Optimized Signal Quality Assessment for Photoplethysmogram Signals Using Feature Selection

OBJECTIVE

With the increasing use of wearable healthcare devices for remote patient monitoring, reliable signal quality assessment (SQA) is required to ensure the high accuracy of interpretation and diagnosis on the recorded data from patients. Photoplethysmographic (PPG) signals non-invasively measured by wearable devices are extensively used to provide information about the cardiovascular system and its associated diseases. In this study, we propose an approach to optimize the quality assessment of the PPG signals.

METHODS

We used an ensemble-based feature selection scheme to enhance the prediction performance of the classification model to assess the quality of the PPG signals. Our approach for feature and subset size selection yielded the best-suited feature subset, which was optimized to differentiate between the clean and artifact corrupted PPG segments.

CONCLUSION

A high discriminatory power was achieved between two classes on the test data by the proposed feature selection approach, which led to strong performance on all dependent and independent test datasets. We achieved accuracy, sensitivity, and specificity rates of higher than 0.93, 0.89, and 0.97, respectively, for dependent test datasets, independent of heartbeat type, i.e., atrial fibrillation (AF) or non-AF data including normal sinus rhythm (NSR), premature atrial contraction (PAC), and premature ventricular contraction (PVC). For independent test datasets, accuracy, sensitivity, and specificity rates were greater than 0.93, 0.89, and 0.97, respectively, on PPG data recorded from AF and non-AF subjects. These results were found to be more accurate than those of all of the contemporary methods cited in this work.

SIGNIFICANCE

As the results illustrate, the advantage of our proposed scheme is its robustness against dynamic variations in the PPG signal during long-term 14-day recordings accompanied with different types of physical activities and a diverse range of fluctuations and waveforms caused by different individual hemodynamic characteristics, and various types of recording devices. This robustness instills confidence in the application of the algorithm to various kinds of wearable devices as a reliable PPG signal quality assessment approach.

Effects of fish meal replacement with Chlorella meal on growth performance, pigmentation, and liver health of largemouth bass (Micropterus salmoides)

Chlorella meal is a potential protein source for aquafeeds. However, the physiological response of carnivorous fish fed Chlorella meal remains elusive. This study evaluated the effects of replacing dietary fish meal with Chlorella meal on growth performance, pigmentation, and liver health in largemouth bass. Five diets were formulated to replace dietary fish meal of 0% (C0, control), 25% (C25), 50% (C50), 75% (C75), and 100% (C100) with Chlorella meal, respectively. Total 300 fish (17.6 ± 0.03 g) were randomly assigned to 15 tanks (3 tanks/group). Fish were fed the experimental diet twice daily for 8 weeks. The increased dietary Chlorella meal quadratically influenced the final body weight (FBW), weight gain rate (WGR), specific growth rate (SGR), and feed intake (FI), which were significantly lower in the C100 group than in the other groups (P < 0.05). The feed conversion ratio (FCR) increased linearly or quadratically with dietary Chlorella meal. Dietary Chlorella meal linearly or quadratically increased the lutein content of plasma, liver, and dorsal muscle of largemouth bass (P < 0.05). Compared to the C0 group, all supplemented Chlorella meal groups significantly improved the yellowness (b∗) of the dorsal body (1.5 to 2.0 fold), abdominal body (1.5 to 1.8 fold), and dorsal muscle (3.8 to 5.4 fold) of largemouth bass (P < 0.05). In addition, compared to the C0 group, the liver vacuolation area of fish was significantly increased in the C75 and C100 groups (P < 0.05). Transcriptional levels of apoptosis-related genes of β-cell lymphoma-2 (bcl2), caspase-9-like (casp9), and caspase-3a (casp3) were markedly upregulated (0.9 to 1.6 fold) in the C100 group compared to the C0 group (P < 0.05). Based on the quadratic regression analysis between FBW, WGR, or SGR and dietary Chlorella meal level, largemouth bass had the best growth when replacing 31.7% to 32.6% of fish meal with 15.03% to 15.43% dietary Chlorella meal. The present results indicated that dietary supplementation with Chlorella meal (11.85% to 47.45%) significantly enhanced the pigmentation; however, total replacement of fish meal (40%) with Chlorella meal (47.45%) caused growth retardation, apoptosis, and liver damage in largemouth bass.

Computational fluid dynamics analysis and experimental hemolytic performance of three clinical centrifugal blood pumps: Revolution, Rotaflow and CentriMag

Centrifugal blood pumps have become popular for adult extracorporeal membrane oxygenation (ECMO) due to their superior blood handling and reduced thrombosis risk featured by their secondary flow paths that avoid stagnant areas. However, the high rotational speed within a centrifugal blood pump can introduce high shear stress, causing a significant shear-induced hemolysis rate. The Revolution pump, the Rotaflow pump, and the CentriMag pump are three of the leading centrifugal blood pumps on the market. Although many experimental and computational studies have focused on evaluating the hydraulic and hemolytic performances of the Rotaflow and CentriMag pumps, there are few on the Revolution pump. Furthermore, a thorough direct comparison of these three pumps' flow characteristics and hemolysis is not available. In this study, we conducted a computational and experimental analysis to compare the hemolytic performances of the Revolution, Rotaflow, and CentriMag pumps operating under a clinically relevant condition, i.e., the blood flow rate of 5 L/min and pump pressure head of 350 mmHg, for adult ECMO support. In silico simulations were used to characterize the shear stress distributions and predict the hemolysis index, while in vitro blood loop studies experimentally determined hemolysis performance. Comparative simulation results and experimental data demonstrated that the CentriMag pump caused the lowest hemolysis while the Revolution pump generated the highest hemolysis.

The AMPK pathway in fatty liver disease

Lipid metabolism disorders are the primary causes for the occurrence and progression of various liver diseases, including non-alcoholic fatty liver disease (NAFLD) and alcoholic fatty liver disease (AFLD) caused by a high-fat diet and ethanol. AMPK signaling pathway plays an important role in ameliorating lipid metabolism disorders. Progressive research has clarified that AMPK signal axes are involved in the prevention and reduction of liver injury. Upregulation of AMK can alleviate FLD in mice induced by alcohol or insulin resistance, type 2 diabetes, and obesity, and most natural AMPK agonists can regulate lipid metabolism, inflammation, and oxidative stress in hepatocytes, consequently regulating FLD in mice. In NAFLD and AFLD, increasing the activity of AMPK can inhibit the synthesis of fatty acids and cholesterol by down-regulating the expression of adipogenesis gene (FAS, SREBP-1c, ACC and HMGCR); Simultaneously, by increasing the expression of fatty acid oxidation and lipid decomposition genes (CPT1, PGC1, and HSL, ATGL) involved in fatty acid oxidation and lipid decomposition, the body’s natural lipid balance can be maintained. At present, some AMPK activators are thought to be beneficial during therapeutic treatment. Therefore, activation of AMPK signaling pathway is a potential therapeutic target for disorders of the liver. We summarized the most recent research on the role of the AMPK pathway in FLD in this review. Simultaneously, we performed a detailed description of each signaling axis of the AMPK pathway, as well as a discussion of its mechanism of action and therapeutic significance.

Enhancement of liver mitochondrial complex I and energy metabolism induced by enteritis: The key role of gut microbiota derived endotoxins

Inflammation is an energy-intensive process and the liver is a key organ in energy regulation. Since the intestine and liver exchange nutrients and metabolites, enteritis can affect the liver. To investigate the correlation between enteritis and liver metabolism, we developed an intestinal inflammation model with concentration-dependent 2,4,6-trinitrobenzene sulfonic acid (TNBS) in gibel carp (Carassius gibelio). The results showed the dysregulation of intestinal tight junction, increased permeability of the gut barrier, and apoptosis of epithelial cells during the development of enteritis. The liver metabolome was analyzed by LC-MS and the live respiration was determined using Oxygraph-2k. The results showed that glycolysis, the TCA cycle and pyrimidine metabolism were affected by intestinal inflammation. In particular, the activity of hepatic mitochondrial respiratory chain complex I was significantly increased. Structure and abundance changes of gut microbiota were analyzed by 16S rRNA sequencing analysis. Pathogenic bacteria in the intestine, as well as plasma LPS, increased significantly. Using a liver cell line, we verified that the dysfunctional metabolism of the liver is related to the dislocation of LPS. All results imply the existence of a connection between enteritis and liver metabolism in gibel carp, and the gut microbiome plays a critical role in this process.

