of patients achieving target serum uric acid (SUA) levels at 12 weeks, the percent changes from baseline in SUA, adverse drug reactions, and the cost of febuxostat therapy were assessed. A total of 221 patients were recruited and 57 pairs of patients were 1:1 matched in the 2 groups. There was no statistically significant difference in the proportion of patients achieving a target SUA levels below 300 μmol/L, the percent changes of SUA decreased from baseline, and the incidence of adverse drug reactions between the 2 groups (all P > .05). The daily febuxostat cost in the generic group were significantly lower than that in original group (P < .05). Based on the results of this study, the clinical efficacy of selected generic febuxostat is comparable to that of original febuxostat for gout with hyperuricemia. No serious adverse reactions were reported in the 2 groups, and generic febuxostat is more economical than the original febuxostat.

Molecular MRD is strongly prognostic in patients with NPM1-mutated AML receiving venetoclax-based nonintensive therapy

ABSTRACT

Assessment of measurable residual disease (MRD) by quantitative reverse transcription polymerase chain reaction is strongly prognostic in patients with NPM1-mutated acute myeloid leukemia (AML) treated with intensive chemotherapy; however, there are no data regarding its utility in venetoclax-based nonintensive therapy, despite high efficacy in this genotype. We analyzed the prognostic impact of NPM1 MRD in an international real-world cohort of 76 previously untreated patients with NPM1-mutated AML who achieved complete remission (CR)/CR with incomplete hematological recovery following treatment with venetoclax and hypomethylating agents (HMAs) or low-dose cytarabine (LDAC). A total of 44 patients (58%) achieved bone marrow (BM) MRD negativity, and a further 14 (18%) achieved a reduction of ≥4 log10 from baseline as their best response, with no difference between HMAs and LDAC. The cumulative rates of BM MRD negativity by the end of cycles 2, 4, and 6 were 25%, 47%, and 50%, respectively. Patients achieving BM MRD negativity by the end of cycle 4 had 2-year overall of 84% compared with 46% if MRD was positive. On multivariable analyses, MRD negativity was the strongest prognostic factor. A total of 22 patients electively stopped therapy in BM MRD-negative remission after a median of 8 cycles, with 2-year treatment-free remission of 88%. In patients with NPM1-mutated AML attaining remission with venetoclax combination therapies, NPM1 MRD provides valuable prognostic information.

B cells in head and neck squamous cell carcinoma: current opinion and novel therapy

Head and neck squamous cell carcinoma (HNSCC) is a common malignant tumour. Despite advancements in surgery, radiotherapy and chemotherapy, which have improved the prognosis of most patients, a subset of patients with poor prognoses still exist due to loss of surgical opportunities, postoperative recurrence, and metastasis, among other reasons. The tumour microenvironment (TME) is a complex organization composed of tumour, stromal, and endothelial cells. Communication and interaction between tumours and immune cells within the TME are increasingly being recognized as pivotal in inhibiting or promoting tumour development. Previous studies on T cells in the TME of HNSCC have yielded novel therapeutic possibilities. However, the function of B cells, another adaptive immune cell type, in the TME of HNSCC patients has yet to be determined. Recent studies have revealed various distinct subtypes of B cells and tertiary lymphoid structures (TLSs) in the TME of HNSCC patients, which are believed to impact the efficacy of immune checkpoint inhibitors (ICIs). Therefore, this paper focuses on B cells in the TME to explore potential directions for future immunotherapy for HNSCC.

Click chemistry-aided drug discovery: A retrospective and prospective outlook

Click chemistry has emerged as a valuable tool for rapid compound synthesis, presenting notable advantages and convenience in the exploration of potential drug candidates. In particular, in situ click chemistry capitalizes on enzymes as reaction templates, leveraging their favorable conformation to selectively link individual building blocks and generate novel hits. This review comprehensively outlines and introduces the extensive use of click chemistry in compound library construction, and hit and lead discovery, supported by specific research examples. Additionally, it discusses the limitations and precautions associated with the application of click chemistry in drug discovery. Our intention for this review is to contribute to the development of a modular synthetic approach for the rapid identification of drug candidates.

The azeotropy eliminating mechanism of ethyl acetate-acetonitrile system via ionic liquid entrainer: A combination of FTIR and DFT study

Ionic liquids (ILs) are good candidates for azeotropy separation. Knowledge of the microstructure properties of azeotrope - IL mixtures is important because they could reveal the molecular intrinsic cause of the elimination of azeotropy and represent the basis for the practical process. In this work, the microstructures of ethyl acetate-acetonitrile azeotrope mixtures and a representative IL, 1‑butyl-3-methylimidazolium bis(trifluoromethylsulfonyl)imide ([BMIM][Tf2N], which could eliminate the azeotropy of the ethyl acetate-acetonitrile system, were studied by Fourier transform infrared spectroscopy with the assistance of quantum chemical calculations and excess spectra. The C≡N stretching vibrational region of acetonitrile was closely examined. The interaction complexes of ethyl acetate-acetonitrile and ion cluster/ion pair/ion - acetonitrile were identified. Weak strength hydrogen-bonds with electrostatically dominant and closed-shell interaction properties were found in these complexes. The interactions between [BMIM][Tf2N] and acetonitrile were stronger than those between ethyl acetate and acetonitrile, which caused the addition of IL to easily destroy the ethyl acetate-acetonitrile interaction complex. The interactions between [BMIM][Tf2N] and acetonitrile were stronger than those between [BMIM][Tf2N] and ethyl acetate, which would influence the relative volatility of ethyl acetate and acetonitrile in the azeotrope system. When x(IL) was larger than 0.027, all the interaction complexes between acetonitrile and ethyl acetate were completely broken apart, and the azeotrope was eliminated.

The intrinsic and extrinsic mechanisms regulated by functional carbon nanodots for the phytoremediation of multi-metal pollution in soils

Functional carbon nanodots (FCNs) were currently demonstrated to regulate plant behavior in the agricultural and environmental areas. However, their regulation mechanisms on the interactions of plant-soil system during phytoremediation remain unrevealed. Here, Solanum nigrum L. was employed to explore the intrinsic and extrinsic mechanisms regulated by FCNs in the phytoremediation of Cd-Pb co-contaminated soils. The mediation of FCNs on metal removal and plant growth showed a hormesis manner, wherein the maximum induction effect was contributed by 15 mg kg-1 FCNs. Cd/Pb removal were enhanced by 8.5% and 31.6%, respectively. Moreover, FCNs reallocate metal distribution in plant by immobilized metals in roots and suppressed metal translocation to leaves. Improving plant growth (by 82.8% for root), stimulating plant hormesis, and activating plant detoxification pathways are the intrinsic mechanism for the phytoremediation smartly regulated by FCNs. Notably, FCNs induced soil enzyme activities that associated with soil nutrients recycling, up-regulated the microbial diversity and the soil immune system, and regulated S. nigrum L. to recruit beneficial microbials in the rhizosphere. The above-mentioned comprehensive improvement of soil micro-environment is the extrinsic mechanism regulated by FCNs. This study provides new insights to evaluate the interactions of nanomaterials with plant-soil system under soil contamination.

