c-di-AMP Accumulation Regulates Growth, Metabolism, and Immunogenicity of Mycobacterium smegmatis

Cyclic dimeric adenosine monophosphate (c-di-AMP) is a ubiquitous second messenger of bacteria involved in diverse physiological processes as well as host immune responses. MSMEG_2630 is a c-di-AMP phosphodiesterase (cnpB) of Mycobacterium smegmatis, which is homologous to Mycobacterium tuberculosis Rv2837c. In this study, cnpB-deleted (ΔcnpB), -complemented (ΔcnpB::C), and -overexpressed (ΔcnpB::O) strains of M. smegmatis were constructed to investigate the role of c-di-AMP in regulating mycobacterial physiology and immunogenicity. This study provides more precise evidence that elevated c-di-AMP level resulted in smaller colonies, shorter bacteria length, impaired growth, and inhibition of potassium transporter in M. smegmatis. This is the first study to report that elevated c-di-AMP level could inhibit biofilm formation and induce porphyrin accumulation in M. smegmatis by regulating associated gene expressions, which may have effects on drug resistance and virulence of mycobacterium. Moreover, the cnpB-deleted strain with an elevated c-di-AMP level could induce enhanced Th1 immune responses after M. tuberculosis infection. Further, the pathological changes and the bacteria burden in ΔcnpB group were comparable with the wild-type M. smegmatis group against M. tuberculosis venous infection in the mouse model. Our findings enhanced the understanding of the physiological role of c-di-AMP in mycobacterium, and M. smegmatis cnpB-deleted strain with elevated c-di-AMP level showed the potential for a vaccine against tuberculosis.

Risk Assessment of Liver Metastasis in Pancreatic Cancer Patients Using Multiple Models Based on Machine Learning: A Large Population-Based Study

Background

A more accurate prediction of liver metastasis (LM) in pancreatic cancer (PC) would help improve clinical therapeutic effects and follow-up strategies for the management of this disease. This study was to assess various prediction models to evaluate the risk of LM based on machine learning algorithms.

Methods

We retrospectively reviewed clinicopathological characteristics of PC patients from the Surveillance, Epidemiology, and End Results database from 2010 to 2018. The logistic regression, extreme gradient boosting, support vector, random forest (RF), and deep neural network machine algorithms were used to establish models to predict the risk of LM in PC patients. Specificity, sensitivity, and receiver operating characteristic (ROC) curves were used to determine the discriminatory capacity of the prediction models.

Results

A total of 47,919 PC patients were identified; 15,909 (33.2%) of which developed LM. After iterative filtering, a total of nine features were included to establish the risk model for LM based on machine learning. The RF showed the most promising results in the prediction of complications among the models (ROC 0.871 for training and 0.832 for test sets). In risk stratification analysis, the LM rate and 5-year cancer-specific survival (CSS) in the high-risk group were worse than those in the intermediate- and low-risk groups. Surgery, radiotherapy, and chemotherapy were found to significantly improve the CSS in the high- and intermediate-risk groups.

Conclusion

In this study, the RF model constructed could accurately predict the risk of LM in PC patients, which has the potential to provide clinicians with more personalized clinical decision-making recommendations.

Relationship Between Number of Lateral Intercondylar Ridges and Area of Denser Bone on the Lateral Intercondylar Wall

Background:

A deeper understanding of the anatomy of the intercondylar notch of the femur may help reduce technical errors during anatomic anterior cruciate ligament (ACL) reconstruction.

Purposes:

To classify the number of ridges on the lateral intercondylar wall, identify factors influencing the number of ridges, and define the relationship between the area of denser bone on the lateral intercondylar wall and the lateral intercondylar ridge.

Study Design:

Descriptive laboratory study.

Methods:

Included were 89 patients with computed tomography (CT) images of the knee joint. On full lateral view of the lateral femoral condyle, the authors evaluated for the presence of a lateral intercondylar ridge. The height and area of the lateral intercondylar wall (notch height and lateral notch area) and the length of Blumensaat line were calculated. Notch outlet length, axial notch area, notch width index, and transepicondylar length were also calculated using 3-dimensional CT. Maximum intensity projection was used to identify the area of denser bone on the femoral lateral intercondylar wall, and the relationship between this area and the lateral intercondylar ridge was investigated.

Results:

The lateral intercondylar ridge exhibited 3 types of morphological variations. The invisible type (no ridge) was observed in 20 knees (22.5%); the ridge type (1 ridge), in 23 knees (25.8%); and the plateau type (2 ridges), in 46 knees (51.7%). There were significant differences in notch height, lateral notch area, Blumensaat line length, and denser bone area among the ridge types (P ≤ .031 for all). The locations of the anterior ridge of the plateau type and of all 23 ridges of the ridge type corresponded to the anterior margin line of the area of denser bone.

Conclusion:

Significant differences were seen in the 3 types of lateral intercondylar ridges. The anterior margin line of the denser bone area on the lateral intercondylar wall was found to correspond to the anterior border of the plateau type and the ridge type.

Clinical Relevance:

The variations in the lateral intercondylar ridge may affect measurement accuracy during evaluation of ACL tunnel position while using the ridge as a landmark. The plateau-type ridge and the area of denser bone on the lateral intercondylar wall may provide a new way for surgeons to determine the femoral tunnel.

Loss of RBMS1 promotes anti-tumor immunity through enabling PD-L1 checkpoint blockade in triple-negative breast cancer

Immunotherapy has been widely utilized in multiple tumors, however, its efficacy in the treatment of triple-negative breast cancers (TNBC) is still being challenged. Meanwhile, functions and mechanisms of RNA binding proteins in regulating immunotherapy for TNBC remain largely elusive. Here we reported that the RNA binding protein RBMS1 is prevalent among immune-cold TNBC. Through a systematic shRNA-mediated screen, we found depletion of RBMS1 significantly reduced the level of programmed death ligand 1 (PD-L1) in TNBC. Clinically, RBMS1 was increased in breast cancer and its level was positively correlated to that of PD-L1. RBMS1 ablation stimulated cytotoxic T cell mediated anti-tumor immunity. Mechanistically, RBMS1 regulated the mRNA stability of B4GALT1, a newly identified glycosyltransferase of PD-L1. Depletion of RBMS1 destabilized the mRNA of B4GALT1, inhibited the glycosylation of PD-L1 and promoted the ubiquitination and subsequent degradation of PD-L1. Importantly, combination of RBMS1 depletion with CTLA4 immune checkpoint blockade or CAR-T treatment enhanced anti-tumor T-cell immunity both in vitro and in vivo. Together, our findings provided a new immunotherapeutic strategy against TNBC by targeting the immunosuppressive RBMS1.

Preliminary Study of the Protectiveness of Vaccination Against the COVID-19 in the Outbreak of VOC Omicron BA.2 - Jilin City, Jilin Province, China, March 3-April 12, 2022

What is already known about this topic?

An outbreak of coronavirus disease 2019 (COVID-19) of Omicron BA.2 emerged in Jilin City since March 3, 2022, which involved in 27,036 cases by April 12. The vaccination program with inactivated COVID-19 vaccines has been implemented since the beginning of 2021.

What is added by this report?

The incidences of moderate, severe, and critical cases in the whole population of the group of 0+1 dose were 1.82-, 9.49-, and 3.85-fold higher than those in the group of 2 doses, and 5.03-, 44.47-, and ∞-fold higher than those received 3 doses vaccination. For the population ≥60 years, the incidences of moderate, severe, and critical cases in the group of 0+1 dose were 29.92, 9.62, and 4.27 per 100,000, showing 4.13-, 43.72-, and 4.85-fold higher than 2 doses, as well as 13.28-, 22.37-, and ∞-fold higher than 3 doses.

What are the implications for public health practice?

The incidences of each type of COVID-19 in the population who were fully vaccinated or booster vaccinated in Jilin City were significantly lower than those who were unvaccinated and/or partially vaccinated. Booster vaccination with homologous inactivated vaccines induces stronger protectiveness for COVID-19 caused by variant of concern (VOC) Omicron.

