Randomized phase II adjuvant trial to compare two treatment durations of icotinib (2 years versus 1 year) for stage II-IIIA EGFR-positive lung adenocarcinoma patients (ICOMPARE study)

BACKGROUND

Despite the prolonged median disease-free survival (DFS) by adjuvant targeted therapy in non-small-cell lung cancer patients with epidermal growth factor receptor (EGFR) mutations, the relationship between the treatment duration and the survival benefits in patients remains unknown.

PATIENTS AND METHODS

In this multicenter, randomized, open-label, phase II trial, eligible patients aged 18-75 years with EGFR-mutant, stage II-IIIA lung adenocarcinoma and who had not received adjuvant chemotherapy after complete tumor resection were enrolled from eight centers in China. Patients were randomly assigned (1 : 1) to receive either 1-year or 2-year icotinib (125 mg thrice daily). The primary endpoint was DFS assessed by investigator. The secondary endpoints were overall survival (OS) and safety. This study was registered at ClinicalTrials.gov (NCT01929200).

RESULTS

Between September 2013 and October 2018, 109 patients were enrolled (1-year group, n = 55; 2-year group, n = 54). Median DFS was 48.9 months [95% confidence interval (CI) 33.1-70.1 months] in the 2-year group and 32.9 months (95% CI 26.6-44.8 months) in the 1-year group [hazard ratio (HR) 0.51; 95% CI 0.28-0.94; P = 0.0290]. Median OS for patients was 75.8 months [95% CI 64.4 months-not evaluable (NE)] in the 2-year group and NE (95% CI 66.3 months-NE) in the 1-year group (HR 0.34; 95% CI 0.13-0.95; P = 0.0317). Treatment-related adverse events (TRAEs) were observed in 41 of 55 (75%) patients in the 1-year group and in 36 of 54 (67%) patients in the 2-year group. Grade 3-4 TRAEs occurred in 4 of 55 (7%) patients in the 1-year group and in 3 of 54 (6%) patients in the 2-year group. No treatment-related deaths or interstitial lung disease was reported.

CONCLUSIONS

Two-year adjuvant icotinib was shown to significantly improve DFS and provide an OS benefit in EGFR-mutant, stage II-IIIA lung adenocarcinoma patients compared with 1-year treatment in this exploratory phase II study.

Glutamine metabolic microenvironment drives M2 macrophage polarization to mediate trastuzumab resistance in HER2-positive gastric cancer

BACKGROUND

Trastuzumab is a first-line targeted therapy for human epidermal growth factor receptor-2 (HER2)-positive gastric cancer. However, the inevitable occurrence of acquired trastuzumab resistance limits the drug benefit, and there is currently no effective reversal measure. Existing researches on the mechanism of trastuzumab resistance mainly focused on tumor cells themselves, while the understanding of the mechanisms of environment-mediated drug resistance is relatively lacking. This study aimed to further explore the mechanisms of trastuzumab resistance to identify strategies to promote survival in these patients.

METHODS

Trastuzumab-sensitive and trastuzumab-resistant HER2-positive tumor tissues and cells were collected for transcriptome sequencing. Bioinformatics were used to analyze cell subtypes, metabolic pathways, and molecular signaling pathways. Changes in microenvironmental indicators (such as macrophage, angiogenesis, and metabolism) were verified by immunofluorescence (IF) and immunohistochemical (IHC) analyses. Finally, a multi-scale agent-based model (ABM) was constructed. The effects of combination treatment were further validated in nude mice to verify these effects predicted by the ABM.

RESULTS

Based on transcriptome sequencing, molecular biology, and in vivo experiments, we found that the level of glutamine metabolism in trastuzumab-resistant HER2-positive cells was increased, and glutaminase 1 (GLS1) was significantly overexpressed. Meanwhile, tumor-derived GLS1 microvesicles drove M2 macrophage polarization. Furthermore, angiogenesis promoted trastuzumab resistance. IHC showed high glutamine metabolism, M2 macrophage polarization, and angiogenesis in trastuzumab-resistant HER2-positive tumor tissues from patients and nude mice. Mechanistically, the cell division cycle 42 (CDC42) promoted GLS1 expression in tumor cells by activating nuclear factor kappa-B (NF-κB) p65 and drove GLS1 microvesicle secretion through IQ motif-containing GTPase-activating protein 1 (IQGAP1). Based on the ABM and in vivo experiments, we confirmed that the combination of anti-glutamine metabolism, anti-angiogenesis, and pro-M1 polarization therapy had the best effect in reversing trastuzumab resistance in HER2-positive gastric cancer.