Antioxidants and the risk of stroke: results from NHANES and two-sample Mendelian randomization study

BACKGROUND

Stroke is the second leading cause of death worldwide, and observational studies have suggested a correlation between antioxidants and reduced stroke risk. However, it remains unclear whether causal relationships exist.

METHODS

This study first performed a cross-sectional study of the association between the Composite Dietary Antioxidant Index (CDAI) and stroke using data from the National Health and Nutrition Examination Survey (NHANES) 2007-2018. Second, a two-sample univariable Mendelian Randomization (MR) was performed to analyze the causal effect of circulating levels of antioxidants on different subtypes of stroke.

RESULTS

The cross-sectional study included a total of 24,892 participants representing more than 200 million US non-institutionalized residents, a multivariable logistic regression model revealed that the risk of stroke decreased by 3.4% for each unit increase in CDAI (P = 0.017), with a non-linear association found, indicating a reduction in stroke risk before an inflection point of 3.078. MR analysis revealed that genetically determined levels of retinol had a suggestive protective effect on subarachnoid hemorrhage (SAH) (OR = 0.348, P = 0.025), and genetically determined levels of selenium had a suggestive protective effect against SAH (OR = 0.826, P = 0.007). However, no causal relationship was found between antioxidants and ischemic stroke or intracranial hemorrhage risk.

CONCLUSIONS

Evidence suggests that diet-derived antioxidants may reduce the risk of stroke, as indicated by the protective effects of retinol and selenium against SAH. However, more research is needed to fully understand how antioxidants prevent stroke.

Establishment of an Evaluation Index System of Competencies for College Senior Students in General Practice Medicine in Anhui Province, China

Background

The competencies of college senior students in general practice medicine have attracted attention. This study aimed to construct an evaluation index system of competencies for college senior students in general practice medicine and to promote the reform and optimization of training programs for general medicine talent in colleges.

Methods

The two-round Delphi method was used to determine the evaluation index system of competencies for college senior students in general practice medicine, and the analytic hierarchy process (AHP) was used to calculate the weights of all levels of elements.

Results

The evaluation index system of competencies for college senior students in general practice medicine was established with 3 primary factors, 9 secondary factors and 32 tertiary factors. The Delphi results revealed that the active coefficient of experts was 1 and the authority coefficient was 0.858. The 3 primary factors were knowledge level, job skills and professionalism with weights of 0.1532, 0.4207 and 0.4261, respectively. Among the secondary factors, the top three weight coefficients were professional ethics (0.2614), community practice (0.1526) and communication skills (0.1308). Among tertiary factors, "scientific research" exhibited the lowest value with a weight coefficient of 0.0049.

Conclusion

In this study, we constructed an evaluation index system of competencies for college senior students in general practice medicine. The consensus on the content of the competencies of college senior students in general practice medicine suggests that these elements are necessary for those who will become general practitioners. This system can be used as the basis to evaluate the ability of college senior students in general practice medicine and provide guidance for the cultivation and evaluation of general medicine talent.

Enzymatic Preparation and Processing Properties of DPP-IV Inhibitory Peptides Derived from Wheat Gluten: Effects of Pretreatment Methods and Protease Types

The choice of appropriate proteases and pretreatment methods significantly influences the preparation of bioactive peptides. This study aimed to investigate the effects of different pretreatment methods on the hydrolytic performance of diverse proteases during the production of dipeptidyl peptidase-IV (DPP-IV) inhibitory peptides derived from wheat and their foaming and emulsion properties. Dry heating, aqueous heating, and ultrasound treatment were employed as pretreatments for the protein prior to the enzymatic hydrolysis of wheat gluten. FTIR analysis results indicated that all pretreatment methods altered the secondary structure of the protein; however, the effects of dry heating treatment on the secondary structure content were opposite to those of aqueous heating and ultrasound treatment. Nevertheless, all three methods enhanced the protein solubility and surface hydrophobicity. By using pretreated proteins as substrates, five different types of proteases were employed for DPP-IV inhibitory peptide production. The analysis of the DPP-IV inhibitory activity, degree of hydrolysis, and TCA-soluble peptide content revealed that the specific pretreatments had a promoting or inhibiting effect on DPP-IV inhibitory peptide production depending on the protease used. Furthermore, the pretreatment method and the selected type of protease collectively influenced the foaming and emulsifying properties of the prepared peptides.

Metagenomic next-generation sequencing for the identification of infections caused by Gram-negative pathogens and the prediction of antimicrobial resistance

OBJECTIVE

The aim of this study was to evaluate the efficacy of metagenomic next-generation sequencing (mNGS) for the identification of Gram-negative bacteria (GNB) infections and the prediction of antimicrobial resistance.

METHODS

A retrospective analysis was conducted on 182 patients with diagnosis of GNB infections who underwent mNGS and conventional microbiological tests (CMTs).

RESULTS

The detection rate of mNGS was 96.15%, higher than CMTs (45.05%) with a significant difference (χ 2 = 114.46, P < .01). The pathogen spectrum identified by mNGS was significantly wider than CMTs. Interestingly, the detection rate of mNGS was substantially higher than that of CMTs (70.33% vs 23.08%, P < .01) in patients with but not without antibiotic exposure. There was a significant positive correlation between mapped reads and pro-inflammatory cytokines (interleukin-6 and interleukin-8). However, mNGS failed to predict antimicrobial resistance in 5 of 12 patients compared to phenotype antimicrobial susceptibility testing results.

CONCLUSIONS

Metagenomic next-generation sequencing has a higher detection rate, a wider pathogen spectrum, and is less affected by prior antibiotic exposure than CMTs in identifying Gram-negative pathogens. The mapped reads may reflect a pro-inflammatory state in GNB-infected patients. Inferring actual resistance phenotypes from metagenomic data remains a great challenge.

In vitro and clinical validation of different correction algorithms for the two-dimensional proximal isovelocity surface area method in a low-velocity flow field for quantifying tricuspid regurgitation

Background

The 2-dimensional proximal isovelocity surface area (2D PISA) method underestimates tricuspid regurgitation (TR) severity. Previously proposed correction algorithms should be further scrutinized.

Methods

Two correction algorithms were tested. One approach involves dividing the 2D PISA effective regurgitant orifice area by a constant of 0.7 (EROA0.7). Another approach involves multiplying the unadjusted EROA by Vorifice/(Vorifice - Valiasing), where Vorifice denotes the TR jet velocity, and Valiasing represents the color aliasing velocity (EROAVo-Va). In vitro validation was performed on a commercially available multifunctional valve tester with different size orifices and peak pressure gradients. A true EROA was derived through the regurgitant volume (RVol) calculated from the tester. For clinical validation, RVol was calculated as the difference between the overall stroke volume and the forward stroke volume of the right ventricle. Volumetric EROA was derived by dividing the RVol by the TR velocity-time integral (VTI). The vena contracta area (VCA) was obtained through direct planimetry with 3D echocardiography. The mean of volumetric EROA and VCA served as the reference in clinical validation.