Presence of organophosphate flame retardants (OPEs) in different functional areas in residential homes in Beijing, China

The production and application of organophosphate esters (OPEs) have dramatically increased in recent years due to their use as a replacement for brominated flame retardants. In this study, 13 OPEs (Σ₁₃OPEs) were analyzed in indoor air samples from kitchens and living rooms in 14 residential homes in Beijing, China. The concentrations of Σ₁₃OPEs in kitchen air samples (mean: 13 ng/m³) were significantly (p < 0.05) higher than in living room air samples (5.0 ng/m³). In addition, paired window surface organic film samples were collected and analyzed to investigate film-air partitioning, exhibiting a mean concentration of Σ₁₃OPEs of 4100 ng/m². The congener profiles showed that tris(2-chloroisopropyl) phosphate (TCPP) was the predominant compound in both window film samples (48%) and the corresponding indoor air sample (56%). The estimated daily intakes (EDI) of OPEs via indoor air inhalation were 2.8 and 1.4 ng/kg/day for infants and adults, respectively, both of which are below the reference dose values (RfDs). Overall, these findings indicate that OPEs in the indoor air environment of residential homes in Beijing are not likely to pose a health risk to the general population.

A comprehensive study on simultaneous enhancement of sludge dewaterability and elimination of polycyclic aromatic hydrocarbons by Fe2+ catalyzing O3 process

Simultaneous removal of polycyclic aromatic hydrocarbons (PAHs) in the process of enhancement of sludge dewaterability via oxidation of hydroxyl radicals (•OH) and flocculation of Fe³⁺ by Fe²⁺-catalyzing O₃ were investigated as a novel research focus. The results showed that capillary suction time (CST) and water content of dewatered sludge cake (Wc) were reduced from 57.9 s and 85.1% to 13.6 s and 69.65% under the optimum usage of 60 mg/g dry solids (DS) O₃ and 80 mg/g DS FeSO₄, respectively. The relevant dewatering mechanism of Fe²⁺-catalyzing O₃ treatment was elucidated. It was found that extracellular polymeric substances-bound (EPS-bound) and intracellular water was dramatically released through destroying sludge cells and EPS gel-like structure by produced •OH. In addition, the results of X-ray photoelectron spectroscopy (XPS), Fourier transform infrared (FTIR) and ¹³C NMR spectroscopy revealed that •OH oxidized and mineralized hydrophilic organic matters intensifying hydrophobicity of sludge surface. Moreover, Fe³⁺ generated by oxidation of Fe²⁺ agglomerated fragmented fine particles into large aggregates and decreased exposure of hydrophilic sites by neutralizing negative charge, which promoted water-solids separation. Meanwhile, sludge surface roughness was decreased which was determined by material type upright confocal laser microscope (CLM). As a consequence, •OH and Fe³⁺ were mainly responsible for enhancement of sludge dewaterability. Moreover, more than 40% of removal rate of PAHs was accomplished by Fe²⁺-catalyzed O₃ treatment mitigating the environmental risks of PAHs spread.

Genome-wide identification and expression analysis of the SWEET gene family in daylily (Hemerocallis fulva) and functional analysis of HfSWEET17 in response to cold stress

BACKGROUND

The Sugars Will Eventually be Exported Transporters (SWEETs) are a newly discovered family of sugar transporters whose members exist in a variety of organisms and are highly conserved. SWEETs have been reported to be involved in the growth and development of many plants, but little is known about SWEETs in daylily (Hemerocallis fulva), an important perennial ornamental flower.

RESULTS

In this study, 19 daylily SWEETs were identified and named based on their homologous genes in Arabidopsis and rice. Phylogenetic analysis classified these HfSWEETs into four clades (Clades I to IV). The conserved motifs and gene structures showed that the HfSWEETs were very conservative during evolution. Chromosomal localization and synteny analysis found that HfSWEETs were unevenly distributed on 11 chromosomes, and there were five pairs of segmentally duplicated events and one pair of tandem duplication events. The expression patterns of the 19 HfSWEETs showed that the expression patterns of most HfSWEETs in different tissues were related to corresponding clades, and most HfSWEETs were up-regulated under low temperatures. Furthermore, HfSWEET17 was overexpressed in tobacco, and the cold resistance of transgenic plants was much higher than that of wild-type tobacco.

CONCLUSION

This study identified the SWEET gene family in daylily at the genome-wide level. Most of the 19 HfSWEETs were expressed differently in different tissues and under low temperatures. Overexpression further suggests that HfSWEET17 participates in daylily low-temperature response. The results of this study provide a basis for further functional analysis of the SWEET family in daylily.

[Liver fibrosis inhibits lethal injury through D-galactosamine/lipopolysaccharide-induced necroptosis]

Objective: To explore the new mechanism of liver fibrosis through D-galactosamine/lipopolysaccharide (D-GalN/LPS)-induced necroptosis as an entry point to inhibit lethal injury. Methods: The carbon tetrachloride (CCl4)-induced mouse model of liver fibrosis was established. At 6 weeks of fibrosis, the mice were challenged with a lethal dose of D-GalN/LPS, and the normal mice treated with the same treatment were used as the control. The experiment was divided into four groups: control group (Control), acute injury group (D-GalN/LPS), liver fibrosis group (Fib), and liver fibrosis + acute challenge group (Fib + D-GalN/LPS). Quantitative PCR and immunofluorescence were used to analyze the expression of necroptosis key signal molecules RIPK1, RIPK3, MLKL and/or P-MLKL in each group. Normal mice were treated with inhibitors targeting key signaling molecules of necroptosis, and then given an acute challenge. The inhibitory effect of D-GalN/LPS-induced-necroptosis on acute liver injury was evaluated according to the changes in transaminase levels and liver histology. Liver fibrosis spontaneous ablation model was established, and then acute challenge was given. Necroptosis key signal molecules expression was analyzed in liver tissue of mice in each group and compared by immunohistochemistry. The differences between groups were compared with t-test or analysis of variance. Results: Quantitative PCR and immunofluorescence assays result showed that D-GalN/LPS-induced significant upregulation of RIPK1, RIPK3, MLKL and/or P-MLKL. Necroptosis key signal molecules inhibition had significantly reduced D-GalN/LPS-induced liver injury, as manifested by markedly reduced serum ALT and AST levels with improvement in liver histology. Necroptosis signaling molecules expression was significantly inhibited in fibrotic livers even under acute challenge conditions. Additionally, liver fibrosis with gradual attenuation of fibrotic ablation had inhibited D-GalN/LPS-induced necroptosis. Conclusion: Liver fibrosis may protect mice from acute lethal challenge injury by inhibiting D-GalN/LPS-induced necroptosis.

First Report of Alternaria alternata Causing Leaf Spot Disease on Daylily in China