CONCLUSIONS

This study revealed that tumor cells secrete GLS1 microvesicles via CDC42 to promote glutamine metabolism, M2 macrophage polarization, and pro-angiogenic function of macrophages, leading to acquired trastuzumab resistance in HER2-positive gastric cancer. A combination of anti-glutamine metabolism, anti-angiogenesis, and pro-M1 polarization therapy may provide a new insight into reversing trastuzumab resistance.

Beyond canonical PROTAC: biological targeted protein degradation (bioTPD)

Targeted protein degradation (TPD) is an emerging therapeutic strategy with the potential to modulate disease-associated proteins that have previously been considered undruggable, by employing the host destruction machinery. The exploration and discovery of cellular degradation pathways, including but not limited to proteasomes and lysosome pathways as well as their degraders, is an area of active research. Since the concept of proteolysis-targeting chimeras (PROTACs) was introduced in 2001, the paradigm of TPD has been greatly expanded and moved from academia to industry for clinical translation, with small-molecule TPD being particularly represented. As an indispensable part of TPD, biological TPD (bioTPD) technologies including peptide-, fusion protein-, antibody-, nucleic acid-based bioTPD and others have also emerged and undergone significant advancement in recent years, demonstrating unique and promising activities beyond those of conventional small-molecule TPD. In this review, we provide an overview of recent advances in bioTPD technologies, summarize their compositional features and potential applications, and briefly discuss their drawbacks. Moreover, we present some strategies to improve the delivery efficacy of bioTPD, addressing their challenges in further clinical development.

Sensory Features of Partially Hydrogenated Oil and Their Connection with Melting and Crystalline Characteristics

Although partially hydrogenated oil (PHO) provides foods with outstanding thick tastes and pronounced "creamy" flavor, the high level of artificial trans-fatty acids (TFA; about 30%) limits its usages around the world in the near future. It is necessary to produce trans-free alternatives with similar tastes to PHO. The relationship between sensory attributes and physicochemical characteristics of PHO and four typical specialty fats were therefore analyzed in the present study. PHO exhibited the highest greasiness score (8.19), accompanying by mild creaminess and aftertaste as well as a weak coolness during swallow, which were resulted from the close-packed arrangements of TFA, its cis-counterparts and other long chain fatty acids. None of artificial trans-fats, mainly anhydrous milk fat, cocoa butter, and coconut oil and its fully hydrogenated counterpart, were similar to PHO in terms of these sensory attributes. The unique fatty acid species of PHO and their arrangements contributed to the relatively smooth solid fat content profile and melting-crystallization curve, as well as forming uniform and dense β' crystal-structures (D_b=1.80). The Pearson correlation analyses relevelled that long chain fatty acids, e.g., t-C18:1 and C18:1, and melting final temperatures were generally positive correlated with greasiness, creaminess and aftertaste; whereas these indices were negatively correlated with coolness. The melting enthalpy was highly connected with coolness, which reflected the endothermic effectiveness during the melting process of fats in the mouth. These indices screened by correlation analyses that were strongly correlated with sensory attributes could provide references for producing trans-free alternatives.

Recent development in multizonal scaffolds for osteochondral regeneration

Osteochondral (OC) repair is an extremely challenging topic due to the complex biphasic structure and poor intrinsic regenerative capability of natural osteochondral tissue. In contrast to the current surgical approaches which yield only short-term relief of symptoms, tissue engineering strategy has been shown more promising outcomes in treating OC defects since its emergence in the 1990s. In particular, the use of multizonal scaffolds (MZSs) that mimic the gradient transitions, from cartilage surface to the subchondral bone with either continuous or discontinuous compositions, structures, and properties of natural OC tissue, has been gaining momentum in recent years. Scrutinizing the latest developments in the field, this review offers a comprehensive summary of recent advances, current hurdles, and future perspectives of OC repair, particularly the use of MZSs including bilayered, trilayered, multilayered, and gradient scaffolds, by bringing together onerous demands of architecture designs, material selections, manufacturing techniques as well as the choices of growth factors and cells, each of which possesses its unique challenges and opportunities.

