Relationship among low baseline muscle mass, skeletal muscle quality, and mortality in critically ill children

BACKGROUND

Studies in adults have shown that low baseline muscle mass at intensive care unit (ICU) admission was associated with poor clinical outcomes. However, no information on the relationship between baseline muscle quality or mass and clinical outcomes in critically ill children was found.

METHODS

3775 children were admitted to the pediatric ICU (PICU), 262 were eligible for inclusion. Abdominal computed tomography was performed to assess baseline skeletal muscle mass and quality. Patients were categorized to normal or low group based on the cutoff value for predicting hospital mortality of the skeletal muscle index (SMI; 30.96 cm2/m2) and skeletal muscle density (SMD; 41.21 Hounsfield units).

RESULTS

Body mass index (BMI) (18.07 ± 4.44 vs 15.99 ± 4.51) and BMI-for-age z score (0.46 [-0.66 to 1.74] vs -0.87 [-1.69 to 0.05]) were greater in the normal-SMI group, the length of PICU stay was longer in the low-SMI group (16.00 days [8.50-32.50] vs 13.00 days [7.50-20.00]), and the in-PICU mortality rate in the normal-SMI group (10.00%) was lower than the low-SMI group (22.6%). Children with low SMD had a higher in-PICU mortality rate (25.6% vs 7.7%), were younger (36.00 months [12.00-120.00] vs 84.00 months [47.50-147.50]) and weighed less (16.40 kg [10.93-37.25] vs 23.00 kg [16.00-45.00]). Mortality was greater in patients with lower SMD and prolonged hospital stay (log-rank, P = 0.007). SMD was an independent predictor for length of PICU stay and in-PICU mortality.

CONCLUSIONS

Low baseline skeletal muscle quality in critically ill children is closely tied with a higher in-PICU mortality and longer PICU stay and is an independent risk factor for unfavorable clinical outcomes.

Left Bundle Branch Area Pacing versus Biventricular Pacing for Cardiac Resynchronization Therapy on Morbidity and Mortality

BACKGROUND

Left bundle branch area pacing (LBBAP) has emerged as an alternative to biventricular pacing (BVP) for cardiac resynchronization therapy (CRT). We aimed to compare the morbidity and mortality associated with LBBAP versus BVP in patients undergoing CRT implantation.

METHODS

Consecutive patients who received CRT from two high-volume implantation centers were retrospectively recruited. The primary endpoint was a composite of all-cause death and heart failure hospitalization, and the secondary endpoint was all-cause death.

RESULTS

A total of 491 patients receiving CRT (154 via LBBAP and 337 via BVP) were included, with a median follow-up of 31 months. The primary endpoint was reached by 21 (13.6%) patients in the LBBAP group, as compared with 74 (22.0%) patients in the BVP group [hazard ratio (HR) 0.70, 95% confidence interval (CI) 0.43-1.14, P = 0.15]. There were 10 (6.5%) deaths in the LBBAP group, as compared with 31 (9.2%) in the BVP group (HR 0.91, 95% CI 0.44-1.86, P = 0.79). No significant difference was observed in the risk of either the primary or secondary endpoint between LBBAP and BVP after multivariate Cox regression (HR 0.74, 95% CI 0.45-1.23, P = 0.24, and HR 0.77, 95% CI 0.36-1.67, P = 0.51, respectively) or propensity score matching (HR 0.72, 95% CI 0.41-1.29, P = 0.28, and HR 0.69, 95% CI 0.29-1.65, P = 0.40, respectively).

CONCLUSION

LBBAP was associated with a comparable effect on morbidity and mortality relative to BVP in patients with indications for CRT.