Results

Excellent correlation between the calculated EROAs and the true EROA was observed in vitro (r=0.98, r=0.97, and r=0.98 for uncorrected EROA, EROAVo-Va, and EROA0.7, respectively; all P values <0.0001). EROAVo-Va underestimated the true EROA and averaged 33% (P=0.3163), while EROA0.7 overestimated the true EROA and averaged 8% (P=0.0032). Clinically, these methods consistently exhibited a notable underestimation that varied with the reference EROA. This systematic underestimation was mitigated by both algorithms when either the VCA (biases of 19.6, 15.1, and 11.8 mm2 for uncorrected EROA, EROAVo-Va, and EROA0.7, respectively) or the volumetric EROA (biases of 10.1, 5.6, and 2.3 mm2 for uncorrected EROA, EROAVo-Va, and EROA0.7, respectively) served as the reference. Their ability to distinguish severe TR was similar, with area under the curve values of 0.905, 0.903, and 0.893 for uncorrected EROA, EROAVo-Va, and EROA0.7, respectively. No statistically significant differences were observed for diagnostic accuracy (all P values >0.05).

Conclusions

Using a correction factor of 0.7 in quantifying TR provides similar accuracy when compared to other techniques. This represents a valuable clinical tool for quickly correcting the underestimation of the 2D PISA method in TR. This simple method may increase the frequency of applying the correction and earlier recognition of patients with severe TR.

Novel biomarkers based on dual-energy computed tomography for risk stratification of very early distant metastasis in colorectal cancer after surgery

Background

Very early distant metastasis (VEDM) for patients with colorectal cancer (CRC) following surgery suggests failure of local treatment strategy and few biomarkers are available for its effective risk stratification. This study aimed to explore the potential of quantitative dual-energy computed tomography (DECT) spectral parameters and build models to predict VEDM.

Methods

Consecutive patients suspected of having CRC and with a clinical indication for enhanced CT from April 2021 to July 2022 at a single institution were prospectively enrolled to undertake spectral CT scanning. The spectral features were extracted by two reviewers and intraclass correlation coefficient (ICC) was used for interobserver agreement evaluation. A total of 16 spectral parameters, including unenhanced effective atomic number, triphasic iodine concentrations (ICs)/normalized ICs (NICs)-A/V/E/1/NIC-A/V/E/spectral curve slopes (λ-A/V/E), two arterial enhancement fractions (AEFs), and venous enhancement fraction (VEF), were determined for analysis. Patients with and without VEDM after surgery were matched using propensity score matching (PSM). The diagnostic performance was assessed using the area under the curve (AUC). Models of multiple modalities were generated.

Results

In total, 222 patients were included (141 males, age range, 32-83 years) and 13 patients developed VEDM. Interobserver agreement ranged from good to excellent (ICC, 0.773-0.964). A total of three spectral parameters (VEF, λ-V, and 1/NIC-V) exhibited significant discriminatory ability (P<0.05) in predicting VEDM, with AUCs of 0.822 [95% confidence interval (CI): 0.667-0.926], 0.738 (95% CI: 0.573-0.866), and 0.713 (95% CI: 0.546-0.846) and optimal cutoff points of 67.16%, 2.46, and 2.44, respectively. The performance of these spectral parameters was validated in the entire cohort; the combined spectral model showed comparable efficiency to the combined clinical model [AUC, 0.771 (95% CI: 0.622-0.919) vs. 0.779 (95% CI: 0.663-0.894), P>0.05]; the clinical-spectral model achieved further improved AUC of 0.887 (95% CI: 0.812-0.962), which was significantly higher than the combined clinical model (P=0.015), yet not superior to the combined spectral model (P=0.078).

Conclusions

Novel spectral parameters showed potential in predicting VEDM in CRC following surgery in this preliminary study, which were closely related with spectral perfusion in the venous phase. However, further studies with larger samples are warranted.

Spin polarized Fe1-Ti pairs for highly efficient electroreduction nitrate to ammonia

Electrochemical nitrate reduction to ammonia offers an attractive solution to environmental sustainability and clean energy production but suffers from the sluggish *NO hydrogenation with the spin-state transitions. Herein, we report that the manipulation of oxygen vacancies can contrive spin-polarized Fe1-Ti pairs on monolithic titanium electrode that exhibits an attractive NH3 yield rate of 272,000 μg h-1 mgFe-1 and a high NH3 Faradic efficiency of 95.2% at -0.4 V vs. RHE, far superior to the counterpart with spin-depressed Fe1-Ti pairs (51000 μg h-1 mgFe-1) and the mostly reported electrocatalysts. The unpaired spin electrons of Fe and Ti atoms can effectively interact with the key intermediates, facilitating the *NO hydrogenation. Coupling a flow-through electrolyzer with a membrane-based NH3 recovery unit, the simultaneous nitrate reduction and NH3 recovery was realized. This work offers a pioneering strategy for manipulating spin polarization of electrocatalysts within pair sites for nitrate wastewater treatment.

Abnormal preoperative fMRI signal variability in the pain ascending pathway is associated with the postoperative axial pain intensity in degenerative cervical myelopathy patients

BACKGROUND CONTEXT

The moment-to-moment variability of resting-state brain activity has been suggested to play an active role in chronic pain.

PURPOSE

To investigate preoperative alterations in regional blood-oxygen-level-dependent signal variability (BOLDsv) and inter-regional dynamic functional connectivity (dFC) in individuals with degenerative cervical myelopathy (DCM), and their potential association with postoperative axial pain severity.

STUDY DESIGN

Cross-sectional study.

PATIENT SAMPLE

Resting-state functional magnetic resonance imaging was obtained in 42 migraine individuals and 40 healthy controls (HCs).

OUTCOME MEASURES

We calculated the standard deviation (SD) of the BOLD time-series at each voxel and the SD and mean of the dynamic conditional correlation between the brain regions which showed significant group differences in BOLDsv.

METHODS

A group comparison was conducted using whole-brain voxel-wise analysis of the standard deviation (SD) of the BOLD time-series which was a measure of the BOLDsv. The brain areas displaying notable group discrepancies in BOLDsv were utilized to outline regions of interest (ROIs). To determine the strength/variability of the dFC, the mean and SD of the dynamic conditional correlation were calculated within these ROIs. Moreover, the postoperative axial pain (PAP) severity of patients was evaluated.

RESULTS

Our results revealed that DCM patients with postoperative axial pain (PAP) demonstrated considerably increased BOLDsv in the bilateral thalamus and right insular, but significantly lower BOLDsv in the right S1. By applying dynamic functional connectivity (dFC) analysis, we found that DCM patients with PAP exhibited greater fluctuation of dFC in the thalamo-cortical pathway (specifically, thalamus-S1), when compared to HCs and patients without PAP (nPAP). Lastly, we established that dysfunctional BOLDsv and dFC in the ascending pain pathway were positively associated with the severity of PAP in DCM patients.