Effectiveness of remimazolam besylate combined with alfentanil for fiberoptic bronchoscopy with preserved spontaneous breathing: a prospective, randomized, controlled clinical trial

OBJECTIVE

The novel short-acting benzodiazepine remimazolam besylate acts rapidly and is used to induce easily controlled sedation. The aim of this study was to investigate the effects of remimazolam besylate combined with alfentanil in patients undergoing fiberoptic bronchoscopy with preserved spontaneous breathing.

PATIENTS AND METHODS

192 patients undergoing painless fiberoptic bronchoscopy were randomly assigned to either propofol (P group) or remimazolam besylate (R group); both groups also received alfentanil 10 µg/kg. The respiratory rate was recorded during the inspection. Mean arterial pressure (MAP), heart rate (HR), oxygen saturation (SpO2), Narcotrend values and Modified Observer's Assessment of Alertness and Sedation (MOAA/S) scores were recorded after entry to the operating room (T0), 1 min (T1), 2 min (T2) and 3 min (T3) after anesthesia, immediately after the bronchoscope entered the vocal cords (T4), when the bronchoscope reached the carina (T5), the patient's eyes opened (T6), and 30 min postoperatively (T7). Secondary outcomes included intraoperative hypotension and body movement grading, etc. RESULTS: There was less respiratory depression during the inspection in the R group than in the P group (p < 0.01). The rate of hypotension during the examination was higher in the P group than in the R group (p < 0.01). Narcotrend values in the P group were less for the R group at the T1-T5 time points (p < 0.01). No difference in the number of body movements ≥ grade 3 was found between the two groups (p > 0.05).

CONCLUSIONS

Remimazolam besylate combined with alfentanil for painless fiberoptic bronchoscopy can better preserve the patient's spontaneous breathing and reduce the incidence of respiratory depression during the inspection than propofol.

One-dimensional nanomaterials for cancer therapy and diagnosis

One-dimensional (1-D) nanomaterials possess unique shape-dependent phyicochemical properties and are increasingly recognized as promising materials for nanotechnology. 1-D nanomaterials can be classified according to their shape, such as nanorods, nanotubes, nanowires, self-assembled nanochains, etc., and have been applied in electronics, photonics, and catalysis. The biological characteristics of 1-D nanomaterials, including high drug loading efficiency, prolonged blood circulation, the ability to capture cancer cells, unique cellular uptake mechanisms, efficient photothermal conversion, and material tunability, have aided in extending their potential to biomedical applications, particularly in cancer therapy and diagnosis. This review highlights a novel perspective on emerging 1-D nanomaterials for cancer therapy and diagnosis by introducing the definition of 1-D nanomaterials, their shape-dependent physicochemical properties, biomedical applications, and recent advances in cancer therapy and diagnosis. This review also proposes unexplored potential nanomaterial types and therapeutic applications for 1-D nanomaterials. In particular, the most significant and exciting advances in recent years, including ultrasound-enabled sonodynamic therapy, magnetic field-based therapy, and bioresponsive 1-D nanomaterials for intracellular self-assembly in situ, are discussed along with novel therapeutic concepts, such as piezoelectric 1-D nanomaterials, nanozyme-based nanomedicine, and others.

Blending Low-Frequency Vibrations and Push-pull Effects Affords Superior Photoacoustic Imaging Agents

Photoacoustic imaging (PAI), a state-of-the-art noninvasive in vivo imaging technique, has been widely used in clinical disease diagnosis. However, the design of high-performance PAI agents with three key characteristics, i.e., near-infrared (NIR) absorption (λabs > 800 nm), intense PA signals, and excellent photostability, remains a challenging goal. Herein, we present a facile but effective approach for engineering PAI agents by amplifying intramolecular low-frequency vibrations and enhancing the push-pull effect. As a demonstration of this blended approach, we constructed a PAI agent (BDP1-NEt2) based on the boron-dipyrromethene (BODIPY) scaffold. Compared with indocyanine green (ICG, an FDA-approved organic dye widely utilized in PAI studies; λabs = 788 nm), BDP1-NEt2 exhibited a UV-Vis-NIR spectrum peaked at 825 nm, superior in vivo PA signal intensity and outstanding stability to offer improved tumor diagnostics. We believe this work provides a promising strategy to develop the next generation of PAI agents.

