Deep-potential enabled multiscale simulation of gallium nitride devices on boron arsenide cooling substrates

High-efficient heat dissipation plays critical role for high-power-density electronics. Experimental synthesis of ultrahigh thermal conductivity boron arsenide (BAs, 1300 W m-1K-1) cooling substrates into the wide-bandgap semiconductor of gallium nitride (GaN) devices has been realized. However, the lack of systematic analysis on the heat transfer across the GaN-BAs interface hampers the practical applications. In this study, by constructing the accurate and high-efficient machine learning interatomic potentials, we perform multiscale simulations of the GaN-BAs heterostructures. Ultrahigh interfacial thermal conductance of 260 MW m-2K-1 is achieved, which lies in the well-matched lattice vibrations of BAs and GaN. The strong temperature dependence of interfacial thermal conductance is found between 300 to 450 K. Moreover, the competition between grain size and boundary resistance is revealed with size increasing from 1 nm to 1000 μm. Such deep-potential equipped multiscale simulations not only promote the practical applications of BAs cooling substrates in electronics, but also offer approach for designing advanced thermal management systems.

Global burden of head and neck cancers from 1990 to 2019

Head and neck cancer (HNC) exerts a significant healthcare burden worldwide. Insufficient data impedes a comprehensive understanding of its global impact. Through analysis of the 2019 Global Burden of Disease (GBD) database, our secondary investigation unveiled a surging global incidence of HNC, yet a decline in associated mortality and disability-adjusted life years (DALYs) owing to enhanced prognosis. Particularly noteworthy is the higher incidence of escalation among females compared to males. Effective resource allocation, meticulous control of risk factors, and tailored interventions are imperative to curtail mortality rates among young individuals afflicted with HNC in underprivileged regions, as well as in elderly individuals grappling with thyroid cancer.

Association between multiple sleep dimensions in obstructive sleep apnea and the early sign of atherosclerosis

STUDY OBJECTIVES

We investigated the associations between multiple sleep dimensions in obstructive sleep apnea (OSA) and carotid intima-media thickness (CIMT), an early sign of atherosclerosis, in subjects from the Shanghai Sleep Health Study (SSHS).

METHODS

We performed secondary analysis of SSHS in a group of subjects performed the ultrasound evaluation from 2018 to 2022. Multiple sleep dimensions were measured using standard polysomnography. CIMT was measured from ultrasound images as an early sign of atherosclerosis. Multivariable-adjusted linear regression and logistic regression analyses were performed to detect associations between sleep traits in OSA and CIMT.

RESULTS

CIMT was found to increase with increasing severity of OSA (P < 0.001). When adjusted for conventional risk factors, microarousal index (MAI) and hypoxic burden (HB) were positively correlated with CIMT while slow wave sleep (SWS) and mean apnea-hypopnea event duration (MAHD) showed negative correlation with CIMT (all P < 0.01). In binary logistic regression analysis, participants with high MAI, less SWS, higher HB and shorter MAHD showed a higher prevalence of thick CIMT with no evidence of interaction by age, sex, or body mass index (P-interaction > 0.05).

CONCLUSIONS

Subjects with more severe sleep fragmentation, more severe hypoxemia and increased arousability were more likely to have increased CIMT after adjusting for potential confounders. It is important to evaluate novel indices of sleep fragmentation, hypoxemia and arousability in OSA for early detection and prevention of cardiovascular disease, including stroke.

CLINICAL TRIAL REGISTRATION

Chinese Clinical Trial Registry; URL: http://www.chictr.org.cn/showproj.aspx?proj=43057; No. ChiCTR1900025714.

Integrating artificial intelligence into the modernization of traditional Chinese medicine industry: a review

Traditional Chinese medicine (TCM) is the practical experience and summary of the Chinese nation for thousands of years. It shows great potential in treating various chronic diseases, complex diseases and major infectious diseases, and has gradually attracted the attention of people all over the world. However, due to the complexity of prescription and action mechanism of TCM, the development of TCM industry is still in a relatively conservative stage. With the rise of artificial intelligence technology in various fields, many scholars began to apply artificial intelligence technology to traditional Chinese medicine industry and made remarkable progress. This paper comprehensively summarizes the important role of artificial intelligence in the development of traditional Chinese medicine industry from various aspects, including new drug discovery, data mining, quality standardization and industry technology of traditional Chinese medicine. The limitations of artificial intelligence in these applications are also emphasized, including the lack of pharmacological research, database quality problems and the challenges brought by human-computer interaction. Nevertheless, the development of artificial intelligence has brought new opportunities and innovations to the modernization of traditional Chinese medicine. Integrating artificial intelligence technology into the comprehensive application of Chinese medicine industry is expected to overcome the major problems faced by traditional Chinese medicine industry and further promote the modernization of the whole traditional Chinese medicine industry.