Acute effects of variable resistance training on force, velocity, and power measures: a systematic review and meta-analysis

Objective

Acute effects of variable resistance training (VRT) and constant resistance training (CRT) on neuromuscular performance are still equivocal. We aimed to determine the differences between VRT and CRT in terms of force, velocity, and power outcomes.

Methods

We searched PubMed, Web of Science, and SPORTDiscus electronic databases for articles until June 2021. Crossover design studies comparing force, velocity, and power outcomes while performing VRT and CRT were included. Two reviewers independently applied the modified version of the Cochrane Collaboration's tool to assess the risk of bias. A three-level random effects meta-analyses and meta-regressions were used to compute standardized mean differences (SMDs) and 95% confidence intervals.

Results

We included 16 studies with 207 participants in the quantitative synthesis. Based on the pooled results, VRT generated greater mean velocity (SMD = 0.675; moderate Grading of Recommendations Assessment, Development and Evaluation (GRADE) quality evidence) and mean power (SMD = 1.022; low) than CRT. Subgroup analyses revealed that VRT considerably increased the mean velocity (SMD = 0.903; moderate) and mean power (SMD = 1.456; moderate) in the equated loading scheme and the mean velocity (SMD = 0.712; low) in the CRT higher loading scheme. However, VRT marginally significantly reduced peak velocity (SMD = -0.481; low) in the VRT higher loading scheme. Based on the meta-regression analysis, it was found that mean power (p = 0.014-0.043) was positively moderated by the contribution of variable resistance and peak velocity (p = 0.018) and peak power (p = 0.001-0.004) and RFD (p = 0.003) were positively moderated by variable resistance equipment, favoring elastic bands.

Conclusions

VRT provides practitioners with the means of emphasizing specific force, velocity, and power outcomes. Different strategies should be considered in context of an individual's needs. Systematic review registration: PROSPERO CRD42021259205.

Proteomic analyses of mitochondrial damage in postmortem beef muscles

BACKGROUND

The objective of the study was to examine the expression profiles of mitochondrial proteins in at-death and 24 h postmortem (PM) using tandem mass tag (TMT) approach to characterize the mitochondria possible mechanisms that are affiliated with tenderization.

RESULTS

Results showed that the tender meat at 24 h PM emerged with more serious mitochondrial damage. Altogether 456 mitochondrial proteins were identified, including 442 down-regulated and 14 up-regulated proteins. These differentially-expressed proteins were primarily involved in the progress of PM energy metabolism, apoptosis, and the morphological alterations of mitochondrial. Among them, 47 subunits (such as NDUFA2, COX4I1, and ATP5PB) were annotated into the oxidative phosphorylation pathway. VDAC1, VDAC2, and VDAC3 involving in the damage of MPTP, and IMMT, CHCHD3, APOL and APOO modulating the morphology of mitochondria, and DIABLO and AIFM1 released from mitochondria affect caspase's activation. HSPD1 and HSPE1 involved in apoptosis, mitochondrial physiological and morphological alterations.

CONCLUSION

The earlier-mentioned proteins were validated as potential indicators of tenderness regulated by mitochondrial damage. These results highlighted that mitochondrial damage possibly participate in PM tenderization of beef muscles by energy metabolism and cell apoptosis status. © 2022 Society of Chemical Industry.

Benefits of tolvaptan on early dyspnea relief in patients with acute heart failure: A meta-analysis

Considering the prevalence of dyspnea in acute heart failure (AHF), its reduction is important to both patients and caregivers. This meta‐analysis was performed to determine the efficacy and safety of tolvaptan on early dyspnea relief in patients with AHF. A systematic search was made of PubMed, Embase, Web of Science, Cochrane Library, and clinicaltrials.gov, without language restrictions. Randomized controlled trials (RCTs) on treatment of AHF with tolvaptan, compared with placebo or blank, were reviewed. Studies were pooled to relative risk (RR), with 95% confidence interval (CI). Five RCTs (enrolling 4857 participants) met the inclusion criteria. Tolvaptan presented significant effects on 12 h dyspnea relief (RR: 1.98; 95% CI: 1.24−3.15; p = .004), 24 h/day 1 dyspnea relief (RR: 1.15; 95% CI: 1.07−1.24; p = .0003), 48 h dyspnea relief (RR: 1.20; 95% CI: 1.06−1.36; p = .004), and 72 h dyspnea relief (RR: 1.18; 95% CI: 1.02−1.37; p = .03). No significant increase was noticed in the incidence of worsening renal function in tolvaptan group (RR: 1.10; 95% CI: 0.87−1.39; p = .43). Tolvaptan treatment significantly improved patient‐assessed dyspnea early and persistently in patients with AHF.

Speciation-specific Cr bioaccumulation, morphologic and transcriptomic response in liver of Plectropomus leopardus exposed to dietary Cr(III) and Cr(VI)

Trivalent chromium (Cr(III)) and hexavalent chromium (Cr(VI)) are the two mainly stable oxidation states of Cr in aquatic environments, while the difference of their bioavailability and toxicity by dietary exposure has been rarely known in aquatic organisms. Using juvenile coral trout (Plectropomus leopardus), Cr(III) and Cr(VI) as model system, this study tested the hypothesis that the dietary Cr bioaccumulation and toxicity in fish were highly dependent on Cr speciation. The fish were chronically exposed to 200 mg kg^-1 of dietary Cr(III) and Cr(VI) for 8 weeks, and then the Cr bioaccumulation, morphologic change, and RNA-Seq in fish liver were determined. The results showed that dietary Cr(III) and Cr(VI) exposure significantly induced fish weight gain, while 1.17 folds and 1.26 folds increased in relation to Control group, respectively. Cr contents in liver was increased significantly in dietary Cr(VI) but not in Cr(III) groups. Both Cr treatment induced lipid deposition in liver tissue structure, moreover, pancreatic part was increased in dietary Cr(III) but its reduced in Cr(VI) exposure. RNA-Seq in fish liver were significantly different as well. Specifically, there were 138 differentially expressed genes (DEGs) in dietary Cr(III) group, including 76 up-regulated and 62 down-regulated, and these DEGs were mainly involved in lipid metabolism, while there were 175 DEGs in dietary Cr(VI) group, including 85 up-regulated and 90 down-regulated, and these DEGs were mainly involved in immune system. The qRT-PCR confirmed the RNA-seq data were reliable. Overall, these results supported our hypothesis that the chronic dietary Cr(III) and Cr(VI) exposure resulted in apparently different Cr bioaccumulation and toxicity in fish. Our findings here help us to fill in a big gap in our knowledge of speciation-specific Cr bioavailability and toxicity in aquatic organisms, which has been largely unclear previously. CAPSULE: Dietary Cr(III) increased lipid metabolism and dietary Cr(VI) activated immune system in liver of coral trout at transcription levels.