Daylilies (Hemerocallis spp.; Xanthorrhoeaceae) originated from Eastern Asia and are widely cultivated as perennial ornamentals from the tropics to their native high latitudes. In June 2021, daylily cultivar 'Tao Hua Zhai' with leaf spot symptoms were found at the Shanghai Institute of Technology, Shanghai, China. The disease prevalence was about 14.5 % in a 33,000 m2 planting area indicated by survey statistics. Symptoms of the disease initially appeared as small, circular, brown spots on the leaves. As disease progressed, spots increased gradually until they were distributed uniformly over the lamina, the leaf tip became withered and the rest of the leaf became chlorotic. Symptomatic leaf tissue pieces (5 × 5 mm) from lesion margins were sterilized with 75 % ethanol for 1 min, rinsed three times with sterile distilled water, then incubated on potato dextrose agar (PDA) plates at 28 °C in the dark. A pure culture (ATHF-1) was obtained. Its upper surface on PDA was olive green with loose aerial hyphae, and its lower surface was brown.Conidiophores were brown, single or branched, producing numerous short chains conidia. Conidia were obclavate to obpyriform or ellipsoid, pale brown to dark brown, with a short cylindrical beak at the tip, contained 2-6 transverse septa and 0-4 longitudinal septa. The size of conidia were 15.9-47.3 µm × 7.6-16.6 µm (n=50), and length/width ratios were 1.51 to 4.92. Based on the morphological characteristics, the fungus was identified as Alternaria spp. (Simmons, 2007). For molecular characterization, three genes (the internal transcribed spacers [ITS], plasma membrane ATPase [ATPase] and major allergen Alt a 1) of ATHF-1 were amplified with primer pairs ITS1/ITS4 (White et al. 1990), ATPDF1/ATPDR1 (Lawrence et al. 2013) and Alt-for/Alt-rev (Hong et al. 2005), respectively. The sequences were deposited in GenBank (ITS, MZ983611; ATPase, MZ962978; Alt a 1, OK021654). Blastn searches showed the nucleotide sequences of ATHF-1 were highly similar to the reference sequences of Alternaria tenuissima (ITS, 99 % to KU982591; ATPase, 98 % to MT833928; Alt a 1, 100 % to MT109294). A phylogenetic tree based on the ITS, ATPase and Alt a 1 sequences was constructed by MEGA7.0, which showed that ATHF-1 was closely related to A. tenuissima and A. alternata. But according to Woudenberg et al. (2015), they were synonymized under the species name A. alternata. So, based on morphological and molecular characteristics, the fungus was identified as A. alternata. For pathogenicity tests, ten healthy two-month-old potted seedlings from tissue culture daylilies were sprayed with 20 ml of suspension (approximately 2×105 spores/ml), ten daylilies were used as controls and sprayed with sterile water. After covering with transparent plastic bags for 48 h to maintain humidity, the plants were placed in the greenhouse at 25 ℃ with 12 h photoperiod. The pathogenicity tests were repeated twice. Seven days after inoculation, lesions appeared on the plants inoculated with the pathogen, which were consistent with the symptoms observed in the field, while the controls remained symptomless. The morphological characteristics and gene sequences of the re-isolated strain from the diseased leaves were consistent with those of the inoculated strain. To our knowledge, this is the first report of A. alternata affecting leaf spot disease on daylily in China. Identification of the causal agent of the disease is important for developing effective disease management strategies. References: Hong, S.G., et al. 2005. Fungal Genet Biol. 42(2):119-129. https://doi.org/10.1016/j.fgb.2004.10.009 Lawrence, D.P., et al. 2013. Mycologia. 105(3):530-546. https://doi.org/10.3852/12-249 Simmons, E.G. 2007. Alternaria: An Identification Manual. CBS Fungal Biodiversity Centre, Utrecht, the Netherlands. White, T. J., et al. 1990. Amplification and Direct Sequencing of Fungal Ribosomal RNA Genes for Phylogenetics. PCR protocols: a guide to methods and applications, 18(1), 315-322. Woudenberg J.H.C., et al. 2015. Studies in Mycology. 82(82):1-21. https://doi.org/10.1016/j.simyco.2015.07.001.

Contribution of atmospheric deposition to halogenated polycyclic aromatic hydrocarbons in surface sediments: A validation study

Surface sediments are both sinks and sources of chlorinated and brominated polycyclic aromatic hydrocarbons (Cl/Br-PAHs) in the environment. It is important to study the source of Cl/Br-PAHs in the surface sediment for controlling the ecological risk of Cl/Br-PAHs. Clues from the previous research suggested that atmospheric deposition may be one of the main sources of Cl/Br-PAHs in sediment. However, due to the lack of matched sediment and atmospheric Cl/Br-PAHs data, the contribution of atmospheric deposition to Cl/Br-PAHs in sediment has not been confirmed. This study investigated the characteristics of 37 Cl/Br-PAHs and validated the contribution of atmospheric sedimentation to Cl/Br-PAHs in sediment by a case study in the surface sediments of the Chaobai River, China. To the best of our knowledge, four Cl-PAHs and eleven Br-PAHs were found in the sediments for the first time. The total concentrations of 18 Cl-PAH species were 76-2301 pg/g, while those of Br-PAHs were 6-238 pg/g. The toxic equivalent quantities (TEQ) of the Cl-PAHs in surface sediments in the water conservation area and in the urban comparison area were 0.73 pg TEQ/g and 2.21 pg TEQ/g, respectively. The TEQ of the Br-PAHs in surface sediments in the water conservation area and in the urban comparison area were 2.85 × 10^-2 pg TEQ/g and 6.6 × 10^-2 pg TEQ/g, respectively. Based on the characteristics comparison and correlation analysis of Cl/Br-PAHs in both sediment and ambient air, it was initially confirmed the contribution of atmospheric deposition to Cl-PAHs in sediments. However, there was no conclusion of Br-PAHs in sediment similar to Cl-PAHs in sediment. It was inferred that the sources of Br-PAHs in sediment were different from Cl-PAHs in sediment.

[Effect of hypochloric acid on Escherichia coli biofilm and the clinical efficacy of hypochloric acid for wounds with Escherichia coli infection]

Objective: To investigate the effect of hypochloric acid on Escherichia coli biofilm and the clinical efficacy of hypochloric acid for wounds with Escherichia coli infection. Methods: One strain of Escherichia coli with the strongest bacterial biofilm forming ability among the strains isolated from specimens in 25 patients (16 males and 9 females, aged 32-67 years) from five clinical departments of the 940th Hospital of the Joint Logistic Support Force was collected for the experimental study from September to December 2019. The Escherichia coli was cultured with hypochloric acid at 162.96, 81.48, 40.74, 20.37, 10.18, 5.09, 2.55, 1.27, 0.64, and 0.32 μg/mL respectively to screen the minimum bactericidal concentration (MBC) of hypochloric acid. The Escherichia coli was cultured with hypochloric acid at the screened MBC for 2, 5, 10, 20, 30, and 60 min respectively to screen the shortest bactericidal time of hypochloric acid. The biofilm formation of Escherichia coli was observed by scanning electron microscopy at 6, 12, 24, 48, 72, and 96 h of incubation, respectively. After 72 h of culture, hypochloric acid at 1, 2, 4, 8, and 16 times of MBC was respectively added to Escherichia coli to screen the minimum biofilm eradicate concentration (MBEC) of hypochloric acid against Escherichia coli. After hypochloric acid at 1, 2, 4, and 8 times of MBEC and sterile saline were respectively added to Escherichia coli for 10 min, the live/dead bacterial staining kit was used to detect the number of live and dead cells, with the rate of dead bacteria calculated (the number of samples was 5). From January to December 2020, 41 patients with infectious wounds meeting the inclusion criteria and admitted to the Department of Burns and Plastic Surgery of the 940th Hospital of Joint Logistic Support Force of PLA were included into the prospective randomized controlled trial. The patients were divided into hypochloric acid group with 21 patients (13 males and 8 females, aged (46±14) years) and povidone iodine group with 20 patients (14 males and 6 females, aged (45±19) years) according to the random number table. Patients in the 2 groups were respectively dressed with sterile gauze soaked with hypochloric acid of 100 μg/mL and povidone iodine solution of 50 mg/mL with the dressings changed daily. Before the first dressing change and on the 10th day of dressing change, tissue was taken from the wound and margin of the wound for culturing bacteria by agar culture method and quantifying the number of bacteria. The amount of wound exudate and granulation tissue growth were observed visually and scored before the first dressing change and on the 3rd, 7th, and 10th days of dressing change. Data were statistically analyzed with one-way analysis of variance, Dunnett-t test, independent sample t test, Mann-Whitney U test, Wilcoxon signed-rank test, chi-square test, or Fisher's exact probability test. Results: The MBC of hypochloric acid against Escherichia coli was 10.18 μg/mL, and the shortest bactericidal time of hypochloric acid with MBC against Escherichia coli was 2 min. Escherichia coli was in a completely free state after 6 and 12 h of culture and gradually aggregated and adhered with the extension of culture time, forming a mature biofilm at 72 h of culture. The MBEC of hypochloric acid against Escherichia coli was 20.36 μg/mL. The Escherichia coli mortality rates after incubation with hypochloric acid at 1, 2, 4, and 8 times of MBEC for 10 min were significantly higher than that after incubation with sterile saline (with t values of 6.11, 25.04, 28.90, and 40.74, respectively, P<0.01). The amount of bacteria in the wound tissue of patients in hypochloric acid group on the 10th day of dressing change was 2.61 (2.20, 3.30)×104 colony forming unit (CFU)/g, significantly less than 4.77 (2.18, 12.48)×104 CFU/g in povidone iodine group (Z=2.06, P<0.05). The amounts of bacteria in the wound tissue of patients in hypochloric acid group and povidone iodine group on the 10th day of dressing change were significantly less than 2.97 (2.90, 3.04)×106 and 2.97 (1.90, 7.95)×106 CFU/g before the first dressing change (with Z values of 4.02 and 3.92, respectively, P<0.01). The score of wound exudate amount of patients in hypochloric acid group on the 10th day of dressing change was significantly lower than that in povidone iodine group (Z=2.07, P<0.05). Compared with those before the first dressing change, the scores of wound exudate amount of patients in hypochloric acid group on the 7th and 10th days of dressing change were significantly decreased (with Z values of -3.99 and -4.12, respectively, P<0.01), and the scores of wound exudate amount of patients in povidone iodine group on the 7th and 10th days of dressing change were significantly decreased (with Z values of -3.54 and -3.93, respectively, P<0.01). The score of wound granulation tissue growth of patients in hypochloric acid group on the 10th day of dressing change was significantly higher than that in povidone iodine group (Z=2.02, P<0.05). Compared with those before the first dressing change, the scores of wound granulation tissue growth of patients in hypochloric acid group on the 7th and 10th days of dressing change were significantly increased (with Z values of -3.13 and -3.67, respectively, P<0.01), and the scores of wound granulation tissue growth of patients in povidone iodine group on the 7th and 10th days of dressing change were significantly increased (with Z values of -3.12 and -3.50, respectively, P<0.01). Conclusions: Hypochloric acid can kill Escherichia coli both in free and biofilm status. Hypochloric acid at a low concentration shows a rapid bactericidal effect on mature Escherichia coli biofilm, and the higher the concentration of hypochloric acid, the better the bactericidal effect. The hypochloric acid of 100 μg/mL is effective in reducing the bacterial load on wounds with Escherichia coli infection in patients, as evidenced by a reduction in wound exudate and indirect promotion of granulation tissue growth, which is more effective than povidone iodine, the traditional topical antimicrobial agent.