CONCLUSION

Our results indicate a potential correlation between impaired pain ascending pathway and postoperative axial pain in DCM patients. These findings could potentially spark novel treatment approaches for individuals experiencing preoperative axial pain.

Proteomics analysis of serum and urine identifies VCP and CTSA as potential biomarkers associated with multiple myeloma

AIMS

We analyzed the differentially expressed proteins (DEPs) in serum and urine in order to provide new potential biomarkers for MM.

METHODS

Data-Independent Acquisition-based proteomics of serum and urine was performed to identify potential biomarkers for MM patients. Then we performed Western Blotting (WB), ELISA along with their ROC curve analysis to confirm DEPs.

RESULTS

A total of 1653 proteins in serum and 4519 proteins in urine were identified using Data-Dependent Acquisition method. VCP was the only protein that showed significant differences in different comparison groups in both serum and urine. Pathway analysis revealed that protein processing in the endoplasmic reticulum was the most relevant pathway associated with MM. Furthermore, the increased expression of HSP90B1, VCP, CTSA, HYOU1, PDIA4, and RAB7A was detected by WB. The results of ELISA indicated that a combination of VCP and CTSA provided a high area under curve (AUC) value of 0.883 (95 % CI, 0.769-0.997, p < 0.001) to diagnose NDMM. The combination of VCP, CTSA, ALB, and HGB exhibited better performance (AUC = 0.981), with 100 % specificity and 86.7 % sensitivity.

CONCLUSION

These findings suggest VCP and CTSA exhibit potential as biomarkers for MM, which may be helpful in the molecular mechanisms and pathogenesis upon further investigation.

Silencing PKM2 Attenuates Brain Injury Induced by Status Epilepticus by Inhibiting the AKT/mTOR Pathway and the NLRP3 Inflammasome

PKM2 is a glycolytic pyruvate kinase isoenzyme, and its role in neurological diseases has been published. However, the role and mechanism of PKM2 in the process of status epilepticus have not been reported. The purpose of this study is to explore the role and mechanism of PKM2 in epilepsy. Quantitative real-time polymerase chain reaction (qRT-PCR) and western blotting were used to explore the expression of PKM2 in cells. Enzyme-linked immunosorbent assay kits were used to evaluate the level of inflammatory factors. An epilepsy model was established by intraperitoneal injection of lithium chloride in rats. Various behavioural assays were conducted to explore the learning ability and cognitive level of rats. PKM2 expression was upregulated in Mg2+-induced hippocampal neurons. PKM2 inhibition ameliorated Mg2+-induced hippocampal neuronal inflammation and reduced neuronal apoptosis. In addition, PKM2 silencing inhibited the metabolic dysfunction of Mg2+-induced hippocampal neurons. Subsequent experiments showed that the Akt/mTOR pathway and NLRP3 inflammasome are involved in PKM2-mediated neuronal regulation. More importantly, PKM2 inhibition could alleviate status epilepticus in rats. PKM2 inhibition attenuates Mg2+-induced hippocampal neuronal inflammation, apoptosis and metabolic dysfunction and improves the cognitive ability of rats. Therefore, PKM2 may be an important target for epilepsy treatment.

Preoperative MRI features predicting very early recurrence of intrahepatic mass-forming cholangiocarcinoma after R0 resection: a comparison with the AJCC 8th edition staging system

PURPOSE

This study aimed to establish a nomogram based on preoperative magnetic resonance imaging (MRI) features to predict the very early recurrence (VER, less than 6 months) of intrahepatic mass-forming cholangiocarcinoma (IMCC) after R0 resection.

METHODS

This study enrolled a group of 193 IMCC patients from our institution between March 2010 and January 2022. Patients were allocated into the development cohort (n = 137) and the validation cohort (n = 56), randomly, and the preoperative clinical and MRI features were collected. Univariate and multivariate stepwise logistic regression assessments were adopted to assess predictors of VER. Nomogram was constructed and certificated in the validation cohort. The performance of the prediction nomogram was evaluated by its discrimination, calibration, and clinical utility. The performance of the nomogram was compared with the T stage of the American Joint Committee on Cancer (AJCC) 8th edition staging system.

RESULTS

Fifty-three patients (27.5%) experienced VER of the tumor and 140 patients (72.5%) with non-VER, during the follow-up period. After multivariate stepwise logistic regression, number of lesions, diffuse hypoenhancement on arterial phase, necorsis and suspicious lymph nodes were independently associated with VER. The nomogram demonstrated significantly higher area under the curve (AUC) of 0.813 than T stage (AUC = 0.666, P = 0.006) in the development cohort, whereas in the validation cohort, the nomogram showed better discrimination performance, with an AUC of 0.808 than T stage (0.705) with no significantly difference (P = 0.230). Decision curve analysis reflected the clinical net benefit of the nomogram.

CONCLUSION

The nomogram based on preoperative MRI features is a reliable tool to predict VER for patients with IMCC after R0 resection. This nomogram will be helpful to improve survival prediction and individualized treatment.

High titer (>100 g/L) ethanol production from pretreated corn stover hydrolysate by modified yeast strains

Developing a reliable lignocellulose pretreatment method to extract mixed sugars and engineering efficient strains capable of utilizing xylose are crucial for advancing cellulosic ethanol production. In this study, chemical and characterization analyses revealed that alkali cooking can significantly remove lignin from lignocellulose crops. The highest amount of mixed sugar was obtained from corn stover hydrolysates with a 15 % solid loading. Our genetically engineered yeast strain ΔsnR4, derived from a well-staged WXY70, demonstrated excellent performance in low 10 % solids loading corn stover hydrolysate, producing a high ethanol yield of 0.485 g/g total sugars. When a combined NaOH-ball milling pretreatment strategy was applied at high solids loading, ΔsnR4 exhibited the maximum ethanol titer of 110.9 g/L within 36 h, achieving an ethanol yield of 92.9 % theoretical maximum. Therefore, ΔsnR4 is highly compatible with high solid loading NaOH-ball milling pretreatment, making it a potential candidate for industrial cellulosic ethanol.

Diterpenolignans and cephalotane diterpenoids from Cephalotaxus oliveri mast. with antitumor activity

Four undescribed naturally diterpenolignans, and two cephalotane diterpenoids, along with seven known compounds, including two pairs of enantiomers, were isolated from the twigs and leaves of Cephalotaxus oliveri Mast. Their structures were elucidated via spectroscopic data interpretation, chiral-phase HPLC analysis, NMR calculations, and electronic circular dichroism analysis. All the isolated compounds were evaluated for their cytotoxic activities against three kinds of human tumor cell lines. Among them, compound 8 exhibited the most potent activities against MCF-7, HepG2 and A549 cell lines with IC50 values of 2.83, 4.75 and 2.77 μM, respectively.