Ferroptosis mediated by TNFSF9 interferes in acute ischaemic stroke reperfusion injury with the progression of acute ischaemic stroke

In this study, we investigated the potential involvement of TNFSF9 in reperfusion injury associated with ferroptosis in acute ischaemic stroke patients, mouse models and BV2 microglia. We first examined TNFSF9 changes in peripheral blood from stroke patients with successful reperfusion, and constructed oxygen-glucose deprivation-reperfusion (OGD-R) on BV2 microglia, oxygen-glucose deprivation for 6 h followed by reoxygenation and re-glucose for 24 h, and appropriate over-expression or knockdown of TNFSF9 manipulation on BV2 cells and found that in the case of BV2 cells encountering OGD-R over-expression of TNFSF9 resulted in increased BV2 apoptosis. Still, the knockdown of TNFSF9 ameliorated apoptosis and ferroptosis. In an in vivo experiment, we constructed TNFSF9 over-expression or knockout mice by intracerebral injection of TNFSF9-OE or sh-TNFSF9 adenovirus. We performed the middle cerebral artery occlusion (MCAO) model on day four, 24 h after ligation of the proximal artery, for half an hour to recanalize. As luck would have it, over-expression of TNFSF9 resulted in increased brain infarct volumes, neurological function scores and abnormalities in TNFSF9-related TRAF1 and ferroptosis-related pathways, but knockdown of TNFSF9 improved brain infarcts in mice as well as reversing TNFSF9-related signalling pathways. In conclusion, our data provide the first evidence that TNFSF9 triggers microglia activation by activating the ferroptosis signalling pathway following ischaemic stroke, leading to brain injury and neurological deficits.

Multimodal mechanisms of pathogenic variants in the signal peptide of FIX leading to hemophilia B

Signal peptide (SP) is essential for protein secretion, and pathogenic variants in the SP of FIX have been identified in hemophilia B (HB). However, the underlying mechanism for the genotype-phenotype correlation of these variants has not been well studied. Here we systematically examined the effects of 13 pathogenic point variants in the SP of FIX using different approaches. Our results showed that these point variants lead to HB by missense variants and/or aberrant pre-mRNA splicing. The missense variants in h-region mainly affected the co-translational translocation function of the SP, and those in c-region caused FIX deficiency mainly by disturbing the co-translational translocation and/or cleavage of the SP. Almost absolute aberrant pre-mRNA splicing was only observed in variants of c.82T>G, but a slight change of splicing patterns was found in variants of c.53G>T, c.77C>A, c.82T>C, and c.83G>A, indicating that these variants might have different degree to affect pre-mRNA splicing. Although two 6-nt deletion aberrant pre-mRNA splicing products caused FIX deficiency by disturbing the SP cleavage, but they could produce some functional mature FIX and vitamin K could increase the secretion of functional FIX. Taken together, our data indicated that pathogenic variants in the SP of FIX caused HB through diverse molecular mechanisms or even a mixture of several mechanisms, and vitamin K availability could be partially attributed to varying bleeding tendencies in patients carrying the same variant in the SP.

Role of arylalkylamine N-acetyltransferase 7 in reproduction and limb pigmentation of Aedes aegypti

Arylalkylamine N-acetyltransferase (aaNAT) is a crucial enzyme that catalyses the transfer of acetyl groups from acetyl coenzyme A to arylalkylamines and arylamines. Evolutionary studies have identified a distinct class of aaNATs specific to mosquitoes, yet their functions remain elusive. This study focuses on Ae-aaNAT7, a mosquito-unique gene in Aedes aegypti (Diptera:Culicidae), to explore its functionality. Temporal and spatial expression analysis of Ae-aaNAT7 mRNA revealed high expression during embryonic development and in first-instar larvae, with notable expression in the limbs of adult mosquitoes based on tissue expression profiling. By further employing CRISPR/Cas9 technology for loss-of-function studies, our investigation revealed a reduction in the area of white spotting in the limbs of Ae-aaNAT7 mutant adult mosquitoes. Further investigation revealed a significant decrease in the fecundity and hatchability of the mutants. Dissection of the ovaries from Ae-aaNAT7 heterozygous mutants showed a noticeable reduction in the oocyte area compared with wild type. Dissection of the exochorion of the eggs from Ae-aaNAT7 homozygous mutants consistently revealed a striking absence of mature embryos. In addition, RNA interference experiments targeting Ae-aaNAT7 in males resulted in a reduction in fecundity, but no effect on hatchability was observed. These collective insights underscore the substantial impact of Ae-aaNAT7 on reproduction and its pivotal contribution to adult limb pigmentation in Ae. aegypti. These revelations offer insights pivotal for the strategic design of future insecticide targets.