A high spatial resolution dataset of China's biomass resource potential

Assessing biomass resource potential is essential for China's ambitious goals of carbon neutrality, rural revitalization, and poverty eradication. To fill the data gap of high spatial resolution biomass resources in China, this study estimates the biomass resource potential for all types of lignocellulosic biomass feedstock at 1 km resolution in 2018, including 9 types of agricultural residues, 11 types of forestry residues, and 5 types of energy crops. By combining the statistical accounting method and the GIS-based method, this study develops a transparent and comprehensive assessment framework, which is in accordance with the principle of food security, forest land and pasture protection, and biodiversity protection. In the end, we organize and store the data in different formats (GeoTIFF, NetCDF, and Excel) for GIS users, integrated modelers, and policymakers. The reliability of this high spatial resolution dataset has been proved by comparing the aggregated data at the subnational and national levels with the existing literature. This dataset has numerous potential uses and is a crucial input to many bioenergy-related studies.

New charge transfer-based organic room temperature phosphorescent trace doping systems

A series of room temperature phosphorescent doping systems were constructed. Benzothiazole groups containing heteroatoms (S, N) and heavy atoms (Br) were applied as the host. Their charge-transfered luminescence mechanism was revealed by molecular dynamics simulations and molecular cluster calculations. Additionally, BCN/BT's excellent anti-counterfeiting performance demonstrated their application potential.

Comparison between the influence of roxadustat and recombinant human erythropoietin treatment on blood pressure and cardio-cerebrovascular complications in patients undergoing peritoneal dialysis

Introduction

Roxadustat treatment in PD patients is equivalent to ESAs in increasing hemoglobin (Hb). But blood pressure, cardiovascular parameters, cardio-cerebrovascular complications and prognosis in the two groups before and after treatment has not been sufficiently discussed.

Methods

Sixty PD patients who were treated with roxadustat for renal anemia in our PD center recruited from June 2019 to April 2020 as roxadustat group. PD patients treated with rHuEPO were enrolled at a 1:1 ratio as rHuEPO group using the method of propensity score matching. Hb, blood pressure, cardiovascular parameters, cardio-cerebrovascular complications and prognosis were compared between the two group. All patients were followed up for at least 24 months.

Results

There were no significant differences in baseline clinical data or laboratory values between roxadustat group and rHuEPO group. After 24 months of follow-up, there was no significant difference in Hb levels (p > 0.05). There were no significant changes in blood pressure, or the incidence of nocturnal hypertension before and after treatment in roxadustat group (p > 0.05), while blood pressure significantly increased in rHuEPO group after treatment (p < 0.05). Compared with roxadustat group after follow-up, rHuEPO group had a higher incidence of hypertension, the levels of cardiovascular parameters were worse and cardio-cerebrovascular complications had a higher incidence (p < 0.05). Cox regression analysis showed age, systolic blood pressure, fasting blood glucose, and rHuEPO use before baseline were risk factors for cardio-cerebrovascular complications in PD patients, while treatment with roxadustat was a protective factor for cardiovascular and cerebrovascular complications.

Conclusion

Compared with rHuEPO, roxadustat had less influence on blood pressure or cardiovascular parameters, and it was associated with a lower risk of cardio-cerebrovascular complications in patients undergoing PD. Roxadustat has a cardio-cerebrovascular protective advantage in PD patients with renal anemia.

Klotho enhances bone regenerative function of hPDLSCs via modulating immunoregulatory function and cell autophagy

BACKGROUND

Human periodontal ligament stem cells (hPDLSCs) have a superior ability to promote the formation of new bones and achieve tissue regeneration. However, mesenchymal stem cells (MSCs) are placed in harsh environments after transplantation, and the hostile microenvironment reduces their stemness and hinders their therapeutic effects. Klotho is an antiaging protein that participates in the regulation of stress resistance. In our previous study, we demonstrated the protective ability of Klotho in hPDLSCs.

METHODS

A cranial bone defect model of rats was constructed, and the hPDLSCs with or without Klotho pretreatment were transplanted into the defects. Histochemical staining and micro-computed tomography were used to detect cell survival, osteogenesis, and immunoregulatory effects of hPDLSCs after transplantation. The in vitro capacity of hPDLSCs was measured by a macrophage polarization test and the inflammatory level of macrophages. Furthermore, we explored autophagy activity in hPDLSCs, which may be affected by Klotho to regulate cell homeostasis.

RESULTS

Pretreatment with the recombinant human Klotho protein improved cell survival after hPDLSC transplantation and enhanced their ability to promote bone regeneration. Furthermore, Klotho pretreatment can promote stem cell immunomodulatory effects in macrophages and modulate cell autophagy activity, in vivo and in vitro.