Spindle Epithelial Tumor With Thymus-Like Differentiation of Thyroid (SETTLE): A Case Report and Literature Review

Spindle epithelial tumor with thymus-like differentiation of thyroid (SETTLE) is very rare neoplasm with 2 cellular forms, epithelial cell and spindle cell, and most reported cases have been in young people. An 11-year-old boy presented with painless swelling of the right neck lasting for more than 2 months. A tumor size measuring approximately 3 × 3 cm was resected, and intraoperative frozen pathology suggested a spindle cell tumor, which was confirmed as SETTLE by immunohistochemical staining and external hospital consultation. The immunohistochemical staining profile of the resected tumor tissue was as follows: cytokeratin (CK) (+), smooth muscle actin (weak+), vimentin (+), CK7 (focal+), B-cell lymphoma 2 (partial+), CD99 (-), calcitonin (+), galectin-3 (+), CK19 (+), and Ki-67 (10%+). Ultrasound at 1-year postoperative follow-up revealed no local recurrence of the lesion or lymph node metastasis in the thyroid gland. We summarized the disease characteristics of SETTLE among 6 cases reported to date and found that SETTLE is associated with a good prognosis and low postoperative recurrence rate. Thus, for this type of malignant thyroid tumor, diagnosis depends mainly on postoperative pathology and immunohistochemical staining and simple surgical resection is recommended.

Intraoperative brainstem auditory evoked potential monitoring during cerebellopontine angle surgery via retrosigmoid approach

OBJECTIVES

Brainstem auditory evoked potential (BAEP) monitoring was used to identify the influence of auditory function during cerebellopontine angle (CPA) surgery for cranial neuropathy via the retrosigmoid approach.

METHODS

This prospective study included 20 patients who underwent CPA surgery for cranial neuropathy via the retrosigmoid approach with intraoperative BAEP monitoring and pure tone audiometry (PTA). The latency and interpeak latency were analyzed at each surgical step in combination with the pre- and postoperative PTA.

RESULTS

Follow-up data were available for 17 patients. The mean pre- and postoperative PTA values were 25.65 dB and 20.70 dB, respectively. Two patients (2/17, 11.76%) developed hearing loss postoperatively. The latency of wave І significantly changed during direct auditory nerve manipulation and at the end of the surgery, while that of wave III only changed during direct auditory nerve manipulation. The appearance of wave V peak was delayed during CPA surgery.

CONCLUSIONS

CPA surgery for cranial neuropathy via the retrosigmoid approach can cause hearing loss to varying degrees, and intraoperative BAEP monitoring can reduce the occurrence of hearing loss. Intraoperative hearing function can be estimated by the latency of wave I. Hearing loss due to stretching of the brainstem can be estimated by the latency of wave III, and wave V is an early indicator of intraoperative hearing loss. Waves I and III remained stable both pre- and postoperatively, whereas wave V was unstable despite no surgery. Therefore, a precise operation and well-defined operative steps for surgeons during CPA surgery could facilitate maximal preservation of the anatomical structure and function.

Metabolomics of Extracellular Vesicles: A Future Promise of Multiple Clinical Applications

Extracellular vesicles (EVs) can contain DNA, RNA, proteins and metabolic molecules from primary origins; they are coated with a phospholipid bilayer membrane and released by cells into the extracellular matrix. EVs can be obtained from various body liquids, including the blood, saliva, cerebrospinal fluid, and urine. As has been proved, EVs-mediated transfer of biologically active molecules is crucial for various physiological and pathological processes. Extensive investigations have already begun to explore the diagnosis and prognosis potentials for EVs. Furthermore, research has continued to recognize the critical role of nucleic acids and proteins in EVs. However, our understanding of the comprehensive effects of metabolites in these nanoparticles is currently limited and in its infancy. Therefore, we have attempted to summarize the recent research into the metabolomics of EVs in relation to potential clinical applications and discuss the problems and challenges that have occurred, to provide more guidance for the future development in this field.

Identification of a novel gene signature of lung adenocarcinoma based on epidermal growth factor receptor-tyrosine kinase inhibitor resistance

INTRODUCTION

Tyrosine kinase inhibitors (TKIs) that target epidermal growth factor receptor (EGFR) mutations are commonly administered to EGFR-positive lung cancer patients. However, resistance to EGFR-TKIs (mostly gefitinib and erlotinib) is presently a significant problem. Limited studies have focused on an EGFR-TKI resistance-related gene signature (ERS) in lung adenocarcinoma (LUAD).

METHODS

Gefitinib and erlotinib resistance-related genes were obtained through the differential analyses of three Gene Expression Omnibus datasets. These genes were investigated further in LUAD patients from The Cancer Genome Atlas (TCGA). Patients in the TCGA-LUAD cohort were split into two groups: one for training and one for testing. The training cohort was used to build the ERS, and the testing cohort was used to test it. GO and KEGG analyses were explored for the enriched pathways between the high-risk and low-risk groups. Various software, mainly CIBERSORT and ssGSEA, were used for immune infiltration profiles. Somatic mutation and drug sensitivity analyses were also explored.