Organelle 16S rRNA amplicon sequencing enables profiling of active gut microbiota in murine model

High-throughput sequencing of ribosomal RNA (rRNA) amplicons has served as a cornerstone in microbiome studies. Despite crucial implication of organelle 16S rRNA measurements to host gut microbial activities, genomic DNA (gDNA) was overwhelmingly targeted for amplicon sequencings. Although gDNA could be a reliable resource for gene existing validation, little information is revealed in regard to the activity of microorganisms owing to the limited changes gDNA undertaken in inactive, dormant, and dead bacteria. We applied both rRNA- and gDNA-derived sequencings on mouse cecal contents. Respective experimental designs were verified to be suitable for nucleic acid (NA) purification. Via benchmarking, mainstream 16S rRNA hypervariable region targets and reference databases were proven adequate for respective amplicon sequencing study. In phylogenetic studies, significant microbial composition differences were observed between two methods. Desulfovibrio spp. (an important group of anaerobic gut microorganisms that has caused analytical difficulties), Pediococcus spp., and Proteobacteria were drastically lower as represented by gDNA-derived compositions, while microbes like Firmicutes were higher as represented by gDNA-derived microbiome compositions. Also, using PICRUSt2 as an example, we illustrated that rRNA-derived sequencing might be more suitable for microbiome function predictions since pathways like sugar metabolism were lower as represented by rRNA-derived results. The findings of this study demonstrated that rRNA-derived amplicon sequencing could improve identification capability of specific gut microorganisms and might be more suitable for in silico microbiome function predictions. Therefore, rRNA-derived amplicon sequencings, preferably coupled with gDNA-derived ones, could be used as a capable tool to unveil active microbial components in host gut. KEY POINTS: • Conventional pipelines were adequate for the respective amplicon sequencing study • Groups, such as Desulfovibrio spp., were differently represented by two methods • Comparative amplicon sequencings could be useful in host active microbiota studies.

Four Novel PAX9 Variants and the PAX9-Related Non-Syndromic Tooth Agenesis Patterns

The purpose of this research was to investigate and identify PAX9 gene variants in four Chinese families with non-syndromic tooth agenesis. We identified pathogenic gene variants by whole-exome sequencing (WES) and Sanger sequencing and then studied the effects of these variants on function by bioinformatics analysis and in vitro experiments. Four novel PAX9 heterozygous variants were identified: two missense variants (c.191G > T (p.G64V) and c.350T > G (p.V117G)) and two frameshift variants (c.352delC (p.S119Pfs*2) and c.648_649insC(p.Y217Lfs*100)). The bioinformatics analysis showed that these variants might be pathogenic. The tertiary structure analysis showed that these four variants could cause structural damage to PAX9 proteins. In vitro functional studies demonstrated that (1) the p.Y217Lfs*100 variant greatly affects mRNA stability, thereby affecting endogenous expression; (2) the p. S119Pfs* 2 variant impairs the subcellular localization of the nuclear expression of the wild-type PAX9 protein; and (3) the four variants (p.G64V, p.V117G, p.S119Pfs*2, and p.Y217Lfs*100) all significantly affect the downstream transcriptional activity of the BMP4 gene. In addition, we summarized and analyzed tooth missing positions caused by PAX9 variants and found that the maxillary second molar (84.11%) and mandibular second molar (84.11%) were the most affected tooth positions by summarizing and analyzing the PAX9-related non-syndromic tooth agenesis positions. Our results broaden the variant spectrum of the PAX9 gene related to non-syndromic tooth agenesis and provide useful information for future genetic counseling.

Phloridzin Reveals New Treatment Strategies for Liver Fibrosis

Liver fibrosis is an urgent public health problem which is difficult to resolve. However, various drugs for the treatment of liver fibrosis in clinical practice have their own problems during use. In this study, we used phloridzin to treat hepatic fibrosis in the CCl4-induced C57/BL6N mouse model, which was extracted from lychee core, a traditional Chinese medicine. The therapeutic effect was evaluated by biochemical index detections and ultrasound detection. Furthermore, in order to determine the mechanism of phloridzin in the treatment of liver fibrosis, we performed high-throughput sequencing of mRNA and lncRNA in different groups of liver tissues. The results showed that compared with the model group, the phloridzin-treated groups revealed a significant decrease in collagen deposition and decreased levels of serum alanine aminotransferase, aspartate aminotransferase, laminin, and hyaluronic acid. GO and KEGG pathway enrichment analysis of the differential mRNAs was performed and revealed that phloridzin mainly affects cell ferroptosis. Gene co-expression analysis showed that the target genes of lncRNA were obvious in cell components such as focal adhesions, intercellular adhesion, and cell–substrate junctions and in metabolic pathways such as carbon metabolism. These results showed that phloridizin can effectively treat liver fibrosis, and the mechanism may involve ferroptosis, carbon metabolism, and related changes in biomechanics.

Taurine Alleviates Cadmium-Induced Toxicity via Genetically Specific Strategies in Two Strains of Gibel Carp (Carassius gibelio)

Our previous studies in gibel carp (Carassius gibelio) have shown that cadmium (Cd) exposure elicits deleterious effects depending on the genetic background, and thus we hypothesized that mitigation via nutritional intervention may vary between strains. Therefore, two gibel carp strains (the A and F strains) were fed diets supplemented with 0% or 1% taurine for 8 weeks prior to 96 h Cd exposure, and the responses of antioxidant pathways, endoplasmic reticulum (ER) stress, autophagy, and apoptosis were investigated. The results showed that taurine supplementation had no effect on the growth performance of gibel carp. After Cd exposure, histological damage to mitochondria and ER, induction of oxidative stress and antioxidant responses, occurrence of ER stress, and apoptotic signals were observed in the livers. Upon the diet effects, taurine supplementation alleviated the ER-stress-induced autophagy and apoptosis after Cd exposure and stimulated antioxidant pathways. Regarding the difference between strains, taurine played a protective role in alleviating Cd toxicity through the antioxidant response, ER stress, and autophagy in the F strain, whereas such effects were achieved by the attenuation of apoptosis in the A strain. Taken together, our results demonstrate the potential use of taurine in the mitigation of heavy metal toxicity in aquatic organisms.

MRI-based radiomics analysis in differentiating solid non-small-cell from small-cell lung carcinoma: a pilot study

AIM

To investigate the ability of a T2-weighted (W) magnetic resonance imaging (MRI)-based radiomics signature to differentiate solid non-small-cell lung carcinoma (NSCLC) from small-cell lung carcinoma (SCLC).

MATERIALS AND METHODS

The present retrospective study enrolled 152 eligible patients (NSCLC = 125, SCLC = 27). All patients underwent MRI using a 3 T scanner and radiomics features were extracted from T2W MRI. The least absolute shrinkage and selection operator (LASSO) logistic regression model was used to identify the optimal radiomics features for the construction of a radiomics model to differentiate solid NSCLC from SCLC. Threefold cross validation repeated 10 times was used for model training and evaluation. The conventional MRI morphology features of the lesions were also evaluated. The performance of the conventional MRI morphological features, and the radiomics signature model and nomogram model (combining radiomics signature with conventional MRI morphological features) was evaluated using receiver operating characteristic (ROC) curve analysis.

RESULTS

Five optimal features were chosen to build a radiomics signature. There was no significant difference in age, gender, and the largest diameter. The radiomics signature and conventional MRI morphological features (only pleural indentation and lymph node enlargement) were independent predictive factors for differentiating solid NSCLC from SCLC. The area under the ROC curves (AUCs) for MRI morphological features, and the radiomics model, and nomogram model was 0.69, 0.85, and 0.90 (ROC), respectively.

CONCLUSIONS

The T2W MRI-based radiomics signature is a potential non-invasive approach for distinguishing solid NSCLC from SCLC.

Modified Bilhaut-Cloquet Procedure for the Reconstruction of Wassel Type III Radial Polydactyly

BACKGROUND

The purpose of this research is to study the modified surgical effect of Wassel type III radial polydactyly thumbs of equal or nearly equal size treated.

METHODS

The study sample consisted of 12 reconstructed cases of Wassel type III radial polydactyly. The proximal phalanx was unequally combined by the curvature osteotomy and aligned the articular surface, and the distal phalanx was symmetrically combined. A fragment bone was filled in the depression of the distal phalanx to correct nail curvature and prevent seagull deformities. Twelve cases were available for assessment using an evaluation form on the Japanese Society for Surgery of the Hand.

RESULTS

An average functional point was 13.75 points (maximum 14 points). The interphalangeal joint motion was reduced, but this joint was stable in all cases. The cosmetic score was averaged 3.6 (maximum 4 points), and most parents were satisfied with the postoperative appearance and functional results.

CONCLUSION

Our modification of Bihaut-Cloquet procedure is an effective way to provide a well-functioning thumb for Wassel type III radial polydactyly thumbs.

LEVEL OF EVIDENCE

Level IV.