CONCLUSION

These findings suggest that the Klotho protein protects hPDLSCs from stress after transplantation to maintain stem cell function via enhancing the immunomodulatory ability of hPDLSCs and inhibiting cell autophagy.

Effects of urban living environments on mental health in adults

Urban-living individuals are exposed to many environmental factors that may combine and interact to influence mental health. While individual factors of an urban environment have been investigated in isolation, no attempt has been made to model how complex, real-life exposure to living in the city relates to brain and mental health, and how this is moderated by genetic factors. Using the data of 156,075 participants from the UK Biobank, we carried out sparse canonical correlation analyses to investigate the relationships between urban environments and psychiatric symptoms. We found an environmental profile of social deprivation, air pollution, street network and urban land-use density that was positively correlated with an affective symptom group (r = 0.22, Pperm < 0.001), mediated by brain volume differences consistent with reward processing, and moderated by genes enriched for stress response, including CRHR1, explaining 2.01% of the variance in brain volume differences. Protective factors such as greenness and generous destination accessibility were negatively correlated with an anxiety symptom group (r = 0.10, Pperm < 0.001), mediated by brain regions necessary for emotion regulation and moderated by EXD3, explaining 1.65% of the variance. The third urban environmental profile was correlated with an emotional instability symptom group (r = 0.03, Pperm < 0.001). Our findings suggest that different environmental profiles of urban living may influence specific psychiatric symptom groups through distinct neurobiological pathways.

Explore traffic conflict risks considering motion constraint degree in the diverging area of toll plazas

In the diverging area of toll plazas, the absence of lane markings, the gradual widening of lanes, and the crossing of vehicles with different tolling methods increase the likelihood of collisions. This study proposed a concept of motion constraint degree to investigate traffic conflict risks in the toll plaza diverging area. On the basis of the motion constraint degree, a two-step method was developed, in which all potentially influencing factors were separated into two parts. The first part was used to analyze the association between the motion constraint degree and some factors, while the remaining factors were utilized for risk regression/prediction together with the motion constraint degree. The random parameters logit model was applied for regression analysis and four prevalent machine learning models were employed for risk prediction. Results indicate that (1) the proposed approach considering motion constraint degree outperforms the conventional direct method, no matter for conflict risk regression or prediction; (2) the motion constraint degree is not monotonically correlated with the risk level of vehicles; (3) due to the layout of the toll plaza, ETC vehicles are less likely to be at risk in the diverging area; and (4) lane-changing behaviors in the restricted space increase the conflict risk.

Utility of Photon-Counting Detector CT Myelography for the Detection of CSF-Venous Fistulas

CSF-venous fistulas are an increasingly recognized type of CSF leak that can be particularly challenging to detect, even with recently improved imaging techniques. Currently, most institutions use decubitus digital subtraction myelography or dynamic CT myelography to localize CSF-venous fistulas. Photon-counting detector CT is a relatively recent advancement that has many theoretical benefits, including excellent spatial resolution, high temporal resolution, and spectral imaging capabilities. We describe 6 cases of CSF-venous fistulas detected on decubitus photon-counting detector CT myelography. In 5 of these cases, the CSF-venous fistula was previously occult on decubitus digital subtraction myelography or decubitus dynamic CT myelography using an energy-integrating detector system. All 6 cases exemplify the potential benefits of photon-counting detector CT myelography in identifying CSF-venous fistulas. We suggest that further implementation of this imaging technique will likely be valuable to improve the detection of fistulas that might otherwise be missed with currently used techniques.

2,4-Dinitrotoluene (2,4-DNT) exposure induces liver developmental damage and perturbs lipid metabolism and oxygen transport gene expression in zebrafish (Danio rerio)