Efficient degradation of tetracycline via peroxymonosulfate activation by phosphorus-doped biochar loaded with cobalt nanoparticles

The accumulation of tetracycline hydrochloride (TCH) threatens human health because of its potential biological toxicity. Carbon -based materials with easy isolation and excellent performance that can activate peroxymonosulfate (PMS) to generate reactive oxygen species for TCH degradation are essential, but the development of such materials remains a significant challenge. In this study, based on the idea of treating waste, tricobalt tetraoxide loaded P-doped biochar (Co NP-PBC) was synthesised to activate PMS for the degradation of TCH. Possible degradation pathways and intermediate products of TCH were identified using High performance liquid chromatography tandem mass spectrometry (HPLC-MS) detection and density functional theory analysis. Toxicity analysis software was used to predict the toxicity of the intermediate products. Compared to catalysts loaded with Fe and Mn and other Co-based catalysts, Co NP-PBC exhibited an optimal performance (with a kinetic constant of 0.157 min-1 for TCH degradation), and over 99.0% of TCH can be degraded within 20 min. This mechanism demonstrates that the non-free radical oxidation of 1O2 plays a major role in the degradation of TCH. This study provides insights into the purification of wastewater using BC-based catalysts.

Development of an enzyme-linked immunosorbent assay using a monoclonal antibody to a dominant epitope in non-structural protein 4 of porcine reproductive and respiratory syndrome virus

Porcine reproductive and respiratory syndrome (PRRS) caused by the PRRS virus (PRRSV) is one of the most severe swine diseases causing great economic losses for the international swine industry. Non-structural protein 4 (NSP4) is critical to the life cycle of PRRSV and contains dominant B cell epitopes. This study prepared a monoclonal antibody against Nsp4, and 2D11, which contained the sequence 138KQGGGIVTRPSGQFCN153, was confirmed as the epitope. A 2D11-based double antibody sandwich enzyme-linked immunosorbent assay (dasELISA) was next developed with a cut value of 0.1987. A total of 1354 pig serum samples were detected by dasELISA and compared to a commercial ELISA kit (N-coated iELISA), resulting in a positive coincidence rate of 98.8% and negative coincidence rate of 96.9%. A total of 119 sera were positive by dasELISA while negative by iELISA. Higher positive rates by dasELISA were found in pig farms where PRRSV antibody levels varied widely. These results indicated that the dasELISA was a useful tool to detect PRRSV antibody in clinical samples.

Safety of Tonsillectomy and/or Adenoidectomy in Pediatric Patients with Prolonged Activated Partial Thromboplastin Time and Factor XII Deficiency

Objective

To evaluate the safety and feasibility of tonsillectomy and/or adenoidectomy (T&A) in pediatric patients with prolonged activated partial thromboplastin time (APTT) and coagulation factor deficiency.

Methods

A prospective study was admitted to the children undergoing T&A at our institution between October 2019 and January 2020, specifically focusing on preoperative coagulation function. Within this group, we identified 5 patients exhibiting prolonged APTT and coagulation factor deficiencies, constituting the experimental group, and 10 patients matched by gender and age with normal blood coagulation function were selected as the control group. Comparative analyses between the two groups were conducted, focusing on surgical duration, intraoperative bleeding volume, duration of hospital stay, and postoperative complications such as active bleeding across the groups. At the six-month postoperative mark, a reassessment of coagulation functions and factor assays was conducted within the experimental group.

Results

No statistically significant differences were discovered in terms of surgical duration or bleeding volume when comparing the experimental subgroups with their respective control counterparts. Furthermore, there were no incidences of postoperative active bleeding observed in any of the groups. Notably, postoperative APTT values (32.7 ± 1.7s) exhibited a significant disparity compared to preoperative levels (43.7 ± 1.8s, p < 0.01). Coagulation factors demonstrated normalization, evidenced by a significant difference in postoperative Factor XII levels (40.2 ± 5.4%) compared to preoperative levels (63.1 ± 5.9%, p < 0.01).

Conclusion

Prolonged APTT with FXII factor deficiency does not show a significant bleeding tendency and is not a contraindication for T&A surgery. Post T&A surgery, children with abnormal coagulation function and deficient clotting factors show significant improvement compared to pre-surgery. It is important to consider that chronic inflammation in adenoids and tonsils may contribute to the prolongation of APTT and the manifestation of Factor XII deficiency.