RESULTS

An ERS based on five genes (FGD3, PCDH7, DEPDC1B, SATB2, and S100P) was constructed and validated using the TCGA-LUAD cohort, resulting in the significant stratification of LUAD patients into high-risk and low-risk groups. Multivariable Cox analyses confirmed that ERS had an independent prognostic value in LUAD. The pathway enrichment analyses showed that most of the genes that were different between the two risk groups were related to the immune system. Further immune infiltration results revealed that a lower immune infiltration score was observed in high-risk patients, and that various leukocytes were significantly related to the ERS. Importantly, samples from the high-risk group showed lower levels of PD-1, PD-L1, and CTLA-4, which are important biomarkers for immunotherapy responses. Patients in the high-risk group also had more gene mutation changes and were more sensitive to chemotherapy drugs like docetaxel and sorafenib. The ERS was also validated in the GSE30219, GSE11969 and GSE72094, and showed a favorable prognostic value for LUAD patients.

DISCUSSION

The ERS established during this study was able to predict a poor prognosis for LUAD patients and had great potential for predicting drug responses.

Analysis of the Failure of Removal of the Urinary Catheter for Patients With Intracerebral Hemorrhage Postoperatively

BACKGROUND

We conducted this study to assess the value of clinically relevant data for predicting the failure of removing urinary catheters among patients with intracerebral hemorrhage postoperatively.

MATERIALS AND METHODS

We retrospectively analyzed the medical records of all patients with intracerebral hemorrhage who underwent surgery for removal of intracerebral hematoma between January 2014 and December 2019, all of whom retained their urinary catheter. The patients were classified into 2 groups. Group A included patients who underwent successful removal of the catheter while group B included patients who underwent a failed removal. Univariate analysis was performed to determine the relationship between the failure of catheter removal and the patients' preoperative clinical characteristics. Independent prognostic predictors were identified using multivariate analyses.

RESULTS

The site of intracerebral hematoma ( P =0.004), volume of hematoma ( P <0.001), intraventricular hemorrhage ( P <0.001), admitted Glasgow Coma Scale (GCS) ( P <0.001), GCS before urinary catheter removal ( P <0.001), smoking ( P =0.011), herniation ( P <0.001), urine protein ( P =0.013), creatinine ( P =0.037), and timing of urinary catheter removal ( P <0.001) were significantly different among the 2 groups. Multiple logistical regression analysis indicated that GCS before urinary catheter removal (odds ratio=1.171; 95% confidence interval=1.050-1.306; P =0.005) and timing for urinary catheter removal (odds ratio=0.962; 95% confidence interval=0.944-0.981; P <0.001) were associated with failure of urinary catheter removal.

CONCLUSIONS

This study demonstrated that GCS before urinary catheter removal and the timing of urinary catheter removal are independent factors associated with failure of urinary catheter removal among patients with intracerebral hemorrhage.

Exploration of a Novel Circadian miRNA Pair Signature for Predicting Prognosis of Lung Adenocarcinoma

Lung adenocarcinoma (LUAD) is the primary histological subtype of lung cancer with a markedly heterogeneous prognosis. Therefore, there is an urgent need to identify optimal prognostic biomarkers. We aimed to explore the value of the circadian miRNA (cmiRNA) pair in predicting prognosis and guiding the treatment of LUAD. We first retrieved circadian genes (Cgenes) from the CGDB database, based on which cmiRNAs were predicted using the miRDB and mirDIP databases. The sequencing data of Cgenes and cmiRNAs were retrieved from TCGA and GEO databases. Two random cmiRNAs were matched to a single cmiRNA pair. Finally, univariate Cox proportional hazard analysis, LASSO regression, and multivariate Cox proportional hazard analysis were performed to develop a prognostic signature consisting of seven cmiRNA pairs. The signature exhibited good performance in predicting the overall and progression-free survival. Patients in the high-risk group also showed lower IC50 values for several common chemotherapy and targeted medicines. In addition, we constructed a cmiRNA–Cgenes network and performed a corresponding Gene Ontology and Gene Set enrichment analysis. In conclusion, the novel circadian-related miRNA pair signature could provide a precise prognostic evaluation with the potential capacity to guide individualized treatment regimens for LUAD.

Auricular Malignant Proliferating Trichilemmal Tumor: A Case Report

Malignant proliferating trichilemmal tumor (MPTT) is a dermal adnexal tumor originated from the external root sheath of hair follicles. In this article, we reported a rare case of auricular MPTT in a 65-year-old male with gradually enlarging and bleeding mass on the right auricle measuring 30 × 20 × 12 mm in size and detailed the surgical strategy for therapy. The diagnosis of MPTT was established primarily by histopathological observation with abrupt keratinization, cytological atypia, abnormal mitoses, and infiltrating margins. Following extensive excision, no recurrence was noted for 14 months. We also discuss its clinicopathological features, differential diagnoses, and treatment methods and review the relevant literature in this regard.