Candidate biomarkers in brown adipose tissue for post-mortem diagnosis of fatal hypothermia

Post-mortem diagnosis of fatal hypothermia (FHT) is challenging in forensic practice because traditional morphological and biochemical methods lack specificity. Recent studies have reported that brown adipose tissue (BAT) is activated during cold-induced non-shivering thermogenesis in mammals, but BAT has not been used to diagnose FHT. The aim of this study was to identify novel biomarkers in BAT for FHT based on morphological changes and differential protein expression. Two FHT animal models were created by exposing mice to 4 or -20 °C at 50% humidity. Morphologically, the unilocular lipid droplet content was significantly increased in BAT of FHT model mice compared with that of control mice. Proteomics analysis revealed a total of 283 and 266 differentially expressed proteins (DEPs) between the 4 or -20 °C FHT subgroups and control group, respectively. In addition, 140 proteins were shared between the FHT subgroups. GO and KEGG analyses revealed that the shared DEPs were mainly enriched in pathways associated with metabolism, oxidative phosphorylation, and thermogenesis. Further screening (|log2FC| > 1.6, q-value (FDR) < 0.05) identified GMFB, KDM1A, DDX6, RAB1B, SHMT-1, CLPTM1, and LMF1 as candidate biomarkers of FHT. Subsequent validation experiments were performed in FHT model mice using classic immunohistochemistry and western blotting. RAB1B and GMFB expression was further verified in BAT specimens from human cases of FHT. The results demonstrate that BAT can be used as a target organ for FHT diagnosis employing RAB1B and GMFB as biological markers, thus providing a new strategy for the post-mortem diagnosis of FHT in forensic practice.

In Vitro Phosphatase Assays for the Eya2 Tyrosine Phosphatase

Protein tyrosine phosphatases (PTP), such as the Eyes Absent (Eya) family of proteins, play important roles in diverse biological processes. In vitro phosphatase assays are essential tools for characterizing the enzymatic activity as well as discovering inhibitors and regulators of these phosphatases. Two common types of in vitro phosphatase assays use either a small molecule substrate that produces a fluorescent or colored product, or a peptide substrate that produces a colorimetric product in a malachite green assay. In this chapter, we describe detailed protocols of a phosphatase assay using small molecule 3-O-methylfluorescein phosphate (OMFP) as a substrate and a malachite green assay using the pH2AX peptide as a substrate to evaluate the phosphatase activity of EYA2 and the effect of small molecule inhibitors of EYA2. These protocols can be easily adapted to study other protein tyrosine phosphatases.

Errors and Adherence to Inhaled Medications in Chinese Adults with COPD

BACKGROUND

Adherence to inhaled medications is key to chronic obstructive pulmonary disease (COPD) control and management.

OBJECTIVE

To assess errors and adherence to inhalation therapy in COPD patients, and identify potential factors associated with poor adherence.

METHODS

This cross-sectional study was conducted from October 1, 2022, to November 30, 2022, in 24 hospital outpatient departments in different cities of Hunan Province, China. Adherence to inhaled medications was measured using the 10-item Test of Adherence Inventory, and the results were expressed using both descriptive and inferential statistics.

RESULTS

A total of 2218 clinically confirmed adult COPD patients completed the questionnaires, and 1423 patients with more than a 3-month history of inhalation therapy were analyzed. This study found that 61.3% of patients made one or more use errors. Not holding the breath after inhalation or holding the breath for less than 3 s had the highest reporting rate (30.7%). A considerable proportion of patients (66.6%) demonstrated suboptimal adherence to inhaled medications. Patients who resided in rural areas (OR 1.45, 95% CI 1.12-1.88), used dual therapy (OR 1.47, 95% CI 1.05-2.05), and exhibited common use errors (OR 3.02, 95% CI 2.39-3.82) were more likely to present suboptimal adherence. Patients with CAT (Chronic Obstructive Pulmonary Disease Assessment Test) score < 10 (OR 0.73, 95% CI 0.56-0.94), a junior high school education and above (OR 0.73, 95% CI 0.57-0.94), and duration of inhaled medication use > 3 years (OR 0.63, 95% CI 0.47-0.83) were associated with better adherence.

CONCLUSION

Suboptimal adherence to inhaled medications and many inhalation therapy errors were identified among COPD patients. Common use errors in inhaled medications, CAT score, and education background were predictive of and influenced adherence to inhaled medications. It is necessary to strengthen training in Chinese patients about inhaler use and follow-up intensively with patients throughout treatment, especially for patients with risk factors.

Matrine alleviates hypoxia-induced inflammation and pulmonary vascular remodelling via RPS5/NF-κB signalling pathway

Hypoxia-induced vasoconstriction and vascular remodelling are the main pathological features of hypoxic pulmonary arterial hypertension (HPAH), and inflammation is participated in the occurrence of pulmonary vascular remodelling (PVR). Matrine is an alkaloid with the effects of anti-inflammation, antifibrosis and antitumour. But, few studies have explored the role of matrine in regulating PVR, and the related mechanisms are still unknown. In this study, we found that hypoxia-induced pulmonary artery smooth muscle cells (PASMCs) proliferation and inhibited its apoptosis, reduced the expression of ribosomal protein s5 and activated the nuclear factor kappa-B (NF-κB) signalling. Matrine, sildenafil and NF-κB inhibitor Bay 11-7082 could reverse these changes and impel the cell cycle in phase S retardation, and reduced the expression of p50, p65, proliferating cell nuclear antigen (PCNA), Bcl-2. In addition, matrine could lower right ventricular systolic pressure and mean pulmonary artery pressure of rats, α-smooth muscle actin and PCNA expression in pulmonary artery media, the levels of tumor necrosis factor-α and interleuki-1β, thus improved hypoxia-induced PVR. This study indicated that matrine could alleviate inflammation and improve PVR through reversing the imbalance of proliferation and apoptosis of PASMCs, thus it had a therapeutic effect on HPAH.

Developing predictive models for surgical outcomes in patients with degenerative cervical myelopathy: a comparison of statistical and machine learning approaches

BACKGROUND CONTEXT

Machine learning (ML) is widely used to predict the prognosis of numerous diseases.

PURPOSE

This retrospective analysis aimed to develop a prognostic prediction model using ML algorithms and identify predictors associated with poor surgical outcomes in patients with degenerative cervical myelopathy (DCM).

STUDY DESIGN

A retrospective study.

PATIENT SAMPLE

A total of 406 symptomatic DCM patients who underwent surgical decompression were enrolled and analyzed from three independent medical centers.

OUTCOME MEASURES

We calculated the area under the curve (AUC), classification accuracy, sensitivity, and specificity of each model.

METHODS

The Japanese Orthopedic Association (JOA) score was obtained before and 1 year following decompression surgery, and patients were grouped into good and poor outcome groups based on a cut-off value of 60% based on a previous study. Two datasets were fused for training, 1 dataset was held out as an external validation set. Optimal feature-subset and hyperparameters for each model were adjusted based on a 2,000-resample bootstrap-based internal validation via exhaustive search and grid search. The performance of each model was then tested on the external validation set.

RESULTS

The Support Vector Machine (SVM) model showed the highest predictive accuracy compared to other methods, with an AUC of 0.82 and an accuracy of 75.7%. Age, sex, disease duration, and preoperative JOA score were identified as the most commonly selected features by both the ML and statistical models. Grid search optimization for hyperparameters successfully enhanced the predictive performance of each ML model, and the SVM model still had the best performance with an AUC of 0.93 and an accuracy of 86.4%.