The protective role of vagus nerve stimulation in ischemia-reperfusion injury

Ischemia-reperfusion injury (IRI) encompasses the damage resulting from the restoration of blood supply following tissue ischemia. This phenomenon commonly occurs in clinical scenarios such as hemorrhagic shock, severe trauma, organ transplantation, and thrombolytic therapy. Despite its prevalence, existing treatments exhibit limited efficacy against IRI. Vagus nerve stimulation (VNS) is a widely utilized technique for modulating the autonomic nervous system. Numerous studies have demonstrated that VNS significantly reduces IRI in various organs, including the heart, brain, and liver. This article reviews the pathological processes during IRI and summarizes the role and possible mechanisms of VNS in IRI of different organs. Furthermore, this review addresses the current challenges of VNS clinical applications, providing a novel perspective on IRI treatment.

ZAP facilitates NLRP3 inflammasome activation via promoting the oligomerization of NLRP3

The NOD-like receptor family protein 3 (NLRP3) inflammasome is a crucial complex for the host to establish inflammatory immune responses and plays vital roles in a series of disorders, including Alzheimer's disease and acute peritonitis. However, its regulatory mechanism remains largely unclear. Zinc finger antiviral protein (ZAP), also known as zinc finger CCCH-type antiviral protein 1 (ZC3HAV1), promotes viral RNA degradation and plays vital roles in host antiviral immune responses. However, the role of ZAP in inflammation, especially in NLRP3 activation, is unclear. Here, we show that ZAP interacts with NLRP3 and promotes NLRP3 oligomerization, thus facilitating NLRP3 inflammasome activation in peritoneal macrophages of C57BL/6 mice. The shorter isoform of ZAP (ZAPS) appears to play a greater role than the full-length isoform (ZAPL) in HEK293T cells. Congruously, Zap-deficient C57BL/6 mice may be less susceptible to alum-induced peritonitis and lipopolysaccharide-induced sepsis in vivo. Therefore, we propose that ZAP is a positive regulator of NLRP3 activation and a potential therapeutic target for NLRP3-related inflammatory disorders.

Surface Acoustic Wave-Driven Enhancement of Enzyme-Linked Immunosorbent Assays: ELISAW

Enzyme-linked immunosorbent assays (ELISAs) are widely used in biology and clinical diagnosis. Relying on antigen-antibody interaction through diffusion, the standard ELISA protocol can be time-consuming, preventing its use in rapid diagnostics. We present a time-saving and more sensitive ELISA without changing the standard setup and protocol, using surface acoustic waves (SAWs) to enhance performance. Each step of the assay, from the initial antibody binding onto the walls of the well plate to the target analyte molecules' binding for detection─except, notably, for the blocking step─is improved principally via acoustic streaming-driven advection. Using SAWs, the time required for one step of an example ELISA is reduced from 60 to 15 min to achieve the same binding amount. By extending the duration of SAW exposure to 20 min, the sensitivity can be significantly improved over the 60 min, 35 °C ELISA without SAWs. It is also possible to confer beneficial improvements to bead-based ELISA by combining it with SAWs to further reduce the time required for binding to 2 min. By significantly increasing the speed of ELISA, its utility may be improved for a wide range of point-of-care diagnostics applications.

Kidney medicine meets computer vision: a bibliometric analysis

BACKGROUND AND OBJECTIVE

Rapid advances in computer vision (CV) have the potential to facilitate the examination, diagnosis, and treatment of diseases of the kidney. The bibliometric study aims to explore the research landscape and evolving research focus of the application of CV in kidney medicine research.

METHODS

The Web of Science Core Collection was utilized to identify publications related to the research or applications of CV technology in the field of kidney medicine from January 1, 1900, to December 31, 2022. We analyzed emerging research trends, highly influential publications and journals, prolific researchers, countries/regions, research institutions, co-authorship networks, and co-occurrence networks. Bibliographic information was analyzed and visualized using Python, Matplotlib, Seaborn, HistCite, and Vosviewer.