Definitive chemoradiotherapy versus neoadjuvant chemoradiotherapy followed by surgery in patients with locally advanced esophageal squamous cell carcinoma who achieved clinical complete response when induction chemoradiation finished: A phase II random

BACKGROUND AND PURPOSE

More than 40% of patients with esophageal squamous cell carcinoma (ESCC) exhibit pathological complete responses (pCR) after neoadjuvant chemoradiotherapy (nCRT), and theoretically, these patients may be cured by CRT and omit surgery. This prospectively randomized pilot study compared definitive chemoradiotherapy (dCRT) with nCRT in patients with locally advanced ESCC who achieved clinical complete responses (cCRs) to nCRT.

MATERIALS AND METHODS

Single center, randomized, open phase 2 study of 256 patients with locally advanced ESCC enrolled between April 2016 and November 2018. Immediately when nCRT finished, patients enrolled underwent response evaluations within 1 week. Patients with cCR were randomly allocated to undergo surgery (arm A) or complete CRT up to the definitive radiation dose (arm B). The primary end point was 3-year disease-free survival (DFS).

RESULTS

Finally, 71 patients were randomly assigned to the nCRT (n = 36) and dCRT (n = 35) arms. The median observation time was 35.7 months. The 3-year DFS rate was 56.43% in arm A versus 54.73% in arm B (hazard ratio [HR] = 0.862, 95% confidence interval [CI] = 0.452 to 1.645, P = 0.652). The 3-year overall survival (OS) rates in arms A and B were 69.5% and 62.3% (HR = 0.824, 95% CI = 403-1.688, P = 0.597), respectively.

CONCLUSIONS

According to our treatment response evaluation criteria, survival of the patients with cCR after nCRT was not significant different between nCRT group and dCRT group. An optimized response evaluation strategy soon after nCRT may guide next therapy decisions for patients with locally advanced ESCC.

Benefits of continuous positive airway pressure on blood pressure in patients with hypertension and obstructive sleep apnea: a meta-analysis

This meta-analysis was performed to determine the effects of continuous positive airway pressure (CPAP) on blood pressure (BP) in patients with systemic hypertension and obstructive sleep apnea (OSA). A systematic search was conducted using PubMed, Embase, Web of Science, Cochrane Library, and clinicaltrials.gov, without language restrictions. Randomized controlled trials on the treatment of hypertension and OSA with CPAP, compared with sham CPAP or no CPAP, were reviewed. Studies were pooled to obtain weighted mean differences (WMDs) with 95% confidence intervals (CIs). Nineteen trials (enrolling 1904 participants) met the inclusion criteria. CPAP had significant effects on 24-h systolic blood pressure (SBP) (WMD -5.01 mmHg, 95% CI -6.94 to -3.08; P < 0.00001), 24-h diastolic blood pressure (DBP) (WMD -3.30 mmHg, 95% CI -4.32 to -2.28; P < 0.00001), daytime SBP (WMD -4.34 mmHg, 95% CI -6.27 to -2.40; P < 0.0001), daytime DBP (WMD -2.97 mmHg, 95% CI -3.99 to -1.95; P < 0.00001), nighttime SBP (WMD -3.55 mmHg, 95% CI -5.08 to -2.03; P < 0.00001), nighttime DBP (WMD -2.33 mmHg, 95% CI -3.27 to -1.40; P < 0.00001), office SBP (WMD -3.67 mmHg, 95% CI -5.76 to -1.58; P = 0.0006), office DBP (WMD -2.61 mmHg, 95% CI -4.25 to -0.97; P = 0.002), and heart rate (WMD -2.79 beats/min, 95% CI -4.88 to -0.71; P = 0.009). CPAP treatment was associated with BP reduction in patients with systemic hypertension and OSA, except when the follow-up period was shorter than 3 months.

Novel DLX3 variant identified in a family with tricho-dento-osseous syndrome

OBJECTIVES

To identify DLX3 variants in a Chinese family with typical clinical manifestations of tricho-dento-osseous syndrome (TDO).

DESIGN

Sanger sequencing was performed to detect DLX3 variants in the TDO family. Three-dimensional laser scanning microscopy, bioinformatic and conformational analyses were employed to explore the phenotypic characterization and the functional impact.

RESULTS

We identified a novel heterozygous variant in the DLX3 gene (c.534G>C; p.Gln178His). Familial co-segregation verified an autosomal dominant inheritance pattern. Bioinformatic prediction demonstrated the deleterious effects of the variant, and DLX3 structure changes suggested the corresponding functional impairments.

CONCLUSIONS

We identified a variant in the DLX3 gene in an integrated family of Han nationality for the first time. This study expands the variant spectrum of DLX3 and phenotype spectrum of TDO syndrome.

Red Blood Cell Membrane-Coated Ultrasmall NaGdF4 Nanoprobes for High-Resolution 3D Magnetic Resonance Angiography

Enhanced angiography based on magnetic resonance imaging (MRI) has emerged as a noninvasive, robust, and high-resolution imaging technique for the clinical evaluation of vascular diseases. However, the effects of clinical Gd-chelating contrast agents are unsatisfactory for MRI contrast enhancement owing to their short blood half-life caused by rapid vascular extravasation, especially in microvessels. To address these issues, nanoprobes based on red blood cell membrane-coated ultrasmall NaGdF4 nanoparticles that exhibit much higher longitudinal molar relaxivity (r1) than the clinically used contrast agent gadolinium diethylenetriaminepentaacetic acid have been developed. Furthermore, the appropriate hydrodynamic diameter and stealth nature aid the nanoprobes to reside longer within the blood vessels without extravasation, thereby increasing the contrast between the blood vessels and surrounding tissues. Through probe-enhanced three-dimensional (3D) dynamic contrast-enhanced MR angiography, the main arteries and veins of the mouse were readily discernible, and even tiny vessels with sub-millimeter diameters could be clearly depicted. With this level of outstanding MR angiography performance, the embolization and recanalization processes of the carotid artery can be serially monitored with high imaging resolution using only a single injection. Additionally, the results of clearance studies and the toxicity tests further highlight the safety features of the nanoprobe. To summarize, the nanoprobes used in this study exhibit less extravascular leakage and a longer blood half-life, thus successfully overcoming the defects of the conventional low-molecular-weight Gd-based contrast agents and demonstrating their potential usefulness in enhanced MR angiography.

Usability of a smartwatch for atrial fibrillation detection in older adults after stroke

Background

Smartwatches can be used for atrial fibrillation (AF) detection, but little is known about how older adults at risk for AF perceive their usability.

Methods

We employed a mixed-methods study design using data from the ongoing Pulsewatch study, a randomized clinical trial (NCT03761394) examining the accuracy of a smartwatch-smartphone app dyad (Samsung/Android) compared to usual care with a patch monitor (Cardea SOLO™ ECG System) for detection of AF among older stroke survivors. To be eligible to participate in Pulsewatch, participants needed to be at least 50 years of age, have had an ischemic stroke, and have no major contraindications to anticoagulation therapy should AF be detected. After 14 days of use, usability was measured by the System Usability Scale (SUS) and investigator-generated questions. Qualitative interviews were conducted, transcribed, and coded via thematic analysis.

Results

Ninety participants in the Pulsewatch trial were randomized to use a smartwatch-smartphone app dyad for 14 days (average age: 65 years, 41% female, 87% White), and 46% found it to be highly usable (SUS ≥68). In quantitative surveys, participants who used an assistive device (eg, wheelchair) and those with history of anxiety or depression were more likely to report anxiety associated with watch use. In qualitative interviews, study participants reported wanting a streamlined system that was more focused on rhythm monitoring and a smartwatch with a longer battery life. In-person training and support greatly improved their experience, and participants overwhelmingly preferred use of a smartwatch over traditional cardiac monitoring owing to its comfort, appearance, and convenience.

Conclusion

Older adults at high risk for AF who were randomized to use a smartwatch-app dyad for AF monitoring over 14 days found it to be usable for AF detection and preferred their use to the use of a patch monitor. However, participants reported that a simpler device interface and longer smartwatch battery life would increase the system's usability.