Integration of immune and hypoxia gene signatures improves the prediction of radiosensitivity in breast cancer

Immunity and hypoxia are two important factors that affect the response of cancer patients to radiotherapy. At the same time, considering the limited predictive value of a single predictive model and the uncertainty of grouping patients near the cutoff value, we developed and validated a combined model based on immune- and hypoxia-related gene expression profiles to predict the radiosensitivity of breast cancer patients. This study was based on breast cancer data from The Cancer Genome Atlas (TCGA). Spike-and-slab Lasso regression analysis was performed to select three immune-related genes and develop a radiosensitivity model. Lasso Cox regression modeling selected 11 hypoxia-related genes for development of radiosensitivity model. Three independent datasets (Molecular Taxonomy of Breast Cancer International Consortium [METABRIC], E-TABM-158, GSE103746) were used to validate the predictive value of radiosensitivity signatures. In the TCGA dataset, the 10-year survival probabilities of the immune radioresistant (IRR) and hypoxia radioresistant (HRR) groups were 0.189 (0.037, 0.973) and 0.477 (0.293, 0.776), respectively. The 10-year survival probabilities of the immune radiosensitive (IRS) and hypoxia radiosensitive (HRS) groups were 0.778 (0.676, 0.895) and 0.824 (0.723, 0.939), respectively. Based on these two gene signatures, we further constructed a combined model and divided all patients into three groups (IRS/HRS, mixed, IRR/HRR). We identified the IRS/HRS patients most likely to benefit from radiotherapy; the 10-year survival probability was 0.886 (0.806, 0.976). The 10-year survival probability of the IRR/HRR group was 0. In conclusion, a combined model integrating immune- and hypoxia-related gene signatures could effectively predict the radiosensitivity of breast cancer and more accurately identify radiosensitive and radioresistant patients than a single model.

A Clinically Applicable Nomogram for Predicting the Risk of Invasive Mechanical Ventilation in Pneumocystis jirovecii Pneumonia

Objective

Pneumocystis jirovecii pneumonia (PCP) is a life-threatening disease associated with a high mortality rate among immunocompromised patient populations. Invasive mechanical ventilation (IMV) is a crucial component of treatment for PCP patients with progressive hypoxemia. This study explored the risk factors for IMV and established a model for early predicting the risk of IMV among patients with PCP.

Methods

A multicenter, observational cohort study was conducted in 10 hospitals in China. Patients diagnosed with PCP were included, and their baseline clinical characteristics were collected. A Boruta analysis was performed to identify potentially important clinical features associated with the use of IMV during hospitalization. Selected variables were further analyzed using univariate and multivariable logistic regression. A logistic regression model was established based on independent risk factors for IMV and visualized using a nomogram.

Results

In total, 103 patients comprised the training cohort for model development, and 45 comprised the validation cohort to confirm the model’s performance. No significant differences were observed in baseline clinical characteristics between the training and validation cohorts. Boruta analysis identified eight clinical features associated with IMV, three of which were further confirmed to be independent risk factors for IMV, including age (odds ratio [OR] 2.615 [95% confidence interval (CI) 1.110–6.159]; p = 0.028), oxygenation index (OR 0.217 [95% CI 0.078–0.604]; p = 0.003), and serum lactate dehydrogenase level (OR 1.864 [95% CI 1.040–3.341]; p = 0.037). Incorporating these three variables, the nomogram achieved good concordance indices of 0.829 (95% CI 0.752–0.906) and 0.818 (95% CI 0.686–0.950) in predicting IMV in the training and validation cohorts, respectively, and had well-fitted calibration curves.

Conclusions

The nomogram demonstrated accurate prediction of IMV in patients with PCP. Clinical application of this model enables early identification of patients with PCP who require IMV, which, in turn, may lead to rational therapeutic choices and improved clinical outcomes.

Multifunctional high-Z nanoradiosensitizers for multimodal synergistic cancer therapy

Radiotherapy (RT) is one of the most common and effective clinical therapies for malignant tumors. However, there are several limitations that undermine the clinical efficacy of cancer RT, including the low X-ray attenuation coefficient of organs, serious damage to normal tissues, and radioresistance in hypoxic tumors. With the rapid development of nanotechnology and nanomedicine, high-Z nanoradiosensitizers provide novel opportunities to overcome radioresistance and improve the efficacy of RT by deposition of radiation energy through photoelectric effects. To date, several types of nanoradiosensitizers have entered clinical trials. Nevertheless, the limitation of the single treatment mode and the unclear mechanism of nanoparticle radiosensitization have hindered the further development of nanoradiosensitizers. In this review, we systematically describe the interaction mechanisms between X-rays and nanomaterials and summarize recent advances in multifunctional high-Z nanomaterials for radiotherapeutic-based multimodal synergistic cancer therapy. Finally, the challenges and prospects are discussed to stimulate the development of nanomedicine-based cancer RT.

Overexpression of SLC25A51 promotes hepatocellular carcinoma progression by driving aerobic glycolysis through activation of SIRT5

Solute carrier family 25 member 20 (SLC25A51) is a newly identified mammalian mitochondrial NAD⁺ transporter. However, the clinicopathological and biological significance of SLC25A51 in human cancers, including hepatocellular carcinoma (HCC), remains unclear. The aim of this study was to define the role of SLC25A51 in HCC progression. Here we demonstrate that SLC25A51 is significantly overexpressed in human HCC specimens and cell lines, caused by, at least in partial, the decrease of miR-212-3p. SLC25A51 overexpression is positively correlated with the clinicopathological characteristics of vascular invasion and tumor diameter, as well as poor survival in patients with HCC. Knockdown of SLC25A51 attenuated, while overexpression of SLC25A51 enhanced the growth and metastasis of HCC cells both in vitro and in vivo. Mechanistically, glucose metabolism reprogramming from oxidative phosphorylation to glycolysis by activation of mitochondrial sirtuin 5 (SIRT5) was found to contribute to the promotion of growth and metastasis by SLC25A51 in HCC cells. Together, these findings reveal important roles of SLC25A51 in HCC tumorigenesis and suggest SLC25A51 as a promising prognostic marker and therapeutic target for treating HCC.

A Radiosensitivity Prediction Model Developed Based on Weighted Correlation Network Analysis of Hypoxia Genes for Lower-Grade Glioma

Background and Purpose

Hypoxia is one of the basic characteristics of the physical microenvironment of solid tumors. The relationship between radiotherapy and hypoxia is complex. However, there is no radiosensitivity prediction model based on hypoxia genes. We attempted to construct a radiosensitivity prediction model developed based on hypoxia genes for lower-grade glioma (LGG) by using weighted correlation network analysis (WGCNA) and least absolute shrinkage and selection operator (Lasso).