RESULTS

There was an increasing trend in the number of publications on CV-based kidney medicine research. These publications mainly focused on medical image processing, surgical procedures, medical image analysis/diagnosis, as well as the application and innovation of CV technology in medical imaging. The United States is currently the leading country in terms of the quantities of published articles and international collaborations, followed by China. Deep learning-based segmentation and machine learning-based texture analysis are the most commonly used techniques in this field. Regarding research hotspot trends, CV algorithms are shifting toward artificial intelligence, and research objects are expanding to encompass a wider range of kidney-related objects, with data dimensions used in research transitioning from 2D to 3D while simultaneously incorporating more diverse data modalities.

CONCLUSION

The present study provides a scientometric overview of the current progress in the research and application of CV technology in kidney medicine research. Through the use of bibliometric analysis and network visualization, we elucidate emerging trends, key sources, leading institutions, and popular topics. Our findings and analysis are expected to provide valuable insights for future research on the use of CV in kidney medicine research.

The anti-fatigue and sleep-aiding effects vary significantly among different recipes containing Ganoderma lucidum extracts

Aims

This study aims to delve into the anti-fatigue and sleep-aiding effects of various formulations containing Ganoderma lucidum extracts.

Materials and methods

PGB [incorporating Ganoderma lucidum extract (GE), broken Ganoderma lucidum spore powder (GB) and Paecilomyces hepiali mycelium (PH)] and GBS [composed of GE, GB, and Ganoderma sinense powder (GS)] were chosen as representative recipes for this study. Mice were treated with these recipes or key components of Ganoderma lucidum for 14 consecutive days. Subsequently, a weight-bearing swimming experiment was conducted to assess the mice's exhaustion time and evaluate the anti-fatigue properties of the recipes. Sleep-aiding effects were analyzed by measuring the sleep latency and duration. Furthermore, levels of blood lactic acid, serum urea nitrogen, hepatic glycogen, muscle glycogen, and malondialdehyde (MDA) were measured in the livers and muscles.

Key findings

The anti-fatigue abilities of the tested mice were significantly improved after treatment with PGB and their sleep quality improved as well with GBS treatment. PGB treatment for 14 days could significantly prolong the exhaustion time in weight-bearing swimming (from 10.1 ± 0.5 min to 15.2 ± 1.3 min). Meanwhile, glycogen levels in the livers and muscles were significantly increased, while the levels of serum lactic acid, serum urea nitrogen, and MDA in the livers and muscles were significantly decreased. In contrast, mice treated with GBS for 14 days experienced significant improvements in sleep quality, with shortened sleep latency (from 6.8 ± 0.7 min to 4.2 ± 0.4 min), extended sleep duration (from 88.3 ± 1.4 min to 152.5 ± 9.3 min), and decreased muscle MDA levels. These results indicated that Ganoderma lucidum extracts can be used for anti-fatigue and or aid in sleeping, depending on how they are prepared and administered.

Significance

This study provides experimental evidence and theoretical basis for the development of Ganoderma lucidum recipes that are specifically designed to help with anti-fatigue and sleep.

CPT1A loss disrupts BCAA metabolism to confer therapeutic vulnerability in TP53-mutated liver cancer

Driver genomic mutations in tumors define specific molecular subtypes that display distinct malignancy competence, therapeutic resistance and clinical outcome. Although TP53 mutation has been identified as the most common mutation in hepatocellular carcinoma (HCC), current understanding on the biological traits and therapeutic strategies of this subtype has been largely unknown. Here, we reveal that fatty acid β oxidation (FAO) is remarkable repressed in TP53 mutant HCC and which links to poor prognosis in HCC patients. We further demonstrate that carnitine palmitoyltransferase 1 (CPT1A), the rate-limiting enzyme of FAO, is universally downregulated in liver tumor tissues, and which correlates with poor prognosis in HCC and promotes HCC progression in the de novo liver tumor and xenograft tumor models. Mechanically, hepatic Cpt1a loss disrupts lipid metabolism and acetyl-CoA production. Such reduction in acetyl-CoA reduced histone acetylation and epigenetically reprograms branched-chain amino acids (BCAA) catabolism, and leads to the accumulation of cellular BCAAs and hyperactivation of mTOR signaling. Importantly, we reveal that genetic ablation of CPT1A renders TP53 mutant liver cancer mTOR-addicted and sensitivity to mTOR inhibitor AZD-8055 treatment. Consistently, Cpt1a loss in HCC directs tumor cell therapeutic response to AZD-8055. Conclusion: Our results show genetic evidence for CPT1A as a metabolic tumor suppressor in HCC and provide a therapeutic approach for TP53 mutant HCC patients.