The Effects of Dietary Arthrospira platensis on Oxidative Stress Response and Pigmentation in Yellow Catfish Pelteobagrus fulvidraco

In aquaculture, fish are often exposed to several stress conditions, which will cause oxidative disorder and bring about health and quality problems. Arthrospira platensis contains abundant bioactive ingredients, which are beneficial for animal health. This study was conducted to investigate the effects of A. platensis on pigmentation, antioxidant capacity, and stress response after air exposure of fish. A total of 120 yellow catfish Pelteobagrus fulvidraco (initial weight 70.19 ± 0.13 g) were divided into three tanks per treatment and fed diets supplemented with 0 g kg−1 A. platensis (CON) and 20 g kg −1 A. platensis (AP) for 65 days. The results indicated that dietary A. platensis had no effects on the growth of yellow catfish. The AP diet significantly reduced lactic acid (LD) and cortisol levels stimulated by air exposure stress (p < 0.05). Dietary A. platensis significantly increased plasma superoxide dismutase (SOD) and glutathione peroxidase (GPX) activities and glutathione (GSH) contents, and the relative expression levels of sod and cat, to protect against oxidative stress caused by air exposure (p < 0.05). The AP diet significantly improved the relative expression level of nrf2 (nuclear factor erythroid-2 related factor 2), while the relative expression level of keap1 (kelch-like ECH associated protein 1) was downregulated, and the protein levels of liver Nrf2 were significantly increased after air exposure stimuli (p < 0.05). Dietary A. platensis significantly increased skin lutein contents, increased skin redness, yellowness and chroma (p < 0.05), and improved body color abnormalities after oxidative stress caused by air exposure stimuli. Skin yellowness was associated with lutein contents and the expression levels of some antioxidant genes to varying degrees. Overall, dietary A. platensis could be utilized as a feed additive to activate the antioxidant response, as well as alleviate oxidative stress and pigmentation disorder induced by air exposure.

Feed Restriction Alleviates Chronic Thermal Stress-Induced Liver Oxidation and Damages via Reducing Lipid Accumulation in Channel Catfish (Ictalurus punctatus)

Caloric restriction is known to suppress oxidative stress in organ systems. However, whether caloric/feed restriction alleviates chronic thermal stress in aquatic animals remains unknown. Here, we set up three feeding rations: 3% BW (3% body weight/day), 2.5% BW (restricted feeding, 2.5% body weight/day) and 2% BW (high restricted feeding, 2% body weight/day), to investigate the effects and mechanism of feed restriction on improving chronic heat-induced (27 to 31 °C) liver peroxidation and damages in channel catfish (Ictalurus punctatus). The results showed that, compared to 3% BW, both 2.5% BW and 2% BW significantly reduced the liver expressions of hsc70, hsp70 and hsp90, but only 2.5% BW did not reduce the growth performance of channel catfish. The 2.5% BW and 2% BW also reduced the lipid deposition (TG) and improved the antioxidant capacity (CAT, SOD, GSH and T-AOC) in the liver of channel catfish. The heat-induced stress response (plasma glucose, cortisol and NO) and peroxidation (ROS and MDA) were also suppressed by either 2.5% BW or 2% BW. Moreover, 2.5% BW or 2% BW overtly alleviated liver inflammation and damages by reducing endoplasmic reticulum (ER) stress (BIP and Calnexin) and cell apoptosis (BAX, Caspase 3 and Caspase 9) in the liver of channel catfish. In conclusion, 2.5% body weight/day is recommended to improve the antioxidant capacity and liver health of channel catfish during the summer season, as it alleviates liver peroxidation and damages via suppressing lipid accumulation under chronic thermal stress.

Structure-Activity Relationships of Dopamine Transporter Pharmacological Chaperones

Mutations in the dopamine transporter gene (SLC6A3) have been implicated in many human diseases. Among these is the infantile parkinsonism-dystonia known as Dopamine Transporter Deficiency Syndrome (DTDS). Afflicted individuals have minimal to no functional dopamine transporter protein. This is primarily due to retention of misfolded disease-causing dopamine transporter variants. This results in a variety of severe motor symptoms in patients and the disease ultimately leads to death in adolescence or young adulthood. Though no treatment is currently available, pharmacological chaperones targeting the dopamine transporter have been shown to rescue select DTDS disease-causing variants. Previous work has identified two DAT pharmacological chaperones with moderate potency and efficacy: bupropion and ibogaine. In this study, we carried out structure-activity relationships (SARs) for bupropion and ibogaine with the goal of identifying the chemical features required for pharmacological chaperone activity. Our results show that the isoquinuclidine substituent of ibogaine and its analogs is an important feature for pharmacological chaperone efficacy. For bupropion, the secondary amine group is essential for pharmacological chaperone activity. Lastly, we describe additional ibogaine and bupropion analogs with varying chemical modifications and variable pharmacological chaperone efficacies at the dopamine transporter. Our results contribute to the design and refinement of future dopamine transporter pharmacological chaperones with improved efficacies and potencies.

[Role of inflammation and apoptosis in right ventricular dysfunction induced by injurious mechanical ventilation in rats]

OBJECTIVE

To investigate whether myocardial inflammation and apoptosis are involved in right ventricular dysfunction (RVD) induced by injurious mechanical ventilation with high tidal volume (VT) in rats.

METHODS

Total 30 adult male SD rats were randomly divided into the control group (CON group), the low VT ventilation group (LVT group) and the injurious mechanical ventilation group (HVT group), with 10 rats in each group. The CON group was maintained spontaneous breathing, the LVT group and HVT group were ventilated with different VT 6 mL/kg and 20 mL/kg for 4 hours, respectively. The right jugular vein and the left carotid artery were catheterized and connected with the PowerLab biological signal acquisition and analysis system to record heart rate (HR), mean arterial pressure (MAP), right ventricular systolic pressure (RVSP), the maximum rate of rising of right ventricular pressure (+dp/dt max). Echocardiography was performed to measure left ventricular end-diastolic diameter (LVEDd), right ventricular end-diastolic diameter (RVEDd), tricuspid annulus plane systolic migration (TAPSE) and myocardial performance index (MPI). The rats were sacrified by cervical dislocation. Specimens of right ventricle tissues were taken for hematoxylin-eosin (HE) staining, and morphological changes of right ventricle tissues were observed under light microscope. Real time reverse transcription-polymerase chain reaction (RT-PCR) and Western blotting were used to detect the mRNA and protein expressions of interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), caspase-3, apoptosis-related proteins Bax and Bcl-2.

RESULTS

HR, MAP, +dp/dt max gradually decreased, while RVSP gradually increased in different group with the increase of VT ventilation. There was no significant difference between the CON group and LVT group. However, there was a statistically significant difference with respect to these index in HVT group as compared to CON group and LVT group [HR (bpm): 397.6±5.7 vs. 433.0±4.8, 441.6±7.8; MAP (mmHg, 1 mmHg ≈ 0.133 kPa): 102.0±2.4 vs. 108.5±2.2, 110.6±2.1; +dp/dt max (mmHg/s): 2 357.65±62.80 vs. 2 661.27±55.62, 2 679.43±75.13; RVSP (mmHg): 28.8±1.0 vs. 22.6±10.8, 21.9±0.4; all P < 0.05]. Echocardiography findings showed that RVEDd/LVEDd and MPI gradually increased, TAPSE gradually decreased in different group with the increase of VT ventilation. There was no significant difference between the LVT group and CON group. However, there was a statistically significant difference with respect to these indexes in HVT group as compared to the CON group and LVT group [RVEDd/LVEDd: 0.36±0.02 vs. 0.26±0.01, 0.23±0.02; MPI: 1.23±0.03 vs. 0.84±0.04, 0.86±0.03; TAPSE (mm): 1.65±0.03 vs. 1.88±0.02, 1.91±0.04; all P < 0.05]. Histopathological observation of the right ventricle tissue showed that myocardial cells of the rats in the CON group were orderly arranged and uniformed in size. In the LVT group, there was a small amount of inflammatory cell infiltration in the myocardial interstitium, while in the HVT group, the myocardial cell arrangement was obviously disordered, the structure was obviously damaged, and more inflammatory cell infiltration was found. RT-PCR and Western blotting analysis showed that the mRNA and protein expressions of IL-6, TNF-α, caspase-3 and Bax in HVT group were significantly higher than those in the LVT group and CON group [mRNA expression (2^-ΔΔCt): IL-6 were 1.97±0.07 vs. 1.09±0.02, 1.02±0.03, TNF-α were 1.69±0.10 vs. 1.10±0.03, 1.05±0.04, caspase-3 were 1.82±0.09 vs. 1.08±0.02, 1.06±0.03, Bax were 2.19±0.14 vs. 1.07±0.03, 1.04±0.03; protein expression (gray value): IL-6 were 0.64±0.02 vs. 0.38±0.03, 0.31±0.04, TNF-α were 0.50±0.04 vs. 0.16±0.01, 0.15±0.01, caspase-3 were 0.58±0.02 vs. 0.29±0.01, 0.25±0.02, Bax were 0.50±0.03 vs. 0.21±0.01, 0.26±0.02; all P < 0.05], and the mRNA and protein expressions of Bcl-2 in the HVT group were lower than those in the LVT group and CON group [mRNA expression (2^-ΔΔCt): 1.23±0.05 vs. 1.43±0.05, 1.50±0.08; protein expression (gray value): 0.42±0.02 vs. 0.62±0.03, 0.65±0.03, all P < 0.05].