Electrically-driven robust tuning of lattice thermal conductivity

The two-dimensional (2D) materials, represented by graphene, stand out in the electrical industry applications of the future and have been widely studied. As commonly existing in electronic devices, the electric field has been extensively utilized to modulate the performance. However, how the electric field regulates thermal transport is rarely studied. Herein, we investigate the modulation of thermal transport properties by applying an external electric field ranging from 0 to 0.4 V Å^-1, with bilayer graphene, monolayer silicene, and germanene as study cases. The monotonically decreasing trend of thermal conductivity in all three materials is revealed. A significant effect on the scattering rate is found to be responsible for the decreased thermal conductivity driven by the electric field. Further evidence shows that the reconstruction of internal electric field and generation of induced charges lead to increased scattering rate from strong phonon anharmonicity. Thus, the ultralow thermal conductivity emerges with the application of external electric fields. Applying an external electric field to regulate thermal conductivity illustrates a constructive idea for highly efficient thermal management.

Study on Instant Delivery Service Riders' Safety and Health by the Effects of Labour Intensity in China: A Mediation Analysis

The Instant Delivery Service (IDS) riders' overwork by “self-pressurisation” will not only reduce the level of their physical and mental health but also lose their lives in safety accidents caused by their fatigue riding. The purpose of this article is to examine whether there is overwork among IDS riders in big and medium cities in China? What's going on with them? Based on the Cobb-Douglas production function in the input-output theory, this study characterised the factors on IDS riders' safety and health associated with labour intensity. A mediating model with moderating effect was adopted to describe the mediation path for the 2,742 IDS riders who were surveyed. The results of moderating regression demonstrated that (1) 0.4655 is the total effect of labour intensity on the safety and health of IDS riders. (2) 0.3124 is the moderating effect that working hours make a greater impact on labour intensity. (3) The mediating effect of work pressure is the principal means of mediation both upstream and downstream.

Collaborative Construction of a Silver Nanocluster Fluorescent Probe Using the Pyridinium-Based Ionic Liquid [C4py][DCA]

A silver nanocluster fluorescent probe was synthesized by using the pyridinium-based ionic liquid [C₄py][DCA] as the protective agent, AgNO₃ as the precursor, and NaBH₄ as the reducing agent. The presence of pyridine group enhanced the fluorescence intensity of Ag nanoclusters and facilitated the coordination interaction between Ag nanoclusters and AsO₃ ^3-. Therefore, the collaborative construction of a silver nanocluster probe using the pyridinium-based ionic liquid [C₄py][DCA] offered outstanding selectivity and sensitivity to detect AsO₃ ^3- in water. More interestingly, the fluorescent probe quenched by AsO₃ ^3- could be recovered with the addition of H₂O₂. This fluorescent probe provided a rapid and superior method for the detection of As(III) in the linear concentration range of 0-60 ppb with the lowest detection limit of 0.60 ppb. The mechanism of fluorescence quenching was a static quenching, considered to be due to electron migration between functional groups on the surface of Ag nanoclusters constructed with [C₄py][DCA] and AsO₃ ^3-.

Accessing negative Poisson's ratio of graphene by machine learning interatomic potentials

The negative Poisson's ratio (NPR) is a novel property of materials, which enhances the mechanical feature and creates a wide range of application prospects in lots of fields, such as aerospace, electronics, medicine, etc. Fundamental understanding on the mechanism underlying NPR plays an important role in designing advanced mechanical functional materials. However, with different methods used, the origin of NPR is found different and conflicting with each other, for instance, in the representative graphene. In this study, based on machine learning technique, we constructed a moment tensor potential for molecular dynamics (MD) simulations of graphene. By analyzing the evolution of key geometries, the increase of bond angle is found to be responsible for the NPR of graphene instead of bond length. The results on the origin of NPR are well consistent with the start-of-art first-principles, which amend the results from MD simulations using classic empirical potentials. Our study facilitates the understanding on the origin of NPR of graphene and paves the way to improve the accuracy of MD simulations being comparable to first-principle calculations. Our study would also promote the applications of machine learning interatomic potentials in multiscale simulations of functional materials.