Immobilising an acid-cleavable dimeric phthalocyanine on gold nanobipyramids for intracellular pH detection and photodynamic elimination of cancer cells

An acetal-linked dimeric phthalocyanine has been synthesised and immobilised on the surface of gold nanobipyramids. The resulting nanocomposite serves as a highly sensitive probe for intracellular pH through its acid-responsive fluorescence and surface-enhanced Raman scattering signals. The phthalocyanine units released in the acidic intracellular environment can also effectively eliminate the cancer cells upon light irradiation, rendering this simple fabricated nanosystem a bimodal and bifunctional theranostic agent.

Association between health insurance programs and rehabilitation services utilisation among people with disabilities: evidence from China

OBJECTIVES

Rehabilitation is crucial to improve the health status of people with disabilities. Previous studies mainly analysed the impact of health insurance on utilisation of general health services; the relationship between health insurances and rehabilitation services utilisation among Chinese people with disabilities has been long neglected. This study aimed to analyse the association between health insurance programs and rehabilitation services utilisation among disabled people.

STUDY DESIGN

This was a cross-sectional study.

METHODS

The data used in this study were derived from 2021 National Household Income Survey of Disabled People and National Basic Database of People with Disabilities conducted by China Disabled Persons' Federation. Logistic regression model was used to analyse the relationship between health insurance and rehabilitation services utilisation, and the propensity score matching method was used to check the robustness of the results.

RESULTS

(1) Disabled people insured by the Basic Medical Insurance System for Urban Employees (BMISUE) and the Basic Medical Insurance System for Urban and Rural Residents (BMISURR) were positively associated with rehabilitation service utilisation (odds ratio [OR] = 1.852, 95% confidence interval [CI]:1.268, 2.707; OR = 1.375, 95% CI: 0.962, 1.966). (2) The utilisation level of rehabilitation service among disabled people insured by BMISUE was significantly higher than those insured by BMISURR (OR = 1.355, 95% CI: 1.161, 1.581). (3) The supply of rehabilitation services at the community level was positively correlated with the utilisation by people with disabilities.

CONCLUSION

Health insurance can improve the financial accessibility of using rehabilitation services, and the utilisation level will increase as the benefits level of health insurance increase.

Light-Induced Conductance Potentiation and Depression in an All-Optically Controlled Memristor

Optoelectronic memristors are new multifunctional devices with both electrically tunable and light-tunable synaptic plasticity, attracting great attention as key promising devices for optoelectronic neuromorphic computing systems. At present, the conductance modulation in most optoelectronic memristors is conducted in a hybrid photoelectric mode, suffering some problems such as heat generation and control complexity. Here, an optoelectronic memristor based on the p+-Si/n-ZnO heterojunction is proposed where the conductance can be reversibly modulated in an all-optically controlled mode. The electron detrapping/trapping mechanism at the p+-Si/n-ZnO interface barrier region is presented to explain the light-induced conductance potentiation/depression behavior. Furthermore, some synaptic functions, including excitatory postsynaptic current (EPSC), inhibitory postsynaptic current (IPSC), and paired-pulse facilitation (PPF), are successfully mimicked in the p+-Si/n-ZnO heterojunction memristor, instructing its application potential for optoelectronic neuromorphic computing.

Minor (≤ 10%) Ground-Glass Opacity Component in Clinical Stage I Non-Small Cell Lung Cancer: Associations With Pathologic Characteristics and Clinical Outcomes