CONCLUSION

Myocardial inflammation and apoptosis may be involved in RVD induced by injurious mechanical ventilation.

Effect of S-Nitrosylation of RIP3 Induced by Cerebral Ischemia on its Downstream Signaling Pathway

OBJECTIVES

Our preliminary experiments indicate that receptor-interacting protein 3 (RIP3) is S-nitrosylated and contributes to its autophosphorylation (activation) after 3 h of rat brain ischemia/reperfusion mediated by activation of the N-methyl-D-aspartate receptor (NMDAR)-dependent neuronal NO synthase (nNOS) and is involved in the process of neuronal injury. Here, we will to demonstrate whether S-nitrosylation of RIP3 facilitates the activation of the downstream signaling pathway and finally exacerbates ischemic neuron death.

MATERIALS AND METHODS

Adult male Sprague-Dawley rat transient brain ischemia/reperfusion and cortical neurons oxygen and glucose deprivation (OGD)/reoxygenation models were performed. The hippocampal CA1 regions or cultured cells were homogenized and the cytosolic fraction were collected as tissue samples. Coimmunoprecipitation and western blot analysis were carried out for detecting phosphorylation of RIP1 and mixed lineage kinase-like domains (MLKL) and the Cleaved-Caspase8 (Cl-Caspase8). The activities of Glycogen phosphorylase (PYGL), Glutamate-ammonia ligase (GLUL) and Glutamate dehydrogenase (GLUD1) were detected with ultraviolet absorption method.

RESULTS

This study showed that active RIP3 could phosphorylate RIP1 and MLKL through its kinase activity, promote the conversion of Caspase8 to active Cl-Caspase8, enhance the activities of PYGL, GLUL and GLUD1, and finally aggravate neuronal injury in cerebral ischemia/reperfusion. The inhibition of RIP3 S-nitrosylation inhibited the phosphorylation of RIP1 and MLKL, inhibited the activities of Caspase8, PYGL, GLUL, and GLUD1, and alleviated neuronal damage in cerebral ischemia/reperfusion.

CONCLUSIONS

S-nitrosylation of RIP3 increased RIP1 and MLKL phosphorylation levels, Cl-Caspase8 content and PYGL, GLUL and GLUD1 activities and aggravated neuronal damage during cerebral ischemia/reperfusion and regulating the S-nitrosylation of RIP3 and its downstream signaling pathway might be a therapeutic target for stroke.

Vitamin D regulates insulin pathway and glucose metabolism in zebrafish (Danio rerio)

1,25-dihydroxyvitamin D₃ [1,25(OH)₂ D₃ ], the most active vitamin D (VD) metabolite, is a steroid hormone playing an important role in many physiological functions in addition to maintaining mineral homeostasis. In this study, we explored the mechanism that the VD regulated insulin pathway and glucose metabolism in zebrafish in vitro and in vivo. Our results show that 1,25(OH)₂ D₃  significantly enhances the expression of insulin receptor a (insra), insulin receptor substrate 1 (irs1) and glucose transporter 2 (glut2), and promotes glycolysis and glycogenesis, while suppressing gluconeogenesis in zebrafish liver cell line (ZFL) under the condition of high glucose (20 mM), instead of the normal glucose (10 mM). Moreover, consistent results were obtained from the zebrafish fed with VD₃ -deficient diet, as well as the cyp2r1^-/- zebrafish, in which endogenous VD metabolism is blocked. Furthermore, results from dual-luciferase reporting system exhibited that 1,25(OH)₂ D₃ directly activated the transcription of insra, rather than insrb in zebrafish by binding to vitamin D response element (VDRE) located at -181 to -167 bp in the promoter region of insra. Importantly, the 1,25(OH)₂ D₃ treatment significantly alleviated the symptoms of hyperglycemia in diabetic zebrafish. In conclusion, our study demonstrated that VD activates VDRE located in the promoter area of insra in zebrafish to promote insulin/insra signaling pathway, thereby contributing to the maintenance of glucose homeostasis.

Selective synthesis of Kagome nanoporous graphene on Ag(111) via an organometallic template

Kagome nanoporous graphenes (NPGs) are fascinating due to their exotic electronic and magnetic properties. The emerging on-surface synthesis (mostly on metal surfaces) provides a new opportunity to fabricate Kagome NPGs with atomic resolution. Previously the Kagome NPGs synthesized on surfaces were largely heteroatom-doped and suffer from morphological defects (evidently on metal surfaces). The on-surface synthesis of pristine Kagome NPG with improved structural quality is extremely desirable. In this paper, using a halogenated precursor, we report a bottom-up fabrication of pristine NPG with Kagome topology on Ag(111) via classic Ullmann coupling. The templating effect of organometallic (OM) intermediates for subsequent covalent coupling is determined by comparing the OM phase and resultant covalent product. The reaction parameters are found to have a significant impact on the topology and quality of OM intermediates. Specifically, a higher surface temperature and lower evaporation rate favor the growth of better-quality and higher-yield OM Kagome NPGs. The covalent Kagome NPGs obtained by further annealing of these OM networks are affected likewise due to the template effect of OM intermediates. Our work further confirms the generality of the OM template effect. It also offers a novel method to achieve the selective synthesis of Kagome lattice networks.

Models of Shear-Induced Platelet Activation and Numerical Implementation With Computational Fluid Dynamics Approaches

Shear-induced platelet activation is one of the critical outcomes when blood is exposed to elevated shear stress. Excessively activated platelets in the circulation can lead to thrombus formation and platelet consumption, resulting in serious adverse events such as thromboembolism and bleeding. While experimental observations reveal that it is related to the shear stress level and exposure time, the underlying mechanism of shear-induced platelet activation is not fully understood. Various models have been proposed to relate shear stress levels to platelet activation, yet most are modified from the empirically calibrated power-law model. Newly developed multiscale platelet models are tested as a promising approach to capture a single platelet's dynamic shape during activation, but it would be computationally expensive to employ it for a large-scale analysis. This paper summarizes the current numerical models used to study the shear-induced platelet activation and their computational applications in the risk assessment of a particular flow pattern and clot formation prediction.