Targeting Cancer Cell Ferroptosis to Reverse Immune Checkpoint Inhibitor Therapy Resistance

In recent years, cancer therapies using immune checkpoint inhibitors (ICIs) have achieved meaningful success, with patients with advanced tumors presenting longer survival times and better quality of life. However, several patients still do not exhibit good clinical outcomes for ICI therapy due to low sensitivity. To solve this, researchers have focused on identifying the cellular and molecular mechanisms underlying resistance to ICI therapy. ICI therapy induces apoptosis, which is the most frequent regulated cell death (RCD) but lacks immunogenicity and is regarded as an “immune silent” cell death. Ferroptosis, a unique type of non-apoptotic-RCD, has been preliminarily identified as an immunogenic cell death (ICD), stimulating tumor-antigen-specific immune responses and augmenting anti-tumor immune effects. However, ferroptosis has rarely been used in clinical practice. Present evidence strongly supports that the interferon-γ signaling pathway is at the crossroads of ICI therapy and ferroptosis. TYRO3, a receptor tyrosine kinase, is highly expressed in tumors and can induce anti-programmed cell death (PD)-ligand 1/PD-1 therapy resistance by limiting tumoral ferroptosis. Therefore, in this review, we summarize the clinical practice and effects of ICI therapy in various cancers. We also provide an overview of ferroptosis and report the molecular connections between cancer cell ferroptosis and ICI therapy, and discuss the possibility to reverse ICI therapy resistance by inducing cancer cell ferroptosis.

Selective synergistic anticancer effects of cisplatin and oridonin against human p53-mutant esophageal squamous carcinoma cells

Oridonin (ORI) is known to pose anticancer activity against cancer, which could induce the therapeutic impact of chemotherapy drugs. However, such simple combinations have numerous side effects such as higher toxicity to normal cells and tissues. To enhance the therapeutic effects with minimal side effects, here we used ORI in combination with cisplitin (CIS) against different esophageal squamous cell carcinoma (ESCC) cell lines in vitro, to investigate the synergistic anticancer effects of the two drugs against ESCC. Calcusyn Graphing Software was used to assess the synergistic effect. Apoptosis, wound healing and cell invasion assay were conducted to further confirm the synergistic effects of ORI and CIS. Intracellular glutathione (GSH) and reactive oxygen species assay, immunofluorescence staining and western blot were used to verify the mechanism of synergistic cytotoxicity. ORI and CIS pose selective synergistic effects on ESCC cells with p53 mutations. Moreover, we found that the synergistic effects of these drugs are mediated by GSH/ROS systems, such that intracellular GSH production was inhibited, whereas the ROS generation was induced following ORI and CIS application. In addition, we noted that DNA damage was induced as in response to ORI and CIS treatment. Overall, these results suggest that ORI can synergistically enhance the effect of CIS, and GSH deficiency and p53 mutation, might be biomarkers for the combinational usage of ORI and CIS.

Unique Arrangement of Atoms Leads to Low Thermal Conductivity: A Comparative Study of Monolayer Mg2C

Two-dimensional Mg₂C, one of the typical representative MXene materials, is attracting lots of attention due to its outstanding properties. In this study, we find the thermal conductivity of monolayer Mg₂C is more than 2 orders of magnitude lower than graphene and is even lower than MoS₂ despite the relatively lighter atoms of Mg and C. Based on the comparative analysis with graphene, silicene, and MoS₂, the underlying mechanism is found lying in the unique arrangement of atoms (lighter atoms in the middle plane) and large electronegativity difference in Mg₂C. The phonon anharmonicity is strong due to the resonant bonding. In addition, dual band gaps emerge in the phonon dispersion of Mg₂C, which limit the phonon-phonon scattering and reduce the phonon relaxation time. This study reveals a new mechanism responsible for low thermal conductivity, which would be helpful for designing thermal functional materials and pave the way for applications in thermoelectrics.

Shared Cultural Values Influence Mental Health Help-Seeking Behaviors in Asian and Latinx College Students

The current study sought to understand the influence of cultural values on mental health attitudes and help-seeking behaviors in college students of diverse ethnic backgrounds. Asian and Latinx college students (N = 159) completed an online survey in which they reported on their adherence to cultural values as measured by ethnicity-specific cultural values and general attitudes towards mental health. Factor analysis revealed two common factors of cultural values irrespective of ethnicity: Interdependent Orientation (IO) and Cultural Obligation (CO). Regardless of ethnicity, the more students endorsed IO values, the less likely they were to perceive a need for mental health treatment. IO value adherence was also predictive of more negative attitudes towards mental health. CO values were not predictive of perceived need or help-seeking behaviors. Findings highlight the importance of understanding shared cultural values across ethnic-racial groups and considering how the multidimensionality of culture may help explain shared mental health behaviors crossing lines of ethnic group membership.