2,4-Dinitrotoluene (2, 4-DNT) is a common environmental pollutant. The toxic effect on mammals of 2,4-DNT has been well studied, but its toxicity on aquatic organisms is little known. In this study, 126 healthy female zebrafish (Danio rerio) were exposed to different concentrations of 2,4-DNT (0, 2, 4, 8, 12 and 16 mg/L) to determine 96-h semi-lethal concentrations (LC₅₀). And then, 90 female zebrafish were exposed to 0, 2, 4 and 8 mg/L 2,4-DNT for 5 days to study liver toxicity. Exposed zebrafish developed hypoxia features, such as floating head and breathing rapidly, and then died. 96-h LC₅₀ of 2,4-DNT in zebrafish was 9.36 mg/L. Histological data revealed that 2,4-DNT severely damaged the liver tissues, following with the round nucleus, dense interstitial tissue, dense arranged hepatocyte cords and more inflammatory cells. Additionally, the further result showed that the lower levels of lipid transport and metabolism (apoα2, mtp, ppar-α and acox) were noticed. But, exposed to 2,4-DNT for 5 days significantly upregulated the expression levels of genes involved in respiration (hif1a, tfa and ho1, p < 0.05). These results indicated that 2,4-DNT exposure disturbed lipid transport and metabolism and oxygen supply in zebrafish, which could contribute to severe damage in liver and death.

[RITA selectively inhibits proliferation of BAP1-deficient cutaneous melanoma cells in vitro]

OBJECTIVE

To screen for small molecular compounds with selective inhibitory activity against cutaneous melanoma cells with BAP1 deletion.

METHODS

Cutaneous melanoma cells expressing wild-type BAP1 were selected to construct a BAP1 knockout cell model using CRISPR-Cas9 system, and small molecules with selective inhibitory activity against BAP1 knockout cells were screened from a compound library using MTT assay. Rescue experiment was carried out to determine whether the sensitivity of BAP1 knockout cells to the candidate compounds was directly related to BAP1 deletion. The effects of the candidate compounds on cell cycle and apoptosis were detected with flow cytometry, and the protein expressions in the cells were analyzed with Western blotting.

RESULTS

The p53 activator RITA from the compound library was shown to selectively inhibit the viability of BAP1 knockout cells. Overexpression of wild-type BAP1 reversed the sensitivity of BAP1 knockout cells to RITA, while overexpression of the mutant BAP1 (C91S) with inactivated ubiquitinase did not produce any rescue effect. Compared with the control cells expressing wild-type BAP1, BAP1 knockout cells were more sensitive to RITA-induced cell cycle arrest and apoptosis (P < 0.0001) and showed an increased expression of p53 protein, which was further increased by RITA treatment (P < 0.0001).

CONCLUSION

Loss of BAP1 results in the sensitivity of cutaneous melanoma cells to p53 activator RITA. In melanoma cells, the activity of ubiquitinase in BAP1 is directly related to their sensitivity to RITA. An increased expression of p53 protein induced by BAP1 knockout is probably a key reason for RITA sensitivity of melanoma cells, suggesting the potential of RITA as a targeted therapeutic agent for cutaneous melanoma carrying BAP1-inactivating mutations.

The hemoglobin, albumin, lymphocyte, and platelet (HALP) is a potent indicator for the prognosis in hemodialysis patients

The hemoglobin, albumin, lymphocyte, and platelet (HALP) values were marked as a original index of general nutritional and inflammatory conditions. The purpose of this investigation was to evaluate the potential relationship between HALP and prognosis in hemodialysis (HD) patients. Patients with maintenance HD from multiple dialysis centers in China were retrospectively analyzed. The primary poor outcome were cardiovascular disease (CVD) and all-cause death. The computational equation of HALP values as the follows: hemoglobin (g/L) × albumin (g/L) × lymphocytes (/L)/ platelets (/L). All participants were divided into Tertile 1, Tertile 2, and Tertile 3 according to the tertiles of baseline HALP values. The Kaplan-Meier curve and the Cox regression was done to figure out the relationship about HALP and adverse outcomes. The restricted cubic splines further identified the possible associations. The time-dependent receiver operating characteristic curve and C-index were implemented for evaluate the predictive values of the HALP composite model. There were 4796 patients incorporate into ultimate study. Compared with patients in Tertile 1, patients in Tertile 3 had an lower risk of all-cause mortality [hazard ratios = 0.66, 95% confidence intervals: 0.49-0.86, P = .007] and CVD mortality [sub-distribution hazard ratio = 0.51, 95% confidence intervals: 0.34-0.80, P = .005]. The composite model with the supplement of HALP outperformed the traditional factor model in the time-dependent receiver operating characteristic curve. High HALP values at baseline are related to a diminished risk of CVD death and all-cause death in HD patients. HALP is a novel and potent index for the prognosis of HD patients.