Background: The presence of a ground-glass opacity (GGO) component is a favorable prognostic factor in non-small cell lung cancer (NSCLC), although the prognostic impact of a very small GGO component remains poorly investigated. Objective: To investigate the impact of a minor (≤10%) GGO component on the prognosis of clinical stage I NSCLC in comparison with pure-solid nodules. Methods: This retrospective study included 382 patients (mean age, 61 years; 210 men, 172 women) who underwent surgical resection between January 1, 2015 and December 31, 2015 for clinical stage I NSCLC appearing on preoperative chest CT as a nodule with a consolidation-to-tumor (CTR) ratio ≥0.9 and <1.0. Two radiologists independently assigned nodules to a minor-GGO (≥0.9 CTR <1.0) or pure-solid (CTR=1.0) groups. Recurrence-free survival (RFS) and cancer-specific survival (CSS) were assessed by Kaplan-Meier curves and compared between groups using log-rank tests. Cox proportional hazards models were used to assess associations with outcomes. Results: The two radiologists agreed for all nodules' classification into the minor-GGO (n=106) or pure-solid (n=276) groups. The mean CTR of the minor-GGO group was 0.93±0.02 (range, 0.90-0.97). Minor-GGO nodules, in comparison with pure-solid nodules, showed greater solid component diameter (2.68 vs 2.16 cm, p<.001) and total nodule diameter (2.89 vs 2.16 cm, p<.001). The minor-GGO group, in comparison with the pure-solid group, showed lower frequencies of visceral pleural invasion (6.6% vs 17.0%, P=.009), pathologic lymph node involvement (4.7% vs 20.3%, P<.001), and epidermal growth factor mutation (71.6% vs 39.9%; P<.001). The minor-GGO group, in comparison with the pure-solid group, showed better 5-year RFS (83.4% vs 55.0%; P<.001) and better 5-year CSS (92.4% vs 76.4%, P=.004). In multivariable analysis adjusting for patient, imaging, pathologic, and genetic factors, a minor-GGO component was independently associated with a decreased likelihood of recurrence (HR=0.37, P=.001) but not with the likelihood of CSS. Conclusion: Among patients with clinical stage I NSCLC, cancers with a minor-GGO component were associated with a better prognosis versus those with a pure-solid appearance. Clinical Impact: Radiologists encountering predominantly solid nodules on CT should carefully assess images for even a minor-GGO component given the favorable prognosis.

A site-resolved two-dimensional quantum simulator with hundreds of trapped ions

A large qubit capacity and an individual readout capability are two crucial requirements for large-scale quantum computing and simulation1. As one of the leading physical platforms for quantum information processing, the ion trap has achieved a quantum simulation of tens of ions with site-resolved readout in a one-dimensional Paul trap2-4 and of hundreds of ions with global observables in a two-dimensional (2D) Penning trap5,6. However, integrating these two features into a single system is still very challenging. Here we report the stable trapping of 512 ions in a 2D Wigner crystal and the sideband cooling of their transverse motion. We demonstrate the quantum simulation of long-range quantum Ising models with tunable coupling strengths and patterns, with or without frustration, using 300 ions. Enabled by the site resolution in the single-shot measurement, we observe rich spatial correlation patterns in the quasi-adiabatically prepared ground states, which allows us to verify quantum simulation results by comparing the measured two-spin correlations with the calculated collective phonon modes and with classical simulated annealing. We further probe the quench dynamics of the Ising model in a transverse field to demonstrate quantum sampling tasks. Our work paves the way for simulating classically intractable quantum dynamics and for running noisy intermediate-scale quantum algorithms7,8 using 2D ion trap quantum simulators.

Inkjet Printing Photoresist with Ultralow Viscosity on Silicon Wafers for Uniform Coating

Inkjet printing is introduced into the photoresist coating process for uniform photoresist film formation on silicon wafers with the in-house inkjet experimental prototype. The optimization of a dual negative voltage waveform is proposed to achieve stable droplet jetting for the ultralow viscosity (0.71 mPa·s) photoresist with a 1:10 dilution ratio employed in the semiconductor packaging processes. Moreover, the maximum droplet jetting velocity can reach 9.51 m/s, and the droplet volume is controlled at ∼6.5 pL with excellent droplet concentration. The uniform film of the AZ P4620 photoresist is coated on silicon wafers by quantitatively exploring and optimizing the printhead driving frequency and movement velocity utilizing the droplet deposition model and experimental analysis. Results show that the optimal inkjet parameters with 5 kHz in jetting frequency and 6 mm/s in motion velocity can obtain a film evenness index of 4.81% with the thickness of 0.945 μm, which exhibits a more uniform photoresist film than the spray coating method. The study not only expands the application of the inkjet printing technique but also offers an alternative for photoresist coating in the photolithography process.