CONCLUSIONS

Overall, the study demonstrated that ML classifiers such as SVM can effectively predict surgical outcomes for patients with DCM while identifying associated predictors in a multivariate manner.

Evaluation and spatial convergence of carbon emission reduction efficiency in China's power industry: Based on a three-stage DEA model with game cross-efficiency

Reducing carbon emissions is essential for achieving sustainable development in China. In this study, we developed a framework for measuring carbon emission reduction considering both thermal power and clean energy generation perspectives. Subsequently, we constructed a three-stage data envelopment analysis (DEA) model with game cross-efficiency to eliminate the influence of external environmental factors, random factors, and regional competition. Thereafter, we calculated the carbon emission reduction efficiencies (CEREs) of the power industries of 30 provinces in China from 2010 to 2020. Based on this, we conducted temporal and spatial analyses of the carbon emission reduction amount (CERA), evaluated CERE, compared different DEA models, and assessed spatial convergence effects. The evaluation results of CERE across 30 provinces, cities, and autonomous regions in China showed that: (1) although China's CERA increased, substantial regional differences exist in the carbon emission reduction structure. (2) The overall average CERE ranged from 0.485 to 0.737. Since 2016, the highest CERE values have been observed in southwest China, followed by the eastern coastal and central regions, while the northwestern region experienced notable fluctuations. (3) The three-stage DEA model with game cross-efficiency, which eliminates the influence of competition and external environmental factors, can be used to accurately measure CERE. (4) CERE has a spatial convergence effect on China's power industry and is promoted by energy structure, upgrading of industrial structure and government interventions. These findings provide important insights for optimizing the carbon emissions reduction structure and improving CERE.

Lignosulfonate sodium and ionic liquid synergistically promote tough hydrogels for intelligent wearable human-machine interaction

Flexible wearable devices are garnering significant interest, with conductive hydrogels emerging as a particularly notable category. While many of these hydrogels offer impressive conductivity, they often lack the innate ability to adhere autonomously to human skin. The ideal hydrogel should possess both superior adhesion properties and a wide responsive range. This study introduces a novel double-network conductive hydrogel, synthesized from lignosulfonate sodium and ionic liquid using a one-pot method. The gel's mechanical robustness (fracture elongation of ∼3500 % and tensile strength of ∼130 kPa) and exceptional conductivity sensing performance arise from the synergistic effects of electrostatic interactions, dynamic hydrogen bonding, and a three-dimensional network structure. Additionally, the phenolic hydroxyl and sulfonic groups from lignosulfonate sodium imbue the hydrogel with adhesive qualities, allowing it to easily bond with varied material surfaces. This hydrogel excels in human physiological signal detection and wireless monitoring, demonstrating a rapid response time (149 ms) and high sensitivity (a maximum gauge factor of 10.9 for strains between 400 and 600 %). Given these properties, the flexible, self-adhesive, and conductive hydrogel showcases immense promise for future applications in wearable devices and wireless transmission sensing.

Biodegradable chitosan‑zirconium composite adsorptive membranes for potential arsenic (III/V) capture electrodialysis

Combining adsorption with other technologies holds great potential in fast and deep arsenic ion removal. Herein, chitosan‑zirconium composite adsorptive membranes (CS-Zr CM) were successfully prepared using simple casting and sodium hydroxide coagulation strategies, which was demonstrated the use in arsenic ion-capture electrodialysis based on their good adsorption performance. In the batch adsorption tests, the maximum adsorption capacities of CS-Zr CM for As(III) and As(V) were 134.2 mg/g and 119.5 mg/g, respectively. CS-Zr CM also exhibited satisfying adsorption selectivity and good reusability toward As(III) and As(V). However, the adsorption kinetics showed that they needed 48 h to reach the adsorption equilibrium and the adsorption ability toward trace arsenic ion was ineffective. Furthermore, CS-Zr CM was applied as the adsorptive membrane in the electrodialysis process. Under the influence of electric field, the As(III) and As(V) removal equilibrium time was shortened to 12 h and the concentrations of As(III) and As(V) ions could be efficiently reduced to below the WHO limit in drinking water (10 μg/L), which far surpassed the physicochemical adsorption method. Such good arsenic ion removal ability of CS-Zr CM together with the ease scalable fabrication, low cost, and biodegradable properties shows its huge prospects in arsenic-containing wastewater treatment.

Active sites engineering on FeNi alloy/Cr3C2 heterostructure for superior oxygen evolution activity

Exploring high active electrocatalysts for oxygen evolution reaction (OER) is of great significance for a sustainable hydrogen economy. The development of non-precious transition metals, with sufficient active sites and ample intrinsic activity, remains a challenge. Herein, a new type of FeNi-Cr3C2 heterostructure anchored on carbon sheets (FeNi-Cr3C2@C) was reported, which can effectively catalyze OER with swift kinetics and outstanding intrinsic activity. The introduced Cr3C2 phase not only serves as a support material but also effectively suppresses the thermal coarsening of FeNi alloy nanoparticle. The FeNi-Cr3C2@C displays a robust OER activity with a low overpotential of 283 mV at the current density of 10 mA cm-2, a high turnover frequency value of 1.69 s-1 at the overpotential of 300 mV (10 times higher than that of FeNi@C) and good stability in alkaline media. Density functional theory calculations (DFT) calculations show that Cr3C2 can facilitate the generation of electron-rich region at the Ni site in FeNi alloys as an active site, exhibiting an optimized adsorption behavior toward oxygen intermediate species with regard to decreased thermodynamic energy barriers. Our work opens up a promising path to modulate the electrocatalytic active sites using inexpensive and durable Cr3C2 for electrochemical catalytic reactions.

Self-Standing Porous Aromatic Framework Electrodes for Efficient Electrochemical Uranium Extraction

Electrochemical uranium extraction from seawater provides a new opportunity for a sustainable supply of nuclear fuel. However, there is still room for studying flexible electrode materials in this field. Herein, we construct amidoxime group modified porous aromatic frameworks (PAF-144-AO) on flexible carbon cloths in situ using an easy to scale-up electropolymerization method followed by postdecoration to fabricate the self-standing, binder-free, metal-free electrodes (PAF-E). Based on the architectural design, adsorption sites (amidoxime groups) and catalytic sites (carbazole groups) are integrated into PAF-144-AO. Under the action of an alternating electric field, uranyl ions are selectively captured by PAN-E and subsequently transformed into Na2O(UO3·H2O)x precipitates in the presence of Na+ via reversible electron transfer, with an extraction capacity of 12.6 mg g-1 over 24 days from natural seawater. This adsorption-electrocatalysis mechanism is also demonstrated at the molecular level by ex situ spectroscopy. Our work offers an effective approach to designing flexible porous organic polymer electrodes, which hold great potential in the field of electrochemical uranium extraction from seawater.