C(alkyl)-C(vinyl) bond cleavage enabled by Retro-Pallada-Diels-Alder reaction

Activation and cleavage of carbon-carbon (C-C) bonds is a fundamental transformation in organic chemistry while inert C-C bonds cleavage remains a long-standing challenge. Retro-Diels-Alder (retro-DA) reaction is a well-known and important tool for C-C bonds cleavage but less been explored in methodology by contrast to other strategies. Herein, we report a selective C(alkyl)-C(vinyl) bond cleavage strategy realized through the transient directing group mediated retro-Diels-Alder reaction of a six-membered palladacycle, which is obtained from an in situ generated hydrazone and palladium hydride species. This unprecedented strategy exhibits good tolerances and thus offers new opportunities for late-stage modifications of complex molecules. DFT calculations revealed that an intriguing retro-Pd(IV)-Diels-Alder process is possibly involved in the catalytic cycle, thus bridging both Retro-Diels-Alder reaction and C-C bond cleavage. We anticipate that this strategy should prove instrumental for potential applications to achieve the modification of functional organic skeletons in synthetic chemistry and other fields involving in molecular editing.

Carbon Nitride Pillared Vanadate Via Chemical Pre-Intercalation Towards High-PerformanceAqueous Zinc-Ion Batteries

Vanadium compounds are promising cathode materials for aqueous zinc-ion batteries (AZIBs) due to their high specific capacity. However, the narrow interlayer spacing, low intrinsic conductivity and the vanadium dissolution still restrict their further application. Herein, we present an oxygen-deficient vanadate pillared by carbon nitrides (C3N4) as the cathode for AZIBs through a facile self-engaged hydrothermal strategy. Of note, C3N4 nanosheets can act as both the nitrogen source and pre-intercalation species to transform the orthorhombic V2O5 into layered NH4V4O10 with expanded interlayer spacing. Owing to the pillared structure and abundant oxygen vacancies, both the Zn2+ ion (de)intercalation kinetics and the ionic conductivity in the NH4V4O10 cathode are promoted. As a result, the NH4V4O10 cathode delivers exceptional Zn-ion storage ability with a high specific capacity of 398.7 mAh g-1 at 0.5 A g-1, a high-rate capability of 194.7 mAh g-1 at 20 A g-1 and a stable cycling performance of 10000 cycles.

Simultaneously improving the efficiencies of photo- and thermal isomerization of an oxindole-based light-driven molecular rotary motor by a structural redesign

We designed a novel highly efficient light-driven molecular rotary motor theoretically by using electronic structure calculations and nonadiabatic dynamics simulations, and it showed excellent performance for both photo- and thermal isomerization processes simultaneously. By the small structural modification based on 3-(2,7-dimethyl-2,3-dihydro-1H-inden-1-ylidene)-1-methylindolin-2-one (DDIYM) synthesized by Feringa et al. recently, an oxindole-based light-driven molecular rotary motor, 3-(1,5-dimethyl-4,5-dihydrocyclopenta[b]pyrrol-6(1H)-ylidene)-1-methylindolin-2-one (DDPYM), is proposed, which displays a significant electronic push-pull character and weak steric hindrance for double-bond isomerization. The newly designed motor DDPYM shows a remarkable improvement of the quantum yield for both EP → ZM and ZP → EM photoisomerization processes, compared to the original motor DDIYM. Furthermore, the rotary motion in photoisomerization processes of DDPYM behaves more like a pure axial rotational motion approximately, while that of DDIYM is an obvious precessional motion. The weakness of the steric hindrance reduces the energy barriers of the thermal helix EM → EP and ZM → ZP inversion steps, and would accelerate two ground-state isomerization steps significantly. Our results confirm the feasibility of simultaneously improving the efficiencies of photo- and thermal isomerization of oxindole-based light-driven molecular rotary motors and this design idea sheds light on the future development of more efficient molecular motors.

Global age-structured spatial modeling for emerging infectious diseases like COVID-19

Modeling the global dynamics of emerging infectious diseases (EIDs) like COVID-19 can provide important guidance in the preparation and mitigation of pandemic threats. While age-structured transmission models are widely used to simulate the evolution of EIDs, most of these studies focus on the analysis of specific countries and fail to characterize the spatial spread of EIDs across the world. Here, we developed a global pandemic simulator that integrates age-structured disease transmission models across 3,157 cities and explored its usage under several scenarios. We found that without mitigations, EIDs like COVID-19 are highly likely to cause profound global impacts. For pandemics seeded in most cities, the impacts are equally severe by the end of the first year. The result highlights the urgent need for strengthening global infectious disease monitoring capacity to provide early warnings of future outbreaks. Additionally, we found that the global mitigation efforts could be easily hampered if developed countries or countries near the seed origin take no control. The result indicates that successful pandemic mitigations require collective efforts across countries. The role of developed countries is vitally important as their passive responses may significantly impact other countries.