Precise Crystal Orientation Identification and Twist-Induced Giant Modulation of Optical Anisotropy in 1T'-ReS2

The ability to precisely identify crystal orientation as well as to nondestructively modulate optical anisotropy in atomically thin rhenium dichalcogenides is critical for the future development of polarization programmable optoelectronic devices, which remains challenging. Here, we report a modified polarized optical imaging (POI) method capable of simultaneously identifying in-plane (Re chain) and out-of-plane (c-axis) crystal orientations of the monolayer to few-layer ReS2, meanwhile, propose a nondestructive approach to modulate the optical anisotropy in ReS2 via twist stacking. The results show that parallel and near-cross POI are effective to independently identify the in-plane and out-of-plane crystal orientations, respectively, while regulating the twist angle allows for giant modulation of in-plane optical anisotropy from highly intrinsic anisotropy to complete optical isotropy in the stacked ReS2 bilayer (with either the same or opposite c-axes), as well modeled by linear electromagnetic theory. Overall, this study not only develops a simple optical method for precise crystal orientation identification but also offers an efficient light polarization control strategy, which is a big step toward the practical application of anisotropic van der Waals materials in the design of nanophotonic and optoelectronic devices.

Discovery of ITI-333, a Novel Orally Bioavailable Molecule Targeting Multiple Receptors for the Treatment of Pain and Other Disorders

Development of more efficacious medications with improved safety profiles to manage and treat multiple forms of pain is a critical element of healthcare. To this end, we have designed and synthesized a novel class of tetracyclic pyridopyrroloquinoxalinone derivatives with analgesic properties. The receptor binding profiles and analgesic properties of these tetracyclic compounds were studied. Systematic optimizations of this novel scaffold culminated in the discovery of the clinical candidate, (6bR,10aS)-8-[3-(4-fluorophenoxy)propyl]-6b,7,8,9,10,10a-hexahydro-1H-pyrido[3',4':4,5]pyrrolo[1,2,3-de]quinoxalin-2(3H)-one (compound 5, ITI-333), which exhibited potent binding affinity to serotonin 5-HT2A (Ki = 8.3 nM) and μ-opioid receptors (MOR, Ki = 11 nM) and moderate affinity to adrenergic α1A (Ki = 28 nM) and dopamine D1 (Ki = 50 nM) receptors. ITI-333 acts as a 5-HT2A receptor antagonist, a MOR partial agonist, and an adrenergic α1A receptor antagonist. ITI-333 exhibited dose-dependent analgesic effects in rodent models of acute pain. Currently, this investigational new drug is in phase I clinical development.

Advancing Bone Regeneration: Unveiling the Potential of 3D Cell Models in the Evaluation of Bone Regenerative Materials

Bone, a rigid yet regenerative tissue, has garnered extensive attention for its impressive healing abilities. Despite advancements in understanding bone repair and creating treatments for bone injuries, handling nonunions and large defects remains a major challenge in orthopedics. The rise of bone regenerative materials is transforming the approach to bone repair, offering innovative solutions for nonunions and significant defects, and thus reshaping orthopedic care. Evaluating these materials effectively is key to advancing bone tissue regeneration, especially in difficult healing scenarios, making it a critical research area. Traditional evaluation methods, including two-dimensional cell models and animal models, have limitations in predicting accurately. This has led to exploring alternative methods, like 3D cell models, which provide fresh perspectives for assessing bone materials' regenerative potential. This paper discusses various techniques for constructing 3D cell models, their pros and cons, and crucial factors to consider when using these models to evaluate bone regenerative materials. We also highlight the significance of 3D cell models in the in vitro assessments of these materials, discuss their current drawbacks and limitations, and suggest future research directions. STATEMENT OF SIGNIFICANCE: This work addresses the challenge of evaluating bone regenerative materials (BRMs) crucial for bone tissue engineering. It explores the emerging role of 3D cell models as superior alternatives to traditional methods for assessing these materials. By dissecting the construction, key factors of evaluating, advantages, limitations, and practical considerations of 3D cell models, the paper elucidates their significance in overcoming current evaluation method shortcomings. It highlights how these models offer a more physiologically relevant and ethically preferable platform for the precise assessment of BRMs. This contribution is particularly significant for "Acta Biomaterialia" readership, as it not only synthesizes current knowledge but also propels the discourse forward in the search for advanced solutions in bone tissue engineering and regeneration.