Adenosine triphosphate induced cell death: Mechanisms and implications in cancer biology and therapy

Adenosine triphosphate (ATP) induced cell death (AICD) is a critical cellular process that has garnered substantial scientific interest for its profound relevance to cancer biology and to therapeutic interventions. This comprehensive review unveils the intricate web of AICD mechanisms and their intricate connections with cancer biology. This review offers a comprehensive framework for comprehending the multifaceted role of AICD in the context of cancer. This is achieved by elucidating the dynamic interplay between systemic and cellular ATP homeostasis, deciphering the intricate mechanisms governing AICD, elucidating its intricate involvement in cancer signaling pathways, and scrutinizing validated key genes. Moreover, the exploration of AICD as a potential avenue for cancer treatment underscores its essential role in shaping the future landscape of cancer therapeutics.

A Zero-Valent Sulfur Transporter Helps Podophyllotoxin Uptake into Bacterial Cells in the Presence of CTAB

Podophyllotoxin (PTOX) is naturally produced by the plant Podophyllum species. Some of its derivatives are anticancer drugs, which are produced mainly by using chemical semi-synthesis methods. Recombinant bacteria have great potential in large-scale production of the derivatives of PTOX. In addition to introducing the correct enzymes, the transportation of PTOX into the cells is an important factor, which limits its modification in the bacteria. Here, we improved the cellular uptake of PTOX into Escherichia coli with the help of the zero-valent sulfur transporter YedE1E2 in the presence of cetyltrimethylammonium bromide (CTAB). CTAB promoted the uptake of PTOX, but induced the production of reactive oxygen species. A protein complex (YedE1E2) of YedE1 and YedE2 enabled E. coli cells to resist CTAB by reducing reactive oxygen species, and YedE1E2 was a hypothetical transporter. Further investigation showed that YedE1E2 facilitated the uptake of extracellular zero-valent sulfur across the cytoplasmic membrane and the formation of glutathione persulfide (GSSH) inside the cells. The increased GSSH minimized oxidative stress. Our results indicate that YedE1E2 is a zero-valent sulfur transporter and it also facilitates CTAB-assisted uptake of PTOX by recombinant bacteria.

Ciprofloxacin enhances the biofilm formation of Staphylococcus aureus via an agrC-dependent mechanism

Staphylococcus aureus readily forms biofilms on host tissues and medical devices, enabling its persistence in chronic infections and resistance to antibiotic therapy. The accessory gene regulator (Agr) quorum sensing system plays a key role in regulating S. aureus biofilm formation. This study reveals the widely used fluoroquinolone antibiotic, ciprofloxacin, strongly stimulates biofilm formation in methicillin-resistant S. aureus, methicillin-sensitive S. aureus, and clinical isolates with diverse genetic backgrounds. Crystal violet staining indicated that ciprofloxacin induced a remarkable 12.46- to 15.19-fold increase in biofilm biomass. Confocal laser scanning microscopy revealed that ciprofloxacin induced denser biofilms. Phenotypic assays suggest that ciprofloxacin may enhance polysaccharide intercellular adhesin production, inhibit autolysis, and reduce proteolysis during the biofilm development, thus promoting initial adhesion and enhancing biofilm stability. Mechanistically, ciprofloxacin significantly alters the expression of various biofilm-related genes (icaA, icaD, fnbA, fnbB, eap, emp) and regulators (agrA, saeR). Gene knockout experiments revealed that deletion of agrC, rather than saeRS, abolishes the ciprofloxacin-induced enhancement of biofilm formation, underscoring the key role of agrC. Thermal shift assays showed ciprofloxacin binds purified AgrC protein, thereby inhibiting the Agr system. Molecular docking results further support the potential interaction between ciprofloxacin and AgrC. In summary, subinhibitory concentrations of ciprofloxacin stimulate S. aureus biofilm formation via an agrC-dependent pathway. This inductive effect may facilitate local infection establishment and bacterial persistence, ultimately leading to therapeutic failure.

Development and Validation of the Home Hospice Care Needs Questionnaire for the Dying Old Adult (HHCNQ-DE) in Mainland China

Context: Home hospice needs assessment is the key to the development of home hospice services. Therefore, there is a need to develop assessment tools in mainland China to meet the comprehensive needs of the old adult at the end of life. Objective: To develop and validate a tool to assess Chinese mainland palliative care needs of the dying old adult at home. Methods: Using the Harmony Nursing Theory as a theoretical framework, through reference to the China home hospice care needs scale, literature research, in-depth conversations with the dying old adult, and group discussions among members of the research team, 43 original questionnaire items were preliminarily drafted. A 31-item predictive questionnaire was formed through 2 rounds of expert review and small sample testing. From April to September 2023, 199 old adult at the end of life at home in Jinzhou, Liaoning Province were investigated to determine the reliability and validity of the questionnaire. Results: The final questionnaire included 31 items. Exploratory factor analysis extracted 5 common factors, and the cumulative variance contribution rate was 68.811%; the Cronbach's alpha coefficient of the total questionnaire was 0.832, and the re-test reliability was .806; the content validity index of the questionnaire was 0.982, and the content validity index of the items was 0.83-1.00. Conclusion: The construction method of the HHCNQ-DE is scientific and reliable, with good reliability and validity, and it can be used as a tool to measure the needs of home hospice care in mainland China in the future.

Fabrication of cobalt-zinc bimetallic oxides@polypyrrole composites for high-performance electromagnetic wave absorption

Composite materials that combine magnetic and dielectric losses offer a potential solution to enhance impedance match and significantly improve microwave absorption. In this study, Co3O4/ZnCo2O4 and ZnCo2O4/ZnO with varying metal oxide compositions are successfully synthesized, which are achieved by modifying the ratios of Co2+ and Zn2+ ions in the CoZn bimetallic metal-organic framework (MOF) precursor, followed by a high-temperature oxidative calcination process. Subsequently, a layer of polypyrrole (PPy) is coated onto the composite surfaces, resulting in the formation of core-shell structures known as Co3O4/ZnCo2O4@PPy (CZCP) and ZnCo2O4/ZnO@PPy (ZCZP) composites. The proposed method allows for rapid adjustments to the metal oxide composition within the inner shell, enabling the creation of composites with varying degrees of magnetic losses. The inclusion of PPy in the outer shell serves to enhance the bonding strength of the entire composite structure while contributing to conductive and dielectric losses. In specific experimental conditions, when the loading is set at 50 wt%, the CZCP composite exhibits an effective absorption bandwidth (EAB) of 5.58 GHz (12.42 GHz-18 GHz) at a thickness of 1.53 mm. Meanwhile, the ZCZP composite demonstrates an impressive minimum reflection loss (RLmin) of -71.2 dB at 13.04 GHz, with a thickness of 1.84 mm. This study offers a synthesis strategy for designing absorbent composites that possess light weight and excellent absorptive properties, thereby contributing to the advancement of electromagnetic wave absorbing materials.