Methods

In this research, radiotherapy-related module genes were selected after WGCNA. Then, Lasso was performed to select genes in patients who received radiotherapy. Finally, 12 genes (AGK, ETV4, PARD6A, PTP4A2, RIOK3, SIGMAR1, SLC34A2, SMURF1, STK33, TCEAL1, TFPI, and UROS) were included in the model. A radiosensitivity-related risk score model was established based on the overall rate of The Cancer Genome Atlas (TCGA) dataset in patients who received radiotherapy. The model was validated in TCGA dataset and two Chinese Glioma Genome Atlas (CGGA) datasets. A novel nomogram was developed to predict the overall survival of LGG patients.

Results

We developed and verified a radiosensitivity-related risk score model based on hypoxia genes. The radiosensitivity-related risk score served as an independent prognostic indicator. This radiosensitivity-related risk score model has prognostic prediction ability. Moreover, a nomogram integrating risk score with age and tumor grade was established to perform better for predicting 1-, 3-, and 5-year survival rates.

Conclusions

We developed and validated a radiosensitivity prediction model that can be used by clinicians and researchers to predict patient survival rates and achieve personalized treatment of LGG.

New insight to superoxide radical-mediated degradation of pentachlorophenate: Kinetic determination and theoretical calculations

This study reported the reactivity and mechanisms of superoxide radical (O₂˙^-)-mediated transformation of pentachlorophenate. Our results indicated that O₂˙^- alone exhibits limited effects on its degradation, and bimolecular nucleophilic substitution is the dominant reaction pathway.

Enhanced Glass Transition Temperature of Thin Polystyrene Films Having an Underneath Cross-Linked Layer

Due to the importance of the interface in the segmental dynamics of supported macromolecule ultrathin films, the glass transition temperature (T_g) of polystyrene (PS) ultrathin films upon solid substrates modified with a cross-linked PS (CLPS) layer has been investigated. The results showed that the T_g of the thin PS films on a silica surface with a ∼5 nm cross-linked layer increased with reducing film thickness. Meanwhile, the increase in T_g of the thin PS films became more pronounced with increasing the cross-linking density of the layer. For example, a 20 nm thick PS film supported on CLPS with 1.8 kDa of cross-linking degree exhibited a ∼35 and ∼50 K increase in T_g compared to its bulk and that on neat SiO₂ substrate, respectively. Such a large T_g elevation for the ultrathin PS films was attributed to the interfacial aggregation states in which chains diffused through nanolevel voids formed in the cross-linked layer to the SiO₂-Si surface. In such a situation, the chains were topologically constrained in the cross-linked layer with less mobility. These results offer us the opportunity to tailor interfacial effects by changing the degree of cross-linking, which has great potential application in many polymer nanocomposites.

Enhanced waste activated sludge dewaterability by the ozone-peroxymonosulfate oxidation process: Performance, sludge characteristics, and implication

Dewatering treatment is an essential step to diminish sludge volume, cut down transportation costs, and improve subsequent disposal efficiency. In this study, ozone-peroxymonosulfate (O₃/PMS) oxidation process was employed to ameliorate sludge dewaterability. Sludge capillary suction time (CST) and water content (Wc) of dewatered sludge cake could reduce from 70.5 s and 81.93% to 26.7 s and 65.65%, respectively, under the optimal dosage of 30 mg/g TS O₃ and 0.4 mmol/g TS PMS. The increased sludge zeta potential, particle size, and fluidity promoted sludge dewatering performance apparently. The decreased hydrophilic, fluorescent EPS components and proteins/peptides-like + Lipids percentage in EPS as well as the ratio of α-helix/(β-sheet + random coil) of treated EPS protein secondary structure was greatly responsible for the enhanced sludge dewaterability. SO₄^- and OH were detected in ozone-peroxymonosulfate process to crack sludge flocs, eliminate hydrophilic substances and liberate bound water. Moreover, the concentrations of both heavy metals and polycyclic aromatic hydrocarbons (PAHs) of sludge after O₃/PMS conditioning were decreased, and the stability and toxicity of heavy metals were also reduced, except Zn. In conclusion, this work offered a comprehensive insight based on ozone-peroxymonosulfate (O₃/PMS) advanced oxidation for improving the sludge dewaterability and environmental implication.

Identification of Candidate Genes for Meat Color of Chicken by Combing Selection Signature Analyses and Differentially Expressed Genes

Meat color, an important index of chicken quality, is highly related to heme pigment, glycolysis, and intramuscular fat metabolisms. The objective of this study is to obtain candidate genes associated with meat color in chickens based on the comparison of fast-growing, white-feathered chickens (Line B) and slow-growing, yellow-feathered chickens (Jingxing Yellow), which have significant differences in meat color. The differentially expressed genes (DEGs) between Line B and Jingxing Yellow were identified in beast muscle. The fixation index (F_ST) method was used to detect signatures of positive selection between the two breeds. Screening of 1109 genes by the F_ST and 1317 candidate DEGs identified by RNA-seq. After gene ontology analysis along with the Kyoto Encyclopedia of Genes and Genomes, 16 genes associated with glycolysis, fatty acid metabolism, protein metabolism, and heme content were identified as candidate genes that regulate the color of chicken breast meat, especially TBXAS1 (redness), GDPD5 (yellowness), SLC2A6 (lightness), and MMP27 (lightness). These findings should be helpful for further elucidating the molecular mechanisms and developing molecular markers to facilitate the selection of chicken meat color.

Learning Backtrackless Aligned-Spatial Graph Convolutional Networks for Graph Classification

In this paper, we develop a novel backtrackless aligned-spatial graph convolutional network (BASGCN) model to learn effective features for graph classification. Our idea is to transform arbitrary-sized graphs into fixed-sized backtrackless aligned grid structures and define a new spatial graph convolution operation associated with the grid structures. We show that the proposed BASGCN model not only reduces the problems of information loss and imprecise information representation arising in existing spatially-based graph convolutional network (GCN) models, but also bridges the theoretical gap between traditional convolutional neural network (CNN) models and spatially-based GCN models. Furthermore, the proposed BASGCN model can both adaptively discriminate the importance between specified vertices during the convolution process and reduce the notorious tottering problem of existing spatially-based GCNs related to the Weisfeiler-Lehman algorithm, explaining the effectiveness of the proposed model. Experiments on standard graph datasets demonstrate the effectiveness of the proposed model.

Uncertainty matters: Bayesian modeling of bicycle crashes with incomplete exposure data

BACKGROUND

One major challenge faced by neighborhood-level bicycle safety analysis is the lack of complete and reliable exposure data for the entire area under investigation. Although the conventional travel-diary surveys, together with the emerging smartphone fitness applications and bike-sharing systems, provide straightforward and valuable opportunities to estimate territory-wide bicycle activities, the obtained ridership suffers inherently from underreporting.

METHODS

We introduced the Bayesian simultaneous-equation model as a sound methodological alternative here to address the uncertainty arising from incomplete exposure data when modeling bicycle crashes. The proposed method was successfully fitted to a crowdsourced dataset of 792 bicycle-motor vehicle (BMV) crashes aggregated from 209 neighborhoods over a 3-year period in Hong Kong.

RESULTS

Our analysis empirically demonstrated the bias due to omission of activity-based exposure measures or to the direct use of cycling distance extracted from the travel-diary survey without correcting for incompleteness. By modeling bicycle activities and the frequency of BMV crashes simultaneously, we also provided new evidence that an expansion of bicycle infrastructure was likely associated with a significant increase in cycling levels and a substantial reduction in the risk of BMV crashes, despite a slight increase in the absolute number of BMV crashes.

CONCLUSIONS

Our approach is promising in adjusting for the uncertainty in raw exposure data, extrapolating the missing exposure values, and untangling the linkage among built environment, bicycle activities, and the frequency of BMV crashes within a unified framework. To promote safer cycling, designated facilities should be provided to consecutively separate cyclists from motor vehicles.