Ionic Liquid "Water Pocket" for Stable and Environment-Adaptable Aqueous Zinc Metal Batteries

The strong reactivity of water in aqueous electrolytes toward metallic zinc (Zn), especially at aggressive operating conditions, remains the fundamental obstacle to the commercialization of aqueous zinc metal batteries (AZMBs). Here, a water-immiscible ionic liquid diluent 1-ethyl-3-methylimidazolium bis(fluorosulfonyl)amide (EmimFSI) is reported that can substantially suppress the water activity of aqueous electrolyte by serving as a "water pocket", enveloping the highly active H₂ O-dominated Zn²⁺ solvates and protecting them from parasitic reactions. During Zn deposition, the cation Emim⁺ and anion FSI^- function respectively in mitigating the tip effect and regulating the solid electrolyte interphase (SEI), thereby favoring a smooth Zn deposition layer protected by inorganic species-enriched SEI featuring high uniformity and stability. Combined with the boosted chemical/electrochemical stability endowed by the intrinsic merits of ionic liquid, this ionic liquid-incorporated aqueous electrolyte (IL-AE) enables the stable operation of Zn||Zn_0.25 V₂ O₅ ·nH₂ O cells even at a challenging temperature of 60 °C (>85% capacity retention over 400 cycles). Finally, as an incidental but practically valuable benefit, the near-zero vapor pressure nature of ionic liquid allows the efficient separation and recovery of high-value components from the spent electrolyte via a mild and green approach, promising the sustainable future of IL-AE in realizing practical AZMBs.

Factors affecting the toxicity and oxidative stress of layered double hydroxide-based nanomaterials in freshwater algae

Layered double hydroxide (LDH) nanomaterials are utilized extensively in numerous fields because of their distinctive structural properties. It is critical to understand the environmental behavior and toxicological effects of LDHs to address potential concerns caused by their release into the environment. In this work, the toxicological effects of two typical LDHs (Mg-Al-LDH and Zn-Al-LDH) on freshwater green algae (Scenedesmus obliquus) and the main affecting factors were examined. The Zn-Al-LDH exhibited a stronger growth inhibition toxicity than the Mg-Al-LDH in terms of median effect concentration. This toxicity difference was connected to the stability of particle dispersion in water and the metallic composition of LDHs. The contribution of the dissolved metal ions to the overall toxicity of the LDHs was lower than that of their particulate forms. Moreover, the joint toxic action of different dissolved metal ions in each LDH belonged to additive effects. The Mg-Al-LDH induced a stronger oxidative stress effect in algal cells than the Zn-Al-LDH, and mitochondrion was the main site of LDH-induced production of reactive oxygen species. Scanning electron microscope observation indicated that both LDHs caused severe damage to the algal cell surface. At environmentally relevant concentrations, the LDHs exhibited joint toxic actions with two co-occurring contaminants (oxytetracycline and nano-titanium dioxide) on S. obliquus in an additive manner mainly. These findings emphasize the impacts of the intrinsic nature of LDHs, the aqueous stability of LDHs, and other environmental contaminants on their ecotoxicological effects.

A Biodegradable, Waterproof, and Thermally Processable Cellulosic Bioplastic Enabled by Dynamic Covalent Modification

The growing environmental concern over petrochemical-based plastics continuously promotes the exploration of green and sustainable substitute materials. Compared with petrochemical products, cellulose has overwhelming superiority in terms of availability, cost, and biodegradability; however, cellulose's dense hydrogen-bonding network and highly ordered crystalline structure make it hard to be thermoformed. A strategy to realize the partial disassociation of hydrogen bonds in cellulose and the reassembly of cellulose chains via constructing a dynamic covalent network, thereby endowing cellulose with thermal processability as indicated by the observation of a moderate glass transition temperature (T_g  = 240 °C), is proposed. Moreover, the cellulosic bioplastic delivers a high tensile strength of 67 MPa, as well as excellent moisture and solvent resistance, good recyclability, and biodegradability in nature. With these advantageous features, the developed cellulosic bioplastic represents a promising alternative to traditional plastics.