Study on the Fluidization Quality Characterization Method and Process Intensification of Fine Coal Separation in a Vibrated Dense Medium Fluidized Bed

Uniform and stable bed density is the basis of efficient coal separation by a gas-solid dense medium fluidized bed. The traditional air dense medium fluidized bed (ADMFB) is a kind of bubbling bed. By introducing vibration energy, a vibrated dense medium fluidized bed (VDMFB) with uniform and stable bed density can be formed, where the bubble merger is suppressed, the gas-solid contact can is strengthened, and the fluidization quality is also improved. In this paper, the transfer process of vibration energy in a fluidized bed is studied in detail. By calculating the coherence of pressure signals induced by vibration energy and bubbles at different bed heights, the suppression effect of vibration energy on bubble merger is analyzed. The coefficient R _imp to quantitatively evaluate the improvement effect of vibration energy on the fluidization quality is proposed. The differences and incentives of density uniformity and stability in different height bed areas have been clarified under different vibration parameters and gas flow parameters. It is proposed that the optimal separation bed height area of VDMFB is about H = 40-150 mm. The separation effect of the ADMFB and the VDMFB on 1-6 mm fine coal was compared. The results show that, compared with the ADMFB, the VDMFB reduces the separation probable error, E, from 0.134 to 0.083 g/cm³, and the ash content of the clean coal is reduced from 18.83 to 14.97%. The vibration energy significantly improves the fluidization quality of the ADMFB and the separation effect of fine coal.

Is oseltamivir suitable for fighting against COVID-19: In silico assessment, in vitro and retrospective study

BACKGROUND

Oseltamivir is a first-line antiviral drug, especially in primary hospitals. During the ongoing outbreak of coronavirus disease 2019 (COVID-19), most patients with COVID-19 who are symptomatic have used oseltamivir. Considering its popular and important role as an antiviral drug, it is necessary to evaluate oseltamivir in the treatment of COVID-19.

OBJECTIVE

To evaluate the effect of oseltamivir against COVID-19.

METHODS

Swiss-model was used to construct the structure of the N-terminal RNA-binding domain (NRBD) of the nucleoprotein (NC), papain-like protease (PLpro), and RNA-directed RNA polymerase (RdRp) of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). TM-align program was performed to compare the structure of the viral proteins with the structure of the neuraminidase of influenza A. Molecular docking was used to analyze the theoretical possibility of effective binding of oseltamivir with the active centers of the viral proteins. In vitro study was used to evaluate the antiviral efficiency of oseltamivir against SARS-CoV-2. By clinical case analysis, we statistically evaluated whether the history of oseltamivir use influenced the progression of the disease.

RESULTS

The structures of NRBD, PLpro, and RdRp were built successfully. The results from TM-align suggested that the S protein, NRBD, 3C-like protease (3CLpro), PLPrO, and RdRp were structurally similar to the influenza A neuraminidase, with TM-scores of 0.30077, 0.19254, 0.28766, 0.30666, and 0.34047, respectively. Interestingly, the active center of 3CL pro was found to be similar to the active center from the neuraminidase of influenza A. Through an analysis of molecular docking, we discovered that oseltamivir carboxylic acid was more favorable to bind to the active site of 3CLpro effectively, but its inhibitory effect was not strong compared with the positive group. Finally, we used in vitro study and retrospective case analysis to verify our speculations. We found that oseltamivir is ineffective against SARS-CoV-2 in vitro study and the clinical use of oseltamivir did not improve the patients' symptoms and signs and did not slow the disease progression.

CONCLUSIONS

We consider that oseltamivir isn't suitable for the treatment of COVID-19. During the outbreak of novel coronavirus, when oseltamivir is not effective for the patients after they take it, health workers should be highly vigilant about the possibility of COVID-19.

A New Proposal for Severity Evaluation of Menière's Disease by Using the Evidence From a Comprehensive Battery of Auditory and Vestibular Tests

To date, no widely accepted criteria exist to quantify the severity of Menière's disease (MD) by using vestibular tests. This study aimed to compare association of hearing loss and vertigo severity with association of accurate assessments of vestibular function and the vertigo severity. The severity of vertigo was documented by a comprehensive medical history with number of vertigo attacks in the past 6 months and a Dizziness Handicap Inventory (DHI) questionnaire. The involvement of vestibular organs was verified by audio-vestibular tests in 80 definite MD patients. Correlations between DHI scores, number of vertigo attacks in the past 6 months, audio-vestibular function, and the number of involved vestibular end organs were evaluated. We show that there are no significant differences in either severity of vertigo or laboratory results across the degree of hearing loss. Furthermore, the number of involved vestibular end organs was significantly correlated with vestibulo-ocular reflex gain in anterior and posterior canal video head impulse test (vHIT), interaural asymmetry ratio in vestibular-evoked myogenic potentials (VEMPs), and number of vertigo attacks in the past 6 months and DHI score. The vestibulo-ocular reflex gain in the rotatory chair test (RCT) was significantly correlated with the DHI Physical scores and number of involved vestibular end organs at 0.08 Hz. These results indicate that hearing loss is a poor indicator of vertigo severity in MD whereas the number of involved vestibular end organs may serve as an objective measure for MD progress. A battery of vestibular tests targeting different sensor organs is a complementary method for evaluating inner ear deficits and may aid in "grading" the severity of MD.

Development and validation of a risk factor-based system to predict short-term survival in adult hospitalized patients with COVID-19: a multicenter, retrospective, cohort study

BACKGROUND

Coronavirus disease 2019 (COVID-19) has become a public health emergency of global concern. We aimed to explore the risk factors of 14-day and 28-day mortality and develop a model for predicting 14-day and 28-day survival probability among adult hospitalized patients with COVID-19.