Halorussus halobius sp. nov., Halorussus marinus sp. nov. and Halorussus pelagicus sp. nov., isolated from salted brown alga Laminaria

Four halophilic archaeal strains, designated HD8-83T, LYG-36T, DLLS-82 and RC-68T, were isolated from the salted brown alga Laminaria of three different origins (Dalian, Lianyungang, Dalian and Rongcheng) in PR China. All strains had pleomorphic rod cells that were motile, lysed in distilled water, stained Gram-negative, and formed red-pigmented colonies on agar plate (except for DLLS-82, which formed white colonies). Based on phylogenetic analyses of the 16S rRNA genes, strain HD8-83T was closely related to Halorussus litoreus HD8-51T (97.9 % similarity), strain LYG-36T and DLLS-82 to Halorussus rarus TBN4T (94.4 % and 94.7 % similarities, respectively), and strain RC-68T to Halorussus salinus YJ-37-HT (96.9 % similarity). Results of phylogenetic analyses based on rpoB' genes and 728 concatenated single-copy orthologous clusters also showed that these strains formed three different branches and clustered tightly with the Halorussus members. The average nucleotide identity, average amino acid identity and in silico DNA-DNA hybridization values between strains LYG-36T and DLLS-82 were 98.9, 98 and 92.4%, showing that they were different strains of the same species. While those values between the isolates and other Halorussus members were below 84.7, 82.9 and 28.9 %, respectively. Based on the phenotypic, chemotaxonomic and phylogenetic properties, strains HD8-83T, LYG-36T, DLLS-82 and RC-68T represent three novel species of the genus Halorussus for which the names Halorussus halobius sp. nov. (type strain: HD8-83T=CGMCC 1.15334T=JCM 31110T), Halorussus marinus sp. nov. (type strain: LYG-36T=CGMCC 1.13606T=JCM 32952T; reference strain: DLLS-82=CGMCC 1.13604=JCM 32951) and Halorussus pelagicus sp. nov. (type strain: RC-68T=CGMCC 1.13609T=JCM 32953T) are proposed.

Alteration of N6-Methyladenosine mRNA Methylation in a Human Stem Cell-Derived Cardiomyocyte Model of Tyrosine Kinase Inhibitor-Induced Cardiotoxicity

Background

N⁶-methyladenosine (m⁶A) plays important roles in various cardiovascular diseases (CVDs), including cardiac hypertrophy and heart failure. Sunitinib (SUN) is a tyrosine kinase inhibitor (TKI) that is widely used in the treatment of different types of solid and blood tumors, but its efficacy is restricted by a concomitant rise in cardiotoxicities. However, the methylation modification of m⁶A messenger RNA (mRNA) in cardiomyocytes treated with TKI has not been investigated.

Methods

The global m⁶A methylation level of SUN-induced cardiotoxicity was detected by m⁶A dot blot and colorimetric methylation assay. MeRIP-Seq (methylated RNA immunoprecipitation sequencing) and RNA-seq (RNA sequencing, input) were employed to depict the landscapes of transcriptome and epitranscriptome in TKI. Changes in major m⁶A-related enzymes were detected by qRT-PCR and Western blot. In addition, the effects of FTO on SUN-induced cardiotoxicity were evaluated by gain and loss of function studies.

Results

In this study, we observed that the m⁶A methylation level was significantly elevated in SUN-treated human-induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CMs) and paralleled a positively correlated cellular damage level. Through a genome-wide analysis of m⁶A mRNA methylation by methylated RNA immunoprecipitation sequencing (MeRIP-seq) and input RNA sequencing (RNA-seq), we identified a total of 2,614 peaks with significant changes, of which 1,695 peaks were significantly upregulated and 919 peaks were significantly downregulated. Quantitative reverse transcription PCR (RT-qPCR), immunofluorescence, and Western blotting revealed that the RNA demethylase fat mass and obesity-associated protein (FTO) was downregulated, whereas the RNA methylases methyltransferase-like 14 (METTL14) and wilms' tumor 1-associating protein (WTAP) were upregulated. Furthermore, gain- and loss-of-function studies substantiated that FTO is cardioprotective in TKI.

Conclusion

This study deciphered the methylation modification of m⁶A mRNA in hiPSC-CMs post-TKI treatment and determined that FTO may be a promising therapeutic target for TKI-induced cardiotoxicity.

DIA-based quantitative proteomic analysis on the meat quality of porcine Longissimus thoracis et lumborum cooked by different procedures

A DIA-based quantitative proteomic strategy was used to investigate the effects of different cooking procedures (steaming and boiling) on pork meat quality. Results showed that steamed meats had higher redness, cohesion, springiness, but lower lightness, yellowness, shear force, hardness, chewiness and cooking loss than boiled meats. In total of 1608 proteins were identified and 103 proteins exhibited significant difference (fold change > 1.5, P < 0.05). These DAPs mainly involved in protein structure, metabolic enzyme, protein turnover and oxidation stress. ALDOC, PVALB, PPP1R14C, AMPD1, CRYAB and SOD1 were validated as potential indicators of color variations in cooked meat. CFL1, COL1A1, COL3A1, RTN4, NRAP, NT5C3A, and SOD1 might be potential biomarker for texture changes of cooked meats. Moreover, these validated proteins exhibited significant (P < 0.05) correlation with cooking loss and could be serve as candidate predictors for cooking loss changes of meats in different cooking procedures.

The safety of long-term use of inhaled corticosteroids in patients with asthma: A systematic review and meta-analysis

PURPOSE

This systematic review and meta-analysis was performed to determine the safety of long-term use of ICS in patients with asthma.

METHODS

A systematic search was made of PubMed, Embase, Web of Science, Cochrane Library, and clinicaltrials.gov, without language restrictions. Randomized controlled trials (RCTs) on treatment of asthma with ICS, compared with non-ICS treatment (placebo or other active drugs), were reviewed.

RESULTS

Eighty-six RCTs (enrolling 51,538 participants) met the inclusion criteria. Oral or oropharyngeal candidiasis (RR 2.58, 95% CI 2.00 to 3.33), and dysphonia/hoarseness (RR 1.56, 95% CI 1.31 to 1.85) were less frequent in the control group. There was no statistically significant difference in the risk of upper respiratory tract infection, lower respiratory tract infection, influenza, decline in bone mineral density, and fractures between the two groups.

CONCLUSION

In addition to the mild local adverse events, the long-term use of ICS was safe in patients with asthma.

A balanced Oct4 interactome is crucial for maintaining pluripotency

Oct4 collaborates primarily with other transcriptional factors or coregulators to maintain pluripotency. However, how Oct4 exerts its function is still unclear. Here, we show that the Oct4 linker interface mediates competing yet balanced Oct4 protein interactions that are crucial for maintaining pluripotency. Oct4 linker mutant embryonic stem cells (ESCs) show decreased expression of self-renewal genes and increased expression of differentiation genes, resulting in impaired ESC self-renewal and early embryonic development. The linker mutation interrupts the balanced Oct4 interactome. In mutant ESCs, the interaction between Oct4 and Klf5 is decreased. In contrast, interactions between Oct4 and Cbx1, Ctr9, and Cdc73 are increased, disrupting the epigenetic state of ESCs. Control of the expression level of Klf5, Cbx1, or Cdc73 rebalances the Oct4 interactome and rescues the pluripotency of linker mutant ESCs, indicating that such factors interact with Oct4 competitively. Thus, we provide previously unidentified molecular insights into how Oct4 maintains pluripotency.

Oxycodone relieves permeability damage and apoptosis of oxygen-glucose deprivation/reoxygenation-induced brain microvascular endothelial cells through ras homolog family member A (RhoA)/ Rho-associated coiled-coil containing kinases (ROCK)/ myosin light chain 2 (MLC2) signal

Cerebrovascular disease, an important cause of acute ischemic stroke, has attracted worldwide attention. Oxycodone has been widely used to treat various painful disorders. This study was designed to explore the mechanism of oxycodone in oxygen-glucose deprivation/reoxygenation (OGD/R)-induced brain microvascular endothelial cell model. For the reliability of the results in the following experiments, the viability was firstly detected using CCK-8. With the application of LDH, TEER and TUNEL assays, the LDH expression, permeability and apoptosis of brain microvascular endothelial cells were detected, respectively. Besides, the mRNA and protein expressions of tight junction proteins and RhoA were measured using RT-qPCR and Western blot. Moreover, RT-qPCR was employed to evaluate the expressions of inflammatory cytokines. Western blot was adopted to measure the levels of RhoA, ROCK, MLC2 and apoptosis-related proteins. The results revealed that oxycodone attenuated permeability damage, inflammatory factor release and apoptosis of OGD/R-induced brain microvascular endothelial cells in a dose-dependent manner. It was also found that oxycodone could reduce the expressions of RhoA, ROCK and MLC2 in brain microvascular endothelial cells induced by OGD/R. More importantly, oxycodone exhibited desirable effects on OGD/R-induced brain microvascular endothelial cells through RhoA/ROCK/MLC2 signal. In conclusion, oxycodone relieved permeability damage and apoptosis of OGD/R-induced brain microvascular endothelial cells through RhoA/ROCK/MLC2 signal, suggesting that oxycodone might be an effective method for the improvement of cerebral ischemia-reperfusion injury.