Identification of organic pollutants with potential ecological and health risks in aquatic environments: Progress and challenges

Thousands of organic pollutants are intentionally and unintentionally discharged into water bodies, adversely affecting the ecological environment and human health. Screening for organic pollutants that pose a potential risk in aquatic environments is essential for risk management. This review evaluates the processes, methods, and technologies used to screen such pollutants in the aquatic environment and discuss their advantages and disadvantages, in addition to the challenges and knowledge gaps in this field. Combining non-target screening, target screening, and suspect screening is often effective for compiling a list of potential risk compounds and enables the quantitative analysis of these compounds. Sample preparation technologies and pollutant detection technologies considerably affect the results of pollutant screening. The limited amount of chemical and toxicological information contained in databases hinders the screening of organic pollutants with potential risk. Machine learning, high-throughput methods, and other technologies will increase the accuracy and convenience of screening for high-risk pollutants. This review provides an important reference for screening these compounds in aquatic environments and can be used in future pollutant screening and risk management.

Recent Advances in Multiresponsive Flexible Sensors towards E-skin: A Delicate Design for Versatile Sensing

Multiresponsive flexile sensors with strain, temperature, humidity, and other sensing abilities serving as real electronic skin (e-skin) have manifested great application potential in flexible electronics, artificial intelligence (AI), and Internet of Things (IoT). Although numerous flexible sensors with sole sensing function have already been reported since the concept of e-skin, that mimics the sensing features of human skin, was proposed about a decade ago, the ones with more sensing capacities as new emergences are urgently demanded. However, highly integrated and highly sensitive flexible sensors with multiresponsive functions are becoming a big thrust for the detection of human body motions, physiological signals (e.g., skin temperature, blood pressure, electrocardiograms (ECG), electromyograms (EMG), sweat, etc.) and environmental stimuli (e.g., light, magnetic field, volatile organic compounds (VOCs)), which are vital to real-time and all-round human health monitoring and management. Herein, this review summarizes the design, manufacturing, and application of multiresponsive flexible sensors and presents the future challenges of fabricating these sensors for the next-generation e-skin and wearable electronics.

An 11-Gene Signature Based on Treatment Responsiveness Predicts Radiation Therapy Survival Benefit Among Breast Cancer Patients

Purpose

We developed a strategy of building prognosis gene signature based on clinical treatment responsiveness to predict radiotherapy survival benefit in breast cancer patients.

Methods and Materials

Analyzed data came from the public database. PFS was used as an indicator of clinical treatment responsiveness. WGCNA was used to identify the most relevant modules to radiotherapy response. Based on the module genes, Cox regression model was used to build survival prognosis signature to distinguish the benefit group of radiotherapy. An external validation was also performed.

Results

In the developed dataset, MEbrown module with 534 genes was identified by WGCNA, which was most correlated to the radiotherapy response of patients. A number of 11 hub genes were selected to build the survival prognosis signature. Patients that were divided into radio-sensitivity group and radio-resistant group based on the signature risk score had varied survival benefit. In developed dataset, the 3-, 5-, and 10-year AUC of the signature were 0.814 (CI95%: 0.742–0.905), 0.781 (CI95%: 0.682–0.880), and 0.762 (CI95%: 0.626–0.897), respectively. In validation dataset, the 3- and 5-year AUC of the signature were 0.706 (CI95%: 0.523–0.889) and 0.743 (CI95%: 0.595–0.891). The signature had higher predictive power than clinical factors alone and had more clinical prognosis efficiency. Functional enrichment analysis revealed that the identified genes were mainly enriched in immune-related processes. Further immune estimated analysis showed the difference in distribution of immune micro-environment between radio-sensitivity group and radio-resistant group.

Conclusions

The 11-gene signature may reflect differences in tumor immune micro-environment that underlie the differential response to radiation therapy and could guide clinical-decision making related to radiation in breast cancer patients.

Mechanistic Understanding of Superoxide Radical-Mediated Degradation of Perfluorocarboxylic Acids

Perfluorocarboxylic acids (PFCAs) exhibit strong persistence in sunlit surface waters and in radical-based treatment processes, where superoxide radical (O₂^•-) is an important and abundant reactive oxygen species. Given that the role of O₂^•- during the transformation of PFCAs remains largely unknown, we investigated the kinetics and mechanisms of O₂^•--mediated PFCAs attenuation through complementary experimental and theoretical approaches. The aqueous-phase rate constants between O₂^•- and C3-C8 PFCAs were measured using a newly designed in situ spectroscopic system. Mechanistically, bimolecular nucleophilic substitution (S_N2) is most likely to be thermodynamically feasible, as indicated by density functional theory calculations at the CBS-QB3 level of theory. This pathway was then investigated by ab initio molecular dynamics simulation with free-energy samplings. As O₂^•- approaches PFCA, the C-F bond at the alpha carbon is spontaneously stretched, leading to the bond cleavage. The solvation mechanism for O₂^•--mediated PFCA degradation was also elucidated. Our results indicated that although the less polar solvent enhanced the nucleophilicity of O₂^•-, it also decreased the desolvation process of PFCAs, resulting in reduced kinetics. With these quantitative and mechanistic results, we achieved a defined picture of the O₂^•--initiated abatement of PFCAs in natural and engineered waters.

LncRNA UCA1 mediates Cetuximab resistance in Colorectal Cancer via the MiR-495 and HGF/c-MET Pathways

Background: Cetuximab is one of the most widely used monoclonal antibodies to treat patients with RAS/BRAF wild-type metastatic colorectal cancer (mCRC). Unfortunately, cetuximab resistance often occurs during targeted therapy. However, the underlying epigenetic mechanisms remain unclear. Our previous study demonstrated that the exosomal transfer of urothelial carcinoma-associated 1 (UCA1) confers cetuximab resistance to CRC cells. The goal of this study was to elucidate the detailed role of UCA1 in cetuximab resistance in CRC and the underlying molecular mechanism.

Methods:In vitro and in vivo functional studies were performed to assess the role of UCA1 in cetuximab resistance in CRC cell lines and xenograft models. Quantitative reverse transcription-polymerase chain reaction (qRT-PCR) was used to examine UCA1 localization and expression. Bioinformatics analysis was performed to predict the potential mechanism of UCA1, which was further validated by the dual-luciferase reporter assay and the RNA immunoprecipitation (RIP) assay. Cells treated with indicators were subjected to Cell Counting Kit-8 (CCK-8) and western blotting to investigate the role of hepatocyte growth factor (HGF)/c-mesenchymal-epithelial transition (c-MET) signalling in UCA1-mediated cetuximab resistance.

Results: We showed that UCA1 decreased CRC cell sensitivity to cetuximab by suppressing apoptosis. Mechanistic studies revealed that UCA1 promoted cetuximab resistance by competitively binding miR-495 to facilitate HGF and c-MET expression in CRC cells. Moreover, HGF was shown to attenuate the cetuximab-induced inhibition of cell proliferation by activating the HGF/c-MET pathway in CRC cells.

Conclusion: We provide the first evidence of a UCA1-miR-495-HGF/c-MET regulatory network involved in cetuximab resistance in CRC. Therefore, UCA1 has potential as a predictor and therapeutic target for cetuximab resistance.

Facile synthesis of Fe-modified lignin-based biochar for ultra-fast adsorption of methylene blue: Selective adsorption and mechanism studies

A novel Fe-modified lignin-based biochar (Fe-LB) was fabricated via a facile one-step carbonization method for methylene blue (MB) removal from wastewater. Fe-LB exhibited a high specific surface area (885.97 m²/g) and micropore volume (0.3203 m³/g), and demonstrated high affinity for MB with the maximum adsorption capacity of 2.7-fold by Fe-LB than LB. It was found that quick adsorption could be achieved in 15 min with the MB removal efficiency of 100% and adsorption capacity reached 200 mg/g. Selective adsorption studies indicated that Fe-LB preferentially adsorbed MB in high salt and multiple dye systems (binary, ternary, and quaternary) over a wide pH range from 2 to 12. The removal efficiency of CR was greatly improved due to the synergistic effect between MB and CR in the binary system. This work demonstrated that Fe-LB can effectively remove dye contaminants and possessed great potential in the treatment of MB polluted dye wastewater.