METHODS

In this multicenter, retrospective, cohort study, we examined 828 hospitalized patients with confirmed COVID-19 hospitalized in Wuhan Union Hospital and Central Hospital of Wuhan between January 12 and February 9, 2020. Among the 828 patients, 516 and 186 consecutive patients admitted in Wuhan Union Hospital were enrolled in the training cohort and the validation cohort, respectively. A total of 126 patients hospitalized in Central Hospital of Wuhan were enrolled in a second external validation cohort. Demographic, clinical, radiographic, and laboratory measures; treatment; proximate causes of death; and 14-day and 28-day mortality are described. Patients' data were collected by reviewing the medical records, and their 14-day and 28-day outcomes were followed up.

RESULTS

Of the 828 patients, 146 deaths were recorded until May 18, 2020. In the training set, multivariate Cox regression indicated that older age, lactate dehydrogenase level over 360 U/L, neutrophil-to-lymphocyte ratio higher than 8.0, and direct bilirubin higher than 5.0 μmol/L were independent predictors of 28-day mortality. Nomogram scoring systems for predicting the 14-day and 28-day survival probability of patients with COVID-19 were developed and exhibited strong discrimination and calibration power in the two external validation cohorts (C-index, 0.878 and 0.839).

CONCLUSION

Older age, high lactate dehydrogenase level, evaluated neutrophil-to-lymphocyte ratio, and high direct bilirubin level were independent predictors of 28-day mortality in adult hospitalized patients with confirmed COVID-19. The nomogram system based on the four factors revealed good discrimination and calibration, suggesting good clinical utility.

1041 Sleep Quality Mediates The Relationship Between Fear Of Cancer Recurrence And Psychological Distress In Young Adults With Cancer

Introduction

Fear of cancer recurrence is common in young adults with cancer and also related to poorer psychological outcomes. Sleep may be disrupted by anxious thoughts about cancer, causing long-term psychological distress. Thus, the current study tests sleep as a putative mediator of the association between fear of cancer recurrence and overall psychological distress in young adult cancer survivors.

Methods

In a national cross-sectional survey of Canadians, 436 young adults diagnosed with cancer between the ages of 15-39 (current age range 20-39, m=32.39, SD=4.70; 88% female) completed the Pittsburgh Sleep Quality Index, the Fear of Cancer Recurrence Inventory—Short Form, and the Kessler 10 Distress Inventory. Mediation was estimated using PROCESS. Age, sex, and on/off treatment status were entered into models as covariates.

Results

In the current sample, average fear of cancer recurrence was above the clinical cut-point (m=22.92, SD=6.84), psychological distress was high (m=25.18, SD=7.81), and sleep quality was poor (m=9.11, SD=3.95). Females reported significantly higher fear of cancer recurrence than males [F(1, 435)=15.49, p &lt;.001]. Patients on treatment reported significantly higher fear of cancer recurrence [F(1,435)=11.43, p=.001], poorer sleep quality [F(1,435)=6.48, p=.011], and greater psychological distress [F(1,435)=4.73, p &lt;.001] than patients off treatment. Using a bootstrapping model with covariates, higher fear of cancer recurrence was related to poorer sleep quality and, in turn, higher psychological distress as indicated by the indirect effect’s confidence interval not containing 0 (indirect effect=.13; 95%CI=0.081, 0.189).

Conclusion

Sleep quality may play an important role in connecting the common experience of fear of cancer recurrence to psychological distress in young adult cancer survivors. Future longitudinal research is needed to examine this possible mediator of young adult cancer patients’ psychological distress outcomes over time.

Support

This research was supported by a grant from the Newfoundland and Labrador Support for People and Patient-Oriented Research and Trials (NL-SUPPORT) Unit. Sheila Garland is supported by a Scotiabank New Investigator Award from the Beatrice Hunter Cancer Research Institute (BHCRI).

Value of serum tumor markers for predicting EGFR mutations and positive ALK expression in 1089 Chinese non-small-cell lung cancer patients: A retrospective analysis

PURPOSE

The role of serum tumor markers (STMs) in the modern management of epidermal growth factor receptor (EGFR) and anaplastic lymphoma kinase (ALK) mutations in lung cancer remains poorly described. In this study, we investigated whether STMs could be a valuable noninvasive tool to predict EGFR mutations and ALK positivity in non-small-cell lung cancer (NSCLC) patients.

EXPERIMENTAL DESIGN

We retrospectively reviewed and included 1089 NSCLC patients who underwent EGFR or ALK mutation testing and STMs measurement prior to treatment. The differences in several clinical characteristics and STMs between the subgroups were analyzed. Multivariate logistic regression analysis was performed to identify predictors of EGFR mutations and ALK positivity.