Transcriptional correlates of frequency-dependent brain functional activity associated with symptom severity in degenerative cervical myelopathy

BACKGROUND

Neuroimaging techniques provide insights into the brain abnormalities secondary to degenerative cervical myelopathy (DCM) and their association with neurological deficits. However, the neural correlates underlying the discrepancy between symptom severity and the degree of spinal cord compression, as well as the transcriptional correlates of these cortical abnormalities, remain unknown in DCM patients.

METHODS

In this cross-sectional study, which collected resting-state functional MRI (rs-fMRI) images and the Japanese Orthopedic Association (JOA) score, enrolled 104 participants (54 patients and 50 healthy controls). The frequency-dependent amplitude of low-frequency fluctuation (ALFF) was obtained for all participants. We investigated the ALFF differences between mild-symptom DCM patients and severe-symptom DCM patients while carefully matching the degree of compression between these two groups via both univariate comparison and searchlight classification for three frequency bands (e.g., Slow-4, Slow-5, and Full-band). Additionally, we identified genes associated with symptom severity in DCM patients by linking the spatial patterns of gene expression of Allen Human Brain Atlas and brain functional differences between mild symptom and severe symptom groups.

RESULTS

(1) We found that the frequency-specific brain activities within the sensorimotor network (SMN), visual network (VN), and default mode network (DMN) were associated with the varying degrees of functional impairment in DCM patients; (2) the frequency-specific brain activity within the SMN correlated with the functional recovery in patients with DCM; (3) a spatial correlation between the brain-wide expression of genes involved in neuronal migration and the brain functional activities associated with symptom severity was identified in DCM patients.

CONCLUSION

In conclusion, our study bridges gaps between genes, cell classes, biological processes, and brain functional correlates of DCM. While our findings are correlational in nature, they suggest that the neural activities of sensorimotor cortices in DCM are associated with the severity of symptoms and might be associated with neuronal migration within the brain.

The relationship between dynamic monitoring network plans and eco-efficiency - New evidence from atmospheric quality monitoring policy in China

China's rapid economic development in recent decades has come at a considerable environmental cost. This paper explores whether atmospheric quality monitoring policy (AQMP) improves eco-efficiency by using AQMP as a natural experimental group. We assessed the eco-efficiency of 285 cities in China from 2009 to 2019 using the super-efficient SBM model and estimated the impact of AQMP using the propensity score method Difference-in-Difference (PSM-DID) model. The key findings of this paper are as follows: First, AQMP can enhance eco-efficiency, promoting sustainable urban development. Second, governmental and non-governmental organizations play contrasting roles in either fostering or reversing the positive effects of AQMP. Factors like innovation, clean energy adoption, and industrial structure have a positive mediating influence. Finally, the impact of AQMP on eco-efficiency varies across cities, displaying heterogeneity. Specifically, AQMP has a positive effect on eco-efficiency in resource-rich cities, small and medium-sized urban centers, smart cities, and coastal areas. These findings carry significant implications for the establishment of dynamic monitoring networks and the advancement of eco-efficiency in emerging countries, including China.

Selected humanization of yeast U1 snRNP leads to global suppression of pre-mRNA splicing and mitochondrial dysfunction in the budding yeast

The recognition of 5' splice site (5' ss) is one of the earliest steps of pre-mRNA splicing. To better understand the mechanism and regulation of 5' ss recognition, we selectively humanized components of the yeast U1 snRNP to reveal the function of these components in 5' ss recognition and splicing. We targeted U1C and Luc7, two proteins that interact with and stabilize the yeast U1 (yU1) snRNA and the 5' ss RNA duplex. We replaced the Zinc-Finger (ZnF) domain of yU1C with its human counterpart, which resulted in cold-sensitive growth phenotype and moderate splicing defects. Next, we added an auxin-inducible degron to yLuc7 protein and found that Luc7-depleted yU1 snRNP resulted in the concomitant loss of PRP40 and Snu71 (two other essential yeast U1 snRNP proteins), and further biochemical analyses suggest a model of how these three proteins interact with each other in the U1 snRNP. The loss of these proteins resulted in a significant growth retardation accompanied by a global suppression of pre-mRNA splicing. The splicing suppression led to mitochondrial dysfunction as revealed by a release of Fe 2+ into the growth medium and an induction of mitochondrial reactive oxygen species. Together, these observations indicate that the human U1C ZnF can substitute that of yeast, Luc7 is essential for the incorporation of the Luc7-Prp40-Snu71 trimer into yeast U1 snRNP, and splicing plays a major role in the regulation of mitochondria function in yeast.

Changes of left atrial morphology and function evaluated with four-dimensional automated left atrial quantification echocardiography in patients with coronary slow flow phenomenon and preserved left ventricular ejection fraction

BACKGROUND

Coronary slow flow phenomenon (CSFP) can cause left ventricular diastolic dysfunction (LVDD). In multiple studies, the left atrial (LA) strain has been reported to be an excellent parameter for assessing LVDD. The 4-dimensional automated LA quantification (4D Auto LAQ) dedicated to the LA was recently available. Our study aimed to evaluate subclinical changes in LA morphology and function with 4D Auto LAQ in patients with CSFP and preserved left ventricular ejection fraction (LVEF).

METHODS

Forty-eight patients with CSFP confirmed with coronary angiography and 46 age and gender-matched controls with normal coronary flow were enrolled. The thrombolysis in myocardial infarction frame count (TFC) method was used to record coronary blood flow velocities for each major coronary artery. LA volume, LA longitudinal and circumferential strains during each of the three LA phases (reservoir, conduit, and contraction), LA total emptying fraction (LATEF), LA active emptying fraction (LAAEF), and LA passive emptying fraction (LAPEF) were quantified with 4D Auto LAQ analysis.

RESULTS

Compared with controls, LA longitudinal reservoir strain (LASr), LA longitudinal strain during the conduit phase (LAScd), LA contraction strain (LASct), LA conduit circumferential strain (LAScd-c), LATEF, LAPEF decreased significantly in individuals with CSFP. Of the 4D- LAQ parameters, only LASr [odds ratio (OR): 0.773, P < 0.001] and LATEF [OR: 0.762, P < 0.001] were associated with CSFP in multivariate analysis. A LASr ≤23.00% can differentiate CSFP from controls [sensitivity, 66.7%; specificity, 93.5%; area under the curve (AUC), 0.823; P < 0.001]. A LASr of ≤19.00% could predict the elevation of LV filling pressure in the CSFP cohort [sensitivity, 76.9%; specificity, 74.3%; area under the curve (AUC), 0.792; P < 0.001]. LASr was the only index to demonstrate significant changes compared to controls in single-vessel CSFP. Compared to the right coronary artery (RCA) and left circumflex (LCX), TFC of the left anterior descending (LAD) artery was the only independent variable of LASr (Standardized Coefficients: -0.386, P = 0.037).

CONCLUSIONS

Impairment of LA reservoir function reflected by changes in LASr and LATEF can be seen in patients with CSFP. LASr could predict the elevation of LV filling pressure in CSFP individuals. LASr is more sensitive than LATEF in detecting LA reservoir dysfunction in single-vessel CSFP. CSFP in LAD exerts a more prominent influence on LASr than RCA or LCX.