Fluorinate polyacrylic acid and its use as a potential adjuvant field

This study describes a polymer potentially used as a vaccine adjuvant. We first synthesized a novel polyacrylic acid modified by perfluorinated butanol—a bioactive compound that is biocompatible. The main aim was to functionalize the polyacrylic acid by fluorine. This functionalization could offer a permanent graft by an esterification reaction. The chemical structure of the polymer has been characterized by the hydrogen nuclear magnetic resonance spectrum (1H-NMR) and fourier transform infrared spectrum (FT-IR). Thermal analysis showed that the esterification reaction was successful on the polyacrylic acid. Viscosity testing showed that the viscosity of the sample aqueous solution increases along with esterification. The surface tension of the polymer was also tested. The results show that the surface tension of the polyacrylic acid markedly decreased when modified by fluorine. Finally, the interaction of these materials with macrophages was tested on cell test. Results showed that the modified polyacrylic acid performed better improve the activation effect than pure polyacrylic acid in 1L-1β.

Gold-catalyzed formal (3 + 2) and (4 + 2) cycloaddition reactions using propiolates: assembly of 2,3-dihydrofurans and 3,4-dihydropyrans via a multistep cascade process

A gold-catalyzed formal dipolar cycloaddition reaction was developed using polarized alkynes as dipolarophiles and butenediol or pentenediol derivatives as formal dipoles. Silyl groups were used to solve the selectivity issue of unsymmetrical diols.

Pembrolizumab versus chemotherapy for patients with esophageal squamous cell carcinoma enrolled in the randomized KEYNOTE-181 trial in Asia

BACKGROUND

In the randomized phase III KEYNOTE-181 study, pembrolizumab prolonged overall survival (OS) compared with chemotherapy as second-line therapy in patients with advanced esophageal cancer and programmed death-ligand 1 (PD-L1) combined positive score (CPS) ≥10. We report a post hoc subgroup analysis of patients with esophageal squamous cell carcinoma (ESCC) enrolled in KEYNOTE-181 in Asia, including patients from the KEYNOTE-181 China extension study.

PATIENTS AND METHODS

Three hundred and forty Asian patients with advanced/metastatic ESCC were enrolled in KEYNOTE-181, including the China cohort. Patients were randomly assigned 1 : 1 to receive pembrolizumab 200 mg every 3 weeks for ≤2 years or investigator's choice of paclitaxel, docetaxel, or irinotecan. OS, progression-free survival, response, and safety were analyzed without formal comparisons. OS was evaluated based on PD-L1 CPS expression level.

RESULTS

In Asian patients with ESCC, median OS was 10.0 months with pembrolizumab and 6.5 months with chemotherapy [hazard ratio (HR), 0.63; 95% CI 0.50-0.80; nominal P < 0.0001]. Median progression-free survival was 2.3 months with pembrolizumab and 3.1 months with chemotherapy (HR, 0.79; 95% CI 0.63-0.99; nominal P = 0.020). Objective response rate was 17.1% with pembrolizumab and 7.1% with chemotherapy; median duration of response was 10.5 months and 7.7 months, respectively. In patients with PD-L1 CPS <1 tumors (pembrolizumab versus chemotherapy), the HR was 0.99 (95% CI 0.56-1.72); the HR (95% CI) for death was better for patients with PD-L1 CPS cut-offs >1 [CPS ≥1, 0.57 (0.44-0.75); CPS ≥5, 0.56 (0.41-0.76); CPS ≥10, 0.53 (0.37-0.75)]. Treatment-related adverse events were reported in 71.8% of patients in the pembrolizumab group and 89.8% in the chemotherapy group; grade 3-5 events were reported in 20.0% and 44.6%, respectively.

CONCLUSIONS

Pembrolizumab monotherapy demonstrated promising efficacy in Asian patients with ESCC, with fewer treatment-related adverse events than chemotherapy. PD-L1 CPS ≥1 is an appropriate cut-off and a predictive marker of pembrolizumab efficacy in Asian patients with ESCC.

Discovery of tumor immune infiltration-related snoRNAs for predicting tumor immune microenvironment status and prognosis in lung adenocarcinoma

Lung adenocarcinoma (LUAD) has a high mortality rate and is difficult to diagnose and treat in its early stage. Previous studies have demonstrated that small nucleolar RNAs (snoRNAs) play a critical role in tumor immune infiltration and the development of a variety of solid tumors. However, there have been no studies on the correlation between tumor-infiltrating immune-related snoRNAs (TIISRs) and LUAD. In this study, we filtered six immune-related snoRNAs based on the tissue specificity index (TSI) and expression profile of all snoRNAs between all LUAD cell lines from the Cancer Cell Line Encyclopedia and 21 types of immune cells from the Gene Expression Omnibus database. Further, we performed real-time quantitative polymerase chain reaction (RT-qPCR) to validate the expression status of these snoRNAs on peripheral blood mononuclear cells (PBMCs) and lung cancer cell lines. Next, we developed a TIISR signature based on the expression profiles of snoRNAs from 479 LUAD patients filtered by the random survival forest algorithm. We then analyzed the value of this TIISR signature (TIISR risk score) for assessing tumor immune infiltration, immune checkpoint inhibitor (ICI) treatment response, and the prognosis of LUAD between groups with high and low TIISR risk score. Further, we found that the TIISR risk score groups showed significant differences in biological characteristics and that the risk score could be used to assess the level of tumor immune cell infiltration, thereby predicting prognosis and responsiveness to immunotherapy in LUAD patients.

Off-the-shelf Vδ1 gamma delta T cells engineered with glypican-3 (GPC-3)-specific chimeric antigen receptor (CAR) and soluble IL-15 display robust antitumor efficacy against hepatocellular carcinoma

BACKGROUND

Glypican-3 (GPC-3) is an oncofetal protein that is highly expressed in various solid tumors, but rarely expressed in healthy adult tissues and represents a rational target of particular relevance in hepatocellular carcinoma (HCC). Autologous chimeric antigen receptor (CAR) αβ T cell therapies have established significant clinical benefit in hematologic malignancies, although efficacy in solid tumors has been limited due to several challenges including T cell homing, target antigen heterogeneity, and immunosuppressive tumor microenvironments. Gamma delta (γδ) T cells are highly cytolytic effectors that can recognize and kill tumor cells through major histocompatibility complex (MHC)-independent antigens upregulated under stress. The Vδ1 subset is preferentially localized in peripheral tissue and engineering with CARs to further enhance intrinsic antitumor activity represents an attractive approach to overcome challenges for conventional T cell therapies in solid tumors. Allogeneic Vδ1 CAR T cell therapy may also overcome other hurdles faced by allogeneic αβ T cell therapy, including graft-versus-host disease (GvHD).

METHODS

We developed the first example of allogeneic CAR Vδ1 T cells that have been expanded from peripheral blood mononuclear cells (PBMCs) and genetically modified to express a 4-1BB/CD3z CAR against GPC-3. The CAR construct (GPC-3.CAR/secreted interleukin-15 (sIL)-15) additionally encodes a constitutively-secreted form of IL-15, which we hypothesized could sustain proliferation and antitumor activity of intratumoral Vδ1 T cells expressing GPC-3.CAR.

RESULTS

GPC-3.CAR/sIL-15 Vδ1 T cells expanded from PBMCs on average 20,000-fold and routinely reached >80% purity. Expanded Vδ1 T cells showed a primarily naïve-like memory phenotype with limited exhaustion marker expression and displayed robust in vitro proliferation, cytokine production, and cytotoxic activity against HCC cell lines expressing low (PLC/PRF/5) and high (HepG2) GPC-3 levels. In a subcutaneous HepG2 mouse model in immunodeficient NSG mice, GPC-3.CAR/sIL-15 Vδ1 T cells primarily accumulated and proliferated in the tumor, and a single dose efficiently controlled tumor growth without evidence of xenogeneic GvHD. Importantly, compared with GPC-3.CAR Vδ1 T cells lacking sIL-15, GPC-3.CAR/sIL-15 Vδ1 T cells displayed greater proliferation and resulted in enhanced therapeutic activity.

CONCLUSIONS

Expanded Vδ1 T cells engineered with a GPC-3 CAR and sIL-15 represent a promising platform warranting further clinical evaluation as an off-the-shelf treatment of HCC and potentially other GPC-3-expressing solid tumors.