RESULTS

EGFR mutations were found more frequently in females (63.11%), never-smokers (59.69%), and those with lung adenocarcinoma (ADC) (53.87%). Negative carbohydrate antigen (CA) 125, ferritin (FERR), squamous cell carcinoma antigen (SCC), and soluble fragment of cytokeratin 19 (CYFRA 21-1) levels were significantly associated with EGFR mutations (p < 0.05). Multivariate analysis demonstrated that ADC, never-smoker status, and negative CA 125 and SCC results were predictors of EGFR mutations (p < 0.05). The receiver operating characteristic (ROC) curve yielded an area under the curve (AUC) of 0.715 (95% confidence interval [CI]: 0.673-0.758) for the combination of the four factors. Positive ALK expression was found more frequently in younger patients (median age: 49 years), females (8.40%), never-smokers (8.82%), and those negative for carcinoembryonic antigen (CEA) (8.02%). Multivariate analysis demonstrated that younger age and never-smoker status were the only independent predictors of ALK positivity (p < 0.05). The ROC curve yielded an AUC of 0.760 (95% CI: 0.677-0.844) for the combination of these two factors.

CONCLUSION

STMs are associated with mutant EGFR status and could be integrated with other clinical factors to enhance the ability to distinguish EGFR mutation status among NSCLC patients. For ALK-positive patients, younger age and never-smoker status could predict the mutation status, whereas STMs could not.

[Diagnostic value of serum miRNA let-7a for laryngeal carcinoma and effects of let-7a on proliferation and apoptosis of laryngeal carcinoma cells]

Objective: To investigate the diagnostic value of serum miRNAlet-7a in laryngeal carcinoma and the effect of let-7a on proliferation and apoptosis of laryngeal carcinoma cells. Methods: Real-time quantitative PCR was used to determine the expression level of serum miRNAlet-7a. The miRNA let-7a mimetic was synthesized and transiently transfected into the laryngeal carcinoma Hep-2 cell line by cationic liposome method. The effects of up-regulation of let-7a expression on laryngeal cancer Hep-2 cells were detected by FCM and MTT assays,respectively. The association of let-7a levels with laryngeal cancer and the diagnostic value for laryngeal cancer were analyzed. Measurement data were taken by t test or analysis of variance; Counting data were analyzed by χ(2) test and Fisher exact probability method. The receiver operating characteristic curve was used to analyze the diagnostic value of let-7a for laryngeal cancer. Results: The relative expression of serum let-7a in healthy subjects was significantly higher than that in patients with laryngeal cancer (0.931±0.094) vs (0.380±0.113) (t=26.507,P<0.01). The relative expressions of serum let-7a in patients with laryngeal cancer before and after surgery were (0.380±0.113) vs(0.493±0.164),with significant difference (t=3.848,P<0.01).The relative expression of serum let-7a was related to lymph node metastasis (t=2.946, P<0.01). There was a positive correlation between the relative expression of let-7a in laryngeal carcinoma and that in serum (r=0.466,P=0.003). After transfection of let-7a mimics, Hep-2 cells showed an increased significant increase in the expression of let-7a (P<0.01), proliferation (P<0.01) and apoptosis (P<0.01). ROC curve analysis showed that the best critical value for relative expression of let-7a in the diagnosis of laryngeal carcinoma was 0.557 with a sensitivity of 0.794,a specificity of 0.727,an area under curve(AUC) of 0.859,and a 95%CI of 0.773-0.926. Conclusions: miRNA let-7a can inhibit the proliferation of laryngeal carcinoma Hep-2 cells and promote apoptosis. Serum let-7a is down-regulated in patients with laryngeal cancer and the level of let-7a is related to lymph node metastasis,which would help early diagnosis and postoperative disease monitoring of laryngeal cancer,but further research is needed.

Alterations in folate-dependent one-carbon metabolism as colon cell transition from normal to cancerous

Folate-dependent one-carbon cycle metabolism (FOCM) plays a critical role in maintaining genomic stability through regulating DNA biosynthesis, repair and methylation. Folate metabolites as well as other metabolites in the FOCM are hypothesized to be altered when cells transition from normal to cancerous state. Using cells at different stages in their development into colorectal cancer, the FOCM metabolites were profiled as an effort to phenotype the cells, and the metabolite levels were compared to the expressions of related genes. Here, we investigate whether there is a correlation between the metabolite levels, DNA methylation levels and the expression of the related genes that drive the levels of these metabolites. Using CRL1459, APC10.1, HCT116 and Caco-2, we show for the first time that FOCM metabolites correlate with the gene expression patterns. These differences follow a trend that may facilitate distinguishing colon cells at the different stages as they transition into cancerous state. The folate distribution and methionine levels were found to be key in determining the staging of the colon cells in CRC development. Also, expression of CBS, MTRR and MAT genes may facilitate distinguishing between untransformed and transformed colon cells.