Spatial Distribution and Predictive Significance of Dendritic Cells and Macrophages in Esophageal Cancer Treated With Combined Chemoradiotherapy and PD-1 Blockade

Background

The first clinical study (NCT03671265) of first-line chemoradiotherapy combined with PD-1 blockade showed promising treatment outcomes in locally advanced esophageal squamous cell carcinoma (ESCC). However, partial patients did not respond to the combination treatment. The roles of dendritic cells (DCs) and macrophages in this combination treatment remain poorly understood.

Methods

We performed multiplexed immunofluorescence method to identify CD11c⁺ DCs, CD68⁺ macrophages, and their PD-L1^- or PD-L1⁺ subpopulations in paired tumor biopsies (n = 36) collected at baseline and during the combination treatment (after radiation, 40 Gy) from the phase Ib trial (NCT03671265). We applied whole exome sequencing in the baseline tumor biopsies (n = 14) to estimate tumor mutation burden (TMB). We dynamically investigated the spatial distribution of DCs and macrophages under chemoradiotherapy combined with PD-1 blockade, and evaluated the association between their spatial distribution and combination outcome, and TMB.

Results

The results showed that high percentages of PD-L1^- DCs and macrophages in the baseline tumor compartment, but not in the stromal compartment, predicted improved OS and PFS. Chemoradiotherapy combined with PD-1 blockade promoted DCs and macrophages to migrate closer to tumor cells. During combination treatment, PD-L1^- tumor cells were nearest to PD-L1^- DCs and macrophages, while PD-L1⁺ tumor cells were next to PD-L1⁺ DCs and macrophages. High TMB was closely associated with a shorter distance from tumor cells to DCs and macrophages. Shorter distance between PD-L1⁺ tumor cells and PD-L1⁺ DCs or PD-L1^- macrophages during the combination was correlated with better OS. Shorter distance between PD-L1^- tumor cells and PD-L1^- macrophages during combination was associated with both longer OS and PFS.

Conclusions

PD-L1^- or PD-L1⁺ DCs and macrophages exhibit distinct spatial distribution in ESCC. The close distance between tumor cells and these antigen-presenting cells (APCs) is critical to the clinical outcome in chemoradiotherapy combined with PD-1 blockade in ESCC patients. Our results highlight the predictive potential of spatial patterns of APCs in chemoradiotherapy combined with immunotherapy and reveal the underlying mechanism of APCs participating in chemoradiotherapy-induced antitumor immune response in ESCC.

Exploiting the tumor-suppressive activity of the androgen receptor by CDK4/6 inhibition in castration-resistant prostate cancer

The androgen receptor (AR) plays a pivotal role in driving prostate cancer (PCa) development. However, when stimulated by high levels of androgens, AR can also function as a tumor suppressor in PCa cells. While the high-dose testosterone (high-T) treatment is currently being tested in clinical trials of castration-resistant prostate cancer (CRPC), there is still a pressing need to fully understand the underlying mechanism and thus develop treatment strategies to exploit this tumor-suppressive activity of AR. In this study, we demonstrate that retinoblastoma (Rb) family proteins play a central role in maintaining the global chromatin binding and transcriptional repression program of AR and that Rb inactivation desensitizes CRPC to the high-dose testosterone treatment in vitro and in vivo. Using a series of patient-derived xenograft (PDX) CRPC models, we further show that the efficacy of high-T treatment can be fully exploited by a CDK4/6 inhibitor, which strengthens the chromatin binding of the Rb-E2F repressor complex by blocking the hyperphosphorylation of Rb proteins. Overall, our study provides strong mechanistic and preclinical evidence on further developing clinical trials to combine high-T with CDK4/6 inhibitors in treating CRPC.

Individual exposure to ambient PM2.5 and hospital admissions for COPD in 110 hospitals: a case-crossover study in Guangzhou, China

Few studies have evaluated the short-term association between hospital admissions and individual exposure to ambient particulate matter (PM_2.5). Particularly, no studies focused on hospital admissions for chronic obstructive pulmonary disease (COPD) at the individual level. We assessed the short-term effects of PM_2.5 on hospitalization admissions for COPD in Guangzhou, China, during 2014-2015, based on satellite-derived estimates of ambient PM_2.5 concentrations at a 1-km resolution near the residential address as individual-level exposure for each patient. Around 40,002 patients with COPD admitted to 110 hospitals were included in this study. A time-stratified case-crossover design with conditional logistic regression models was applied to assess the effects of PM_2.5 based on a 1-km grid data of aerosol optical depth provided by the National Aeronautics and Space Administration on hospital admissions for COPD. Further, we performed stratified analyses by individual demographic characteristics and season of hospital admission. Around 10 μg/m³ increase in individual-level PM_2.5 was associated with an increase of 1.6% (95% confidence interval [CI]: 0.6%, 2.7%) in hospitalization for COPD at a lag of 0-5 days. The impact of PM_2.5 on hospitalization for COPD was greater significantly in males and patients admitted in summer. Our study strengthened the evidence for the adverse effect of PM_2.5 based on satellite-based individual-level exposure data.

Interstitial Fluid Behavior and Diseases

Living things comprise a typical hierarchical and porous medium, and their most fundamental logical architectures are interstitial structures encapsulating parenchymal structures. The recent discovery of the efficient transport mechanisms of interstitial streams has provided a new understanding of these complex activities. The substance transport of interstitial streams follows mesoscopic fluid behavior dynamics, which is intimately associated with material transfer in nanoconfined spaces and a unique signal transmission. Accordingly, the evaluation of interstitial stream transport behavior at the mesoscopic scale is essential. In this review, recent advances in physical and chemical properties, the substance transport model, and the characterization methods of interstitial streams at the mesoscopic scale, as well as the relationships between interstitial streams and disease are summarized. Interstitial stream transport can be used as a basis to fully mine hierarchal behavior in images to expand imaging behavior into an omics field. By starting from the perspective of soft matter, a new understanding can be gained of health and disease and quantitative physical markers for research, clinical diagnosis, and treatment can be provided, as well as prognosis evaluation in complex diseases such as cancer and Alzheimer's disease. This will provide a foundation for the development of medicine of soft matter.

Targeted long-read sequencing reveals clonally expanded HBV-associated chromosomal translocations in patients with chronic hepatitis B

Background & Aims

Methods

Results

Conclusions

Lay summary

•

Fresh frozen liver biopsies from patients with CHB were subjected to targeted long-read RNA and DNA sequencing.

•

Inter-chromosomal translocations associated with HBV integration events detected in one-third of patients.

•

Chromosomal translocations were unique to each biopsy sample, suggesting that each originated randomly.

•

A larger fraction of the HBV transcriptome originates from cccDNA in patients who are HBeAg-positive.

Elesesterpenes A–K: Lupane-type Triterpenoids From the Leaves of Eleutherococcus sessiliflorus

Elesesterpenes A–K (1–11), eleven new lupane-type triterpenoids, triterpenoid glycosides, and nortriterpenoid were isolated from the leaves of Eleutherococcus sessiliflorus. Their structures and relative configurations were completely elucidated by a combination of diverse methods including physical, spectroscopic data. The absolute configuration of elesesterpenes A–B (1–2) was defined by single-crystal X-ray diffraction. Meanwhile, all the isolates were evaluated for anti-inflammatory activities on lipopolysaccharide-induced nitric oxide production in BV2 microglial cells, and antiproliferative activities against human hepatoma (HepG2), human lung adenocarcinoma (A549), and human glioma cells (LN229) in vitro. It was found that some of them exhibited obvious anti-inflammatory activities and potent antiproliferative activities.