Scalable Flexible Phase Change Materials with a Swollen Polymer Network Structure for Thermal Energy Storage

3D porous structural materials are proved to be enticing candidates for the fabrication of high-performance organic phase change materials (PCMs), but the stringent fabrication process and poor processability greatly hampered their commercialization. Herein, flexible leakage-proof composite PCMs with pronounced comprehensive performance are fabricated by a scalable polymer swelling strategy without using any solvent, in which the paraffin wax (PW) segment is confined in a robust flexible 3D polymer network, giving rise to the composite PCMs with excellent form stability even at 160 °C, a high latent heat energy storage density of 133.6 J/g, and an outstanding thermal conductivity of up to ∼5.11 W/mK. More importantly, the mass production of the flexible composite phase change fiber, film, and bulk products can be achieved by adopting mature processing technologies. These resultant composite PCMs exhibit promising thermal management ability to solve the overheating problem of electronics and high-efficiency solar-thermal energy conversion capacity.

Urinary complement proteins and risk of end-stage renal disease: quantitative urinary proteomics in patients with type 2 diabetes and biopsy-proven diabetic nephropathy

PURPOSE

To investigate the association between urinary complement proteins and renal outcome in biopsy-proven diabetic nephropathy (DN).

METHODS

Untargeted proteomic and Kyoto Encyclopedia of Genes and Genomes (KEGG) functional analyses and targeted proteomic analysis using parallel reaction-monitoring (PRM)-mass spectrometry was performed to determine the abundance of urinary complement proteins in healthy controls, type 2 diabetes mellitus (T2DM) patients, and patients with T2DM and biopsy-proven DN. The abundance of each urinary complement protein was individually included in Cox proportional hazards models for predicting progression to end-stage renal disease (ESRD).

RESULTS

Untargeted proteomic and functional analysis using the KEGG showed that differentially expressed urinary proteins were primarily associated with the complement and coagulation cascades. Subsequent urinary complement proteins quantification using PRM showed that urinary abundances of C3, C9, and complement factor H (CFAH) correlated negatively with annual estimated glomerular filtration rate (eGFR) decline, while urinary abundances of C5, decay-accelerating factor (DAF), and CD59 correlated positively with annual rate of eGFR decline. Furthermore, higher urinary abundance of CFAH and lower urinary abundance of DAF were independently associated with greater risk of progression to ESRD. Urinary abundance of CFAH and DAF had a larger area under the curve (AUC) than that of eGFR, proteinuria, or any pathological parameter. Moreover, the model that included CFAH or DAF had a larger AUC than that with only clinical or pathological parameters.

CONCLUSION

Urinary abundance of complement proteins was significantly associated with ESRD in patients with T2DM and biopsy-proven DN, indicating that therapeutically targeting the complement pathway may alleviate progression of DN.

Endoscopic-mediated, biliary hydrodynamic injection mediating clinically relevant levels of gene delivery in pig liver

BACKGROUND AND AIMS

Gene therapy could provide curative therapies to many inherited monogenic liver diseases. Clinical trials have largely focused on adeno-associated viruses (AAVs) for liver gene delivery. These vectors, however, are limited by small packaging size, capsid immune responses, and inability to redose. As an alternative, nonviral, hydrodynamic injection through vascular routes can successfully deliver plasmid DNA (pDNA) into mouse liver but has achieved limited success in large animal models.

METHODS

We explored hydrodynamic delivery of pDNA through the biliary system into the liver of pigs using ERCP and a power injector to supply hydrodynamic force. Human factor IX (hFIX), deficient in hemophilia B, was used as a model gene therapy.

RESULTS

Biliary hydrodynamic injection was well tolerated without significant changes in vital signs, liver enzymes, hematology, or histology. No off-target pDNA delivery to other organs was detected by polymerase chain reaction. Immunohistochemistry revealed that 50.19% of the liver stained positive for hFIX after hydrodynamic injection at 5.5 mg pDNA, with every hepatic lobule in all liver lobes demonstrating hFIX expression. hFIX-positive hepatocytes were concentrated around the central vein, radiating outward across all 3 metabolic zones. Biliary hydrodynamic injection in pigs resulted in significantly higher transfection efficiency than mouse vascular hydrodynamic injection at matched pDNA per liver weight dose (32.7%-51.9% vs 18.9%, P < .0001).

CONCLUSIONS

Biliary hydrodynamic injection using ERCP can achieve higher transfection efficiency into hepatocytes compared with AAVs at magnitudes of less cost in a clinically relevant human-sized large animal. This technology may serve as a platform for gene therapy of human liver diseases.

Role of hypobromous acid in the transformation of polycyclic aromatic hydrocarbons during chlorination

Hypobromous acid (HOBr), a highly reactive active species, can be formed and impact reaction processes with organic pollutants in source water during chlorination disinfection of the water containing bromide (Br-). In this study, we investigated the transformation kinetics of 10 parent polycyclic aromatic hydrocarbons (PAHs) and formation mechanisms of transformation products in the presence of Br- during chlorination. The results indicated that HOBr can accelerate the processes of electrophilic substitution (ES) and single electron transfer (ET) reactions in PAHs, and the second-order rate constants of HOBr are 10²-10³ times higher than those of hypochlorous acid (HOCl) with PAHs. HOBr was more conductive to induce ES reactions than HOCl. In water containing Br-, HOBr and HOCl dominate the reaction processes with PAHs, although other active bromine species may still affect reaction processes. In terms of transformation products, higher reactivity of HOBr results from faster formation of oxygenated PAHs (OPAHs) and halogenated PAHs (HPAHs) than HOCl. As an example of 3 model PAHs, anthracene transforms faster to its oxygenated products at a higher concentration, while pyrene and fluorene transform faster to halogenated products. These fundamental results were essential to understanding the transformation kinetics of PAHs and the formation of toxic disinfection by-products in the presence of Br-.

[Research progress of tannins in traditional Chinese medicines in recent ten years]

In this paper, the newly isolated tannins were sorted after a review of the literature concerning tannins in recent 10 years, and their research progress was summarized in terms of extraction, isolation, pharmacological activity and metabolism. Hydrolysable tannins and condensed tannins are the main structural types. Modern research shows that tannins have many pharmacological effects, such as bacteriostasis, antioxidation, antitumor, antivirus and blood glucose reduction, and have broad development prospects. They are usually extracted by water, ethanol and acetone and isolated and purified by macroporous resin and gel column chromatography. The packings commonly adopted for the column chromatography mainly included Sephadex LH-20, Diaion HP-20, MCI-gel CHP-20 and Toyopearl HW-40. Modern analytical techniques such as nuclear magnetic resonance spectroscopy(NMR), fast atom bombardment mass spectrometry(FAB-MS) and circular dichroism(CD) are generally used for the structural identification of tannins. Howe-ver, their isolation, purification and structural identification are still challenging. It is necessary to use a variety of high-throughput screening methods to explore their pharmacological activities and to explore the material basis responsible for their functions through experiments in vivo.

Anatomical knee variables result in worse outcomes of lateral meniscal allograft transplantation with discoid lateral menisci than with nondiscoid lateral menisci

PURPOSE

To compare the clinical results of meniscal allograft transplantation (MAT) between patients with discoid lateral meniscus (DLM) and non-DLM (NDLM) and to analyse whether anatomical deformities cause worse clinical results in DLM patients.

METHODS

Patients who underwent unilateral MAT from 2005 to 2017, including 115 patients with DLMs or NDLMs, were included in this study. Clinical outcomes [International Knee Documentation Committee (IKDC) scores, Lysholm scores, Tegner scores, and visual analogue scale (VAS) scores] and radiographic and MRI data were assessed. Clinical outcomes and anatomical knee variables were analysed by multivariate stepwise regression.

RESULTS

After more than 2 years of follow-up, 9 patients were lost to follow-up, and 59 patients with DLM and 47 patients with NDLM were included. The mean postoperative results were significantly better than the preoperative data (P < 0.05) in both the DLM and NDLM groups. In addition, postoperative IKDC, Lysholm, and VAS scores but not Tegner scores were better in the NDLM group than in the DLM group. Several anatomical knee variables differed significantly between the NDLM and DLM groups and were associated with MAT outcomes. The condylar prominence ratio of the lateral and medial femoral condyles adjacent to the intercondylar notch and squaring of the lateral femoral condyle (the distance of the straight articular condylar surface) were independent factors significantly correlated with the Lysholm scores for MAT at last follow-up.

CONCLUSION

MAT improved knee function in both patients with DLM and patients with NDLM, but patients NDLM had better clinical outcomes than patients with DLM. The condylar prominence ratio and squaring of the lateral femoral condyle may underlie this result.

LEVEL OF EVIDENCE

III.